Before I call on Senator Flynn, I welcome Stepaside Educate Together Secondary School to the Visitors Gallery. They are most welcome to Seanad Éireann and I thank them for being here.
Nithe i dtosach suíonna - Commencement Matters
School Attendance
I thank the Minister of State for being here this morning to address what I believe is a very important issue that was raised recently by the journalist Maria Delaney, a reporter with The Journal. Her report showed that the number of pupils on reduced timetables has increased to 1,275. This is something that is very close to my heart as someone from the Traveller community who came through the education system, was put down at the back of the class for Irish and was taken out when there was a Traveller teacher, who was not a member of the Traveller community, and who went through special education, which every member of the Traveller community received whether they needed or not in the school I attended in Ballyfermot. For me, seeing this report is frightening, as it is for young members of the Traveller community and for children with additional needs. The report talks about children with autism who are also impacted by the reduced timetables.
In the past five years I have been a Member of this House, I have sat on the education committee. We have seen numerous reports in which members of the Traveller community and children who are autistic are put at a disadvantage in this country. We need to be moving away from that. What is the Department doing to stop children from the Traveller community, the Roma community and children who are autistic from being on these reduced timetables? I understand some children need to be on reduced timetables. That is understandable. I was an SNA and I know all about behaviours and so forth. A child should not be denied an education because of his or her behaviour, however. I see this issue arise many times on the halting site in Labre Park, Ballyfermot. Mothers are coming to me saying that their child can go into school for one hour and then come home. The parents do not know what to do with the young people for the day. They have no supports at home. When is this going to change? It is the children on the margins of society who are impacted again. While 1,275 may be a small number, it is a lot of children from a population that makes up 1% of Irish society. It is also a big number of children with additional needs. What is the Department going to do to resolve this issue and inequality for these children?
I thank the Senator for her passionate plea this morning on this issue, which I am taking on behalf of the Minister for Education, Deputy McEntee. Reduced school days, RSD, is a transitionary arrangement which should only be put in place in exceptional circumstances and for very limited and time-bound circumstances and only with the consent of the parent or the guardian. It is designed to assist the student to attend for some part of the school day along with his or her peers where it is not possible at a point in time for them to attend in a full-time capacity. The use of reduced school days can, if used appropriately, be a positive intervention which has the intention of assisting a student to return to full-time attendance, such as supporting a student to return to school after a period of absence due to a medical or mental health-related condition or due to other exceptional circumstances. It is based on the needs of the individual student.
The number of children on a reduced school day in the past school year was 1,275, or 0.13% of the student population. This increased by 22% from 1,044, or 0.11% of the student population, in 2022-2023. The main reason for the increase is likely to be the increased awareness in schools of the requirement to report the activation of a reduced school day. Of the total Traveller and Roma enrolments in the school population, 87 or 0.6% were placed on the reduced school day for part of the school year.
This represents a 10% decrease on the numbers reported to be on the RSD from the Traveller or Roma communities for the 2022-23 school year. The monitoring and use of RSD is a key action in the Traveller and Roma education strategy, TRES, which was published in July 2024, alongside the plan for implementation and action for 2024 to 2026. This strategy is specifically developed to meet the needs of the children, young people and adults from the Traveller and Roma communities with the aim of enhancing their education experience and success.
Under the first two-year implementation plan, two national Traveller and Roma education strategy co-ordinators have been appointed to support the implementation of actions within the strategy. Funding has also been secured to establish 15 community link workers to support Traveller and Roma children and young people and those most at risk of educational disadvantage. It is envisaged that these workers will be appointed during quarter 2 of 2025. In addition to the TRES, other supports include ten home school community liaison, HSCL, co-ordinators, serving 14 non-DEIS post-primary schools which have a high number of Traveller and Roma students, and which aim to improve school attendance, participation and school completion. In the past year, the Department has worked with the TESS and the NCSE to introduce a data-sharing agreement which enables TESS to advise the NCSE directly where a child with special educational needs begins a reduced school day.
The Department's inspectors and the NEPS psychologists sometimes raise the use of reduced school days during their meetings or inspections in school. The inspectorate also conduct dedicated inspections in schools with high numbers of children from Traveller and Roma backgrounds. These inspections have a specific focus on attendance, use of reduced school day and literacy for Traveller and Roma children and young people. The NCSE SENOs work collaboratively with TUSLA educational welfare officers at a local level where appropriate to ensure all necessary supports are available to students with special educational needs who are out of school. Both TESS and the NCSE in conjunction with the Department are monitoring the situation to ensure the effective operation of the RSD scheme, and to provide the best outcomes for students, schools and parents.
I thank the Minister of State for his reply. Yesterday, I had a group of young Travellers with a youth service in here. It honestly broke my heart when a young man asked what Leinster House was. I tried to explain to him. He looked at the portrait of Michael D. Higgins on the wall and asked whether he was the Taoiseach. I told him no, that Micheál Martin is the Taoiseach - trying to educate young children within the Traveller community. I see these young children constantly being failed by the education system and we are talking about 15 and 16-year-olds who are on reduced timetables and who are colouring in pages for homework in leaving certificate year. I understand the education strategy and I thank the then Minister, Deputy Foley, who at the time supported Pavee Point to introduce it. If it works, it will be very effective and will make a lot of changes for young children within our community. However, it is not good enough. We and the Department of Education need to put in stronger measures to make sure that children with additional needs and children from the Traveller and Roma communities are not being pushed aside any more.
My wee girl is five years of age and is able to name Fianna Fáil and Fine Gael to me and to name the President. My child is very privileged and she is a member of the Traveller community. It is unfortunate that we have 16- and 17-year-olds who have not had that opportunity. It is a failure of the Department and the State. I look forward to working with the Minister, Deputy McEntee, moving forward, and hopefully we can come up with a solution that stops it.
I thank Senator Flynn for what she said and I hope her message will get back to the Minister. I thank her for raising the matter and giving me the opportunity to assure the House that the Department of Education, TESS and the NCSE are committed to delivering an education system that is the highest quality and where every child and young person feels valued and is actively supported and nurtured to reach their full potential. They assure me they will continue to support children and their families, providing information on the reduced school days guidelines and by continuing to monitor the use of reduced school days for children of all ethnic backgrounds and in particular children with special educational needs. They will ensure that the school is provided with the supports required to enable a child to return to school on a full-time basis.
On what the Senator just said, I remember Mary Forde, who was principal of Presentation College, Athenry. She had a number of students from the Traveller community. One of them went on to do the leaving certificate - unfortunately not many of them did so - achieved great results and went on to do a teaching course. There is a young man in Galway named Ian McDonagh with whom I am very friendly. He is an exceptional young man. I had him up here for a full day with me and we met the Taoiseach and every Minister. He is a very good young lad who stayed in school. Senator Flynn is making a very valid point. I was sad to hear what she had to say about the members of the community coming in, and the young man who was looking up at the picture of Michael D. Higgins and did not know who our Taoiseach is. I hope the programmes that have been put in place will encourage more Travellers to go back to school and to play a part in our community and our education system.
Hospital Services
I thank the Minister of State for coming to the House. I am looking for an update on the second model 4 hospital for Limerick and the mid-west. University Hospital Limerick is in the news nearly every day of the week. Unfortunately it sends out the wrong message for families and patients who need to attend the hospital. While there are an awful lot of things that work excellently there, the accident and emergency unit is too small for the size of the region. The population is growing and we need a second hospital. I know HIQA was carrying out a report and I am asking for information or an update on that.
I have been asked by the Minister for Health to respond on the Senator's Commencement matter this morning. I thank the Senator for the opportunity to address the House on hospital provision in the mid-west region.
The mid-west currently has one model 4 hospital, namely, University Hospital Limerick, and three model 2 hospitals. In 2013 the smaller hospitals framework defined the activities that can be performed in the smaller model 2 hospitals in a safe, sustainable, and efficient manner. The framework ensures that patients who require emergency or complex planned care are managed safely in a larger hospital environment, such as UHL. Model 2 hospitals such as those in Ennis and Nenagh provide inpatient medical beds, medical assessment units, injury units and day surgery. St. John's Hospital is classified as a model 2S hospital and can carry out intermediate surgery and day case surgery. The model 2 hospitals play a pivotal role in the delivery of safe, high-quality patient care in the mid-west. They accept transfers of appropriate patients from UHL. These patients can either be stepped down from an inpatient ward or, where a clinician has decided it is appropriate, transferred directly from the emergency department, ED.
In May 2024, HIQA was requested by the then Minister for Health to conduct a review of urgent and emergency care in the mid-west region with the primary objective of ensuring safe, quality acute care. As part of this review, HIQA was requested to consider the case for a second ED in the context of the population changes in recent years and ongoing pressures at the ED at University Hospital Limerick. HIQA submitted an interim briefing on 28 February 2025 and the report was published on the Department of Health website on 19 March. The interim briefing provides a progress update on the various workstreams of the ongoing work programme. The final report of the review is expected by the end of May 2025. This report will contain advice for the Minister, informed by the evidence compiled across the various workstreams, to support decision-making around the design and delivery of urgent and emergency healthcare services in the mid-west region.
The review is ongoing against a backdrop of continued investment in the capacity and reform of the mid-west health system, particularly at University Hospital Limerick. In December 2024 a fast-track 16-bed inpatient block opened at University Hospital Limerick. Another 16-bed unit is due to open in June and a 96-bed block will be delivered by September. Enabling works are also under way for a second 96-bed block. In total, including further beds planned for the acute hospital inpatient bed capacity expansion plan, up to 308 new beds will be opened at University Hospital Limerick by 2028.
This expansion is supported by the increase in staffing and hospital reforms. Whole-time equivalent staffing at the hospital has grown by 43% since December 2019. That is 255 more doctors and consultants and 455 more nurses and midwives across the mid-west region. Fewer patients are now waiting on waiting lists, with a total reduction of 30% from December 2021 to March of this year. The Government will continue to focus on delivering the necessary reforms and improvements in health services for the mid-west region.
I thank the Minister of State. One can but hope. In regard to the report at the end of May, we cannot envisage what is going to be in that report. However, the Minister, Deputy Carroll MacNeill, visited the hospital on Good Friday on a spot check. It was busy, but that was a quiet busy. I hope that a new model 4 hospital will be delivered for the region. We only have one hospital and it is actually the busiest hospital in the whole country per capita. Hopefully, that is in the report. I thank the Minister of State for laying out the work that has been done to date. I am looking forward to much more work into the future in order that patients will have a safe experience and also the staff working there will be safe. They work under acute circumstances. They work really hard.
The people of the mid-west region deserve access to responsive and safe urgent and emergency care. The Government is delivering improvements through a combination of increased capacity and reform. These reforms are seeking to increase acute capacity and, where appropriate, divert people away from the emergency department to more suitable services. Overall, 572 new inpatient beds will be delivered in the mid-west region from 2020 to 2031. Site works have been commenced on the new Limerick surgical hub for elective procedures. Opening hours have been extended at the medical assessment units in Ennis and Nenagh hospitals from 8 a.m. until midnight, expanding the service availability across the region. Local injury units are accepting patients 12 hours a day, seven days a week, at St. John's, Ennis and Nenagh hospitals. As part of HIQA’s review, the ESRI has been commissioned to conduct national and regional demand and capacity reviews. There has been a high level of public interest in the process with 1,121 submissions being received during the six-week public consultation. As part of the stakeholder engagement workstream, the final report of the HIQA review will inform future decision-making around the design and delivery of urgent and emergency healthcare services in the mid-west as requested by the Minister for Health.
I met the Minister one day when she was on her way to Cork to inspect University Hospital Cork. She is passionate about getting more consultants working over the weekends, particularly at bank holiday weekends. In some hospitals where there is an excellent rota in place, there is a greatly reduced number of people on trolleys.
Health Promotion
I would like to speak on an issue that may sound dramatic but is an issue of life and death at the moment, that is, the urgent need to introduce mandatory cardiac screening for all competitive sports players between the ages of 12 and 18. Too often we only act after tragedy strikes. However, now we have a chance to act before it does. Heart conditions are among the leading causes of sudden death among young athletes. Many of these conditions remain undiagnosed due to their silent nature. There are no symptoms or warnings yet the consequences can be devastating.
Studies show that early detection through cardiac screening, particularly electrocardiogram, ECG, testing, can significantly reduce the risk of sudden cardiac events by identifying underlying conditions before they become fatal.
Across the world we see compelling evidence for preventative action. Italy's mandatory screening programme introduced in the 1980s has resulted in an 89% reduction in sudden cardiac deaths among young athletes. This is a clear demonstration that proactive measures save lives. In contrast, Ireland lacks a nationwide cardiac screening policy. While voluntary screenings are available, the reach remains limited and many young athletes remain vulnerable simply because they never had the opportunity to be tested.
In Ireland, about 100 young people die every year from sudden adult death syndrome, SADS. Many of them are involved in sports and these young lives are cut short by inherited or undiagnosed heart conditions, silent invisible threats that often show no symptoms until it is too late. We cannot allow a screening programme to depend on tragedy for action. We need to prevent these incidents, not just respond to them.
Sports organisations and charities have stepped up where policy has lagged behind. The Dillon Quirke Foundation, established after Dillon's sudden death during a hurling match in 2022, has already screened more than 10,000 young people, identifying 243 who required further cardiac evaluation. These screenings have undoubtedly saved lives, but no family should have to rely on charity alone for protection. If we require gumshields and helmets to safeguard our children from physical impact, why do we not check the organ most vulnerable under pressure, their hearts? The cost of inaction is measured in lost lives, grief-stricken families and communities devastated by preventable tragedies.
I am calling on the Minister for Health, the Minister for sport and indeed the Government to introduce immediate legislation which would make cardiac screening, including ECGs, mandatory for all competitive sports participants between the ages of 12 and 18. This must be a nationwide State-supported programme developed in a partnership with schools, sports bodies and medical professionals.
Furthermore, we must ensure this programme is accessible to all, regardless of socioeconomic background. It should not be a privilege but must be a right. Screening should be integrated into routine health checks for young athletes, creating a culture of prevention rather than reaction. We owe it to the families who have lost loved ones and to those who could be spared the heartbreak to act now before another young life is lost.
I could go through personal tragedies which families have endured in recent weeks in my own area and even in the Munster area, where young teenagers have passed suddenly. One coach was on to me recently to say they had done a public test in a training dressing room where they asked 30 players how many were using inhalers. Two put up their hands but when they did a private survey on that team, seven were using inhalers to enhance their performance. We are living in a competitive sporting environment right now and, if anything, this cardiac screening must be introduced.
I thank Senator Kennelly and I have been asked by the Minister for Health to respond to his Commencement matter. I thank him for facilitating this opportunity to discuss this important matter of cardiac screening for young athletes.
Ireland has very robust procedures in place for the introduction of new screening programmes. Any proposed changes to Ireland’s screening programmes will be facilitated through established evidence-driven protocols. The national screening advisory committee, NSAC, is the independent expert group which considers proposed changes to screening programmes or the introduction of new screening programmes. The NSAC assesses the evidence robustly and transparently and against internationally accepted criteria before making recommendations to the Minister for Health.
All screening programmes have both harms and benefits, so these NSAC processes ensure recommendations are based on solid evidence. This is critical to maintaining rigorous processes for effective, quality-assured, and safe screening programme standards. I must emphasise that any changes to Ireland’s screening programmes will always be based on the evidence. The NSAC holds calls for submissions, which invite proposals from all stakeholders and organisations, including members of the public, the HSE and other medical professionals, for the introduction of new screening programmes or changes to existing programmes. The next call for submissions will open shortly.
Regarding sudden arrhythmic death syndrome, the cause may be related to underlying cardiac disease, inherited cardiac conditions or may remain unknown.
Children’s Health Ireland, CHI, at Crumlin provides targeted screening and ongoing care of children identified at high risk of or affected by an inherited cardiovascular condition, ICC. Children are primarily identified based on wider family history in partnership with, first, the family heart screening clinic, FHSC, at Heart House, Mater Misericordiae University Hospital and, second, cardiac risk in the young, CRY, at Tallaght University Hospital. CHI at Crumlin, along with FHSC and CRY, work together and as a combined entity are a recognised centre of European excellence for the care of ICC families with accreditation through the European Reference Networks.
The national review of adult specialist cardiac services was published recently. The review provides a detailed, evidence-driven analysis of adult cardiac services. The review provides 23 recommendations around cardiac health policy. The report gives us the data and roadmap reform of cardiac services, and the Minister is ambitious to progress this important work. Specifically, the review recommends that services for inherited cardiac conditions be provided as a national service, with strong links to regional cardiology centres and supported by genetic services aligned with a national clinical genetics service. The Minister has written to the HSE to begin developing an implementation plan for the review’s recommendations. This will be a key facilitator of our new national cardiovascular strategy as promised in the programme for Government.
Enhanced community response is critical to improving cardiac arrest survival rates, and this is wholly recognised in the National Ambulance Service’s out-of-hospital cardiac arrest strategy. The National Ambulance Service has a network of more than 250 community first responder schemes, supported by the community engagement team. In the event of a cardiac arrest, automated text messages direct community first responders to the scene of any cardiac arrest that occurs in the catchment area. The Government is committed to ensuring that Ireland continues to improve out-of-hospital cardiac arrest survival rates. Work is already in progress to implement the National Ambulance Service's national AED - defibrillator - registry, which will be mapped to the National Ambulance Service dispatch system and a supporting app for dispatching first responders.
I thank the Minister of State for the response. Really, it is where we are and where we want to be, to be honest. Even in the last paragraph of his written reply, it refers to response times. I want to get away from the response times and to early intervention, where people are mapped from ages 12 to 18. They need to be mandatorily screened, with a certificate if they are going into competitive sports or whatever. They need to be mandatorily tested. It is not the response on the last page of the Minister of State's reply that I am looking for; rather, I am looking for a response that will put in place a mandatory screening check for every child who wants to participate in sports – nothing else.
I respect that there is a lot going on but it is all nearly parallel to running afterwards. I want it to be mandatory and I want the Government to take up my proposal to make it mandatory. It is not illegal to save a life through early prevention. If we could monitor kids going to school, there could be an underlying condition identified in their older siblings or whatever and a child’s life could be saved in the meantime. I have seen it in Killarney. There was a case recently of a male athlete whose whole family needed pacemakers within a week because there was an underlying condition.
I respect the Minister of State’s response but I call on the Minister to implement mandatory screening for all of the kids involved.
I am only here delivering the reply from the Minister but, as an avid GAA man myself, unfortunately I have come across these cases. I came across a case where a young person collapsed on the pitch and the ambulance could not even get in with how the barrier came across at the gate. It was terrible to see what happened that day.
I agree with the Senator and I hope the Minister and the officials within the Department will listen to what he has to say. I know he is passionate on this issue. As I said, I am an avid GAA supporter and, unfortunately, a lot of these cases occur at pitches where children are involved in sports activities. I do not know how much it would cost to screen people or how a scheme can be implemented but I am sure we would learn from a pilot scheme and could build on it. I will bring this matter to the attention of the Minister. I hope that the officials are watching and listening. Perhaps they will listen to the Senator and put something in place. Screening would be worthwhile even if it saved one life and I am sure it would save a lot of lives. I again thank the Senator for bringing this matter to our attention.
I welcome the students from St. Cronan's Senior National School. Their visit will be the first time I can tell a group of students they do not have any homework today. It is absolutely brilliant to give them a day off from it. We hope that the students make the most of their visit. I hope that at least one of them will end up in here in the future as a politician, and maybe not in the Seanad but in the Dáil. I wish them every success. They will have no homework this evening. Enjoy the rest of your visit to Leinster House.
Before suspending, I welcome the Minister of State, Deputy Cummins, to the House. Even though he did not get to reply to the Commencement matter, it is a privilege for me to see him here as a Minister of State as I served with him in this House in the last term.
I thank the Acting Chairperson.
Cuireadh an Seanad ar fionraí ar 11.08 a.m. agus cuireadh tús leis arís ar 11.33 a.m.
Sitting suspended at 11.08 a.m. and resumed at 11.33 a.m.