Léim ar aghaidh chuig an bpríomhábhar

Seanad Éireann díospóireacht -
Monday, 8 Mar 2021

Vol. 275 No. 2

Nithe i dtosach suíonna - Commencement Matters

Gender Equality

I welcome the Acting Chairman, Senator Currie, who has taken the Chair on this auspicious day - International Women's Day. Cuirim fáilte roimh an Aire Stáit Collins and I thank him for joining us here today.

Today, in Ireland, the actual amount of female representation in senior positions at third level is shocking to many. We need change and this has been proven by: the Equality Tribunal in 2014; the 2016 Higher Education Authority, HEA, review of gender and equality; the Gender Action Plan 2018-2020; and the gender equality task force. Across our seven universities only one out of all is a woman because, in September 2020, Professor Kerstin Mey was appointed as interim president for the University of Limerick.

Many of our institutes of technology are on their way to technological university status. Two out of nine presidents or provosts are women: Dr. Orla Flynn is the president of Galway-Mayo Institute of Technology; and Dr. Patricia Mulcahy is president of the Institute of Technology Carlow.

I am also happy to note that all three institutes under the Connacht-Ulster Alliance technological university have applied for the bronze Athena SWAN award and the results are due at the end of March. The Athena SWAN committee is an international body for gender equality, particularly in science, technology, engineering and mathematics, STEM, areas in higher education institutes. There is also a recent publication by Professor Pat O'Connor, University of Limerick, and Dr. Gemma Irvine, vice-president for equality and diversity at Maynooth University. Their publication points to the fact that an Athena SWAN award, particularly at silver level, is bound to be associated with a higher ranking on the Quacquarelli Symonds, QS, world university rankings system. However, an Athena SWAN award alone will not increase the number of women in professorships. The former Minister, Mary Mitchell-O'Connor, was proactive and set up the senior academic leadership initiative, SALI, that has 45 new female professorships, of which 20 were allocated in 2019 and 15 more are due to be announced in May with two being allocated to the National University of Ireland, Galway, NUIG, and one to the Athlone Institute of Technology. GMIT has applied for two posts in this year's round.

How on earth are we to reach the target of 40% of professorships being held by females by 2024 when only 26% are so held right now? We have the women, the talent and the leadership; we now need the change. I request that higher education institutions' performance in equality be linked to and noted in the Higher Education Authority block grant and that there be recruitment and support for funding agencies targeted at women in leadership.

I dtús báire, cuirim fáilte roimh an Aire Stáit. I welcome the Minister of State to the House again. We have previously had very constructive engagements with the Minister, Deputy Harris, and I appreciate the Minister giving me a hearing on those occasions. I am glad to have the opportunity to address the Minister of State on International Women's Day and thank Senator Dolan for her gracious gesture in sharing time with me. It is good to see acts of collegiality and solidarity between female Members of the Oireachtas who are, after all, a minority.

Regarding the Commencement matter, it is important to allow everybody to flourish and to give people the opportunity to flourish in their fields, regardless of their sex or gender. I support the principles of equality of opportunity and egalitarianism. If women aspire to pursue a career in academia or research, they should be encouraged and supported in doing so. There should be no barriers to women entering the world of academia and research and no glass ceilings. I would, however, voice a note of caution about going too far down the road of social engineering, positive discrimination, gender quotas and equality of outcome. Surely, we want talent to be selected on merit. It would be awful to have people regarded as a mere token, as simply being there to fill a quota or as having been hired to allow an employer to signal virtue or for a person to be given a post because there is a financial incentive for the employer or institution in question. I acknowledge the brilliant work of women in teaching and research at every level in every setting.

I thank Senators Dolan and Keogan for raising this important issue on International Women's Day. While we have made significant progress in recent years, we have a lot more to do. Higher education legislation requires institutions to promote gender balance among students and staff and the Higher Education Authority, HEA, to promote the attainment of equality of opportunity.

The 2016 report of the expert group on gender equality and the 2018 gender equality task force report encompass a suite of initiatives to bring about sustainable organisational change and to empower a culture of gender equality at all levels in all our institutions among all staff, including academic and professional staff, management and support staff. These initiatives would lead to a more equal system in which a person’s gender was not a barrier to career progression. The HEA monitors institutional performance and is included as a key focus in the performance framework.

One of the recommendations in the 2018 gender equality task force’s action plan was that a Centre of Excellence for Gender Equality be established. This was established in the HEA in 2019 and now also covers diversity and inclusion. The centre ensures an acceleration towards gender equality and is a key enabler in ensuring sustainable change by providing centralised support for the institutions, facilitating the sharing of good practice and funding innovative organisational and cultural change initiatives nationally.

In 2019, the senior academic leadership initiative was launched by the Department to assist in accelerating gender balance at senior levels through the award of 45 gender-targeted senior academic leadership posts over three years.

In 2020, an annual gender equality enhancement fund was established by the HEA centre of excellence to encourage cross-sectoral collaboration as a means to achieve national transformation. The centre uses this fund to encourage innovative approaches to addressing gender inequality across the institutions.

The Athena SWAN charter is a framework used across the globe to support and transform gender equality in higher education and research. Engagement with the charter is a key pillar of our national strategy for gender equality in higher education. The charter was launched in Ireland in 2015 with a specific remit to encourage and recognise commitment to advancing the careers of women in higher education. As of the end of 2020, a total of 56 Athena SWAN bronze awards were held by Irish higher education institutions including 14 awards for institutions and 42 for departments.

The Athena SWAN award achievement is a requirement for research funding eligibility from the three main research funding agencies, the Irish Research Council, IRC, the Health Research Board, HRB, and Science Foundation Ireland, SFI. The HEA sets and monitors timelines within which higher education institutes, HEIs, should apply for and attain Athena SWAN accreditation. In light of these requirements, HEIs stand to lose access to research funding from the IRC, HRB and SFI if they do not achieve Athena SWAN awards within the set timeframe.

The IRC is working with the HEA and other research funders on issues of gender equality and the implementation of the gender action plan 2018 to 2020. The council was among the first research funders globally to gender-blind applicants to its research funding programmes. For assessment panels, the IRC targets gender parity in the composition of such panels, at minimum of no less than 40% of each gender. The council monitors gender balance in applications and awards annually. For awards made in 2019 there was gender parity on applications, with female awardees comprising close to 55% of the total.

The Athena SWAN charter is one thing but it is not enough. We need to ensure that women come through. Although there is 26% of professorships, only 30% of applications came from women. In other words, we need to ensure there is funding available for starting investigators, PhDs, post doctorates and increasing funding at IRC and SFI level. We need to make sure that the centres of excellence being funded bring through women principal investigators, PIs, as well and not solely excellence. We know excellence exists. Look, for example, at the Vice-Chancellor of Oxford University, Professor Louise Richardson. She is in the top five in the world. Is the Minister of State saying that we cannot have the same number of professorships in Ireland? I do not think so. The excellence is there and we need to support it.

We need to make sure there is a targeted plan of teaching buy out to allow women to focus on research. We need to make sure we support them in terms their peer review publications, their h-index and their participation in EU funding programmes such as Horizon 2020. To become a professor, one needs to ensure one can drawdown on Exchequer and non-Exchequer funding. We need to make sure that we support those women to achieve that target. Science Foundation Ireland recently stated in its statement of strategy that 35% of its award holders would be female. That is a target we need to achieve.

In 2016, Science Foundation Ireland launched the SFI gender strategy which provided a comprehensive framework to streamline gender initiatives across all SFIs funding programmes, with the overarching aim of improving the gender balance among its award holders. SFI sets a target for gender representation in its portfolio. The original target was 25% female award holders. This target was revised upwards to 30% in 2017 after the original target was reached. As a result, SFI has seen an increase in female award holders in its portfolio of awards from 21% in 2015 to 29% in 2019.

I thank the Senators for raising the issues. The Minister, Deputy Harris, and I take them on board and take them very seriously. We have, of course, much done in this area but there is more to do. I also take on board the points raised by both Senators in that we want to avoid tokenism and that people achieve progression by virtue of ability. We should not get into a gender balancing exercise purely for that purpose alone. People should get there on merit also.

It may take another 20 years to do it.

Value Added Tax

Everyone of us became more aware of the issue of plastic pollution over the last number of years. This is not just because of the unsightly nature of it but because we are now very aware of the knock-on impacts plastics have on all manner of wildlife. When I worked on the EU single use plastic directive, we were told that period products are the fifth most common item found in marine litter and that on average a person who menstruates will use on average 150 kg of tampons, pads and applicators in their lifetime. However, the approach favoured by the EU was not to regulate the manufacturers. It was not to insist that as a bare minimum they print on the packet the amount of plastic contained in their products, which is on average 90% of the contents.

Instead the EU wanted to impose an environmental tax on period products. I strongly resisted this. Why should women be made pay the cost of cleaning up what is an essential product to their everyday lives, while manufacturers make huge profits? The disposable period product industry is worth £265 million per year in Britain alone. The period product industry deliberately chose to push women into purchasing disposable products as it is a far better business model to have women come back every month rather than every couple of years, or in the case of menstrual cups, every five to ten years.

It is estimated that only 5% of the population are using reusable products. This is down to many factors, including a lack of awareness of their existence, which can be addressed through public awareness campaigns. A second factor in the lack of use of sustainable products is their low visibility. Supermarket shelves are dominated with disposables because it suits the manufacturers' business model and many have preferential contracts with supermarkets.

However, the biggest barrier to widespread uptake of sustainable period products is their cost. Reusables are not appropriate in many circumstances, especially for vulnerable groups such as women who are homeless or living in precarious situations without access to their own bathrooms. However, cost is preventing a large proportion of the menstruating population from accessing sustainable products. One simple measure that could be taken would be to reduce the VAT rate on those products.

Currently, standard period products are 0% VAT while reusable products such as period underwear and menstrual cups are 13.5%. I am aware that EU rules prevent us reducing the VAT to 0%. However, it is interesting that products relating to a normal bodily function that affects women are on a higher VAT rate than going to a restaurant or pub and a rate almost three times that of trading a greyhound. It shows a bizarre set of priorities when it comes to women's health and protection of the environment.

Even more disturbing is that incontinence pads are taxed at the highest rate of VAT, which has increased to 23% as of 1 March. The rate of VAT on incontinence products is yet another example of regressive tax that disproportionately affects women. Incontinence is not a luxury. It affects women far more than men. It is estimated that as many as one in five women over 40 is affected by some level of incontinence and up to 70% of expectant and new mothers are affected.

I ask for a commitment that incontinence pads and sustainable period products have their VAT levels reduced to the minimum level possible. What measures have been taken to change EU rules to provide for 0% VAT on all period and incontinence products? Can the Minister of State give me a commitment that the Government will consider rolling out a similar scheme to that in Scotland where free samples of reusable products were offered alongside a public awareness campaign?

I thank the Senator for raising this important issue this morning. I listened carefully to everything she said. The Senator seems to be knowledgeable of VAT regulations in Ireland and the UK and I want to thank her for the excellent presentation of the case. However, as the Senator may be aware, Ireland is the only country in the EU that applies a 0% VAT rate to period products such as tampons and sanitary towels. This rate was applied in 1991 and we have been able to maintain this rate under the provisions of the VAT directive that allow for a 0% rate to be maintained if it applied in 1991. I am sure the Senator is aware of that.

A number of new products have come on the market since then, which have attracted a standard rate of VAT. The period poverty working group led by the Department of Health as part of the national strategy for women and girls published a report on period poverty on 8 February 2021. It recommended a reduced VAT rate be applied to certain newer period products in circumstances in which a 0% VAT rate cannot be applied. It also recommended that Ireland continue negotiations at EU level to allow for a 0% VAT rate to apply to all period products.

I am pleased to say that following the passage of the Finance Bill, new period products in question have had a reduced VAT rate applied to them as of 1 January 2021. The VAT rate directive provides for the application of a reduced rate of VAT to such products in paragraph 3 of annexe 1. I understand that before introducing the change officials ensured that the reduced rate applying to newer period products would not risk the 0% VAT rate on tampons and sanitary towels, which are far more common, and have attracted the 0% rate because it applied in 1991 and that still holds.

I can confirm that Ireland and a number of other EU member states are looking for greater flexibility in the VAT directive to allow a zero rate to be applied to these new period products. That is essentially where we are. These discussions are connected to a wider VAT rate debate. Any agreement on VAT rates must be agreed by every member state because it is a taxation issue. We are seeking greater flexibility on this. A number of other states are assisting but it will have to be agreed by every member state.

I thank the Minister of State for his response. I welcome that he has confirmed Ireland is pushing at an EU level to change the VAT rules. However, there needs to be urgency on it given the level of plastic pollution and the fact that cost is a real barrier to accessing these products. I welcome the fact that the VAT rate was reduced but it is still higher than the 9% VAT rate on restaurants, pubs and the hospitality sector and three times higher than the rate for trading animals. Our priorities need to be reflected.

Regarding incontinence pads, it must be an oversight that they are in the luxury category. That should be addressed. Based on equivalent UK figures, there could be as many as 255,000 women affected by incontinence issues in this country. I imagine they do not see incontinence pads as a luxury on which a 23% VAT rate should be paid.

I again thank the Senator. I will take on board, and take back to the Department of Finance, the issue of the luxury rate on incontinence pads. I know they can be a very heavy cost for many families. We all know, through our work as local public representatives, community nurses regularly provide substantial amounts of incontinence pads, through the HSE, to patients in their areas who require them. However, we all hear locally they can sometimes be rationed. Some people are provided with incontinence pads through the HSE.

Period products such as menstrual cups, pants and sponges, previously at the standard VAT rate, were reduced to 13.5% on 1 January 2021. The Senator rightly asked why they were not reduced to the 9% applied to the hospitality sector. People understand that the VAT reduction from 13.5% to 9% in the hospitality sector was a temporary response to support those facing serious economic difficulties due to Covid-19. It is only a temporary measure and the plan is that the rate will go back to 13.5%. It was strictly a Covid measure for those particular businesses.

It is important to note that the rate of VAT applied relates to the type of product rather than whether it is sustainable. That is a broad issue we will all have to raise at European level. This means that sustainable sanitary towels and more environmentally friendly tampons still have a zero rate applied to them. It is very important to say that. I reiterate that sustainable sanitary towels and more environmentally friendly tampons still have a zero rate applied to them.

National Maternity Hospital

I welcome the Minister of State at the Department of Health, Deputy Anne Rabbitte, to the House on International Women's Day. Later today, the Seanad will honour nurse Elizabeth O'Farrell who served much of her life in the National Maternity Hospital. It is perhaps fitting that I now ask the Minister of State and the Minister for Health to review plans for the new national maternity hospital, take steps to ensure the hospital has full public ownership and accountability, and ensure the land it is built on is owned by the State and not subject to a limited period lease, which could compromise the provision of maternity and reproductive healthcare for future generations.

This State has a sad history of failing women when it comes to maternal and reproductive health, from symphysiotomy to CervicalCheck, and transferring power to religious charities when it comes to pregnant women.

We were painfully reminded of the consequences of that abdication of responsibility by the recent appalling report on mother and baby homes.

This power has been tightly held. When Dr. Noël Browne attempted to introduce the mother and child scheme, it was blocked by religious pressure. Just last year, the State was in the unacceptable position of waiting to hear if the Vatican would give permission to the Sisters of Charity regarding a proposed site for a new national maternity hospital. When that permission came, it had conditions. Despite headlines about gifting the land to the people of Ireland, it emerged that it had not been given to the State, but transferred to a trust, St. Vincent's Holdings, from which the State would lease the land for a period of just 99 years. Dr. Peter Boylan has spoken about how the board of the national maternity hospital has been told that the deal is complex and not a regular deal, the documents will not be regular and there will be a plethora of different structures and ownerships. Religious orders have become proficient in the shifting of assets and accountability through complex company structures, but this does not mean that they lose sight of long-term ownership and control. The new charitable trust's constitution, lodged with the Companies Registration Office last August, is similar to the constitution of the St. Vincent's Healthcare Group. Clause 5.11 specifies that the directors may hold, sell, manage, lease or mortgage any or all of the parts of the company's property. This is a major hostage to fortune.

Why would any trust, charitable or not, have control of any kind over our national maternity hospital? Why is this trust allowed to lease the land to the State instead of selling or giving it? Why is the State diluting its responsibilities again? The Sisters of Charity, whose documented role in illegal adoptions has been a subject of recent public outrage, last week called for an investigation into that matter dating back to 1922. If they can ask us to investigate mistakes made 99 years ago, I will ask the Minister of State to look forward 99 years, which is the proposed length of the lease. That is not very long. We are talking about our children's children's children. We will spend millions of euro on a hospital, then the lease will expire and maternal and reproductive healthcare will suddenly be up for negotiation again. We are in a different Ireland. It is even different than it was for the 2016 Mulvey report. The people of our country have broken their silence and taken back control of women's reproductive rights. The State has had to apologise time and again for how it failed women in the past. Let it learn from that and not make bad compromises that will fail the women of the future.

At a time when EU fiscal rules are suspended and 0% loans are available, there is no financial justification for giving our national maternity hospital to a charitable trust. I call on the Minister of State to deliver something better. Commit to a review of the plans and take steps, including a compulsory purchase order if necessary, to ensure full public control, public accountability and public ownership of our national maternity hospital.

I wish everyone a happy International Women's Day. I am taking this matter on behalf of the Minister for Health, Deputy Stephen Donnelly.

I welcome the opportunity to address the House on this issue and to confirm that the Government is firmly committed to the development of a new national maternity hospital on the St. Vincent's University Hospital campus at Elm Park. It should be acknowledged that the national maternity hospital project is unprecedented and inherently complex, given that we are relocating one voluntary hospital onto the campus of another voluntary hospital to a hospital building owned by the State. Therefore, a legal framework is being developed to protect the State's investment in the new national maternity hospital and to ensure that the hospital remains in State ownership.

The hospital will be built on the site leased from the St. Vincent's Healthcare Group. I am satisfied that its development on a site with a leasehold interest of 99 years and rights of renewal will not in any way compromise the provision of maternity care for future generations. On the contrary, by building the new hospital, we will secure maternity care for future generations of women.

The corporate and clinical governance arrangements for the new maternity hospital at Elm Park are encompassed in the Mulvey agreement, which was finalised following an extensive mediation process between the National Maternity Hospital and the St. Vincent's Healthcare Group.

The Mulvey agreement provides for the establishment of a new company, the national maternity hospital at Elm Park DAC, which will have clinical and operational as well as financial and budgetary independence in the provision of maternity, gynaecological and neonatal services. It ensures a full range of services will be available at the hospital without religious, ethnic or other distinction. It is important to emphasise that those overriding objectives will be copper-fastened through the legal framework. I acknowledge that the development of the legal framework has proved to be more difficult and deliberations more protracted than originally anticipated, but I understand there has been good ongoing engagement between the key stakeholders. I am advised it is anticipated that discussions will be concluded and the drafting of the legal documents finalised in the coming weeks. It should be noted that once finalised, the legal framework will be brought to the Government for approval.

I am conscious the buildings in Holles Street are no longer fit for purpose. The national maternity strategy sets out a vision for future maternity services where women are treated with dignity and respect in an appropriate physical environment. We must now move forward with building the new national maternity hospital and providing the necessary infrastructure to facilitate the delivery of modern, safe, high-quality maternity services for women and infants.

The Mulvey agreement is outdated and precedes a number of significant changes. Protracted negotiations should not be needed because the only stakeholders who matter, whom the State should have to accommodate or please, are the women of Ireland. It should not have to negotiate with others. A stronger approach is needed. Ninety-nine years is not a long time in the context of the generations to come. The structures are clear. It could be the case that a company with its own motivations could have mortgaged properties, could have created debt attached to properties and could create a long and more protracted negotiation in 99 years' time. Let us not bequest that to the women of the future. We are in a different fiscal situation now and the State can access funds in a way that it perhaps could not have a few years ago. I ask the Minister of State to reconsider our approach on this issue without delay.

I will note all the Senator's comments and relay them to the Minister. I take on board what she said about the Mulvey report being outdated and about Ireland having moved on a great deal since it was commissioned and finalised. I also take on board the point about the 99-year lease, although I am sure the State is examining all the legal frameworks. I will take on board everything the Senator said. Given that the matter will come before the Houses again, I am sure that further discussions will give everyone the opportunity to contribute.

Disease Management

I am sharing time with Senator McGreehan. I wish a happy International Women's Day to everyone, not least to all the women in Ireland who suffer with endometriosis, which is what this Commencement matter concerns. The Minister of State will be aware this chronic condition affects one in ten Irish women and girls. It is incurable. Some of the main symptoms include chronic pain and fatigue, heavy bleeding, and infertility or mental health issues, to name but a few. There are still no clear clinical guidelines for GPs and no clear care pathway through our health service. On average, it takes women seven years to get a diagnosis, with many saying it can take them in excess of ten years. That is important because the longer the disease is left unchecked to wreak havoc internally, the more damage it does. It is so important, like in many aspects of healthcare, that there is early intervention.

Because GPs are not properly educated and trained to spot the symptoms and because of the absence of clinical guidelines for GPs, this condition often goes undiagnosed or misdiagnosed, with many women reporting having been prescribed antidepressant medication and having been told it was all in their heads, it was all part of being a woman and they needed to buckle up and deal with the pain because it is just their lot. That this story is reported by so many women shows it is prevalent throughout our health service, with many women reporting of the trauma of being gaslit by their GP and of being told what they are feeling is not really happening and it is all in their heads.

We need urgent action on this.

With every week and month that go by, another woman or young girl is suffering and in pain, bedridden and missing weeks of school. These women are unable to have a good quality of life and are missing out on work and education opportunities. The damage being done to a significant cohort of the population is immense. One in ten women have this condition. I ask the Minister of State to please take back to the Minister for Health, Deputy Donnelly, the need for urgent action, clear clinical guidelines, a care pathway for treatment and education among GPs to spot the symptoms early on.

As a sufferer of endometriosis, I know it is a tremendous disease. It takes over one's body and mind. One deals with pain several times each month. It is incredible. I am one of the lucky ones because I know what is wrong with me. There are thousands of women who do not know what the problem is. They are told by their doctors that it is a normal pain. It is not normal. As Senator Chambers stated, they are told to buck up and get on with it and that this is part of being a woman. Pain is not part of being a woman. That said, we have seen time and again that pain is synonymous with being a woman in this country and we have seen the bruises and suffering associated with that.

The current waiting lists for gynaecological outpatients' appointments are incredible. More than 30,000 women are awaiting treatment and a doctor's appointment. That is absolutely horrendous. Given that one in ten women has endometriosis, how many of those women awaiting an outpatient's appointment have endometriosis but are not getting treatment? We need quick action on getting those ambulatory clinical services open sooner rather than later because this is about quality of life for young women and girls who are suffering but do not know what is wrong with them. They are told it is all in their heads. I ask the Minister of State to please bring that back to the Minister, Deputy Donnelly, because action needs to be taken.

I thank the Senators for bringing this issue to the floor of the Seanad and giving me an opportunity to address it. My speech is on behalf of the Minister, Deputy Donnelly, but both he and I are acutely aware that the Senators have long been advocates on this issue. I wish to begin by emphasising that the Government is committed to promoting and improving women's health outcomes. That commitment is spelled out very clearly in the programme for Government and has been underpinned by a provision of €12 million in budget 2021 for new developments in maternity and gynaecology services.

As Senator Chambers stated with regard to the current treatment of endometriosis, a general practitioner referral to a gynaecologist is the standard pathway of care for the management of this condition. This is similar to the pathway in place for the management of other gynaecological conditions. I am advised that all obstetricians and gynaecologists are trained in the diagnosis and treatment of endometriosis.

The HSE national women and infants health programme has advised that the best way to help the majority of patients with endometriosis is to improve access to gynaecology services generally. I think all present would agree on that. The programme has developed a plan to increase capacity and reduce waiting times for women for gynaecology appointments. The plan aims to reorient general gynaecology services to an ambulatory or see-and-treat model, rather than the traditional outpatients referral model. The new model of care involves the establishment of one-stop ambulatory gynaecology clinics. These clinics will help to ensure that gynaecology patients receive safe and appropriate treatment, reduce the need for multiple appointments, ensure a more effective use of public funds and, ultimately, improve clinical outcomes. The roll-out of phase 1 of the new model of care commenced last year and I am delighted to confirm that the ambulatory gynaecology clinics in Cork and Galway are now providing services, while it is anticipated that the clinics in the Rotunda Hospital and Waterford will be operational this year. It is important to state that although I have mentioned four hospitals, that is not nearly enough by any manner or means. With the new funding provided in budget 2021, the roll-out of the model of care will be accelerated and additional ambulatory gynaecology clinics will be established this year.

Last year, the women's health task force identified several priority areas for action. In that context, the need to improve services for women with endometriosis was recognised and included as part of a priority work stream to improve gynaecological health for women and girls.

The endometriosis work stream identified a number of potential actions in this area, including enhanced services and supports, and the potential establishment of a centre of excellence for endometriosis surgery.

Budget 2021 has also provided a dedicated €5 million health fund to progress a programme of actions arising from the work of the health task force. The Department of Health has engaged with the HSE to identify proposals which could be implemented in 2021 and funded through the women's health fund. A number of proposals are being finalised with stakeholders and it is anticipated that announcements will be made in the coming weeks on the actions which will be supported by the fund. The developments I have outlined underscore this Government's commitment to improving services for endometriosis and gynaecology more broadly.

However, as Senator Chambers says, one in ten is the figure, there are 30,000 on a waiting list, two hospitals are providing the service and two more are due to come on stream in 2021. That is clearly not good enough. It is about education and providing support to our GPs as well. We must get rid of the idea that it is in one's head. There is an issue with that. We need to be able to call that out and give people their lives back.

I know the Minister, Deputy Stephen Donnelly, is aware of this and I have spoken to him about it on a number of occasions. The female members of Fianna Fáil will be meeting the women's task force in the coming days to discuss this and other women's health issues. Can we imagine any other area of healthcare where one in ten men would be this impacted and where there would be no care pathway, no proper referral system and no education? I cannot imagine that. There have to be wrap-around services, including mental health services, pain management and education for young girls so they can identify what is not a normal pain and when to seek help.

I want the Minister of State to bring the issue of the €2.5 million in funding for the critical care unit in the Rotunda Hospital back to the Minister. It is the world's oldest maternity hospital and that is all that is needed for it to move forward to the next stage and to get its standard of care up to a modern level. Some 3,000 people are on the waiting list for care in the Rotunda Hospital and I would ask the Minister of State to move on funding for the critical care unit.

I will bring everything the Senators have said back to the Minister. The women's task force is meeting later on this week and I will be 100% supportive of it. For far too long, young ladies did not really know what they were presenting with. They all thought this was normal but it is far from normal. No man in the country would accept this. It is mainly ladies who are present in the Chamber for this conversation on International Women's Day and there is no way a man would put up with what the Senators have described this morning. We all know what bad period pain is like and one would hope it would go away with two Panadols but it should not continue without a diagnosis being sought and it should not reoccur every month along with other pains. This pain is debilitating and we have to stop that happening.

We have to give women back their lives, and the only way we can do so is by having a proper ambulatory service throughout the country. It should not just be available in four hospitals or in certain geographic areas. We have to look at everybody. We must also provide education for our GPs so that when these young people go back and talk to their mams, there will no longer be any talk from GPs about this all being in their heads. We need to stop that approach.

Gender Equality

I welcome the Minister to the House and I wish him a happy International Women's Day. On this day, the Labour Party Senators have asked the Minister to give us a proposed timeline for the introduction of gender pay gap legislation. We are all only too well aware of how urgent this is.

Every year, 9 November marks Equal Pay Day, which recognises that Ireland’s gender pay gap of 14.4% effectively means women work for free for the rest of the year. To put it another way, women stop getting paid at around 4 p.m. every day.

In other jurisdictions, gender pay gap legislation requires employers to publish disaggregated data illustrating whether a gender pay gap exists and requires them to take action where it does. This sort of legislation has been effective in addressing the gender pay gap. The Labour Party introduced a Bill in the previous term, namely, the Irish Human Rights and Equality Commission (Gender Pay Gap Information) Bill 2017, which would have applied to all organisations with more than 50 employees. It passed all Stages in the Seanad by 3 October 2018 and was referred to the Dáil, passing Second Stage there in November 2018. We are asking the Minister to contemplate taking on that Bill. I am conscious that the previous Government also introduced the Gender Pay Gap Information Bill 2019 in that term but that Bill remains languishing before the Dáil. Does this Government propose to introduce a new Bill, for which there is a commitment in the programme for Government, or will it take on our Bill or the previous Government's Bill? Either way we want to ensure there is progress on this issue.

A piece by Mark Tighe in The Sunday Times yesterday gave a very strong indication of why this is necessary. The publication of the pay gap figures from RTÉ showed that a significant pay gap on grounds of gender still exists in RTÉ three years after the initial publication of figures in 2016. According to 2019 data, one in five women working in RTÉ earns less than €40,000, compared with almost one in ten men, and 63% of women there earn less than €60,000, compared to just 46% of men.

It is great to have the Minister in the Chamber today. It is difficult to convey the enormity of the challenge of trying to close the gender pay gap in this country. Senator Bacik spoke about the hourly wage gap but we all relate to weekly or monthly earnings and the average weekly earnings for women in this country are 25.05% less than the average weekly earnings of men. That is because of the gap in hourly pay but also because more women are trapped in part-time employment. Some 11% of men were in part-time employment in this country last year, compared to 28% of women. When it comes to retirement, that gap gets even bigger. We know from EUROSTAT figures that there is a 28.6% gap between the pensions of men and women.

Such is the scale of the gap that no single legislative measure will be a magic bullet. We need a series of measures. The legislation Senator Bacik put forward three years ago will only shine a spotlight into recruitment and progression practices within firms. That is an important starting point and an important spotlight but it cannot be the finish line. The game-changer in closing the gender pay gap is the right to be recognised for collective bargaining. One might ask how that relates to women. There is a growing body of international evidence that shows that where there are higher levels of co-ordinated bargaining within workplaces there is lower wage dispersion, and when there is lower wage dispersion there is less of an earnings gap between men and women. The EU adequate minimum wages directive will also be hugely instrumental in allowing a framework for the right to collective bargaining in this country. The Tánaiste, along with fellow EU employment ministers, is actively trying to hobble this directive. As a first step, we are asking the Government to get on with the legislation and then allow this directive to pass.

I thank Senators Bacik and Sherlock for raising this important issue today. I wish them and the House a happy International Women's Day. I share the Senators’ concerns regarding measures to increase pay transparency as a means to tackle the gender pay gap, although Senator Sherlock is right that it is just one of the means. As the Minister with responsibility for gender equality, I am very conscious of the importance of the gender pay gap as a metric of women’s economic empowerment relative to men’s. It illustrates the degree to which women’s hourly pay, on average, is lower than men’s during their working lives, with implications for their risk of poverty, including in later life. Senator Sherlock outlined the enormity of the problem pre-Covid but I am also conscious that, in the emerging women's labour market, participation is being impacted differently and to a greater degree than that of men as a result of Covid-19.

Women are over-represented in the sectors that have been badly affected. Women are experiencing greater conflict between working and their family lives. Women are more likely to have reduced working hours, suffer job loss or leave the labour market. After earlier periods of lockdown, the female labour market has recovered at a slower pace than that of men. If this pattern persists, it could have long-term implications for female participation and employment rates, women's career progression and women’s pay in general. These are all factors that are already known to impact on the existence and size of gender pay gaps.

Addressing the factors behind the gender pay gap is a key commitment in the national strategy for women and girls. It is a multifaceted task involving a number of Departments and agencies. Initiatives to address the gender pay gap can be expected to have a positive impact on disparities in income for women across and after their working lives. This is why, in the programme for Government, we have committed to legislate to require publication of the gender pay gap in companies and the public service. The aim of the Government’s Gender Pay Gap Information Bill is to provide transparency on the gender pay gap and incentivise employers to take measures to address the issue insofar as they can.

The Bill was published on 8 April 2019, completed Dáil Committee Stage in June 2019 and was restored to the Order Paper in July 2020. I intend to bring legislative amendments to Cabinet in the next fortnight which will allow the Bill to progress to Report Stage. I am committed to enabling the enactment of this Bill as early as possible and I will seek to do so after the Easter recess. I assure Senators that I view the Bill as a priority so it will languish no more.

Senators may also be aware that, last week, on 4 March, the European Commission published proposals for the introduction by member states of binding pay transparency measures. This proposal meets a commitment of the EU gender equality strategy and reflects one of the political priorities of the European Commission. The legislative proposal focuses on two core elements of equal pay, namely, measures to ensure pay transparency for workers and employers and strengthened access to justice for victims of pay discrimination on the grounds of gender. In particular, it would require the introduction of statutory obligations on large employers to publish information on the gender pay gap and provide for internal reporting on pay differences among female and male workers in the same category. Employers would also be required to assess the pay of a category of workers where the gender pay gap exceeded a given threshold - 5% is proposed - and is not justifiable on objective gender-neutral factors.

It is envisaged that the proposal will now go to the European Parliament and Council for approval and that, once adopted, the Commission proposes that member states will have two years to transpose the directive into national law and communicate the relevant texts to the Commission. These proposals are an important development at an EU level and will be reviewed in the context of the provisions of existing employment obligations and entitlements and the Gender Pay Gap Information Bill once that has been legislated for.

I thank the Minister for setting out so clearly the proposed timeframe. I am glad to hear that he proposes to bring legislative amendments to the existing Government Bill from 2019 and that he plans to do so in the next fortnight. We will work constructively with the Minister to ensure the legislation is swiftly enacted and that, as the Minister said, it languishes no more. In particular, we will ask him to adopt some of the principles that were in the Labour Party's gender pay gap Bill which made it a stronger Bill than the original Government Bill from 2019. The Minister's colleagues in the Green Party supported our Bill when in opposition in the Seanad. I hope we will see stronger legislation and that, in particular, it will apply not only to larger employers but also to those with 50 or more employees. I also hope it will include significant remedies and penalties for employers which do not take remedial action to meet their obligations under the legislation.

I will consider all amendments proposed in the legislative process, as I always try to do. We are bringing a number of changes to the Bill and having examined the original draft, I believe, they will strengthen it. In particular, we intend to introduce a mechanism for an earlier review. I understand the review period in the current draft is after five years and I intend to shorten that. There is always a balance to be struck between giving legislation some time to demonstrate its strengths and potential weaknesses and not leaving it too long.

Five years is probably a little bit on the long side for a review period so that is certainly one element I am looking at. I am also looking at the role and powers of remedy of the Irish Human Rights and Equality Commission, IHREC, which are important as well. Obviously I do not want to go into huge detail until I have discussed this with Cabinet colleagues but I will look at amendments from across the House on that as well.

Domestic Violence

Guím Lá Idirnáisiúnta na mBan sona do chách. I thank the Minister for coming to the House and wish everyone a happy International Women's Day.

The most recent report to the Dublin city joint policing committee shows a marked increase in cases involving domestic violence. On the one hand, I am pleased that if the figures to the Garda are increasing, it shows more people are reporting domestic violence. What I believe is happening, however, is an overall increase in people suffering domestic violence and, consequently, we have an increase in the numbers supplied by the Garda.

Despite it being International Women's Day, I acknowledge that domestic violence is not only a female issue. Men, trans and non-binary people also suffer domestic violence. While I do not know the specific statistics for Ireland, I have been privy to a number of conversations and representations that would demonstrate that a trans or non-binary person in a relationship is disproportionately vulnerable to domestic violence or intimate partner violence.

Based on the figures I do know, women are statistically more likely to be attacked and abused repeatedly in their own home, more likely to be subjected to abuse and coercive control, and more likely to be killed by their partner or former partner. This is not news and I welcome the steady increase in funding we have seen over recent years. The response, certainly during Covid, has been very impressive and welcome, and the most recent budget has been fantastic as well. However, no matter how well we are doing and how much our funding is being increased, if it is not being targeted and is not being monitored, reviewed and constantly assessed, we are not doing enough to ensure it is going where it should be and that it is being targeted at the right groups. Do we look into our souls and believe we are doing enough? I congratulate the Minister on all that has been done, but until we start seeing figures drop, there is always much more to do and we will never have done enough.

I welcome the Minister to the House. The pandemic has had devastating consequences for women and children living in fear within their own homes. Across our State, the silence from homes where abuse is taking place is deafening. We know that connection to community and visibility helps to prevent incidents of domestic violence, and the environment created by this pandemic has been a breeding ground for an escalation in domestic, sexual and gender-based violence. Homes should be places of refuge and instead they are frequently places of fear. On International Women's Day I think of all of those women who we cannot see who live in daily fear.

The programme for Government was the first to call out domestic violence as an epidemic. Little did we know that things would only get worse over the last year. In Galway domestic disputes for which no cause is noted in the joint policing committee report went up by 40%. Breaches of barring orders went up by 25%. An increase of €4.7 million to €30 million was committed to in Budget 2021 to deal with this epidemic, with €2 million to help support services during the Covid crisis. I am aware the Minister has also committed to domestic abuse leave. An audit of the segmentation of domestic, sexual and gender-based violence responsibilities across the Departments was also committed to, along with the development of the third national strategy on domestic, sexual and gender-based violence. I would like the Minister to outline the progress of these to date and how it aligns with our commitments under the Istanbul Convention. I also want to hear about progress of the implementation of the O’Malley report in addressing the fact that many feel retraumatised by our court system.

I thank all of those services which have continued to operate, including Cope Galway, Galway Rape Crisis Centre and Domestic Violence Response. This is an epidemic that affects women and children more than men, although men should not be forgotten. I am reminded of a lecture once given by Margaret Atwood in which, and I paraphrase, she said that perhaps the source of men’s fear of women is a fear of being embarrassed, but women fear men because they fear being killed. For too many women in our country this second part of her comment rings true.

I thank Senators Pauline O’Reilly and Seery Kearney for raising this issue and I welcome the opportunity to respond. Again, it is particularly apposite that we are discussing this issue on International Women's Day.

As the Senators noted, domestic, sexual and gender-based violence can occur in many different forms and can be experienced by any one of us but it is indisputable that girls and women are disproportionately affected by such acts. The Minister for Justice has lead responsibility for co-ordinating policy on domestic, sexual and gender-based violence but ensuring an effective infrastructure to respond to it is also a very significant priority for my Department. I am actively working with the Minister for Justice to fulfil the commitment in the programme for Government to conduct an audit of the segmentation of responsibility for domestic, sexual and gender-based violence across Departments and agencies. This audit is under way and I am hopeful that it will shortly provide us with proposals on the required infrastructure to ensure all issues with domestic, sexual and gender-based violence are dealt with in the most effective and holistic manner possible. We really need to provide the best service to those who need this type of support.

Tusla, which falls within the remit of my Department, has statutory responsibility for the care and protection of victims of domestic, sexual and gender-based violence. It provides funding for about 60 organisations across the country, including those providing emergency refuge for adults and children fleeing domestic violence, 16 rape crisis centres and a range of community-based domestic violence supports. In 2021, I increased Tusla's allocation for domestic, sexual and gender-based violence by €4.7 million to a total of €30 million, €28 million of which is core funding for the services, while a further €2 million is Covid contingency funding to help address the increased demand referred to by both Senators with regard to the pandemic. This is a very significant increase in core funding and indicates the real importance that this Government places on this issue.

Investments in recent years have seen the roll-out of child-centred services for younger victims of domestic and sexual violence. Senator Pauline O'Reilly will know about the Barnahus pilot project in Galway for child and adolescent victims of sexual violence. It is a very positive development and we plan to expand this service to locations in Dublin and Cork as well.

Last December, I got Cabinet agreement to commence a process to introduce paid domestic violence leave and benefit. Consultations on this proposal are ongoing. I spoke with trade unions and employers' groups about this issue last week and I will bring forward proposals to Cabinet by the end of the year.

Senator Seery Kearney raises a particular report with regard to Garda statistics in the Dublin South Central area. Tusla has advised me that almost €1.5 million of the €4.7 million additional funding is being directed to services in the greater Dublin area - Dublin, Wicklow and Kildare. Tusla has also advised me that additional domestic violence outreach services are being rolled out in Dún Laoghaire-Rathdown and County Wicklow to enhance supports for both women and children experiencing domestic violence, with additional outreach planned to come on stream in the Dublin South Central area. The number of Safe Home accommodation units with support services in Dublin will reach 20 in 2021, which is an increase of 13 from last year. Tusla has provided additional resources to the national 24-7 domestic violence and sexual violence helplines, which are operated by Women’s Aid and the Dublin Rape Crisis Centre. Senator Pauline O'Reilly referred to COPE Galway. It opened a new and improved domestic violence refuge in the city supported by Tusla. Saoirse Women’s Refuge also opened a new refuge in the south Dublin area in early 2020.

Both Senators will be aware that Tusla is currently undertaking a review of emergency accommodation, which will consider the current level of provision and the configuration of accommodation that may be needed. It is the intention that this review will inform decisions around future investment in refuge accommodation for victims of domestic, sexual and gender-based violence.

I thank the Minister. I really welcome the increase in funding. In particular, the Safe Ireland initiative has been a very successful one. I am particularly grateful for the work of Saoirse and the Inchicore women's support service, which provide fantastic services in the Dublin South Central area. I really welcome the report. We need to know what is and is not working to ensure we are funding correctly into the future.

I thank the Minister for all the commitments. I look forward to more updates from him in the future. We must recognise that beyond the kind of measures outlined by him, it is a deep-rooted problem within our society and the causes need to be tackled. It concerns awareness about consent and coercive control, which has been tolerated for generations.

These also have to be part of what we now do as a society and as a government. I am hopeful that, with some of the recent sentences handed down by the courts and the commitments in our education system, we are turning a corner. However, I believe we have a long way to go before many of us will be fully convinced.

As we called it out in the programme for Government, domestic, sexual and gender-based violence is an epidemic in our country. We are ever more conscious of this during Covid-19. The high reporting figures are good because they represent a sign that primarily women are coming forward to say what is happening. The Government has identified this epidemic and is going to address it. There are four major areas besides all the other items that Senator O'Reilly mentioned, including the additional funding - we are going to continue that through each budget - and the audit of responsibility. We need to design our structures better because they are not working fully as they currently are. We are going to redesign them. The audit response should be with us in the next number of months.

We will be one of the first countries in Europe to adopt domestic violence paid leave and that will be essential in recognising the poverty that so many people fleeing domestic violence fear. Finally, we have the accommodation review. We are aware of the desperate need for more accommodation throughout the country. We are taking a step back and looking to see where it is. Is it emergency accommodation? Is it step-down accommodation? We are asking what is needed so we can better plan and put in resources, especially capital resources to initiate a refuge or supported accommodation. This is a commitment for the Government. It is a job between myself, the Minister for Justice, Deputy McEntee, and other Ministers and we are absolutely committed to addressing this issue.

Sitting suspended at 11.40 a.m. and resumed at 12.05 p.m.