Dáil Éireann díospóireacht -
Wednesday, 21 Feb 2024

Vol. 1050 No. 1

Ceisteanna ó Cheannairí - Leaders' Questions

Deputy Mary Lou McDonald

Seven years ago, the then Minister for Health and the Taoiseach's Fine Gael colleague, Deputy Simon Harris, promised that no child would be waiting longer than four months for scoliosis surgery. That promise was never met and of all the Government's broken promises, I think it is one of the most callous. The fact is there are more children on scoliosis-related waiting lists now than when the Minister gave that commitment in 2017. This has happened on the Taoiseach's watch. There remain, as of this month, 327 children on waiting lists for scoliosis-related surgery. It is not acceptable.

The families and children involved deserve better. Last night, I met with them and I listened to their concerns. I listened to the tragic stories of those families and heard about the pain that their children are in and the life-limiting state in which many of these children find themselves. What these children and families must endure is heart-breaking. They feel they have been let down because Government promises have been made and broken time and again.

Mothaíonn na teaghlaigh seo gur ligeadh síos iad toisc go bhfuil gealltanais an Rialtais briste arís agus arís eile.

Two years ago, in 2022, I raised the issue of children with scoliosis waiting years here in the Dáil. I visited Cappagh Hospital and I met with CHI management. I also met with parents and advocacy groups. The Government subsequently committed to €19 million of additional spending on the promise that this would result in no child waiting longer than four months by the end of 2022. That promise has also been broken.

Astoundingly, the Minister for Health, Deputy Stephen Donnelly, informed the Dáil last night that he cannot guarantee that the €19 million was spent for the purposes for which it was intended. He does not know. The Government does not know. What we do know is that far too many children are waiting and waiting.

One such child is Kylie Ann from Donegal. Kylie Ann is ten years old and she has been waiting five years for life changing surgery. That is half of her young life. Kylie Ann’s mother has challenged all of us here to see Kylie Ann as she sees her, with love, to give her the chance and the quality of life she deserves. I think we should meet that challenge. That is why our motion tonight matters so much. These children deserve better.

Will the Taoiseach agree to work with us and the parents and advocates to establish a task force that works? Will he work with us to achieve accountability and transparency? Will he work with us to put in place a plan that delivers finally for these children? There is an urgency to all this. Every and all treatment options must be on the table for these children and young people. Everyone must commit to doing everything necessary to end the scandal of children waiting for spinal surgery once and for all.

Our motion sets out that plan to address all of these matters in co-operation with parents, advocates, clinicians and the Taoiseach. As a gesture of seriousness and goodwill, I ask the Taoiseach to withdraw the Government's amendment to our motion this evening. I ask that he work collectively with us to finally crack this and get the job done. The plan we have set out is the plan the families want implemented. As I understand, they are looking to meet the Taoiseach to discuss that plan. Will he meet them?

The Taoiseach

Gabhaim buíochas leis an Teachta as a cuid ceisteanna. Tá a fhios agam go bhfuil fadhb mhór againn leis na seirbhísí sin agus tá brón orm faoi. I know from my own experience, having worked in medicine as a doctor in what seems a long time ago now, that the problem of failures and inadequate services when it comes to spinal surgery, scoliosis and spina bifida surgery for children, goes back generations, sadly. It goes back many more lifetimes than these children have yet experienced. I guarantee that if it had ever been an issue simply of money, political will or how much we care about this, it would have been resolved a long time ago. I do not have adequate answers as to why it has not been fixed but I intend to do anything I can to establish why not and to put things right. The Deputy has my assurance on that point and I would be happy to work with her, provided it is in good faith, to deal with this issue because it should not be a political football. I know that is not the Deputy’s intention but there are others who would make it such. We need to stand together against those and work together to resolve this issue, which will take more than one Government to solve, in my view, but at least, let us get started on it.

At the outset, I want to acknowledge that there is no doubting the worry, anxiety and pain for many patients and families attending these services. A comprehensive patient safety review has been commissioned into paediatric orthopaedic surgery services. This is independent and is led by independent expert Mr. Selvadurai Nayagam. Concerns initially related to the clinical outcomes of some complex surgery, including what appears to be a higher than normal incidence of post-operative complications and infections and two serious surgical incidents. This, of course, does not necessarily mean that somebody did something wrong. These may have been high-risk patients that other doctors would not operate on but we need to make sure we know the facts before we make any further decisions.

Two additional patient groups are now being included. Patients have been randomly selected for the purpose of audit and patients have been identified as potential cases of concern by other surgeons in CHI. Those directly affected have been informed and patient advocates have also been informed. After meeting with the paediatric orthopaedic surgeons, the Minister for Health has also determined that a dedicated paediatric spinal surgery unit should be established. Mr. David Moore, a consultant surgeon, has recently been appointed to head it up. The Minister met him in January. Senior staff have been appointed to the new unit and the Minister has requested that a task force be convened as soon as possible with an independent chair. The task force will include all stakeholders, including patient representatives and clinicians. This is a model that has worked well in other areas, such as haemophilia and cystic fibrosis.

The Minister wrote to all advocacy groups and invited them to meet with him, seeking their engagement and views on the terms of reference for this task force, which will have an independent chairperson.

He met with a number of the groups earlier this week. The Minister's invitation to meet those who did not attend or request separate meetings remains open. Mr. Nayagam has met with the Minister for Health, families, patient representatives and other stakeholders following which he finalised the terms of reference for his independent review. In addition, the Minister has asked HIQA, the independent patient safety regulator, to carry out a statutory review of springs that were not see CE marked.

On waiting lists, we have increased the numbers of procedures being carried out significantly. In 2019, which we often use as a base year for comparison because it was the year before the pandemic, 380 spinal procedures were carried out. That went up to 509 in 2022. In 2023, 464 procedures were carried out. There has been a big increase in the number of procedures being carried out and waiting lists have gone down. As of the end of last year, 78 patients were on the active waiting list, which was a reduction. Some 231 patients are awaiting spinal procedures.

I am advised by the Department of Health that Sinn Féin has miscalculated the waiting list figures. The claim that 327 children are on the waiting list is incorrect, even if those who are only waiting a few weeks are included.

Deputy Mary Lou McDonald

Tá níos mó ná fadhb ann sa scéal seo. Tá sé scannalach go bhfuil daoine óga ag feitheamh is ag feitheamh is ag feitheamh agus ag fulaingt mar seo. Tá sé scannalach agus is é sin an focal ceart atá i gceist. I have being raising this issue here for almost a decade, as have other colleagues. It is time for the Taoiseach to confess and own up to the fact that it is utterly scandalous that children in that degree of pain are left to wait. More scandalous yet is the fact that the Minister for Health could state last night that he does not know where the €19 million that was to be dedicated for the children's treatment is. He cannot tell us where that money went. I am not interested in a political football; nor are the families and their advocates. We are interested in a credible, good-faith response from the Government. That means accountability and it means action. It is certainly not acceptable that the Taoiseach cannot answer basic questions on where resources have gone.

Will the Government withdraw the amendment to the Private Members' motion? Will it accept in good faith the plan that the families and advocates support? Will the Taoiseach meet with them to discuss that very plan?

The Taoiseach

I thank the Deputy. Is fadhb mhór í agus is tubaiste é i mo thuairim agus táimid ag lorg níos mó eolais agus ag iarraidh an fhadhb sin a réiteach. I have met the patient groups and I would be happy to meet them again. It is not my practice to organise meetings on the floor of the House, but I will be happy to meet them again as soon as there is a gap in my diary. There are different groups involved, however, and they do not all agree with each other. The Deputy knows how complicated it can be to deal with an issue when there are different groups with different perspectives representing the same people in the context on what should and should not be done.

Acting in good faith means being big enough to admit when one has got one's numbers wrong. It also means not misrepresenting the Minister in the House. It is not the case that we do not know where the €19 million was spent. We know where it was spent. It provided for an additional 204 healthcare professionals working, at least some of the time, on spinal surgery at CHI at Temple Street, CHI at Crumlin and the National Orthopaedic Hospital Cappagh. It also provided for a fifth theatre in Temple Street, which is now open. It further provided for an additional MRI scanner and for additional beds. What we cannot establish for certain is exactly how much of the €19 million was spent on this. We need to find that out.

Deputy Pearse Doherty

That is the point.

The Taoiseach

No, it is not the point. The Deputy had used misinformation about the waiting lists here in the House.

Deputy Mary Lou McDonald

Are you serious? Let it publish details relating to the waiting lists.

The Taoiseach

She has also claimed that the Minister said that he did not know where the money was spent. That is not what he said. It was spent on 200 staff, more beds, a new theatre-----

Deputy David Cullinane

He should spend it for the purpose for which it was intended.

The Taoiseach

-----and a new MRI scanner. If the Deputy and her party honestly want to be involved in helping us to come up with a solution, which should not be political football, they need a different approach.

Deputy Mark Ward

Withdraw the amendment.

An Ceann Comhairle

Can we stop the heckling Members, please. I call Deputy Bacik.

Deputy Ivana Bacik

Gabhaim buíochas leis an gCeann Comhairle. Upon taking office in December 2022, the Taoiseach's stated aim was to make Ireland the best country in which to be a child and to improve well-being and opportunity for children. However, there are many children in Ireland today who are being failed by the State. I am talking about children who are denied care in our health system, who are waiting for surgery, who are lost in mental health services or who are not receiving the care and support they so badly need. No parent wants to make public the private pain of their son or daughter, but we are seeing so many who are utterly desperate. Some parents have even been driven to posting videos on social media of their young children sobbing with pain through the night in a desperate effort to secure appropriate healthcare. Those videos are harrowing. It is even more harrowing to meet the parents and the children and hear their stories.

As we know, in 2017, the then Minister for Health, Deputy Harris, made a commitment that no child would be made to wait more than four months for surgery. Yet, children are still waiting longer for spina bifida or scoliosis surgery than was the case when the Government took office. As my colleague, Deputy Duncan Smith, said in the debate last night, 78% of children are waiting longer than Sláintecare target times for paediatric and orthopaedic inpatient appointments and 81% are waiting longer than that target for inpatient urology services. There are also the outpatient waiting lists.

Let us look at the children's mental health services. Yesterday, we heard yesterday from the Children’s Rights Alliance that, for the third year in a row, the Government deserves only an E grade, an unacceptable grade, in respect of access to children's mental health services. Four years ago, the Government made a commitment to end the admission of children to adult psychiatric wards. Yet despite successive damning reports from the Mental Health Commission, children’s ombudsman, and others, the Government has apparently rowed back on that important commitment. The Department of Health has acknowledged that in some cases children with mental health problems will continue to be admitted to inappropriate wards. Last year, 50% of children were unjustifiably admitted to such wards because there were no beds available in child and adolescent mental health services, CAMHS, units. We know that almost a third of in-patient CAMHS beds were not operational in 2023 due to staff shortages. The waiting list for a first appointment for CAMHS stood at almost 4,000 in July 2023. This is a national disgrace.

On so many fronts, we are seeing vulnerable children let down by State health services. It appears that the Government has quietly abandoned commitments it made on children's health. It is not good enough to say that it may take two successive Government terms to recover this. I heard that the Taoiseach saying that in a response earlier. There are things the Government can do now. The Irish Hospital Consultants Association has pointed to staff shortages as a real factor in driving unacceptable delays for services relating to children. Will the Government end the recruitment freeze and the embargo relating to certain grades in the health service. Will it move to tackle the outrageous waiting lists and address the failings in CAMHS that have been made so glaringly obvious in so many reports, including that from Children's Rights Alliance yesterday.

The Taoiseach

I thank the Deputy. Ireland is a very good country in which to raise a child. Out of 200 countries in the world, we are in the top ten or 20 in almost everything. We have very good maternal and neonatal health services. We have among the lowest infant mortality rates in the world. We have a very good education system with among the best education outcomes in the world. We have introduced early years education and by September the cost of childcare will be half what it was when this Government came to office. We have the free schoolbooks scheme and hot school meals schemes. We get an A grade from the Children's Rights Alliance, to which the Deputy referred, when it comes to online safety and media regulation, particularly in light of the appointment of the Online Safety Commissioner. Of the 16 matters on which the Children's Rights Alliance grades us, we are up in four, the same in 12 and down in none. We fail only in only one of the 16. I absolutely believe that this is not good enough, because my ambition is something more. It is for this to be the best country in the world to be a child, bar none. That is one of the things which drives my work and that of the Government.

On the recruitment freeze, I know the Deputy wants to know the facts - that is not always the case with people in this House but she is one of the ones who does - since the Government came to office, 26,000 more people are working in our public health service than was the case before. That includes 1,000 more consultants, 2,000 more doctors and 6,000 more nurses and midwives. By extra I mean extra, not replacements. When the recruitment freeze was in place last year, the total number of staff in the HSE increased by more in a year than has been the case for many years. Some 8,000 extra staff were hired by the HSE last year. This year, during the so-called recruitment freeze, the HSE has the authority to hire an extra 3,000 staff. Those are the facts.

What we cannot allow the HSE to do, which is what happened in the past, is that money allocated for one purpose is spent on another. It may be a worthy purpose, but that is not the point. I refer, for example, to funding being allocated to hire 50 staff in a certain area and then 50 staff being hired somewhere else for some other purpose else. While all of the latter might be doing really important work, that type of thing is just not good enough.

The new CEO of the HSE agrees with me and is making those changes.

On children being admitted to adult psychiatric units, we stand over our promise, I restate it and we are making progress in that regard. In 2019, the year before this Government came to office, 54 children were placed in adult wards. Last year that was down to 12, so we are going in the right direction in that regard. All decisions to put a child in an adult ward are made by a consultant psychiatrist with the interest of protecting the young person and their well-being. The majority were over 17 years, all were voluntarily detained for a short period of time and in some cases the young people even turned 18 and transferred to adult care during their admission. No consultant takes the decision lightly and it is often done in consultation with parents. I have been there, Deputy, and sometimes it makes sense for a 17-year-old or even a 16-year-old to be in a private room on an adult ward rather than in a children's unit 200 miles away.

Deputy Ivana Bacik

We are certainly ready to acknowledge progress where it has been made and we have welcomed moves by Government to review how additional funding for spinal surgery was spent by the VHI as that is important. However, I repeat that it is just not good enough for the Taoiseach to say it will take two Governments to resolve issues with children's health in Ireland. He is in government and has been for many years now and it is not good enough that we are still seeing these waiting lists.

Let us look at facts. The Irish Hospital Consultants Association tells us the difficulty with filling permanent consultant posts is a root cause of what it in its words are "unacceptably long" child waiting lists. In August last year the association told us over 100,000 children and young people were on hospital waiting lists with 20,600 children waiting longer than a year for treatment or assessment by a hospital consultant. The latest HSE data reveals the number of unfilled permanent consultant posts has risen to a record 933 and the Irish Hospital Consultants Association says this is the highest consultant vacancy rate ever. These are the facts, just as there are facts on the admission of children to adult psychiatric units. A commitment was made by the Taoiseach's Government four years ago to end this practice yet we see 50% of those children admitted to an adult unit last year. This was done because no bed was available in a CAMHS unit. There are unacceptable waiting lists for CAMHS services. There are the facts and the Taoiseach's Government has simply not done enough to address them.

Deputy Aodhán Ó Ríordáin

Hear, hear.

The Taoiseach

I thank the Deputy. I will clarify one point and I appreciate I was not clear. When I say it will take more than one Government to solve some of these problems, I do not mean two Governments over ten years; I mean this Government has a year to run and this problem is not going to be solved within a year. The opening of the new children's hospital next year and everything around that creates a once-in-a-generation opportunity to dramatically improve paediatric healthcare in Ireland and I am determined that should be the case.

When it comes to consultant appointments we have 1,000 more consultants now than when this Government came to office and that is significant. There was a time when the number of doctors per head of population in Ireland was below the OECD average and it is now above it. That happened during my party's term in office. The term "vacancy" as used by the IHCA is a misleading one as when the people at home hear "vacancy" they think empty, thinking that is what "vacant" means. Of course, a lot of these posts are not empty; they are filled by locums, people on contracts or through agencies.

Deputy Ivana Bacik

Permanent. I said "permanent".

The Taoiseach

That is for a lot of different reasons and much of the time, unfortunately, it is in peripheral locations where consultants, especially Irish ones, are not willing to work and therefore we rely-----

Deputy Sean Sherlock

"Peripheral to Dublin" is what the Taoiseach means.

The Taoiseach

-----on people to come from other parts of the world who are willing to work in places that sometimes Irish doctors are not.

I wish to clarify again the recruitment restrictions that exist do not apply to filling consultant posts on a permanent basis.

Deputy Ivana Bacik

But we need the team of medics to support the consultants.

Deputy Richard Boyd Barrett

For a considerable time People Before Profit has argued we need a State construction company in order to address the absolutely dire housing and homelessness crisis and to deliver the housing we need, and especially the social and affordable housing we need.

The evidence for that is manifold. The Government has not met its own social housing targets, nor its affordable housing targets. The national residential property price index today again confirms private developers and the private sector are still delivering housing that is getting ever more expensive. Prices were up 4% last year, this is the seventh month in a row that house prices have gone up, and they are now above Celtic tiger heights. Something I have mentioned a few times in the last few weeks is the private sector is not building family homes, that is, three- and four-bedroom homes, but are disproportionately building one- and two-bedroom ones because these maximise profits and this is contributing directly to the rise in child and family homelessness.

As if all that was not enough evidence, we have more today with Goodbody Stockbrokers - an unlikely source - confirming that private developers and private builders simply do not have the capacity to meet the housing requirements of the State. The report says the State's homebuilding sector has a "distinct lack of scale" and that "This lack of scale threatens the attainment of Ireland’s housing requirements". This was also recorded in an ESRI report at the beginning of this year that said we do not have enough construction workers to deliver on the State's housing requirements and we are probably 15,000 to 20,000 construction workers short of getting to the necessary levels of housing supply in order to begin to address the housing crisis. Goodbody elaborates on the point when it says that compared with England the top ten builders here are building a far lower proportion of the housing we need, that only five companies built more than 500 units last year and that the Irish building and construction sector is dominated by small-scale builders who are building on average 34 units per year.

We are simply not at the races in terms of delivering the scale of housing output and especially the social and affordable housing output we need to address the crisis. Do we not now have all the evidence we need that the State must have its own construction capacity? The private developers and builders are not capable of giving us the housing supply, and particularly the affordable and social housing supply, that we need to address the dire and urgent housing crisis.

The Taoiseach

I thank the Deputy. First of all, the State has a construction company and it is called the LDA. It was established in 2019. It got off to a slow start, but it is really getting going now. The Deputy will know Shanganagh in his constituency, where hundreds of social and affordable houses are being built. He likes to claim there is none in his constituency, but there are hundreds being built and they will be available quite soon for people to occupy. I certainly hope when people do live there that you will not have the brass neck to knock on their doors and look for their votes-----

Deputy Jennifer Carroll MacNeill

And in Cualanor.

The Taoiseach

-----because the LDA is a body you voted against the establishment of.

Deputy Richard Boyd Barrett

You have some brass neck, but I will come back to that.

The Taoiseach

I have been sent a very long list by Deputy Carroll MacNeill just now, and indeed previously by Deputy Devlin, of all the developments in your own constituency you have objected to-----

Deputy Michael Healy-Rae

There are a lot in here doing that.

An Ceann Comhairle

Please.

The Taoiseach

-----on ideological grounds because-----

Deputy Michael Healy-Rae

A lot of objectors in this House.

The Taoiseach

-----they are built by a private provider and they were one-beds and two-beds. However, if we look at the facts, look at the homelessness and look at the housing shortage, the areas we need the most new housing in are one-beds and two-beds. We need family homes as well, but the biggest shortage is for one-beds and two-beds and these are the kind of things Deputy Boyd Barrett and people who share his ideology seem to regularly object to.

We built over 30,000 new homes last year. That is up from 20,000 when I first became Taoiseach back in 2017 and up from 7,000 when my party got into office. We are scaling this up and doing so as fast as we possibly can. We are not willing to cut corners because we saw what happened in the past when that was done. It should not be a case of public versus private. If we try to fix the housing crisis with just the public sector we are putting one hand behind our backs. I understand the Deputy's position based on his politics and ideology - and he is entitled to his ideology - is that pretty much all houses, or the vast majority, should be built by the State. That is a mistake. We would build fewer and it would cost more. What we want is the public sector and the private sector working together.

He is right about the skills shortage. We know that is an issue. That is why the Minister, Deputy Harris, in particular, has led the charge on apprenticeships. We now have about 10,000 people becoming apprentices every year now, which is pretty extraordinary. We have also changed the work permit and work visa system to allow more people with construction skills from outside the EU to come here. They are much-needed and they are very welcome. We are investing in modern methods of construction, MMC, so we can build homes much more quickly. The Deputy is welcome to come out to Church Fields in my constituency to see where Fingal County Council, a public body, is building hundreds of social and affordable homes using MMC.

I encourage councils that are not doing that to do it. The whole point of local government is autonomy. The latter allows councils to do different things. There are good examples of very good councils - of best-practice councils. I ask people to come to Fingal and see what a local authority, a public body, is doing in my constituency, using MMC and building hundreds of social and affordable houses. It is the same in the Deputy's constituency, in Shanganagh, which he always refuses to acknowledge.

Deputy Richard Boyd Barrett

You have some brass neck. I have been campaigning for Shanganagh-----

Deputy Michael Healy-Rae

Objecting.

Deputy Richard Boyd Barrett

-----and for the development of public and affordable housing there for 17 years. It was Fine Gael and Fianna Fáil on the council that insisted that there would be some private development. It was People Before Profit that argued relentlessly that the entire development-----

(Interruptions).

Deputy Richard Boyd Barrett

I was not talking to you.

Deputy Josepha Madigan

Will you stop shouting?

Deputy Richard Boyd Barrett

People Before Profit argued that the entire development should be social and affordable. We eventually won out against the resistance of Fianna Fáil and Fine Gael, but it has taken 17 years to finally deliver - they have still not been delivered - the social and affordable housing on that site. What we are saying is that we should supplement the lack of capacity in the private sector, so do not play at this either-or business. We are saying, and Goodbody is arguing, that private builders and developers do not have the capacity and that we need to ramp up our housing delivery and to deliver social and affordable housing, which your Government is failing to do. It missed its social targets, it missed its affordable targets and it is self-evident that the housing being built by the private sector is unaffordable. The average house price is €327,000; in my area it is €620,000. The average rent in Dún Laoghaire is now €2,400; in Dublin in general it is €2,200.

An Ceann Comhairle

Thank you, Deputy. Your time is up.

Deputy Richard Boyd Barrett

This is not affordable. We need a State construction company to build up capacity, to build houses and to make those houses public and affordable.

Deputy Michael Healy-Rae

You are a serial objector.

The Taoiseach

There is something I admire about the Deputy. I do mean this; I am not trying to be smart. Deputy Boyd Barrett is very articulate, very passionate and performs really well in this House.

Deputy Michael Healy-Rae

And he is an objector.

The Taoiseach

It is really obvious, however, when you get angry - not just pretending to be angry-----

Deputy Josepha Madigan

Shouting.

The Taoiseach

-----but genuinely angry - and the way you spoke to Deputy Carroll MacNeill there was-----

Deputy Richard Boyd Barrett

Because she was heckling.

The Taoiseach

No.

Deputy Richard Boyd Barrett

Because she was heckling.

Deputy Mary Butler

You are heckling now.

An Ceann Comhairle

Deputy Boyd Barrett, please, will you let the Taoiseach respond?

Deputy Richard Boyd Barrett

She was heckling. You do not like being heckled, do you, Taoiseach?

The Taoiseach

No, but-----

Deputy Richard Boyd Barrett

No. So why should she heckle me?

The Taoiseach

No, but I am in this House four or sometimes five hours a week. I am constantly heckled.

Deputy Richard Boyd Barrett

Not by me.

The Taoiseach

Sometimes by you.

Deputy Richard Boyd Barrett

Not by me.

The Taoiseach

Sometimes by you-----

Deputy Richard Boyd Barrett

Not by me.

The Taoiseach

-----just as you are doing now, and often by Members opposite, and I have never talked down to somebody, particularly a female Deputy across the way, like that and say "I am not listening to you".

Deputy Richard Boyd Barrett

She was heckling. I said I was not talking to her.

An Ceann Comhairle

Deputy, please.

The Taoiseach

Again with your brass neck. Do you not see the irony of it? I am criticising you for talking down to Deputy Carroll MacNeill, for heckling her, and then you are heckling me.

Deputy Richard Boyd Barrett

No. She was heckling me, which is out of order.

The Taoiseach

A Cheann Comhairle, is the Deputy not out of order?

An Ceann Comhairle

He is out of order, yes.

The Taoiseach

Thank you. The Deputy-----

Deputy Richard Boyd Barrett

Oh, but Deputy Carroll MacNeill was not out of order?

An Ceann Comhairle

There are many Members out of order.

Deputy Richard Boyd Barrett

Ah.

The Taoiseach

Anyway, let us deal with the substantive issue now that we have dealt with the nonsense.

Deputy Pauline Tully

We cannot really because the Taoiseach is out of time.

An Ceann Comhairle

We are out of time, a Thaoisigh.

The Taoiseach

What we need is more private and more public housing. The constraint does not relate to who owns the company; it relates to getting workers with the necessary skills and the materials. That is where the constraint lies.

An Ceann Comhairle

May we go on to the Regional Group and Deputy Seán Canney, please? We will not have any heckling from the Regional Group, will we?

Deputy Seán Canney

I hope not. My two colleagues are here; I will restrain them as best I can.

I am interested in a particular issue that has arisen over recent weeks. It relates to special education training hours for national schools. The Department has issued a circular which has caused fear and anxiety among school principals, boards of management and parents. It relates to the criteria by which children will be assessed for these hours. The biggest problem with this is that the criteria are not based on the specific or complex needs of the children. This is causing a great deal of stress for parents. I spoke to the Minister of State, Deputy Madigan, and her adviser yesterday about this, but we need to get clarity on what is actually happening.

In my constituency, over 50% of the schools surveyed will get less hours next year than they did last year, about 20% of them will remain as they were last year and maybe 30% of them will get an increase in hours. The budget has remained the same; it is just that the allocation of the hours has changed. Yet the schools that have lost hours will have the same problems next year as they have this year. There is something amiss in the context of what is going on.

It is important that we try to resolve this matter prior to September, because what we are talking about here is children who need every chance to fulfil their full potential. If we have schools that have lost up to five hours in special education teaching time, it is a major concern for the school and the parents. I ask, therefore, that this be looked at. I know it is a complex issue, that children's disability network teams, CDNTs, especially the one we have in Tuam, are way behind the curve in assessing children and that the waiting time to get assessments is impacting all this. Perhaps the Taoiseach will look at this and see what we can do to improve the system we have so the schools can retain the staff they have in order to provide the education that is required for our students.

The Taoiseach

I thank Deputy Canney for raising this very important issue. It has been raised with me by other Deputies, including very many here on the Government benches. When any change is made to how resources are allocated to schools, it can cause worry for students, parents and the schools in question. Inevitably, when a change is made, there will be schools that gain hours and schools that lose hours, but that is based on objective criteria and, most importantly, on the needs of the children in the schools concerned.

Special education teachers provide valuable additional teaching assistance for students with special needs enrolled in mainstream classes in primary and post-primary schools. For the next school year, which starts in September, there will be 14,600 special education teachers, 1,000 more than at the end of 2021 and many more than the entire Defence Forces at full strength, just to give the Deputy the context of the number of special education teachers we now have. This is reflected in the fact that 98% of all children with special educational needs are now in mainstream settings.

The Department of Education commenced a review of the model in late 2022. This involved consultation with unions, management bodies and schools to hear their views on how things could be done more fairly. There were 30 meetings and 12 consultation sessions. The NCSE undertook 40 reviews of individual schools to get their feedback. This feedback was incorporated into the revised model. The allocation for September next distributes the total number of special education teachers in line with each school's profile and need across the country. It is not about the schools, it is about the children who attend them and the needs of those children. Of course, that changes from year to year. The model ensures that children with the greatest level of need can get access to additional hours and are allocated the greatest level of resource. It is transparent and the model takes into account a number of factors. These include the total enrolment of a school, complex needs, literacy, numeracy and disadvantage. Of all the schools in the country, 67% will either have the same number of hours or will gain hours.

In County Galway specifically, there has been an increase of 25 in the number of hours for post-primary schools. There has, however, been an overall reduction of 148 in the case of primary schools. That is because the number of pupils in primary schools has fallen considerably. Ten schools will have 30 or fewer pupils next year. To give an example, that is the equivalent of 30 fewer classes of children in Galway next year in primary school. The Minister acknowledges, however, that there may be particular issues in particular schools that need to be looked at, and for that reason a review process is now being put in place. The Minister and I encourage any school that has a concern about its allocation to engage with the NCSE in order that we can see if it can be reviewed upwards or if, perhaps, a transitional arrangement can be put in place. Schools can make their applications for a review for March through to May of each year. The review will be completed before school the school holidays in order that a school will know where it stands for September.

Deputy Seán Canney

I acknowledge the work of the Minister of State, Deputy Madigan, on this and welcome the fact that there will be a review and that schools will be able to look for a review in order to try to get the problems that are there sorted out. The worst thing for schools is that while the support hours are based on a three particular criteria, a school is then asked to look at how it will allocate its special educational teaching hours based on the complex needs of the children.

There is an anomaly there that needs to be looked at.

As a member of the Joint Committee on Disability Matters, we come across many things we might say would not make us proud of what is happening with disabilities. For sure, we need to be able to stitch in what is happening with the HSE's early diagnosis and early interventions with what is happening in the education sector, and we need to do that as a matter of urgency so that we actually give every child the same and equal opportunity to fulfil his or her full potential.

The Taoiseach

I thank the Deputy again for his contribution. What is happening here is that the amount of resource for special education is increasing, but it is shifting from primary to secondary. That is the right thing to do because that is where the population is moving. As I mentioned previously, in the county of Galway alone, there will be 300 fewer children in primary school next year and ten fewer classes and, of course, that means fewer teachers. Logically, it would mean that. However, we are not reducing the number of teachers. We are moving that resource to follow the children into the post-primary area, and that is the right thing to do.

In terms of how the allocation is weighted, the baseline number of enrolments for the size of schools is weighted at 25%. The weighting in favour of boys has been got rid of because that was deemed to be inappropriate in a modern world. Disadvantage remains a criterion, and so do complex needs, literacy and numeracy. There has been some suggestion that complex needs are not taken into account anymore. That is incorrect. We are not willing to use the HSE data for complex needs, however. We will use the education data, but we are not willing to use the HSE data for complex needs anymore because we do not believe it is reliable.

An Ceann Comhairle

I thank the Taoiseach. That concludes Leaders' Questions.