Dáil Éireann díospóireacht -
Wednesday, 3 Apr 2019

Vol. 981 No. 4

Ceisteanna ó Cheannairí - Leaders' Questions

Deputy Micheál Martin

I am sure the Taoiseach will agree that over the last ten years the national CervicalCheck programme has made a very significant contribution to public health and that it has been effective in reducing cervical cancer rates since its inception. More than 1 million women aged between 25 and 60 years were screened in its first ten years. The participation rate is close to 80%, which is on a par with some of the best programmes across the globe. In the first ten years of CervicalCheck an estimated 65,000 cases of high-grade pre-cancer were detected. Cervical cancer rates, which had been rising year on year before the CervicalCheck programme began, have been reducing by 7% per year.

The decision of the Minister for Health in April 2018 to offer free smear tests out of schedule to every woman who wanted one has clearly damaged this programme and put it under enormous strain. Some 79,500 women are now waiting for results and the backlog is getting worse as a result of that decision. Some have been waiting up to 33 weeks. Some 71,000 women have been waiting longer than four weeks. The HSE says that two thirds of the backlog is due to the decision on free testing. The introduction of the new HPV test, which will be far more accurate and precise, has been delayed indefinitely.

In a submission to the Joint Committee on Health, the former clinical director of CervicalCheck, Dr. Gráinne Flannelly, confirmed that prior to the Minister's decision and his tweet giving the go-ahead on the Saturday afternoon in question, a Department of Health official contacted the screening service to discuss this proposal. Dr. Flannelly immediately advised against the decision, saying that, among other issues she instanced, it would fundamentally undermine the programme, that the laboratories would not have sufficient capacity and that waiting times would be longer. Within the hour the Department of Health responded by saying that the decision was to proceed with this policy in any event. This contradicts flatly the assertions made to this House by the Minister who has said in answer to parliamentary questions that neither he nor his officials were advised in advance of this decision.

Deputies Donnelly and Lisa Chambers and I have been asking questions on this since January. It has taken us three months to get to this point. Some specific questions were simply avoided and were not answered. The Minister said that neither he nor his officials received advice that recommended against these tests in advance of the decision. His officials did receive advice from the clinical director, Dr. Gráinne Flannelly, that this would undermine the programme. In the committee Deputy Lisa Chambers asked the Minister whether any clinical expert or any of his officials advised him against his decision and he said that, to his recollection, they had not. He doubled down on this assertion in replies to subsequent parliamentary questions.

I put it to the Taoiseach that there are two elements to this. The programme has been damaged. It is a stark illustration of how a very poor decision can be damaging to public health. The truth needs to be told in this House. Questions need to be answered comprehensively and the full truth told about the exact sequence of events that occurred. I ask the Taoiseach to ask the Minister for Health to come to the House and give a comprehensive statement outlining the full sequence of events leading to his decision and the interactions between his Department and CervicalCheck.

The Taoiseach

I thank the Deputy very much. I agree that CervicalCheck, alongside the HPV vaccine for girls, has been successful in reducing the incidence of cervical cancer in Ireland. It has led to women being diagnosed with cervical cancer sooner, which has resulted in a fall in the number of cases of cervical cancer and the number of deaths resulting from cervical cancer. Overall, both CervicalCheck and the HPV vaccine have made a huge difference with regard to women's health. I very much agree with the Deputy on that.

The damage to the programme was not done by the Minister for Health but by the scandal of non-disclosure. The officials the Deputy quoted and the conditions he mentioned were at the centre of that scandal. On 1 May 2018, the Deputy himself was very critical of those officials. He said they were cold and calculating and suggested they may have been involved in illegality or in a conspiracy. In his comments on 1 May he was extremely critical of the same people he is now quoting.

As the Deputy knows, the backlog of smear tests is very significant. While the clinical risk is minimal, there are tens of thousands of women who are waiting far too long to receive the results of their smear tests, which is causing anxiety and worry. I understand that. It is a big problem which we need to get on top of. Approximately 100,000 more smear tests were carried out last year than in the previous year. That was down to two factors, namely, the fact that an out-of-cycle smear test was offered and the increase in the number of women taking up the offer of cervical screening. The increase was not solely down to the extra out-of-cycle smear tests; it was also down to the increase in the number of people attending for smear tests who otherwise would not have attended. It is a positive thing that more people were attending, but it meant that there were many more smear tests than the system and laboratories could handle. As a result, while the majority of women are getting their results within 15 weeks, in some cases women are waiting as long as 33 weeks. Obviously, that is not acceptable.

I am informed by the HSE that it has now sourced additional laboratory capacity, which will allow it to reduce the backlog. We should see that backlog decreasing over the coming weeks and months.

Deputy Micheál Martin

I put it to the Taoiseach that he and the Minister have been in denial and that the Minister has not been upfront with this House. He needs to correct the record. Is the Taoiseach denying the sequence of events outlined by Dr. Gráinne Flannelly? Is he saying that this sequence of events did not occur? I also put it to the Taoiseach that his approach to the national screening service, notwithstanding the crisis last year, lacks character. The Minister's response also lacks character. The Taoiseach cannot say on one hand that a ten-year screening programme that has had a profound and significant impact on public health and which has reduced cancer rates-----

Deputy Mattie McGrath

Fianna Fáil voted confidence in the Minister.

An Leas-Cheann Comhairle

There will be no interruptions from Deputy Mattie McGrath.

Deputy Micheál Martin

The Taoiseach cannot accept that and then turn on those people and dismiss them. He is following the same line that the Minister, Deputy Harris, did in an interview with Brendan O'Connor during which he simply dismissed all of those people involved in CervicalCheck, their contribution to public health and their records in order to save his own skin. The Government panicked. The decision reeked of incompetence and panic and there were no public health criteria nor any advice from relevant individuals to justify it. Essentially, it was the wrong decision. Sometimes, it is better to admit that up front and be honest with the House when people ask basic questions. Last January, thejournal.ie ran a story on this matter and I asked questions on foot of it. They were avoided. Deputy Lisa Chambers and others also asked questions. It has taken until now and a submission being made by a person who made a contribution. I am a balanced individual and I will honestly state that the non-disclosure was wrong, but Dr. Gráinne Flannelly made a significant contribution to building up CervicalCheck.

An Leas-Cheann Comhairle

The Taoiseach to respond. We have exceeded the time.

Deputy Micheál Martin

It is wrong for Ministers to cast a person and the entire service aside just to save their own skins and cover their tracks for a wrong decision being taken. Will the Taoiseach ask the Minister to appear before the House and give the full sequence of events honestly?

The Taoiseach

The Minister has been before the House on a number of occasions in respect of this issue. He has also been before the health committee. I am sure he will be happy to answer further questions if they are asked. The Deputy has asked me to account for conversations to which I was not party and for correspondence that I did not receive. As a result, it is not possible for me to answer the questions.

Deputy Timmy Dooley

We asked the Minister.

Deputy Micheál Martin

I have asked the Taoiseach to ask the Minister to appear before the House.

The Taoiseach

The Deputy's approach and the attack in which he has engaged lack character. Remember what he stated about the senior people in CervicalCheck on 1 May.

Deputy Timmy Dooley

Context, Taoiseach.

The Taoiseach

He stated that they were cold and calculating and suggested that they may have been involved in illegality. He also suggested that they could have been involved in a conspiracy. Perhaps Deputy Micheál Martin should reflect on that. If he holds the views that he has outlined, he may wish to correct the record and withdraw those remarks that he made about those senior clinicians and senior people in CervicalCheck on 1 May.

Deputy Timmy Dooley

It is not a case of either-or.

The Taoiseach

The situation at the time was that there were a lot of women who were really concerned about the accuracy of their smear tests.

Deputy Timmy Dooley

They are still concerned and they want the results.

The Taoiseach

They were attending their GPs looking for repeat tests. They were contacting the helpline looking for repeat tests. There were some doctors calling for repeat tests to be allowed. Patient advocates were also calling for that. When it was done, it was welcomed by the Opposition and it was agreed by the IMO. This was not just a decision made by the Minister for Health.

Deputy Micheál Martin

I questioned it at the time.

An Leas-Cheann Comhairle

The Taoiseach, without interruption.

The Taoiseach

It was also made with the agreement of the chief medical officer.

Deputy Timmy Dooley

Those women are still waiting.

An Leas-Cheann Comhairle

I call Deputy McDonald, who has three minutes.

Deputy Mary Lou McDonald

I thank the Ceann Comhairle or, rather, the Leas-Cheann Comhairle. I am sorry.

An Leas-Cheann Comhairle

That is all right.

Deputy Timmy Dooley

He will take that in time too.

Deputy Mary Lou McDonald

I was just getting the Chair's title right.

Last week, I raised with the Taoiseach the UN special rapporteur on adequate housing's damning condemnation of the Government's record on housing. New research published in The Economic and Social Review further illustrates the points I raised last week and shows that many households and individuals are paying more than half of their incomes on rent. Those in the private rental sector, young and old, are being hit time and again with unbearable rental costs and hikes. All the while, the Taoiseach and the Minister for Housing, Planning and Local Government, Deputy Eoghan Murphy, stand idly by.

For many people, owning a home is but a pipedream. In real terms, home ownership is beyond reach for an entire generation. Not only are houses unaffordable, but rents are at such a level that no one can put away a few quid to save for a deposit. Many of these people are working in good jobs and earn good salaries. They are up bright and early. They are people who, at any other time, would be well able to afford a decent home but are now under serious pressure, yet the Taoiseach does not seem to grasp that. Those who can ask their parents for the money for a deposit are few and far between. He should know that.

The housing system is broken, yet the Government's response is to stick with its plan even though that is failing spectacularly. Sticking with the plan is predicated on preserving the interests of landlords, not on giving renters a break, which ought to be the Government's first priority. On Monday, it was revealed that Cairn Homes was to sell 300 apartments in Dublin wholesale to a vulture fund, which, in turn, will charge exorbitant rents. This is playing out now.

Yesterday, the Tánaiste stated that the legislation relating to rent pressure zones is to be extended to the end of 2021, but that will not deal in any real way with the magnitude of the problem we face. We need real solutions, not piecemeal actions. We need more social homes, more private homes at affordable prices, more cost rental homes, tax relief for renters and real rent control. We also need legislation to prevent buy-to-let landlords seeking vacant possession; in other words, to prevent them from sending people into homelessness in order that they can sell their properties. That legislation will be before us and a vote will be taken on it tomorrow. I urge the Government to support it even though the Government and its friends in Fianna Fáil have previously opposed it. I am asking the Taoiseach to do this one right thing as a signal and as the beginning of a process of the Government getting to grips with the rental crisis, which affects approximately 1 million people across the State.

The Taoiseach

I thanks the Deputy for raising this very important issue once again. The Government and I are really strong supporters of home ownership. I believe in home ownership and that everyone has the right to shelter and should be able to aspire to owning his or her own home. In Ireland, 71% of people own their homes. That is actually higher than the European average. The figure used to be even higher and I want to see it increase again. It was the norm for a very long time that people in their 20s could afford to buy their own homes. That is now not the case. The average person who can afford to buy his or her own home is now well into his or her 30s and people end up paying rent for a very long time before they can get on the property ladder. As a result, a figure of 71% in respect of home ownership is not good enough for me. I want to see that rise. We are absolutely committed to doing everything we can to increase home ownership again in this State.

Rents are very high in Ireland, in many cases higher than what people would pay if they had a home in terms of their mortgage. That is unusual. Second, a lot of people struggle to raise a deposit, which one needs to buy a home.

There are solutions, and the solutions lie in three areas. They lie in supply and providing more housing of all sorts, they lie in enhancing tenants' rights, and they also lie in helping first-time buyers. Supply is now picking up, with 18,000 new homes built last year, more than any year in the past decade. We anticipate as many as 25,000 new homes of all sorts being built this year - social housing units, but also private homes that people can buy. There will be places that people can rent because people also need places to rent. Everyone is not going to buy. People who move around a lot need to be able to rent.

Second, we are enhancing tenants' rights. The Deputy will be aware of what the Minister for Housing, Planning and Local Government announced last night with the approval of the Government. We are: extending the rent pressure zones to 2021 in order to ensure that nobody in those areas will be the subject of a rent increase of more than 4%; changing the criteria for rent pressure zones so that they apply in more areas; extending those rules to student accommodation; and - something that I think will help to make a difference - extending notice to quit periods so that if someone is renting and the owner of the house is going to renovate or sell or if a family member is going to move back in, the owner will have to give much more notice of three months, or six in some cases, in order that the person in the house will have much more time than he or she has at present to find somewhere to live. In the current circumstances, if one is asked to vacate, one only has a few weeks to find somewhere else to live. That is not enough time in the current market. These laws will give people much more time to find place to lives.

We are also helping first-time buyers. More than 10,000 people have already been helped through the help-to-buy scheme to raise deposits. That has been a very significant help for 10,000 people. The Government has given them some of their income tax back to help them raise a deposit. Ten thousand people have already been assisted to buy a home through that action.

Deputy Mary Lou McDonald

Leo fiddles while Rome burns. I am glad the Taoiseach has shared with us his deep commitment to homeownership. I am glad he at least recognises that there is a crisis and that homeownership for a whole generation is off the cards unless their mammy and daddy can help out with a deposit. The Taoiseach is missing the point of my question, perhaps deliberately. I have set out for him the real pressure that renters are under. He will be aware, as Focus Ireland has reported, that up to 70% of families presenting as homeless come from the private rental sector.

I have asked the Taoiseach to take one concrete action, set aside the rhetoric and do something constructive by backing the Sinn Féin legislation that is before the Dáil. That legislation will ensure that buy-to-let landlords cannot insist on vacant possession to sell the property because that renders these families homeless. I am sure that people outside the Dáil are sick to the back teeth of the housing crisis and politicians talking about it. They want action and this is one solid action that could be taken, that could prove to people, by deed rather than word, that the Taoiseach is serious about getting to grips with family homelessness and the crisis in the rental sector.

The Taoiseach

I will correct the Deputy on one point. The Government is helping people to raise a deposit to buy their own home. Some 10,000 people have already benefited from the help-to-buy scheme by getting some of their taxes back to put towards a deposit and 10,000 is not a small number.

We are taking concrete action. The Minister for Housing, Planning and Local Government, Deputy Eoghan Murphy, yesterday announced reforms to extend the notice-to-quit periods. A renter who is asked to quit a property because it is being renovated, sold or a family member is moving back in will have much more time to find an alternative place to live and rent. That is a concrete action.

Sinn Féin's proposal is not a concrete action. We examined it and met with chief executive officers of NGOs about it. The problem is that the Sinn Féin proposal cannot apply retrospectively or to existing tenancies so it would not help one person who is currently renting or facing homelessness. It might, in fact, be counter-productive by discouraging people who are thinking about renting out a property from doing so. Somebody who has upgraded and bought a new home and is thinking about renting out their existing property might be discouraged from doing so were they to find out they would be unable to sell that property.

We are taking concrete action. What Sinn Féin is proposing cannot be retrospective and will not help anyone who is currently renting or facing homelessness. It might get Sinn Féin on the news but that it is all it will do.