Saincheisteanna Tráthúla - Topical Issue Debate

Cannabis for Medicinal Use

I am slightly disappointed that the Minister for Health, Deputy Harris, is not here to answer the questions I have been trying to raise in the Dáil for at least a year.

Two years ago the Health Products Regulatory Authority, HPRA, produced a report entitled Cannabis for Medical Use - A Scientific Review. I argue that the review was fast-tracked due to Vera Twomey's fight for access to medicinal cannabis for her daughter. In the two years since the report's publication nothing has been done. We were critical of the report because of its limitations, its conservatism and its stipulation that medicinal cannabis should only be used in the treatment of three conditions. Incredibly a major omission from the report related to chronic pain. The greatest efficacy for medicinal cannabis is for chronic pain.

The report was published two years ago and we still have no cannabis, no access and no programme. Parents and patients are forced to go abroad and forced to break the law which is completely unsustainable. Parents have run out of options. They have tried everything clinically, but they have to leave the jurisdiction to obtain this medication. The Government has failed them.

The Minister for Health has come out with the mantra that it is a supply issue, but it is not a supply issue. I do not find that a credible response. This comes from institutionalised resistance by the HSE, the Department of Health, the HPRA, the Government and some in the medical profession.

After waiting for two years, the people want meaningful progress on the issue. Just before Christmas, Thailand, which has one of the most extreme anti-drug laws, passed legislation on the legalisation of medicinal cannabis. It has also happened in Mexico and other countries. Six months ago Britain had no policy on the matter and the Tory Government has changed even though it is extremely restrictive.

In this country we have issued 13 licences to 13 individuals over two years. I have been extremely critical of that licensing system. It is extremely bureaucratic and cumbersome. Most of the time people going to their doctor or specialist have a negative experience. The specialists claim they do not have enough information about it and so forth. That licensing system is not workable.

If the patient is granted a licence, there is no guarantee that they will be reimbursed and in addition they have to go abroad to get the medication. Therefore we are sending the patient to, in particular, the Netherlands to get the medication and bring it back. The medical profession, the public and the vast majority of Deputies will say that is not sustainable. I keep going on about this issue because of the injustice of normal parents seeking the best for their children having to go abroad and break the law which is unacceptable.

I thank Deputy Gino Kenny for raising this very important issue and apologise on behalf of the Minister for Health, Deputy Harris, who is unavailable. The report of the Health Products Regulatory Authority, HPRA, entitled Cannabis for Medical Use - A Scientific Review, recommended that if access to cannabis is to be permitted for medical purposes, its use should only be initiated as part of a structured process of formal, ongoing clinical evaluation for a limited number of clearly defined medical conditions which have failed to respond to all other previous treatments and where there is at least modest evidence that cannabis may be effective. Patients should be under the direct supervision of an appropriately trained and experienced medical consultant. The specified medical conditions or indications are spasticity associated with multiple sclerosis, intractable nausea and vomiting associated with chemotherapy and severe, refractory or treatment-resistant epilepsy.

The Minister for Health undertook to establish an access programme to facilitate access to cannabis based treatments in certain circumstances, in line with the HPRA’s recommendations. An expert reference group was tasked with the development of operational, clinical and practice guidelines for this access programme. The group was asked to advise on the development of operational, clinical and practice guidelines for healthcare professionals treating patients through an access programme. These guidelines have been published on the Department of Health’s website as part of a comprehensive repository of information on cannabis for medical use. The purpose of the access programme is to facilitate access to cannabis based products or preparations that are of a standardised quality and which meet an acceptable level of quality assurance during the manufacturing process. Availability of cannabis products that are of an appropriate quality standard and are affordable to patients is clearly critical in establishing the access programme. Canada and the Netherlands are the only two countries that currently permit the export of cannabis products which meet acceptable quality control standards beyond their borders. The Netherlands permits exports of cannabis dried herb but does not permit commercial export of oil-based cannabis formulations. Department officials continue to work intensively on finding solutions to the supply of appropriate quality assured cannabis products for Irish patients. Doctors continue to utilise the ministerial licence route to prescribe medical cannabis for their patients. Until suitable medical cannabis products are made available in Ireland, prescribers and their patients are sourcing the prescribed product from a pharmacy in the Netherlands, on foot of their medical prescription. It is intended that the ministerial licence application scheme will continue to operate in parallel with the cannabis for medical use access programme after the programme becomes operational, for exceptional cases only and where there is an un-met clinical need.

I do not know who writes this rubbish but this answer is exactly the same as all previous answers I have received. The HPRA report was published two years ago but there is still no access programme. People are having to go abroad, break the law or use the ministerial licence system. The Minister of State made reference to the clinical guidelines which hold that the access programme will not recommend cannabis based products with THC for refractory epilepsy. There are 13 licencees at the moment, nine of whom have epilepsy. These patients are being prescribed cannabis with THC by specialist doctors. What will happen to them when and if the access programme is up and running? Will they stay in the ministerial licence system? Will they still have to go abroad and will they continue to have fears around reimbursement? This is an absolute mess. There are hundreds, if not thousands of people who could benefit from medical cannabis but this Government is denying them access because of bureaucracy. This is a question of institutionalised resistance from top to bottom.

I do not find it credible that the Department cannot find a supplier of medical cannabis for Irish patients. That is just not credible. Why was this issue not flagged a year and a half ago by the HPRA, the Department or the Minister? There is serious institutional resistance to this. The Government may have time on its hands but thousands of patients do not. They are suffering because of bureaucracy. I do not know how members of the Government can live with themselves.

If it is not possible to get the access programme up and running, the Government should revert to the Bill that I put before the House over two years ago and which garnered the support of the majority of Members of this Dáil. The Government has stalled the progress of that legislation.

I disagree with the Deputy's argument because the answer is not the same-----

It is the same.

There is no issue of institutionalised resistance. Considerable progress is being made on the cannabis for medical use access programme. An expert group has drawn up clinical guidelines for healthcare professionals treating patients through the access programme. These guidelines are available on the Department's website. While medical cannabis products are not medicines, ensuring that such products meet appropriate quality standards when they are made available to the Irish market is a critical aspect of facilitating safe access to medical cannabis for Irish based patients.

Officials from the Department of Health are working intensively on this issue to ensure a supply of appropriate medical cannabis products to meet the needs of Irish patients. They recently visited Denmark and held meetings with a number of government bodies and other stakeholders in the medical cannabis supply chain. The aim of these meetings was to ascertain whether aspects of the Danish programme can be replicated in Ireland, including the importation of medical cannabis products. This represents real progress.

I assure the Deputy that I will bring the other issues he raised to the attention of the Minister.

Vaccination Programme

The next Topical Issue is in the names of Deputies Brassil, Thomas Byrne and O'Reilly. It is customary to give Deputies one minute each but as Deputy O'Reilly is not here at the moment, I will give the other two Deputies a minute and a half each.

This issue first came to light last Thursday morning when Dr. Suzanne Cotter, a public health medicine specialist with the HSE, was interviewed on "Morning Ireland". She stated that 11 cases of meningococcal disease had been notified in the previous two weeks, which was higher than normal and that three deaths had occurred. I was contacted subsequently by a constituent who was concerned about the MenB vaccine which has been available to newborn infants since 1 October 2016 but not to children born before that date. Following a week of news items and debate on various television programmes, the HSE and the Minister for Health are now saying that they do not want to extend the MenB vaccine by way of a catch-up programme. If the vaccine was deemed suitable for children born after 1 October 2016, why is it not suitable for children born prior to that date? What evidence is there to show that MenB can only be effective in newborns? My research tells me that there is no evidence to that effect. It can be as effective in a young child as in a young infant. What would the one-off capital cost of a catch-up programme be? If such a programme were to save even one life, it would be worth it. A catch-up vaccine costs €300 which is prohibitive for most families. I ask that the Minister for Health and representatives of the HSE appear before the health committee to provide clear answers on this matter. This is a real public health concern which must be addressed.

I agree with the comments of my party colleague, Deputy Brassil, who is a pharmacist and a qualified health professional. Indeed, I am very grateful to him for the advice he has given to me on this issue.

The State should be glad that parents are very concerned about a vaccine programme and want it to be made available to more children, given that have been several controversies around vaccines in recent years. Rather than being defensive, if not rude, the Minister for Health should be glad that people are looking for this vaccine.

He should be grateful that people are looking for vaccines against the disease.

As Deputy Brassil noted, the fears of the public were heightened, probably rightly, when a HSE public health doctor appeared on "Morning Ireland" last week and made the case that the recent increase, as described in the official release from the HSE, is a cause for concern. Parents were concerned, in many cases because their children had not received access to the vaccine. In the recommendation from the officials charged with making it, we were told the vaccine should not be provided to children born before 2016, but no reason has been given. Is it refused on grounds of safety, cost or efficacy, that is, whether it works? The evidence is that it does, and last week people were strongly urged by the HSE to take up the vaccine. Complaints were made that the rate of the uptake of the meningococcal vaccine among children has been suboptimal. I strongly encourage those who are able to get the vaccine to get it for their children if they have not done so because it is important. The people deserve an answer from the State about why many of their children cannot get the vaccine.

I thank Deputies Brassil and Thomas Byrne for raising this important issue and for the opportunity to update the House on it, which has been the subject of recent media coverage. Invasive meningococcal disease is a vaccine-preventable disease which may present as meningitis or blood poisoning, and has a high mortality rate if untreated. It may occur at any age but is most common in infancy and early childhood with an additional smaller peak of disease activity in adolescents and young adults. There are five primary serogroups of the neisseria meningitidis bacteria that cause meningococcal disease. Group B and group C are the most common forms in Ireland.

The immunisation programme is based on the advice of the national immunisation advisory committee, NIAC. The NIAC is a committee of the Royal College of Physicians of Ireland which comprises experts from a number of specialties, including infectious diseases, paediatrics and public health. The meningitis C vaccine was introduced in Ireland in 2000 to the infant immunisation schedule at two, four and six months of age. In 2014, the NIAC updated guidance relating to meningitis C vaccination. The committee recommended that two doses of meningitis C vaccine be given in early childhood and that an adolescent dose be given at 12 or 13 years of age.

In 2015, the NIAC recommended that the meningitis B vaccine be included in the primary childhood immunisation programme if the vaccine could be made available at a cost-effective price. Meningitis B disease is most common in babies under the age of one, of which the scheduling of the administration of the vaccine under the immunisation programme takes account. The change recommended by the NIAC took effect from 1 December 2016 and the meningitis B vaccine is now given at two, four and 12 months of age. Ireland was the second country in Europe to make the meningitis B vaccine available free of charge as part of its national immunisation programme. There are no plans to introduce a catch-up programme for older children.

A total of 89 meningococcal cases were notified in 2018. Some 11 cases of meningitis have been notified to the Health Protection Surveillance Centre since the last week of December, with three deaths notified among these cases. The 11 cases notified compare with five cases for the same period last year. Importantly, the HSE has noted that this does not represent an outbreak but instead reflects the known increased incidence of the disease in winter and early spring. Provisional data on the strain types identified indicate that different strains of the disease are circulating. In the cases of the three deaths, two different strain types were identified, neither of which was meningitis B.

In June 2018, the chair of the NIAC wrote to the Department to advise that it is engaged in a review of the epidemiology of meningococcal disease in Ireland and that it will develop recommendations based on these findings. The Department awaits the outcome of the NIAC’s deliberations. Parents are strongly advised to ensure their children are immunised according to the vaccination programme. Information on the disease and the immunisation program are available on the HSE’s website.

The Minister of State stated the disease is "most common in infancy and early childhood", the latter being children born before October 2016. He also said the most common cases are group B and group C, yet he went to say the advisory committee sees no need to give the meningitis B vaccine to children born before October 2016. That is contradictory and does not add up. If young children are susceptible to meningitis B, there should be a vaccination programme for them. I dread to think what will happen in the coming years if there is an incident, or a couple of incidents, leading to the death of a young child because of meningitis B. We will stand in the Chamber while the Minister of State or the Minister for Health tries to explain why a once-off catch-up programme was not introduced for the vaccine. As I said, if we can save even one life, it is worth doing. The HSE, which provided the information in the first place, stated it was concerned and asked people to be vigilant, is now saying there is no need for a catch-up programme. It does not add up.

Nowhere in the Minister of State's reply, nor anywhere in the public commentary of the Minister for Health has the reason for not providing the vaccine been given. Rather, the Government is standing over what it says is the advice given to it and providing no further comment or answers.

Approximately ten years ago, there was a review of patient safety in Navan hospital. Other Deputies from Meath and I met senior representatives of the HSE to discuss the issue. We were given assurances that there was a severe issue with a consultant that had to be addressed. A number of years later, there was a High Court case relating to that consultant. All was forgotten about the issue and the consultant's good name was upheld. As a result of that case, I question everything. It is not disrespectful to professionals to question their advice. It can subsequently be accepted, but it should be questioned and interrogated, which is what parents are asking us to do in the Dáil. In the reply the Minister of State provided, he has not answered the concerns or given a reason that people will find satisfactory.

I appeal to those parents whose children qualify for the vaccination but have not received it to get it. We on this side of the House urge them to do so.

Ten years ago, there was a review of patient safety in Navan hospital. Other Deputies from Meath and I met senior people in the HSE to discuss the issue of patient safety. We were given assurances that there was a severe issue with a consultant

I appeal to those parents whose children qualify for vaccination but are not already vaccinated to get the vaccine. On this side of the House, we urge them to do so.

I acknowledge the genuine anxiety of my colleagues and the issues they raised relating to evidence, early childhood and the catch-up programme. Deputy Thomas Byrne spoke about the fears of the public, and I will raise his concerns with the Minister and the Department of Health.

There is anxiety among the public as a result of the recent media coverage of meningitis. In today's world where people have access to multiple sources of information, it is difficult to prevent a message designed to inform members of the public from becoming a catalyst for fear and anxiety, which is unfortunate. I will ask the HSE to consider what measures should be put in place for future communications about meningitis and other diseases to ensure a balance is struck between advising and informing the public, on the one hand, while minimising fear and anxiety on the other.

I reiterate that none of the recent deaths has been attributed to meningitis B. Like my colleagues, I urge parents to ensure their children are fully vaccinated against meningitis B and C, as per the immunisation programme. I will bring the Deputies' concerns to the Minister, his Department and the HSE.

Cancer Screening Programmes

This is a hugely important issue. As we all know, the CervicalCheck scandal that broke last year did huge damage to our confidence in the health system in this country. Specifically, I want answers to the following matters. At the time of the response by the Government to this issue, we found out that the Minister had established a review of all the slides of women who had cervical cancer by the Royal College of Obstetricians and Gynaecologists, RCOG. That review was to be concluded by May but it was not as it was not commenced. The Taoiseach said in the Dáil in July that he was very disappointed it had not been commenced. That was six months ago. It was then meant to be concluded before the Scally report issued. That did not happen either. We know now, as of this week, that the Minister for Health has said that the slides are being transferred and the review should be concluded within six months. That will be well over a year. I do not believe it will be concluded even this year.

There are real issues here. In all these cases the women are waiting to find out if they have issues to deal with and, in particular, if there is negligence. It is not acceptable that these timelines are so far out. It will be the end of this year possibly, and it might not even get done this year. That is not acceptable to Ms Vicky Phelan or the 221 women and families affected.

Furthermore, the tribunal, which was to be set up after Mr. Justice Meenan's review, will possibly not be in place this year. We have all the legislation on Brexit and other matters, which is complicated legislation. However, that tribunal will not be in place and operating until 2020.

Let us not beat around the bush on this matter. I will 100% guarantee the Minister of State that a number of women will end up in the High Court and will have to give the details of their situation in the same way in which the late Emma Mhic Mhathúna and Vicky Phelan and others had to do and it will happen very soon because the Government has not honoured its commitments to ensure these women would not have to go through that ordeal. I guarantee that this will happen. People will come in here and ask the Government questions, as will the media, because it is scandalous.

I know of one woman who will be going through this process in the coming weeks and she and her family are terrified of it. This woman should not have to go to the High Court. She does not want to do so and wants to avail of this tribunal. It is not acceptable that she should be put through this, given the situation she finds herself in.

What is the status of the slides for the 221 women affected? This has also been delayed for a long time. We have no idea of the outcomes. Why is there such a delay with this? These are the priorities, and the ones we know about. This is outside of the National Cancer Registry and the review that is being done by RCOG. Why have we not got this information yet? There needs to be a reprioritisation of this issue otherwise there is going to be a huge wake-up call for the Minister of State's Government because the public is still focused on it and it supports the women and the families affected. This issue is not being prioritised by this Government. It has gone off the priority radar. I have given the Minister of State two examples - Mr. Justice Meenan's tribunal and the RCOG review. In both cases, they are essentially a year behind schedule.

I thank Deputy Kelly for raising this important issue which is one he is doing a lot of work on. This also provides me with the opportunity to update the House on this very important and urgent matter. The Royal College of Obstetricians and Gynaecologists has been asked by the Government to undertake an independent expert panel review of the screening results of women who have developed cervical cancer and who had participated in the screening programme. This will provide independent clinical assurance to women about the timing of their diagnosis and issues relating to their treatment and outcome. Upon completion, each participant will be provided with an individual report, and an aggregated report will be submitted to the Minister for Health. It is the Minister’s intention to publish this report, following Government approval. Over the past number of months, a significant body of work has been undertaken by the Department of Health and by the HSE in progressing the expert panel review.

This has included seeking the consent of women or their next of kin, where the woman has, sadly, died, for participation in the review. This ensures that only those who wished to be involved would have their screening history examined. The HSE also set up a dedicated information line, staffed by administrative and clinical staff to support those invited to participate in the review.

The HSE has noted that the validation of data held in relation to all the women eligible for the review has been a very complex process involving engagement between the National Screening service, the HSE acute hospital division and the National Cancer Registry Ireland. Over 1,700 women or their next-of-kin have been written to, and approximately 1,100 have given their consent to be included. This is a high participation rate of 62%, which indicates a very good level of engagement with the review. The high participation rate will ensure that the expert panel can provide the necessary robust analysis in their aggregate report for the Minister. The HSE has informed the Department of Health that it is expected the process of transferring the slides from the CervicalCheck laboratories to the expert panel review will commence later this month, which is the answer to the Deputy's question. The RCOG expert panel has indicated that it will take at least six months from the commencement of the analysis of the slides, for the review to be completed.

It is of paramount importance that the review is conducted in a way that ensures the quality, comprehensiveness and integrity of the results. The Department of Health is committed to continuous support to facilitate RCOG and the HSE in progressing this review as expeditiously as possible, and this the priority for the Minister for Health, Deputy Harris.

The Minister of State said that his response answered the question. The RCOG review will commence because slides will be transferred but this will take a period of time. I am looking for detail on this from the Minister of State. It will take at least six months but I do not believe it will be concluded by the end of this year. That is a failure of this Government.

The Taoiseach failed these women with his foolish commitment on "Six One" that they would not end up in the High Court. They are going to end up in the High Court in the coming weeks and months. I guarantee the Minister of State that. The Taoiseach made that commitment again in conversation with Ms Vicky Phelan, which she has spoken about.

Some of the women who are not part of this audit and who are part of the second tranche through the National Cancer Registry are in a very bad situation, unfortunately. They cannot avail of the assistance that is being given to the women who are part of the audit and the programme that was put in place to support them. That has to change as it is not acceptable. They are in the same situation as the women who are part of the audit but they are not getting the support of the Government. I ask the Minister of State to address that.

There is a backlog of cases where women who are waiting for reviews are waiting up to 20 weeks for checks. There is no prioritisation in respect of women who need to be prioritised. If one is going for one's three yearly review or if one needs to be prioritised, one is still in the same pot. That is not acceptable. When will the 20-week period be reduced to what is an appropriate time limit?

A matter that is really bugging me is that in October I raised the issue of Pembro being made available to all women at stage four cervical cancer whose clinicians advocated for it. The Taoiseach, the Minister for Health and Professor Michael Barry of the National Centre for Pharmacoeconomics, NCPE, said that women would get this. Over Christmas I have been left in the difficult situation of taking calls and receiving messages from women who want to go on this drug. They want to know if they can say "Yes" and start it given these public commitments. The Government, however, has still not confirmed that it will pay for the drug.

I am left in a situation where I had to advise them that in order to help prolong their lives they should take the drug. Why in the name of God has the Government not come out and said that the women will be allowed to take this drug and that it will be paid for?

The Deputy is way over time.

They are taking the drug on the basis of oral promises made by those three people on the national airwaves. That is not good enough. That is not the way to treat them.

I again thank Deputy Alan Kelly. The women in this particular case deserve all of our support. I will personally raise the issue he mentioned about the drug with the Minister, Deputy Harris.

As Members will be aware, the independent expert panel review is one of two reviews undertaken on CervicalCheck in 2018. The completion of the review is a priority for the Government. It is one key aspect of the work being undertaken to ensure the national cervical screening programme is as effective as it can be. Separately, Dr. Gabriel Scally was asked to undertake a scoping inquiry and his final report was published on 12 September last. An implementation plan has now been published on the website of the Department of Health. Significant work is under way within the Department, the HSE and the National Cancer Registry in progressing the implementation of the 50 recommendations made by Dr. Scally in his report on CervicalCheck. Significant funding has been allocated in budget 2019 to support the implementation of the recommendations. In addition, funding will also support the extension in 2019 of the HPV vaccine to boys, as well as the introduction of HPV testing as the primary cervical screening test. The work of the expert panel review, together with the implementation of the recommended improvements in the cervical screening programme, are vital to ensure that women can feel confident in the cervical screening programme. Through a combination of screening and vaccination for boys and girls, we can make cervical cancer a rare disease in Ireland. That is the Government's goal and we take it very seriously.

Water and Sewerage Schemes

I thank the Ceann Comhairle for allowing me the opportunity to raise this particularly important issue. I also thank the Minister for coming into the House to reply. The Ceann Comhairle correctly identified the scheme as the Balyna scheme, which is an offshoot of the famous Allen-Killina group water scheme of many years ago, which was vintage in the 1970s. It had many stages and extensions in the interim period, especially when the Department was directly responsible for administering the schemes.

Unfortunately, in recent years there seems to have been a distraction of one sort or another and the issue affects an area composed of approximately 1,000 families and there are a couple of schools involved as well as the local community. I will not go into the usual mode of criticising the neglect of rural areas. Those people are citizens of this country and of County Kildare. They deserve equal treatment with people anywhere else in the country. A wellfield was developed in recent years but for some reason the local authority did not proceed with it. I suspect that was for several reasons.

I will describe how the aquifer in the area is operating. In recent years the water has been flowing out over the top of an artesian borehole into a nearby stream. At that stage it is free water coming out of the ground and it should have been possible to harness it. First, there was going to be no refund but in the heel of the hunt there was an intervention and the subscribers have had 80% of their funding refunded. However, that is not what they applied for in the first instance. They applied for a group water scheme and the supply of water to their scheme. It is more than 25 years since they first subscribed their money to the scheme. Needless to say, I was very disappointed that the scheme was deemed to go no further, in particular given that a number of households in the catchment area have no supply of drinking water. Their water supply is contaminated with what we call rust, namely iron deposits, and it also has heavy lime deposits which is damaging to washing machines and all kinds of modern kitchen appliances. Sadly, the views and requirements of those people have been neglected without any reason being given. What is worse, in the summer of 2018 the water supply of a school in the area was deemed to be unsafe and measures had to be put in place to ensure a water supply would continue to be provided.

I know the Ceann Comhairle would agree with me if he was sitting where I am now. There is no reason for the scheme not to be re-invented, resubscribed as necessary and for provision to be made for the men, women and children whose families are living in the area, all of whom are taxpayers and are entitled to the same treatment as everybody else. The question is who decided that they are not entitled to this treatment. Is there a reason for the lack of supply or can the water not be supplied economically? It was always thus. There were always people who could not subscribe to a scheme at a particular time. It was left open to them to opt into a scheme at a later time if they wanted to. In the final analysis, insofar as I am concerned, I have never seen a scheme abandoned in that fashion previously and I certainly do not want to see another one even if I live to be 100, which I do not intend to do, as the Ceann Comhairle will be glad to hear.

Deputy Durkan is well on the way.

I thank the Deputy for raising this matter with me as a Topical Issue. As the Deputy knows well, group water schemes are independent community-owned enterprises and are an important means of providing piped water to rural areas where no such supply exists. While I as Minister am responsible for overall policy direction and prioritisation of rural water services and for funding for the multi-annual rural water programme, local authorities lead on local implementation of the funding measures. This includes the related administration and requisite capital assessments for inclusion in the funding programme. Group schemes rely on Exchequer funding for infrastructural and maintenance support. The Exchequer also subsidises group water schemes to ensure households do not have to pay for their domestic water supplies.

I wish to address the specific matter raised by the Deputy, which is the group water scheme that was proposed for development in Balyna, County Kildare. The Balyna scheme commenced planning its development in the early 1990s. At that time the scheme proposed to supply more than 800 houses, plus farms and commercial premises, to a relatively large area of north-west County Kildare, covering approximately 4% to 5% of the area of the county.

The Balyna scheme was to source its water from a public water supply – wellfields at Johnstown Bridge and Robertstown, which also to be developed and was similarly dependent on Exchequer funding. The Balyna scheme, which was equal to a medium sized public water supply scheme, was very large by group water scheme standards. Accordingly, it was included in my Department's water services investment programme for the period 2007 to 2009 for public schemes. There was little progress on the project over the next few years and it was not included in my Department's subsequent water services investment programme for the period 2010 to 2013. Since 1 January 2014, Irish Water has statutory responsibility for all aspects of water services planning, delivery and operation at national, regional and local level. Irish Water's primary function is to provide clean safe drinking water to customers and to treat and return wastewater safely to the environment. Irish Water, as single national utility, is taking a strategic, nationwide approach to asset planning end investment, and to meeting customer requirements.

I understand that Kildare County Council and Irish Water met with the Balyna group water scheme in 2015. It became clear at the meeting that there is little prospect of the Johnstown Bridge wellfield scheme, the source of supply for the Balyna scheme, being included in the Irish Water capital investment programme. I understand that alternatives were also considered and discussed at the meeting but were ruled out because they were not technically feasible. Therefore, the scheme would not able to proceed either in the short or medium term and the promoters of the scheme were informed accordingly by Irish Water. I understand that soon after the 2015 meeting the scheme decided to wind up.

Acknowledging that costs were incurred in development work on the scheme, my Department recently agreed to recoup an amount of some €79,000 to assist in meeting these costs. Kildare County Council was advised of this position on 14 November 2018. Households in the area of the scheme also have other alternatives to improve their domestic water supply if necessary. The individual wells grant under my Department's rural water programme can be accessed through the council, to assist with the provision of necessary improvement of an individual water supply to households. I again acknowledge the Deputy's interest in this matter. I hope the update I have provided clarifies the evolution of this scheme in its initial years and what has happened in subsequent years.

I thank the Minister for his reply but I do not accept or agree with the chronology of events as set out because I also attended meetings with the subscribers to the scheme in 2012, 2013 and 2014 and no indication was given at that stage that the scheme would have to cease. In fact, the participants were most anxious that the scheme would proceed at the earliest opportunity.

I am not trying to embarrass the Minister. The fact is that somebody somewhere made a decision. No one is telling the Minister who made that decision but somebody made it and did so without the authority of the people of the area, who trusted they would be provided with a scheme.

The other issue I cannot understand is that, long before Irish Water was invented, an indication was given to the effect that the local authority and the then Department of the Environment, Heritage and Local Government together did not want to proceed. I tabled parliamentary questions way back, from 2000 onwards, asking why provision of capital funding towards the scheme was not made by the Department and this was never directly answered. The Ceann Comhairle and I know why it did not happen, namely, the money was spent elsewhere. Somebody somewhere decided and all kinds of excuses have been used since to explain why it could not, and should not, proceed. Excuses were put forward on the basis that it was a rural area and the people had alternatives. I ask that somebody would go out to some of those people to whom I made reference, who do not have a drinking water supply and who would love to know what the alternatives are. They should not be placed in a position where they have to spend their own money after all these years.

I ask the Minister to go to the people who know the circumstances of this situation and demand from them that we hear more about what they propose to do.

My understanding is that the scheme was originally in the proposals for funding but, within the period in which it was there to be progressed, it was not progressed and, therefore, did not make it into a subsequent programme for funding and development. Again, this was all before my time but that is my understanding. I wonder if it is the Deputy's understanding that it was in an initial funding programme but was not progressed in that time and, therefore, fell out of that. My understanding is also that it was understood in 2015 that we were not proceeding with this scheme, that the members of the scheme were aware of this and that it was wound down subsequently. I would be interested to know if the Deputy agrees that was the case in 2015.

Perhaps the Deputy and I will have a chance to discuss this outside the Chamber so we can get clarity between ourselves as to the chronology. However, since I became Minister with responsibility for water, I have done a lot of work with the National Federation of Group Water Schemes. I have attended its annual conference and have met its representatives in a number of different formats to discuss how we can continue to make sure there is a safe, clean and adequate drinking water supply and waste water system in every part of the country. To that end, in April last year I established a working group to conduct a review of the wider investment needs relating to the rural water services sector. At the end of last year, I received the group's first report, which addresses deliberations on the composition and distribution of funding for the multi-annual rural water programmes from this year to 2021. I will shortly announce details of that programme, which are basically the priority for the next three years of the funding cycle, and that will also include details of a revised individual wells grant, which will be relevant to people in Balyna insofar as we know at the moment that the scheme is not being progressed.