Nithe i dtosach suíonna - Commencement Matters

Social and Affordable Housing Provision

I welcome the Minister of State.

He is always very welcome. Senator Lombard has the floor.

It is great to have the Minister of State, Deputy English, here to respond to this matter which relates to the Minister with responsibility for local government investigating the option of developing an affordable housing scheme in Kinsale on lands that are in the ownership of Cork County Council.

The Minister of State has a connection to Kinsale and will know that it is a thriving town that has been the subject of significant development in the past 15 years. Its population has increased by more than 30%. The town has witnessed major infrastructural development in terms of schools and roads. Other infrastructural and sporting projects have all developed amazingly during the past decade.

I wish to refer to the lack of affordable housing in the town. Work is under way on six private developments in the town. An important social housing scheme comprising 40 houses is under construction, which is a very welcome development. This importance of this €9.7 million project needs to be acknowledged. The remaining portion of land in the ownership of Cork County Council is quite significant. The original plan was that this site could provide anything up to 150 houses but I am not sure if that figure still stands. I understand an affordable housing scheme to be one that can involve both the local authority and private developers building houses at a cheaper rate to facilitate members of the general public accessing housing cheaper and also being able to have ownership of the property.

This land has been in the ownership of the local authority since the early days of millennium. Very little has been done with this land, other than the work carried out in recent months. There is a wonderful opportunity to develop it for the residents of Kinsale. We have nearly everything that is needed to do that bar the will to drive the development of such a project. I would be hopeful that the Minister for Housing, Planning and Local Government could instruct the local authority to move to ensure the development of the asset of this land portfolio.

It is almost criminal that such land in the ownership of Cork County Council is not being developed. This is a significant issue for the town. We have spoken about land in the ownership of the State and about the housing crisis. We have an affordable housing crisis and a social housing crisis in Kinsale. We need a pathway to ensure the development of this land portfolio, whether it be through a public private partnership or the Department instructing the local authority that it will put the value of the land portfolio against the houses. A mechanism needs to be put in place to ensure the delivery of this site for the construction of affordable housing in Kinsale. This site could accommodate a significant number of houses, be it 50, 60 or 70. I am not sure how many it could accommodate but the land is available. We need the political will to develop it. We need central government to work with the local authority to deliver housing on the remainder of this land portfolio. If that was done it would provide a perfect mix in Kinsale with an affordable housing scheme that, hopefully, we can get off the ground, the social scheme currently being built and the other private developments.

The lack of an affordable housing scheme is the gap in the market that the people are talking about. Such a scheme would assist a household with two incomes who find they are just short of what they need to get mortgage. We need to ensure Cork County Council moves on this project. That is important. We need leadership from central government to ensure we get that movement on this.

I thank Senator Lombard for raising a very important issue for Kinsale as well as the wider issue of the affordability of housing and the Government's plans to deliver affordable housing. The Senator is correct in saying that I have connections in Kinsale and I am always glad to discuss it and to visit it because it is a fabulous part of the country. It is an area that is doing very well in the context of job creation, business and tourism. It is a very self sufficient town for which housing is very important. I have family who are very happy living in Kinsale. The town is well served with schools and other education facilities but it is important that we deliver the necessary housing there too. I am glad to say that 40 social housing units are being built on a site in the town. Work on that site began just before Christmas and it is great to see construction activity there. I hope to visit it soon.

While the issue raised by Senator Lombard this morning is affordable housing, when it comes to social housing it must be said that there is a lot happening in Cork. Cork County Council is probably one of the leading local authorities when it comes to the delivery of social housing under the direction of Mr. Tim Lucey, the county manager, and Mr. Maurice Manning, director of service for housing and his team. I have met them on numerous occasions to discuss social housing projects as well as affordable housing schemes. They are very interested in driving on with the development of affordable housing. The Senator is on the nail in terms of the importance of affordable housing and Cork County Council understands that too and has been doing good work in that area. I am happy to work with the local authorities in Cork to bring forward more proposals.

In fairness to all local authorities, they have been doing good work over the last year or two in rebuilding their housing teams, putting in serious effort and concentrating on the delivery of housing. That is now paying off. The delivery of social housing has increased a lot and we now have a healthy pipeline of projects. In Cork, the pipeline contains more than 1,700 units over the next few years. We want to double that again and keep going. There is good pressure there in terms of social housing and now that we have the social housing delivery back on track, we want to move on to a key phase, which is the delivery of affordable housing for those who are at work but who are unable to afford a mortgage on the open market. Affordable housing is for those people earning less than approximately €75,000 jointly who would not be in a position to buy a house at full market value but who, with some help from local authorities in terms of providing sites, would be able to access an affordable home. In this context, the State's land bank has an important role to play.

Senator Lombard has asked whether land in Kinsale which is owned by Cork County Council can be used for affordable housing and the short answer is "Yes". It can be used and it will be used if all the plans for it come together. I will outline the position in that regard shortly. More generally, the State land bank plays a vital role in delivering housing. Increasing and accelerating housing delivery, particularly for social and affordable purposes, is at the heart of Rebuilding Ireland, the Government's action plan for housing and homelessness. The Minister has made it clear that the focus will be on affordable housing going forward. The plan places a particular focus on maximising the output of housing from the land banks of housing authorities, the Housing Agency and the broader public sector. Thankfully, there is a large State-owned land bank in Cork. There is enough land to deliver more than 3,500 houses. There is also land in Cork in the ownership of the Housing Agency that can be used for housing. There are many sites available, amounting to 160 ha, in State ownership that can be developed for social, affordable and private housing.

On the site in Kinsale, to which Senator Lombard refers, I understand that Cork County Council has conducted an economic assessment and concluded that it would qualify for affordable housing. The site was not put forward in the first round of affordable housing projects announced in June of last year. We have now set aside €310 million for the serviced sites fund which will service land belonging to local authorities and a second round will open in the coming weeks. The local authority in Cork has assessed four or five different sites for affordable housing, and the site at Glanmire qualified for funding in the first round. When the next round opens, I imagine it will put forward the site at Kinsale as well as others located in Mallow, Midleton, Carrigaline and Clonakilty, all of which would pass the test for affordable housing. I hope that we will see a number of applications submitted by the local authority in Cork. I see no reason for Kinsale not being successful. Indeed, development of that site would compliment the work that is going on there already to provide social housing. If everything goes to plan, 40 affordable housing units could be delivered in Kinsale. There may even be some space to deliver more.

We are trying to use State owned land throughout the country. We know that there are approximately 1,700 ha of land in the ownership of local authorities and we want to see a lot of it used for housing. While it will not all be suitable for housing, the majority of it can be utilised for a blend of social, affordable and private housing. Cork is leading the way in that regard.

I thank the Minister of State for his response, which was very informative. I welcome the announcement of a second round of funding to service sites for affordable housing. That will give the opportunity for sites in Carrigaline, Kinsale and Clonakilty to be brought back into the system. That is what I wanted to hear this morning. I am glad the scheme will be reopened and other sites will be considered. Kinsale is a very important site, as are the sites at Clonakilty and Carrigaline, in the context of the growing population around Cork city. I welcome the Minister of State's assurance that there will be a second round of funding and I ask him to work closely with officials from the local authority to ensure that the sites to which I refer can be included. If they are included, that will be the last string in the bow in terms of affordable housing projects that we need to get off the ground in Cork. If these sites can be brought to market, the knock on effect will be very positive. Those people whose joint income is less than €70,000 will be able to access affordable housing. The desire to own a home is very strong in Ireland. People really want to own their homes.

I ask the Minister to clarify when he is proposing to reopen the scheme to applications. What amount of funding will be provided?

We will be inviting applications for the serviced site fund shortly. Under that fund, €310 million has been set aside over the next three years to service sites. Applications originally opened in June 2018 when we had €100 million set aside. The funding was increased in budget 2019. We will be opening the scheme again in the next few weeks but I do not have an exact date at the moment. Local authorities will be invited to make applications for funding for various sites, including the ones we referred to in Cork. I expect that the site in Kinsale will be on the application from Cork County Council. We have engaged with local authority officials on this. We had a workshop in November with the local authorities which was attended by Mr. Maurice Manning and his team and they engaged fully with us. I was in Cork recently with Senator Lombard to open a housing project and had further discussions with Mr. Manning about opportunities to provide more affordable housing. He is very much on the ball.

In terms of how the process will work, local authorities will apply to the fund which will help to service the land that they own. The regulations for the scheme will be announced in the next couple of weeks by the Minister. These regulations will clarify who qualifies for the scheme. It is expected that those who would qualify for the Rebuilding Ireland home loan, that is, those with a joint income of around €75,000, or a single income of €50,000 will qualify for affordable housing. Each local authority will decide itself on the priority and allocation process in terms of who qualifies for any houses built. The allocation systems will be designed locally.

This is a good scheme and we hope it will deliver between 6,000 and 7,000 houses over the next few years. We will have an opportunity to deliver a lot more into the future too.

Local Authority Functions

I thank the Cathaoirleach's office for selecting this matter. I ask the Minister of State to clarify the reserved functions of the elected members of city and county councils in the context of the capital budget. As we all know, all local authorities have a revenue budget and a capital budget. Each local authority adopts its budget annually. Members can accept, amend or reject the day-to-day revenue budget but there seems to be some misunderstanding in relation to the capital budget. There is an inconsistency across the 31 local authorities in terms of how the capital budget is treated.

Some weeks ago, the Minister of State at the Department of Housing, Planning and Local Government, Deputy Phelan, was in this House talking about local government reform. He spoke about the need for greater transparency and accountability. He also spoke about empowering local city and county councillors to manage their organisations. He referred to fancy ideas about mayors in some local authorities but not in others. He said that it is Government policy to empower local councillors and to give them more functions and powers.

I acknowledge the important step in that regard. I want to be clear about it, however, and that is why I am seeking a response today.

I have in front of me legal advice from a number of local authorities. There is inconsistency in that advice. The Minister of State will be aware that section 135 of the Local Government Act 2001 clearly deals with capital budgets and the reserved and executive functions. Where there is an absence of a reserved function, it is usually inferred that it falls back on the executive. As a result, there is inconsistency.

I have spoken to a number of the Minister of State's party colleagues from various councils about this. I would have believed it right and proper that members would have the right to accept, amend or reject capital budgets. They are entrusted with responsibility and they are elected by the people. It is important and correct that the executive prepares the rolling three-year capital budget but there is inconsistency across local authorities. Some very good chief executives engage with their corporate policy group, bring the measure through the various sections in the council and seek interaction with the elected members while others quite bluntly refuse to do so, stating that it is an absolute executive function and that they have one obligation, namely, to go to the council and tell the members what has been agreed. That is crazy.

If we are serious about local government reform and empowering elected city and county councillors, we need to address this issue. I hope to hear today the Minister of State's professional legal advice from within the Department. More important, I want to hear a sympathetic Minister state that this has to be a matter for the elected members of the councils. Surely elected representatives have to hold an executive to account. Surely elected councillors have a right to decide the priorities of their funding. That is important. I am not trying to water down any functions of the executives of any local authority, lest they think otherwise, but I want to be sure city and county councillors are empowered to accept, amend or reject capital budgets.

I thank Senator Victor Boyhan for raising this issue. I gather it is not the first time he has raised it. As usual, he is persistent on these matters in order to get to the detail. That is fair enough; that is what it is all about. I hope to clarify the issue as best I can. The Senator has raised an important question concerning the ability of local authority members to use their role to the maximum and also to have a say on major projects in their counties, be they local or of national significance. Certainly, capital expenditure is important. As we roll out Project Ireland 2040, which is a major capital expenditure programme for the country for the next ten years and beyond and which involves an allocation of €120 billion in taxpayers' money, it is important that local authorities be involved in capital projects and in ensuring that they happen on time and, if at all possible, within budget. Expenditure is an ongoing issue as costs increase.

As set out in correspondence to the Senator from my colleague, the Minister of State, Deputy Phelan, it is not the role of Ministers to provide legal advice. We cannot do that. It is interesting that the Senator has obtained different legal advice from different sources. It will differ depending on who gives it. We cannot give the Senator legal advice but I will be happy to confirm what the legislation sets out and what it is meant to be. That is the best I can do for the Senator.

Elected members of local authorities are vested with various reserved functions that enable them to direct and oversee the activities of the local authority generally. These reserved functions are provided for by a broad suite of enactments. Section 149(4) of the Local Government Act 2001, as amended by the Local Government Reform Act 2014, provides that every function of a local authority that is not a reserved function is an executive function to be carried out by the chief executive. Part 14 of the 2001 Act sets out the role of the elected council and provides that it is a reserved function of the elected members to adopt a revenue budget; this provision does not extend to the capital budget or plan. I am no sure of the history of that but that is the way it always has been. It could certainly be considered in the future. It was not a change in 2001; it was always that way. I am just clarifying, from our point of view, what the legislation states.

Section 135 of the 2001 Act provides that before the start of each local financial year, the chief executive shall prepare and submit to the elected council a report indicating the programme of capital projects proposed by the local authority for the forthcoming year and the following two local financial years, having regard to the availability of resources. This report may be considered at the local authority budget meeting or at such other meeting as the elected council may by resolution decide. While the Act provides that both the revenue budget and capital plan be placed before the elected members, section 103 requires the revenue budget to be adopted by the members, while section 135 requires that the capital programme be submitted for consideration and comment only.

The Senator asked me about best practice. I am stating the position in the legislation. To me, it is best practice and would make sense for councillors to consult on and debate the capital programme, and even vote on a motion thereon. I would imagine that, in most cases, local authorities do so. From talking to councillors around the country, I am aware that they generally feel they have a say in this regard. It happens in practice although it might not always be set out in legislation. It would be good practice to have the members on board in respect of projects and to bring them with one as best one can.

Other relevant provisions of the 2001 Act addressing the role of elected members in the area of capital budgeting - this is where they do have very clear powers - include: section 137, which provides that the elected council may by resolution require the chief executive to prepare plans and specifications for particular works and an estimate of their cost; section 138, which provides that the chief executive shall inform the elected council before any works, other than maintenance or repair, of the local authority are undertaken or before committing the local authority concerned to any expenditure in connection with the proposed works; and section 139, which provides that, once the elected council is informed in accordance with section 138 of any works, it may by resolution direct that those works shall not proceed. Therein lies the power of a local authority member when it comes to capital projects. It is very clear that they have a role if they have a difficulty with or are positively disposed towards a project. Section 140 provides that the elected council may, by resolution and subject to the requirements of the section, direct that any specific act be done by the local authority. Again, the elected members have very powers in this regard, which is important. This might satisfy the Senator regarding what elected members can do under the law.

While responsibility for the full range of local authority functions is split between the elected members and the executive, the intention has always been that the members, in the exercise of their role, would act on a basis akin to that of a board of directors served by a full-time chief executive. Councillors, in my view, are the directors of a local authority. They have a very serious and important role. That is very clear in the Department's interpretation.

The legal character of a local authority thus comprises two elements, the elected council and the executive, with responsibility for performing local authority functions shared between them. Legally, however, all functions, whether performed by the elected council or by the chief executive, are exercised on behalf of the local authority. While the law must provide for a precise division of functions, and responsibility for their exercise may be clearly defined, in practice the policy and executive roles are intended to be complementary. That is best practice. I thank the Senator for the opportunity to address the Seanad on this matter. I hope I brought some clarity to the legal position.

Most capital projects require the raising of money, which means loans. Government grants might be available for some part of a project. Under Project Ireland 2040, taxpayers' money, spent through Departments, will fund a significant amount but in some cases money will also have to be found locally. Local authority members have to pass loans. The cost of the loans, in interest, is part of a revenue budget.

I thank the Minister of State for that. Everything he said, I know. I will have to look at the Official Report to see his response. I was handed a script with only four paragraphs by way of response. It is very different from what the Minister of State read. He went way beyond the script, which I appreciate. I also appreciate his knowledge on this matter.

Ultimately, the Minister of State said it makes sense for councillors, elected members, to be involved with the capital budget. Of course it does. The Minister of State is clearly saying there is no provision in legislation. This is the Legislature. The Minister of State can take it from me today that I will, very soon in the next few weeks, seek to muster up support among members of the Joint Committee on Housing, Planning and Local Government for what I propose. It is timely in the run-up to a local election, when politicians are going around the country canvassing and talking about powers in their communities, that we identify the absolute weakness. I will write to the Minister formally today asking him to ask his colleagues and the Minister to examine this matter again. We have identified a real problem here. In some councils, when the manager has his or her capital budget he or she then proceeds to enter into commitments. When people enter commitments, it costs money. It is very difficult to pull out of commitments on a capital budget when they have been initiated.

We should avoid this. We should have clarity and no ambiguity. The time has come to embed in legislation the requirement that each council approve its capital budget. I hope I have the Minister of State's support in this as well as the support of the three Fine Gael Ministers who are doing an excellent job in the Custom House. I look forward to engaging early with the Minister of State and making this a really important issue about accountability in the run-up to the May 2019 local elections.

I have outlined to the Senator the law in this regard. I want to make clear that councils have a role in capital projects under the law. The Senator's specific question concerns a capital plan, in which a number of votes are taken together, but individually on each project local authority members have functions if they want to use them. The law is clear on this, as I tried to set out to the Senator as best I possibly could. We will have other chances to debate legislation later.

We can improve it, though.

National Children's Hospital Expenditure

The Minister of State is more than welcome.

The Minister of State has seen the outline of the Commencement matter. I know that the Minister is scheduled to come before us after lunch today to discuss the national children's hospital. I do not know whether he will come in person or whether the Minister of State, Deputy Daly, will deputise again at that stage. He might enlighten us in this regard if possible. As we know, there is a cost review of this project ongoing at a cost of just under €500,000. We are told the review will be carried out relatively quickly and that we could press pause on the project while the review is ongoing because there has not been much more than the base works and groundworks completed on the site so far. That is the general gist of the Commencement matter, as the Minister of State can see.

I thank Senator Davitt. I welcome the opportunity to address the House on this matter. I assure him that I take the matter of the increased cost of the new children's hospital very seriously. The significant increase in costs was and remains extremely disappointing and concerning.

When Government approved the construction investment decision in April 2017, the capital cost for the delivery of the hospital build project, following the evaluation of main construction tenders and selection of preferred contractors, was €983 million, of which €916 million was to be met by the Exchequer. In December 2018, following completion of the guaranteed maximum price process, the capital cost for the delivery of the hospital build project stood at €1.433 billion. The total of €450 million requires net additional Exchequer funding of €320 million, of which €50 million is VAT, and an additional €130 million in philanthropy funding.

In December 2018, when the Government approved the construction investment to allow phase B of the hospital to be instructed, it made very clear its serious concerns about the major escalation in the cost of the project. The Government considered the alternative options and made the decision on 18 December to proceed with the project with the current contractor.

The new children's hospital project is under way, the contractor is on site at the St. James's Hospital campus and construction work is well under way on the two associated outpatient and urgent care centres, with the outpatient urgent care centre in Connolly Hospital due to open in a couple of months and the centre in Tallaght Hospital opening next year. We must replace outdated hospital buildings with modern and appropriate infrastructure designed to best serve the needs of our children and their families and of the staff who care for them as soon as possible. This project will not be halted.

As the Senator will be aware, however, the Government approved the commissioning of an independent review of the escalation in cost in determining the adjusted contract sum in respect of the new children's hospital. This independent review has been commissioned by the HSE and is being undertaken by PwC. The terms of reference have been revised and finalised and have now been published. The primary focus of the review is on the governance and management arrangements in place within and between the National Paediatric Hospital Development Board and the executive, design team, relevant consultants, user groups and contractors. The review will deal with the accountability of the relevant key parties, functions and roles. This may inform appropriate next steps by decision-makers, including Government. The review will establish the sequence of events regarding the cost increases experienced by the project; what was known, when and by whom; and the reporting of relevant information from the project team to the relevant oversight and governance bodies, including the National Paediatric Hospital Development Board and its committees, the HSE and the Department of Health. The terms of reference also require the review to develop any further recommendations which may identify any areas of potential cost savings or reductions which are consistent with the applicable contractual undertakings and the delivery of the project in light of its current status, address major residual risks, control and oversight issues and bring greater oversight of performance and value for money.

The development board is fully committed to collaborating with this review and to implementing any recommendations arising. The HSE and the Department will equally fully support the expeditious conduct and implementation of the review.

I thank the Minister of State for coming here to handle this matter. I am sure this is not this Minister of State's fault, but "this project will not be halted" is the punchline before we get to talk about the review or whatever else. I come from a business background. If these guys carry out a review and come back and tell us what we all know, that is, that this has got out of control and is costing double what we originally thought it would cost, how can we say "this project will not be halted" before we get back the results of the review? That is a very childish response, not from the Minister of State - he is here reading the statement he has been given - but it is very silly. I could say many more things about it but I do not want to be demeaning. To have that punchline in the response before we talk about the review process and what it will come back with regarding expenses and so on, I do not know how anyone can do business like that. That is probably why we are in the mess we are in.

I believe the date of the publication of the review is the last day of March. If the Minister of State could confirm that, I would appreciate it. I would go back to whoever wrote up this wish-wash in the Department and ask why he or she put the line "this project will not be halted" in the Minister of State's response before the review committee we have heard so much about has reported.

I thank the Senator for his questions. The decision not to halt the project was taken by the Government. It was not a wish-wash response from any Department official, as the Senator is trying to suggest. It was carefully considered at a meeting of Government on 18 December last year, at which all the options were considered. There was much consideration of the options by the Department, the Minister and officials in the HSE prior to that meeting. A decision was taken not to halt the project, and that decision was not taken lightly, I assure the Senator.

As for the issue of the review being undertaken and commissioned by the Government, it is important to maintain a distance between the two different issues. One is whether there is value for money here. That is what people want to know. It may be the case that the projected costs were unrealistic and not right. We do not know where the error lies, whether it was on the side of whoever projected the costs on the first day and got it so badly wrong, or whether we are still getting value for money. That is the key issue I, as a taxpayer and Minister of State, and the Government want to get to the bottom of and that is what the review will determine. We have decided to wait for that review. It will not be a very long time. I do not have the exact date that the Senator asked me for, but we will have the review imminently. When it will be-----

I think it will be the last day of March, the same day as Brexit.

That may well be the case.

Both of us already know the answers to the questions the Minister of State raised.

I ask the Senator to respect the Chair.

The review will not be good value for money. It is costing €500,000. It is more money wasted.

Hospital Consultant Recruitment

I thank the Minister of State for taking this matter. The bones of the issue are really simple. The HSE conducted interviews for the position of medical oncologist with a special interest in sarcoma at St. Vincent's University Hospital on Tuesday, 14 March 2017. Now we are informed that a successful candidate from that process is due to start in the summer of 2019. Should the sarcoma specialist commence work this summer, it will have been three years since the Minister for Health, Deputy Harris, created the post and two and half years since interviews were held.

According to the HSE's policy, external recruitment candidates will be required to take up duty within three months of the receipt of a formal offer of employment. Furthermore, the HSE states it reserves the right to withdraw an offer of employment should appointees fail to meet the timeframe for taking up a position. However, St. Vincent's University Hospital stated that, as a voluntary hospital, it operates its own recruitment policy and has full discretion regarding appointments.

We talk about value for money and adherence to policies but the hospital is funded by the State, which does not often sit comfortably with the hospital, so it should follow the HSE guidelines. The hospital was not slow about following the HSE's guidelines when it came to pay cuts for healthcare staff. The hospital cannot pick and choose what it will adhere to.

My involvement started when I met a gravely ill group of sarcoma patients who had set up a support group and this is one of first issues that I lobbied on as a new Senator in 2016. We managed to secure a meeting with the Minister for Health that summer. Lo and behold who comes in behind him, whom we had not invited, only a troupe of personnel or top dogs from St. Vincent's hospital. These people tried to answer for the Minister but he was there to answer to sick patients, many of whom have died since.

I seek clarity on three issues. What is the Minister of State's stance on publicly funded hospitals applying their own recruitment policies that have damaging consequences for patients? Why was a temporary contract not offered to cover the period of more than two years since the departure of the last sarcoma specialist? What will the Minister and the Minister of State do to immediately rectify a situation whereby patients still do not have access to an oncologist specialist in sarcoma?

I wish to advise the Senator that she can ask questions by tabling a Commencement matter. I will reply regarding what she has asked to have addressed this. If she wants to address ancillary issues, then I ask her to please table them as part of a Commencement matter. The Minister and I do not micromanage the health system. We do not engage at the level of detail that the Senator sought when she asked about the recruitment process applied by individual hospitals throughout the country, neither would it be proper or fair to expect us to answer those kind of questions.

It is implicit in my matter. The Minister of State should have known that these questions were-----

The Minister of State please, without interruption. Please respect the Chair.

I did not interrupt the Senator so she might have the decency to allow me to continue without shouting me down.

I will reiterate for the benefit of the House the matter the Senator - "The need for the Minister for Health to provide an update on the employment starting date of a sarcoma specialist for St. Vincent's hospital". That is what I will address, if that is okay with the House.

I thank the Senator for raising this issue and for the opportunity to update the House on the matter. I am advised that the person recruited to fill a permanent post of consultant medical oncologist, with a special interest in sarcoma, at St. Vincent's University Hospital will commence on 1 September 2019.

More than 200 adults are diagnosed with some form of sarcoma every year in Ireland. For patients with a new sarcoma diagnosis, it is important that decisions on the management of cases are made through a multidisciplinary team process. Multidisciplinary teams can involve clinicians and other medical personnel, as well as health and social care professionals, based in several hospitals.

The outputs of their deliberations provide recommendations on the best approach to investigations, treatment and follow-up for the individual patient. Services for patients with sarcoma are currently provided in St. Vincent's University Hospital, Dublin, and in Cork University Hospital. Both hospitals are designated cancer centres and have an extensive range of multidisciplinary services and expert clinical advice available.

A national clinical lead in soft tissue sarcomas is in place to oversee services for patients. Patients have their cases presented and discussed at one of the two sarcoma multidisciplinary teams and members of these teams have links with European specialists in sarcoma.

This Government and the HSE are committed to providing a high quality, responsive and sustainable service for sarcoma patients. St. Vincent's hospital has access to all of the relevant specialties for treatment, including surgery, medical oncology, radiation oncology, radiology and pathology.

The National Cancer Strategy 2017-2026 sets out the plan for the development of cancer services for the next decade. Effective prevention, early diagnosis, access to quality treatment, survivorship, patient involvement and safe high quality patient-centred care are key aims of the strategy. Services for rare cancers such as sarcoma received considerable attention in the development of the strategy. The importance of improving awareness of rare cancers among both the public and healthcare practitioners is acknowledged. Furthermore, the strategy sets out the need for clear care pathways for the diagnosis and treatment of patients with rare cancers, with particular emphasis on timely treatment planning in multidisciplinary teams, sub-specialty expertise in diagnosis and treatment, and linkages to international centres of excellence for specialist advice and intervention. There is a particular focus on the co-ordination of care in an expert setting.

I thank the Minister of State for his comments but he has chastised me by suggesting ways for me to table questions.

The Minister for Health knows the details and history behind this matter. He created this post following the tenacious efforts of the Sarcoma Action & Support Group, which comprises feeble and physically ill individuals. He knows that a vacancy has existed for three years, yet sarcoma patients still do not get the specialist care that they have been promised. I will continue ask these questions this matter and we will see if the appointment is ever made.

l have no further comment other than to confirm that the start date is 1 September.

Sitting suspended at 11.15 a.m. and resumed at 11.30 a.m.