Léim ar aghaidh chuig an bpríomhábhar

Dáil Éireann díospóireacht -
Tuesday, 9 Apr 2019

Vol. 981 No. 6

Ceisteanna ó Cheannairí - Leaders' Questions

Last week I referred to the fact that as many as 80,000 women were waiting for cervical smear test results. There is an enormous backlog, largely because of a decision taken by the Minister for Health last April to offer a free test to every woman who requested one. For about three months we have been seeking to ascertain the extent to which the Minister sought, received or ignored official advice on this decision because it has had significantly damaging repercussions for the programme which has been very effective over a period of ten years, with 65,000 pre-cancer cases being diagnosed and a very high participation rate. It is now in something of a crisis.

The truth and the record of the House matter. The Minister's story has shifted continuously from January onwards, following questions about the issue. We need a comprehensive statement from him. On 5 February he denied that the decision had been made against official advice. He said that was not the case, but we now know that there was official advice against the decision. Professor Gráinne Flannelly's submission was one element of it. We know that there was a meeting between Department of Health and CervicalCheck officials on that day and that an email went from CervicalCheck to the Department. The Minister subsequently said the warnings had been significantly after he had made his decision. He set this out in a statement to the Dáil in February. We know that Mr. Tony O'Brien, the then director general of the HSE, spoke to the Minister on the Sunday after the decision was made and asked him to walk it back. This was before a Cabinet meeting on the following Tuesday at which the decision was formally endorsed and when a presentation was made. Were Ministers aware of all of that detail, the warnings and official advice against the decision to proceed? A number of the statements from the Minister are incorrect. There were warnings from very senior people on the day and the day after.

On 8 May I asked the Taoiseach during Leaders' Questions if there was the capacity to do the smear tests and if it was the correct official response. That was despite all of the spin that I had allegedly welcomed all of this. I asked some clear, pertinent questions on 8 May and what I said has been borne out in the fullness of time because Professor Gráinne Flannelly said the decision had fundamentally undermined the advice.

Will the Taoiseach ask the Minister to come to the House and issue a comprehensive statement outlining the sequence of events leading up to the decision, the advice he received and when he received it and correcting the Dáil record as he does so? Will he publish the email sent by CervicalCheck to the Department on the day he made his decision? What is the timeline for the elimination of the backlog? Will the Taoiseach confirm that the CervicalCheck screening programme can cope with the overload that has resulted and that there is capacity to clear the backlog while continuing with the programme?

The most important thing is that we deal with the backlog. There is a backlog of approximately 80,000 smear tests waiting to be examined. While the clinical risk is negligible, there are, of course, lots of women who are very concerned about their test result and have been waiting a long time for it. We need to deal with that issue. Some women are getting their result back within four weeks. The average is 15 weeks, but, in some cases, it is 33.

The Health Service Executive, HSE, and the National Cancer Screening Service have been doing a lot of work to try to find laboratories that would be willing to take on additional tests. They have sourced capacity, but they need to spec the laboratories and come to commercial arrangements with them to take on the additional tests. Given the litigious environment in Ireland, among other things, it can be difficult to get laboratories to agree to take on additional tests, but the HSE has identified laboratories that may be willing to take on the additional tests, subject to a commercial agreement and an agreement on liability should there be future claims.

The Minister for Health will be before the Oireachtas Joint Committee on Health tomorrow when I am sure Deputies will take the opportunity to ask him questions. I am absolutely confident that he will be willing to answer any question he has not answered already. In my view, he has answered the questions already. There was indeed advice from CervicalCheck after the announcement had been made, albeit on the day. I think the email to which the Deputy referred has been published. I certainly heard the party's spokesperson quoting from it-----

It was sent after the announcement had been made, not prior to it, and it was sent by a staff member in CervicalCheck to an official in the Department. It did not go, as the Deputy claims, to the Minister for Health.

The advice from the chief medical officer, CMO, was reflected in the decision made by the Minister for Health which was subsequently endorsed by the Government. If the Deputy refers to the statement released on 28 April 2018, it states: "For any woman who has had a CervicalCheck smear test and where her GP feels she should have a further test as part of her reassurance, the Minister has asked CervicalCheck to make the necessary arrangements, including payment provision. These arrangements will be confirmed next week."

Was that the CMO's advice?

It was very much in line with the advice from the CMO, that if a repeat smear test was to be done out of cycle, it should be done after consultation with and on the advice of a GP.

Will the Taoiseach read the tweet sent by the Minister?

Read the tweet.

That is the statement that was issued publicly.

The tweet was not included in the statement.

I can inform the House that between 1 May and 31 December last year, when the free out-of-cycle smear test was on offer, there were 112,000 consultations with GPs but only 57,800 repeat smear tests. That proves that the CMO's advice was followed because 100,000 women attended their GPs and in about half the number of cases a repeat smear test was done.

The Taoiseach has said the email was published. My understanding is the email from CervicalCheck to the Department has not been published. What has been put forward is that because it is subject to a freedom of information request the Department does not want to release it. I will stand corrected if it has been published, but I would like the Taoiseach to say in the Dáil today that he will ensure it will be published before the end of the day. There is no reason it should not and cannot be published. I want that commitment from the Taoiseach because this has been ongoing for three months and the story has shifted and changed. Sometimes it is better to put the hands up on day one and admit that it was a huge error and mistake because why else would the director general of the HSE talk to the Minister and ask him to walk back? What the Taoiseach has just read is an attempt by the system to walk back from the Minister's kneejerk tweet. That is very clear from the story in The Examiner on Saturday, which is very interesting, about who leaked the text between the CMO and the Minister.

There is a very short list of people who are potentially responsible. He mentioned a request from a doctor in the National Association of General Practitioners, NAGP and then said:

Tony please see below confidentially. From NAGP. Would seem better to do this than be forced to do it??

That seems to be the rationale for a decision which has heaped hundreds of thousands of additional unnecessary tests on the system, causing an enormous backlog, and has delayed the rolling out of the new human papillomavirus, HPV test, which is far more precise and more accurate and would yield even better results for the women concerned. The record of the House unquestionably needs to be corrected and the Minister needs to make a comprehensive statement. Tomorrow's business in the House is about the wide Estimates in health, it is not specifically about this issue.

The Deputy is again engaging in conspiracy theories. To the best of my knowledge, the information that was on the front page of the Irish Examiner was not a leak, it was on foot of a freedom of information request made by that newspaper, so the Deputy is really into his conspiracy theories again. A newspaper makes a freedom of information request-----

All conspiracy theories.

-----it has a story and puts it on the front page and the Deputy imagines that there is a leak or a conspiracy involved but I am sure the Irish Examiner can confirm whether it was a leak or was down to good journalism by the newspaper by putting in a freedom of information request.

On what happened at the time, it is important to bear in mind what was happening at the time.

Women were attending GP surgeries, they were very concerned about their smear tests being inaccurate and in many cases they were asking for a repeat smear test. This was the major issue coming up on the helpline, the NAGP called for repeat smear tests, the Irish Medical Organisation, IMO signed an agreement to provide them and it was welcomed by the Opposition. Some Opposition spokespersons said that they would have done the same thing and patient advocates called for it too, so this was done for good reasons.

On the email the Deputy mentioned, I will check whether it has been published. If it has not been published, I do not see why it could not be but I will check into that. What I do know is that the email was sent after the decision was made and it was not sent to the Minister, it was sent to officials.

The phone calls were made beforehand and the Taoiseach knows that.

The Deputy does not know that.

We do know that.

Does the Deputy have any evidence of that?

No one disputes that.

What about the women who are waiting for their results?

This is causing great uncertainty and stress for women. Stop being in denial about a bad decision.

Could we please stop the classroom antics? I call Deputy McDonald.

Last Tuesday, I raised with the Tánaiste the critical issue of hospital overcrowding, and given the continued state of crisis in our hospitals, I want to raise it again today with the Taoiseach. Last week there were serious problems in Cork University Hospital, CUH, and a black status escalation was declared, which meant that the hospital was at maximum capacity and was deemed unsafe to admit further patients. The outworking of that has had serious implications and two specific incidents were reported in the Southern Star newspaper yesterday, which illustrate the extent of the problems at Cork University Hospital.

A general practitioner, GP, in Bandon, Dr. Mary Roycroft, has said that an 84 year old patient refused to attend the emergency department at CUH, despite being very unwell, and told her that she would rather die at home than be in there. She said that the patient's response is not unique and that many other patients have expressed similar fears. These are patients who need to be in hospital but who are unwilling and afraid to attend accident and emergency services because of persistent overcrowding. That is a scandalous situation. In addition, an elderly man who fell in Skibbereen last week was left lying on a pavement for nearly two hours while waiting for an ambulance to take him to CUH. The ambulance in question was one of eight that were queueing outside the hospital waiting to offload patients and it never came. This man was eventually taken to hospital by a paramedic crew from County Kerry. This is no way for our health service to operate and yet it is the reality. It is in a state of perpetual chaos and no meaningful action is being taken to address the extent of this crisis. That is a disgrace.

University Hospital Limerick was similarly in a state of chaos last week and that shows no sign of letting up.

There are 55 patients on trolleys there today and Limerick is yet again the worst affected hospital in the State. State-wide today, there are 631 patients on trolleys, the highest number in 2019 so far according to the INMO. There are 55, as I said, in Limerick, 42 at Cork University Hospital, 50 at Sligo University Hospital, 39 in Beaumont, and 37 in Galway. I am advised by Deputy Ferris that there are 36 patients on trolleys in Kerry University Hospital and nine sitting in chairs. It was equally chaotic yesterday. On and on it goes. It is frightening. Overcrowding, as the Taoiseach knows, impacts on patients and puts them at risk. It also affects the health and well-being of staff. Both of these things are intolerable. This is no longer a winter problem or one that is amenable to a seasonal intervention. It is year-round and State-wide. The Taoiseach has failed to get to grips with it. Quite simply, I ask what he and his Minister for Health, Deputy Harris, plan to do to respond to the capacity crisis in a meaningful way.

I am afraid I cannot comment on those individual cases without knowing all the facts. I do know and understand the enormous inconvenience and suffering that hospital overcrowding causes patients and their families who care for them, and also the stress and pressures it puts on staff. I say that as somebody who spent over a year working in emergency departments in three different hospitals, where we often experienced very high levels of overcrowding. None of us wants to see that persist.

I never like to reduce this to statistics because it is not about statistics, it is about people. The Deputy is right to point out that the number of patients on trolleys today, whether we use the nurses' figures or the HSE figures, is the highest so far this year. It is not higher than it was last year, however, or in the three years before that. It is always possible to pull out record highs and record lows by identifying a particular day of the week or a particular hospital or a particular month.

It is every day.

How about three years?

If we take the first three months of this year, according to the HSE we have had the lowest levels of overcrowding in five years. Even taking the nurses' figures, which cannot really be used for year-on-year comparisons because they change the way they count them every year, or at least have changed the way they count them on a few occasions in recent years, their figures show fewer patients on trolleys so far this year compared with last year.

The Deputy's question is what we are going to do about it. We should focus on solutions, not on accusations. Our solutions are threefold, namely, bed capacity, better use of our existing resources and beds, and I will explain what I mean by that a little later, and investment in primary care and community care. The first item is bed capacity and we are increasing the number of beds in our hospitals all the time. There are three new hospitals under construction, new wings in Limerick as the Deputy mentioned-----

-----and in Clonmel and many other places as well. By the end of this year, we will be back up to about 11,000 beds in our acute hospital system. That is the highest number since 2009, reversing the policy of the previous Fianna Fáil and Green Party Government to reduce the number of hospital beds, by restoring those beds.

The second area is better use of our existing bed capacity. Obviously a hospital with an average length of stay of six days needs way more beds than one with an average length of stay of four days, even though it sees the same number of patients. That is about making sure that there is reduced length of stay, that patients get out of hospital quicker, and if they are in hospital, that they get their tests and investigations more quickly and are not waiting around for days to see a specialist, have a scan or have an intervention they need.

The third area is investment in primary and community care, because in Ireland we rely too much on our hospital system. Much more can be done in primary and community care. That is why last week's agreement with the IMO on a revised contract for GPs is so significant. It is a 40% increase in resources for general practice over the next three and a half years, including provision of 250 more practice nurses. What are we doing? We are providing for more beds, more efficient use of our existing resources, and a decisive shift to primary and community care.

Having said that he does not wish to deal with statistics, the Taoiseach reached for statistics. He has typified the stories I told him as accusations. They are nothing of the sort.

They are the experiences of two people in Cork, namely, an 84 year old woman and an elderly man who fell and was left on the pavement for two hours. That is not an accusation. It is a scandal and an utter disgrace. I am shocked that the Taoiseach seems to be so out of touch that he would classify that as an accusation. These are the stories behind the statistics that are so regularly quoted.

The Taoiseach has said that he is pulling out all of the stops and is on top of this. All of the evidence contradicts that. The evidence tells us that this is a crisis and that the Government cannot manage it. It tells us that this is a disaster. Staff in Kerry told Deputy Ferris so earlier today and people are saying the same in Cork. I was in Mayo last week, where the emergency department and its staff is under enormous pressure. The Taoiseach seems to be totally out of touch and is blissfully unaware of this. I put it to the Taoiseach that, rather than providing any positive solutions, it is quite shocking that the Minister has spoken recently about a recruitment freeze and an overtime ban. How on earth will that do anything other than worsen the capacity crisis at accident and emergency departments?

The Deputy is trying to twist my words again. I said I could not comment on those individual cases because I do not know the facts. The accusations she made concerned what was said about the Government, not those individual cases. The Deputy asked about solutions. I provided the solutions to her. I pointed towards the three areas in which we are implementing solutions. I have not heard, nor do I ever hear, solutions in the Deputy's contributions to this House.

I appreciate that the Deputy is outraged and angry on behalf of patients who have received a very bad service, whether in Cork or elsewhere. Where is her outrage for those who are receiving a really bad health service in Northern Ireland? The last Minister for Health was Michelle O'Neill, the Sinn Féin deputy leader, or its leader in the North. She walked away from government in Northern Ireland. We should not forget what the situation in Northern Ireland is like at the moment. I regularly read the Irish News to ensure that I am up to date in the situation in Northern Ireland.

Perhaps the Taoiseach knows more about the situation in the North than in the jurisdiction of which he is Taoiseach.

The number of people waiting for an operation or procedure for more than a year is 21,477 in Northern Ireland, compared with 4,900 here, representing 1.1% of the population of Northern Ireland compared with 0.1% here. The number of people waiting more than a year for an outpatient appointment in Northern Ireland is 94,000, compared with 89,000 here, which is 5.2% of the population compared with 1.6% here. The situation in Northern Ireland is much worse.

Everything is great here.

Sinn Féin had the opportunity to show people what could be done. It controlled the Department of Health in Northern Ireland-----

Everyone is going to the North for operations.

-----and it failed. Why should anyone believe that it would do a better job?

The people from here are having to travel North.


Can we have silence for Deputy Howlin please?

I met a man in Cork yesterday who is working in that city but cannot afford to pay rent in that city. Does the Minister think this is funny? I do not, and that man did not.

Fine Gael thinks it is hilarious.

That man is commuting daily from Dunmanway, which is 54 km each way. It is hilarious, is it not? That man cannot rent in the city in which he works. His story is typical of many people who have been failed by Fine Gael's strategy for the rental sector, the policy that introduced rent-pressure zones. The effect of those zones is "to limit rent increases, both within existing tenancies and between tenancies, to 4% per annum for a specified period", yet the housing affordability crisis is getting worse. More than 10,000 people are experiencing homelessness at present. Since the policy was brought in, we have seen more and more areas designated as rent-pressure zones because rents have been shooting up in the areas alongside rent-pressure zones. This is the case in Galway, Maynooth and Drogheda. Housing officers in local government have told me directly that rent-pressure zones are the single worst thing to have happened to the private rental sector. Rather than capping rents, the policy has given a signal to landlords to increase rents by 4% per year. Landlords believe that as every landlord is doing the same thing, they should too. Rent inflation is at 4% in the rent-pressure zones, but inflation outside of the zones, in the contiguous areas, is even worse. The policy is a failure and the reason for that failure is that the benchmark used for rent affordability is wrong.

Affordability must be benchmarked against earnings, what people can actually afford to pay. Average annual earnings for full-time workers grew by 1.7% between 2016 and 2017. Rents in rent-pressure zones are capped at 2.5 times the growth in earnings over the same period, which makes no sense whatsoever.

The minimum wage set by Government rose by 1% in 2017 and another 3.2% in 2018. The minimum wage in turn affects sectoral wages in cleaning, security, retail, hairdressing and other low-paid occupations. Many people working in these areas are renters. The Government is setting wage increases at far less than the 4% rent increase that it is not only tolerating, but in many cases encouraging. It is effectively encouraging a 4% annual increase in rents. Why did no one make the link between a proposed cap on rents and actual increase in earnings? Who came up with the 4% figure? Does the Taoiseach honestly believe that such a level of rent inflation continues to be acceptable or sustainable?

I acknowledge, as does everyone on these benches, that rents in Ireland are very high, particularly high in our cities, and have become unaffordable for many people who, as the Deputy has said, are forced to opt for long commutes instead. That is why we introduced the rent-pressure zones. They have only been in place for a few years. There is evidence from the RTB's quarterly reports that rent increases are now moderating. That can be seen in the most recent report. They were never going to work overnight; it was always going to take time for them to work. However, we can now see a slowdown in the rate of increases and even some reductions in rents in the last quarter.

No amount of rent-pressure zones, caps, regulations or formulas will solve this problem. They can help to alleviate the problem and make it less bad. They can act to treat the symptoms, but as long as there are more people who want or need to rent than properties available to rent, we will have a problem. It might appear as rent price inflation or under-the-counter cash payments, which is what happens in countries with very strict rent controls. It might appear in the form of people who cannot find anywhere to rent and have to continue to live with friends or relatives because there is a waiting list for a place to rent.

The solution must be based on supply. We need to ensure more places are available for people to rent, which will moderate prices and bring them down. The last time rent prices in Ireland fell was because the mismatch between supply and demand was corrected, and there was more supply than demand for rental properties. That is why we have put such effort into increasing supply.

Into selling off oversupply by NAMA.

Some 18,000 new homes were built last year and we are aiming to have more than 20,000 homes built this year - around 25,000 in fact. The policy is to ensure there is a greater supply of housing: social housing for people on the housing lists; private housing for people who want to buy because most people want to buy their own home; and places available for people to rent.

Any other measures such as rent caps, rent-pressure zones or whatever formula we use are only treating the symptoms and are not actually treating the problem. However, symptomatic treatment is important while we solve the underlying problem. That is why the Minister for Housing, Planning and Local Government is introducing additional measures to strengthen the rent-pressure zones, to make them more enforceable by giving more powers and resources to the RTB; to change the way they are calculated so that they are calculated differently outside Dublin, because there are parts of the country that would be rent-pressure zones but they are not because the Dublin rents distort things; to extend the notice-to-quit periods and other such measures; and to extend the rent-pressure-zone rules to student accommodation, an issue on which the Minister of State, Deputy Mitchell O'Connor, and the Minister, Deputy Eoghan Murphy, have worked very closely, recognising that many people in student accommodation have seen very big increases in their rents because they had not been covered by this legislation to date.

Of course, the issue needs to be cured and the cure is to increase supply. There is a way of doing that quickly. We have public land and the Government should use public money to build public houses on public land. In the meanwhile, before we actually implement the cure, we need to treat the symptoms. People are in pain and that pain needs to be addressed and alleviated.

We suggested the introduction of a national cap on rents because people cannot afford existing rents. If we had a national cap on rents, we would not have the instant pressure on the next zone that is outside the current line for the rental pressure, where they can increase, as we heard in one instance, by 30% because they think that they will be next. Let us have a national rental zone and link it to something sensible such as the consumer price index or wage inflation, not to an arbitrary figure of 4% which makes it unaffordable.

We need to increase supply dramatically and we need to see dramatic action, as set out in our own proposals, to deploy €16 billion to build public and affordable houses on public land, but in the interim we need to allow people to continue to rent and not be in mortal fear of not being able to afford their rent or find they have to commute inordinate distances to keep themselves in a job.

We agree that supply is the solution. We have a rising population, increasing by about 1.5% a year - very few countries in the western world have a population increasing as fast as ours - and we also have an emerging phenomenon of smaller household sizes, so we need a great deal of extra housing every year just to stand still. We agree that supply is the solution to the underlying problem, and addressing that is what we are doing. A total of 18,000 new homes built last year. One in four of those new homes were for social housing built by local authorities or affordable housing bodies. I do not know the last time we built one in four houses for social housing but that is what was done last year. It was probably the biggest social housing programme in decades, and that needs to continue. We want to increase that to about 25,000 new homes this year. If we could ramp it up quicker, believe me, we would, but we have not been able to do that.

We considered the introduction of a national cap on rents a year or two ago and there were a number of reasons we concluded that was not a good idea. First, we do not have a national rental market. Dunmanway is very different from Cork city and Cork city is very different again from Dublin.

The issue is the rate increase.

Treating the entire country the same when it comes to rents is a mistake and it might do more harm than good. The other concern we had with a rent cap, as in zero increases, is that it in itself might affect supply. We know that to deal with this problem-----

It should not affect the capacity at this stage.

-----we need more properties available to rent. We need people to rent out properties they own.

Where did the Government get the 4% figure?

A major concern was that by having a cap it might reduce supply, thereby not allowing us to solve the underlying problem, which we acknowledge is supply.

Transport Infrastructure Ireland stated recently that 70% of people who commute to work use their cars to do so. Sixty percent drive and 10% travel as passengers. There is daily gridlock on the roads leading into Cork city. For example, tens of thousands of motorists use the south link road daily. People from west Cork in my constituency travel daily to Cork city for work. People are spending hours on the road driving, often stuck in traffic on outdated roads starved of proper funding. I would point to the unfinished southern bypass in Bandon and the proposed two-phase relief road on the northern side of Bandon, which if it goes ahead in two phases would be a disaster for Bandon as we go forward. I point to the promised bypass for Innishannon, which was an election promise but it has not been delivered on. While I acknowledge there has been some resurfacing of damage to the N71 road, the main N71, R586 and R585 roads to west Cork desperately need funding to bring them up to an acceptable standard.

The existing public transport services from west Cork are not sufficient to meet the needs of the people. Fares are too high and timetables are not always suitable. While I recognise the Kinsale bus serves the airport, it is difficult for other commuters from west Cork using public transport to access the airport. Accessing the railway station using public transport from west Cork is almost impossible, with many people having to walk from the bus station in Cork to the railway station. Many commuters using the Cork to Dublin train are forced to use their cars to access the railway station due to the lack of suitable public transport, especially from rural regions of the county.

I want to concentrate on a solution. I know there is no hope of getting rail to west Cork but the Taoiseach can ensure something is done. Will the Government consider putting in place a park and ride type service for west Cork as a pilot project? Specifically, a park and ride type service from Clonakilty to Cork city would be of major advantage to workers and others travelling to the city. If such a service was properly run, it could have buses linking from Skibbereen to Mizen Head, from Dunmanway through to Bantry to the Beara and Sheep's Head peninsulas and could also cater for people from Bandon, Innishannon and surrounding areas on its way to Cork.

For every 40 people travelling by public transport to work, 30 cars fewer would be on the road. The reduction in traffic congestion and carbon emissions could be considerable. If fares were competitive, timetables suitable, and wheelchair accessible buses used, with some buses servicing the airport and railway station, this type of service would have the potential to be hugely popular. It would also give financial ease to families who are financially squeezed at this time and who may not require a second car in the home.

Is the Government willing to request Transport Infrastructure Ireland, TII, to pilot a park and ride system from Clonakilty to Cork city? I am confident it would get backing from the local community in west Cork and, for example, I believe sporting organisations and other community groups would not be found wanting in regard to parking facilities if this service was piloted. This park and ride service could be tendered out by TII. Companies like Bus Éireann, LocalLink or private operators could tender for the service, which could become cost-neutral.

I thank the Deputy. I am delighted that Cork is getting so much attention on Leaders' Questions today. We have great ambitions for the beautiful second city. As the Deputy knows, our ambition is that the population of Cork will increase by 50% between now and 2040 and that Cork will grow at double the rate of Dublin between now and then.

How is that conference centre coming along?

Some houses would be helpful.

To make that possible, we need investment in infrastructure, including investment in transport, and we need to look at Cork in the round, not just the city area but the whole city region stretching into west Cork, as well as east and north Cork, of course.

In terms the Deputy's specific suggestion, I will take it up with TII and the National Transport Authority, NTA. We have had mixed experience of park and rides. Sometimes they work and sometimes they do not. Perhaps the suggestion the Deputy makes would work but it would require the NTA, TII and Cork County Council to work together. I will take up the suggestion with TII and see if it is a feasible solution.

In terms of other investment, the Deputy will be aware the enabling works have begun at Dunkettle, and anyone who knows Cork will know the kind of congestion that is faced at the Dunkettle interchange. As I said, those initial works have started. There will also be progress this year on the N28 and N22, thereby improving the road network in Cork. The bulk of road investment now is happening in the north west, the south west and the south east, and there will also be investment in public transport, with a BusConnects programme for Cork, which will reduce traffic in the city and make things better for people who live outside the city and are commuting into it. The NTA is also working on a new Cork transport strategy, which I anticipate will leave open the option of a light rail system for Cork, which will be needed in the decades ahead.

The Taoiseach is probably aware that, in 1886, we had rail right through west Cork to Schull and, in 1892, on the northern side of west Cork, we had rail all way to down to Bantry. It is astonishing that, in 2019, not alone do we not have rail in west Cork, we do not even have a connecting bus service to the train station from west Cork. A spokesperson from the Automobile Association is quoted as saying recently that the recovery in Cork will be hampered unless traffic gridlock is dealt with. As a country, we will not meet our reductions targets for carbon emissions and may face massive fines. In rural Ireland, most people are being forced to use their cars to get to work due to the lack of public transport. A park and ride service, if properly planned, could help reduce our carbon footprint and give greater ease to stressed motorists in west Cork.

In 1886, we had railways all over the country. We did not have so many roads and we had no dual carriageways, no motorways and very few people owned cars, so it was a very different world back then. It was the development of the roads and the expansion in car ownership that caused the railways to close in the first place because they became non-viable.

When it comes to Cork, as the Deputy knows, our ambition is to increase the population of the Cork city region by 50% between now and 2040 and to ensure that it grows at twice the rate of Dublin. We have an opportunity in Cork to learn from the mistakes made in Dublin and to get it right. That involves a lot more high density development in the city centre area, in Tivoli, the docklands and all around that area, which is very much part of Project Ireland 2040. It also means getting public transport right. That is why we have set aside €200 million for BusConnects to make sure Cork has a much better bus service, and it is why we need to listen to suggestions, such as the Deputy's suggestion on park and ride.

As I said, I will take that up with Transport Infrastructure Ireland and the National Transport Authority.