Ceisteanna ó Cheannairí - Leaders' Questions

I remind leaders that we will have expressions of sympathy after Leaders' Questions and I ask them to, please, observe the clock.

Today we learned that the CervicalCheck screening service has a backlog of approximately 78,000 slides to examine and that it is taking up to 27 weeks to provide reports on those tests. It is taking laboratories an average of 93 days to report on smear checks. Ms Anne O'Connor, the interim director general of the HSE, stated to the Oireachtas Joint Committee on Health this morning that approximately 370,000 women presented to the programme in 2018, an increase from 280,000 in 2017. There is no question that that increase of circa 90,000 tests results from the decision in April of last year by the Minister for Health, Deputy Harris, to offer a free out-of-cycle smear to any woman who wanted it. My sources confirm that the overwhelming impact of that decision has been to create this shocking backlog which is now damaging the programme and undermining its overall objectives.

There has been too much secrecy on this issue for far too long. We need a candid acknowledgement that the wrong decision was made because there was no clinical rationale for it. It was a knee-jerk political reaction by the Minister which has damaged the overall programme and cost approximately €10 million that could have been better used elsewhere in the health service. In May of last year, after the decision was made, I asked the Taoiseach on Leaders' Questions if it was the correct initial response and whether the system had the capacity to fulfil it. I suggested an alternative approach. The Taoiseach replied that, "A financial agreement on the fee was made last Friday" and went on to say that, "Obviously, there will be logistical and cost issues in getting the tests done as soon as possible but we will overcome them". However, the Taoiseach and the Government have not overcome them. The programme is under significant pressure and is in crisis mode dealing with these backlogs.

The then director general of the HSE, Mr. Tony O'Brien, did not advocate or recommend the approach taken. He stated that it was not actively advised at the time and that the message the HSE was trying to communicate was that women should attend for their scheduled programme appointment - nothing more and nothing less.

The Minister, Deputy Harris, received a significant amount of communication following the decision, including from a gynaecologist in the mid west who stated, "This is dangerous", and that there had been a delay in reporting a test carried out in June. As early as August of last year, GPs wrote to the Minister and the programme to state that smear tests were expiring. In October, the Minister was warned by gynaecologists in the mid west. Of course, in October the CervicalCheck programme recommended the discontinuation of out-of-cycle testing because of the damage that was being done.

Looking back, does the Taoiseach accept that the decision to recommend a free smear test to every woman was wrong? Does he accept that it had no clinical basis, was not resourced properly and has caused unacceptable stress and backlogs costing approximately €10 million overall?

In the first instance, we should recall that cervical screening works. It saves lives. As a result of cervical screening, the incidence of cervical cancer in Ireland has fallen considerably in recent years. Fewer women die from cervical cancer and fewer women face life-changing operations or treatment. It is encouraging and welcome that the number of women attending for smear tests has increased over the past year, notwithstanding the screening controversy. The objective of the Government is to make cervical cancer a very rare disease such that it is almost eliminated. We will achieve that by improving screening through becoming one of the first countries in the world to move to the new primary HPV test and by promoting the uptake of the HPV vaccine by girls and extending it to boys for the first time this year. Those measures are programmed and funded for this year.

I acknowledge that there is significant anxiety and concern among tens of thousands of women who have had a smear test and are awaiting the result. When the programme was working at its best, women received a result within four to six weeks, but it now takes closer to four to six months. There are two reasons for the delay, namely, the general increased uptake in the number of women attending for smear tests, which has continued into this year even though the free test is no longer available, and the decision last year to offer a free test to any woman who wanted one on foot of a consultation with her GP. Those two factors have given rise to the backlog. We are doing everything we can to reduce it. Additional laboratory capacity is being sought. Laboratories are taking on extra staff and, where appropriate, staff are working overtime to speed up the analysis of the tests. We anticipate that the backlog will start to decrease, although it may take some time before we get back to results being received within four to six weeks.

It is worth acknowledging that although some doctors opposed the decision to offer a free smear test, others called for it, as did some patient advocates. It was one of the major concerns raised by women who called the free help and information line. The decision was welcomed by many patient advocates, the Irish Medical Organisation and many Opposition Deputies.

The core lesson that should be learned is that politics does not make for good clinical decision making. It is a very worrying development that a gynaecologist has stated that tests have expired and that a diagnosis has been made in the case of a woman whose test results were delayed. The laboratories have written to the Minister to state that they cannot sustain this level of testing.

We need to be candid. There has been an attempt to cover this up and attribute it to several factors. The decision to provide out-of-cycle testing led to approximately 90,000 additional smears over approximately 230,000 annually. That had a significant impact on the cytology laboratories, which were not resourced to deal with that decision. The programme has been damaged as a result.

The Taoiseach referred to the HPV vaccine. It was promised for last September but that target was not met. It was then promised for January.

Is the Deputy referring to the test?

The Deputy has mixed up the vaccine and the test.

At the meeting of the health committee this morning, Deputy Donnelly asked whether it would be introduced in 2019. The witnesses were unable to provide any commitment or date in that regard.

The fundamental point is that €10 million was spent on the free test. There was no clinical rationale for it at all. The Minister said the assistant secretary and the Chief Medical Officer did not recommend it.

They supported it.

The Chief Medical Officer did not recommend it. The Minister should show me the note.

They supported it.

The Minister should show me anybody in the CervicalCheck team who recommended it.

The Taoiseach to respond.

The CervicalCheck team is appalled by the decision.

The Taoiseach to respond.

Many people in the programme are. The only reason they are worried is out of concern for the programme. They believe the programme has been damaged. I agree with the Taoiseach it has been very effective but this decision damaged it. We should learn lessons from it.

If we change the time, we change the time-----

I have reflected a lot on CervicalCheck, how it was handled, the extent to which it was handled well, and the extent to which we in government might have handled it better. I still reflect on it and on how we will handle these ongoing issues in the future. The truth, which I remember well, is that during the period in question, the Government was under a huge amount of pressure to act quickly. There were very few people in this House and in the media, and even more generally, who were willing to wait for all the information and the facts. We were under enormous pressure from many quarters to act quickly. Everything we did was in good faith. Sometimes we acted perhaps from the heart rather than the head but this decision was made in good faith. Tens of thousands of women were genuinely concerned about their smear tests and the accuracy. Tens of thousands of women attended for the tests. It is true that some doctors warned this backlog would arise but others called for the decision. The Chief Medical Officer supported the decision to do this. When the contract was negotiated with the general practitioners to provide the service, the IMO welcomed it.

Over the past few weeks, we have borne witness to the scale of the absolute crisis in the health service under the Taoiseach's watch and that of the Minister, Deputy Harris. Our nurses and midwives were forced to take to the streets, which would never have happened if the Minister had listened to and taken on board their concerns over the recruitment and retention crisis. General practitioners have protested outside the gates of Leinster House. Hospital waiting lists continue to grow to very high levels and the trolley crisis is one that we are facing day in, day out, and not just during the winter period. The debacle surrounding the national children's hospital rumbles on. It will have a serious effect on capital projects in health and in other areas. Thankfully, we will have an opportunity later today to quiz the Minister for Health on his handling of this because there are very serious questions that still need to be answered. Despite the acquiescence of Fianna Fáil, an apology that was offered yesterday will not cut it. It is not good enough. We in Sinn Féin are very clear that this Minister is out of step and not up to the job.

The issue I want to raise with the Taoiseach today is yet another example of why the Minister, Deputy Harris, needs to go from the Department of Health. As has been mentioned, it emerged this morning that nearly 80,000 smear test results are subject to a delay of up to 27 weeks. This happened as a result of a ministerial decision taken last year to make free screening available in the wake of the CervicalCheck controversy. Women we know are now waiting up to six months for the results. It is undoubtable, unfortunately, that some of those results will indicate cancerous cells. It is appalling and of the utmost concern to women right across the State. It is yet another example of the complete incompetence and chaotic system that we see in the Department of Health and that are evident in the ministerial oversight of that Department.

The Minister announced free screening without any consultation with the laboratories and without carrying out any analysis of whether there was capacity to do what he intended to be carried out. Going ahead without ensuring the laboratories had the means to carry out the tests and to deal with the increased workload guaranteed a major crisis and major problems that we now see emerging.

It was suggested earlier this week in the media, including on RTÉ, that the former director general of the HSE was not made aware of the political decision made by the Minister, Deputy Harris. He also suggested he indicated that the decision should be walked back because it would have unintended consequences. Unfortunately, we see very clearly what those unintended consequences are. Unfortunately, there are 78,000 women waiting up to 27 weeks for their results. The Minister did not consult the laboratories. He made a political decision, which has now had a direct impact on the length of time taken. Is this not another clear example of how the Minister is out of his depth? During the period in question, the Minister pledged to us that the HPV vaccine would be rolled out.

The Taoiseach to respond. Deputy Pearse Doherty will have another minute.

He said it would be in the autumn and then said it would be in January. Now we hear from the committee that we cannot even be told whether it will be rolled out in 2019.

The Taoiseach should respond.

Should the Minister have taken on board the advice of the director general of the HSE? Should he have consulted the laboratories to avoid the crisis we are in today? Is it not now really time to face up to the fact that the Minister has to go?

The Taoiseach to respond.

I think Sinn Féin called for it.

It is curious to hear Sinn Féin now quoting Mr. Tony O'Brien, the former director general of the HSE, as part of an attack on the current Minister for Health. Sinn Féin's last motion of no confidence, if I remember correctly, expressed no confidence in the former director general of the HSE, Mr. O'Brien-----

It was in the Minister for Housing, Planning and Local Government, Deputy Eoghan Murphy, actually.

The Taoiseach should be allowed to continue without interruption.

-----whom Sinn Féin thought a few months ago was unfit for office. Now it is using his words as an attempt to pursue the next head. It shows the entire approach of Sinn Féin to the health service. It really does not care about patients or the health service whatsoever; its approach is just a stick to beat the Government with. It is just a constant, ongoing political attack.

Health is a very difficult area to manage and a very difficult area to lead in for any Minister or Government. It is, however, an area in which, despite the many difficulties we have, real progress is being made. We see that in the fact that life expectancy has increased in the past couple of years. We see it in falling cancer mortality rates, improving stroke survival rates, improving heart attack survival rates and much better clinical outcomes across the board. These things do not happen by accident; they happen because of the hard work and professionalism of our healthcare staff. They happen because the Government is pursuing the right policies and strategies, by and large, and because of the additional resources we are putting into the health service all the time. Even in some of the most difficult areas, as with people waiting for operations and procedures, until last month or at least until the strike, the number of patients waiting more than 12 weeks for operations was at a four-year or five-year year low. There will now be a setback for the next few months as a consequence of the strike but we will get on top of that again. This year so far, the number of patients spending time on hospital trolleys has been at a three-year low, if not a four-year low although I accept there are still too many.

In Clonmel, it is not.

The other matter to which I turn Deputy Pearse Doherty's attention is the situation in Northern Ireland.

The Taoiseach should answer the question the Deputy put to him.

It is an area where his party was in government for over ten years. The last health Minister, until two years ago, was the Deputy's party leader in the North, Ms Michelle O'Neill. Many of the same problems are faced in Northern Ireland, including overcrowding in hospitals, unacceptable waiting times, overruns on budgets and a reform plan that is not being implemented, the Bengoa plan. A very good editorial the other day in The Irish News stated the health service needs a Minister. Why does the health service in Northern Ireland not have a Minister?


This is unbelievable. He has not even answered the question.

The health service in Northern Ireland has no minister because the Sinn Féin health minister resigned over a heating initiative.

Having denied Northern Ireland a health minister, Sinn Féin now wants to take away ours. We are not going to let that happen.

Let me be very clear to the Taoiseach. The women at the heart of this latest scandal are our wives, sisters and mothers in Sinn Féin. Therefore, the Taoiseach should not lecture me about my concern for people whom we love. What has occurred is a direct result of a political decision that was made without any analysis by the Minister for Health. The Minister for Health has said he had full support in regard to the decision he made. What we have is the director general telling us he advised walking back from this decision because there would be unintended consequences. Regardless of this, what is known as a fact is that there was no analysis carried out of capacity. What is known as a fact is that there was no consultation with the director general of the HSE. What is known as a fact is that the Minister did not consult the laboratories about capacity.

The Taoiseach says that he acted with his heart instead of his head. That is cold comfort to the women who are waiting 27 weeks to find out if there are abnormalities in their smear tests.

The Government talks about accountability and that is what we are looking for. This Minister is completely out of his depth. It is not just the cervical cancer scandal or the children's hospital scandal. Week after week, people we know and love who have cancer are having operations cancelled because of the dysfunctionality of the Department of Health and the HSE and the lack of oversight and hands-off approach of this Minister.

Is the Taoiseach aware of any consultation or capacity analysis carried out by the Minister for Health before he made the decision which has resulted today in 78,000 women waiting up to 27 weeks to find out whether they have cancerous abnormalities in their smear tests? That is the issue and the Taoiseach should stop trying to divert attention from it.

That is the issue and I acknowledge the anxiety, concern and worry for tens of thousands of women who are waiting for results of their smear tests. When the programme was working efficiently, people would get a result in four to six weeks whereas it is now taking four to six months. I acknowledge that is a big problem and we are doing all that we can, working with the HSE and CervicalCheck, to reduce the backlog and get back to a turnaround time of four to six weeks and that will be done.

The situation has arisen, as I have pointed out, because of the increase in the number of women attending for smear tests both because of the free test and a general increase in those attending which has continued into this year. The solution to this problem is not a political attack on anyone, nor is it removing the Minister for Health. Removing the Minister for Health will not mean the children's hospital will be built any quicker or cheaper.

It certainly will not mean that the backlog and the waiting times for women worrying about smear tests will get any shorter.

The Taoiseach keeps making the wrong decision.

It would be the same as Northern Ireland and walking away from responsibilities.

It is about holding people to account.

It would mean not taking accountability and leaving the control of a health service in the hands of civil servants. Sinn Féin removed itself from responsibility in Northern Ireland and the department of health in Northern Ireland where it could have done things right and shown us how things should be done. Sinn Féin now wants to remove the health service in Ireland.

People should be held accountable.

The national children's hospital has shown a very serious problem with Fine Gael's competence to manage the public finances and the economy. The national budget is the most important vote in Dáil Éireann every year. The budget presented in October last year by Deputy Paschal Donohoe, as both Minister for Finance and Minister for Public Expenditure and Reform, did not include any provision for the cost overrun on the national children's hospital although it was known about months previously. Why was there no provision whatsoever for an additional capital spend which was known to be required for this project in the course of 2019 when this House was presented with the budget in October?

The Government has accepted that it knew full well and had full knowledge of the extra costs of the hospital by, at the latest, November last year, including the additional €100 million required for 2019. Everybody accepts that. The Government might have gained that knowledge a bit earlier had the Taoiseach appointed a separate Minister for Public Expenditure and Reform and Minister for Finance, which was one of the main recommendations after the economic collapse.

The October budget was inaccurate but the Government now accepts that it knew about the extra cost in November. Why was that not pointed out when the Revised Book of Estimates, the most important spending document, was presented to this House by the Department of Public Expenditure and Reform in mid-December? Why was there no revision of the projected costs in the Department of Health for 2019? Why was capital spending in the Revised Estimate not revised for the national children's hospital?

On Wednesday, 19 December, a month after the Government had full knowledge of these costs, the Minister for Communications, Climate Action and Environment, Deputy Richard Bruton, moved that the Revised Estimates for the public services be presented to Dáil Éireann and circulated to Members for consideration by select committees. Surely the Dáil was misled when that was done.

In October, the Dáil voted to give the Fine Gael minority Government €7.3 billion to spend on capital projects. That was unrevised from budget day. We now know that the cost of the national children's hospital will be €100 million more than expected this year. The Government has claimed that no major projects will be delayed more than a few months but €100 million of new money needs to be found this year. If projects worth €100 million are pushed back into next year, the same €100 million will have to be found next year unless the Government increases the capital spend.

As we know, it is not just that €100 million for this year. At least €450 million of new money now needs to be found over the next few years in order to build the children's hospital. It is not credible that €450 million worth of savings can be found by postponing projects for a few months.

I directly ask the Taoiseach does he accept that an inaccurate revised volume of public expenditure was presented to this House last December.

I do not accept that. The budget was agreed by this House and the Government in October. The Government did not know the full cost of the overrun, or how it would be profiled, until November and we did not decide what change we would make until the Cabinet meeting this week. The Revised Estimates were done in December. The budget was in October, the extent of the overrun was known in November, the Revised Estimates were done in December and a decision on the reallocation was not made until January. That is the timeline.

Deputy Howlin was Minister for Public Expenditure and Reform for five years. I worked with him during that period on many capital projects, particularly in the area of transport. The Deputy knows that, during the course of every year, there was virement. That is not a Revised Estimate, but being transferred from one capital project to another and one Department to another. That is called virement. I imagine that, if we went back over the record, we would probably find 20 to 30 occasions on which Deputy Howlin, as Minister, signed off on virement, moving money from one Department to another, from current to capital expenditure and from one project to another. It happens throughout the course of the year.

In an overall context, while not diminishing it in any way, the capital budget for this year and the amount of money we will invest in public infrastructure this year is €7.3 billion. That is approximately €140 million per week. We have to find roughly a week's spending, or four and a half days' spending to reallocate within the additional capital spending and that is what we have done.

Is €100 million of no consequence?

It is of consequence.

Why does the Taoiseach diminish it then?

It is done through virement, just as occurred many times when Deputy Howlin was Minister for Public Expenditure and Reform in amounts of €50 million, €100 million and €20 million, and money was regularly moved from one year to the next. I remember him doing it and I thank him for doing it. It was very helpful on the sports campus project.

Money was moved from capital to current expenditure and from one Department to another. It is done throughout the course of the year and that is exactly what we have done on this occasion. As I said yesterday, this is not an issue of taxpayers' money being wasted. This money has not even been spent yet. The issue is a serious underestimate in the cost of building the project and we accept responsibility for that. The mistake was made by our agents. We signed off on it, we accept responsibility for it, and we will deal with it and build this project. It will be open to our children in 2022 and 2023.

I have heard many comparisons over the past couple of days with other projects in the past such as the Dublin Port tunnel, the original Luas line and the personal, payroll and related systems, PPARS, which overran considerably. It has been compared to other projects including Metro North, the Thornton Hall prison site, the "Bertie bowl" and e-voting, which all cost a lot of money but were rashly abandoned and never concluded. It is telling that people use those comparisons precisely because every single one of them is more than ten years ago and occurred under previous Governments. Overruns in capital projects used to be the norm ten or 20 years ago. They are not the norm anymore.

There was no capital expenditure for seven or eight years.

We have got this right, by and large. The children's hospital is an exception but we will get it right too.

I remind Deputies that this is a question from Deputy Brendan Howlin.

There was no capital spending.

I refuse to accept that the Taoiseach is so ignorant of the budgetary process that he believes what he just said to me. Of course virement can happen after the solemn decision of this House but accurate figures have to be presented to this House in the Book of Estimates for constitutional reasons because the Government has no money at all to spend until the Estimates are voted upon.

If the Taoiseach was aware that the provision allocated to the Department of Health was not true – he admitted himself that he was aware of that when this Revised Estimate was presented by the Minister, Deputy Bruton, on 17 December last – then that was an inaccurate presentation in defiance of his constitutional duty. That is a clear fact.

Yesterday I asked about Directive 2014/24/EU, on public procurement and the Taoiseach spoke about giving people advance notice. Has he had an opportunity since I raised that yesterday to take advice from the Attorney General? Will the Taoiseach assure the House that the contract awarded to build the national children's hospital is in full compliance with that directive?

The overall allocation for capital spending has not changed. It is still €7.3 billion. We only made the decision this week to reallocate some spending from Departments to others. Many of those departmental Estimates have yet to go through the House. They will go through the House and will be accurate at the time but they may yet change again. Out of a budget of €60 billion per annum, there will be always changes during the year. There are virements between Departments and from capital to current expenditure. Sometimes there have to be Supplementary Estimates where Departments overrun a budget. There is nothing unusual about any of that.

Unfortunately I have not had the opportunity to speak to the Attorney General about the EU directive. I will check up on it and get back to the Deputy.

I want to turn from the national to the international. In a month, the Taoiseach, Ministers and officials will head around the world for St. Patrick's Day. Over 300 venues around the world will be lit green for that day. That is some achievement and some recognition for a small country with a small population. One of the items on the agenda will be to secure the 192 votes necessary to get a seat on the UN Security Council.

Why do we want this seat? I know it was decided back in 2005. What will it cost Ireland? I am not just talking about euro to secure the seat. I ask these questions in the context of strange and, what I would call, "unIreland" decisions made recently. Will we see more of these types of decisions in order to get the seat?

I have two examples of these decisions. Our neutrality puts us in a strong position, enhanced by the reputation of our troops in UN mandated peace missions. Despite protestations to the contrary, that neutrality is under threat, whether that relates to Shannon Airport, permanent structured co-operation, PESCO, or EU battlegroups. We see this increasing drawing of Ireland into the European securitisation agenda. Some months ago, there was an overwhelming vote in the European Parliament on a report emphasising PESCO's compatibility with NATO and that the EU should be capable of launching autonomous military missions.

My second example is the decision to recognise a self-appointed person as president of Venezuela whose previous role in the Venezuelan National Assembly was akin to that of speaker in other parliaments. This self-proclaimed president is openly calling for violence on the streets. I was waiting for Ireland's voice to condemn the sanctions, which have been causing the problems in Venezuela, as well as waiting for Ireland to condemn the threat of military invasion but, instead, Ireland joined European countries in condemning the Venezuelan President, Nicolás Maduro.

Are these the prices we are paying in exchange for votes for a seat on the UN Security Council? The organisation of which we want to be part has permanent members with unprecedented power to veto. We see the political games that go on between the three permanent NATO members and the other two members of the council. There is a litany of failures by the Security Council in making the world more secure. A former UN Commissioner for Human Rights spoke about the pernicious use of the veto leading to the most prolific slaughterhouses, referencing Syria, the Congo, Burundi, Myanmar, and before that, Biafra, Cambodia, Bosnia, Rwanda and Darfur. The most blatant recent example is Yemen. There was an initiative in 2014 to call on the five permanent members of the UN Security Council to voluntarily pledge not to use the veto in the case of genocide and crimes against humanity, which came to nothing.

Our unique voice is one that has been non-aligned, impartial and humanitarian focused. Why are we risking that for a seat on the UN Security Council, which has a serious democratic deficit and which might require us to make decisions not in keeping with a sovereign, independent republic?

I thank the Deputy for raising this important issue. As far as the Government is concerned, we will seek election to the UN Security Council for the 2021 to 2022 term. We have the support of almost all the Oireachtas in this regard. As a country, we have served on the Security Council in the past. I believe we have made a valuable contribution to the UN and the Security Council and we want to be able to do so again. Part of that is a reflection of our ambition to double Ireland's global footprint and increase our influence around the world. Part of it is also about our commitment to multilateralism, precisely because we believe the greatest challenges and problems which the world faces are best dealt with by countries working together, whether through the UN or the EU. It is linked to our commitment to peacekeeping of which the House is rightly proud.

There is peacekeeping we have done with UN in places like Lebanon but also peace operations in which we have been involved through the European Union. These involved operations in Mali, which I had the opportunity to visit earlier this year, and the Mediterranean Sea, under Operation Sophia, where we have been disrupting human trafficking, people smuggling and rescuing migrants from the sea. Those were EU operations, not UN operations, and I do not consider them a violation of our neutrality. I am proud we have taken part in those missions in the Mediterranean Sea and Mali.

The fact we have increased our budget for international development this year by more than €100 million, striving to reach that target of 0.7% of GNI, speaks to our commitment to international development. We believe the best way to deal with many of the world’s problems is to build capacity, democracy, human rights and economic opportunities in developing countries. We are committed to that and we want to bring that vision and voice to the top table in the world.

It is also because of our commitment to free trade and free enterprise. Nothing has lifted more people out of poverty in the history of the world than free enterprise and free trade. We have seen in China and other Asian countries how hundreds of millions of people have been lifted out of poverty through free trade and free enterprise. We want to bring that voice to the top table of the world as well.

We also want to bring our voice and our commitment to human rights and equality to the top table, whether it is equality among the genders or LGBT rights. Ireland has a unique voice and perspective to offer in that regard. That is the backdrop to our decision to seek a seat on the Security Council.

We strongly support the people of Venezuela in their demands for free elections, as well as the restoration of democracy, human rights and freedoms, and economic opportunity. We have listened to the Venezuelan community in Ireland as well. I invite people to do that if they have not done so. There are always differences of opinion but the majority of Venezuelans in Ireland know exactly where they stand on this issue, and we should listen to them as well. In taking the decision to recognise a new interim president of Venezuela, we did so recognising the Venezuelan Constitution allows for an interim president to be elected by the Venezuelan Congress should the directly elected president be deemed illegitimate. We did so not on our own but alongside many other EU countries, including neutral ones, as well as the Lima Group comprising Canada and a large number of Latin American countries.

A Cheann Comhairle, perhaps you as speaker here would like to proclaim yourself President at some point and expect the rest of Europe to recognise you.

I am okay where I am.

The emperor's clothes.

Ireland has a respected voice. It comes from our history, culture and the empathy we can bring to other countries because we have experienced famine, conflict and displacement. The Taoiseach mentioned his recent visit to Africa. That shows up the contradictions. In Mali, he visited Irish troops. Why are those troops part of an EU training mission, which could be seen as propping up France's interests in Mali's uranium resources? The Taoiseach then went to Ethiopia and was back to the traditional Irish role, Irish Aid, which is about the empowerment of women, rural development, social protection and health. We are in danger of losing that respected voice, which we have because of our positive relationships with other countries. There are more appropriate arenas in which Ireland can keep up that reputation and good name, not the UN Security Council and not at the price we appear to be paying to get those votes.

I am not sure the Deputy meant the way that came across. We are not paying for any votes. That is not at all what is happening. I have a thick skin but I hope that our hard-working diplomats in the UN and around the world do not take that the way the Deputy said it. Perhaps it is not the way she meant it.

In terms of philosophy, I do not see a conflict between being involved in peacekeeping and peace support operations on the one hand and international development on the other. I see what we do in Mali and Ethiopia as mutually complementary. International development is worth nothing without security, and security will never last without international development, economic opportunity and freedom for people. I see these things working together. We can do nothing for the refugees fleeing Eritrea in the camps in Ethiopia without having security in Ethiopia and Eritrea. They have to go hand in hand - security as well as international development, democracy, human rights and economic opportunity. I do not see a conflict there. It would be an error of philosophy in foreign policy to say that we will only be involved in international development, but if guerrillas come in or an offensive government comes in, overruns and sets fire to all our projects and knocks down the schools, we cannot say we do not care. That is not what we do.