Dáil Éireann díospóireacht -
Thursday, 9 Dec 2021

Vol. 1015 No. 6

Saincheisteanna Tráthúla - Topical Issue Debate

Mental Health Services

Deputy Maurice Quinlivan

I did not realise the Minister of State, Deputy Feighan, worked for the Department of Justice.

I welcome the pilot 24-7 multi-agency mental health de-escalation team, which I understand has been set up in my own city of Limerick. It is something I welcome and support. Unfortunately, like most of the country, in Limerick issues regarding mental health have increased over the course of the pandemic. One of the things that the pandemic has cruelly demonstrated is how woefully under-resourced our mental health services are. Mental health is as important as physical health. A mental health concern is as big an impediment to an active life as any physical injury, but like an injury, if the resources are not provided, a mental health challenge cannot be addressed.

In Limerick, we have seen the child and adolescent mental health services, CAMHS, become overwhelmed with referrals. On many occasions, voluntary organisations have stepped up and have done an incredible job in supporting those in need. While there are many groups that I do not have time to mention, I would like to particularly commend the work of volunteers at the Limerick Haven Hub, Limerick Suicide Watch and Limerick Treaty Suicide Prevention, who do fantastic work on a voluntary basis.

The recent budget presented an opportunity to address the underfunding of mental health services. It missed the mark. What we needed was real investment. Sinn Féin proposed an investment of €113 million, but the Government has offered the equivalent of a lick of paint when the whole structure needs investment. The final outcome of the failure to treat mental health issues is often, sadly, suicide. In my home county of Limerick, we have lost too many - often young - people to suicide. Too often, the sound of a helicopter over the River Shannon is a signal that, tragically, another life has been lost and another family has been devastated by suicide. As such, any project or scheme that can alleviate pressure on these organisations while delivering care to those who need it should be welcomed and supported. My understanding of this pilot scheme is that it will be a multi-agency scheme that will involve mental health professionals, paramedics and specially trained gardaí. If a person is experiencing a mental health issue locally, then a specially trained team will contact them, triage them, treat them, and bring them or refer them to appropriate services. The scheme was part of a motion on the mental health crisis put forward by my colleague, Deputy Ward.

Deputy Mark Ward

I am delighted to have the opportunity to discuss this pilot project in Limerick for a multi-agency mental health de-escalation team. It is a mouthful, but it is a really welcome initiative. When I got the role of spokesperson on mental health, I said that I would work in a tangible real way in opposition. I will welcome initiatives that are good.

As was mentioned, the triage team contains mental health experts, members of An Garda Síochána and a paramedic. I first heard about this scheme in a pilot project that was rolled out in parts of Belfast by my mental health spokesperson counterpart in the North, Ms Órlaithí Flynn MLA. It was run between the hours of 7 p.m. and 7 a.m. on a Friday and Saturday in parts of Belfast for a year. The results speak for themselves. They were really good. The team had 193 referrals in that space of time. Of these, 94 referrals were face-to-face crisis de-escalation contacts. Out of these crisis de-escalation contacts, they managed to divert 131 people who would have had to attend emergency departments, which is most welcome. It took the pressure off an already-under strain hospital system. It also diverted 61 people from the judicial system. I spoke last week about how the gardaí are the gatekeepers for mental health. The pilot diverted 61 people who, on another day, could have found themselves being charged, despite the fact that they were mentally unwell, because they may or may not have broken the law. This crisis de-escalation team was able to meet, treat and triage them in the community and refer them to the appropriate services.

I am looking forward to hearing the Minister of State's response to the issue, because it is a welcome initiative.

Minister of State at the Department of Health (Deputy Frankie Feighan)

On behalf of the Minister for Justice, I would like to thank the Deputies for raising this matter today. The Deputies will be aware that the Garda Commissioner is responsible under the law for the management and administration of An Garda Síochána, including the training and deployment of Garda personnel. The Minister for Justice has no direct role in such decisions. However, the area of mental health in the justice sector has been a priority for the Minister, Deputy McEntee, so we are grateful for the opportunity to provide an update on this important initiative.

Members of An Garda Síochána in the Limerick division are leading on the implementation of a pilot project that examines, designs and resources a 24-7 multi-agency approach to responding to mental health-related incidents. The Minister, Deputy McEntee, is grateful to them for their leadership on this important project. The assistant commissioner with responsibility for roads policing and community engagement is sponsoring this important project within An Garda Síochána while local Garda management in Limerick is engaged in the design, planning and eventual roll-out of the project. The Limerick crisis intervention team project is in the consultation phase and is scheduled for implementation in the third and fourth quarters of 2022. The intention is that the pilot project will involve a co-located response unit comprising a community psychiatric nurse working alongside front-line members of An Garda Síochána to respond to calls from anyone in crisis.

The project team has engaged with an academic research partner from the University of Limerick who will assist in evaluating the project over a two- to three-year period. This person will also assist the team with policy terminology and language in respect of vulnerability and eligibility criteria. A training programme is also being drafted. The learning from the pilot initiative in Limerick will be of enormous value in shaping a model for crisis intervention teams to be rolled out across the country and ensure that all people with mental health needs receive the support they deserve and are diverted from the criminal justice system whenever possible.

Deputy Maurice Quinlivan

I thank the Minister of State for his response. I really appreciate it. The only concern I have is with regard to the third and fourth quarter of 2022 and I hope it will be done sooner than this. People in Limerick, the Garda Síochána and people who will be involved in this will not be found wanting in delivering the service, which I genuinely believe will be a game changer for many people who find themselves vulnerable. As I mentioned earlier, the community responders include Limerick Suicide Watch, Limerick Treaty Suicide Prevention and the Haven Hub. Their job will be made easier. This initiative will divert people from having to go to the accident and emergency department in Limerick which, as the Minister of State knows, is well overcrowded. For years it has consistently had the highest number of people on trolleys.

This is a very welcome initiative. I believe it will work very well. It will save lives and that is what we are about. I hope that when people see something as positive as this working well in Limerick it will be rolled out throughout the State. I hope to God it will work well in Limerick. I believe it will if we get the resources and support. I imagine areas will be shouting for it once we get it up and running.

Deputy Mark Ward

This is part of Sinn Féin policy. It was part of our alternative budget. It would cost €6.8 million to roll this out across each CHO throughout the State. I welcome the involvement of the University of Limerick. Research is very valuable. I read out statistics from the pilot rolled out in Belfast. We can see how invaluable the service was. The Minister of State mentioned diversion from the judiciary system. This is also invaluable. Last week, I spoke about how the prison system is failing people with mental health issues. This is a way to stop people going into the prison system in the first place. It has to be welcomed. How long will the pilot project be? The Minister of State mentioned two or three years with regard to the contribution of University of Limerick. Will the pilot project be for two or three years? Does the Minister of State expect it to be rolled out in other areas within these two or three years? This would be very welcome.

Deputy Frankie Feighan

I thank the Deputies for raising this important initiative. The Deputies are aware of the recent publication of a report from the Mental Health Commission on access to mental health services for people in the criminal justice system. It refers to the crisis intervention team pilot project in Limerick. The Minister for Justice is grateful to the inspector of mental health services and the Inspector of Prisons for their work on this important issue. The publication of the report is very timely. We know the healthcare needs of vulnerable and sometimes seriously ill people who interact with the criminal justice system are complex and require whole-of-system consideration and priority action. It is widely acknowledged these people are too ill to be in prison as they require urgent medication and treatment. There is a vital need to put in place properly resourced and appropriately located systems of care for those vulnerable people in society. This is also acknowledged in the programme for Government commitment to the establishment of a high-level cross-departmental cross-agency task force to consider the mental health and addiction challenges of those in prison and primary care support on release.

The Deputies asked how long the pilot roll-out is. I do not have this information to hand. I will try to find out. The Limerick crisis intervention team is in consultation phase and is scheduled for implementation in the third and fourth quarters of next year. This is approximately six months from now. I will find out. I invite the Deputies to send an email to me or the Minister and we will try to get this detail for them. I do not have it to hand.

Covid-19 Pandemic

Deputy Ged Nash

As the Minister of State knows, Drogheda is Ireland's largest town and the population of the borough itself is almost 50,000. The very immediate hinterland of the town brings the population of the area to in excess of 80,000. The Government and the HSE would not dream of leaving Waterford city or Galway city without a Covid-19 testing centre but Drogheda is left without one. It seems that nobody is accountable. As the Minister of State knows, I am from Drogheda. I live there. I love my town. I care deeply about it. I am not making a narrow, local, parochial case for Drogheda to have a permanent Covid-19 testing centre or a community vaccination centre. I am making a rational logical case based on the evidence before us and based on our experience.

The Drogheda local electoral areas and the Laytown-Bettystown local electoral area which adjoins Drogheda consistently feature at the top of the charts of the areas most adversely affected by Covid-19 but we still have no vaccination centre. There is no logic to this. This is a real problem in the area. When rates were running at 40 cases per 1,000, and now we are much higher, we had to beg the HSE nationally to provide us with a temporary testing centre in the locality just for a weekend. It made an impact. It works. The evidence is clear. The centre in Louth is in Ardee in mid-Louth. The people there do a very good job. Nobody is debating this or arguing about it. However, 21% of all households in Drogheda town alone have no car. They have no access to private transport. People with symptoms do not want to have to get on a bus or public transport to go for a test because they do not want to run the risk of infecting others. This is a laudable position to take.

Neither does Drogheda have a community vaccination centre. In May, the 50 to 60 age group in Louth were among the last in the State to be vaccinated. I had to make a series of interventions with the HSE to enable them to have the Johnson & Johnson jab administered in the Helix. This cannot be allowed to happen again. The 50 to 60 cohort in Louth and east Meath cannot be left behind. As the Minister of State knows, those over 50 are at risk. Tomorrow, the walk-in centre in Dundalk will be open but not for the 50 to 60 age group. This simply is not on. We know all about the waning efficacy of the Johnson & Johnson vaccine. People can wait no longer. Those vulnerable people cannot be exposed because of the inadequate roll-out of the booster vaccine and the lack of facilities in my locality. It is not safe. It is not on. It is not acceptable. We need a vaccination centre in Drogheda, Ireland's largest town.

Those aged over 50 in Louth and east Meath were badly let down by the HSE nationally in April and May. If we are to tackle this disease properly and if we are to make people safer, testing and vaccination centres need to be provided where people live and where they are. We know the countries that perform best are those that have good testing and contact tracing systems, and have systems in place to respond to the needs in urbanised areas. We simply do not have this, as is evidenced by the fact we do not have a Covid-19 permanent testing centre in Drogheda and neither do we have a community vaccination centre in the locality. I request that the Minister of State address this with the HSE on an urgent basis.

Deputy Frankie Feighan

I thank Deputy Nash for raising this issue to discuss the need for a permanent Covid-19 testing centre in Drogheda. Testing and contact tracing continues to be a key component of the Government’s response to the pandemic and is fundamental to identifying the source and containing the spread of the virus. Demand for testing at this time is very high with approximately 216,000 tests conducted in the last seven days. This demand on the testing and tracing system is due to the high level of infection currently being experienced in the community. The HSE has significantly increased community PCR test capacity to 25,000 tests per day and with the current high demand of people using the self-referral online portal when booking a test, one may find that there are no appointments available.

Appointments become available at different times during the day, so people should try again later. If anyone with symptoms has concerns about booking a test, he or she should contact their GP. The HSE is prioritising those who are clinically referred to it and symptomatic close contacts. The HSE is routinely assessing locations where community testing centres are located. The HSE, in particular, has the goal of ensuring that well in excess of 90% of the population have access to a centre within a 45-minute drive from their residence. I should add that any individual who has a medical condition that prevents him or her from getting to a test centre can be referred by a GP for a home test.

On an ongoing basis, in response to regional demand, the HSE evaluates options to augment capacity through the use of pop-up centres. I am informed by the HSE that there are currently two test centres open in Louth, located in Ardee and a pop-up centre currently in Dundalk. The permanent site located in Ardee was selected following a detailed evaluation as it best met defined criteria, including suitability and sustainability of the location as a long-term testing centre. In addition, travel times from both Dundalk and Drogheda, as the Deputy is aware, are about 25 minutes.

It is important to reiterate the public health advice that anybody waiting for a test who has symptoms of Covid-19 should continue to isolate until they are 48-hours symptom-free. This should minimise any impact for a person who may have to wait a number of days for a test.

The HSE is currently taking every necessary action to respond to the significant current demands, which includes working with private providers to add new capacity, extending the opening hours of swabbing centres, ongoing recruitment and redeployment of swabbing teams, and doubling the number of National Ambulance Service mobile teams. It is currently continuing to monitor the need for testing centres and the most appropriate locations where they open at any given time. This includes ongoing consideration of the need to open pop-up centres, the relocation of permanent centres, or both in response to demand.

The Deputy has asked about Drogheda and, as he has said, it is Ireland’s biggest town with a population of 50,000, which is one of great significance. This is not my area but I certainly feel that the Deputy has a point which he has argued very validly. There was a pop-up centre in operation in Drogheda on 27 and 28 November and 2 and 5 December. There will also be such centres in Dundalk on 6 and Friday 10 December. I agree that for a town that size, the suggestion makes sense and I will bring back the Deputy’s concerns to the HSE. If he wishes, perhaps he might send me in an email and I will pass it on for the attention of the HSE.

Deputy Ged Nash

I thank the Minister of State for his considered response which is greatly appreciated. I know that he will raise it at senior level with the HSE. I believe regional officials in the HSE in the north east understand the requirement for such a centre in the area. I repeat again that I am not making a narrow, local, parochial case for my own home town. It is an observable fact that Drogheda is the largest town in the country and that it has consistently featured at or near the top of the charts of areas most adversely affected since the pandemic hit our shores in early 2019. The evidence is there. We know from experience elsewhere that the countries which best deal with the challenge they face through Covid-19 are those that ensure contact tracing and testing centres are available where people live. Accessibility is key. I have dealt with countless cases over the past number of months of people who do not have transport and who are embarrassed that the very busy National Ambulance Service is mobilised to go to a home to test somebody because he or she cannot make it to the testing centre in Ardee. It also causes great disruption to people’s lives. I can share many cases with the Minister of State of people in very vulnerable situations who could not go for a test as recently as last week because they did not have transport or access to a test in their own locality.

That needs to be reviewed urgently and I repeat again the requirement for a community vaccination centre in the area. The 50 to 60-year-old cohort in the area were, I am afraid to say, left behind last April and May. That cannot happen again and if we are to be successful with the our national vaccine booster programme, we also need not just testing centres in areas where people live and where the population is most concentrated, but we also need community vaccination centres.

Deputy Frankie Feighan

I thank the Deputy and I agree with him that testing and tracing continues to be fundamental to our response to the pandemic. It is critical that we continue to monitor demand for testing to ensure that we can identify and contain the spread of the virus. The HSE are continuously monitoring the demand for testing and attendance rates at both regional and local level in order to ensure that Covid-19 testing is available on a regional basis. As I explained earlier, the HSE has the goal of ensuring that well in excess of 90% of the population has access to a centre within a 45-minute drive from their residence. As the Deputy is aware, the test centre located in Ardee fulfils that requirement.

The current very high demand means that testing is now operating at surge capacity and every effort is being made to ensure that resources are targeted to where they are most efficiently deployed to mitigate the impact of the virus across the entire population. I wish to reassure the House that the national testing policy, including the location of testing centres, is kept under continual review and the HSE continually evaluates the requirement of both pop-up and permanent testing centre response to the emerging demand. I am no expert in this area but there is a case to be made, in my opinion, for Drogheda as the largest town with a population of 50,000 to have a testing centre within walking distance of those 50,000 people. I will bring that opinion to the HSE.

Disability Services

Deputy David Cullinane

This Topical Issue matter is to ask the Minister of State to give an update to the House on the roll-out of the progressing disability services for children and young people, PDS, programme in Waterford and in the south east. There is also the related issue of the operationalising of the children's disability network teams in the same region. I thank the Ceann Comhairle.

Minister of State at the Department of Health (Deputy Anne Rabbitte)

I thank the Ceann Comhairle for selecting this issue and for giving me to the opportunity to respond. I also thank the Deputy for putting this Topical Issue matter down for debate. From the outset, I wish to acknowledge that there have been considerable challenges in certain parts of the country in the implementation of the PDS programme by the HSE. This has resulted in delays for families to access much-needed therapies for their children. I, of course, regret that and I wish to put on the record my sincerest apologies to any family experiencing such delays. I have only just come off the telephone with the HSE and, as such, my script has changed.

There are 12 teams in the area that the Deputy has mentioned in the south east. These 12 teams are made up of one which is led by Enable Ireland, based in Kilkenny. One is led by the Central Remedial Clinic, CRC, which is for the Waterford south city location. The other ten areas are led by the HSE, which comprise Carlow, Thomastown, Enniscorthy, Cashel, Clonmel, Dungarvan, Waterford north city, New Ross, Gorey and Wexford. The whole-time-equivalent staff complement working within all of that area is 168.15. There are vacancies there at present. When I refer to vacancies, the Deputy should be aware that I am talking about people who are on maternity, sick or parental leave or shared time which is 40. The number of complex needs children is 4,600.

I refer to active recruitment in the context of 2021 and the funding I provided in phases 1 and 2 and the special schools. It comes to 16.05 in terms of whole-time equivalent staff. In that regard, staff have been recruited to only three of the new additional posts that I allocated to CHO 5. That is not down to a lack of funding. The funding is there. Three staff have been recruited and there is a shortage of 13.05 whole-time equivalent staff. In addition, 40 staff are on various types of leave. That is a considerable number of individuals missing from key posts within the various groups.

That is not to take away from the work being done at present. I compliment the staff who are there on the front line and who have helped with delivering assessments of need in the past 12 months. The reconfiguration took place on 27 September 2021. For the three months beforehand, access was determined taking account of what was closest to your school or your address and families had a choice in all of that. I compliment the Minister of State, Deputy Butler, because she brought to my attention that the access was not working and that on the Dungarvan side, for example, people were getting notified that they must choose a particular location. We changed that to give parents the choice of closest to home or to the school. That is an overshot from an operational point of view in exactly where we are at this moment in the progressing disability services, PDS, model being rolled out in the south east.

The recruitment is being progressed as a matter of urgency by the HSE national recruitment services, and directly in the case of section 39 lead agencies, to support network teams to optimise service delivery. The area represented by the Deputy is in a fortunate position because ten of the teams are run by the HSE. Only two of the teams are section 39 groupings. The complete control, ownership, power, direction and sense of travel all rest completely with the HSE. It knows exactly what the service level provision is. It sends that in. It is in control of the direction of travel. This model of PDS is one it has designed and implemented and has been ongoing since 2014. I have just finished a phone call with Gobnait Ní Chrualaoí of CoAction in Cork who was part and parcel of the setting up of it at the very beginning. There is nothing new here for the HSE. It is just that, as part of the reconfiguration, the transfer of files took longer than would have been optimal. Communication has not been of the best quality but I am confident that now that we have reconfigured, communication will improve.

Deputy David Cullinane

I welcome the acknowledgement by the Minister of State that there were difficulties and challenges in rolling out these services and establishing the networks. Any Deputies who understand changing structures know that doing so is very difficult and challenging and, obviously, trying to align staff under the new structures was always going to be a difficulty. I certainly accept what the Minister of State has said in good faith. However, I want to get to an important part of the scripted response circulated on her behalf. It states:

Of the 100 additional development posts that were approved to strengthen Network Teams across the country in 2021, 13 were allocated to CHO5. However, only 3 of those posts have been filled due to challenges in recruitment and due to staff preferences for work in other care group areas.

We know there is a difficulty in the recruitment of staff in many areas of the HSE. We are seeing it in the area of home helps as well. The difficulty is obvious in the area of support staff and very important staff needed to roll out services for children with disabilities. There are several issues that arise from that.

I met a group of parents from the south east last week. They had mixed experiences. Some were getting good services, while the services others were getting were not so good. I found that the service level overall was very patchy, depending on where the person lived or the type of therapy his or her child was getting and possibly depending on availability. The Minister of State referred to the Minister of State, Deputy Butler. We met Finian McGrath when he was Minister of State with responsibility for disabilities several years ago regarding the need for additional speech and language therapists, occupational therapists and other posts to ensure the capacity was there. I am not sure that capacity was ever put in and I am not sure there is currently the capacity necessary to provide the services. For all the talk of early intervention, it still does not happen for too many children. What really concerns me is that the Minister of State's scripted speech notes there is a current waiting list of more than 1,000 children for ASD diagnostic assessments in the south east. That is a very high figure.

Deputy Anne Rabbitte

Absolutely. The Deputy is right in respect of retention and recruitment and the challenges that exist in the context of trying to make disability attractive as a workplace. This week, I met Mark Smyth of the Psychological Society of Ireland, who sent me a submission relating to various grades and preferences. In fact, if there are more senior posts, it may be easier to attract and train in staff. We also need to look at the panels. I am sure the Deputy is considering that in his role as a member of the Opposition. The panels have been in place for the past ten years and we have to question whether they are effective.

It must be acknowledged that it is predominantly a female workforce. We need to start factoring in the fact that people are on maternity leave, paternity leave or extended leave. That comes at a price of 40% over and above the baseline. That is what we need to discuss. Prior to the call with Gobnait Ní Chrualaoí I was on a call with Deborah Jacob of CHO 7. We discussed the need to have relief panels booked with the HSE so that there are people with a rich skill set available to cover for staff on maternity leave put into one of the teams. That would ensure consistency in the delivery of care, the continuation of that pathway, and the level of clinical governance and oversight for the junior grades. Deborah and her eight counterparts around the country would be in control and we would at all times be able to identify the needs and fill the gaps utilising a rich team of therapists within the gift of the HSE.

To go back to the Deputy's final point in respect of the 1,000 children awaiting ASD diagnostic assessments, it is a priority for me. Like the Deputy, I was very disappointed to see that figure this afternoon.

Employment Support Services

Deputy Paul McAuliffe

I welcome the opportunity to raise the issue of the important work being done in communities by local employment services and the great deal of uncertainty within those communities in respect of the indicated tendering process. It is not an unfounded concern because many of these partnership companies, or local development companies as they are often called, bear the scars of the social inclusion and community activation programme, SICAP, process. That programme was often the other arm of the partnership model. I am mentioning partnership repeatedly because partnership was a response in the late 1980s and early 1990s to the problems that were happening in many communities. It was a way of ensuring agencies such as the HSE, education and training boards and the Department of Social Protection, along with local politicians and the community, could come together with business and the trade union movement to ensure we could respond to the needs in communities. It is a model that did not come out of nowhere. It did not arrive on our doorstep as some theory-based model. It is a model that was championed by many people and is so important to communities. I will speak about why that is so in a moment.

The difficulty arises in the context of each Department seeking to comply with tendering processes and other measures. I was present at the meeting of the Committee of Public Accounts this morning when the Secretary General of the Department of Social Protection spoke about how these contracts are regarded as non-compliant procurement. The difficulty is that as we start to ensure they all comply with tendering regulations,we are separating out the local decision making each of the partnerships is able to make. That will strip away the flexibility in SICAP and local employment services. It will move from a local service to a regional service and suddenly it will have lost all the benefits the partnership model had.

I refer to the fears of local providers. None of them has any difficulty tendering but they have doubts regarding the need to tender to comply with European regulations. That is a legal issue. When the Attorney General says something, I have to listen and the Government has to listen, but there are differing legal opinions on this issue.

If we go through with the tendering process, we need to ensure that process recognises the expertise of many of the existing service providers and rewards them for it, compared with another company that does not have the same local knowledge. The process must ensure there is a pay and fee structure that is not all about progressing people to employment, because that means the quality work cannot be done that often needs to be done with people who are exiting long-term unemployment. We must ensure partnership bodies have the cash flow they might need to switch from the current system in which they are paid per year to one in which they would not be paid upfront but after the progression has been made.

It is crucial that the ability to react locally to local issues is retained. It must not, for example, be solely about referrals from the Department of Social Protection; there must be the ability to allow walk-in referrals as well. We have seen how this type of local response is crucial in communities, which I will speak about after the Minister of State replies. It is the backbone of what partnership is and the backbone of what these organisations do. If we continue to nationalise through contracts and the different models they provide, we open ourselves up to the allegation that some of us in government are ideologically focused on a particular way of delivering a service rather than on delivering for the community.

Deputy Frankie Feighan

I am grateful for this opportunity to discuss, on behalf of the Minister, Deputy Humphreys, the ongoing efforts to expand employment services in the State. I acknowledge that existing service providers are concerned about the future contracting of public employment services and I look forward to discussing this issue with the Deputy.

The Department of Social Protection is procuring a regional employment service, RES, over two phases. Phase 1 will see the new service commence in seven counties in the north west and midlands from January 2022. Phase 2, to commence shortly, will roll out the RES model throughout the rest of the State. This is a significant expansion of the State's public employment service capacity, with phase 2 services expected to commence from July 2022. The RES will primarily engage with the long-term unemployed, particularly those furthest from the labour market. When completed, the procurement will see the replacement of the local employment service, which currently services just eight counties in their entirety and another four counties partially, with a regional service covering all 26 counties. This is a welcome and significant expansion of employment services, providing comprehensive engagement for the first time for those furthest from the labour marker throughout the State.

The Department of Social Protection has signalled these changes for several years now, particularly since the publication of the 2018 Indecon reviews. There has been continuous engagement with local development companies and other relevant stakeholders since 2018 by the Minister and her officials. The latter have visited every single service provider in the State and the providers have understood for some time that the Department is changing how employment services are procured. In addition, the Department frequently meets with the Irish Local Development Network and has had intensive discussions with it on these issues. In early November, parties interested in tendering for the current phase were hosted by a Department webinar, involving more than 150 participants. After a presentation on the procurement phases, questions were taken for more than an hour. While the procurement process is competitive, in line with legal requirements, the numerous local and community bodies already supplying similar services on behalf of their communities will be well positioned to tender for the new lots and will, if successful, continue to deliver those services in their communities.

The RES lots will remain on a county or bi-county basis, where feasible, and function on a sustainable basis to provide the most appropriate service for the long-term unemployed. They will remain accessible and locally available services. Just as local employment services sprang up in response to unemployment blackspots in the 1990s, the RES is being designed to respond to the challenges facing the Irish labour market today. The key requirement in the request for tenders is quality of service in order to ensure that those who are long-term unemployed receive the quality service they deserve. The procurement will ensure the State adopts best practices when it comes to engaging with those furthest from the labour market. I have heard the same concerns that the Deputy expressed and I thank him for raising them.

Deputy Paul McAuliffe

I appreciate the Minister of State's response. I was disappointed to get a call from the Minister's private secretary only an hour ago to say she would not be able to take this debate. To be fair to her, she has met with me and many other Fianna Fáil Deputies to discuss this matter, about which there is grave concern. The work of a Deputy from one of the parties in government is often done behind the scenes rather than here in the Chamber. There are probably two instances in which we choose to raise matters in the House. The first is when we want to put on the record the work we are doing and the second is when we feel we might be getting the cuddly meeting treatment, where one meets with the Minister but, afterwards, one is not quite sure whether anything has changed. My fear is that we are getting much consultation but I am not sure we are getting the change that is needed.

I acknowledge the Minister of State's reassurances on the finances and regarding existing providers. That is all very welcome and will go a long way to giving people reassurance on some of their concerns. However, I am not seeing what I would prefer, which is an assurance that services will stay local. I say that because a county-by-county provision would see Dublin city going from 11 different providers down to perhaps one to three. Even five would be too few. On the north side of Dublin, we have separate local employment services in Finglas and Ballymun as well as two covering the eastern side and the city centre. The idea that those four areas would be reduced into one does not account for a scenario, for instance, where there is a crisis in Dublin Port and a company closes. How could a regional service respond to that local need? If there was a huge boom of employment because of construction - perhaps in the Ballymun area, where we hope to build many new homes on empty lands and where we are looking to recruit tradespeople - there would not be the local employment services in the community to direct people from local schools or the local labour supply. If something like the Debenhams closure last year happened again, we would not have those local employment services in place to work with people who have lost their jobs. I hear everything the Minister of State said but I am also still hearing the word "regional" rather than the word "local", which is the cause of my concern.

An Ceann Comhairle

I am not sure whether the Minister of State does cuddly meetings.

Deputy Frankie Feighan

It is the first time I have heard of cuddly meetings and I thank Deputy McAuliffe for introducing the term to Parliament.

An Ceann Comhairle

There is a first time for everything.

Deputy Frankie Feighan

I thank the Deputy for his contribution. I would like to reiterate some key points. The procurement process for the regional employment service is the outcome of a lengthy process of engagement and consultation with all existing service providers. The tender will allow the Department of Social Protection to procure employment services on a legally sound basis and in line with best practices. The RES will continue the delivery of accessible and local services. With the exception of Dublin, the services are being procured on a county or bi-county basis. Existing providers are well placed to submit quality competitive bids. I am not sure whether there will be three or five providers in Dublin but I am sure we can get that confirmed.

Phase 1 of the procurement has provided significant feedback for the Department, particularly around minimum referral numbers, but also in regard to bringing clarity in respect of upfront payments and the front-loading of payment stages. The Department has worked hard to eliminate barriers for existing local service providers which have been encouraged to work together, where necessary, to form partnerships for tenders. I understand the period after the publication of the request for tender will be longer than usual to facilitate the forging of such partnerships. Ultimately, the focus is on providing a quality service to the long-term unemployed. The bids submitted in phase 2 will be evaluated on the basis of their quality and the tenderer's ability to access a wide range of local supports and services that best meet their clients' specific needs. For successful tenderers, they will have more long-term contracts, greater freedom to manage their service and the capacity to be properly assessed for their performance. The new service will have a strong local focus and its fee structure will be heavily weighted towards client engagement. The Minister for Social Protection and her Department will continue to engage with the sector and listen to its concerns right up until the publication of the request for tender later this month.