Dáil Éireann díospóireacht -
Tuesday, 24 Jan 2023

Vol. 1032 No. 1

Saincheisteanna Tráthúla - Topical Issue Debate

Primary Care Services

Deputy Joan Collins

A constituent contacted me recently regarding local parents whose babies and children are registered with the Old County Road primary care clinic. The clinic is no longer doing baby and child developmental checks. Several local mothers have reported being told by the clinic that these checks cannot be carried out on their babies or small children due to staff shortages. They are being sent postal questionnaires in the place of physical checks, including, in some cases, the crucial three-month and ten-month checks. These parents are very concerned that issues unknown to them may go undetected in their children, with potentially serious consequences. These developmental checks are essential. The HSE states on its website:

Make sure you bring your child to their developmental checks. It can help identify any health or developmental problems. Early diagnosis and treatment can help to improve issues your child may have.

I tabled a parliamentary question to the Minister for the attention of the HSE. It confirmed that this is the case. It confirmed that it will try to have the children on the waiting list seen in 2023. It stated that every effort is being made to recruit new public health nurses and a recruitment campaign will get under way in January 2023. There is a bit of a contradiction there. I do not know how it is going to catch up on the backlog when it does not even have the public health nurses required.

This is a basic healthcare provision that is required for newborn babies and children. Parents have been let down. Does the Minister of State, Deputy Butler, agree that this situation is intolerable? The Old County Road clinic is another area of the health service that is in crisis, just like home care packages, the trolley crisis, consultants, mental health, access to dental services and services for disabled children and adults. Other areas, such as the Armagh Road clinic, have not been affected in this way.

I am raising this issue because it is very concerning and I want to find out exactly what the HSE is doing to resolve it. Maybe the Minister of State will provide the number of children on the waiting lists in this regard. I have not yet been given that information.

Minister of State at the Department of Health (Deputy Mary Butler)

I thank the Deputy for raising this matter and for the opportunity to update the Dáil on it.

Public health nurses play an extremely valuable role within the community healthcare system and provide an extensive range of services, including the provision of child health screening and supports for parents. It is vital that the local community in Crumlin, and all communities across the country, have access to public health nurses when they need them.

Their valuable role was highlighted when public health nurses, along with other front-line staff, were redeployed to assist and lead the Covid-19 response. This redeployment, in turn, had an impact on the capacity of the public health nurse service to deliver day-to-day services, including child development checks. During this period of redeployment, a prioritisation framework for child development checks was put in place by the HSE to enable public health nursing staff to identify and support those at greatest need in the community. Public health nursing staff have since returned to core duties. However, in some local health areas, the public health nursing service continues to be challenged by staff shortages, mainly due to reductions in the availability of staff due to retirement, internal movement, leave and challenges in replacing staff. Where these shortfalls are occurring, the prioritisation framework continues to be utilised to ensure those with the greatest need in the community continue to be prioritised and supported. It is important to note that this framework also ensures the safe delivery of services.

Data to August 2022, the latest published data, shows that, nationally, 83.8% of children reaching 12 months within the reporting period had their child health development assessment on time or before reaching 12 months. This represents a significant improvement from the 59.8% of 12-month checks that had taken place on time at year-end 2021, when many staff were redeployed to assist in the response to Covid-19. We sometimes forget that at this time 12 months ago, we were in the throes of the Covid pandemic. Thankfully, that is no longer the case.

Specifically with regard to child development checks at Old County Road primary care centre, the HSE has advised there has been a delay in completing checks due to staffing shortages. However, it has advised that a plan has now been put in place by the services in Crumlin to address the backlog. This plan commenced last week and children have been invited to attend developmental appointments. I know the Deputy will welcome that. The HSE has advised that it is exploring every avenue to fill outstanding staff vacancies and recruitment is ongoing.

Of course, the Department recognises the stress and frustration caused by the delay in the delivery of development checks. The Department and HSE would encourage any parents with a concern about their child's development to contact their GP or local public health nursing service directly. Any of us who had the support of a public health nurse when we had a very young baby recognise the importance of ensuring parents, especially first-time mothers, can get those supports.

In addition, in response to the broader challenges of recruitment and retention of public health nurses, the HSE recently established a community nursing national oversight group. The group is tasked with developing proposals and recommendations that will aim to address issues in the recruitment and retention of public health nurses and community registered general nurses. The Department of Health recognises the need to improve access to the wide range of services provided by public health nurses and it will continue to engage with and support the HSE to address these existing challenges.

Deputy Joan Collins

I thank the Minister of State for her reply. What is happening in the area in question? I understand there was a lot of restructuring and that public health nurses were redeployed to deal with the Covid crisis but this issue relating to developmental checks has been going on for a year. The Covid crisis lifted in April last year and one would have expected that staff would have moved back into their roles at that stage. The Minister of State pointed to retirement and so on and stated that parents who are concerned about their child's development should contact their GP - GPs are also under severe pressure at the moment - or the local public health nursing service directly.

I am not satisfied with the response of the Minister of State. She stated that 83.8% of children reaching 12 months within the reporting period had their child health development assessment on time or before reaching 12 months, which is better than the 59% that pertained previously, but this is a crucial area of health for children and babies. They need these checks, which are very important for their long-term future. In the first 12 months, there is vitamin D, tests for babies, the BCG vaccine, pneumococcal conjugate vaccination, meningitis C vaccination, hearing tests and heel prick tests. There are so many tests done in that period to assess the future development of the child.

There are certain areas into which the HSE should be putting its staff and resources. This is one of the main such areas. It should have contacted and put in place either a GP visit or another measure to respond to the situation.

I would like more feedback on that because I am still concerned about the situation at Old County Road. We do not know what is happening in many other clinics.

Deputy Mary Butler

To reiterate, I am pleased to confirm that the return of public health nurses to their core duties has now enabled the resumption of child development checks across the country. Last year, for example, 84% of children had the check before they reached 12 months, whereas in the previous year, in the height of Covid, the rate was sitting at 59.8%. There has been a huge increase but we want to get it to 100%. We want to make sure every child receives these vital checks, as the Deputy suggested. The role of the public health nurse cannot be underestimated, whether it pertains to very young babies and children or older individuals.

Specifically on the child development projects at Old County Road primary care centre, which I know the Deputy addressed in her question, the HSE has advised that there has been a delay in completing checks due to staffing shortages. However, it has also advised that a plan has now been put in place by the service in Crumlin to address the backlog. This plan commenced last week and children have already been invited to attend developmental appointments. The HSE has advised that it is exploring every avenue to fill outstanding staff vacancies, and recruitment is ongoing. I hope all those invited will take up positions and that the backlog can be addressed as soon as possible.

Hospital Services

Deputy Brian Leddin

The challenging situation at University Hospital Limerick, UHL, has been well reported over the past few weeks. Just last weekend, thousands of citizens from across the mid-west region marched in Limerick city to demand that the situation be resolved. One of the demands is that the accident and emergency departments at Ennis, Nenagh and St. John's hospitals be reopened. I acknowledge that there are competing points of view as to whether this is the correct course of action but I know the Minister, Deputy Stephen Donnelly, will take the loud call seriously. Whatever decisions are made must be in the best long-term interests of the mid-west.

It is with the medium- to long-term challenge in mind that I raise this matter. This evening, I want to discuss the potential role of St. John's Hospital's in the provision of healthcare in a city and region that is expecting and targeting steep population growth in the coming years. Indeed, I believe that kind of growth can happen only if infrastructure projects such as that proposed for St John's are developed. After all, we will struggle to attract people and jobs to Limerick if we do not have adequate healthcare infrastructure.

The national planning framework targets a 50% population increase for Limerick city in less than two decades. State policy is to grow the city population at twice the Dublin rate. The State also has a firm policy of compact growth, meaning we should build up our cities and reverse the pattern of development of the past 70 years. In those decades, before we realised how misguided an approach it was, we allowed and even encouraged our cities to sprawl outwards year by year, with them creeping farther by farther in all directions through a process of enabling and planning development on greenfield sites. We have seen this in every city in Ireland, but Ireland is far from unique in this regard.

The consequences of the misguided approach have been car dependency and the decline of town and city centres. In fact, UHL was one of the first outward pushes of the city in the 1950s. The suburb of Dooradoyle sprung up around it. It was because of this and a series of other major suburban developments that the city centre fell into decline. St. John's, of course, is very much the heart of old Limerick, which suffered so badly over the decades in question due directly to the policies of unfettered greenfield development. Now we are bringing the old city back to life and many in Limerick are involved in this effort. Those of us in government are helping by scrapping the policies of sprawl. In the coming years, through the development of multiple sites, tens of thousands of new citizens will live near St. John's Hospital.

When we plan any infrastructure, we do so first by trying to assess future needs, but our thinking has to go beyond just considering this because any infrastructure development has powerful impacts. These can be good and bad. Supporting the St. John's proposal to develop a 150-bed block would have a powerfully positive impact on a city that can and should have bold ambitions. It would make Limerick city stronger, and a stronger Limerick city would deliver a stronger mid-west region and fulfil our national aspiration to rebalance growth away from Dublin, as laid out in the national planning framework.

From a healthcare point of view, I believe it is the right decision. The Minister, Deputy Stephen Donnelly, and I have spoken in private about this on a few occasions. I have always appreciated those engagements. Most recently, he indicated there had been no decision on whether a fourth public elective hospital would get the go-ahead. I do not believe that the rationale that Cork and Galway, being within a 90-minute drive of Limerick, can meet Limerick's needs is sound given how development policy has been turned on its head recent years. I ask that the Minister support the development of St. John's Hospital in Limerick city.

Deputy Mary Butler

I thank the Deputy for raising this important issue and welcome the opportunity to address the House.

While acknowledging that there are significant challenges in the provision of healthcare services in Limerick and the mid-west region, there has been and continues to be substantial investment in UL Hospitals Group. For example, in October 2022 the Minister for Health broke ground on a new 96-bed inpatient block project at UHL. This capital project will deliver a four-storey, 96-single-bed acute inpatient ward block and will go some way toward addressing capacity issues in the region.

In 2021, a new 60-bed modular ward block opened at UHL, and prior to that an extra 38 inpatient beds were provided at the hospital through two rapid-build projects, constructed in response to the Covid-19 emergency. There has also been investment across UL Hospitals Group, including the new injury unit at Ennis hospital, which opened last April, as well as a modern state-of-the-art ward complex, which opened at Croom orthopaedic hospital in 2021.

Separate from these initiatives, the Government approved in December 2022 the next stage of the enhanced provision of elective care programme. New national elective hospitals will be delivered in Cork, Dublin and Galway. No other locations are under consideration at this time. The locations were chosen to allow for new facilities of a size and scale to implement a national elective care programme that will tackle waiting times nationally.

These hospitals will provide significant additional capacity, enabling the separation of scheduled and unscheduled care. This will change how day cases, scheduled procedures, surgeries, scans and outpatient services are arranged across the country. These hospitals will ensure greater capacity in the future and help to address waiting times. This new delivery capability into the public healthcare system will benefit the whole population, including those who do not fall within the immediate traditional geographical catchment.

It is envisaged that the new Cork and Galway facilities combined will cater for up to 350,000 patients or procedures annually, which would include patients from the mid-west.

Complementary to the development of the new elective hospitals, the HSE also plans to develop surgical hubs in Cork, Galway, Limerick, Waterford and Dublin to provide a narrower scope of procedures. The HSE will work with hospital groups and forthcoming regional health areas to progress these proposals in the shorter term. An advantage of the surgical hubs is that they will be developed much quicker than the elective hospitals. This intervention will also support efforts to consider the necessary reforms and enablers needed to separate unscheduled and scheduled care pathways that will be required in the longer term provision of the elective care programme.

A capital submission for the development of a 150-bed facility at St. John's Hospital has not been received. However, I assure the Deputy that the Department of Health continues to work closely with the HSE to ensure that UL Hospitals Group and, indeed, the mid-west are fully supported.

Deputy Brian Leddin

I thank the Minister of State for the reply. I acknowledge her final remark that the HSE and Department will continue to work with UL Hospitals Group. I want to make the case strongly for St. John's and believe I have done so, notwithstanding that the capital submission has not been progressed.

The thinking around development in this country has completely changed. It is not acceptable that the St. John's project is not being actively considered at this time.

I believe this is a misalignment with the national planning framework. I will speak about it again to the Minister for Health, Deputy Stephen Donnelly. I acknowledge absolutely the substantial efforts that have been made to address the challenges in health in the mid-west region. I acknowledge the efforts of the UL Hospitals Group, and to point out and agree that we are in a very unprecedented situation given the viruses that have gripped the world at this time. There is, however, a whole lot we can do. When we are thinking about healthcare we must think about the medium and long term. It is in that context I bring this matter this evening. We need to think to 2030, 2035, and 2040. I ask that the Minister of State, Deputy Butler, would say to the senior minister in the Department, the Minister Deputy Stephen Donnelly, that St. John's Hospital makes absolute sense in the context of the provision of healthcare in the mid-west region. It will not be acceptable to the people of Limerick or to the people of the mid-west region that Cork and Galway are the cities they must travel to. It is not acceptable that we are planning infrastructure on the rationale of these hospitals being within a 90-minute drive. The Minister of State, Deputy Butler, coming from Waterford, will sympathise with this sentiment. I will engage further with the Minister and with the Minister of State, Deputy Butler. I hope that in time we will develop an excellent care facility at St. John's.

Deputy Mary Butler

The Minister, Deputy Stephen Donnelly, the Government, along with the Department of Health, remain fully committed to improving services in Limerick, the mid-west region and across the entire country. I believe that only recently the Minister, Deputy Stephen Donnelly, and the Taoiseach, met with the elected representatives in that area.

It is very clear that after what has been a very difficult couple of years for the UL Hospitals Group significant efforts are being made to ensure that issues such as delays to elective care are being addressed as matters of priority.

Deputy Leddin referred to the situation in the past few weeks and the perfect storm we had of three viruses: we had Covid, flu and RSV. We saw unprecedented overcrowding, and especially in University Hospital Limerick. As I have said, there has been, and there continues to be, substantial investment in the UL Hospitals Group, of which the Deputy is very much aware.

To conclude, a capital submission for the development of a 150-bed facility at St. John's Hospital has not been received. I am not sure if that is going to be progressed. The Department has not received it as yet. I will certainly bring the Deputy's comments on what he has said. The Deputy has spoken about Limerick so eloquently, and the fact that it had the sprawl and now it is moving back in. I will certainly bring the Deputy's concerns to the Minister for Health, Deputy Stephen Donnelly. I thank the Deputy.

Home Care Packages

Deputy Christopher O'Sullivan

I will speak about some of the difficulties that people are having in accessing home care supports in west Cork, but in doing that I must first acknowledge the incredible work being done in this whole area by the Minister of State, Deputy Butler, since she became the Minister of State. Year on year the Minister of State, Deputy Butler, has secured and allocated more funding for home care supports and has done more than any other Minister previously in securing that level of support. The Minister of State began the process and has revolutionised nursing home care and I know she will do the same for home care. That said, the Minister of State has also acknowledged the unprecedented level of demand for home care support services in the State. The Minister of State has acknowledged this and it is what I want to speak about today.

It is surely time that the HSE becomes accountable for this and that it starts showing some results and some value for money for the money and the funding that the Minister of State has secured for the sector. This applies right throughout the healthcare sector. The HSE and the management structures within the HSE need to start showing that value for money and return for taxpayers' funding that goes into that service. For example, in 2019 the funding for the HSE was some €16 billion. This has increased to €23 billion. It is about a 40% increase yet we are not seeing that value for money and we are not seeing the return in increased services. This has certainly played out in previous weeks. I am aware that we have had unprecedented levels of viruses, which has also been the situation throughout Europe but we have seen situations here where we have had record numbers of people on trolleys and people awaiting care.

The whole point of home help, home support and home care is to take people, elderly people, and dependent patients, out of those acute services. It underlines the importance of a functioning home support service. Far too often, unfortunately, and certainly in my area in west Cork, that is not the case. There are numerous examples I could give to the Minister of State but I will focus on one example. I thank the family that has given me permission to give it as an example. I will not use the names. The man has dementia, stage 4 cancer, and Parkinson's disease. A good few months ago back in September he fell and broke his hip. He went to the hospital and was operated on. He was ready to be discharged from hospital a number of weeks later but he could not be discharged because the level of required home support services was not there to assist him. The requirement was that he would have two home carers in the morning, two in the afternoon, and two in the evening. The best that he could be offered at the time when the HSE went out to tender for it, was two in the morning and one in the afternoon. This was very quickly withdrawn because one of the home care workers was no longer available. The HSE, of course, gave the response that there were issues with recruitment and issues with securing staff. While this may very well be the case, the upshot is that a family wanted to bring their father and family member home and spend time with him - however long that gentleman has left - and they wanted to spend as much time with him at home as possible. They could not do it because the appropriate level of home care and home supports services was not there. We need to see that change. The Minister of State has put the funding in place. She has resourced it and the HSE now needs to step up to the mark to ensure that this level of support is provided for families who desperately need it.

Deputy Mary Butler

I thank Deputy O'Sullivan for raising this very important issue, and for giving me an opportunity to address it.

Since budget 2021, I have secured an additional €207 million in funding for home support. This year, the overall home support budget will be more than €700 million. I am probably the first Minister of State that has ever stood here who has the capacity to provide every home care hour that is needed in the country, but I do not have the staff to deliver it. This funding will enable the HSE to progress the development of a reformed model of service delivery to underpin the statutory scheme for the financing and regulation of home support services. This will fund nearly 24 million hours.

The dementia-specific proportion of the new home support hours increased from 5% in 2021, 11% last year, and this year in 2023 I will have 15% that is dementia specific. The delivery of home support hours in communities is increasing, in line with enhanced investment. Older people want to age well at home. There are three things that can mean an older person can age well at home: home care supports; access to day-care centres; and meals on wheels. These three are the triangle that means people can age well at home.

As of November 2022, 56,429 people were in receipt of the service. At the moment we have approximately 56,500 people who receive home care every day. There were 3,240 new applicants funded and waiting for supports, and 2,819 people were already receiving supports but not the maximum hours advised, such as the gentleman the Deputy spoke about. Seven people were assessed and waiting on funding. Whereas previously people were waiting on funding, that is not the case anymore. Last year, up until the end of November, we delivered 19 million hours of home supports. I expect this to land some place in and around 21 million hours. Specifically in the context of Cork and Kerry CHO 4, we have seen an increase in those waiting in that area. Between January and November last year, preliminary data show that more than 2 million hours had been provided in Cork to more than 7,000 clients. At the end of November the waiting list in Cork stood at 429 people waiting on additional hours - so they had some form of supports but not the full package that was recommended - and 589 were new applicants. We have seen unprecedented demand for new home care supports. As I have said, 589 were new applicants.

Last year, I established a strategic workforce advisory group which came back to me with 16 recommendations. I accepted all these recommendations as quickly as I could. As of 1 January 2023, and working with my colleague, the former Minister of State, Deputy English, I have secured 1,000 employment permits which will allow home care workers from non-EU-EEA countries the opportunity to work in Ireland. This is an immediate intervention to support the sector. We did that previously for the nursing home sector and at the last count we had 2,500 people who came in on permits. I would be very hopeful that in the next month or two, we will see people who would be prepared to come in here. The average person provides interventions to about six people a day. If we could get 500 or 600 people in, it would almost clear the waiting list. In conjunction with wider sectoral reforms which are in train, implementation of the group's recommendations will have a real and lasting impact on addressing our workforce challenges.

Deputy Christopher O'Sullivan

The Minister of State quoted a lot of the facts and figures. She has secured €700 million in funding this year for home care. There is an unprecedented provision of hours. She also mentioned the statutory scheme of 24 million hours. I spoke about her revolutionising the sector and I think that will happen. Of course, we have to give this time to settle in. We have to look at the circumstances now. I appreciate the efforts that are being made in recruiting non-EU workers to take up those positions and clear the backlogs. That is very welcome. We have to look at workers within Ireland as well and consider why we are struggling to recruit staff and fill those positions. Do we need to look at the working conditions? These are incredible people in our community who love their work. They love doing what they do. They love the help and support they give people but clearly we do not seem to be doing enough to recruit people into that profession. It is certainly something that needs to be looked at. I am very heartened to hear of the efforts being made in recruiting non-EU workers into Ireland to clear that backlog. It is a very important step and something I hope will make a difference.

However, that is not to lose sight of the main reason I am raising this issue. As with the example I have given, it is for the family who want to be reunited with their loved one. They want to see him discharged from hospital for what they thought would have been a routine procedure but he has been in there since September. This is all about ensuring that those families are reunited and can be together in the home. I want the Minister of State to take that example and hopefully we can see a difference made for that family.

Deputy Mary Butler

I am committed to supporting people to age in place at home in their communities with the wrap-around supports, including the dementia-specific day care services, meals on wheels and home care. In order to bolster staff resources and reduce waiting times for allocation of service, Cork-Kerry community healthcare advertises on an ongoing basis for healthcare support assistants throughout the region. It has a rolling campaign ongoing at the moment. The rates of pay are quite attractive. The HSE rates start at €16.49 an hour, plus mileage. I have to say that we have been challenged to try to sell home care as a viable career opportunity. The private providers are also actively endeavouring to recruit additional staff resources. Given the nature of this role, this recruitment is normally conducted at a very local level, which is important, across the region. One of the recommendations of the strategic workforce advisory group is also that those private providers would have to pay a minimum of the living wage and they would also have to include mileage. That new tender is being worked out at the moment.

I understand the point the Deputy makes about the gentleman in question whose family wanted to bring him home but did not have sufficient home care. Many of the Deputies in the House will be able to relate to that case. From Monday to Friday, we are okay but a lot of the challenges are at the weekends and in rural areas. That is why it is important that, if we can at all, trying to recruit people at a local level is vital. In addition, patients regularly discharge directly home from the acute setting with home support. Where patients are on the delayed transfer of care list because it is proving difficult to secure appropriate home supports, they can be offered a transitional care bed in a residential care facility. Last December just gone, we used that facility 1,000 times and in the first week of this year it was used 289 times. Home care is one of the issues I am trying hard to resolve. When I was appointed, there were over 9,000 people waiting for home care. Today, there are 3,200 people waiting and 2,800 with a partial home care package. I am hopeful that we will see some new people coming into the country who might be able to provide some support for us.

Business Supports

Deputy Mairéad Farrell

I am sharing time with Deputy Conway-Walsh.

Gabhaim buíochas leis an Aire Staít as an gceist seo a thógáil. An fáth go bhfuilimid á hardú inniu ná gur chas mise le gnólacht i gConamara agus dúirt sé liom go bhfuil sé ag úsáid an gháis peitriliam leachtaithe seo. Mar gheall air sin, níl sé in ann an scéim chun cabhrú i dtéarmaí fuinnimh a úsáid, rud a chiallaíonn go bhfuil sé an-deacair dó na doirse a choinneáil ar oscailt, rud a chiallaíonn go bhfuil sé an-deacair dó daoine a choinneáil fostaithe. Is féidir linn breathnú air seo agus oibriú lena chéile chun féachaint cén bhealach gur féidir linn cabhrú leis na gnólachtaí seo. Is léir nach an gnólacht seo amháin atá i gceist ach go bhfuil an deacracht seo ag gnólachtaí timpeall na tíre.

I want to raise this issue. I met with a business in Connemara which uses this liquefied petroleum gas, LPG, and as a result it was unable to access the temporary business energy support scheme, TBESS. It has been struggling badly over the last number of years between Covid and now the huge rise in energy costs. As a result, the business cannot be kept open all the time. It is a hotel. In a small, rural area that has a serious impact on employment in the village. It is having a big knock-on effect. It is important to raise this issue. We can work on it together to see if there is a way to help these businesses in the west that are impacted to try to keep the doors open.

Deputy Rose Conway-Walsh

The Government has made a big mistake by not including LPG in the TBESS, which is designed to help viable businesses to survive in the current spike in energy prices. This has excluded many rural businesses unfairly from the support scheme. The Minister of State must appreciate the fear and anger caused in rural Ireland when businesses were informed by Revenue that the TBESS will only apply to those metered in the supply of gas and electricity. As people in Mayo are all too aware, mains natural gas is simply not available in that part of the country. This does not make sense. It was a mistake, an unintended consequence. It means that businesses in rural Ireland that rely on bulk gas purchase of LPG are denied access to the scheme. These businesses, like many others, have seen unsustainable increases in their energy costs. Rural Ireland and Mayo seem to be an afterthought for the Government.

I want to get this right. I hoped it was an oversight that would be addressed but, disappointingly, when I raised it with the previous Minister of State, he said he would not review the scheme until after it had closed at the end of February, when it is too late for businesses to access the support. This is wholly unacceptable and it risks doing irreparable damage to our rural economies. The Government must see reason and allow all businesses to access the support. Businesses in Mayo and across rural Ireland cannot afford to be treated in this unfair manner. This has to be put right. We have all the auditing done by Revenue so the Government can tell how much energy is being used this year, how much it cost, how many units have been used and what was used last year. The differential can be quantified in order for these businesses to be included in the support scheme. There is no reason whatsoever they cannot be included. These businesses are employing people in places like Achill, Ballina, Belmullet and similar areas across the county. They deserve much better than this. I am asking the Minister of State to please reverse this and right the wrong.

Minister of State at the Department of Finance (Deputy Jennifer Carroll MacNeill)

I thank both Deputies for raising this important question. Deputy Conway-Walsh will be aware I have a strong interest in Mayo, with significant family connections and family businesses there. I have a good understanding of the pressures faced right across Mayo and other parts of rural Ireland. Indeed, her constituency colleague, Deputy Dillon, also raised this with the Minister, Deputy Michael McGrath, on Question Time earlier.

l will cut to the chase on the reasons for it because that is what the Deputies specifically raised, and we can provide further detail. The difficulty with this is that many of these businesses would have received broad supports through the employment wage subsidy scheme, EWSS, and a range of different supports during Covid. As a result, there is no intention whatsoever to exclude businesses of any particular geographical position or type.

On the issue of oil and LPG being excluded from the scheme, this was because they were not supplied by way of a meter. Revenue and the Department of Finance pointed out at the time the scheme was devised that it would be difficult to accurately determine the actual usage for each claim period, the relevant unit price for each claim period, and the actual increase in that unit price and usage over the same timeframe in the reference period.

As her party's spokesperson on public expenditure, Deputy Mairéad Farrell will be particularly concerned about how schemes are structured and making sure they can be captured in a way that Revenue can accurately assess what is being done. As she knows, the scheme opened generally for registration at the end of November and for claims on 5 December. There are €12 million worth of claims of which close to €11 million have been paid out. It is still early days in the taking up of the scheme but that does not address the Deputy's point about businesses using oil and LPG as energy sources.

TBESS is available to all tax-compliant businesses carrying on trade, the profits of which are chargeable to tax under case I or case II of Schedule D. It also applies to sporting bodies and charities that carry out trading activities. There is no intention to exclude businesses or services; it is simply a matter of how that is recorded. The Minister stated earlier that the scheme is due to end at the end of February 2023. There is provision under sections 100 to 102 of the Finance Act to extend it to the end of April and to consider the caps. The Minister indicated that he would look at the operation of TBESS for the first three months, as the Department of Finance and the Government did in respect of other schemes that were designed to provided supports through difficult periods.

I will set out the facts for the House more broadly. To be eligible to make a claim under TBESS a business must demonstrate that the average unit price for electricity or gas, as the case may be, on the relevant bill has increased by 50% or more compared to the average unit price in the reference period. It is tightly analysed and assessed in order to make that comparison. In broad terms, it is the average unit price in the month that is 12 months prior to the month in which the relevant bill arises. That is the energy cost threshold.

I hear what both Deputies are saying with regard to whether we can do something more, or if we can we work on this. I urge them to contribute to the review and provide specific ideas, during the revision or the devising of any new scheme, on the specific problem of measuring the use, the actual cost and the change over time in circumstances where one is dealing with something that is not metered in the course of ordinary business.

Deputy Mairéad Farrell

Is í an fhadhb a atá agam i ndáiríre ná má bhíonn ar ghnólachtaí áirithe fanacht roinnt míonna go dtí go mbeidh an chabhair sin acu, ciallaíonn sé sin go mbeidh ar chuid acu a gcuid doirse a dhúnadh. Mar gheall ar sin, dóibh siúd atá i gceantair níos iargúlta, táimid ag admháil faoi sin mar gheall go bhfuil siad ag brath ar ola agus an LPG seo agus nach féidir leo an chabhair a fháil ón Rialtas. Caithfimid breathnú air sin.

I take the Minister of State's point that we need to bring ideas into the review, but I would make the point that a number of months in a small business's life, in a small rural isolated area, can have a serious impact in terms of it having to close its doors. We do need to look at any kind of way we can assist those businesses to remain open, for the viability of small villages across the west.

Deputy Rose Conway-Walsh

The crux of matter seems to be the auditing, showing the exact usage and the measurement issue. If we can prove to the Minister of State or Revenue, which I believe we can beyond any doubt whatsoever, the exact usage, the number of units and the exact costs and do absolute comparisons in the same way that is done elsewhere, can this scheme be applied retrospectively to those who have missed out on this scheme in recent months? That is where we need to home in. I can 100% provide that evidence to the Minister of State or Revenue, or I can get the businesses to supply it. Nobody is looking to avail of something that they are not entitled to or to abuse the system in any way. Everything is upfront and can be audited.

Deputy Jennifer Carroll MacNeill

I completely appreciate the point made by both Deputies, particularly on auditing. This scheme is devised under a European framework and is also subject to state aid rules so it is not simply me, the Department or a lack of desire. It is constructed under the state aid rules as a particular intervention measure, all of which we must comply with. Therefore, please do not let me go further than I can in any of that. The Minister has said he will look at the operation of the scheme, in broad terms, to see if there are ways in which it can be adapted for in the future.

The Deputy is correct to point out the impact weeks or months of difficulties can have on the viability of any business. I refer, in particular, to many tourism interests that find it difficult to attract business over the winter period. When one looks at the scheme and how it has operated versus expectations, one must also consider energy prices and where they are relative to expectations. Despite them having been extraordinarily high, energy prices are much lower than we had expected at this time of year both because of changes in energy price in respect of oil and gas generally on the wholesale market, and the considerably warmer than expected weather for the period. This has meant that bills, while they were exceptionally high during the August-September period - which I saw in my own constituency - have not been as high as might have been expected. By way of additional detail, wholesale gas prices are expected to be 57% lower in the first quarter of this year than they would have been expected to be last October. Of course, the winter period is not over and gas and oil prices remain considerably high, but it is worth making the point that they are lower.

We continue to urge eligible businesses to make claims under the scheme. The window for making claims is important. Revenue has endeavoured to make it as easy as possible. I appreciate that this speaks to the application of the scheme more broadly and not to the specific points raised by the Deputies in respect of the exclusions from that part of the scheme.

Cuireadh an Dáil ar athló ar 12.08 a.m. go dtí 9.12 a.m., Dé Céadaoin, an 25 Eanáir 2023.

The Dáil adjourned at 12.08 a.m. until 9.12 a.m. on Wednesday, 25 January 2023.