Dáil Éireann díospóireacht -
Wednesday, 15 Feb 2023

Vol. 1033 No. 4

Ceisteanna ó Cheannairí - Leaders' Questions

Deputy Mary Lou McDonald

Yesterday, I raised the matter of the patient safety Bill with the Taoiseach. I record that the 221+ group, working with the Minister for Health, alongside my colleague, Deputy Cullinane, and Deputy Kelly, have agreed an appropriate wording for an amendment to that Bill. I commend and thank all of them for that work. It has been most constructive and very much welcomed by the 221+ group.

The cost-of-living crisis is impacting on households. People struggle to keep up with soaring bills across the board. Many people, three in five, according to a report from Deloitte, have no money left at the end of the month. People are now very worried about the months ahead. Times are especially hard for those on low pay whose wages have been outstripped by soaring costs. A report published by the Mandate trade union today presents the stark reality faced by many working in the retail sector. We see two thirds of retail workers earn less than €450 a week and only 20% of them earn more than €500 a week. The main reason for this is that many workers are not able to get the hours they need to make a decent living. Sharp practice by some employers denies additional hours to workers when they become available, forcing many close to the breadline.

We are living through the biggest squeeze on household incomes in 40 years. Rents are through the roof, mortgage repayments are soaring, energy bills are out of control, grocery bills are increasing sharply and childcare fees are sky high. How can someone on a low or middle income get by? The answer is with very great difficulty. Many are on the brink. I spoke to one retail worker this morning who told me about the stress and pressure that she is under. Here is what she told me:

I work hard but I just don’t get the hours I need to live with any security. Things were bad already, but we were just about getting by. Since the rise in living costs, I am having real trouble paying my bills. We’re really worried about being able to keep up the mortgage now. I don’t have a hope of putting any money away for a rainy day or if something goes wrong. The money isn’t there. I have colleagues - people who put in tough shifts - but they are now choosing between putting food on the table or paying the electricity bill. There is so much uncertainty and worry. It’s really tough going.

Léiríonn tuarascáil Mandate go bhfuil oibrithe ar phá íseal faoi bhrú ollmhór de réir mar a leanann an ghéarchéim sa chostas maireachtála ar aghaidh. Ní mór don Rialtas pacáiste tacaíochta a thabhairt chun cinn chun an chinnteacht atá ag teastáil a thabhairt do theaghlaigh.

The cost of living is devastating for people but just as it did last year, the Government is moving far too slowly in responding. Like last year, the Government is failing to give workers and families the clarity and certainty they need. In the last couple of weeks, the Government refused to back mortgage relief measures and refused to legislate to ban extortionate rent increases. When I asked the Taoiseach yesterday about extending the eviction ban, he came up blank. People are struggling now. They want to see a plan from the Government that will help them make it through the difficult months ahead. People are worried now. I ask the Taoiseach to give them the certainty they need today. I ask him to lay out clearly what actions his Government will take as the cost-of-living crisis continues to bite hard.

The Taoiseach

I will take a moment to pay tribute to Scotland's First Minister Nicola Sturgeon, MSP, who announced her resignation today. I met her many times in Dublin and also in the context of the British-Irish Council. I always found her to be an impressive, competent, articulate and thoughtful politician, a true European and a friend of Ireland. Certainly, she will always be welcome at our table. Táimid fíorbhuíoch de Nicola Sturgeon, Céad-Aire na hAlban. Is polaiteoir cliste, misneach agus láidir í. Bhí sí mar chara na hÉireann agus cara na hEorpa.

Maidir le ceist an Teachta, tá an costas maireachtála an-ard in Éirinn anois agus tá a lán teaghlaigh agus daoine faoi bhrú. Rinne an Rialtas go leor agus cabhróidh an Rialtas sa todhchaí freisin. I acknowledge the fact that many people are suffering as a consequence of the rising cost of living. As the Deputy previously acknowledged, people appreciate that the factors driving it are largely international, including high energy prices, the war in Ukraine and a prolonged period of monetary policy that has now given rise to a high level of inflation.

The Government has taken many actions to date. We will continue to act in the coming months to help people with the cost of living. Unfortunately, it will not be possible to fully compensate people for rising costs. We will do that as best we can for those on the lowest incomes and those who need the most help. However, it will not be possible for us to do it for everyone as, ultimately, anything we do is done with taxpayers' money and has to be recouped from people and businesses in the long run.

It is worth once again putting on the record the 25 interventions the Government has already made to help people with the cost of living. These are: an autumn double payment of weekly social welfare and pension payments; a double payment of child benefit; a €400 fuel allowance lump-sum payment; a €500 working family payment lump-sum payment; €500 for people with disabilities, people who are blind and people on the invalidity pension; a €200 lump-sum payment for people in receipt of the living alone allowance; €500 for carers; a Christmas bonus double payment for pensioners and people on social welfare; in the past few weeks, a €12 a week increase in pension and weekly social welfare payments, which is the largest single increase since the mid-2000s; the largest ever expansion of the fuel allowance scheme, with a particular focus on people over 70; increased income thresholds for the working family payment; the expansion of hot school meals; an increase in the back-to-school clothing and footwear allowance; two fuel allowance lump-sum payments; an energy credit of €200, with another €200 being paid at the moment and a further €200 to come in March; a reduction in student fees; a 25% reduction in childcare costs; a rent tax credit; a reduction in public transport fees; a reduction in the cost of the drugs payment scheme; and reductions in VAT and excise duties.

A lot has been done, but we acknowledge that inflation is still high, that prices continue to rise and that we will need to act again in the coming weeks to help people with the cost of living through the spring and summer. Ministers will meet this week with a view to making a decision at Cabinet next Tuesday on further actions we can take.

Finally, I have not yet had a chance to read the Mandate report but I have seen the summary. The Government is committed to making work pay better and ensuring that efforts are rewarded. There was a 7.8% increase in the national minimum wage only a few weeks ago. We think that will actually exceed the inflation rate for this year, and that will result in a knock-on increase for others on low pay. Statutory sick pay is now a reality, workplace tips and gratuities are now protected, we have had the additional public holiday and we are now moving towards a living wage over the next four years.

Deputy Mary Lou McDonald

I also acknowledge Nicola Sturgeon, who has been an outstanding leader and an outstanding advocate for the independence of her country. I have absolutely no doubt but that she will continue always to advocate for the country and the people she loves. Nicola, beir bua agus beannacht.

The Taoiseach gave me a very studied non-answer to my question, unless he is contesting the reality that three in five people report that they have no money left at the end of the week, or unless he is contesting the fact that those on low and middle incomes are struggling badly and need answers from him now as to what he is prepared to do now, not retrospective self-praise, which, I remind him, is in the end no praise.

I have asked the Taoiseach to set out specifics. People are struggling with the cost of their mortgages, they are struggling with the cost of their rents and their energy bills are now sky-high. As for groceries, it is widely reported that people are making choices between food on the table and the electricity bill. Will the Taoiseach please be more specific and set out in his view what needs to happen to support these struggling families?

The Taoiseach

I am not in a position to be specific today. Ministers will have to meet later in the week to look at all the options, come to a decision on them and then bring a recommendation to the Cabinet on Tuesday. I will be able to be specific in a few days' time, once we have made those decisions. I do not think it is unreasonable of me to point out what has been done. It would be a more gracious Opposition leader who would be willing to acknowledge what has been done. I have pointed out what has been done.

I have been a bit concerned as I have listened to some of the things the Deputy has said over recent weeks. We have stood opposite each other in this Chamber again on only a few occasions so far this year, and in that period the Deputy has proposed an uncosted energy price cap, she has proposed to reopen historical compensation schemes, she has proposed to refund what she says are illegal nursing home charges to a cost of up to €7 billion, she has proposed to increase the rent tax credit and she has proposed mortgage interest relief. None of that can possibly add up. People in Ireland have a good education system; they are able to add and subtract.

Deputy Mary Lou McDonald

As am I.

The Taoiseach

Even with Sinn Féin's 13 tax rises, it cannot afford to keep all those promises. People are starting to see through Sinn Féin.

Deputy Martin Browne

It is the Government's policies that are referred to in this report.

Deputy Ivana Bacik

I also acknowledge Nicola Sturgeon's stepping down today after an eight-year term as Scotland's First Minister. She has been undoubtedly a powerful force in Scottish politics throughout that time. I wish her well personally following that surprise announcement.

The Taoiseach has acknowledged that people across the country are struggling despite the Government's measures introduced in the budget last year. We in the Labour Party predicted last October that there would need to be a mini-budget or a series of further measures implemented by the Government in the spring in order to deal with the cliff edge so many households face now as they see one-off measures come to an end. The Taoiseach has said he will meet with Ministers later this week and will make recommendations to the Cabinet on Tuesday. We are likely, therefore, to see in coming days a drip-feed of leaks emerge from the parliamentary party meetings of Government parties. We are likely to see kites flown and the Government testing the waters to see which proposals are politically expedient and which are not. I hope I am wrong in that prediction but I think it is very likely. However, it would be an insult to households across Ireland who are simply powerless at present. They are unable to plan for the future because they simply have no clarity or certainty from the Government on what will be included in what it is not calling a mini-budget but what will undoubtedly be some sort of cost-of-living package of measures. We are already hearing stories about what may be introduced by the Government but we need clarity.

I will give the Taoiseach an example of a household in my constituency which simply cannot withstand this non-stop kite flying and needs urgently to see clarity from the Government. I raised this case earlier today during the debate on the windfall tax. My constituents, a family of two adults and two children, received a heating bill recently. Despite having been away for three weeks over the two-month billing period, their district heating bill for those two months alone stands at €1,700, a shocking figure. They cannot afford to wait weeks without knowing with any clarity what will come from the Government to assist them.

Other constituents of mine, a single mother and her child who are housing assistance payment, HAP, tenants, have been forced to turn off their heat and hot water altogether because they cannot afford the extortionate bills. With seriously cold weather due to arrive at the end of this month and a "beast from the east" predicted, that mother, and so many others, cannot afford weeks of kite flying from the Government.

We have heard from so many other constituents. One family cannot pay off their tracker mortgage, which is likely to have risen by over €450 per month with the new interest rate increases. They say they simply cannot afford to cut back on anything else.

Right across the country people are struggling. What we need to see is clarity from the Government now as to when the mini-budget will be announced and what its measures will include. Will they be targeted, as Social Justice Ireland has called for, or will they be simply a series of more universal measures which are unlikely to make any real impact for the families I am talking about who are struggling and are in such a dire state of paralysis because they simply do not know how they will meet their spiralling bills?

The Taoiseach

We had a budget in September and it was passed by this House in the form of the Finance Bill, the Appropriation Bill and the Social Welfare Bill by very clear majorities. We will not have a mini-budget. That is not necessary. The budget set out the fiscal parameters for this year, and anything we do or announce between now and the next budget will be done within the confines of those parameters. However, we have some room to manoeuvre. There has been an underspend on the temporary business energy support scheme, TBESS, which means we will be able to do more for business. We have some reserve funds. We will also have revenue coming in from the windfall tax on energy companies. That allows us some room for manoeuvre within the budget parameters of this year. There will be no requirement at all for a mini-budget between now and budget 2024 in the autumn.

I take the Deputy's point about kite flying and speculation. I do not want to say anything today that might raise expectations that end up being dashed next week.

Deputy Sean Sherlock

The Taoiseach is departing from his usual practice.

The Taoiseach

I do not want to make promises today that I may not be able to keep-----

Deputy Aodhán Ó Ríordáin

Like a 30% tax rate.

The Taoiseach

-----and I encourage Opposition parties to follow that policy and not to make promises they cannot keep. People will have clarity no later than next Tuesday. Ministers will meet over the coming days and we will be in a position to set out what we will do on Tuesday. It will probably require a short finance Bill, perhaps next week, or if not next week-----

Deputy Aodhán Ó Ríordáin

So it is a mini-budget.

Deputy Sean Sherlock

It is a mini-budget.

The Taoiseach

-----within the next few weeks, to do what we propose.

Deputy Aodhán Ó Ríordáin

It is a short-term budget.

The Taoiseach

As to what the measures will look like, they will be both universal and targeted. They will be targeted because pensioners, people on low incomes and people in receipt of social welfare payments are suffering the most from the rising cost of living, particularly because groceries and energy costs have gone up the most. There will therefore be targeted measures and there will be a welfare element to this, as I said on Sunday. There will, however, be universal measures as well because all households, including middle-income households, are experiencing the rise in the cost of living, and I do not think it would be right to tell middle-income families that they are being left out and that we are doing nothing for them.

Deputy Ivana Bacik

If it looks like a rose and smells like a rose, it is a rose. This sounds like a mini-budget. If there is a finance Bill, it sounds very much like a mini-budget. I am glad that the Taoiseach has confirmed that there will be clarity on Tuesday. Will we have a Dáil debate next week? Are people likely to know next week what the nature of the measures will be, which ones will be targeted and which ones will be universal? It would be reasonable to give legislators in this Chamber some indication of a timeline for the introduction of these measures. I agree with the Taoiseach that speculation is unhelpful. There has been speculation on things like a 30% tax rate, for example. These kite-flying suggestions are simply not helpful in the context of struggling families and households.

I want to finish by referring to the Mandate report that was launched today. I was glad to meet Mandate earlier and to hear directly from it about the stark examples and situation of so many of its members, 64% of whom earn below €451 per week. That is in a context where, in Dublin, average monthly rents are €2,324 per month. This figure illustrates the shortfall for so many people who simply cannot afford even to pay rents, let alone meet the other bills that are spiralling. I ask the Taoiseach to give us clarity on the timeline for next week now that we have established that next Tuesday will be critical.

The Taoiseach

I can assure people that there will not be a cliff edge on 28 February when a lot of the measures are due to expire. We will make decisions no later than the Cabinet meeting next Tuesday, we will inform the Dáil and the public next Tuesday and then any legislation that has to be done between now and 28 February will be done. I know we will have the Deputy's co-operation with that matter.

On the Mandate report, as the Deputy knows, we are moving from a national minimum wage to a living wage. This is year one of the four-year process of doing that. I understand that in its report, Mandate points out that a lot of retail workers would like to earn more by working longer hours but the banded hours contract system prevents them from doing that. I believe in rewarding work and in making work pay more. If people want to work longer hours, they should be allowed to do so, provided it is not a breach of the working time directive. On foot of the report Mandate has published, the Minister of State with responsibility for employment affairs and retail business, Deputy Richmond, will be happy to sit down with Mandate, hear it out and see how he can respond in a meaningful way.

Deputy Verona Murphy

In 2016, EUROSTAT reported that Ireland has one of the lowest police to population ratios in Europe, with 278 gardaí per 100,000 citizens. That is 40 less than the EU average of 318 per 100,000. Since these 2016 figures were compiled, Ireland is reported to have increased its population to over 5.1 million people as of April 2022. A recent report based on Garda website figures and freedom of information requests shows the Garda to population ratio to be 241 gardaí per 100,000 of population. That is another reduction of some 38 gardaí per 100,000 of population. In recent weeks and months there have been daily headlines such as: "Revealed: the 42 garda stations without any full-time officer". Another headline stated:

Garda morale is at a low as a ‘culture of fear’ pervades the force. One in three of the officers who left last year resigned rather than retiring on age, health or other grounds.

We used to have a problem in not having enough patrol cars but now we do not have enough gardaí to drive them. We read such headlines every day.

Some 450 gardaí left the force last year and the Taoiseach's statement to Deputy McDonald yesterday was that there was enough funding in place for garda retirements and resignations to be taken care of. However, there are only 89 gardaí in training. Was the Taoiseach's statement yesterday accurate? Deputy Varadkar has been in government since 2017, either as Taoiseach or Tánaiste, and the declining numbers are a crisis. Every town in the country is showing signs of this failing. There is no point in setting up drugs task forces or committees to make recommendations that cannot be implemented because the gardaí are not available. There is no point in passing laws to address these issues either.

This same recruitment and retention crisis exists across many of our Government Departments, all of which are getting worse. If money is not the issue, we need to look at the structure and management of same. I asked the Taoiseach last week to review the reason garda transfers were taking so long and he was quite flippant in his response. My information is that gardaí who are driving five hours per day to serve active duty are ready to resign from the force. While I welcome the announcement from Commissioner Drew Harris that the Garda will conduct exit interviews from now on, it is akin to closing the stable door when the horse has bolted. If you listen to any of the representative organisations or associations, the problems are well pronounced, but it seems that no one in charge is listening. Can the Taoiseach give details of what long-term plan is in place to ensure garda numbers grow with the population and are retained in line with European norms?

The Taoiseach

It is the objective of the Government to build safer and stronger communities. In order to do so, we need more gardaí and we need to properly train and support them. We also need to invest in our Defence Forces, the Courts Service and the Irish Prison Service. I appreciate that gardaí are working hard, they are under a lot of pressure and their jobs are much more challenging than they would have been in the past for lots of different reasons. We need to increase the number of gardaí we have. In the budget we allocated enough money to recruit 1,000 new gardaí this year. That has to take account of the fact that there will be retirements, as there always are, and that there will be resignations, as there always are. However, it will still be enough to see a net increase in the number of gardaí this year, and that is what we expect and anticipate will happen. There was a slowdown in recruitment due to the restrictions brought in due to Covid and we will now see recruitment speed up. That is happening already. I met the Garda Commissioner about this before Christmas and I have spoken to the Minister, Deputy Harris, about it as well.

In any comparisons we make, we have to bear in mind that the Garda does not just consist of sworn officers but that there are also Garda staff. Increasingly, we have Garda staff being employed and they are freeing up gardaí for front-line duties, which is of particular importance. The number of gardaí in the country fell to about 12,000 back in 2015 and that was after a period of austerity and retrenchment. By the end of last year it had gone up to 14,000 but I appreciate that is in the context of a rising population and we have to adjust for that, not just when it suits us but for all metrics. Our target is to get up to 15,000 gardaí.

On resignations, roughly 100 gardaí resigned from the force last year, which is roughly a 1% resignation rate. We live in a different world from the one we had five, ten or 15 years ago. Now it is typical in an organisation to see resignation rates of 5% or 6%. We have full employment and people are less interested in the job for life so a 1% resignation rate is not particularly high, either by international standards or when you compare it with other organisations. However, exit interviews are useful and I am glad they will happen.

On transfers, I am sorry if I did not answer the Deputy's question appropriately last week. I do not know the detail of that particular issue but if she wants to give me some more information on it, I would be happy to take it up with the Minister, Deputy Harris, who can then talk to the Commissioner about it.

Deputy Verona Murphy

I appreciate that. While 100 resignations may reflect only 1%, the reality is that if the job was good enough I am not sure we would have any resignations. We need to carry out the exit interviews immediately and we also need to listen to the representative organisations. In County Wexford, Rosslare has seen increased and exponential growth because of Brexit. We have 550,000 passengers coming through the port. In 2022, we had 200,000 freight units come through. However, we have seen no increase in resources, despite numerous business plans being put forward by the hierarchy in the force in Wexford. We have seen a 75% reduction in gardaí in Courtown - from four gardaí to one - even though it has seen population growth. Bunclody is a sizable town, although it is not a town as named in Wexford. It is a big area, but we have reduced capacity in the Garda force there from eight to four. It is not good enough. We have drug issues all over this country. It is not just Wexford but it is all over the country. The front of our local newspaper carries a story every week on the increase in crime. I ask the Taoiseach to take that in hand.

The Taoiseach

I assure the Deputy that I will take it in hand and it is a priority for me as Taoiseach and for this Government to build safer and stronger communities. That involves increasing the number of gardaí and investing in our Defence Forces, the Courts Service and the Irish Prison Service.

It also involves dealing with the underlying causes of crime which are very much linked to poverty and deprivation, and other matters too. We are making a priority of this. As I mentioned earlier, the Garda is funded in the budget to recruit 1,000 gardaí this year. We believe this will be more than enough to cover retirements and resignations. That will lead to a net increase in the number of gardaí this year as we move towards the target of 15,000. Only this week, I will be having a meeting on the issue of Garda stations. A number of projects have been held up for far too long in different places in the country and we are trying to get movement on them as well.

Deputy Carol Nolan

I want to raise with the Taoiseach the lack of services for neurology patients. Before I begin, I acknowledge the great work that has been done by an advocate and, indeed, a patient of neurology herself, Dr. Rosie Mangan, from County Offaly. Rosie attends hospital, and has to travel to Dublin four times a week. She is an advocate, as I say, and has launched a campaign, Right to Rehab. I acknowledge that lady's great work, some of which I am sure the Taoiseach will be aware of.

Indeed, I am sure the Taoiseach will be aware that neurological conditions which affect the brain and spine are the leading cause of disability throughout the world and include many common conditions such as stroke, migraine, epilepsy and acquired brain injury in addition to certain rare and genetic conditions. According to the latest data to hand, almost 24,000 Irish people are on a waiting list for a neurology outpatient appointment. The number of people on the neurology outpatient waiting list is continuing to rise, with the number waiting more than 18 months increasing by 30% in the past year. In fact, there is also a shortfall of 100 neurology nurses in Ireland based on official national and international guidelines relative to population. It is in that context that the Patients Deserve Better campaign was launched. It is being promoted by the Neurological Alliance of Ireland, which is an umbrella group of non-profit organisations advocating for the rights of 800,000 citizens living with a neurological condition.

Today I want to focus on one particular ask, and that is the need for a dedicated community neuro-rehabilitation team for community healthcare organisation, CHO, 8, which includes my constituency of Laois-Offaly, where just one in every two neurology patients has access to services. A community neuro-rehabilitation team for CHO 8 was recommended in the implementation framework for the national neuro-rehabilitation strategy 2019-21 but no team has been funded despite implementation of this framework being a commitment in the current programme for Government.

These multidisciplinary teams provide access to key specialist supports, including physiotherapy, speech and language therapy, neuropsychology and occupational therapy, for people living with a range of neurological conditions including acquired brain injury, Parkinson's disease, multiple sclerosis and rare neurological conditions such as motor neurone disease and Huntington's disease.

We can only imagine what a deficit in services means for those directly affected by such a diagnosis but for their families and loved ones who have to travel to St. James's Hospital in Dublin three or four times a week because there are no local services, it is simply appalling. Will the Taoiseach work with the Minister for Health to commit to the delivery and prioritisation of a neuro-rehabilitation team for Laois-Offaly and the wider CHO 8 area?

The Taoiseach

I thank the Deputy for raising this important issue of neurology services, generally and particularly in CHO area 8 and in Laois-Offaly. It is a specific question about a specific branch of medicine in the Deputy's part of the country, which is the midlands. I do not have a detailed note on it right now but I will try to get the Deputy more information in writing this week or next week. What I can say in broader terms is that we acknowledge that neurology services are nowhere near the standard that they should be. The budget for this year provides additional funding for community-based neuro-rehabilitation teams. I am not sure if CHO 8 will be one of those but we will try to come back to the Deputy with more information over the next couple of days.

One of the issues that we have had a difficulty with is recruiting consultant neurologists around the country and that has caused waiting lists to rise in some parts of the country. We are now at the point where we have a new consultant contract, which is being offered. I understand the Irish Medical Organisation will ballot its members on that. The Irish Hospital Consultants Association will survey its members on it. We hope to be in a position to offer that in a matter of weeks. It is a very attractive offer financially. It requires consultants to phase out private practice in public hospitals and commit to the public health system. It also amends working practices so that we can get more value and make sure more patients get seen. That is a significant reform that the Minister for Health, Deputy Stephen Donnelly, has pretty much got over the line and will bring us a big way towards achieving the vision in the Sláintecare report.

We are also training more advanced nurse practitioners. As somebody who has worked in the health service, I know the excellent work that advanced nurse practitioners do. The more of them we can train, the better. The same goes for clinical nurse specialists.

Finally, I would like to mention to the House that while we do not have the exact figures yet, we are in a position to say that we are now making progress in terms of waiting lists overall, albeit certainly not in every specialty and not in all parts of the country. As the House will be aware, in the Sláintecare report we more or less said that nobody should be waiting more than three months for a procedure or to see a specialist. We all acknowledge there will always be people waiting a few weeks, but nobody should be waiting more than three months or so to see a specialist or to have a particular procedure done, and there are Sláintecare targets in that regard. The end of year figures for 2022 would indicate that the number of people waiting more than that three-month benchmark in Sláintecare has fallen by somewhere between 4% and 10%. That is against a backdrop where we see waiting lists rise north of the Border, in Britain and across the world, against the backdrop of Covid and against the backdrop of a cyberattack. It shows that we are finally making some meaningful progress in terms of waiting lists. We intend to build on that this year.

Deputy Carol Nolan

I thank the Taoiseach for his reply. I want to acknowledge the work done by Senator Victor Boyhan, who brought forward an excellent motion on this issue in the Seanad. There is cross-party support. Deputies in all parties, as I said, have raised this, as have Senators. It is something that has to be got to grips with.

The Taoiseach mentioned that the budget provides for funding for neuro-rehabilitation teams. CHO 8, which includes Laois-Offaly, is without doubt one of the worst. It has to be prioritised because patients are being failed. If just one in every two patients is getting access to a service, particularly when it involves a serious condition such as a neurological condition, it has to be prioritised. I would stress to the Taoiseach that a neuro-rehabilitation team needs to be delivered in Laois-Offaly and the wider CHO 8 area.

I acknowledge that approximately 3,230 additional neurology outpatient appointments were due to be delivered by 2022 through once-off funding. The problem with once-off funding is that it does not provide a patient pathway. It is not long term. It is not consistent. What we need here is long-term vision and consistency.

The Taoiseach

I again thank the Deputy. I am advised that we have funding this year for 23 neuro-rehabilitation nurses. These will be permanent positions, not once-off ones.

As I mentioned in my earlier reply, we have a new consultant contract that is being offered. I hope the bodies that represent doctors will accept that. It will allow us to take some significant steps forward in terms of retaining and hiring specialists in neurology and other areas over the next couple of years.

In relation to CHO 8 which, I appreciate, covers Laois-Offaly, and is the priority of the Deputy's question, I do not have a detailed note on that here. I do not want to give the Deputy information that might not be correct. We will correspond with the Deputy over the course of the next week and give her any more information that we can.