Léim ar aghaidh chuig an bpríomhábhar

Dáil Éireann díospóireacht -
Thursday, 13 May 2021

Vol. 1007 No. 1

Saincheisteanna Tráthúla - Topical Issue Debate

Health Promotion

I begin by complimenting the work of our national broadcaster, RTÉ Radio 1, on its work this week to provide a platform for the women of Ireland to give personal accounts of their own stories, their personal menopausal journeys. It has been liberating to hear them open up about women's health issues and, for far too long, an issue that has been buried behind walls of fear, shame, denial, hurt and ignorance. Joe Duffy allowed these women to kick the lid off decades of silence on a topic that needs a radical shift in attitude from our health service. We know that 40% to 70% of women in Ireland say that menopause is still a taboo subject. Education and research are central to removing taboos around menopause, informing women about a key life change and recognising it as part of a life course approach to women's health. From my research, the HSE states that only one in ten women seek medical advice when they go through menopause. While menopause may not impact all women, some are affected and find it difficult to function in the course of their normal life.

I seek a commitment from the Minister of State for a public awareness campaign to break the taboo and stigma of speaking about menopause. I compliment the Minister of State because in my time in Dáil Éireann and long before my time, she has proven herself to be one of the most proactive and progressive Ministers with responsibility for health as part of the team in Dáil Éireann. I have absolute confidence that she will deliver on this important issue for the women of Ireland.

Key to all of this is education for the next generation of young women. That is why I am calling on the Minister of State to collaborate with the Minister for Education, Deputy Foley, to deliver menopause education through the social, personal and health education curriculum for all teenage boys and girls, as introduced in the UK in July 2019. This is important as raising awareness of menopause and perimenopause will enable the issue to be discussed for women transitioning from menopause to seek and receive support. It is clear that menopause is under-represented in what we discuss and there is a lack of information which can leave women going through this especially difficult part of their life misdiagnosed and feeling that they are alone, when they are actually experiencing common symptoms which other women in their lives, around them and in their community have.

We must support women to lead healthy and fulfilling lives through menopause and we can do that. We need to provide the information about menopause, its symptoms and its impact, and provide a space for women to have conversations about their personal, lived experience with menopause. It would be remiss of me not to mention the Midlife Women Rock Cafés which began in County Waterford. I heard them yesterday on Joe Duffy's show, talking about how they started as a small acorn and have now developed in to a big oak tree, and they are now delivering those information cafés virtually across the country. As somebody who is from that county, I ask the Minister of State to look at that as a model that could be rolled out to provide compassion. That model is there and appears to have worked and they have all of that experience. It is another part of the model of care that we could provide and look at.

We should help women to find solutions and supports for themselves, supporting women in their own lives. This is not just an issue for women but also for men. Men should be aware, educated and able to provide women support in their lives as they go through this difficult journey.

I thank Deputy Smyth for providing the opportunity to speak to the activity both under way and intended in this area. I agree with the Deputy that the broadcasting in the last two weeks, although I have not heard all the programmes myself and will listen to them later, did the State some service. I was looking over the notes tonight and saw that the topic was menopause. As one of the Ministers of State at the Department of Health, I am probably well placed to speak on menopause. It is timely that we are having that discussion, that I am here tonight and that I can understand what some of those women are going through.

It is important that the Government recognises that menopause is a key health issue for women in Ireland today, and work is under way to drive progress in this area. This is being driven by the women's health task force, which was convened in September 2019, to improve health outcomes and health experiences for women and girls. A number of initial priority areas for action were determined by the task force, with the issue of menopause recognised and included as one of these priority areas. It is great that that has happened. I thank Deputy Smyth for her interest in so many issues related to women's health. As Deputy Smyth quite rightly said, there is a taboo about talking about menopause openly when it affects so many people's lives. Some 51% of the population of Ireland are female. Many people have husbands and partners so men know much about menopause too. It is great to have us talking on the airwaves about issues which affect everyday life.

Work was undertaken in 2020 to identify areas for activity related to menopause. Evidence, research and stakeholder engagement, which included advocates and women who had experienced menopause, health professionals and policy makers, informed a number of suggested actions to enhance supports for women through menopause. Final actions are still under discussion and development, and it is hoped to announce finalised activity shortly.

The issue of menopause has also been emphasised through the nationwide "radical listening" exercise, which is currently under way, by the women's health task force. This exercise aims to enable women across the country to share their views and experiences of the health sector and health services. There is a large-scale consultation process intended to maximise the participation of women across all life stages from 18 years upwards, including minority and disadvantaged women. A representative sample of 228 women have participated in open interviews and workshops to date, and interim findings have highlighted issues, one of which is menopause. Through this process, taboo around discussing menopause and a lack of trusted information were consistently raised as key issues for women experiencing menopause.

As the Deputy said, increased education and information on menopause is one of the clear requests that has been raised by women, and I am happy to share commitments to deliver on this today. Menopause will be included as a topic within the new online citizen health guides, which are under development by the HSE to meet the health information needs of Irish citizens. Online citizen health guides will support the current and future information needs of citizens by providing a reliable, single source of information which can be republished across other healthcare systems. A women's health information repository site of trusted sources will be developed over the coming months, which will include the topic of menopause. The women's health task force intends to run an education and communication campaign to highlight information on specific women's health issues, which will include menopause.

I thank the Minister of State. Her response is positive news. As the Minister of State knows, the women's health task force has identified menopause as a critical issue as it affects every woman in the country and a spectrum of supports is needed. It noted that for something with such far-reaching impacts, it is very much overlooked. Following wide consultation with women around Ireland, it has called for us to reframe that conversation to reduce stigma and to positively impact public conversation. For 2021, it has called for enhanced information, education and access to menopause information and service around the topic. The average Irish woman will spend more than one third of her life in the aftermath of menopause. The quality of her life for these years depends on whether diseases partially linked to menopause, such as coronary heart disease, develop. I believe that there is a body of work to be done around education and support for our general practitioners, GPs, and health workers at the front-line, interacting and engaging with women who are going through this.

One striking comment and conversation for some women was about the lack of healthcare provision through GP services. That is not the case in every GP service but there is definitely a deficiency that we must address. I am delighted to hear the information the Minister of State has imparted tonight. It is good news. Joe Duffy, along with the team in RTÉ, has certainly blown the lid on this. Following the last two weeks of public discourse and debate on the matter, the women of Ireland can look forward to a much more positive and compassionate health service when it comes to menopause.

The Government is committed to improving health experiences and outcomes for all women and girls. The women’s health task force, set up in 2019 to drive progress on this issue, identified menopause as a priority issue. It has listened to women about what they would like to see delivered in this area, and the call for information and education has been heard strongly. The three key points are: menopause will be included as a topic within the new online citizens' health guides; a repository site of trusted sources of women's health information, including the topic of menopause, will be developed over the coming months; and the women’s health task force intends to run an education and communication campaign.

I will take on board the point the Deputy made about having it included in the roll-out of SPHE in secondary schools with the Minister for Education, Deputy Foley. Activity is planned or under way to provide the best support in this area. Women’s health will be represented on the healthy workplace framework implementation group, to be set up later this year. Through delivering this activity, the Department will ensure heightened awareness of menopause and access to trusted information for the women of Ireland.

I thank the Deputy for raising this important issue. The highlighting of women’s health is overdue and is much welcomed. I compliment the Joe Duffy programme for highlighting this issue and giving women the forum that they needed to talk to other people. As I was travelling yesterday, there was a doctor on the radio who was able to answer some really significant questions.

For some of the women, it was the first time they had ever aired or spoken about this subject in public. I am very happy to work with the Deputies to get this over the line.

Hospital Overcrowding

I mean no disrespect to the Minister of State but the senior Minister for Health really should be here when we are talking about University Hospital Limerick, UHL, because it is a massive issue, as she will be well aware. I raised this issue in the previous Dáil whenever I could and I also raised it with the Tánaiste last week. There seems to be a problem in our hospital. One always knows there is a big problem when the nurses ask for someone to do something. They have asked the Health Information and Quality Authority, HIQA, to do an inspection. I reiterate my support for that call. That needs to be done as a matter of urgency. There is an ongoing crisis with trolleys and waiting. Everyone tells me that once they get through the emergency department and into the hospital, the staff are fantastic and that they get a very good service. They are very pleased with that but families are being put under stress. The past year has been very difficult for people. As a result of Covid, families cannot visit or be with people in the hospitals.

I want to put some information on the record. The figures this year are stark. In January, there were 949 people on trolleys in the middle of a pandemic; 914 in February; 1,059 in March; 1,020 in April; and 420 in May to date. This is off the scale, even compared to last year when many people did not go to the emergency department because of the pandemic. Today might be considered a good day in that only 35 people are on trolleys but that is 35 families who were affected. One day last week, there were 75 people on trolleys.

We need an intervention. A modular unit was recently opened. It was supposed to be a panacea that would help fix the issue. It did not do so. We did not expect it to. There is a 96-bed unit in progress. We need to know where it is at. Is it going to be expedited? We were all shocked to hear the HSE's recent statement that only half of those beds would be delivered, rather than 96 new beds. We need to make sure we get the 96 new beds. The amalgamation of the three hospitals, those in Nenagh, Ennis and Limerick, is at the root of this problem, which has been ongoing for a number of years. It needs to be addressed.

I want to address two aspects. The Minister of State will probably be aware that we have had consistently high trolley numbers in Limerick over the recent period. There is an historic issue. There was a consultant's report from Teamwork a number of years ago, which stated that we should get at least 138 additional beds. To date, we have got approximately 98 additional beds, including a 60-bed modular block. These are all single-person bedrooms, which makes them very important in the fight against the Covid virus. They certainly kept the incidence rate in the hospital and, by extension, the rate among people in Limerick, down. What plans have been put in place to reduce the number of people on trolleys, which has been, on average, 54 this month? Planning permission for a 96-bed block has been granted to the HSE. The project is due to go out to tender and a preferred bidder will probably be in place by the end of the year. We must ensure this is approved by the HSE board and included in the Government's capital programme so that we can start to build next year with a view to completion by early 2024. Will the Minister of State give us an update on the status of that 96-bed block so that we can reach that critical number of 136 or more? I believe we need more because of Covid and because of the correct move away from Nightingale wards towards single-bed rooms, such as exist in the 60-bed block. This four-storey block of 96 acute beds is to be built over the existing dialysis unit in the hospital. Will the Minister of State give us an update on that? We want to see not only the 98 beds, including the 60-bed block, but also this 96-bed block being built as quickly as possible.

I welcome this opportunity to address the House on the issues raised by Deputies Quinlivan and O'Donnell. I have heard both Deputies raise similar issues on many occasions. I acknowledge the distress that overcrowded emergency departments cause to patients, their families, and the front-line staff working in very challenging conditions in hospitals throughout the country. I also acknowledge the work of staff and their commitment to ensuring the uninterrupted provision of emergency care throughout the pandemic.

The emergency department at UHL is one of the busiest emergency departments in the country, with 65,824 presentations in 2020. As both Deputies have mentioned, over the past number of weeks, the hospital has experienced considerable demand for inpatient beds. This is attributed to a sharp increase in overall emergency department attendance, particularly among those aged over 75 who present with higher acuity, and to increased lengths of hospital stay. The number of presentations between January and April this year was 22,202, an increase of 10.1% on the same period last year. The attendance of those over 75 has increased by 16%.

Additionally, while attendance and admission numbers have now returned to pre-pandemic levels, the continued requirement to provide separate Covid-19 and non-Covid-19 pathways presents an additional challenge to patient flow in all hospitals, including UHL.

The winter plan provided several hospital avoidance measures to support UHL. These include the appointment of a dementia adviser, recruitment for enhanced community care in the south of the city and west Limerick and additional capacity in Nenagh and Croom hospitals.

It is acknowledged that acute bed capacity shortages in the mid-west are a major contributor to overcrowding at the emergency department in UHL. The provision of 98 additional beds in the hospital over the past year has been a significant step in addressing this. These include a new 60-bed modular ward block, providing modern, single-room inpatient accommodation. As well as improving patient experience in terms of comfort, privacy, and dignity, it also improves infection prevention and control capabilities, including better isolation of patients, where necessary. The remaining 38 beds were provided through the completion of two separate rapid-build projects delivered under the Government national action plan in response to Covid-19.

Both Deputies asked about the 96-bed replacement ward. I am pleased that funding has been provided in the 2021 HSE capital plan for a 96-bed replacement ward block at UHL. Following receipt of the final grant of planning permission in early March 2021, the design team have now commenced detailed design and preparation of the procurement documents for this development. It is planned to have the project tendered and a preferred contractor selected by the end of 2021. The construction period from contractor appointment will be approximately 18 months. As we know, all capital development proposals must progress through a number of approval stages in line with the public spending code, including detailed appraisal, planning, design and procurement, before a firm timeline or funding requirement can be established.

I thank the Minister of State for her response. I will come back on the 96-bed unit. Our concern is that the HSE recently told us that there will not be 96 additional beds, but 48. This will not address the problem we have. Unfortunately, there are more than 48 people on trolleys in UHL every day, which is a national scandal. I agree with the call from the INMO for HIQA to investigate the hospital. That should be done as a matter of urgency. I thank all the staff in the hospital, who have done a really good job. I refer to the consultants, the nurses, the porters, the kitchen staff and everybody else in that hospital. Unfortunately, I have family members there myself. It is very difficult for families. We cannot continue like this. We cannot continue having to come into the Dáil every week to talk about a service that should be delivered to everybody. Everybody is equal but there is a sense in the mid-west that we are not equal. The three hospitals announced the other day are to be situated in Galway, Cork and Dublin. Limerick was forgotten about again. There was no vaccination centre in Limerick; it was in the Radisson Hotel in Clare. The new one is to be located in Patrickswell, which is welcome but, again, Limerick feels left out. I hope this will be addressed.

I thank the Minister of State for her response. I seek clarification of a number of points. First, after the 96-bed block has gone to tender and the preferred bidder is in place, will the Government support its approval by the HSE board? We can get that block started in January and then built. It will be a significant build of 18 months of thereabouts. Second, will a plan be put in place now to determine how to reduce the number of people on trolleys? This month's average of 54 is too high. In that context, I acknowledge the fantastic work being done under difficult circumstances by the staff at UHL. People get great care there.

Our region has an historical issue. The 60-bed block has made a major difference, as has the 38-bed block, but we need the 96-bed block. We may even need further beds in future, but the 96-bed block must be got under way as quickly as possible.

I have with me the response from the Minister's office. To be clear, Project Ireland 2040 includes provision for a 96-bed replacement ward block at UHL. Funding for this design work has been provided for in the 2021 HSE capital plan. Following receipt of planning permission in early March, the design team has commenced work on the detailed design and preparation of the procurement documents for the development. The Department of Health and the HSE will continue to work with local hospital management to improve the patient experience in UHL further.

It is accepted that the national development plan provides for the recommended 2,590 additional beds. Compared with the number of beds available at the end of 2019, an additional 834 beds have been provided on a permanent basis. The Programme for Government: Our Shared Future commits to continuing investment in our healthcare services in line with the recommendations of the health service capacity review.

I will take the Deputies' comments on board. It is no secret that University Hospital Limerick has been plagued for a long time with a large number of people on trolleys. We hear about it in the House on a weekly basis. The provision of the 96-bed replacement ward will make a significant difference. As Deputy O'Donnell pointed out, though, it must happen very quickly. I will bring the Deputies' concerns to the Minister.

The Minister of State's assistance in these matters is appreciated.

Housing Policy

I am grateful for the opportunity the Ceann Comhairle has given me to contribute. I acknowledge the courtesy of the Minister, Deputy Darragh O'Brien, in alerting me to his inability to take this matter, for which he has a good reason.

I voted against the programme for Government last year. I stood alone on the issue of strategic housing developments, SHDs, having witnessed their impact on my constituency, including their lack of democratic input and transparency and the fact that they so easily ignore and override local area plans and county development plans. As the Ceann Comhairle well knows, county development plans are arrived at by democratic agreement following what is usually 99 weeks of extensive public consultation and engagement and are approved by locally elected public representatives who have, by the end of the 99 weeks, attained a solid sense of what their communities can bear, taking into account national imperatives around housing needs.

The recent furore around investment funds seemed to surprise people, yet the first such bulk buy that I witnessed was of the former Notre Dame convent site in south Dublin. Young couples had eagerly placed their names on the list for apartments to buy in the development only to be told when the apartments were completed that none of them was to go for sale on the open market and that all of them would be rented. That must be close to four years ago. I believe it was an Irish pension fund that invested in them.

Strategic housing developments are a tantalising prospect for investment funds. We now see that some of them are applying the same rules to residential developments as they have applied to commercial developments for many years, leaving vacant units lying idle rather than reducing their rents in order to maintain the capital value of those units over time and keeping local rents high to boot.

From 2019, I witnessed the torrent of young adults returning, quite literally in their droves, to their family homes. No matter how loving the welcome or how secure the tenure offered by their parents, being forced to return home to live with one's folks because one cannot afford rents is humiliating and embarrassing, strong emotions that, if left unresponded to, will surely manifest in individual and public anger eventually.

The journalist, Mr. Killian Woods, wrote extensively at the time of the introduction of SHDs about how developers had pulled the wool over the eyes of officials and the then Minister for Housing, Planning and Local Government, who were sold on the concept lock, stock and barrel because SHDs promised fast-track planning. However, half of the permissions granted in 2018 and 2019, never mind in later years, have not been acted on and no ground has been broken on them.

Disturbingly, it is not only apartment developments that are now subject to either SHDs or bulk buying in my constituency, but even housing estates are becoming build-to-rents at colossal rents. One such estate is White Pines on Stocking Avenue. Twenty SHDs are in the system for Tallaght, the most famous locally being the Cosgrave lands in Knocklyon, where almost 600 apartments will be built to rent close by mature residential estates housing the very same young adults who have been forced home to live because they cannot afford market rents. The worst example that I have heard of was of a 60-year-old woman who had returned to live with her 80-year-old mother because she could not afford a rental in Dublin.

Investment funds have a place in the modern building environment but they have begun to dominate it in my constituency.

I thank Deputy Lahart for putting the case so strongly, well and passionately.

The Planning and Development (Housing) and Residential Tenancies Act 2016 introduced for a limited time new streamlined arrangements to enable planning applications for strategic housing developments of 100 housing units or more, or student accommodation or shared accommodation of 200 bed spaces or more, to be made directly to An Bord Pleanála for determination. The primary purpose of the SHD arrangements was to speed up the planning decision-making process, thereby providing greater planning certainty for developers in terms of the timelines within which proposals for such developments could be determined, while fully respecting the statutory requirements for public consultation in respect of such proposals.

The SHD arrangements have been successful in delivering on this objective, resulting up to the end of March in the granting of planning permission in respect of 49,291 housing units, comprising 12,991 houses, 27,816 apartments and 8,484 build-to-rent properties, as well as 769 shared accommodation units and 12,173 student bed spaces. In particular, the number of apartments approved annually under the SHD arrangements trebled in the period from 2017 to 2020.

SHDs are, by their nature, developments of at least 100 units. The financing of large-scale developments and the viability of apartment development in urban areas are challenging. This is an area where investment funds can, and do, play a role to enable investment and promote viability. This represents additionality in terms of supply, which would not otherwise have come forward for rent or purchase. Enabling development at scale in urban areas, particularly of apartments, is key to ensuring that we meet the need for housing in the coming years, which we know is likely to be around 33,000 dwellings per year.

However, the Government shares the concerns expressed widely regarding the purchase by investment funds of traditional houses that might otherwise have been sold to ordinary families. The Government has clearly signalled that they should not be competing with first-time buyers and it has committed to proposing as a matter of urgency appropriate solutions through a mix of planning and taxation or related measures to ensure that the pathway to home ownership is protected in low-density suburban developments and enabled in high-density apartment developments.

The Government will take steps to deal with this issue and the relevant Ministers are working on proposals in that regard.

I note the points raised by the Deputy in terms of the impact on his constituency, particularly in Tallaght. There probably are some unforeseen consequences of what were intended to be good provisions. Good legislation can sometimes have unintended consequences.

I thank the Minister of State. I take this opportunity to acknowledge the focus and motivation of the Minister, Deputy Darragh O'Brien, in this area. I commend his incredible energy in addressing his portfolio.

This issue is worthy of interrogation. The Minister of State pointed out in his reply that the arrangements for SHDs apply for a limited period. One of the reasons I voted against the programme for Government was the inclusion of provision for SHDs, although Fianna Fáil has succeeded in ensuring the limited time extension will lapse on 31 December this year. The problem is that this time limit accelerated the rate of SHD activity. Developers know the scheme is coming to an end in December and have piled on the applications. Half of the permissions granted have not been acted on. If a developer gets planning permission via a SHD for 1,000 units, there is a huge increase in the value of the land to which the application pertains. The Minister of State said that permission has been given for more than 27,000 apartments. How many of them have been built? The number of planning permissions granted for apartments has tripled but, as I said, only half of the developments that were given permission since 2018 or 2019 have been built.

My concern is that the rents being charged on these apartments leave absolutely no saving room for those who rent them if they want to move on and buy their own homes. That is assuming they can afford the rent. In my constituency, people are looking at paying approximately €2,000 per month. In addition, as I keep saying, these apartments are being built adjacent to housing estates where young people have returned in droves to live in their family homes because they cannot afford current rents. As Killian Woods recently pointed out in the Business Post, vacant apartments in these new blocks will be left idle rather than let at a lower rate in order to protect the ongoing capital value of the entire development. We have seen the same thing happen with shopping centres and other commercial developments for a number of years. Rather than reduce the rents, the funds are leaving the apartments idle or, in some cases, as we are learning from Killian Woods, they are offering incentives for tenants to rent them.

There is no doubt that the Deputy is correct in his points. He highlighted in his opening comments a lack of transparency and public engagement around SHDs, which he described as "a tantalising prospect" for development funds and a cause of inflated rents. They have undoubtedly had a distorting impact on the housing market. I take on board the point that putting a deadline into the legislation at the outset has perhaps led to a rush of applications for SHDs. However, viability in the housing sector remains a very significant issue. Any combination of planning and taxation measures to support home ownership in lower density types of developments must be balanced and proportionate, while remaining cognisant of the ongoing viability issues.

The Minister, Deputy Darragh O'Brien, recently brought to Cabinet measures that will increase Part V provision from 10% to 20% and include affordable-purchase housing as well as social housing. That will prevent investment funds from snapping up entire developments. We will also continue to prioritise the range of measures that are in place to increase supply and support first-time buyers to take their first step onto the property ladder. The SHD arrangements are being extended to 25 February 2022, after which they will expire. Work is ongoing on the development of new legislative proposals for the wind-up of the current SHD arrangements and dealing with the submission of large-scale housing planning applications, including student accommodation, to local planning authorities. It is intended to publish the general scheme of a Bill for this purpose as soon as possible.

Road Safety

I raise the issue of safety on our rural roads because another family has suffered an unbearable loss this week. Another innocent life has been taken, that of Aoibheann Duffy, an 11-year-old girl from County Kerry who was out for a cycle on a summer evening near her home. We have failed this young girl and her family. We have failed in our duty of care towards people living in rural areas. We have failed because we are willing to tolerate roads that are simply no longer safe for the people living along them.

This is a relatively recent phenomenon. It is only in the past 20 or 30 years that our rural roads have become the sole preserve of the car, van and truck. Before that, our roadways were shared and people could, and did, walk and cycle safely on them. Vehicles have got bigger and faster and roads have been widened and designed for speed to the extent that many families are locked inside their front gates, unable to go anywhere unless they do so by car. We have made people in rural Ireland more dependent than ever on cars, with all the dire health and social impacts that go with that. In our towns and cities, we have rightly adopted a hierarchy of road users when we design roads. This hierarchy states that we must satisfy the needs of the most vulnerable first. The order of priority goes from the most vulnerable road user to the least vulnerable. In rural Ireland, perversely, we have, in effect, inversed that hierarchy and it is the fast, powerful vehicle that dominates.

I know the Minister of State, Deputy Noonan, has a commitment to active travel and to the health and environmental benefits that travelling under one's own steam brings. He and his colleagues, the Minister for Transport, Deputy Eamon Ryan, and the Minister of State, Deputy Naughton, have been starting a revolution in active travel, with unprecedented investment in walking and cycling infrastructure, safe routes to schools and greenways in rural areas. We need to give more attention to our rural roads. Cycling and walking are not solely urban activities. We must afford everyone the opportunity to get the exercise they need to stay healthy. In addition, not everyone wants to, or can, use a car for all their daily mobility needs. Making our rural roads safer to walk and cycle on is the fair and right thing to do for our environment, our health and our society.

We can do more to stop families from experiencing the preventable death of a child on the roads. I want to extend my sympathies to the Duffy family in Kerry and, indeed, to all the families who have lost loved ones in road accidents. One of my own family members was killed by a driver while cycling and I know the hurt and pain of such a loss can persist for decades. In the Netherlands, an active travel revolution was started in the 1970s with the call to "Stop de Kindermoord", which means "stop the child murder". This past year has demonstrated the capacity of the State to act to prevent premature deaths from the coronavirus pandemic. We have stayed at home, worn masks and kept our distance. We do not have to shut down our economy to prevent children from dying on the roads of rural Ireland. We just need to stop, think of the unbearable grief suffered by families and demonstrate the same capacity for action to prevent the premature deaths of children in road accidents.

I thank Deputy Leddin for raising this matter, which I am taking of behalf of the Minister of State for Transport, Deputy Naughton. First, I take this opportunity, on behalf of both the Minister, Deputy Eamon Ryan, and the Minister of State, to express our deepest sympathies to the family of Aoibheann Duffy, who was killed in a collision near Abbeydorney on Monday night. Any death on the road is a death too many but we can all agree that the loss of a young child - in this case, only 11 years of age - is desperately sad.

I understand Aoibheann was cycling near her home on Monday when she was struck by a van. This has become an all too familiar story on our roads, particularly in rural Ireland, as Deputy Leddin outlined. While we have made remarkable progress in the field of road safety over the past 20 years and fatalities on Irish roads have reduced dramatically since we first started following a strategic approach to road safety in 1998, deaths and serious injuries among vulnerable road users remain a serious concern. The next road safety strategy, which will run from 2021 to 2030, is being prepared by the Road Safety Authority, RSA, and the programme for Government has committed to focusing the new strategy on protecting vulnerable road users, particularly pedestrians and cyclists.

As the Deputy is aware, rural roads throw up a whole different set of infrastructural and safety challenges compared with roads in more built-up, urban areas. I must make absolutely clear that the improvement and maintenance of regional and local roads is the statutory responsibility of each local authority, in accordance with the Roads Act 1993. Works on those roads, including the maintenance of traffic management systems and the responsibility for setting or amending speed limits, lies with the elected members of the relevant local authority.

The provision of footpaths and cycle lanes also falls under the responsibility of local authorities. Under the regional and local roads grants programme operated by the Department of Transport, provision has been made for local authorities to apply for funding for safety improvement works. It is the responsibility of the local authority to identify and determine the appropriateness of schemes for submission for safety improvement works. The Department also provides a range of publications to local authorities to assist them in promoting safer interaction with road users. These include the Department's updated guidelines for setting and managing speed limits across Ireland, which outline: a range of criteria relating to the setting of speed limits; the traffic management guidelines, which detail the options available to local authorities to facilitate traffic calming measures; and the traffic signs manual, which is a ministerial directive published by the Department of Transport and is the standard for signing and road marking in this country. While the provision of safer infrastructure is critical to bringing down the number of cyclist and pedestrian fatalities, it is clear that this goal cannot be met through infrastructure alone. Protecting the safety of vulnerable road users demands a multifaceted strategy to promote a greater understanding of and a mutual respect between everyone who uses the road, irrespective of the mode of transport.

As the House may recall, the previous Minister with responsibility for transport, Sir Shane Ross, introduced a new law in 2019 making it an offence for motorists to dangerously overtake cyclists. It is the intention that this law, bolstered by widespread RSA education and media campaigns, will lead to a heightened awareness of the importance of sharing road space in a respectful and considerate manner. Nowhere is this respect and awareness more important than on our network of rural roads. Deputy Leddin is correct: as the summer approaches it is so important that people can go out and enjoy our rural areas on whatever mode of transport they choose and should not have to face into these terrible challenges, with speeds reaching sinister and dangerous new levels.

As the Minister of State has acknowledged, we have made progress on road deaths, and fatalities have decreased significantly in the past decade. Paradoxically, however, by making roads safer for those in cars, vans and trucks, we have inadvertently made them lethal for those who are not in such vehicles. It is a questionable success if it relies on our roads being so dangerous that our young and old are too terrified to walk or cycle along them because of the high risk they bring.

There is one area that could be examined in respect of our rural roads. This year we have budgeted €584 million for the maintenance and upkeep of regional and local roads. Work in this regard is managed and funded through our local authorities. I am aware of arguments that this is necessary investment to achieve a steady state in the condition of our regional roads, but I would argue that if this is a steady state that involves children getting killed while walking and cycling, it is an unacceptable steady state. Most of our regional roads in rural areas are bordered by drainage ditches and hedgerows. There is scope on many if not most regional roads to provide a segregated section for walkers and cyclists. It may require narrowing carriageway widths in some places and taking away parts of ditches but it is very possible and is done in other countries. If we did this, we would provide people living in rural areas with the freedom to leave their front gates in safety. While we maintain and upgrade rural roads with that approximately €500 million annually, we can also make them much safer for children and adults who wish to go for a walk or to hop on a bike.

I thank the Deputy again for raising this matter and for the contribution he made. There are many factors involved in road safety. Vehicle standards, road conditions and, above all, road user and driver behaviour have an impact on how safe our roads are. In just over two decades we have seen a large reduction in the number of fatalities on our roads, from 472 in 1997 to a record low of 138 in 2018. This remarkable transformation was due to many actions by many people and organisations and was achieved against a backdrop of a significant increase in the number of vehicles on our roads. However, we cannot be complacent. As the number of deaths has reduced, it has become harder to get it down further. In 2020 there were 149 deaths, nine more than in 2019, and this happened in spite of an unprecedented drop in traffic volumes as part of that period during the pandemic. Both the RSA and An Garda Síochána have indicated that they will focus on education and enforcement for the remainder of the year. Later this year, the RSA is planning to develop a new road safety campaign that will focus on the safety of rural roads. The campaign will have a particular focus on appropriate measures on excessive speeding by drivers and the need to always expect the unexpected.

I thank Deputy Leddin for the constructive comment he has made and his proposal. The Department should give serious consideration to it. It is something that has been raised in my constituency, where rural communities are proposing such infrastructure on rural verges. This is an opportunity we should seize with additional funding for cycling and walking, which was unprecedented in the most recent budget. It is vitally important we tackle this issue. As already stated, young people and people of all ages should be able to enjoy our rural countryside in safety without vehicles getting faster and bigger. We have a serious challenge ahead but it is important that the Government tackles it.

I thank the Minister of State for being here to deal so sensitively with this vitally important matter and I thank Deputy Leddin for raising it. I am sure I can say on behalf of the House that we all join the Minister of State and Deputy Leddin in extending our deepest sympathies to the family of Aoibheann Duffy on their agonising loss.

The Dáil adjourned at 7.47 p.m. until 2 p.m. on Tuesday, 18 May 2021.