Dáil Éireann díospóireacht -
Thursday, 2 Feb 2023

Vol. 1032 No. 6

Saincheisteanna Tráthúla - Topical Issue Debate

Tourism Schemes

Deputy Marian Harkin

I thank the Minister of State for coming in to take this matter. I wish to discuss with him the need for some type of support schemes or compensation measures to assist businesses and individuals dependent on seasonal tourism, in particular, where there is a very substantial reduction in available tourism accommodation, due to the fact that hotels and other accommodation providers are now providing accommodation for refugees. This, of course, has a significant impact on local businesses depending on tourists and visitors alike in the short and long term. While this issue impacts on a number of different places in my constituency and elsewhere, I raise it in the context of a meeting I attended earlier this week with my colleagues, Deputy MacSharry and the Minister of State, Deputy Feighan, in Rosses Point, County Sligo, on Monday last. As a follow-up to that meeting, Deputy MacSharry suggested tabling a Topical Issue matter. We agreed to do that.

I will be crystal clear. The tone and content of the meeting at Rosses Point was constructive and sought solutions. There was no blame game and no anti-refugee sentiment. In fact, it was the opposite. There was, however, a recognition that the impact of a huge increase in the population of Rosses Point and the consequent impact on all public services, as well as the loss of significant numbers of beds for the upcoming tourism season, must be managed for the community, businesses and refugees. As one man at the meeting said, if the situation were reversed, he would not want to be stuck in a hotel in Ukraine.

It is in that context and framework of seeking solutions and managing the situation that I will mention the broader need for accelerated and co-ordinated action, first, to appoint a dedicated community liaison officer to help ensure integration of new arrivals in the area, second, to increase bus capacity to and from Rosses Point, especially at peak times and school times and, third, increase policing in the peninsula to help ensure security for all. I will tease out the final issue a little more. This is the need to appoint a dedicated tourism officer to address the loss of revenue to local, tourism-dependent businesses. It is important to remember that those businesses employ people, support the fabric of Rosses Point, and pay taxes and rates to maintain the area. If they close or downsize, the impact is felt throughout the community.

I ask the Minister of State to consider some Covid-type supports for businesses that are interdependent on tourism accommodation. We are speaking of restaurants, bars, and businesses involving maritime or other leisure activities. Approximately 25% of the tourism accommodation outside Dublin is now devoted to housing refugees. In some places, such as Rosses Point, the figure is much higher. Is there any possibility of some kind of support scheme specifically for those businesses where it can be shown that the impact is substantial? It is not just support schemes for loss of income. It is also about greater marketing for areas that are worst affected. That is where a dedicated tourism officer could help to support business.

The first stage was helping to house refugees. I am fully supportive of that, as are the people who attended that meeting. The next stage is to support both communities and refugees. We are now at the next stage. I want to hear what plans the Government has in place for that.

Minister of State at the Department of Tourism, Culture, Arts, Gaeltacht, Sport and Media (Deputy Thomas Byrne)

The Deputy raised the issue of support schemes and compensation measures to help businesses and individuals that are dependent on seasonal tourism, which could be adversely affected by the reduction in capacity available this season due to hotels and other tourism accommodation being used to house international asylum seekers and Ukrainian people fleeing war. I thank her for relaying the constructive tone of the meeting at Rosses Point and the constructive tone also shown by her and Deputies Feighan and MacSharry.

We are approaching the first anniversary of the start of the war in Ukraine. Since then, the people of Ireland have welcomed more than 90,000 people between those fleeing that war in Ukraine and other applicants for international protection. This is, by some distance, the largest humanitarian operation ever undertaken by the State and the Irish people, and tourism accommodation has played a highly significant role in the national response to the crisis. This has placed a strain on the availability of tourism accommodation, with knock-on impacts for other tourism businesses and businesses in the wider local economy.

Officials in the Department with responsibility for tourism are engaging with a range of Departments, with input from Fáilte Ireland, to consider how best to mitigate the potential impacts on the wider tourism ecosystem of the long-term use of tourism accommodation. Analysis is being done in those towns or areas most impacted by the unavailability of tourism accommodation.

In addition, I can confirm the Government has approved the construction of 700 rapid-build homes with the potential to house up to 2,800 individuals in family units. These rapid-build homes will be constructed on State-owned land. The OPW is leading this in conjunction with the Department of Children, Equality, Disability, Integration and Youth. The objective is to install 500 units by March or April of this year.

The strong early recovery of inbound tourism to Ireland last year was very welcome but it is fair to say that the tourism industry faces a number of challenges this year. The combination of increasing interest rates in all major economies, rising energy and food prices and the growing prospects of global recession are major threats to the recovery of international tourism for 2023.

In Ireland hotel capacity, energy costs and labour shortages will continue to challenge the tourism industry. In budget 2023 the Minister, Deputy Catherine Martin, who apologises for not being here, secured €15 million in additional funding for overseas marketing of Ireland. As global competition heightens, sustaining extensive marketing campaigns will be vital to support the ongoing recovery effort, building on the initial inbound tourism demand seen in 2022.

The budget also contains an additional €15 million for a range of industry initiatives, including a continuation of the investment in skills development and retention, which is €3 million. This provision will facilitate the continuation of work with Fáilte Ireland to address the employment challenges faced by tourism businesses in attracting talent, helping skills development and retaining staff. There is a €2 million increase in funding for domestic marketing to promote Ireland's tourism offering to Irish holidaymakers. The Minister also secured additional funding of €3 million to allow Fáilte Ireland to continue its work in the area of sustainability.

Tourism agencies are working hard to help those in the tourism sector. Tourism Ireland will roll out an extensive and targeted programme of activity in 2023 with a total marketing budget of €78 million. A wide range of promotional activities will be undertaken, including a new global marketing campaign, publicity and programming as well as working with tourism industries at home and overseas to facilitate the sales. Fáilte Ireland will announce plans shortly for work in the area of recruitment and retention of staff and sustainability.

The temporary business energy support scheme, TBESS, which is designed to help businesses to cover their energy costs in the winter months, will run until 28 February. The Government is looking at reviewing the operation of the scheme. The Minister has received extensive feedback from the tourism sector, in written form and in person at the hospitality and tourism forum that she co-chairs. She is also aware that the 9% VAT rate is to the forefront of tourism businesses and individuals at present. A strong message was taken away from the recent hospitality and tourism forum meeting on the need to ensure there is no cliff edge with regard to the supports that have already been put in place. The Minister will continue with her regular interaction with Government colleagues to communicate the concerns of the industry about the long-term effect these issues could potentially have on the tourism sector.

Deputy Marian Harkin

I thank the Minister of State. There is still a lot of goodwill out there and it is crucial that we harness it. The people best placed to harness it are the Government in the decisions it makes and local Deputies and politicians in trying to support communities. We have to make sure it happens and it is real in order that when people get up tomorrow and the day after they can see it is happening. This is in the context of extra public services such as transport.

I am specifically asking about supports for business. I heard what the Minister of State said about a higher budget for marketing. That is good but we also need to look at those areas that are hardest hit and there are a number of them. We need to focus on some of them. Rosses Point is not the only one in my constituency but it is the one I am discussing this evening. One person at the meeting said people need to know that Rosses Point is open for business. The only way this can happen is if we have specifically focused marketing actions to make sure people have that message.

The Minister of State mentioned the TBESS. Of course all businesses get that. It is in the context of the escalating cost of energy. We need something more focused than this. That scheme is for everybody but we have to recognise the specific issues I am speaking about. I hope the 9% VAT rate will be maintained. This is important for businesses and I hope there is no cliff edge.

I speak, as does the Minister of State, to many people about this issue. People are willing to help and want to help. One man from the RNLI spoke about the fact there are several hundred people who have never seen the sea and do not know there are dangerous currents. From such a simple issue as this to supporting businesses, communities need to know we are on their side.

Deputy Thomas Byrne

I thank Deputy Harkin for raising the issue. I thank her and her colleagues for their relentless advocacy of tourism and business in Sligo and for the constructive approach they have taken on this. I am fully aware of the beautiful tourist sites in Sligo. Deputy Harkin mentioned Rosses Point in particular but she is right to say there are many others, including Knocknarea, Lough Gara and Enniscrone. I am a regular in Yeats country. There is also Mullaghmore and other beautiful places.

The Minister, Deputy Catherine Martin, is acutely conscious of the importance of the tourism sector, particularly on a regional basis. Tourism accommodation has a significant multiplier effect for other businesses in the wider area. The war in Ukraine, combined with the very high number of applicants for international protection, puts real pressure on the Government's ability to offer humanitarian accommodation. The people of Ireland have never seen so many arrive in such a short timeframe. We have welcomed the equivalent of the city of Galway in less than a year. The country has done a tremendous job collectively in doing what is the right thing but we are left dealing with the consequences of it and we are trying to do it in the best possible way. Irish people have sought shelter and opportunities abroad and Ireland has a long tradition over history of helping nations in trouble. It is the right thing to do. The Department of Children, Equality, Disability, Integration and Youth is availing of the wide range of offers of accommodation made to it. The Government is focused on continuing the support for those fleeing the war. It has agreed that there should be a move away from an emergency response to a more mainstreamed approach, including reduced reliance on serviced accommodation. There is now an increased focus on rapid-build housing and a new call for vacant homes led by local authorities.

The Minister consistently engages with, and takes on board, the views of the hospitality and tourism sectors, particularly with regard to the need to avoid a cliff edge and the supports that are needed. She continues to do so and she will take careful note of the comments that Deputy Harkin has made. I am very grateful for them.

Medicinal Products

Deputy Robert Troy

I thank the office of the Ceann Comhairle for selecting this extremely important topic. It is fair to say that access to appropriate healthcare is a fundamental right of all our citizens. I want to take this opportunity to acknowledge the huge progress being made by the Minister, Deputy Stephen Donnelly, and his team in ensuring that we improve our health service in the face of the global pandemic. Despite significant increases in investment there still remain challenges and problems. In an ever-evolving world there always will be. This is why we need the Government to respond to these challenges. It is important that this response is done in an efficient and timely fashion.

Most of us are aware of someone who suffers from cystic fibrosis and the debilitating disease it is. I compliment Cystic Fibrosis Ireland for the work it does in advocacy, supporting families and fundraising. Most of us remember that a number of years ago there was a very comprehensive campaign for the licensing of Orkambi and the huge difference that drug made to the quality of lives of so many people. I am told by the CEO of Cystic Fibrosis Ireland that a new drug, Kaftrio, is much better and makes even more of a difference to people's lives, improving their quality of life. Unfortunately there is a cohort of approximately 35 children aged between six and 12 years who are excluded from this drug because of their genotype. This is despite medical people knowing that the drug will work and greatly enhance the quality of their lives.

I am aware the National Centre for Pharmacoeconomics, NCPE, is in the process of carrying out a health technology assessment, HTA, and that the HSE has prioritised this. I thank the Minister for ensuring this was prioritised. Through the Minister of State, Deputy Collins, I ask that the Minister encourage the HSE to have this process brought to a conclusion as soon as possible and for the HSE to give a commitment not to procrastinate thereafter but to come forward with a positive decision. Every delay is causing irreparable damage to these children and potentially reducing their life expectancy.

A young boy in my constituency, Ciarán Kilmurray, whose family know I am raising this issue, spoke to Joe Duffy before Christmas. Ciarán was in hospital right up until Christmas. I compliment his classmates from St. Kenny National School. They were precluded from visiting him because of his vulnerability. They did not want to put him at any greater risk so they made Ciarán a lovely video to show he was very much missed by the school. I am glad to say he is now back at school but he is sitting on his own with a mask on and cannot participate freely in school activities with his classmates. However, if he had access to this life-changing drug, he could participate. I am sharing this story with the Minister of State in the hope he will bring it back to the Minister to ensure this process is concluded without delay, that we have a positive outcome and that the 34 other children who are in a position similar to Ciarán can get access to this life-changing drug and go on to live their lives normally.

Minister of State at the Department of Further and Higher Education, Research, Innovation and Science (Deputy Niall Collins)

I am taking this matter on behalf of the Minister for Health. I thank Deputy Troy for raising this important issue.

Kaftrio has been a life-changing drug for cystic fibrosis sufferers. Access to drugs like this was what we expected when the HSE signed its agreement with the manufacturer, Vertex Pharmaceuticals, in 2017. The deal stipulated our patients would have access to Vertex's whole portfolio of cystic fibrosis drugs for a capped yearly cost. We made a ten-year commitment that has already seen us pay hundreds of millions of euro to Vertex. We entered this agreement in good faith expecting that as new licences were approved for Kaftrio's medicines, the HSE would receive access at no additional cost. This has been the case previously when new indications were licensed. The agreement was amended in 2019 and 2020 to include these patient groups at no additional cost. However, for this particular sub-type that affects a small group of children, Vertex is requesting additional funds to provide access.

The HSE has statutory responsibility for the community drug schemes. It has structures in place to ensure our health service is able to provide the right care sustainably. Given the substantial budgetary impact of the additional funds sought by Vertex, it must complete the pricing and reimbursement process that is required of all other medicines. This requires the NCPE to complete a HTA of Kaftrio for this patient group. Until recently, Vertex did not engage with this process. Following extensive efforts from the HSE's corporate pharmaceutical unit, Vertex supplied its HTA dossier to the NCPE last month. The NCPE has agreed to treat this HTA as a priority case. The Minister is pushing to have the HTA completed as soon as possible. In the meantime, the HSE's corporate pharmaceutical unit continues its open dialogue with Vertex and met the company a couple of times in January.

The Government is committed to providing access to innovative new medicines for Irish patients. Budgets 2021 and 2022 saw €80 million of funding dedicated to new medicines. Some 112 new medicines, or expanded uses of existing medicines, of which 34 were for the treatment of rare diseases, have been provided since 2021. I thank Cystic Fibrosis Ireland for its efforts in bringing attention to this situation. The organisation provided valuable insight to the Minister during their meetings late last year. The voices of parents and of these children have also been heard and the Minister fully appreciates their concern. He and I are hopeful this situation will be brought to a satisfactory conclusion for everyone shortly.

Deputy Robert Troy

I thank the Minister of State. What is the difference for this particular sub-type? We have 35 children in this situation. I gave a personal example of one of them whose quality of life has been severely impacted by this decision. What is the rationale for this drug company not honouring a deal made a number of years ago? I welcome that a process has commenced and that the HTA will conclude very quickly. I ask that this happen within the next number of weeks, if not days, and that when that process is concluded the HSE proceeds at speed to make this drug available to this cohort of children. As I said, any delay is doing irreparable damage. If the children move onto the drug in a number of weeks, it will not be able to undo the damage that is already done, so time is of the essence. These children, like everyone else availing of this life-changing drug, deserve it. I ask the Minister of State to use his good offices to ensure the Minister continues to keep this as a priority so we can get a satisfactory conclusion in the next number of weeks, if not days.

Deputy Niall Collins

We fully appreciate the severity of cystic fibrosis and acknowledge the fears and frustrations of the families affected by this situation. I also acknowledge the circumstances the Deputy's constituents, Ciarán and his family, whom the Deputy spoke about in his initial remarks, find themselves in. The Minister is working on resolving this issue as a matter of high priority. He has been very clear in telling me that and it is his position and the position of the Government. It is a matter of extreme regret that Vertex has behaved in the manner it has. That being said, we are pursuing every avenue to try to remedy the situation.

The HSE has a statutory responsibility for medicine pricing and reimbursement decisions given under the Health (Pricing and Supply of Medical Goods) Act 2013. This requires the executive to ensure medicines are reimbursed in a cost-effective manner. The HSE is making an effort to fulfil its responsibility. Following extensive efforts by the HSE's corporate pharmaceutical unit, we are now beginning to see progress in this matter. The Minister, the clinical community and, most important, the families affected are all eager to see progress towards making this drug available to these children as soon as possible.

Home Care Packages

Deputy Michael Moynihan

I thank the Ceann Comhairle for allowing me the opportunity to raise this issue. The home care package is a service that has been a lifeline to many families throughout the length and breadth of the country. My family benefited enormously from it in times past. The work done by the care assistants who dedicate their lives to the care of others in their own home is invaluable, as is the care they give and their dedication.

It would be remiss of me not to say that at the outset. At present, we face a crisis in home care and the delivery of home care services. No more than any other Deputies from all sides of this House, my constituency office is getting calls daily from people trying to get home care packages or to find home help services available for loved ones. Due to advancing years, they may want to get an increase in the hours. The home help and home care services undoubtedly have provided an enormous service to the State over the years, have been hugely beneficial and have saved the State an enormous amount of money by keeping people in their own homes for as long as possible. However, we now have a major issue. We came through the winter and many families have been scraping together to try to put together a package. We have worked with some families to try to build a package with private care and so forth because they want to keep their loved ones at home for as long as is humanly possible and are trying to do that. We have been told time out of number by the HSE and the powers that be that there is a shortage of staff. This did not happen today or yesterday, but goes back a number of months.

The issue I want to raise today is what the State, the Government, the Minister and the HSE are doing to recruit more people into this area and to make the job of care assistant in the community more attractive. We have seen instances where the HSE has been contracting out hours to private companies to try to get cover but even that is proving difficult. Some of the senior HSE people are exhausted from trying to provide cover or get home help services. The HSE is then looking at the home help services in existence and is going out through the powers that be to see if they can reduce the hours for some people to spread the service more thinly on the ground. That is totally unacceptable because in some of the cases I have, families need more help for their loved one, not having it reduced because of a shortage of staff. The Government needs to be innovative about getting more people involved. The position of care assistant needs to be an attractive position and new people must be attracted into it to make sure. As we go on, it is fundamental and hugely important, given the aging population, that the home care and home help services are enhanced and strengthened because that is the only way we will be able to keep people in their own homes for as long as is possible.

Deputy Niall Collins

I thank Deputy Michael Moynihan for raising this issue and I am responding on behalf of the Minister for Health, Deputy Stephen Donnelly.

Improving access to home support is a priority for the Government. Since budget 2021, the Government has provided an additional €207 million in funding for home support to the Department of Health. This year, the overall home support budget will be more than €700 million. This 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. It also will fund nearly 24 million hours of home support this year. The dementia-specific proportion of new home support hours will increase from 5% in 2021 to 15% in 2023. The delivery of a high-quality consistent home support service is a key priority for the Cork and Kerry community healthcare organisation, CHO 4, focusing on keeping people well in their homes and communities for as long as possible, in line with enhanced investment.

As of November 2022, the latest available preliminary data show in excess of €19 million hours of home support had been delivered nationally in the year to date. Within the CHO 4 area, the home support service delivered more than 2 million hours from January to November in 2022 to over 7,000 clients. At the end of November there were 56,429 people in receipt of this service nationally. There were 3,240 new applicants funded and waiting for supports while 2,819 people already were receiving supports, albeit not for the maximum hours advised. The HSE has advised us that as of the end of December, 109 people were awaiting home support in north Cork. There are strategic workforce challenges in this sector that have immediate and longer-term implications. Current difficulties in recruiting healthcare workers are already affecting the level of service provision. This has the potential to be exacerbated over time due to an aging demographic. The Government has commenced a number of initiatives to address these challenges. Last year, the Minister of State at the Department of Health with special responsibility for mental health and older people, Deputy Butler, established a strategic workforce advisory group to address the challenges of recruitment and retention of home carers and nursing home healthcare assistants. The Government has published its findings and the implementation of the advisory group's recommendations has commenced. Since January 2023, the Minister of State, Deputy Butler has also secured 1,000 employment permits, which will allow home care workers from non-EU and non-EEA countries the opportunity to work in Ireland. This is an immediate intervention to support the sector. In conjunction with wider sectoral reforms that are in train, implementation of the group's recommendations will have a real and lasting impact on addressing our workforce challenges.

The HSE has advised the Department of Health that more people than ever before are being referred for home care. Consequently, delivery of this service is not without its challenges. Cork-Kerry community healthcare is acutely aware that there are staff resource issues across both direct and indirect provision of home support in Cork and other areas. In order to bolster staff resources and reduce waiting times for the allocation of service, Cork-Kerry community healthcare advertises on an ongoing basis for health care support assistants throughout the region in an effort to recruit as many suitable candidates as possible. Approved 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 and is ongoing across the region. The HSE has also advised that a good working relationship has been established between local hospitals and the community. Patients are regularly discharged directly home from acute settings with home support. Patients can also be offered a transitional care bed in a residential care facility until a carer can be assigned.

Deputy Michael Moynihan

I thank the Minister of State. There are a number of issues. There are 109 people waiting for services. Is there a policy to reduce the amount of home help hours to existing people, referred to in the document as clients, so as to spread the service more thinly because of the shortage of home care assistants? Strategically, in the Minister of State's own Department of Further and Higher Education, Research, Innovation and Science, should there not be an incentive put in place to recruit people to the home care assistants courses that are offered in many of the colleges throughout the country? The Minister of State mentioned permits being brought in to help with the service and that is very welcome but there are an awful lot of people who could be recruited. Has there been co-ordination between the HSE and the Department of Further and Higher Education, Research, Innovation and Science, to see if a new course can be created into which people could be recruited or equally, into the existing healthcare assistant course? If we do not do something at a fundamental level, we will be back here again. I have to say, from the evidence we are getting, we see some people who are well into their 80s and maybe older and there is talk of them surviving on less hours because of the shortage. We have to stamp that out because we cannot be reducing any services that are there. In some cases we have people who are in acute hospitals or in transition beds and they are waiting. They are fit to go home and would go home if there was a home care package available. That again is contributing to the issues across the hospital services.

I refer to the issue of spreading the services we have more thinly on the ground and what is being done to recruit more people at the bottom end and to make the package for a healthcare assistant more attractive.

Deputy Niall Collins

I thank the Deputy for his contribution. There is no policy to reduce hours and end-of-life care is always a priority for the Government. The Government remains committed to supporting people to age in place at home in their communities with access to wraparound supports, including day care and dementia-specific day care services, meals on wheels and home care.

As I mentioned earlier, delivering this enhanced capacity for support requires substantial recruitment and significant work is under way to address the strategic workforce challenges in this regard. The HSE also continues to advertise on an ongoing basis for healthcare support assistants and recruits as many suitable candidates as possible. The Department of Health is continuing to develop a regulatory framework for providers, which will comprise primary legislation for the licensing of providers and secondary legislation in the form of regulations and HIQA national standards. The HSE has begun the recruitment process for 128 interRAI care needs facilitators to progress the national roll-out of interRAI as a standard assessment tool for care needs in the community to determine prioritisation and levels of care required. The HSE is also progressing the recruitment of several key posts to support the establishment of the national home support office.

I was also recently involved in a Zoom call with the Minister for Health and the Taoiseach, and Oireachtas members from the mid-west region. This came on the back of the issue in the region. The specific issue raised by the Deputy also came up as part of that discussion and the point was correctly made that an employment regulation order is also needed for people who work as home carers. This key element is lacking in making this a viable career and option for people to go into work where they will have certainty in this regard. This point was also made on that call with the Minister and the Taoiseach and they were both accepting of it because we have done similar in the child care setting, where, as the Deputy will be aware, an employment regulation order was recently issued to give certainty to people working in that sector. The Deputy asked a specific question about my Department in this regard. It is the intention, and the Higher Education Authority has sought expressions of interest from our higher education institutions, to put on additional courses to train home care assistants and allied health professionals in this area.

Primary Care Centres

Deputy Chris Andrews

In recent weeks, I have met residents in Ringsend and Irishtown. They are greatly concerned that services are being moved from Ringsend and Irishtown primary care centre to the Meath Hospital. Residents are, quite frankly, dismayed by this decision. It will be a great imposition and have a major impact on them, and especially on older people.

Can the Minister of State confirm that this change is going to happen and that services will be moved from Ringsend and Irishtown primary care centre to the Meath Hospital site? These services are important. Residents received letters stating that the physiotherapy and occupational therapy sessions were going to be moved out of Irishtown. This is a well populated area, especially with older people, and this move will have a major impact on people. Regarding these older people, Deputy Moynihan, on the previous matter, mentioned keeping people in their homes. This move is going to fast-track people into hospital and lead to a deterioration in people's health. People are receiving these services because they already have mobility issues. There is no transport link from Ringsend and Irishtown to the Meath Hospital just off the South Circular Road. At the last general election and even at the last by-election, the Government candidate spoke about a 15-minute city. This is going to make a 15-minute city impossible because it will take two bus journeys for people to reach the Meath Hospital. When they arrive there and get off the second bus journey, they will then have to take a long walk up to the hospital.

This issue is about the restricting of access. This move is restricting access for older people in Ringsend and Irishtown to community services. People are genuinely dismayed that they will have to move from a perfectly good primary healthcare centre up to the Meath Hospital. In the letters sent to residents, I noticed that these are signed off with "Building a Better Health Service". These are also signed off with a subheading referring to "care, compassion, trust and learning". None of those elements appear to apply to this decision. There certainly does not appear to have been any learning by the Government if it is going to move a perfectly good health centre, and these services therein, to the Meath Hospital. This move will have a major impact and the Government must review this decision. It should ensure, instead, that it is increasing the services in the primary healthcare centre in Ringsend and Irishtown and not reducing them. I ask the Government to act on this issue.

Deputy Niall Collins

I am taking this Topical Issue matter on behalf of the Minister for Health, Deputy Stephen Donnelly. A central objective of the programme for Government is to deliver increased levels of integrated health care with service delivery reoriented towards general practice, primary care and community-based services to enable a home first approach. Primary care centres play an essential role in the delivery of that objective and significant progress has been made in the delivery of these centres nationally. These centres support the delivery of integrated care by facilitating closer co-ordination and co-operation among health professionals from across different disciplines. They also provide a single point of access to services for the individual and can serve as a resource more broadly for the community. There are currently 165 primary care centres operational and 12 more are scheduled to be delivered during 2023.

The Irishtown and Ringsend primary care centre is one such centre facilitating a range of services, including speech and language therapy, occupational therapy, public health nursing, physiotherapy, psychology, dental services, general practice services and community medical doctors. The HSE has advised that there has been no specific reduction in services in the Irishtown and Ringsend primary care centre. At present, the management and oversight function for Irishtown and Ringsend primary care centre and all HSE services connected to the centre are transferring from CHO 7 to CHO 6. The HSE has assured the Department that this transition of services refers to the management of the services only and not the services themselves.

The transition has commenced, and it is expected that the services currently available will continue to be delivered. In fact, the HSE has advised of plans for the addition of podiatry services to be made available to the population of Irishtown and Ringsend. Currently, unfortunately, dietetics is not provided in the area due to recruitment challenges. The Minister, however, has been assured that active recruitment measures are ongoing and that it is expected this service will soon be available. The HSE has also assured the Department that CHO 6 will continue the recruitment process for current vacancies in Irishtown and Ringsend primary care centre and that HSE management in CHO 6 will be supported by their counterparts in CHO 7 during the transfer to ensure there is a seamless transition of services, which are management services.

Deputy Chris Andrews

That sounds positive. Clearly, though, this information has not been communicated very well.

Many people in Ringsend and Irishtown received these letters and they interpreted them to mean their service would be moved to the Meath Hospital primary care centre. My understanding, and the Minister of State might correct me, is that the files and records will be kept and stored in the Meath Hospital but the services, including additional services, will be at the primary care centre in Irishtown and Ringsend. Is that a fair analysis? Clearly, this is a huge catchment area for people who need these services. These services are vital to keeping people at home. Ringsend and Irishtown are home to a large pool of people who need these services, and they are vital to ensuring the community stays together, stays active and stays engaged. As stated, the idea that people would have to move out of Ringsend and Irishtown for these services is madness. It is positive to hear that services will be increased and that they will be delivered on site.