Dáil Éireann díospóireacht -
Wednesday, 5 Mar 2025

Vol. 1064 No. 2

Saincheisteanna Tráthúla - Topical Issue Debate

Nursing Homes

Deputy Alan Kelly

A year ago, a commitment was given by the former Minister, Stephen Donnelly, when he wrote to me to say that the new nursing home in Nenagh would be opened as a nursing home after completion of the 12-month contract signed with a private operator to take over the nursing home in order for it to be used as a step-down facility for UHL. I fought for this nursing home. The Minister of State knows it is badly needed in the mid-west as he is also from the mid-west. I fought for it for years because HIQA stated the old St. Conlon's home was not fit for purpose and I accepted that. We found a site and, as part of the Government I was in, we got funding of €25 million. It was built, fair play to the HSE and those who fought to get it.

Last April, the town of Nenagh and its surrounds were shocked when the HSE announced that, effectively, it would be taken over as a step-down facility and run by a private company. Nenagh had been screwed when a Fianna Fáil Government closed our emergency department and put our hospital down to a different level. The people felt they were being screwed again with regard to the nursing home and went out on the streets to protest it. As a TD and public representative for 20 years based in Nenagh I know of so many families who cannot find elderly care. They cannot find rehab or respite. Here was a 50-bed state-of-the-art nursing home, the best built in Ireland, and it was being taken over. It was a disgrace.

To compound this disgrace it was privatised. Residents in St. Conlon's have never got to transfer to the facility and many of them have passed away since. The staff never got to transfer. Recruitment never happened for local staff. I have had to fight to get people into nursing homes throughout the mid-west and further afield, in Galway, Laois and everywhere, you name it. We have had to fight to get people even though we have a 50-bed state-of-the-art unit, which is the best in Ireland, sitting right beside the hospital and our new primary care centre in the middle of the town. It is not acceptable.

What the former Minister said, and what the regional executive officer, REO, of the HSE said, was that it would be used as a step-down facility for one year to get us over the winter. The winter is gone and we are now into spring. We were told it would be handed back as a residential facility by this summer. Then it was linked to the 96-bed block in Limerick. This is the famous block for which the Minister of State and I both fought for many years, and which is being built at rapid speed to be fair.

On Tipp FM a week or so ago, Dr. Hennessy, the new clinical lead in UHL, was asked whether it would honour opening the nursing home in the summer of this year. He said he had been assured by the REO before he went on the show that it would be open this year. That was all fine until I received a reply to a parliamentary question asking the exact same thing. In his correspondence to me, Ian Carter, CEO of mid-west acute and older people services, referred to my correspondence dated 21 February 2025 and told me no date for the initiative has been agreed at this time. This contradicts what the clinical lead said a week before.

Will the Minister of State answer to the people of Nenagh and its surrounds, and all the residents, their families and all the workers, on whether our nursing home will be open this summer as committed to by the HSE, the previous Government and this Government? Are we in a situation whereby it will be reneged on and we will not be in a position to trust the HSE or this Government on elderly care in Nenagh?

Minister of State at the Department of Health (Deputy Kieran O'Donnell)

I thank Deputy Kelly for raising this important matter. By way of overview, long-term residential care is a crucial part of the overall continuum of care throughout the country. Our HSE community nursing units and community hospitals play a vital role in the provision of long-term care and other services. I am also very conscious of the importance of strengthening the capacity and resilience of our health system through the delivery of health and social care infrastructure. This Government is committed to continued investment in healthcare infrastructure which supports the highest quality care for our older population.

On the specific point raised by Deputy Kelly, this investment includes the community nursing unit capital programme, which was launched in 2016 to ensure that up to 90 of our public community nursing units and community hospitals would be refurbished or replaced to ensure the best quality for our older people. As part of this capital programme, older person services in the north Tipperary area are being enhanced by the opening of a new state-of-the-art 50-bed community nursing unit in Nenagh, replacing the St. Conlon’s community nursing unit, to which Deputy Kelly referred. A significant investment of €22 million was allocated to this project. The new Nenagh community nursing unit will have a complement of 50 beds, as Deputy Kelly has stated, providing long-stay care, respite care and palliative care services. The unit will provide a high-quality living environment, which will be in line with all regulatory requirements.

As Deputy Kelly is aware, in order to alleviate the significant pressures at UHL, a decision was made to utilise the new Nenagh community nursing unit building, on an interim basis, as a step-down sub-acute and rehabilitation facility for UHL. As Deputy Kelly has said, it is run by a private provider with expertise in such services. The interim use of the unit in Nenagh has provided highly valuable support to the region pending the completion of the first of two 96-bed blocks for UHL, scheduled to be completed in mid-2025. It has always been the intention that this temporary arrangement would be reviewed within one year and that the unit in Nenagh would open for long-term residential care services 12 months after the contract commenced with the private provider. This is still the case. I have followed up on this and it is still the case.

I wish to inform Deputy Kelly that HSE mid-west is working towards a HSE-led model of service delivery at Nenagh community nursing unit.

This will include long-term residential care services, commencing in quarter three this year, for the current St. Conlon's residents. I also assure the Deputy that I am committed to working alongside the HSE to address all concerns in respect of residential care for older people in Nenagh and north Tipperary, now and into the future.

I reiterate the particular point the Deputy raised, which is that the HSE is working towards moving the residents from St. Conlon's to the new community nursing facility in Nenagh within 12 months of the contract being signed with the private provider. That is still the case. Obviously, it arose because of the huge pressures in UHL and I appreciate what this means for the residents of St. Conlon's and their families. I will be working to ensure the residents of St. Conlon's are transferred to the new state-of-the-art facility in Nenagh within 12 months of the contact being signed with the private provider to provide the services for the alleviation of pressures on UHL with that 50-bed unit in the community nursing facility in Nenagh.

Deputy Alan Kelly

I accept the Minister of State's honesty and directness in this and I appreciate his response. I have to ask, though, why did the HSE send me this response to a parliamentary question within the past few days saying it did not have a date and did not know? If the Minister of State can confirm to the House that it is happening after 12 months, which is this summer, what is going on? Why are parliamentary questions not answered honestly? The Minister of State has stated on the record of the Dáil - and I accept it - that it will be within 12 months, which is this summer.

Deputy Kieran O'Donnell

The intention is this summer and that continues to be the case.

Deputy Alan Kelly

I take his word that will happen. I must point out to the Minister of State that the company, Bartra, is advertising 12-month contracts for clinical nurses in Nenagh. If it is advertising for clinical nurses in Nenagh for 12 months, it must expect it is going to stay there a bit longer. By the way, at the end of this I want to see the total amount Bartra was paid for doing this because I expect it will be colossal. Why is it advertising for multiple posts in Nenagh on 12-month contracts if, as the Minister of State says, this will be handed back to the people of Nenagh and surrounds this summer?

I have huge affection for the people involved here. St. Conlon's, the saving of St. Conlon's and the creation of this new CNU are central to everything I believe in politically and everything for which I have fought for years. I fought for this for years. The people of Nenagh have huge affection for this. People who were residents and who have passed away had fought for this unit and wanted to move across to it. Their families have been left without ever getting their loved ones across to this unit.

There is an inherent contradiction here. I take the Minister of State's word. He is an honourable Member and an honourable Minister of State. I take his word that this is happening this summer and what the HSE have responded to in my parliamentary question will not happen but that it will do what he says and that moreover, the issue of Bartra looking for people for 12 months also will not affect the movement of the residents by this summer and all the staff will be in place.

Deputy Kieran O'Donnell

I thank Deputy Kelly for raising that matter. He might provide me with the correspondence he has received.

Deputy Alan Kelly

I will indeed, that is no problem.

Deputy Kieran O'Donnell

I will repeat particular clarifications on a number of points. First, the decision to utilise the Nenagh community nursing home building on an interim basis as a step-down sub-acute and rehabilitative facility was taken to alleviate the significant pressures at UHL. It is about the pressures and that is a fact. I also reiterate the HSE is working towards a HSE-led model of delivery at Nenagh community nursing unit with long-term residential care services, commencing in quarter 3 this year, for the current St. Conlon's residents. The cohort that I want to have significantly transferred, obviously, is that cohort of people who currently are residents in St. Conlon's and they will move to the new facility in quarter 3 of this year.

The current community nursing unit in St. Conlon's, Nenagh, continues to provide excellent care to its residents during the interim period. The new Nenagh community nursing unit will ultimately replace St. Conlon's community nursing unit. I also reiterate that older person services in the north Tipperary area ultimately will be enhanced by the opening of a new state-of-the-art 50 bed community nursing unit in Nenagh, following a significant intervention to help alleviate significant pressure on University Hospital Limerick.

They are the facts as I understand them as of today. Ultimately, my concern, as a Minister of State, is to ensure those residents in St. Conlon's move across and assure their families that they will move across to the new facility in quarter 3 of this year.

Agriculture Industry

Deputy William Aird

It is a great honour for me to be here today and speak for the first time in this Chamber. As a representative for the people of Laois, I thank my constituents for their trust and my family, friends and supporters for their unwavering encouragement. I waited a long time to get here. I was first elected in 1979, the then youngest person ever elected to public life at 19 years of age. As an admirer of Nelson Mandela who said "A winner is a dreamer who never gives up", I am the dreamer. I never gave up and I am a winner speaking here this morning representing the people of Laois.

I wish to ensure that County Laois gets its fair share of investment and opportunity. Our county is at the heart of Ireland, yet too often it has been overlooked. We need real investment and infrastructure; better roads, reliable public transport and broadband to support businesses and communities. Housing remains a huge challenge. Too many young people in Laois are struggling to buy or rent a home. We must cut the red tape, build more houses and ensure that rural families can build in their own communities.

Supporting working families is essential. The cost of living is putting people under pressure and we must ease that burden, whether through lower childcare costs, better healthcare access or tax relief for those who work hard. Safer communities must be a priority. Crime and anti-social behaviour are on the rise and we need more gardaí and stronger protections for our towns and villages.

I came here to deliver for Laois and for our country and to fight for investment, fairness and opportunity. I will work every day to ensure my county's voice is heard loud and clear. A strong message from rural Ireland means strong long local services, schools and Garda stations. Agriculture is the backbone of rural Ireland and farmers need fair prices, practical supports and policies that work with them, not against them.

On the proposals for peat soils, it is unacceptable that an important issue, one that will directly impact the livelihood of thousands of farmers, has been discussed behind closed doors without any farmer representation at the table. Farmers' representatives have rightly pointed out that these proposals, which include the rewetting of 80,000 ha of peat land, were discussed at a meeting of so-called invited stakeholders; a meeting from which farmers were absent. How can the Government justify this? How can we claim to support engagement and co-operation when the very people affected by these decisions were excluded from the discussion?

Let us be clear; the top-down approach that is taken by the Department of Agriculture, Food and the Marine is completely out of touch with the principles of fairness and transparency. If we are serious about tackling climate change and enhancing sustainability in agriculture, we should be serious then. We must also be serious about working with farmers and not against them. Imposing decisions without consultation will only lead to resistance and resentment, which serves no one's interests. Farmers are the custodians of the land and understand better than anyone how to manage and care for it, yet farmers are repeatedly facing increasing regulations, restrictions and bureaucracy. Farmers feel abandoned and disrespected by those in power.

The Government is committed to the principles of engagement and co-operation and we must start by listening to farmers. I call for immediate transparency regarding these proposals. The Department must engage with farming representatives to hear their concerns and ensure that any future decisions regarding peat soils are made in full consultation with those who actually work the land. We cannot allow a situation where farmers are simply dictated to by bureaucrats and policymakers who will never experience the economic and emotional burden of changes that decide their future.

Minister for Agriculture, Food and the Marine (Deputy Martin Heydon)

I acknowledge Deputy Aird's first contribution in the Dáil. It is a great honour and privilege to have him as a colleague here. We first served together on a regional health forum with the HSE back when were we councillors. To be serving with the Deputy here now is a great honour and I look forward to working with him. I do not doubt his passion in representing the people of Laois but also representing those in the agricultural community, which he has raised here as well.

I am absolutely committed to working to improve the economic, social and environmental sustainability of family farms. The issue Deputy Aird has raised is an emotive one, and I want to reassure farmers who work with peat soils. Land use has a key role to play in the achievement of our climate targets. As custodians of the land, farmers will be central to delivering on those targets. Nothing will be achieved in this area without their buy-in and support. I reassure Deputy Aird that farmers will not be dictated to while I am in this position. There will absolutely be engagement and transparency all along the way.

Ultimately, my Department is examining the potential to reduce greenhouse gas emissions through reduced management intensity of grasslands on drained organic soils. This work is at an early stage and any potential future actions from this analysis will be entirely voluntary. I cannot be any clearer than that. Anything farmers want to do here, they will only do it if they want to and if they are financially incentivised to do it. It is voluntary. It is in the programme for Government, and it is a commitment which Deputy Aird voted for and I will uphold. He has my word on that. I want to be clear from the outset that my two guiding principles are the voluntary and well-funded elements of this. If some farmers decide to adopt measures that involve low-intensity management of their ground, it will be because they have chosen to do so, and that will be fine too.

There are also initiatives at different levels. Deputy Aird talked about the workshop that was referenced in media reports last week. There was an exploratory workshop that happened to consider this. That meeting was about was the experience of practitioners who had worked directly with farmers on the likes of EIPs and locally led projects. It is absolutely appropriate that those meetings happen. There are 4,000 people working in the Department of agriculture. Meetings happen every day of the week and farmers' organisations are not always at them. They are about scoping out and getting key learnings to inform an approach that is taken and to ensure that when I am looking to make financial decisions and put proposals to farm organisations and engage with them on it, I will have clear information on what the experiences have been on the ground.

There is nothing sinister here. There is nothing untoward. It is absolutely the type of work that should be happening with my officials and key practitioners who are engaging and working with farmers and getting their experience back in order that we can make informed decisions when the time comes. Proposals would never be agreed without being put to farm organisations for consultation and engagement. Ultimately, I am the senior Minister in the Department of agriculture and I will make decisions after that consultation and taking on board all those points. That will not happen without having engaged with the farm organisations, the environmental pillar and all the key stakeholders who have skin in the game. I will work with them but I will make sure we are making an informed decision. That is what these workshops are about. It is making sure that any decisions we make are informed. It was always intended that, as this work progressed, there would be opportunities for engagement, discussion and input by farmers, farm organisations, the environmental pillars and all other stakeholders.

I reassure Deputy Aird that I understand the concerns he has highlighted. They are valid concerns, particularly in the light of media reports. I reassure him that this is a process that is absolutely as he would expect it to be, as we scope out and get the learning from farmers' experiences of previous locally led projects. This will help inform any key discussions we have with all the key stakeholders.

Deputy William Aird

I am delighted the Minister said everything will be voluntary from the farmers' point of view but he must accept where I am coming from as well. At that meeting where there were no farmers involved, it was announced that 80,000 ha of land were going to be rewetted. Whether we like it or not, a lot of soils throughout this country are peat-nature soils, so it will affect probably every county in the Twenty-six Counties of Ireland. Farmers need support, not mandates. They need incentives, not penalties. Above all, farmers need to be respected as equal partners in shaping agriculture and environmental policy.

If our Government fails to address these concerns, it risks isolating the entire agricultural sector, a sector which is vital to our economy and rural communities and to our national identity. I urge the Minister and all relevant authorities to take immediate action to engage with farmers, include them in decision-making, and ensure that no policy is imposed without farmer input. Anything less would be an insult to the hard-working food producers - I am one of them myself - who feed this nation and many more.

While I have the Minister, I wish to talk to him about the ACRES payments. In County Laois, the number of people being paid under the scheme is 427 but the active participants on day one for ACRES were 599. That means that 172 people, or 29% of the applicants in County Laois, have not yet been paid. All my life, I have been in discussions with the Department of agriculture to the effect that no matter what in an application has to be referred back to the person, a minimum of 85% of the money owed to the farmers should be paid out, with 15% held back.

An Cathaoirleach Gníomhach (Deputy Aengus Ó Snodaigh)

Gabhaim buíochas leis an Teachta.

Deputy William Aird

Could the Cathaoirleach Gníomhach imagine anyone in this building being told on a Wednesday that they would not be getting paid? That is what is happening to us in the farming community.

Deputy Martin Heydon

I thank the Deputy. The climate action plan has provided a pathway for reducing our land use, land use change and forestry emissions since 2021 and commits to the implementation of reduced management intensity on a portion of Ireland’s drained organic soils. This is a relatively new area of work in Ireland, with much uncertainty and complexity. If we are to reduce emissions from drained peat soils, it is important we consider how this might be achieved.

Those at the workshop referenced by Deputy Aird included people involved in projects with expertise of working with farmers in this area, including the European Innovation Partnership programmes, ACRES co-operation and the LIFE projects. There is no question of imposing solutions on farmers. Addressing this challenge will require a national approach involving all stakeholders. I am fully committed to working with farmers, farm organisations, the environmental pillar and other stakeholders to develop a pathway forward that is based on the principles of it being voluntary and well-funded, as I have outlined.

I believe farmers have a positive role to play in this space, and I know the Deputy thinks so too. They have already demonstrated their real commitment to action and 2024 is expected to deliver a third year in a row of reductions in agricultural emissions. Farmers have turned the trend and changed the narrative. I am confident we will do the same in the area of water quality, where we have seen positive early indications from the EPA for the first half of last year. That is what can be achieved when we back farmers and work with them in a spirit of co-operation rather than confrontation. That is the point the Deputy is highlighting. The role that our farmers play in producing safe, quality food is recognised at home and abroad but they also have a role in protecting biodiversity and water quality. Farmers can do more than one thing at the same time. They are up for that challenge, as well as contributing to climate action, and that must be acknowledged and adequately supported. I am really clear on that. It is only fair that, for measures which go beyond baseline requirements, farmers receive adequate financial support if they voluntarily agree to take them on. Farmers cannot go green if they are in the red.

On the point about ACRES, we are making progress. I was down in Wexford last week visiting the officials in Johnstown Castle. We cleared almost 1,700 last week and we are down to 10,400. I am determined that we will improve communication, clear the backlog as quickly as possible and provide long-term solutions that are not just a quick fix for this year but will mean we will not face these problems again next year.

Passport Services

Deputy Séamus McGrath

I thank the Minister of State for being here. At the outset, I acknowledge the great work done by the passport service and the staff. By and large, they provide a very good service. I wish to raise an issue relating to how passports are processed, and in particular, the verification with An Garda Síochána.

All in this House are aware that the Passport Office contacts Garda stations by telephone to verify that a passport has been stamped in the Garda station. I understand that is not done for every passport but, rather, is done on a selective basis. That has presented significant difficulties. As a public representative, I have come across dozens of cases where applications have been cancelled because the Passport Office has not been able to make contact with the Garda station.

We understand that Garda stations are busy places and unfortunately, the phone is often not answered. We would like to change this but it is the reality of the situation at present. Very often, these passport applications are in the system for many weeks before this happens and they are then cancelled with a short period left for the individuals' or the families' travel requirements. What has sparked me to raise this issue is a case I recently came across where it happened twice in the context of the same application. The application for a new passport for one of the children in the family was cancelled for the second time only a week before travelling for a family holiday. I think we would all agree that this is not an acceptable situation and there is a very obvious solution to this. The system of phoning a Garda station is clearly archaic, inefficient and outdated. It needs to be changed urgently, as part of this process. I am not suggesting anything radical but I suggest that we change it to an email system. This would be far more efficient. It would provide a clear, written record of the communication between the Passport Office and the Garda stations and it would give gardaí the opportunity to come back within a day or so to the Passport Office. It would be a far better and more efficient system of verification, I would argue. I ask the Minister to take this issue back to the Department, to make this change. It would avoid families having the significant stress and anxiety of passport applications being cancelled with a short period left to rectify the situation before they travel. As in all other cases, the applicants in this particular case did nothing wrong. The family went to the district Garda HQ and they did everything they could to have their passport in the best shape possible but unfortunately, this issue arose. As I have said, I have come across this numerous times over the years and it finally needs to be addressed. Verbal communication is open to misinterpretation, miscommunication and so on. It is important that there is a clear record of the communication of the verification. We can debate in the House whether it is necessary for gardaí to verify a passport application but that is a debate for another day. I think that needs to be looked at as well but that can be reviewed at another point. For now, it is important that the system is updated and brought into the 21st century so that we do not have families going through this unnecessary anxiety and stress when trying to get a passport application completed.

Minister of State at the Department of Transport (Deputy Jerry Buttimer)

Gabhaim buíochas leis an Teachta as an ábhar seo a ardú. I thank Deputy McGrath for raising the matter. Like the Deputy I want to pay tribute to the staff in the Passport Office and to acknowledge the work that they do. The passport service is currently experiencing a high level of demand for passports, as citizens prepare for upcoming summer travel. The Department of Foreign Affairs has operational and staffing plans in place and the Passport Office is successfully responding to the current level of demand, and has issued almost 200,000 passports to date this year. Virtually all complete passport applications are being processed within or before advertised turnaround times. The Irish passport has a strong international reputation and currently ranks third in the Henley global passport index, as it provides our citizens with visa-free access to 189 countries. As such, the passport service takes its responsibility to protect the integrity of the Irish passport very seriously. Since the introduction of online passport applications in 2017, adults renewing their passports through the Passport Office online are not required to submit a witnessed identity form. Online child renewal applications can be witnessed by members of a wide range of professions, including school teachers, doctors, elected representatives and gardaí. Deputy McGrath raised the issue of the application that was cancelled twice. I will bring that back to the Department. The Deputy raised a very important point that many families are genuinely frustrated and worried, despite their organisational abilities. There are certain passport applications for applicants resident in Ireland that require forms to be witnessed by a member of An Garda Síochána. These include: all passport applications sent by post; first-time adult online applications and first-time child online applications. The witnessing of these forms is an important element of the identity verification process for the passport service, as it provides initial assurance that the person in the photograph is the same person presenting to submit the passport application form.

In the case of an application for a minor, the witnessing of this form provides evidence that guardians have given their consent for a passport to be issued to the child. In order to protect the rights of parents or guardians and children, it is important that forms are correctly completed. As I mentioned previously, it is important to note that not all children’s passport applications must be witnessed by a garda. Child online renewal applications can be witnessed by a range of professions. When a garda does witness an application, it is the responsibility of the garda to ensure that the signature is correctly recorded in the logbook, so that when the passport service calls, the signature can be verified.

In the limited category of applications that require a garda witness, the passport service calls the relevant Garda station to confirm that the garda recorded the form in the station logbook. There is no requirement for the passport service to speak to the witnessing garda directly. Passport service staff will call the Garda station up to three times to verify the garda's signature. Where the passport service cannot reach the Garda station after three attempts, there is a system in place whereby the relevant superintendent’s office can be contacted to verify the details. If the passport service is unable to verify the witness after these steps have been taken, a new witnessed form will be requested from the applicant. Deputy McGrath made reference to the 21st century and the passport service is continuously looking at ways to make the application process easier for applicants, including the enhancement of digital services. The Department of Foreign Affairs would welcome the digitisation of the records maintained by An Garda Síochána when witnessing applications.

The policy on the use of witnesses is currently under review, as part of a general update of passport service policies. The witnessing policy is also being reviewed in the context of the ongoing programme of passport service reform. This reform programme focuses on the future of service delivery by implementing projects that enhance the customer experience while maintaining the integrity of the Irish passport. Elements of the reform programme being rolled out later this year and early next year, will introduce updates to the witnessing process, which will further enhance the service for customers. I will bring back the Deputy's remarks to the Department, because they are valid. All of us here who have experienced passport issues know how frustrating it can be.

Deputy Séamus McGrath

I thank the Minister of State. I welcome the fact that the process is under review and that it is being considered in the wider context. The Minister of State mentioned that 200,000 applications are being processed per annum, which is a huge volume. I acknowledge the great work done by the staff of the passport service. We all value our Irish passport. It is our most important document in many respects. The process of verification needs to be reviewed. The Minister of State's response outlined that there are three attempts made to try to contact the Garda station. That is the case but unfortunately, Garda stations are extremely busy places. We know An Garda Síochána is underresourced. It does not have the manpower in place. An email system would be a far more efficient service. I have discussed this with members and management of An Garda Síochána. They seem to be in favour of an email system being put in place. A review is under way. I thank the Minister of State for taking on board my points. Hopefully, the review will result in a more modern and efficient system, which would prevent families from suffering unnecessary stress, anxiety and heartache. In the particular case I referred to, the family got the passport within hours of their travel. That is not acceptable when the family had applied in good time, a number of months beforehand. They used the online system and they did everything as they should have but unfortunately, the system let them down. That needs to change. I thank the Minister of State for taking my comments on board.

Deputy Jerry Buttimer

I thank the Deputy again for raising this important issue. As we all know in this Chamber, passports are an important topic for us in our offices, especially as we approach the Easter and summer holidays. I assure Members of the commitment of the passport service and which I think we all agree is an excellent service. It is in an excellent position to deliver the demand forecasted for the rest of the year. Last week alone, 35,000 passports were issued, which is a staggering amount. In the context of the Deputy's comments, the passport service maintains a very close working relationship with An Garda Síochána. It offers guidance to gardaí on the correct completions required for identity and consent forms. It is important to recognise that the Passport Office will continue this engagement to discuss how we can work together to improve the situation and the service for citizens. I will bring back to the Department the Deputy's point regarding digitisation and the email system.

In addition, we should all take to our social media channels to urge anyone travelling overseas this year, especially families with young children, to check the validity of their passport before booking travel and to apply online in plenty of time and not wait until the last minute. We are all probably guilty of that as citizens and people.

Online passport renewal applications do not require a Garda signature for adults and children. Passport online is the best option for all our citizens. It is the quickest, most convenient and most cost-effective way to apply for a passport.

I thank the Passport Office and the Passport Office staff for the work they do on our behalf. They have a very good system. A couple tweaks could perhaps be made but we are very well served by them.

I will bring back the comments Deputy McGrath made to the Minister, Deputy Harris.

Ambulance Service

Deputy Claire Kerrane

First, by way of background, the accident and emergency department in Roscommon was closed in 2011. On the back of that, a commitment was made that there would need to be much better ambulance cover for Roscommon because we are farther away from the next nearest emergency department. Both Fine Gael, which was in office at the time, and the HSE committed to ensure there would be advanced life support. It would always be provided given the accident and emergency was no longer there. At that time, a separate roster for advanced paramedics on the rapid response vehicle was put in place. Until 2023, that had been in place for 12 years. In 2015, Leo Varadkar, the then health Minister, restated that a rapid response vehicle crewed by an advanced paramedic providing 24-7 cover in Roscommon was one of the significant improvements made in Roscommon because of the closure of the accident and emergency department. He went on to state his intention that there would be further improvements because we had no accident and emergency department and we were farther away from the next emergency department.

Instead what has happened, and I have been raising this for about a year, is that the advanced paramedic roster on the rapid response vehicle has been filled by a paramedic instead of an advanced paramedic. On the roster that was full with advanced paramedics, one advanced paramedic is missing, meaning that when calls are made, sometimes there is no advanced paramedic when there should be.

I recall last year a further reply from the HSE telling me that paramedics and advanced paramedics were the same thing, and that paramedics had been upskilled and could carry out duties similar to that of advanced paramedics. Of course, that simply is not true. Advanced paramedics can administer an additional 23 medications for acute emergency medical and traumatic conditions like a cardiac arrest. They are the only paramedics in the National Ambulance Service who provide the advanced life support that is needed quickly in very urgent cases.

We started with the use of a paramedic filling the AP roster and now, in the past week, it has been said that the rapid response vehicle – I have confirmed this with management in the National Ambulance Service – is being taken off the road in Roscommon on Thursdays, further downgrading that commitment and breaking that promise to the people of Roscommon. That shift had been filled by overtime. I understand it is a saving to the National Ambulance Service of about €350 a week. It is detrimental to the people of Roscommon should an urgent call come in and there is no advanced paramedic.

We have also had the situation in Roscommon where the air ambulance was relocated to Dublin in November arising from works in Athlone. It was due to come back in January. It is March now, and we are still waiting. I note the majority of calls for the air ambulance come from County Roscommon. We are without the advanced paramedic 24-7 cover, the promised rapid response vehicle and now the air ambulance.

I wish to make a point I have made a number of times in the House. I am concerned with the direction in which the National Ambulance Service is taking the service. It appears to be dismantling entirely the role of the advanced paramedic. It is the policy of the director to go in a different direction. It is looking at establishing something else, which is not even up and running yet. It has not been and is not training advanced paramedics anymore. It also has not been doing the privileging courses. We have about 14 or 15 people in the National Ambulance Service working as paramedics who are fully qualified APs but did not qualify here. The privileging course to make them APs and allow them to work here has been suspended. It is said it will be rolled out in May, but there is no guarantee they will manage to do a privileging course for 14 to 15 people, which is ridiculous.

Deputy Kieran O'Donnell

On behalf of Minister, Deputy Carroll MacNeill, I thank Deputy Kerrane for the opportunity to update the House on the delivery of pre-hospital emergency care in County Roscommon and the important emergency response role delivered by our National Ambulance Service.

The National Ambulance Service serves the county of Roscommon out of three bases located in Roscommon, Boyle and Loughglinn, which all operate on a 24-7 basis. All three bases are staffed by a highly skilled workforce of pre-hospital emergency care practitioners, including paramedics, advanced paramedics and emergency medical technicians. In addition, the National Ambulance Service operates a fleet of modern emergency ambulances, intermediate care vehicles and rapid response vehicles from these bases. I acknowledge the engagement by the Deputy on the establishment of the national ambulance base in Loughglinn.

Ambulance resources in the Roscommon region are deployed by the National Ambulance Service dynamically in line with international best practice. This means the National Ambulance Service prioritises resource allocation to the highest acuity calls that require an immediate emergency response, in direct response to patient needs.

On the specific issue raised by Deputy Kerrane, I am informed that the National Ambulance Service currently operates two rosters at its Roscommon base. One is for the operation of a rapid response vehicle and the other for the emergency ambulances. The rapid response vehicle roster has four paramedic posts and, in February 2025, had two vacancies. I understand an offer has been made for one of these posts through the National Ambulance Service national transfer process and that options for the filling of the second post are being examined.

The rapid response vehicle had been delivered in Roscommon through a combination of basic pay and overtime, but I understand that the rapid response vehicle is not currently rostered for daytime services on Thursday, which the Deputy alluded to. However, the National Ambulance Service operation of dynamic deployment means that Roscommon continues to be served by neighbouring National Ambulance Service bases for both emergency ambulance and rapid response vehicles.

As well as front-line urgent and emergency care, the National Ambulance Service is also a vital partner in the development and expansion of a range of clinically appropriate alternative care pathways to improve patient flow and reduce pressure on emergency departments. I particularly welcome two alternative care pathway developments in Roscommon in recent years involving the implementation of medical assessment unit and local injuries unit patient pathways for 112 and 999 patients. This means patients who are deemed clinically appropriate and do not require treatment in a busy hospital ED can be better looked after in an alternative care setting such as a medical assessment unit or a local injuries unit.

Patient demand for national ambulance services continues to rise, with nearly 430,000 urgent and emergency calls received last year, a year-on-year rise in volume of 8%. The further development and expansion of alternative care initiatives are vital, therefore, in transforming the delivery of urgent and emergency care, improving patient access to care and enhancing patient healthcare experiences and outcomes. I know the National Ambulance Service is committed to the continuing development of these alternative pathways.

I extend my sincere thanks and gratitude to the staff of the National Ambulance Service and to the staff of all our ambulance services for their commitment and dedication to patient care, both in County Roscommon and throughout the country.

Deputy Claire Kerrane

If patient demand for NAS services continues to rise, with nearly 430,000 urgent and emergency calls received last year, representing a year-on-year rise in volume of 8%, why then has the National Ambulance Service stopped training advanced paramedics? Why has it stopped the privileging courses? Fully qualified advanced paramedics who have trained elsewhere, some I understand in the Defence Forces, can only work as paramedics. That privileging course the National Ambulance Service eventually agreed to run in May of this year might not be able to manage the 14 or 15 people. How can it not run a course for 14 or 15 people and allow them to be advanced paramedics?

I am concerned about an acknowledgement that we have more urgent and emergency calls but the only paramedics in the National Ambulance Service who provide advanced life support are not being trained. They are not being respected or recognised either. In fact, I believe they are being dismantled entirely, and Roscommon is a case in point. Management keeps saying they cannot fill the roster in Roscommon. They will not fill it when they are not doing privileging courses and they are not training APs. I am also aware there are advanced paramedics in Roscommon willing to take up a full-time role on that roster but they are stopping themselves from doing it because they are constantly being pulled to cover. If someone became the AP on that roster, they are put off doing that because they are constantly being pulled to cover elsewhere.

We need that roster in place and that decision needs to be reversed. We are not near an accident and emergency department. That is why we got the air ambulance, which is available but further away; it is based in Dublin. An AP can be the difference between life and death. I do not say that to scare people. It is the absolute reality. Nowhere in the Minister of State's response did he acknowledge that a commitment was made to the people of Roscommon and that commitment has been broken. I acknowledge the Minister of State's comments about Loughglynn, where I was lucky enough to be able to deliver a 24-7 service because the previous director Martin Dunne was excellent at engaging and doing what was right. That is also an issue now because we have no engagement at all, unfortunately, with the new director.

Deputy Kieran O'Donnell

I note the points the Deputy raised in respect of Roscommon and the roster. There are currently two vacancies. I understand an offer has been made for one of the posts through the National Ambulance Service national transfer process and options for the filling of the second post are being examined. I have asked my Department to follow up on that issue with the NAS and to look at the particular issue of rostering for daytime services on a Thursday. I understand the needs of the people of Roscommon.

The Deputy raised other issues, including the AP courses. My Department will follow up with the HSE on that matter as well. She also referred to the air ambulance service, which was supposed to be in place in January. We will also follow up on that point. However, with respect to the key element the Deputy raised - the removal of 24-7 advanced paramedic cover in Roscommon - she is effectively speaking about the roster for daytime services on Thursdays. I have been led to understand that an offer has been made for one of the two vacant posts through the NAS transfer process and that the options for filling the second post are being examined. We will be following up with the NAS on those particular two vacant posts in the context of providing a roster for the daytime services on Thursdays.