Ms Maria Joyce:

I will make a couple of points on that. There have been significant cuts to the overall Traveller health budget since 2008, with the onset of the recession.

This meant that meant Travellers experienced a double impact in the specific cuts to the Traveller health budget and the overall cuts in the area. It is good to hear Mr. Walsh refer to the primary healthcare programmes but they have been significantly affected by cuts in recent years. Even though there were some areas under the regions where there was underspending in Traveller health budgets, cuts were still made to services, including Traveller primary healthcare programmes, as a cost-saving measure. As Traveller health budgets were not ring-fenced, they were sucked into the bigger black hole with regard to overall health budgets. One useful thing this committee could do would be to look at those budgets from the Department of Health to the HSE to determine how much is ring-fenced and how much is not spent on what is intended initially in respect of Traveller health.

There is an absolute need for targeted initiatives, not outside of the mainstream and not segregated provision. Primary healthcare is one model of that but there are other pieces of work that must be done. However, no new moneys are coming into Traveller health and that is where things get stuck. This is not just about money. While money is, of course, significant and important, that leadership which was referred to where we have a shift in positive policy is not there. We still have the ingrained negative policy superimposed here. The reality is that change is not coming as swiftly as needed.

Ireland should be ashamed of itself. I cannot put it strongly enough. Ireland should be ashamed that, notwithstanding the statistics that have been set out here today and included in all of the submissions, there is still no real action on the change needed to ensure we do not continue to have these same conversations in ten or 20 years' time and that our grandchildren and great grandchildren will not have to deal with the same kinds of health issues and shortened lifespans heard about across the board today. Ireland should be ashamed of itself when it comes to Traveller health. While the wider determinants are there, it is always something else that is the reason we cannot implement what we have. A number of Departments, whether it relates to accommodation, health or education, are not accepting responsibility for the fact that they need to put the resources in and implement the policies and strategies they have. They need to roll out concrete work, including on disaggregated data, to monitor effectively and ensure there are real outcomes for Travellers.