Ms Ronnie Fay:

On the issue of the Traveller agency, we think it must drive matters. If one considers that 84% of Travellers are unemployed, there has never been a Traveller training or employment plan but when 14% or 18% of the general population were unemployed, it was like a major crisis and everyone galvanised, rightly, to take action. However, the Travellers keep falling through the cracks. This is why we state that such an agency must consider health, culture and accommodation. It can prioritise accommodation in its first year of operation but our point is we have fabulous policies in place on Travellers but the big gap is between the policy and its implementation. While the policy is in place, there is a gap in implementation and that is where it is falling asunder. That is why we thought that if there was an agency to drive it, to hold people to account and to share good practice, we would be hopeful it might bring about change.

As for the issue of fire safety, there were two elements to the initiative, which we welcomed warmly. Moreover, we hope it now will be integrated into the work of the local Traveller accommodation consultative committees and the development of Traveller accommodation programmes in the future because it must be perceived not merely as a crisis measure but must be sustainable. One suggestion we have put forward is for a core module in the primary health care programmes to be on health and fire safety because programmes in this regard have worked for many years and at Christmas and Hallowe'en, fire safety alerts and so on always have been carried out. We were disappointed because we had higher expectations and as the Deputy rightly noted, they consisted of limited visual audits in which someone walked onto the site and looked around. We would suggest it is a starting point but should not be an endpoint and that a more thorough process is needed. However, the second part of the initiative was the development of Traveller fire safety awareness training. That has been more successful and has been particularly successful when it has been rolled out and run in partnership with Traveller organisations. The fire service has been very open but the problem often has been with local authorities. As the initiative was being organised through the local authorities, there were gaps because a local authority might ring a site in the morning to say it wanted the people there to go to a particular place. It was totally ridiculous and highly disrespectful. It was as though no one had anything else to do and that people's time is not important.

It was also a lost opportunity not to work through the Traveller community development programmes because they, and the primary health care programmes, would provide a mechanism and have the best relationship with Travellers. If one wants to be effective, therefore, one should talk to the people who are affected and give them advice.

As regards accommodation, the National Traveller Health Strategy stated:

There is little doubt that the living conditions of Travellers are probably the single greatest influence on health status. Stress, infectious disease, including respiratory disease, and accidents are all closely related to the Traveller living environment. It is clear that an immediate improvement in the living conditions of Travellers is a prerequisite to the general improvement of health status.

That is from the National Traveller Health Strategy. The All-Ireland Traveller Health Study, which was published in 2010, undertaken by the Departments of health both here and in Northern Ireland and done by University College Dublin, stated: "What we can say is that the better accommodated the Traveller family, the better the health status." There is a clear link, therefore, between the accommodation and health situations. That is why we are so disappointed at the inaction since the publication of the All-Ireland Traveller Health Study. We think it was a missed opportunity to build on the momentum.

Suicide accounts of 11% of all Traveller deaths, which is a very large percentage. We are disappointed because before the national suicide prevention strategy, Connecting for Life, was published, we made a submission to it highlighting certain matters. We ended up with one sentence which referred to Travellers and other vulnerable groups. That is very disappointing. They talk about evidence-based policy making, yet the evidence is that 11% of Traveller deaths arise from suicide. We felt that aspect should have been given greater priority and targeting.

Each county has to develop a local implementation plan and we are calling for Travellers to be represented on those, given the suicide profile. We are also seeking an ethnic identifier, so that we will know what the outcomes are and where issues arise. From the All-Ireland Traveller Health Study we know that there is an excess number of Traveller deaths compared to the general population. Cancer, respiratory disease or heart disease do not attack Travellers differently from anybody else. However, we know that there is discrimination in getting access to services, and also in the quality of service that Travellers receive. That has been documented independently in the All-Ireland Traveller Health Study.

There are 134 extra Traveller deaths every year. If one compares Travellers to the general population, there should be 54 deaths annually, but there are 188. This is due to institutional discrimination and racism. That is the reality. People are being forced to live in really bad conditions. It is bad for one's health to be born poor or to become poor. That has all been documented. We see a Traveller community that is most marginalised and one can see it in their health, life expectancy and mortality rates.