Micheál Martin
Ceist:1. Deputy Micheál Martin asked the Taoiseach if he will report on his visit to Belfast; the meetings that he attended; and the issues that were discussed. [25651/18]
Ceisteanna - Questions (Resumed)
Northern Ireland
Micheál Martin
Ceist:2. Deputy Micheál Martin asked the Taoiseach if he will report on his attendance at the opening of the west Belfast festival. [25653/18]
Joan Burton
Ceist:3. Deputy Joan Burton asked the Taoiseach if he will report on his attendance at Féile an Phobail; and the community groups he met. [26472/18]
Joan Burton
Ceist:4. Deputy Joan Burton asked the Taoiseach if he will report on his recent meeting with the Orange Order. [26473/18]
Alan Farrell
Ceist:5. Deputy Alan Farrell asked the Taoiseach if he will report on his recent visit to Northern Ireland with particular reference to his visit to a museum (details supplied). [26542/18]
Brendan Howlin
Ceist:6. Deputy Brendan Howlin asked the Taoiseach if he will report on his visit to Northern Ireland; the meetings he held; and the issues discussed. [26546/18]
Peter Burke
Ceist:7. Deputy Peter Burke asked the Taoiseach if he will report on his recent visit to Northern Ireland with reference to his engagement with civic society groups from all traditions. [26547/18]
Mary Lou McDonald
Ceist:8. Deputy Mary Lou McDonald asked the Taoiseach if he will report on his recent visit to a museum (details supplied). [26616/18]
Mary Lou McDonald
Ceist:9. Deputy Mary Lou McDonald asked the Taoiseach if he will report on his recent visit to west Belfast and his address at the launch of Féile an Phobail. [26617/18]
Richard Boyd Barrett
Ceist:10. Deputy Richard Boyd Barrett asked the Taoiseach if he will report on his visit to Belfast; the meetings that he attended; and the issues that were discussed. [26894/18]
I propose to take Questions Nos. 1 to 10, inclusive, together.
I visited Northern Ireland on Thursday and Friday, 7 and 8 June. I had a number of different engagements during my recent visit to Northern Ireland. This was part of my own and the Government's continuing commitment to stay engaged with all parts of society in Northern Ireland, notwithstanding the absence of functioning political institutions there.
On Thursday, 7 June, I met a group called Civic Space, which is made up of civic unionism and others in Belfast. The meeting was a good opportunity for me to hear from a range of perspectives on major issues such as the political situation in Northern Ireland and Brexit.
On 8 June, my first engagement was a private meeting with Baroness Eileen Paisley at the Bannside Library, which houses the personal collection of Dr. Ian Paisley, Lord Bannside. That morning, I had another private meeting with Mr. Peadar Heffron and his wife, Fiona. Mr. Heffron was a Catholic PSNI officer who was seriously injured in an attack by dissident republicans in 2010. I also visited the Museum of Orange Heritage, where I was welcomed by the Orange Order Grand Master, Mr. Edward Stevenson, and met Orange Order representatives from across the island, including from Cavan, Donegal, Monaghan and Leitrim. I received a warm welcome from the Orange Order in Schomberg House and also from local residents outside the museum. I hope that my visit will be seen as a stepping stone to building relationships and a greater understanding between the Irish Government and the Orange Order into the future.
I also had a meeting with business and community leaders at Queen's University where I heard their views on the political situation in Northern Ireland and on Brexit. In the afternoon, I spoke at the launch event for the 30th year of Féile an Phobail in St. Mary's University College. Following my speech, I met some local guests and had a brief conversation with the vice president of Sinn Féin, Ms Michelle O'Neill.
On Friday evening, I had a very enjoyable visit to Down's oldest GAA club, Mayobridge. During the visit, I met the club chairperson, committee members and many club members, both young and old, including distinguished former All Ireland winning players, and the Down GAA county chairman, Mr. Sean Rooney. I was given a tour of the club grounds by the club secretary, Mr. Thomas O'Hare, during which I met a number of the club's teams.
The final event in my programme was a meeting with the CEOs of the cross-Border, North-South bodies in Newry, where we discussed the current cross-border issues relevant to their work and the future development and role of those bodies.
I was really glad to have the opportunity during this visit to meet with a range of groups from all sides of the community in Northern Ireland and to hear their concerns on the issues.
I thank the Taoiseach for his reply. I welcome the return to a policy of regular visits to Northern Ireland by taoisigh. The Taoiseach, however, would be well advised to understand that the visit two weeks ago was not nearly as historic as he seems to be believe. It is a decade since Uachtarán na hÉireann visited the Orange Order and there has been a 12 July event in Áras an Uachtaráin for quite some time.
What stood out from the visit was the lack of hard substance in terms of the urgent crisis concerning the political, economic and social future of Northern Ireland. It is 520 days since the Northern Ireland Executive was collapsed and the assembly suspended, but there is not the slightest sign of movement. Alarmingly, Northern Ireland remains with no voice in the Brexit discussions, with the assembly denied even the basic right to make a protest similar to that of the Scottish Parliament, which is doing a great deal of good work, against London's catastrophic policies.
The British Government has refused to re-establish the intergovernmental arrangements required in these circumstances. The Taoiseach might update me in that regard on his engagement with the British Prime Minister. The parties are not talking and neither of the heads of the two Governments has yet had even one day of inter-party negotiations. In the circumstances, it is surprising how little the Taoiseach appears to have had to say in recent times, including on this visit. Perhaps it is his policy to leave it to others. Is something going on, on which the media have yet to be briefed by the Taoiseach's normally hyperactive briefing staff?
As the Taoiseach knows, there was some surprise that, in visiting Féile, he had decided that it was not necessary to make any comment on attempts to distort history and give false equivalence to illegitimate campaigns which had been waged in the face of the opposition of the people. Was that a deliberate decision on his part or an oversight? It is an important issue. There has been an attempt for quite some time to shove a particular narrative of Irish history down everybody's throat with reference to the campaign of violence that continued for 30 years. Many innocent people were murdered and there were many unacceptable atrocities, yet some of the events were celebrated at Féile. It is an ongoing narrative led by Sinn Féin which needs to be challenged on every occasion. They are atrocities about which we all know and we cannot allow a distorted narrative to emerge which should be challenged. Perhaps it has something to do with the Taoiseach's satisfaction with the new electoral alliance with Sinn Féin which he recently road-tested in the Seanad elections.
I have not been able to find any copy of the Taoiseach's script at the launch of Féile. Will he explain why that is the case? Other remarks he made on the day are freely available but not this particular script. Is there a reason for it?
In launching Féile an Phobail, the community festival in west Belfast, the Taoiseach was seen as lending his authority and that of his office to the event. Nobody has any difficulty with Olly Murs or the many cultural and music events that took place. However, it is unprecedented for a Taoiseach to be involved in launching an entire programme which included events such as IRA Prisoners' Day at the Felons' Club, particularly when the Chief Constable, Mr. George Hamilton, recently referred to his concern that the IRA army council was still involved in Sinn Féin's strategy. I understand the Taoiseach received a letter from our former Oireachtas colleague and Labour Party Senator, Mairia Cahill, in which she expressed her unhappiness and hurt at the Taoiseach launching Féile, given the resolute refusal of Sinn Féin to address the issue of child abuse, including her own case which we have debated in this Chamber and on which the former Taoiseach and leader of Fine Gael, Deputy Enda Kenny, took a strong line. I know that the Taoiseach has to be aware, from articles she has written, that effectively she had been groomed for sexual abuse through her participation as a child and teenager in Féile's radio station. Like many others, she was shocked by the Taoiseach's endorsement of the event, given its connection with the IRA in west Belfast. By extension, he will potentially be seen as either staying silent or, worse still, endorsing IRA violence, in respect of which we have never had an absolute apology. Will the Taoiseach consider apologising to people like Mairia Cahill and the Stack family who have also mentioned their unhappiness and concern, as well as other victims of IRA violence, for, in effect, failing when he visited Belfast for purposes we welcome, but there is a clear line to be drawn in the sand when it comes to violence perpetrated by the republican movement - the atrocities, killings and injuries.
The Taoiseach is reported as having said during his visit to Northern Ireland that the tectonic plates were shifting. My understanding is the tectonic plates shift very slowly, but, whether they are speeding up, the Taoiseach's meaning is that there are significant shifts in opinions on the constitutional status of Northern Ireland. That will be in very sharp focus in the event of a hard Brexit which, unfortunately, as we will discuss when we deal with other questions, increasingly is becoming more likely. Many weeks ago, at the James Connolly commemorative event at Arbour Hill, a Labour Party event, I called for the establishment of a new forum. The knee-jerk reaction in saying let us have a Border poll if the numbers stack up such that a figure of 50% plus 1 changes the dynamics is very dangerous in that we could find ourselves, like the Brexiteers, arguing for something and not knowing how to proceed. I have asked for the establishment of a forum involving all of the political parties that will participate in it and also civic society to discuss the shape of a new Ireland. We previously had the New Ireland Forum and there is now scope for a new forum, rather than the knee-jerk reaction of simply making a demand for a Border poll. These issues have to be thought out very carefully. They will have to be the subject of much discussion which will have to be framed very carefully. If we could have dialogue to allow all citizens on the island of Ireland to feel at home in a new settlement, it would be a good process to begin. Will the Taoiseach consider sitting down with party leaders to explore that possibility?
The recommendation made by Deputy Brendan Howlin has merit. It is similar to a suggestion we put to party leaders in the past. Attitudes to Irish unity are changing. We can see the mess caused by the Brexit negotiations. The Brexiteers achieved the outcome they wanted without any thought being given to the shape it would take. I welcome the Taoiseach's recent visit to the North which was beneficial. There is no doubt that it was well received. We, in Sinn Féin, support the Taoiseach's ongoing engagement with both communities in the North. That is essential and I hope and have no doubt that it will continue. The small amount of criticism levelled at the Taoiseach was uncalled for - we have heard some of it again today - as was the criticism of Féile an Phobail, which represents all that is good in west Belfast. At the launch I am sure the Taoiseach got a taste of the vibrancy, creativity, talent, inclusivity and energy of the community. We know that Féile an Phobail is a grassroots organisation and that it has become the largest community festival throughout Europe. There is huge anticipation in advance of its landmark 30th anniversary. The Taoiseach's participation in the launch was a boost for all those who have made Féile an Phobail what it has become. I echo the words of the former Democratic Unionist Party mayor when he attended and launched the Féile an Phobail programme. He said it "reflects the true cultural tapestry of our city."
The Taoiseach's meeting with the Orange Order in Belfast was very welcome. I am glad to hear of the welcome he received both inside and outside the room. I hope the initiative might open a new era of engagement with the Grand Lodge and wider society, something which has been lacking. I do not want to downplay, as has been suggested, the importance of the initiative. We need many more such initiatives.
Ireland's greatest revolutionary and socialist James Connolly believed passionately in uniting the country, not by trying to square the circle of green and orange tribal politics or, for that matter, scoring political points off others in the political debate, as we have heard in the last few comments made by Fianna Fáil and the Labour Party. He tried to find the social and economic issues that might practically unite people and advance a radical social and economic agenda that could break down sectarian divisions.
The issue that presents itself very much at the moment in the aftermath of the referendum to repeal the eighth is the demand which is across the communities in the North - Catholic and Protestant, progressive people, young people - demanding the decriminalisation of abortion in the North. The situation persists and has resulted in, for example, the shocking prosecution of a 21 year old young woman for taking an abortion pill when she was reported by her house mates. She had taken that pill because she could not afford to go to Britain for an abortion. It is criminal for her to have an abortion in the North even though it is not in England or Wales. It seems to me that is the thing we should be advancing if we want to unite people across the sectarian divide and North and South. I appeal to the Taoiseach to lobby Prime Minister May directly on this matter and call on her to decriminalise abortion in the North.
I attended a fantastic demonstration in the North on Saturday of the week before last. Bus loads came from Together for Yes down here. We were involved in organising them. Thousands of people were in Belfast - Catholics and Protestants - on the streets saying they want rights for women and they want abortion rights in the North. Why does the Taoiseach not align with them and pressure Prime Minister May to decriminalise abortion in the North? That would be a step towards a united Ireland.
I share with Deputy Micheál Martin a deep concern that the Northern Ireland Assembly and the Northern Ireland Executive are still not functioning. In order for them to function the two largest parties, namely, the DUP and Sinn Féin, will need to build trust and they will need to compromise. I know there were compromises but ultimately trust needs to be built. I have been involved in two coalitions and I know that neither building trust nor compromise is easy but it is what the two parties have to do and the two Governments as co-guarantors will assist them in any way possible to bring about the compromise and trust building that is necessary.
When I was in Northern Ireland I remarked on the fact that there were quite a number of billboards. There was a billboard campaign by the Simon Community telling us about the 100,000 people who it says are homeless in Northern Ireland currently. I read the Irish News last week. It commented on the fact that the Bengoa report, the ten-year plan to reform, modernise and save the NHS in Northern Ireland, has not been implemented. The Irish News called on politicians in particular to make sure there was a Minister for health in Northern Ireland to do that. There are major issues in Northern Ireland similar to the issues we have here around housing and homelessness and also a health service that is struggling. The failure of politicians to take responsibility for those issues in Northern Ireland cannot go without comment.
We have requested a meeting but we do not have a date yet for the British-Irish Intergovernmental Conference. I will be attending the BIC, British-Irish Council, in Guernsey on Friday where I will have an opportunity to have bilateral meetings with First Minister Sturgeon and First Minister Jones and I will also be speaking to the Chancellor of the Duchy of Lancaster, David Lidington, about that particular issue.
I will ask my office to send Deputy Micheál Martin a script of my speech at Féile an Phobail. It is not controversial. I am sure it was recorded so if it had been controversial it would have been reported by now. There is no need for any new conspiracy theories from the office of the Fianna Fáil leader. I am sure it was just an oversight the fact that the particular speech is not on a website.
Normally, all the Taoiseach's speeches are available.
While I understand the terrible personal experience and the trauma that former Senator Cahill was put through, and I understand where the Stack family is coming from, Féile an Phobail is really not a Sinn Féin event, it is a community event in west Belfast. There are many Sinn Féin supporters involved in it. This is a part of Northern Ireland where Sinn Féin wins five out of six seats. Quite frankly, nothing is going to happen in west Belfast without having some people there who have a history or background in Sinn Féin or the republican movement. It is my view that one does not boycott an entire community because it happens to vote for or support a party one does not agree with. My policy is always one of engagement, not one of boycotts or no platform. That is one of the reasons I was very honoured to have been invited to attend the launch.
The event was set up in what was a very dark time in west Belfast when Belfast was a very difficult city to live in, very different to what it is now. When it was set up it gave people, in particular young people and children, a little bit of light in their lives during the summer and a little bit of hope. I do not think that is a bad thing. Other people who have attended in the past include Arlene Foster, Michael Moore, Noam Chomsky, Reg Empey and Mary McAleese. I cannot attend because I am not available the week it is on, but if the opportunity arises in future years I would like to be able to attend some of the events. I really do not think that launching an event is an endorsement of the entire programme. People launch film festivals, theatre festivals and art exhibitions. That does not mean they are endorsing everything on the programme or every piece of art that is being displayed. I think that is a very narrow-minded view. It is almost the kind of view one would have heard from Archbishop McQuaid or extreme Catholics in the past, that even to attend an event or launch an event implies an endorsement. It is a form of censorship and backward thinking that I do not share. It is the new version of the kind of extremism that existed in the past. The shoe is on the other foot so often when it comes to matters like this.
In terms of tectonic plates, Deputy Howlin is absolutely right - tectonic plates do shift slowly and also quickly. That is the nature of tectonic plates, but I did not say anything about tectonic plates on my visit at all. I did say that I was opposed to a Border poll and that I think it is a bad idea at this time and for the foreseeable future. First, I think it would be defeated, and all the polling indicates that. I also think it would be divisive and now is not a time when we need further division in Northern Ireland. I also think in particular it would send out the wrong message at this time of Brexit when all the time the Government is saying to the unionist parties and the unionist community that we have no hidden agenda when it comes to Brexit. All we want from Brexit is to retain the relationships we have currently, namely, that there is no hard border, that citizens’ rights are protected and that we do not see Brexit as an opportunity to change the constitutional status of Northern Ireland. We are not going to try to take advantage of Brexit or exploit it to bring about a united Ireland any faster than the people of Northern Ireland want it. That is why we need to be very careful about these types of things.
The same thing would apply to the suggestion of a forum on the issue. In principle, the idea of a forum on what a united Ireland might look like in the future sounds attractive. We could have a discussion with civic society and political parties on what that might look like but the difficulty is that I feel, in particular at this time, when people are talking about border polls and Brexit, that the vast majority of people who feel themselves to be British - the vast majority of unionist people - would not participate in that and then it would be seen as a pan-nationalist gathering or front.
We could try.
That is why we should not engage in something like that unless we knew that there would be a critical mass of people who feel themselves to be British, who are unionist or Protestant, who would be willing to participate in that, and I do not believe at the moment that is the case.
What about abortion?
I have given my view on that, in the North and in an op-ed. My view on this is very simple. Any right or freedom that an Irish citizen has in Ireland and any right or freedom that a British citizen has in Britain should be enjoyed by Irish and British citizens in Northern Ireland, and that applies to things like marriage equality and abortion rights. I have said that to Prime Minister May. I have said it publicly, but ultimately this is a decision that should be made by the Northern Ireland Executive and the Northern Ireland Assembly, not by people in Dublin or London.
What about the narrative on the North?
I did not understand the Deputy's question.
Is the Taoisech dense? He is not.
No, I am not.
He understood it all right.
Cabinet Committee Meetings
Joan Burton
Ceist:11. Deputy Joan Burton asked the Taoiseach when Cabinet committee E (Health) will next meet. [26475/18]
Cabinet committee E covers issues relating to the health service including health system reforms. The next meeting of this Cabinet committee has not yet been scheduled but last week I met the Ministers for Health and Finance, Deputies Harris and Donohoe, to discuss the Sláintecare implementation report. In addition to meetings of the full Cabinet and Cabinet committees, I meet with Ministers on an individual basis as required to focus on particular issues. In this regard I meet regularly with the Minister for Health, Deputy Harris, to discuss the challenges facing the health service.
The Government is committed to enhancing the quality of the health service and has allocated significant capital funding for investment in health infrastructure of €10.9 billion over the next ten years. This will provide major investment projects and programmes, including the provision of 2,600 additional acute hospital beds to be delivered across all hospitals, along with significant reform initiatives. Investment in our health services must go hand in hand with reform.
A number of actions have been advanced on foot of the Sláintecare report including the independent working group, chaired by Donal de Buitléir, which is examining the impact of removing private practice from public hospitals. We expect that working group to report later this year. We have commenced a public consultation on the geographical alignment of hospital groups and Community Healthcare Organisations, CHOs, as recommended in the Sláintecare report. The Minister for Health has also begun discussions with general practitioner representatives on the reform of the GP contract, while reductions have been made to prescription charges, in line with the Sláintecare recommendations.
The Government’s implementation plan will be published in the coming weeks and the recruitment of a lead executive for the programme is well advanced. We are awaiting final confirmation and will then inform the House of the identity of the new lead executive. Work is also underway to strengthen the governance arrangements in the HSE. The Minister for Health has published the general scheme of the Health (Amendment) Bill to establish a HSE board and earlier this month the Public Appointments Service advertised the position of chairperson of that board. This will be a different position to that which existed in the past. It will come with remuneration so that whoever is appointed will be able to devote two days per week or more to the role.
In the context of the Taoiseach's previous answer, I recall that during the last general election campaign in Dublin West the Taoiseach's slogan over the final days of the campaign was "Don't let Sinn Féin turn west Dublin into west Belfast". Having campaigned on that slogan, the Taoiseach's previous reply suggests that those who do not know history are condemned to repeat it.
The first issue I wish to raise regarding the health services is one that I have raised here previously. Where stand those who work in section 39 organisations? I am talking about the tens of thousands of workers in organisations funded through section 39 who experienced pay reductions at the beginning of the economic crisis. The Government of which the Labour Party was a member, through the then Minister for Public Expenditure and Reform, Deputy Brendan Howlin, put in place a mechanism for restoring public service pay and it was understood that section 39 organisations were to follow. These are people who work in hospices, in Rehab, in the Irish Wheelchair Association and in a wide variety of organisations vital to the health service. We know that discussions are ongoing with the Department of Health. In the summer economic statement which was published yesterday a sum of €2.6 billion has been set aside for "commitments". Does the money set aside in the summer economic statement include funding to restore pay levels for staff working in section 39 organisations or is their pay claim buried somewhere in the bowels of the Department of Health? Will those workers be left with no choice but to initiate the industrial action which they have threatened but stalled because the Taoiseach and the Minister for Finance promised them meaningful discussions?
The Taoiseach made reference to Sláintecare in his reply. Sláintecare is a product of new politics in this Dáil to which all parties and Independent Deputies genuinely contributed. However, 18 months after first talking about it, the Government has not yet appointed an executive director of the Sláintecare implementation office. We all know that without an implementation pathway, it will be almost impossible to achieve anything. What is the fate of new politics as expressed in the comprehensive agreement between all of the Members of the Oireachtas? Where stands that now? Is it sidelined and jettisoned or does the Government intend to proceed with it?
There has been much debate on public radio lately around peoples' experiences of the health service. We can all agree that when one gets into the health system, the service is often very good. However, the bureaucracy and managerial confusion is heartbreaking. People go onto waiting lists which just get longer and longer. Sláintecare was meant to address that but the Government has not even addressed the implementation of same.
I will call on the other Deputies who have indicated but I remind everyone that there is another question with which we must deal before the sos.
It will come as no surprise to the Taoiseach that I raise an issue which is causing great concern in my region of the south east. There have been a number of resignations from psychiatric teams, particularly in the Child and Adolescent Mental Health Services, CAMHS in Wexford. One of the consultant psychiatrists, Dr. Kieran Moore, said that he was resigning from the Wexford team because "it's untenable and unsafe". He also said that two of his colleagues were resigning for the same reason. There is real concern about psychiatric services across the country but the most acute and immediate concerns arise in the south east and in County Wexford in particular. What will the Government do to ensure that there is no hiatus whereby there are no mental health services available to the most vulnerable of people?
The Government's decision to delay the implementation plan for Sláintecare is deeply cynical. The Government wanted to avoid a winter crisis last year but more importantly, it wanted to avoid the Estimates and the provision that would have been necessary for the establishment of an office, the development of an implementation plan, the changes to budgets and so on. This was all referenced subsequently by the HSE's director general. We are now hearing, as confirmed by the Taoiseach, that the plans will be announced in two to three weeks' time, but surely the plan should be announced to the Oireachtas Committee that was responsible for the development of Sláintecare. Will the Taoiseach or the Minister for Health commit to going before that committee to announce the plans to its members and chairperson? Otherwise, we will just see yet another Government signature launch with over the top claims, days of strategically placed articles in newspapers, active partisan briefing and so on. It is stretching credibility to a considerable degree that it would take 18 months to publish implementation plans. Perhaps this suggests that deep down and behind the scenes, despite the public announcements, the Government's heart is not in the Sláintecare plan and that it is not going to implement key elements of same.
Yesterday the Taoiseach said that costings for the global footprint strategy were not mentioned at the launch of the strategy but were included in a follow-up document. I ask the Taoiseach to give us an assurance that he will produce detailed, year to year spending and activity proposals for Sláintecare when he is announcing the implementation plans. Sláintecare represents the formal burying of the failed experiment of moving to compulsory health insurance initiated by the former Minister for Health, now Senator James Reilly, and followed up by the Taoiseach when he was Minister for Health. While off the record briefings regularly distanced the Taoiseach from this policy, the record shows a long series of measures announced by him which he said represented the steps in implementing the plan. If one looks at the massive increases in waiting lists during that period, there is a perfect correlation between the so-called reforms and increases in waiting times and delays in accident and emergency departments. Has any work been undertaken to undo the damage caused by many of these ill-fated changes?
Following on from the previous discussion, it might be wise for Deputies Burton and Martin to visit Féile an Phobail this year. If they were to experience Féile an Phobail, they might be a little more informed in relation to that.
On a point of information, my comments were not about Féile an Phobail.
I have the floor.
My comments were about the Taoiseach's speech, which I did not get a copy of.
Some people in here would probably like to roll back the clock to a time when Sinn Féin did not have 500,000 voters on the island of Ireland, including many in west Belfast. The people have a right to choose who they want to represent them. Thankfully, more and more people have come towards Sinn Féin in each election.
My question relates to Cabinet committee E. The leader of Fianna Fáil has again demanded more investment in Sláintecare and all the rest. We know that cannot happen without the necessary investment. The Government and its partners in Fianna Fáil have set the limited parameters of this year's budget. The €800 million that is available is not exclusively for health. It will have to be used to deal with other areas of need, including the two-tier pay structure across the public service and social welfare. The Taoiseach has suggested that there may be tax cuts. The reality is that Sláintecare will not get off the ground unless the Government makes the necessary investment. Fianna Fáil can argue that we need this, that and the other, but it cannot happen on magic beans. We cannot open additional hospital beds or build capacity within our services on the basis of IOUs on the back of brown envelopes. The Government needs to make decisions and choices. When will we see a plan for the investment of approximately €3 billion that is being called for under Sláintecare to bring about a transformation in the issues that have been presided over by the Government with the support of Fianna Fáil every step of the way? The failure to draw up such a plan has led to the scandalous situation we have today. People are waiting two years for assessments. Scoliosis patients are waiting three years for their first appointments. Some 707,000 people are on hospital waiting lists and many more are on trolleys. The health service is facing many challenges. When can we expect the assisted human reproduction Bill to be published? Has it been considered by Cabinet committee E? In light of the number of complex issues involved in that legislation, would it be possible to deal with sections 2 and 3 of the Children and Family Relationships Act 2015 in a separate Bill as a means of resolving the issues being faced by same-sex couples? Has this been considered by Cabinet committee E? What is the Government's intention in this regard?
I should warn the House that I do not think we will get to the next group of questions.
I want to ask about child mental health services, which have been raised by Deputy Howlin. I think the Taoiseach needs to say something about this serious matter. Child psychiatrists are resigning because they believe child psychiatric services are "untenable and unsafe". This problem is not isolated to Wexford. I will not go into individual cases. I am aware of other areas where exactly the same thing is happening. The numbers of child psychiatrists and mental health teams are not adequate. There are not enough staff, resources and primary care services. Too many people are being referred to the psychiatrists. Essentially, they are under pressure to prescribe drugs. If they do not want to do that because their clinical judgment is that they should not do so, they get into trouble with managers who just want to tick boxes. That is what is going on. The Taoiseach needs to say that child psychiatrists and specialists in this area should act on their clinical judgment and should do what they believe is best in their clinical judgment. Managers should not be forcing them to do things they do not consider right to do. It is very important to send out that message. If we are going to ensure these services are safe, tenable and of the standard necessary to do what they are supposed to do for young and vulnerable people, we need to ensure primary care services and mental health teams are properly resourced.
The Taoiseach has six minutes in which to respond. We will not get to the next group of questions.
I would like to respond to Deputy Burton's remark about west Belfast. The phrase to which she referred was not a campaign slogan. It was a tweet.
It has been part of the Taoiseach's campaign in recent days.
It was a criticism of Sinn Féin's record in government and its poor delivery for communities that vote for it in large numbers. I am happy to clarify that it was not meant to be a criticism of west Belfast as a place or as a community. If I was doing it again, I would do it differently.
Is the Taoiseach apologising to west Belfast?
I am apologising to anyone who was offended by it and believed it was a reference to the people and community of west Belfast, when it was actually a reference to Sinn Féin's poor performance in government in Northern Ireland and its failure to deliver for people in west Belfast.
Sinn Féin has had five out of the six seats in west Belfast.
I think the Taoiseach will say anything at any time when it suits.
Section 39 organisations are very varied. They range in size from small organisations that receive just €10,000 in State funding to major employers that receive most of their income from the HSE or the Department of Health. The staff of section 39 organisations are not employed by the State and do not receive public sector pensions. The various section 39 organisations approached and dealt with the financial crisis in different ways. Some of them cut pay and some of them did not. Some of them are compliant with public pay policy and some of them are very much not. Some of them have restored pay and some of them have not. St. Francis Hospice in my constituency has restored pay to its staff. I am aware that other section 39 hospices have not done so.
How could they, if they do not have the money?
There is a lot going on in this space. There is now a process under way to examine this and resolve it. I am sure it will result in a cost to the taxpayer. We do not yet know what that cost will be. That is part of the work that is being done. It is difficult to allocate money until one knows the actual estimate.
Reference has been made to mental health services in the south east. Timely access to care is an essential part of good healthcare. We are committed to achieving this by increasing the funding allocated for mental health services. Indeed, the amount of money allocated for these services has increased by over €200 million each year since 2012. One CAMHS consultant in the Waterford-Wexford area is moving to Dublin. Two locums, who hold temporary posts in any case, will be resigning in August 2018. The Minister of State, Deputy Jim Daly, is meeting local representatives of the HSE CAMHS to discuss the actions that need to be taken to ensure people in the south east who need care continue to receive it. The Minister of State has scheduled a round-table meeting of all CAMHS service providers in the coming weeks. While there is no doubt that recruitment in this area is difficult, it is being dealt with. The HSE is currently operating a national and international recruitment campaign for CAMHS consultant psychiatrists. The service in the south east plans to draw on this resource to fill positions on a permanent basis, in addition to vacancies being filled on an interim or temporary basis. The recruitment of 114 assistant psychologists and 22 psychologists for primary care child psychology services has almost been completed, with 111 of the 114 assistant psychologist places and 20 of the 22 psychologist places having been filled. Of those who are being recruited, 13 will be assigned to CHO 5, which includes the south east.
Improvements are being made to children's counselling services. It is intended to extend the new Jigsaw service, which is already in Cork, Limerick and Dublin, to 13 sites nationally. The HSE is in the final stages of recruiting the staff required to deliver a mental health service seven days a week in areas that do not have a seven-day service currently. The annual number of undergraduate psychiatric nursing places will increase from the current level of approximately 270 to approximately 400 by the end of the decade. It is important to point out that in April, the total number of people on the CAMHS waiting list reduced by 76 to 2,615. The number of people who have been waiting for more than a year decreased from 386 in March to 356 in April. While I appreciate that too many people are waiting for too long, it is not the case that these waiting lists are increasing.
I think Sláintecare is a good plan. Those who are proposing it have admitted that it is at best a plan for a plan. There is no implementation plan. The Government has been tasked with drawing up such a plan and that is exactly what we are doing. There is a lot to be done because the costings were off. A lot of work has had to be done in that respect. There are issues with the phasing, which proposes that we extend free GP care to an extra 500,000 people each year. Members of the committee will privately admit they do not think it is a good idea because the capacity does not exist to extend by 500,000 a year the number of people with free GP care. It is just too quick, given the capacity constraints that exist in GP surgeries and elsewhere in primary care. It would probably lead to waiting lists to see GPs, which would not be desirable.
I say that as the person who brought in free GP care for those over 70 and under six and announced the decision to extend medical cards as a right to children with serious disabilities. It is something I am very much committed to doing but I honestly believe that an extra half a million a year would be too quick, would overwhelm the services and would make them worse for everyone, not better for some.
I was asked about the transformation fund. It is there in Project Ireland 2040. There is a commitment of €10 billion to be invested over ten years in buildings. There are three hospitals now under construction. The national children's hospital was promised forever by successive health Ministers and is now very much under construction. The new National Rehabilitation Hospital in Dún Laoghaire is under construction. The new forensic mental health campus is under construction in Portrane. Some 100 primary care centres are now up and running. It will also involve the additional acute beds that are needed under the capacity review, additional equipment, and investment in ICT. If there is a game changer in health, it is going to be in ICT.
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