Dáil Éireann díospóireacht -
Thursday, 26 Oct 2023

Vol. 1044 No. 6

Ceisteanna ó Cheannairí - Leaders' Questions

Deputy Pearse Doherty

Níl dabht ar bith ann ach go bhfuil an ghéarchéim tithíochta ag dul in olcas lá i ndiaidh lae. Tá níos mó daoine óga anois ag maireachtáil sa bhaile lena dtuismitheoirí nó ag dul ar imirce thar sáile. Tá teip iomlán ar phlean tithíochta an Rialtais. Ní thabharfaidh ach athrú Rialtais dóchas do dhaoine go dtiocfaidh deireadh leis an ngéarchéim tithíochta.

The housing crisis is worsening every day that this Government is in office. More and more young people now are being forced to live at home with their parents well into their 30s or take the choice to emigrate. More and more working people, as they get closer to retirement, are being locked into an insecure and overpriced rental market and they are fearful for their future.

We were contacted by one person who has a good job at a Dublin hospital. She is in her 30s and on a good salary, but she cannot find a single place to live that is somewhat even reasonable. Most of the apartments in the area are nearly €2,000 per month and that does not include the bills. This person tells us that she feels completely hopeless. She says the situation she and so many of her generation face has been created by successive Governments allowing the few to profit off her generation and lock them out of any sense of stability, and I completely agree with her. This Government is failing to deliver the genuine affordable homes working people need.

It is widely acknowledged that the Government's housing targets are far too low and wholly inadequate to meet the need of the actual demand of housing right across this State. Yet despite all of this, the Government refused to increase housing investment above these inadequate targets in the recent budget. Each year, the Government has failed to even reach those targets.

The Tánaiste keeps telling us that the Government has the most comprehensive housing plan in the history of the State and that it is spending more and more money on social and affordable homes than ever before yet when we look deep into the facts, the reality is very different. This year, €4 billion was to be spent to deliver 14,500 social and genuinely affordable homes. However, today we learned that at the end of September, less than half less of this allocation has been spent. So, what does this mean? It means that thousands of affordable homes for working people promised by this Government will not be delivered this year, just like last year, the year before and the year before that. In fact, figures from the Minister for Housing, Local Government and Heritage show just how bad this Government is doing. By June of this year, only 15% of the social homes that were promised had been delivered and only 123 out of the 4,400 affordable homes that were promised had been delivered, and not a single affordable home was delivered by the Land Development Agency.

If the Tánaiste wants to figure out why house prices and rents are rising, then this is the reason. This is why house prices and rents are rising. This is why homelessness is rising. This is why people feel hopeless, like that woman who works in a Dublin hospital and cannot find anywhere to live. This is why the Government's plan is failing. The housing targets need to be increased. It needs to start with the delivery of 21,000 social and genuinely affordable homes next year. The expenditure ceilings for housing delivery need to be increased and the red tape needs to be cut to ensure local authorities and approved housing bodies can deliver homes at pace and at scale. The response from the Government needs to meet the scale of the emergency that is right across this State. Will the Tánaiste finally accept that the Government's plan is failing? It is failing the worker in that Dublin hospital and the people who are in Dublin Airport at this minute. It is failing people in emergency accommodation and those who are locked out of homeownership and locked into extortionate rents. Will the Tánaiste finally acknowledge that it is failing and turn course?

The Tánaiste

Ní aontaím leis an Teachta. Níl aon amhras anois ach go bhfuil i bhfad níos mó tithe á dtógáil ag an Rialtas seo ná mar a rinne éinne eile. Tá plean i bhfad níos cuimsithí againn ná atá ag an Teachta féin. Níl aon phlean aige. Cé go mbíonn sé ag béiceach i gcónaí, níl mórán taobh thiar de. Níl aon phlean cuimsitheach ag Sinn Féin - faic - agus tá siad i gcoinne scéim i ndiaidh scéime atá ag tabhairt tacaíochta d’aos óg na linne seo.

Deputy Donnchadh Ó Laoghaire

Cosúil leat féin.

The Tánaiste

Deputy Doherty is wrong, and no shouting and roaring is going to change the fact that this Government has significantly turned the dial with regard to house construction. More than 30,000 houses were constructed last year, and we will exceed targets again this year. As reported in the newspapers this morning, commencements are up 14% on last year and completions are up 14% on last year. Sinn Féin does not have a comprehensive housing plan. It has nothing but a collection of sound bites and a few pages.

Deputy Seán Crowe

How does the Tánaiste know that? How does he know what we have?

The Tánaiste

It has not put in the hard work. When it comes to young people in this country, look at Sinn Féin's policies. It does not do anything for first-time buyers. Its policies are anti-first-time buyers. Sinn Féin would get rid of the help-to-buy scheme from which 42,000 young buyers benefitted. Sinn Féin opposed the First Home scheme, which allows 30% State equity in houses for younger people to buy those houses from which 2,500 people benefitted this year. If Sinn Féin had its way, they would not be able to avail of that particular scheme. Sinn Féin opposed the grants we made available in terms of vacant houses or houses that are derelict of €50,000 and €70,000, respectively, as well-----

Deputy Pearse Doherty

We have not.

The Tánaiste

-----and voted against it. To add to that, Sinn Féin opposed the Land Development Agency; it has a long history of opposing. On the ground, it is probably one of the most serial objectors to housing we have witnessed-----

Deputy Mark Ward

Ah, stop.

The Tánaiste

-----over the last five years. It is, therefore, about time Sinn Féin came forward with substance and not empty rhetoric and sound bites. The fact of the matter is that the Government does have the most comprehensive housing plan, and I have said that before. I do not see that comprehensive plan in any policy document Sinn Féin has produced in respect of that.

If we look at, for example, social housing, more than 10,000 social homes were delivered last year in 2022, which is the highest level of social housing delivery in decades. This year, we aim to deliver nearly 12,000 social homes, including 9,100 new-build homes. There is a strong pipeline of more than 22,000 social homes either on site or at design and tender stage. In 2024, we have funding in place to deliver more than 11,600 social homes, including 9,300 new builds. Since 2020, 30,000 new social homes have been added to the social housing stock, including 19,000 new builds.

There are now approximately 2,500 tenant in situ purchases progressing at various stages. In respect of cost-rental houses, for example, there has been a dramatic provision and affordability. To be fair to the Minister for Housing, Local Government and Heritage, he has come forward with a variety of programmes and investments that outrival anything Sinn Féin has produced. Sinn Féin does not have substance in its policies. It has been anti-young-first-time buyer and covered it up. There is camouflage over it. However, if we go through the detail of how Sinn Féin has performed in this House over the last three years when various pieces of housing legislation have come before it, Sinn Féin opposed anything that would help young first-time buyers.

Sinn Féin opposed anything that would help young first-time buyers, and we now have more first-time buyers drawing down mortgages this year and last year than we have had for many a day.

Deputy Pearse Doherty

The Government's response to any of the crises that we point out to it is "but, but, but Sinn Féin". That is how the Government sums it up, that we have stopped all of this, that we are at fault for a housing crisis, despite the fact that the Tánaiste's partners in government have been in government for 12 years, and that Fianna Fáil-----

The Tánaiste

We are not in Government 12 years.

Deputy Pearse Doherty

----- has supported the Government for seven years. The Tánaiste's partners in government have been in government for 12 years, and Fianna Fáil has supported the Government for the last seven years. The Tánaiste can have his head as far in the sand as he wants but there are nearly 13,000 people in emergency accommodation. He talks about home ownership. There is an entire generation of people who have lost hope that they will be getting onto the property ladder because of the policies of the Tánaiste's Government that are pushing up house prices. We still see that even in recent Central Statistics Office, CSO figures. That is the reality of it. Why are people deciding to emigrate? They will tell you that they feel they cannot own a home here. Home ownership is reducing under this Government. We have people who are well-paid in the sector who cannot get homes. People who work in our professional services cannot get homes in Dublin under this Government. Rents, homelessness and house prices are up but somehow, it is always Sinn Féin's fault.

The dogs in the street know that the targets the Government has set are far too law. Worse still, the Minister for Housing, Local Government and Heritage, Deputy Darragh O'Brien-----

An Leas-Cheann Comhairle

I thank the Deputy, he is over time.

Deputy Pearse Doherty

----- just in case the Tánaiste does not know this, has missed his targets on social and affordable housing every single year for the last four years. That is the reality we have.

The Tánaiste

Deputy Doherty is wrong.

Deputy Pearse Doherty

Am I wrong? Explain to me how I am wrong.

The Tánaiste

Here he goes again.

Deputy Pearse Doherty

Explain it to me. Did the Minister, Deputy O'Brien, meet the targets on social and affordable housing?

The Tánaiste

If may say so, a Leas Cheann-Comhairle-----

Deputy Mary Butler

We cannot hear Deputy Doherty.

An Leas-Cheann Comhairle

Before we start, can we please have a little respect? Deputy Doherty has one minute.

Deputy Pearse Doherty

I am interested to hear how the Government met the targets on social and affordable housing. This will be very exciting.

The Tánaiste

Shouting is not a policy. Shouting and roaring does not deal with the substance of provision. I have always said that housing is the biggest social issue facing this country. That is why Fianna Fáil took up the portfolio at the beginning of this Government. We did not take on an easy task here.

Deputy Johnny Guirke

Give it to someone else.

Deputy Pearse Doherty

Fianna Fáil has made it worse.

An Leas-Cheann Comhairle

Let the Tánaiste finish.

The Tánaiste

The important point is we have produced the most comprehensive plan and we are implementing it. Deputy Doherty has not. I will make the point to him that 400 first-time buyers each week are now buying their first home. Listening to the Deputy, one would imagine that nobody was. Some 25,000 first-time buyers drew down mortgages in 2022. That is the highest number since 2008, and over 41,000 homes were purchased between January and August of this year, with 27% of those by first-time buyers. We have developed schemes that are helping first-time buyers, and respectfully-----

Deputy Pearse Doherty

Explain to me how I am wrong that the Minister, Deputy O'Brien, missed his targets.

The Tánaiste

----- I put it to Deputy Doherty that his policies and approach in this House have been negative.

Deputy Pearse Doherty

Does the Tánaiste want me to whisper it to him? Explain to me how I am wrong.

The Tánaiste

He has opposed measures that would improve the situation for first-time buyers.

Deputy Pearse Doherty

The Government has missed every target.

The Tánaiste

Sinn Féin has been anti the first-time buyer initiative.

Deputy Pearse Doherty

It is all Sinn Féin's fault. The Government has missed every single target and it is making things worse. It is time for the Tánaiste to get his head out of the sand.

An Leas-Cheann Comhairle

Deputy, please. Can we do this through the Chair? Thank you.

Deputy Holly Cairns

As I am sure the Tánaiste is aware, the Government is running an advertising campaign at the moment on the United Nations Convention on the Rights of People with Disabilities, UNCRPD. It is as if the Government suddenly wanted to make people aware that disability rights are human rights. Does the Tánaiste understand how disabled people, or parents of children with additional needs who are currently waiting years for basic, bare-minimum services, would think that that the advertising campaign is some kind of a sick joke? Surely the Tánaiste can see the hypocrisy when the State is the reason why people cannot exercise these human rights.

I should not have to remind the Tánaiste that disability services in this country are shameful. Rights are entirely notional. They are on paper, and they are in the UNCRPD but not an option in practice in our communities. Nobody gets anything they are entitled to without a fight. Parents of children with additional needs spend their whole lives fighting. They are in a constant battle with a system that is supposed to support them. The only thing their children are guaranteed is waiting lists. Sometimes those waiting lists last for years.

Some 16,522 children are currently waiting for their first appointment with a children's disability network team, CDNT. More than 10,000 of them have been waiting for over a year with no intervention and no therapy. These delays are so bad because of chronic staff shortages. More than one third of posts in CDNTs are vacant. In some teams, vacancy rates are more than 60%. This wholesale and pervasive State neglect has disastrous and lifelong consequences. Children have a very small and critical window to get essential early intervention therapies. If they do not, their development can be limited and they could be prevented from reaching their full potential and living a full independent life. These children are not just being failed by the State. They are being actively harmed by persistent neglect.

If people had a right, as the Government is now advertising, they would be able to take a case when they cannot exercise their right, but they cannot. Why? It is because the Government and previous Governments have not ratified the optional protocol of the UNCRPD. Then, the Government runs an advertising campaign to tell people that they have rights that they cannot exercise.

This week, three years into this Government, the Minister and Minister of State for Children, Disability, Equality, Integration and Youth, Deputies Roderic O'Gorman and Anne Rabbitte, respectively, have just published a new roadmap for disability services. Among other things, the plan says it will fill 460 vacancies by the end of 2024 and 240 by the end of 2025. Doing that would be an improvement but how is the Government going to do that? The plan says it will fill vacancies with a robust recruitment and retention plan but what specifically will the Government be doing differently to hire staff? I searched the roadmap as well for a budget but could not see it. How much additional or new funding has been assigned to rolling it out? Finally, given that the Government is advertising people's right under the UNCRPD, will the Government ratify the optional protocol?

The Tánaiste

First, I acknowledge that there are very significant challenges facing families with children who have disabilities, particularly with regard to access to therapies. There has to be a balanced perspective regarding overall disability provision. I would argue that over the last three years, there has been very significant progress, and in the years before that, on special education, which the Deputy did not refer to her in her commentary. While that is always challenging, I think it has been a key priority and delivery there has been more effective in the health service in terms of therapies and in the CDNTs.

In budget 2024, we are now looking at about €2.7 billion, which has been allocated to provide additional teaching and care supports for children with special education needs. That is a 5% increase on last year's funding. There will be an additional 744 special education teachers and over 1,200 additional special needs assistant, SNA posts. We now have over 20,000 special education teachers supporting students across the school system, and 21,584 in total. I recall that when I was Minister for Education and Science and I initiated the SNA scheme, we had none. We have to look at things and say that we have a lot more to do but over the decades, a lot happened in education and in the integration of disabilities into education.

In the recent budget, we increased the domiciliary care allowance in terms of once-off funding, and we did the same last year, so we have increased funding for various disability payments on the social protection side. On the health side, and disability has now moved over to the Department of Children, Equality, Disability, Integration and Youth, there is significant funding to assist the expansion of services.

The one area that has proved very challenging and difficult is access to therapies. A model was adopted by the HSE over a decade ago entitled the Progressing Disability Services for Children & Young People, which has not yielded the results that we require. In some areas it has but not in respect of recruitment and retention of physiotherapists, occupational therapists, OTs, and speech and language therapists to that service. We have had many engagements with the HSE and we are continuing. I know that the Minister of State, Deputy Rabbitte, is continuing that engagement with the HSE with regard to recruitment and retention of therapists. Other parts of the health service have been far more effective in recruiting therapists than the paediatric side of the system or that which concerns children with special needs.

That is an issue. There is renewed focus on how we recruit and retain therapists in order that children can have ready access to them.

Deputy Holly Cairns

The Tánaiste said we need to have balance with respect to the overall approach to disability services and flagged education. It is important to note that we are still in the situation whereby there is no assessment done of how many children at primary level will need a particular type of class or school when they go to second level. Then people cannot get access to education. Some people travel for two hours to get to special schools. Flagging education as an area where there has been overall improvement goes to show how pitiful the overall picture is.

Just to highlight the overall picture, in the budget, the Government €64 million allocated to disability services. I thought that was a typo, particularly as the Department’s capacity review stated that we need another €350 million to meet the unmet needs of disabled people. Only a one-off disability payment was introduced, which does not acknowledge the fact that people have disabilities every day of the year, not for one day. Looking at the overall picture again, there are matters such as the motorised transport grant. That was axed ago, and the Government has introduced a new grant. It is almost as if someone is saying "Show me your budget and I will tell you your priorities”. The Government is not prioritising disability services. If there was not an allocation to make real improvement in this budget, with such a huge surplus, it is difficult to believe that the Government will ever do it.

I go back to my questions, which have not been answered. Will the Government ratify the optional protocol? How does he plan to recruit and retain staff in children's disability network teams, CDNTs, now that this new plan has been released? The Joint Committee on Disability Matters has heard time and again that the problem is recruitment and retention, and that millions of euro are being put into trying to recruit and retain staff but this simply is not working. Then we have a situation where, finally, section 39 workers get a pitiful attempt at pay parity, but it is only a 10% increase. We still have a situation where staff in CDNTs do not have pay parity and continue to leave and go to HSE jobs. How is the Government going to staff the CDNTs?

The Tánaiste

It is not pitiful; it is an 8% increase in pay, agreed through-----

Deputy Holly Cairns

Without pay parity, people will still leave and go to-----

An Leas-Cheann Comhairle

Deputy, through the Chair.

The Tánaiste

The Deputy had her chance. The investment in education is not pitiful either. It has been significant over the years and major advances have been made, particularly at primary level. Yes, there needs to be progress at second level. We have provided stronger legislative obligations on all second level schools to take in children with special needs. The core rate went up €12. It is not a once-off. The core rate has gone up €29 since the Government came to office in terms of the core rate relating to the disability payment. The core rate relating to domiciliary rate has increased by even more, which is as it should be. As the Deputy stated, the recruitment of therapists is not a funding issue. It has not been a funding issue for the past few years; it has been a recruitment and retention issue. It is also a work culture issue. When I say that, I mean that the employment space the HSE provides for therapists for children needs to be improved.

Deputy Michael Lowry

For years it has been widely acknowledged that there are fundamental problems and problems of an administrative nature with the HSE. Successive Governments have tried and failed to rectify core issues relating to the delivery of healthcare. Newly ordained senior executives arrived with great ambition and left disheartened. Some of those executives are now sideline commentators who seem to know it all but who have little progress to show for their time in authority. Ministers have been scapegoated in the past. No doubt, the Minister for Health, Deputy Donnelly, will shortly be threatened with the sword. I believe in ministerial and governmental responsibility.

The Tánaiste and his Government colleagues have a duty of care to countless men, women and children who suffer daily because of a totally inadequate service. Clarity must be brought to the financial and budgetary situation of the HSE. Uncertainty is creating widespread fear and trepidation to those who work within the service and the countless people in Tipperary and across the country who rely on the HSE for lifesaving interventions. Also, there are many people afflicted with illness who require ongoing support to sustain a reasonable quality of life. Planned changes by the CEO, Bernard Gloster, to establish six health regions across the country are being viewed as a positive move. This sounds reminiscent of the era of the health boards, when obtaining healthcare was easier and far less traumatic for people. It was a time when people did not languish on hospital trolleys for hours or even days or find themselves on waiting lists for months or even years. A more localised management structure would be better equipped to serve the needs of each region and would be easier and more efficient to navigate. Regional management of health provision is one of the key reforms contained in Sláintecare. Urgent and effective change is crucial.

The Ireland of today is a very different place. There has been a population explosion. Demands for all levels of healthcare have multiplied. Standards in medicine and diagnostics have advanced enormously. People are more knowledgeable and diligent about their health requirements. Each of these factors has increased pressure on an already dysfunctional system. The CEO of the HSE has stridently stated that the health allocation for the coming year is insufficient to meet needs. It is already apparent that a supplementary budget of €1.5 billion will be required to bridge the gap. This has become an established, alarming budgetary pattern. There is major and understandable concern that throwing money into the existing bottomless pit that is the health service, is difficult. It does not address the problem; it simply bridges the gap year after year. Bridging that gap will become insurmountable and our health service will eventually eat into funding required for other crucial sectors of our economy. In the future, it will be difficult for the Government to justify reduced spending on housing, infrastructure, education or business in order to cater for health. Year after year, however, this scenario seems more and more inevitable.

The Tánaiste

I thank the Deputy for the question and the issues that he raised. This year's overall health budget is about €22.5 billion. Allowing for the €2 billion that has been removed and transferred to the Department of Children, Equality, Disability, Integration and Youth for disability services, that is the highest ever allocation for health. Since this Government came to office in June 2020, there have been increased budget allocations of approximately €7.4 billion. That is since 2019, and does not include the funding for disability services. It is important to point out that there has been a lot of increased activity as a result of that spending and people have benefited greatly from it. We removed inpatient hospital charges, for example. We had the biggest expansion of access to free GP care in the history of the State when we made an additional 500,000 people eligible. Therefore, 60% of our population now hold a GP card or medical card. We reduced costs relating to the drug payment scheme costs. Diagnostic scans for patients have been funded. Free contraception up to the age of 31 was introduced. For the first time ever, we are publicly funding assisted human reproduction. There is a new consultant contract to which up to 700 consultants having already signed up. There has been a reduction in waiting times and waiting lists following the build-up that occurred during Covid-19.

The community health service has expanded, with an entirely new programme, particularly in the areas of chronic disease management and primary care, older persons and ambulance services. The community care piece is very important because it was always hit by ongoing increased expenditure on the acute side.

Some 22,000 staff have been added since 2020 and about 1,000 extra beds have been put in, significantly also in ICU. That said, it is worth pointing out that life expectancy improved over a 20-year period. We now have one of the highest life expectancies in the EU. That is positive and not disconnected to significant increases in health expenditure. Also, the way we live our lives has changed. I welcome all the young people and children who are here visiting us. Lifestyle matters and eating good diet matters - seriously. Healthy behaviour matters in terms of lifespan. We have dramatically changed our cancer outcomes. Our heart disease and stroke outcomes have dramatically improved. That has led to better longevity.

The Deputy's point is valid, namely, that there be an evaluation of the funding and the amount of money that goes into the health service in order to improve efficiency in terms of the spending of that money.

The Minister has commissioned a detailed study on the future costs of healthcare-----

An Ceann Comhairle

I thank the Tánaiste. The time is up.

The Tánaiste

-----but also value for money, efficiencies and looking at the drug budget, for example, of €3.3 billion. He will bring in independent experts to analyse that. I will come back to the Deputy on regionalisation at the end.

An Ceann Comhairle

Very good.

Deputy Michael Lowry

The greatest issue facing our health service is the retention of staff. This is partly due to younger people choosing to emigrate as they find it difficult to purchase or afford a place to live in Ireland and due to our more mature and highly experienced staff quitting their jobs prematurely. Their love for their work has not changed, but the conditions they work under are intolerable. The mental and physical pressure they endure is unending and unsustainable. After Covid, the country came to a standstill to applaud our nurses and healthcare staff for their extraordinary work during the pandemic. We need to remember their work every day is no less extraordinary. The work of our health teams is highly pressurised and unrelenting. It is work that is physically and emotionally exhausting. If we do not lighten the burden and increase the staffing numbers and resources, these jobs will become untenable for many people.

The Tánaiste

The Deputy is correct to say recruitment and retention have been a very significant issue, notwithstanding the fact we have recruited 22,000 in three years. In home care, for example, 53,000 people receive that every day now and there have been huge improvements and expansion. Eventually, we were expanding so much in home care that recruitment became an issue towards the latter part of that expansion. The work environment and the whole human resources practice within the HSE needs to improve and focus more on retention and the work environment for high-quality people who are working in our health service, because it is very stressful. It is never-ending. If we consider the acute side in particular, most people going into hospitals today need to go into hospital. The level of acuity is much increased. That means greater stress and burden on people who are working within the service. It is 24-7 with seriously ill people coming into hospitals, especially our acute tertiary hospitals, requiring the attention of our teams of staff. I acknowledge the point the Deputy has made in respect of really working hard on making the work environment better for those who work in the health service.

Deputy Carol Nolan

I am sure the Tánaiste will agree with me that those who have, unfortunately, received a cancer diagnosis do not have the luxury of time while multi-annual budgets are introduced or efficiencies are found in health spending. This is true at the medical end of the spectrum also and it is true with respect to the excellent community support organisations that often accompany cancer patients and their families through what is often one of the most stressful and difficult times in a person's life.

That is why today I highlight the challenges being experienced by a fantastic, Offaly-based service called Dóchas, which is a cancer support group. Representatives from Dóchas, along with other members of a working group, met the Minister, Deputy Donnelly, on 13 September. They impressed on him the seriousness of the funding situation facing the wider collective community of cancer support services. The Department of Health undertook to speak to the national cancer control programme and the community healthcare organisations, CHOs, to see what funding may be available through them, as well as exploring any other avenues for possible once-off funding. Dóchas also submitted a comprehensive business proposal to Ms Carole Broadbank, chief officer of CHO 8, outlining the need for section 39 funding at local level. What did Dóchas get for all its trouble? It got a one-line response with an apology that no funding would be made available for the service despite the fact the Dóchas Offaly cancer support group falls into the same CHO as the Lakelands Area Retreat and Cancer Centre, LARCC, in Mullingar and the Cuisle Cancer Support Centre in Portlaoise, both of which are receiving section 39 funding through CHO 8. Those organisations also do fantastic work. I stress Dóchas has an excellent and collaborative working relationship with the centres I just mentioned which, as I said, do excellent work and it is good they have funding. However, the fact remains there is a gross disparity in funding that needs to be addressed. The major concern in Dóchas is it is not receiving any funding through CHO area 8 despite those other two receiving it. Dóchas and the community throughout Offaly who rely on it for vital support are now at risk of what is looking like a major operating deficit for 2023. My understanding is it is approximately €50,000, but in real terms it may be the difference between Dóchas being able to operate a vital service or not being able to do so. I am calling on the Tánaiste to take whatever action is necessary to revise this decision and have the HSE extend the courtesy of providing something more than a one-line reply to cancer support advocates like Dóchas.

The Tánaiste

First of all, I addressed this issue before the budget. I spoke to the Minister for Health about community cancer support groups throughout the country that came together to seek additional supports for organisations that were established as voluntary organisations. As we all know, significant fundraising efforts in communities countrywide have underpinned these support groups that provide very valuable services to cancer patients and their families. They provide tailor-made, psychological, social and community supports to children, young people, parents, siblings and so forth, and it is very valuable.

It has never been in the section 39 space. Most of these organisations have not been, if we are honest. The idea we would be moving to section 39 overnight was not a realistic proposition, but what the groups asked was that we begin a funding stream for such organisations. The Minister has allocated, I think, €2.75 million going up to €3 million for such organisations. There has been an assessment made. I think the ask was higher, but one has to work through the capacity to absorb and so on. Then the hope is that through the national cancer control programme, which in its latest strategy has allowed for the importance of this, we mainstream that as recurrent funding in future. I do not know when Dóchas got the letter, but I would like to think we would review that in the context of the allocation in the budget. I will talk to the Minister for Health about it.

I believe these services are very valuable. The problem very often is the acute services absorb a lot of the money in health, sometimes to the detriment of the development of other strands of healthcare. The work these groups do is invaluable in providing support. When people leave hospital or come away with a diagnosis of cancer it can be a very anxious and worrying moment. They come out of hospital and have just got news. The centres are very important and are almost lifesavers for people. They provide the opportunity to meet others who have been similarly diagnosed to discuss the implications of it for them and their families. This is a start. The Deputy has raised an important issue I am very interested in. I have worked with these organisations for quite a long time. They came to us to make a submission and we have made a response. It may not be at the scale people might wish, but it is a very significant start and intervention.

Deputy Carol Nolan

I thank the Tánaiste for his response. I acknowledge he has said he would be open to asking the Minister for a review. That is absolutely crucial here. There is so much frustration about the inequity of the funding. Two other groups in the same CHO were able to qualify for section 39 funding, which is welcome, yet Dóchas was not. Its staff do incredible work, without doubt, and they are badly needed in the county and beyond. They do fantastic work and need support. I understand only a small sum, in the grand scale of things, is needed to keep this service operating. It is obviously disappointing that Dóchas invited representatives of the HSE to the centre to see at first hand the invaluable work done there and the invitation was never accepted by them. It is nothing to do with the Tánaiste, but it is important to say that is what has happened.

How can the HSE look for billions of funding when it is not going to support organisations such as Dóchas in our communities? It is a bit much.

The Tánaiste

To be fair to the HSE, it has enormous challenges in budgets, but it should be working with these organisations. The consultant, Professor Seamus O'Reilly, in our city, has been leading the charge for these centres. As a consultant and a clinician, he sees the value of organisations such as ARC in that context and advocates very strongly for them. By the way, the €3 million has to be additional to whatever existing funding CHOs in different parts of the country are allocating to these organisations. We do not want it to replace existing local arrangements and provision. The HSE, to be fair, has provided funding to quite a few organisations in certain CHOs. I will ask the Minister to look at the situation with Dóchas Offaly in light of the Deputy raising it here.