An tOrd Gnó - Order of Business

The business this week shall be as set out in the first revised report of the Business Committee, dated 28 March 2019.

Regarding Wednesday's business, it is proposed that No. 51, Thirty-fifth Amendment of the Constitution (Divorce) Bill 2016 - Order for Report and Report and Final Stages, be taken in Government time; No. 11a, motion re Statement for the Information of Voters regarding the Thirty-fifth Amendment of the Constitution (Divorce) Bill 2016, shall be taken on the conclusion of proceedings on Report and Final Stages of No. 51, without debate, and any division demanded thereon shall be taken immediately; and in respect of No. 30, statements on agrifood market priorities post Brexit, statements of a Minister or Minister of State and the main spokespersons for parties and groups, or a Member nominated in their stead, shall not to exceed ten minutes each, with ten minutes for all other Members and a five-minute response by a Minister or Minister of State, and all Members may share time.

Regarding Thursday's business, it is proposed that, in respect of No. 31, statements on fibromyalgia, statements of a Minister or Minister of State and the main spokespersons for parties and groups, or a Member nominated in their stead, shall not exceed ten minutes each, with ten minutes for all other Members, a five-minute response by a Minister or Minister of State and all Members may share time.

There are two proposals to put to the House. Is the proposal for dealing with Wednesday's business agreed to? Agreed. Is the proposal for dealing with Thursday's business agreed to? Agreed.

Twenty-eight Deputies have indicated that they want to ask questions. The first is Deputy Calleary.

This morning's The Irish Times contains a frightening report by Mr. Paul Cullen relating to an audit report into orthodontic treatment in Dublin between 1999 and 2002. The report was completed in 2015 but has still not been published. Its findings may lead to 7,500 people having their treatments checked. Some may even be recalled up to ten years after their treatments. All sorts of damage have been suggested, including braces being left in for too long, bleeding gums and other conditions arising out of treatment. Does the HSE plan to publish the report? Given that we are a year on from the revelations at CervicalCheck and the commitment to open disclosure, when will those who have been affected by this issue be informed that they have been affected?

I will have to revert to the Deputy with details on that matter. I have not read the report. Since it is clearly an issue, I will revert to the Deputy with some details this afternoon.

According to page 33 of A Programme for a Partnership Government, the Government "will seek to alleviate pressures affecting household budgets across energy, childcare, medical and insurance costs." The Tánaiste may know that Electric Ireland and PrePayPower have announced price increases for gas and electricity, raising the cost of living further for ordinary working families. This follows on from an increase last year despite the fact that we in this State already have some of the highest energy costs in the EU.

The announcement comes just days after the Government and Fianna Fáil came together to propose imposing carbon tax increases on those who can least afford them. Any increase in carbon taxes on top of the price hikes will hit each and every household. Carbon tax increases will not change behaviour or help the environment, but they will put further pressure on families in the midst of a growing cost-of-living crisis. Will the Government do the right thing and take the prospect of increasing carbon taxes off the table and give those working families a break?

I suggest that the Deputy read the Oireachtas committee's report on climate change. It makes a very strong case, not only for investing in changing the way we produce power at a business and home level, but for carbon tax forming a part of the solution to encouraging a change in behaviour. No one is proposing a dramatic increase in carbon tax in the short term. Rather, we are talking about setting a target for 2030 and incremental increases until then so that people can know the trajectory of this cost and be encouraged to consider more sustainable and renewable ways of heating their homes.

The ban on smoky coal was introduced in Dublin in 1990 and now applies to all towns across the country with a population greater than 15,000. That has led to important improvements in air quality and it is estimated to have saved 350 lives per year through the reduction in smog and particulate matter in the atmosphere. A nationwide ban on smoky coal was announced by the then Minister for the Environment, Community and Local Government, Deputy Alan Kelly, in 2015 following discussions he had with the European Commission. A year was given to prepare the industry for that transition but it appears the current Government is dragging its feet on this commitment, even though towns across Ireland desperately need this measure. A person from Enniscorthy contacted me because air quality in the town has exceeded a dangerous threshold on several occasions. That is replicated in many other smaller towns. We understand the ban will now take place from September of this year. A number of suppliers are awaiting a decision by the Government before they invest while many others have invested already. Can the Tánaiste confirm that the ban will be implemented from September onwards? When will the statutory instrument be signed?

I understand that the reason for the delay was the time it took to secure the necessary legal advice. This was not as straightforward as it might sound. It is impossible to justify the use of smoky coals in this day and age but a transition period was needed because many small business operators were continuing to supply that type of coal. It is the Government's intention to move ahead with this ban. That is my understanding.

Will it be in September?

I cannot give the Deputy an exact date but I can come back to him after I clarify the position with the relevant Minister.

The Industrial Relations (Amendment) Bill 2018 has been in committee since last October. Today, for the fifth day, 500 paramedic and ambulance crews are out on strike, with a sixth day scheduled for 10 April. The Government has appointed a new chief executive officer to the HSE, Mr. Paul Reid, who will earn €300,000 a year, a very handsome sum indeed. That should enable him, at the very least, to attempt a solution to this dispute. Does Mr. Reid want to pick a row with 500 medical staff over their choice of representation while the HSE and the Government are up to their proverbials in several health crises? Can we find a solution? This group of workers is simply asking that they be represented by an organisation of their choice. For the third time, the HSE has been written to by the machine of the State, the Workplace Relations Commission, asking it to come in and negotiate on this issue and it is still refusing to do so. Will €300,000 a year allow the HSE boss to sort this out or what will it take to stop the escalation of this dispute?

This is the first national ambulance strike and it is happening on the watch of this Government. I have come straight from the picket line and I am scratching my head and wondering why a group of emergency workers is being abused in this way over something that seems quite simple. Why is the Taoiseach able to write to Kylie Minogue asking for a meeting but is unable to write a letter to the HSE asking it to recognise a group of workers in a union of 500? Is it by any chance because the Minister for Health is being dictated to by a larger union or is it now Government policy only to deal with unions that it believes toe the party line? What is going on? Why is this happening? These workers are using the slogan, "Our union, our choice", and that should be recognised and respected.

Since his name has been raised twice, I wish Mr. Paul Reid well in what is a very difficult job.

He is a very decent and competent person. I know him well from when I was in the Department of Housing, Planning, Community and Local Government.

He is getting a very decent pay packet.

It is an outrageous salary.

Given the enormity of the challenge he is taking on, he will earn every cent of what he is paid.

The workers we are talking about earn every cent of their pay. The ambulance workers earn their money.

This issue has been raised repeatedly. This is a complex dispute which involves an inter-union dispute as well as a series of other issues. The Taoiseach and I have been clear that it will not be solved by a politician.

It needs to be solved within the trade union movement.

Inter-union matters have nothing to do with the Tánaiste. He should recognise the union they choose.

It is stated on page 61 of the programme for Government that the Government will develop protocols to enable ambulances to take patients to the most appropriate location rather than the nearest emergency department. The 24-hour accident and emergency departments in Bantry and Mallow were closed a number of years ago and now, despite the concerns of people in west Cork, ambulances must transport patients to Cork University Hospital. Those in the west of the county are worried about capacity at the hospital and they even came to the Dáil in buses in order to protest and highlight the issues. Yesterday evening, a code black notice was issued in Cork University Hospital because the emergency department was completely overcrowded. Eight ambulances were backed up at one point. This left west Cork with a depleted ambulance service. Ambulance staff - whom we know cannot even have their own union - due to end their shift at 8 p.m. had to work until 3 a.m. The emergency department was totally overcrowded, with reports of people sitting on the floor and queueing out the door. This morning, 70 patients were waiting for beds in Cork University Hospital. It is clear there is a lack of capacity in the hospital to deal with the extra patients resulting from the closure of the 24-hour accident and emergency department in Bantry. Will consideration be given to opening the emergency assessment units in Bantry and Mallow for longer hours and possibly on a 24-hour basis?

Earlier, I was asked a question by Deputy McDonald about Cork University Hospital, which clearly had a lot of pressure last night - it is experiencing it again today - in terms of capacity. The hospital is trying to respond to this in the appropriate way today.

I was hoping the Minister for Health would still be here. In recent times we have been informed that cervical tests were being delayed because of a lack of capacity in the laboratories that test them but over the weekend it was reported that women paying privately receive their results in two to three weeks, which is brilliant for them but not for the 78,000 women who have been waiting up to 28 weeks. They are all being done by the same laboratory, MedLab. I want clarification on what is happening. Why is this happening? How can a private smear test be prioritised over those of the 78,000 women to whom I refer?

This situation has gone beyond serious. The Minister for Health single-handedly caused this backlog and he has failed to get to grips with it. MedLab treats patients and deals with women in rural Ireland, so women in all of the rural constituencies wait much longer than others. The wait to get a smear result has increased from five or six weeks to eight months. Women are being informed that their tests have expired and that they must come back in for further repeat smear tests, having sought repeat tests in the first instance because they were worried. These repeat tests were meant to provide reassurance. What is the Government doing to fix the problem? Where is the extra capacity? Where are the additional resources? When will the backlog be cleared?

The HSE has advised that it has sourced additional capacity - it has been working on doing so for some weeks - in a number of countries and that it is trying to finalise arrangements in order that this capacity can be incorporated into the CervicalCheck programme. This is a capacity issue. We cannot develop increased capacity in Ireland in the short term so we need to source it in other parts of the world. This is what the HSE is endeavouring to do and, for the first time, I have a note which suggests that it has secured capacity and is trying to finalise contractual arrangements in this regard.

The median house price in Dublin is €365,000. The average national income is €38,500. A person who earns €38,500 would require almost ten times that amount in order to afford to buy an average house in Dublin. Fine Gael in government has been promising an affordable housing scheme for at least five years. The Tánaiste did so on many occasions when he was Minister for Housing, Planning, Community and Local Government. We have yet to see the regulations for an affordable housing scheme. The Government has been long-fingering this for at least two years. Local authorities are waiting to see what the Government is talking about with regard to affordable housing. They have umpteen sites that could be developed for affordable housing, which is much needed, but there has been an undue delay regarding to the regulations. What is the reason for the delay and when can we expect those regulations to be signed?

In the most recent budget, the Government allocated significant funding for an affordable housing scheme that was agreed. It was understood that it would take some time to implement the scheme. However, there is currently nothing preventing local authorities coming forward with proposals around affordable housing schemes-----

The regulations have not been completed.

-----using the sites that they have available to them if they wish to so do. There was nothing preventing them from doing so two years ago. Local authorities can use their own initiative and work with the Department on this. The Government is now also moving ahead with the cost rental project.

On affordable housing, local authorities are waiting for regulations from the Department.

It might take a while.

We have agreed to come forward with new proposals for affordable housing schemes and to give guidance on that. I do not have an exact date for what the Deputy is proposing, but the Department is working with local authorities on individual projects and they can be brought forward, as could have been done for the past couple of years.

We need a scheme. The Government has been promising it for a long time.

Local authorities do not always need schemes.

As it stands, the legislation putting rent pressure zones in place will expire at the end of the year. Although the zones have not by any means brought rent affordability to where it should, they have, at least, had an impact in keeping rents in the areas worst hit by rental increases closer to being under control. However, there has been no definitive indication by the Government as to whether it intends to renew the rent pressure zone legislation at the end of the year or under what set of circumstance it would so do. Many people would face enormous rent hikes if the zones lapsed and are living with that uncertainty. I would be grateful if the Tánaiste would clarify the intentions of the Government in this area.

The Government today decided to extend rent pressure zones until the end of 2021 and to change how the qualification criteria for how rent pressure zones are calculated, essentially to separate Dublin from the rest of the country because rents are much higher in Dublin and, therefore, the qualification criteria of having to be above the national average needs to change for outside of Dublin. The Minister for Housing, Planning and Local Government, Deputy Eoghan Murphy, will outline the changes agreed today at Cabinet in some detail in the coming days.

We now move to Deputies carried over from last Thursday. I call Deputy O'Reilly.

Reports in the media at the weekend and replies to parliamentary questions I tabled indicate that the Government has switched off the funding for the maternity strategy. Can the Tánaiste, please, advise whether additional funding will be made available? If it will not, as has been indicated in responses to my parliamentary questions and by Mr. Paul Cullen in The Irish Times, what elements of the maternity strategy will be sidelined? Women have the right to know. We were promised access to anomaly scans on all maternity sites, but we know that is now only possible on 14 sites. What elements of the maternity strategy will be paused? Women have the right to know.

I suggest that that is a question for the Minister for Health, Deputy Harris, who could provide the Deputy with a much more detailed answer than I can. I will certainly raise the issue with him and ask him to respond directly to the Deputy.

There are three major national primary routes through the county of Roscommon, namely, the N4 from Carrick-on-Shannon to Boyle which leaves a lot to be desired, the N5 which cuts right through the centre of the county where I live and the N6 from Athlone to Ballinasloe which, in fairness, has been quite well developed. All Members know there are plans for the N4 and N5. However, the hold-up in the work on the N5 is extremely concerning. On numerous occasions in this Chamber, I have raised with the Minister for Transport, Tourism and Sport, Deputy Ross, by way of Topical Issues and otherwise, the safety issues on the N5. It crosses Roscommon from Termonbarry on the Longford border to Ballaghaderreen on the Mayo border. Yesterday evening, there was another serious accident, this time at the village of Tulsk. It is lucky that I am not standing here extending sympathy to a family. There are serious ongoing issues with the junctions along that road. I am pleading with the Tánaiste to go back to the Minister and Transport Infrastructure Ireland, TII, on this issue. I do not want an answer referring to the proposed bypass. In the meantime, we need safety measures. What price can be put on a life? The safety measures can be put in place. People are deeply concerned by this issue.

The Minister has just walked into the Chamber. I will raise this matter with him in order to ensure that he raises it with the TII, which is the relevant-----

The timing-----

I am not sure he would have been able to stand up in time.

On page 28 of the programme for Government, there is a commitment to a review of building standards and improved fire safety. Yesterday in the Irish Examiner, Mr. Michael Clifford revealed that homeowners in the Verdemont complex in Blanchardstown will have to pay up to €50,000 each for fire safety remedial works on 12 March. I asked the Tánaiste for an update on the review and he promised to forward information to me. I appreciate that he has been busy with other matters. Can he confirm whether the Government will conduct the review and update the fire safety regulations? Will he consider a latent defects redress scheme and a risk audit of Celtic tiger-era developments?

Certainly, there was a commitment in the Department to review fire safety generally in light of some of the tragedies in the United Kingdom, particularly that relating to Grenfell Tower. I am not sure about the current status of the review but I can revert to the Deputy on both of his questions. I do not have the answers off the top of my head.

Could the Tánaiste give the up-to-date position on the Belgooly water supply scheme? I attended a meeting in Belgooly on Friday night and the scheme was one of the main topics of conversation. The people of Belgooly are being held to ransom waiting for a commencement date for the scheme. They have to change their domestic appliances much more often than the rest of us. It is not fair. The problems I have been informed about in recent years have now been resolved. Can the Tánaiste provide information on a commencement date? Is there a reason we are not being told why the scheme is not up and running when, as far as I am concerned, all ducks are now in a row?

I will certainly be checking to make sure that all ducks are in a row. I know Belgooly very well. It is right on the edge of my constituency. I will try to get an answer for the Deputy. It is probably unreasonable to expect me to provide a date now. However, I am very familiar with Belgooly and will certainly revert to the Deputy with an answer.

I wish to raise the issue of mental health services in Sligo, particularly at Saint Columba's hospital, in the context of the programme for Government and the commitment to ensure there are proper mental health services in place. The out-of-hours service is a genuine problem. Let me give the example of a young man who has a long history with the service. He self-harms but when he arrives at the service out of hours, there is no registrar and nobody there to see him. There is a junior registrar on call but that person is also working in the main hospital and is seeing patients there. A backup service is supposed to be in place but the young man sits and waits for four to five hours without any service and then has to go. This has happened on numerous occasions because of the current circumstances at St. Columba's. I want the Government to commit to proper staffing. A new mental health service is being built on the grounds of the Sligo University Hospital but we need proper staffing. There are not enough staff at present to address the very serious issues people are dealing with.

On mental health, I welcome the announcement of Jigsaw services in counties Tipperary and Wicklow. What is the latest update on referral pathways and the 24-7 access that is to occur this year in respect of mental health services?

I have many figures in front of me on increased capacity nationally in mental health services, including youth mental health services. I have the numbers of new assistant psychologists, psychiatrists, psychiatric nurses and so on but both Deputies are looking for more detailed information on individual projects. Therefore, I will have to come back to them on that.

I wish to raise the issue of the out-of-hours service for general practitioners in Tipperary. Caredoc, which covers the whole of the south of Tipperary, has only one general practitioner on duty between 11 p.m. and 8 a.m. In north Tipperary, which is covered by Shannondoc, there is only one general practitioner on duty between 10 p.m. and 8 a.m. Will the HSE consider increasing the resources for the service, particularly as having one doctor in the north of the county and one in the south is not nearly adequate to cover calls?

Once again, this is a local service. It is an important one. I will have to get a response from the HSE for the Deputy.

According to A Programme for a Partnership Government, the Government is "committed to timely access to orthodontic care" and intends to develop a "comprehensive" oral health policy, especially for children. In this context, there is concern that physical damage was done by the HSE orthodontic service in the Dublin-mid-Leinster area between 1999 and 2002. The HSE commissioned a report into this complaint. The report, which was compiled by two independent external dental professionals from the UK, was provided to the Department of Health in 2015 but has not yet been published. An audit of the 7,500 children involved has been carried out. Why has the report not been published? When will the audit into the unpublished report be completed?

I have not read this report and I have not seen it. It was raised with me by Deputy Calleary earlier. The statement of concern relates to concerns raised by two consultant orthodontists about the delivery of orthodontic services in the Dublin-mid-Leinster area between 1999 and 2001. The concern relates to interrupted orthodontic treatment. In some cases, braces were left in place for longer than required.

Maybe you could correspond with the Deputy.

I will correspond with the Deputy. I have not yet read the report.

I have been raising the issue of biosimilar drugs, and the potential savings associated with them, since I was elected to this House in 2016. Last week, I tabled a parliamentary question to look for figures for the past three years. According to an article by Evelyn Ring in this morning's Irish Examiner, over €1.2 billion has been spent on biological drugs in the last three years. In the same period, just €2.2 million has been spent on biosimilar drugs. I have pointed out time and again that an annual saving of €100 million is available to the HSE if it uses biosimilar products. That €100 million could be spent on drugs like Spinraza, which is used to treat spinal muscular atrophy. Alternatively, it could be spent on the autism services that I am continually following up with the Minister of State, Deputy Finian McGrath. Nobody is taking up this possible saving. What do we have to do to get efficiency in the HSE? It is scandalous that this money is being left behind year after year.

I hear what the Deputy is saying, but I have no way of verifying it.

I can give the Tánaiste a 100% guarantee that it is true.

It is a serious claim. I will ask someone from the office of the Minister, Deputy Harris, to contact the Deputy directly on this matter.

The programme for Government contains a commitment to "fully protect the Free Travel pass for all pensioners and work with private and public operators to keep services operating on as many routes as possible". Last week, an 86 year old man who attends a day centre in Virginia received a letter from the HSE requesting a €4 charge on his daily returns. Elderly constituents of mine who attend the millennium club in Tydavnet, County Monaghan, have received similar letters requesting €4 daily payments. It does not sound like much, but it is almost €1,000 at the end of the year. I raised the same matter with the Taoiseach last week because people with disabilities have also received letters asking them for money for their public transport. My constituency has very little public transport. The charges being implemented by the HSE will affect the most vulnerable people in Cavan-Monaghan - the elderly and people with disabilities - and will exacerbate rural isolation. As a result, they will have to stay at home. I ask the Tánaiste to intervene to see what is happening here. It is a matter of communication between the Minister for Health and the Minister for Transport, Tourism and Sport. The free travel pass should be acceptable. These people should not have to pay to travel to their ordinary day services.

Rather than going into the detail of this case, perhaps the Deputy could send me a detailed outline of it. I will look into the issue and try to come back to her.

That concludes Questions on Promised Legislation.

I did not get an answer to my question.

Sorry, on the M5-----

The Minister stepped in, but then he stepped out again.

I just want the message to get through to him that this is a most serious issue for people in my locality.

The Minister is like the Scarlet Pimpernel.

The Minister is afraid he would have to give an answer.

He is having lunch.

I will raise the issue with the Minister, Deputy Ross.

Five Deputies have not been reached and will be given priority tomorrow.