Dáil Éireann díospóireacht -
Thursday, 23 Feb 2023

Vol. 1034 No. 2

Ceisteanna ó Cheannairí - Leaders' Questions

Deputy David Cullinane

I welcome the ambassador from Ukraine. We stand with the people of Ukraine. I also welcome the other guests in the Visitors Gallery.

I am sure the entire House will join with me in unreservedly condemning the attack on an off-duty police officer in Omagh last night. My thoughts are with the officer injured in the shooting and his family, who will be traumatised by this attack. It is an attack on the entire community and must be condemned in the strongest possible terms. Anybody with information on this attack should bring it forward to the police. The sooner those responsible are behind bars the better.

On behalf of Sinn Féin, I wish Deputies Catherine Murphy and Shortall well following their announcement that they are standing down from their leadership positions. I offer my best regards to them and their families.

Yesterday, HIQA published a report on the emergency department at University Hospital Limerick. The report found non-compliance with five national standards in the form of: a significant deficit in governance and management arrangements; gross overcrowding; major patient flow issues; and a significant shortage of medical and nursing staff. Also yesterday, the Irish Nurses and Midwives Organisation, INMO, published trolley watch figures which show that there were more than 100 people on trolleys in University Hospital Limerick and that there were more than 600 on trolleys across the State on Monday, Tuesday and Wednesday of this week. I put it to the Tánaiste that there was only one day so far this year when there were fewer than 400 patients on trolleys. That is simply not good enough. Emergency department waiting times are through the roof under the Government. Patients in need of emergency care are now waiting 20% longer than in 2019, which is nearly three hours longer. Last year, patients who were admitted to hospital through an emergency department waited for more than 12 hours on average. In December of last year it was a scandal when patients had to wait for more than 15 hours on average. For those over the age of 75, it was a 17-hour wait on average across all hospitals.

Some hospitals are performing even worse. In the Tánaiste's constituency in Cork, the average wait time at the emergency departments in the Mercy University Hospital and Cork University Hospital was more than 24 hours. Scandalously, in the month of December last year older people aged over 75 were forced to wait for 40 hours at Cork University Hospital. How can the Tánaiste stand over this? Many of these people were obliged to wait for days on end. This is beyond scandalous and is happening on the Government's watch.

Hospital overcrowding is also causing problems for the ambulance service. At yesterday's meeting of the Joint Committee on Health, we heard that the average hospital turnaround time in Dublin last year was 39 minutes. In 16% of cases, it was in excess of one hour. Ambulance response times in general are up 50% since 2019. Every ambulance that is waiting for 40 minutes to transport a patient is an ambulance that is needlessly taken off the road. As the Tánaiste is aware, overcrowding leads to cancellations and disrupts waiting lists.

In budget 2022 and budget 2023 the Government and the Minister for Health did not fund one additional acute inpatient bed beyond what was funded in budget 2021. From discussions we have had with hospital managers across the State, we know that they are crying out for more capacity and more beds. Yet, the Minister for Health and the Government are not delivering. We are seeing people waiting far too long in emergency departments. The Minister acknowledges that people are waiting for too long, but there is no plan.

How can the Tánaiste stand over a situation whereby, in December, people over the age of 75 in his constituency were obliged to wait more than 40 hours to access beds? Some of them waited for days on end. That is not acceptable. Will the Tánaiste put additional bed capacity in place now in order that next year and next winter we will not have the same problems as this year?

The Tánaiste

I thank the Ceann Comhairle for reminding us of the horrors of nuclear war, and for his comments in respect of the terrible war being waged upon the people of Ukraine as a result of the illegal and immoral invasion of their country by the Russian Federation.

Closer to home, like many others, I find myself struggling to comprehend the savagery and depravity of last night's attack on Detective Chief Inspector John Caldwell, a man whose day job is finding and prosecuting those responsible for the worst and most dangerous threats to his community. This is a man who was spending his free time working with young people at a sports centre, and coaching them in teamwork, friendship and fitness. He was there with his young son and was putting away the equipment when two individuals with weapons walked up and fired multiple shots into his body. They shot him again and again.

They did everything in their power to try to kill him in front of his young son and other children. The very best sort of a man was attacked by the very worst. I am sure we in this House are all united in articulating our absolute and heartfelt disgust at and condemnation of those behind the attack last evening. As Deputy Cullinane said, anybody who has any information at all is duty-bound to give it to the policing authorities. We know that many thousands of others understand the trauma that such attacks and similar experiences over the decades have caused. We do not want to go back to that and we will not go back to it. I welcome the joint statement of all the political parties in the North that was issued this morning in response to this.

Ionsaí uafásach ab ea é gan dabht agus tharla sé os comhair a mhic agus os comhair daoine óga. Níl aon amhras ann ach go n-oibríonn John Caldwell go dian dícheallach, lá i ndiaidh lae, chun muintir an Tuaiscirt a chosaint. Táimid ag smaoineamh air agus ar a theaghlach. Na daoine atá freagrach as an ionsaí seo; caithimid iad a thabhairt os comhair na cúirte.

In respect of the health services and in response to the Deputy's comments, I make the overall point that there has been unprecedented investment in our health services since this Government came into office. The emergency waiting times and the large numbers attending are a cause for concern, particularly in the context of University Hospital Limerick, Cork University Hospital, Mercy University Hospital and other hospitals. It also needs to be pointed out that activity levels in our hospitals have gone up significantly. Post Covid, there has been a significant impact on our hospitals. Covid continued to have an impact over the recent winter period.

More than 1,000 beds have been provided since this Government came into office. Deputy Cullinane neglected to mention that and gave the impression that no beds at all have been provided. We need to do more, however. In answer to the Deputy's question, we will provide more beds and more capacity. A focus now for Government and the Minister for Health is the provision of additional acute hospital beds through modern methods of construction that will deliver those beds much more quickly than would be the case using conventional methods of procurement and provision. The Deputy must acknowledge that the enhanced community care programme has been a significant success in bringing a focus to much of our healthcare, including primary care, which is working strongly with enhanced community care. Ultimately, that is the most effective way to prevent overcrowding in emergency departments and to give people treatments in the right location at the right time by the right physicians.

Deputy David Cullinane

The Tánaiste said that the waiting times at Cork University Hospital and University Hospital Limerick are a cause for concern. They are not just a cause for concern, they are completely unacceptable. What is happening is shocking and scandalous. I put it to the Tánaiste that, in his constituency, people over the age of 75 who deserve better and who should be treated with respect and dignity waited, on average, 40 hours for treatment in the month of December. That is a scandal. The Tánaiste referred to beds. Some 1,200 beds were funded in budget 2021. About 200 of those beds have still not been delivered but the Tánaiste seems to think that is it. There was nothing in budget 2022 or in budget 2023. The Tánaiste seems to think the job is done, yet we have hospital management across the State screaming out for more beds and more capacity. The Government has to do more.

It is not just about beds; it is also about what is happening in the community. We do not have enough step-down beds or recovery beds. We do not have enough GPs, and out-of-hours GP services are collapsing. That is all putting huge pressures on our hospitals and on emergency departments. Despite the Tánaiste's talk, the Government simply has not done enough and much more needs to be done.

The Tánaiste

In my time, we put unprecedented investment into infrastructure in Cork. Regrettably, in the past while, significant proposals did not come forward to the degree that they should have.

Deputy David Cullinane

Say that to the Minister.

The Tánaiste

I come from the region and I am well aware of the position. The projects are now coming on stream. The lack of ready-to-go projects in respect of certain hospitals has been a cause of concern for me. That is why we are looking at a faster method in the context of getting projects delivered. We are saying that we will build more facilities and increase the number of beds. We are going to do this and it will be additional to the unprecedented 1,000 beds provided since 2020. We did not experience a similar expansion in the number of hospital beds in any recent decade.

Deputy David Cullinane

Yet the Government took them out.

The Tánaiste

Parallel with that, there has been a massive increase in the number of people working within our health service. In that context, there are 17,000 more people working in the health service than was the case at the beginning of 2020. That is a 15% increase and it includes more than 5,000 nurses, nearly 3,000 health and social care professionals and 1,800 doctors and dentists. We need to and will do more to provide additional capacity in the context of both personnel and beds.

An Ceann Comhairle

In calling Deputy Catherine Murphy, I acknowledge that she and Deputy Shortall enjoy widespread respect across the House. I wish them well in the next phase of their careers.

Deputy Catherine Murphy

I thank the Ceann Comhairle and Deputy Cullinane. I, too, utterly condemn the shooting of the policeman in Omagh last night. It was truly shocking and unacceptable. Our thoughts are with him and his family and we hope for his recovery. We had all hoped that incidents like this were a thing of the past. Such incidents are a reminder that we cannot take peace for granted.

At the end of next month, the eviction ban will expire unless a decision is taken to extend it. The first thing one does in a crisis is to not make that crisis worse. There is a real fear that this is exactly what is about to happen. We can all see that every week in our constituency offices. Housing, homelessness and the prospect of homelessness constitute the number one issue. In January, nearly 12,000 people were living in emergency accommodation. In Dublin alone, nearly 3,000 households became homeless last year.

Increasingly, people are arriving at our offices in a state of panic. It might be a couple working and paying rent or an individual or family who would qualify for the housing assistance payment if they could get their application processed. The conversation is not terribly different, no matter who is having it, and it is not unusual for people to end up in tears. They have a notice to quit and cannot find alternative accommodation. Even if they could, they cannot afford it. They usually say to us that they never expected that homelessness was something that would happen to people like them. They talk about the stress and the panic. They often talk about how it is impacting their children. The ban on evictions has postponed the inevitable for many but the cliff edge is getting ever nearer. Like many Deputies, I see people who are desperately trying to deal with the fact that they are homeless. They often feel that their lives are on hold. The stress and desperation are obvious. The loss of hope and independence is very real. It is not unusual to have someone tell us that they feel they are a total failure.

In many ways, we have got to a stage where the outrage has disappeared and homelessness has almost become normalised, but there is nothing normal about it. I accept that there is a balance of rights. When we talk about that balance, however, I am of the view that those who are already homeless and those who are facing becoming homeless have to be seen as real people who have been failed and who are damaged. That has to be factored into the balance of rights too. The Tánaiste needs to tell us what exactly the Government is contemplating. Earlier this week, the Taoiseach stated that he is not convinced the eviction ban is working. That is because he sees that the numbers of people who are becoming homeless have increased despite the ban. I thought those comments were instructive. Most people assessing the situation would infer that, without the eviction ban, the floodgates on homelessness would really be opened and that what is a trickle would become a torrent. Does the Tánaiste accept there is a need for an extension of the eviction ban? If he does not accept that, what does he propose to put in place for the additional people who will become homeless? Why was it not planned, because we knew this was a temporary eviction ban?

The Tánaiste

First, I wish the Deputy well. This may or may not be the last occasion on which we have an opportunity for questions on a Thursday morning, but I thank her for her courtesy and respect in her capacity as leader. I thank her and her colleague, Deputy Shortall, for their commitment to the public good and public interest as leaders of their party. Through very challenging times during Covid-19 and so on, they put the nation first ahead of their party. I will always appreciate that. The public health interest in particular was always a key consideration of theirs and I appreciated that.

In respect of the eviction ban, the Government is examining this not just from a legal perspective but from a policy perspective also. Deputy Catherine Murphy has connected this to homelessness correctly, but the broader picture is supply of housing and supply of units for rental and to be rented. The fundamental policy issue we have to consider is if we extend it, and I do not think we could extend it for a short term because we need to be honest with the market and with those who are renting as well, what would the impact of that be on supply? Would it make it worse? I put that honestly to the Deputy. Politically, the simple catch cry is "extend the ban, extend the ban" and then worry about the consequences later or indeed the consequences would be the Government's problem and the Government's fault in the sense of policy research coming back saying we risk reducing supply and we risk increasing rents as a consequence of reducing supply and it makes matters worse.

The parallel with that is that we have increased supply through building houses. The State is the biggest actor in house building at the moment. Through financial supports given to approved social housing bodies, local authorities, cost-rental schemes, Croí Cónaithe, Project Tosaigh, and help to buy, there are a variety of schemes. The first home scheme is proving to be extremely popular with more than 3,000 registrations now. Some 30,000 homes were completed last year, which is an increase of 10,000 on the previous year, and the largest since 2008.

On the other hand, the eviction ban did work during the winter period. We had a particular argument over the winter period because of the crisis caused by the energy situation which gave a very solid legal basis to a winter emergency ban on evictions, because of the position people found themselves in on a number of fronts particularly on inflation and the energy crisis itself. All of those issues will be evaluated by the Government and we will make the decision prior to the expiry date of the ban. Of course the new law we introduced in the context of the eviction ban staggered the end of the protections afforded in the legislation out to June in order to ensure there would be no cliff-edge impact on 1 April. We are giving this very serious consideration from a policy point of view and are mindful of some of the negatives it could have on the wider sector.

Deputy Catherine Murphy

I thank the Tánaiste for his good wishes on behalf of Deputy Shortall and myself. They are very much appreciated.

When this eviction ban was put in place there was a recognition of an emergency and it was said at the time that it is one thing putting an eviction ban in place but there needs to be a plan if this eviction ban will end and it was time-limited. It does not feel like there is a plan of action for the end of this. In a crisis, the number one thing is not to make that crisis any worse, and I accept this is complex but the impact this is having on individuals in relation to the panic they see coming down the road is very real. Certainly, I see people in my office daily who are worried, cannot find anywhere, and the impact it is having. They do not see any hope in this or any plan out of it so we need to know if the Tánaiste will not extend that ban what will he put in place in the immediate term in relation to where people will live and what supports will be there for them.

The Tánaiste

A key consideration has to be the likely impact of any extension on supply. Recent data show that around 21,000 home sales last year involved landlords selling their properties while just 7,500 homes were bought by landlords. That means a net loss of 13,500 homes to the rental stock. We have to ask the question why the smaller landlords are leaving the market in droves. We have a whole range of rent protection zones. They came in I think in 2016 initially-----

Deputy Richard Boyd Barrett

Cashing in on high prices.

The Tánaiste

-----and were then extended in 2019 and 2020. The issue of trust is vital so we must be very clear in terms of what we are doing in this decision and I am sharing these issues with the Oireachtas now because it has to go beyond the catch cry of "you are the uncaring Government that wants to do x, y and z and we are the people who are for apple pie" etc. There is a real issue here. We could make things much worse is the point I am trying to make. We want to build up supply and we are doing it. We are up to 30,000 because of last year but there is a real issue and there are other consequences as well. We have up to a couple of hundred people coming back into the country who need to go back to their own homes who are working on behalf of the State. There are a lot of issues here that we have to work out and will discuss with the Deputies

Deputy Richard Boyd Barrett

It is particularly appropriate that the Ceann Comhairle mentioned the horrors of Nagasaki and Hiroshima as we mark the first anniversary of Putin's bloody, murderous and criminal invasion of Ukraine. The United States, the biggest power in the world, in two days with nuclear weapons incinerated more than 300,000 people. Today, Vladimir Putin, another nuclear power, said he is ramping up his nuclear arsenal and is considering withdrawing from the Strategic Arms Reduction Treaty, START. The Bulletin of the Atomic Scientists, which was set up after the horrors of Nagasaki and Hiroshima, set a thing called the doomsday clock. This January they set that clock at the closest point to midnight that it has been set since Nagasaki and Hiroshima. They set the doomsday clock, by which they mean the prospect of nuclear Armageddon, at 90 seconds to midnight largely because of the terrifying prospect of the war in Ukraine escalating to the point of the use of nuclear weapons. It is worth considering what they said, as their body includes nuclear scientists and ten Nobel Peace Prize laureates. They said that:

The US government, its NATO allies and Ukraine have a multitude of channels for dialogue; we urge leaders to explore all of them to their fullest ability to turn back the Clock.

Nuclear weapons are the weapons of the psychopath. Those who used them in Nagasaki and Hiroshima were operating a psychopathic murderous logic. Vladimir Putin has rained death and destruction on the people of Ukraine and is operating a psychopathic logic. However, it is also the case that NATO, with its own bloody history, is seeking to do nothing other than escalate this conflict to the terrifying possibility that we could have a nuclear situation. Against that background, what does the Tánaiste do? As the Tánaiste of a neutral country, who was formerly Taoiseach, he says now is the time to reconsider the triple lock, to review essentially our position of neutrality and to deploy 30 troops to participate in the war in Ukraine in flagrant breach of our neutral status. When he was in government in 2003 he facilitated 1 million US troops to go through Shannon Airport in order to prosecute another bloody war. Does the Tánaiste not think, one year into the war in Ukraine, that the lesson is that a neutral country should be using its voice on the international stage to call for peace, negotiations and to stop the terrifying escalation of this conflict that we are witnessing which could bring the world to the brink of conflict?

The Tánaiste

I find Deputy Boyd Barrett's remarks deeply disturbing and unfair. Inevitably in every contribution he makes on the war in Ukraine he brings it around to the NATO issue, and it is NATO's fault ultimately in his mind. It is a disgraceful and distorted assessment of his that he has just articulated now, that somehow NATO wants to escalate this.

Deputy Richard Boyd Barrett

It was the Bulletin of the Atomic Scientists.

The Tánaiste

I did not interrupt Deputy Boyd Barrett. He should have the decency to allow me to make a reply. The Deputy has just asserted in a distorted manner the idea that NATO wants to escalate the war on Ukraine to a nuclear status. That is a disgraceful and wrong thing to say. Germany is in NATO. France is in NATO. They did everything they could to persuade Putin not to launch that war. They were lampooned by some for endeavouring to persuade Putin not to launch that war. Why does the Deputy not accept that reality? I have been at meetings where we have been briefed on the dangers in Zaporizhzhia where Ukrainian citizens are surrounded by Russian troops, where there is shelling in its proximity and where, internationally, we have supported moves to create a safe zone around it, notwithstanding Ukrainian sovereignty. The safe zone was to protect and to ensure the avoidance of any untoward event happening in that particular nuclear plant.

German Chancellor Scholz went to China to meet with the Chinese President. Why? It was to get China to articulate unequivocally the need not to use nuclear weapons in Ukraine. Such a statement did emanate from the Chinese authorities to the effect that there should be no nuclear dimension to this war and Russia should not use nuclear weapons. Russia has been the only country that has hinted and implied the use of nuclear weapons in the context of this war. Why? It is because Russia is playing on rational minds. The President of the United States is such a rational mind. He understands the danger of this war and how it can spill over. He understands the line he has to navigate between trying to stop this war and stop Putin’s shocking attack on civilians in Ukraine. Day and night, we all see the bombing of civil infrastructure, energy plants and apartment blocks. Ukrainians have a right to self defence under the UN Charter. We can help with our 30 personnel - that is all - to deal with de-mining. It is only training, on European soil, to help them to deal with medical situations within Ukraine. We know that cluster munitions, which Russia has used, can cause extraordinary damage after an attack, when children go out to play and have limbs amputated-----

An Ceann Comhairle

Time, Tánaiste.

The Tánaiste

-----because they pick up something that does not look like a bomb but is a bomb. Deputy Boyd Barrett is saying we should not help to train people to prevent that terrible impact on civilians.

An Ceann Comhairle

I thank the Tánaiste. We are over time.

Deputy Richard Boyd Barrett

Everybody is clear that Putin is a murderous tyrant and criminal warmonger. However, I quoted the Bulletin of the Atomic Scientists which is made up of ten Nobel Peace Prize laureates who start by condemning Putin and then go on to urge NATO. The problem is that the Tánaiste has a blind spot when it comes to the equally bloody history of NATO and its major powers. The United States has never apologised for the use of nuclear weapons in Nagasaki and Hiroshima. It still believes it has the right to possess them. The Tánaiste states, rightly, that the Ukrainian people have the right to resistance against an illegal occupation. Will he say the same about the Palestinians, of whom ten were killed last night in Nablus in a raid by Israel in what is an illegal occupation and military intervention into land internationally designated for the Palestinians?

An Ceann Comhairle

Time is up now, Deputy, please.

Deputy Richard Boyd Barrett

Will the Tánaiste call that a war crime? Will he say the Palestinians have the right to military resistance against what Israel is doing? Of course he will not because Israel is an ally of the United States. We will never prevent war if a neutral country has a blind spot about some of the warmongers in this world. A consistent position is opposing all nuclear powers, all warmongering powers, whether it is the-----

An Ceann Comhairle

Please, we are over time.

Deputy Richard Boyd Barrett

-----tyrannical regime of Russia or NATO and the western powers.

The Tánaiste

I am the leader of the Fianna Fáil Party, of which Frank Aiken was a member. He was the first Minister for Foreign Affairs to sign the nuclear non-proliferation treaty. My party and colleagues in the Government in this House have a very proud record on the international stage with respect to nuclear disarmament and nuclear non-proliferation.

Deputy Richard Boyd Barrett

This is being done without the assent of this House.

An Ceann Comhairle

Please.

The Tánaiste

This country has a strong record in that regard, even in its most recent iteration on the Security Council of the United Nations for the past two years. We do not have any blind spot about nuclear weaponry. We have been consistent. More than a decade ago, we were the leaders, with Norway, the Vatican and others, in having the international convention banning the use of cluster munitions. Ireland is well respected for its role and well respected in regard to defending Palestinians and providing support to try to develop a two-state solution in Palestine. Indeed, it was a former Fianna Fáil foreign Minister, the late Brian Lenihan senior, who was the first Minister in Europe to recognise Palestinians' right to a homeland. We have been consistent in our support for a two-state solution. Ireland is one of the strongest supporters of the United Nations Relief and Works Agency for Palestine Refugees in the Near East, UNRWA.

An Ceann Comhairle

Time is up now Tánaiste, please.

The Tánaiste

We have been very strong in terms of holding accountability in respect of Israeli attacks and atrocities. We condemned what happened last evening. It was wrong. We are very concerned about the trends in regard to that issue. The fundamental point is this. We stand by the international rules-based order, the United Nations Charter.

An Ceann Comhairle

Time is up, please.

The Tánaiste

Putin has breached it in an appalling manner. All we are saying is we will help to train some Ukrainians in respect of their capability in medical combat, in bomb disposal and in other areas of that kind. It is not too great an ask for this country to make and it does not threaten in any shape or form our neutrality, which is defined by non-military alignment. We are not members of NATO. We have no intentions or immediate plans whatsoever to join NATO.

An Ceann Comhairle

Members, these are tremendously emotive matters. I understand the pressure people are under but please let us adhere to the time limits. I call Deputy Denis Naughten.

Deputy Denis Naughten

On 9 November, my colleagues and I in the Regional Group secured the unanimous support of this House for a motion on long Covid seeking immediate action because of the impact it is having on our health service. That includes studies such as the one published in the Irish Medical Journal in June 2021 which found that long Covid had a significant impact on our health system, particularly in terms of increased demand for healthcare services, longer hospital stays and increased healthcare costs. Another study by researchers in Trinity College Dublin, published in The Lancet Respiratory Medicine journal in September 2021, estimated that up to 11% of individuals infected with Covid-19 in Ireland are likely to experience long Covid which could lead to a significant burden on our healthcare system.

Patients with long Covid, many of whom are young with no underlying health conditions, are presenting to our health services with prolonged, multisystem symptoms that are impacting on their daily lives, affecting their ability to work and causing significant disability for some. Long Covid also has a significant impact on our workforce. It costs millions of euro in lost work and welfare. Data from the Department of Social Protection have shown that 0.8% of those who contracted Covid-19 and claimed the enhanced illness benefit payment were medically certified as being unfit to work 12 weeks later. If this is extrapolated across the total number of people infected with Covid-19 within the adult population, it equates to more than 21,400 people. The welfare data also show that 35% of workers on disability payments as a result of Covid-19 are out of work for at least six months.

Our motion called for the designation of long Covid as an occupational illness for front-line workers who contracted the virus due to their employment. Long Covid being listed as an occupational illness would allow front-line workers to avail of long-term income assistance until they are fit to return to work. At present, only healthcare workers who were out sick prior to 15 November 2021, which was before the Omicron variant was detected, are able to avail of paid leave. This will cease in June this year if they have not made a full recovery which would allow them to return to work. All other front-line workers, including healthcare workers out sick due to long Covid contracted as a result of their work, are now excluded from any support from their employers. The Minister for Social Protection, Deputy Humphreys, has given a commitment to address this issue. She has written to the Minister for Enterprise, Trade and Employment, Deputy Coveney, and the Minister for Health, Deputy Stephen Donnelly, looking to move on this issue. The former has responded positively.

She is still awaiting a response from the latter. Will the Tánaiste intervene, ensure the response is forthcoming and address this issue?

The Tánaiste

I thank the Deputy. In the context of his recent announcement, I wish him the very best, although he very quickly said to me in the corridor that it would not spare him from harassing me, politically speaking, for the next while. He will be as robust as ever.

I acknowledge the Deputy's long-standing and consistent support of the long Covid issue. Very few Deputies have put as much work as he has into endeavouring to understand the prevalence of long Covid across the population and the consequences for individuals and families. I appreciate that. He has argued on the health side for quite some time. The Minister for Health is primarily responsible for developing a national strategy and service for long Covid. Some €2.2 million was allocated for service development last year. The figure for 2023 is €6.6 million. That will ensure the provision of post-acute and long Covid clinics operating within each hospital group to ensure there is a national service. Post-acute clinics are managing patients between four and 12 weeks after the initial onset of infection. Long Covid clinics are managing patients 12 weeks post the onset of infection. The Deputy knows the list of hospitals involved.

It is important that we work on the research side and endeavour to get a proper handle on the longer term implications. The Deputy focused on occupational illness today. He has had good responses from the Ministers, Deputies Humphreys and Coveney. He knows the way Government works. This is an issue we will examine. Fundamentally, we will come to the Estimates and have collective responsibility. It will be an issue we have to examine collectively with the Ministers for Public Expenditure, National Development Plan Delivery and Reform and Finance. The Deputy has made a reasonable case. I appreciate that and we will work across government to address this aspect of the long Covid issue.

We have made significant progress on the health side in terms of the provision of a wide range of facilities, including a tertiary neurocognitive clinic in St. James's Hospital, led by a consultant neurologist. There will be many multidimensional aspects to the long Covid issue we will have to deal with over the longer time. On the income and occupational illness side, the Deputy has identified an issue we have to come back to him on. We are examining it within Government.

Deputy Denis Naughten

The Estimates are too far away. Many front-line workers are getting no support from their employers or through the occupational system. For some front-line healthcare workers, the money will run out next June so money coming at the end of the year is no good.

As I said, we are talking about, on a population basis, over 21,000 people who may be unfit to work due to long Covid. That figure excludes people who have relapsed after initial recovery and the many thousands more who are still in employment but are struggling with the illness. For many of these people, the sad fact is that trying to get care and treatment is nearly impossible. On average, they will wait six months to access a non-Covid clinic and if they happen to be unfortunate enough to be in Dublin, they will wait more than 12 months. At the same time, the Mater hospital long Covid clinic, which treated neurological conditions such as brain fog associated with long Covid, closed at the end of last year, forcing patients to travel abroad to get treatment. When will we have a fully functional long Covid clinic network across the country?

The Tánaiste

As I said, the national service is being rolled out with about €6.6 million allocated for 2023. That will provide post-acute and long Covid clinics. The long Covid clinics currently operational under the new model of care include St. Vincent's University Hospital, Beaumont Hospital and University Hospital Galway. The post-acute Covid clinics operational under the new model of care include University Hospital Galway, the Mater Misericordiae University Hospital and Connolly Hospital Blanchardstown. In addition, Tallaght University Hospital and St. James's Hospital operate combined post-acute and long Covid clinics. Cork University Hospital held its first dedicated long Covid and post-acute clinics for patients in December.

The location of specific clinics is, of course, a matter for the HSE as we roll this out. I have mentioned the tertiary neurocognitive clinic in St. James's Hospital, led by a consultant neurologist with a background in neurocognitive disorders. The clinic is accepting referrals from long Covid post-acute clinics around the country.

In addition to the new clinics established and funded under the interim model of care, some additional hospitals are operating long Covid clinics on an ad hoc basis. Recruitment has been substantial to date. Resources are being provided for 66 staff at those clinics and I understand 34 people have been recruited so far.