Brian Stanley (Laois-Offaly, Sinn Fein)
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The business proposed this afternoon is as follows: minutes, accounts, financial statements, correspondence, work programme and any other business.

The first item of business is the minutes of the meeting of 11 May, which have been circulated to members. Do members wish to raise any matters regarding the minutes? Are the minutes agreed? Agreed. As usual, the minutes will be published on the committee’s webpage.

The next item is accounts and financial statements. No accounts and financial statements were laid before the Houses between 8 and 12 May 2023. I will ask the Comptroller and Auditor General if he wishes to make any comment on any matters relating to accounts and financial statements.

Mr. Seamus McCarthy:

No. As I said before, we are in the fallow period. I have started signing the 2022 financial statements in recent weeks, so they will start to come through in due course.

Brian Stanley (Laois-Offaly, Sinn Fein)
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We are in that time of the year. Moving to correspondence, as previously agreed, items that were not flagged for discussion for this meeting will continue to be dealt with in accordance with the proposed actions that have been circulated, and decisions taken by the committee regarding correspondence are recorded in the minutes of the committee’s meetings and published on the committee’s webpage.

The first category of correspondence under which members have flagged items for discussion is correspondence from Accounting Officers and-or Ministers and follow-up to committee meetings.

No. R1879 B is correspondence received from Mr. Kevin McCarthy, Secretary General of Department of Children, Equality, Disability, Integration and Youth, dated 9 May 2023, providing information requested by the committee arising from our meeting on 16 February 2023. It is proposed to note and publish this item of correspondence. Is that agreed? Agreed. Deputy Catherine Murphy and I flagged this item for consideration. Does the Deputy wish to come in first?

Catherine Murphy (Kildare North, Social Democrats)
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There are a range of different issues here. There are different tables. There are some items on one table that are not on the other and I am confused about that. Obviously I need to go through it further but, for example, nowhere in Kildare is listed in any of those tables except the ones where the cost is associated. I do not know why that would be the case when they are in this table and I know they have been there for some time. My first question concerns why the table is not complete. It is quite useful information, including the capacity in the various categories such as hotels, hostels, bed and breakfast accommodation, guesthouses and so on and the spread across the country. There will always be a cost and I do not think any of us wants to see people not accommodated. That should go without saying. We would be looking at it from the point of view of value for money. It might be that we have to get more information. Different locations will have different amounts because there will be places in the country that are more expensive from the point of view of a hotel, but would it make more sense to purchase buildings rather than use long-term rentals?

The other thing that is particularly striking about appendix 2 is that some of it is for 28 days. That is fine; that is the way the contract is structured. Another is 31 days. Matching that against capacity, it seems like the same amount every month. If the capacity changes, is the same amount paid? For example, if the facility can accommodate 50 people, is payment made for 50 people if 40 people are in it? I would like to see a little bit more on the structure of the contracts.

It was unsatisfactory when we had the Department in previously to discuss due diligence. How the Department sources accommodation is a confidential process. It appears that the Department sources it from the point of view of people coming forward with accommodation as opposed to the Department or the Government going out and looking at buildings that might be suitable or made suitable. In that case, the Department becomes a cost-taker. I am not sure that is a great way of dealing with this. There are issues around the lack of consistency across the various tables and also the information we have. We need further information. When departmental officials were in and I asked them the question, it seemed the only issue is that they are tax compliant. There are other issues, including several here. For example, it states it does not include security. Why would they not give us the information if there is a cost for security? Why can we not have at least full transparency on actual costs? We need to do things better in terms of value for money, but not only that. I am aware of one particular location where they tankered in water. I am sure the Department is paying for a fully functioning building, and that building is not. It is important that we can interrogate that.

Those are some of the points that we need further information on.

Brian Stanley (Laois-Offaly, Sinn Fein)
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We can seek clarification on that.

Some 81,000 people are being provided with accommodation. It is a huge challenge. From the hearing we had with the Secretary General, Mr. Kevin McCarthy, and his senior staff, it seems the Department is being put under huge pressure in respect of all of this. I have some questions around it. A total of 59,000 people sought accommodation and another group of international protection applicants are in direct provision. What is the term in direct provision as well? Have officials examined the option of buying some of these buildings? At the moment, there seems to be a huge scramble. I know it is hard and they have to come up with the capital. I refer to trying to use middlemen, or whatever the term is, to arrange some buildings that are not in use, for example, old public houses, old guesthouses, convents, etc. I received a phone call from someone yesterday inquiring about all of this and seeing how they can get into the business of it. Was the option of the State purchasing some of these on a long-term basis considered?

Second, there is the delay in processing international protection applicants. I understand Ukrainians are a different category because many are here temporarily because of the war. It goes without saying that it is important that we help both groups of people. People who are genuinely fleeing terror, war and persecution need to be helped. We should ask the Department about some of the people in direct provision who seem to be there a long time. I am not clear as to the explanation why. If they have been accepted as having status here, we should be trying to integrate them in own-door accommodation and getting people into work and all of that. We have a situation now where a cohort of people is in direct provision and working, which is good, but we should be trying to move those people out of direct provision and into the community. That would free up space. If we do not free up space, we will continue to have the type of problems we have around the corner here with the reprehensible scenes at the weekend when people and the tents they were living in were attacked.

We should ask the Department to give us a table in simple times. I am trying to recall whether we got this. In respect of people in direct provision, there is a target of how long it takes to process their case and make a decision. Second, we should look for the number who are there between one and two years and, subsequent to that, the number who are in three to four years, four to five years, five to six years and so on. We should ask the Department for a detailed table like that and to give us an explanation as to why anybody would not have their case fully processed after two years. I would like an explanation for that. We know that there were only 47 staff. In terms of management, governance and financial management, if there were only 47 staff working on processing these applications, that would explain some of the reason this system is falling down. Certainly, we are not moving people along through the system. Then, a decision is made that those who can establish a case for international protection quite rightly are accepted. I was just informed that this question will probably have to the Department of Justice as well. The Department of Children, Equality, Disability, Integration and Youth will be able to give us the figures of the time people are in the settings it is providing. We should look for that and, separately, we should ask the Department of Justice why anybody would wait longer than two years to have their cases settled. This is along with the information raised on the tables. The other question, of course, is whether consideration has been given to purchasing accommodation. The option of the State purchasing or providing some buildings directly was proposed in the Government discussion in a White Paper. What consideration is being given to that? We will note and publish-----

Catherine Murphy (Kildare North, Social Democrats)
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I wish to come back in on a couple of issues. All local authorities were asked to identify buildings within their area. I am aware of buildings in my constituency of Kildare North that were identified but were not used and then the local authority was surprised with other ones that were used. I completely agree with the Chair about the Department being overburdened but I think we dealt with that when they were in. This needs to be an all-of-government approach.

Brian Stanley (Laois-Offaly, Sinn Fein)
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They are more overburdened today, unfortunately. They are really under pressure this week. A lot is landing on the people working in that Department who are trying try to sort out all of this.

Catherine Murphy (Kildare North, Social Democrats)
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We should absolutely acknowledge that. My understanding though is that we seem to be taking a very short-term approach to this and that short-term approach is this outsourcing.

The Department would have some measure of control by having buildings it leases long-term or owns. Why has it not taken up some of the ideas put forward by the local authorities? This would require a bit of work but might provide substantial amounts of accommodation. It might also be a more secure way of dealing with things.

There are several issues here. One is accommodation. We have an international obligation in the context of the current situation, and I completely accept that. We would have to say, though, that some of the standards in this regard fall significantly below what is acceptable. We must take a longer view on this issue. It is utterly unacceptable for people to arrive here and to end up on the streets with sleeping bags and tents. We must ask what buildings local authorities have identified, and these need not be named, that have not been used and which might have a more long-term-----

Brian Stanley (Laois-Offaly, Sinn Fein)
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Sometimes there may be good reasons for turning down these buildings.

Catherine Murphy (Kildare North, Social Democrats)
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Yes.

Brian Stanley (Laois-Offaly, Sinn Fein)
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They might be buildings that are a bit difficult to refurbish-----

Catherine Murphy (Kildare North, Social Democrats)
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The other thing is that 4,000 people now have status in accommodation but cannot move because there is nowhere for them to move to. This obviously knits into the housing crisis. This would be a substantially different issue if we did not have a housing crisis.

Brian Stanley (Laois-Offaly, Sinn Fein)
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The fact is we are dealing with hundreds and hundreds of locations. I call Deputy Colm Burke.

Colm Burke (Cork North Central, Fine Gael)
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It is a major problem that we have had to deal with in a short time. In fairness to the Department and the officials, I must say I have been disappointed by the local authorities. I had my own experience of dealing with them in respect of how slow they were to respond. They could have done a great deal more. I accept what Deputy Catherine Murphy is saying about those instances where the local authorities identified properties and then the Department did not come on board.

On the issue of purchasing property, in the long term the Government will have to decide on this issue. The question then will be around who will manage the property. Will it be, for example, the local authorities or a separate State agency? A Department would not be able to manage it. Simple things like maintenance and upkeep will require the employment of staff and ongoing issues that arise will have to be addressed. There does, however, need to be a Government policy on this matter because even if this crisis is resolved in the next three months, we can be assured we will have another crisis within the next three to four years where we will have people coming in from abroad. This is just one of the challenges we now have in the context of the whole way the world is working.

To return to the issue of Ukraine, I do not know what anyone else thinks, but it will be interesting to see how it evolves. All the other countries are pouring arms into Ukraine. The problem is the arms manufacturers are making great money out of this. Is any serious effort being made to bring this conflict to an end? I am a bit concerned about that aspect.

Brian Stanley (Laois-Offaly, Sinn Fein)
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We will not solve it in this room-----

Colm Burke (Cork North Central, Fine Gael)
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We will not.

Brian Stanley (Laois-Offaly, Sinn Fein)
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-----but I agree with the Deputy. I am sure everybody wants to see an end to it. Hopefully, the occupier is repelled and the sovereignty of the country can be restored. This is the nub of the issue-----

Colm Burke (Cork North Central, Fine Gael)
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The problem we have is that we will-----

Brian Stanley (Laois-Offaly, Sinn Fein)
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---and the sooner that happens the better.

Colm Burke (Cork North Central, Fine Gael)
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The problem we have is that we must continue to maintain-----

Brian Stanley (Laois-Offaly, Sinn Fein)
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We do.

Colm Burke (Cork North Central, Fine Gael)
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We must fast-track how we can have a proper structure for dealing with this. We must be able to react faster in providing what is needed in this context. I refer to even having spare accommodation available to let at times as well.

Brian Stanley (Laois-Offaly, Sinn Fein)
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It is fair to say, given the speed with which we have had to deal with huge numbers, that the people in the Department dealing with this have worked very hard at it. If someone had said to us a year and a half ago that we were going to have to deal with this situation and that we would have been able to accommodate this number of people, we would have said there would not have been a hope of doing so. I take on board what the Deputy said regarding some of the accommodation being below a certain standard.

Colm Burke (Cork North Central, Fine Gael)
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Yes.

Brian Stanley (Laois-Offaly, Sinn Fein)
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It is a crisis situation. We will put these questions to the Department of Justice and the Department of Children, Equality, Disability, Integration and Youth.

Colm Burke (Cork North Central, Fine Gael)
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On the cost information attached to the letter, I presume this is not going to be published.

Brian Stanley (Laois-Offaly, Sinn Fein)
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No.

Colm Burke (Cork North Central, Fine Gael)
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I just wish to make sure this is right.

Brian Stanley (Laois-Offaly, Sinn Fein)
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It says that it will not.

Catherine Murphy (Kildare North, Social Democrats)
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Which figures are these?

Colm Burke (Cork North Central, Fine Gael)
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Reference is made to this being commercially sensitive and not for publication.

Catherine Murphy (Kildare North, Social Democrats)
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Okay.

Colm Burke (Cork North Central, Fine Gael)
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I refer to the amount being paid to each hotel group or whatever.

Mr. Seamus McCarthy:

It looks like the answer to the question Deputy Catherine Murphy had about why County Kildare was not appearing on some of these tables is that it just seems to be an oversight. It affects both tables. I would say it may just be a missing line from wherever they took down the data. I say this because when we look at some of the other appendices, there certainly are properties in County Kildare that are listed and there is no obvious reason why they would not have appeared on this table. The Department may be able to replace the letter with a more complete version.

Catherine Murphy (Kildare North, Social Democrats)
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I have read about the cost of one of these in the newspapers today.

Brian Stanley (Laois-Offaly, Sinn Fein)
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Okay, so-----

Catherine Murphy (Kildare North, Social Democrats)
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For what it is worth.

Colm Burke (Cork North Central, Fine Gael)
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Is the Deputy saying they do not want to give her the information?

Catherine Murphy (Kildare North, Social Democrats)
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No, it is on that list.

Brian Stanley (Laois-Offaly, Sinn Fein)
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I know.

No. R1883 B is correspondence received from Mr. Michael Corban, Department of Health, dated 9 May 2023, providing information requested by the committee arising from our meetings on 2 and 9 February 2023. It is proposed to note and publish this item of correspondence. Is that agreed? Agreed.

Catherine Murphy (Kildare North, Social Democrats)
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Agreed

Brian Stanley (Laois-Offaly, Sinn Fein)
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I flagged this because there are several issues in it that I wish to raise. There is detailed information in this regard concerning GP services and the shortage of GPs. My specific question concerned what the Department was doing in respect of taking on the option of directly employed GPs, as set out in the Sláintecare policy documents. An answer is given stating that a strategic review is being commenced of this aspect. The correspondence goes on to refer to how best to ensure the provision of GP services and that this review will examine these issues. Reference is also made to circumstances where use could be made of salaried GPs. I think we need to watch this issue because some of the problems we discussed earlier this year regarding the out-of-hours GP services and ordinary daytime ones arise from this context.

Colm Burke (Cork North Central, Fine Gael)
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One other issue arises from this point, though. If salaried GPs are taken on, and it will have to happen in certain areas, it will then be necessary to also take on the support staff, like the administrative staff-----

Brian Stanley (Laois-Offaly, Sinn Fein)
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That is correct.

Colm Burke (Cork North Central, Fine Gael)
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-----whereas at the moment, the money going to GP practices is covering the administration and nursing staff. There is a need to look at should the nurses, for instance, be employed directly instead of by the GP practices.

Brian Stanley (Laois-Offaly, Sinn Fein)
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A lot of money is already going into GP practices for those support staff. If we look at the General Medical Services, GMS, contracts-----

Colm Burke (Cork North Central, Fine Gael)
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I know, but the ratio of nurses to GPs compared with other jurisdictions is much lower than it should be here. I say this because nurses can do an awful lot of the work GPs are doing but we do not have sufficient numbers of them.

Brian Stanley (Laois-Offaly, Sinn Fein)
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Correct, but this provision has to be funded one way or the other-----

Colm Burke (Cork North Central, Fine Gael)
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Yes.

Brian Stanley (Laois-Offaly, Sinn Fein)
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-----whether it is through private practice or salaried GPs. We specifically asked questions around recruitment and the pipeline of new GPs, which was an issue that has caused problems. Figures have been given for the number of training places to be increased. It is stated that the Irish College of General Practitioners, ICGP, currently estimates that 890 GPs will graduate from GP training over the three years between 2023 and 2026. A breakdown of these numbers is provided.

A figure is also provided that is an issue of concern. The correspondence refers to the number of GPs aged over 72, which seems to be a marker. Out of the 2,539 GP GMS contracts held, the number of those with a full contract who will turn 72 in the three-year period referred to alone is 92.

As you work down through the correspondence and get down into people in their 60s, those numbers will be a lot larger. It is an area that is bedevilling the health services. The fact is that we do not have sufficient staff in the community to provide the full primary care services we need. That is an important matter.

Figures for the dental treatment service scheme have been given, and I am puzzled by them because it looks like, on page 9 of the correspondence, where the budget for dental services is given, there is €66.8 million for the dental treatment service scheme, DTSS. That is the scheme for adult medical card patients. There is the treatment benefit scheme, which includes public dental services. That is the scheme for PRSI employees. There is €64.4 million there for that and €23.8 million for orthodontic treatment, which is significant enough. When added all together, it is €155 million. However, what I am puzzled about - some of you have heard me say this before - is that in the county I live in there is no DTSS. There is €66.8 million available for it but we do not have a breakdown as to how much of that is being spent in County Laois, as far as I can see, or County Offaly or any other county. I would be interested in getting that breakdown because it states under the DTSS that there is no cap on spending in the community healthcare organisation, CHO, areas. That is all it says for CHO 8. I think there are six counties in CHO 8. Would that be correct? If, however, there is no cap on the spending for it, what is happening in those counties in that regard? I request, if the committee is agreeable, that we look for a breakdown of the spend last year per county in the CHO 8 area in respect of the DTSS. Figures are given for the public dental scheme and the orthodontic scheme, but it states that there is no capital spending in CHO areas, and under CHO 8 it does not give any figure. It does give a figure for the public dental scheme, that is, the PRSI scheme, and the orthodontic services, but what happens to the medical card patients? We just do not know. There is only one dental practitioner that deals with medical card patients. They are not taking on any new patients and are dealing with only a very small number at the moment. The day has long gone that they are taking on new patients, but what was spent in Counties Laois and Offaly separately on the DTSS last year? If there is no cap on the figure in the CHO areas, how much is budgeted for Laois and how much is budgeted for Offaly this year? I am curious to know that. If any other member knows of a county where they have no service, as is the case in my neck of the woods, and if they want to put that county in with the request, they are free to do so.

Catherine Murphy (Kildare North, Social Democrats)
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One of the difficulties is that things are not coterminous. For example, there may well be a fair distribution based on the population of CHO 8, but it may not be the case that that distribution is fair when it comes to looking at it from the point of view of the allocation for individual counties. It is a postcode lottery with a lot of HSE services. For example, CHO 7 is the area I am in. There is part of west Dublin, there is Kildare and there is west Wicklow. I may well be able to get the figure for that breakdown but I might not be able to get the figure as to what is spent in west Wicklow. The fact is that Wicklow is broken into more than one CHO area, as indeed is west Dublin, which indicates that Dublin is broken down into several CHO areas. It is quite difficult to see if there is a fair spread. You highlight one which is a glaring omission, a Chathaoirligh.

Brian Stanley (Laois-Offaly, Sinn Fein)
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There is no service.

Catherine Murphy (Kildare North, Social Democrats)
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Given the age profile in Laois and Offaly, you can see that that will be a particular problem. The CHO areas are problematic from that point of view. For example, when it comes to GP services, we can measure them on the basis of CHO area, but you would not get on a GP's list for love nor money in my area. That has not been possible for the past year. There are people presenting in accident and emergency departments inappropriately because they have an infection or something, whereas going to a GP would resolve the issue by getting an antibiotic or something. I am not sure if we are seeing the information. We might ask the Department if it is possible for it to break this down on the basis of county as well as CHO area, not exclusively dental services, because that makes more sense to us and makes more sense to the people using the services.

Brian Stanley (Laois-Offaly, Sinn Fein)
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Specifically, though, I would like to see the breakdown for the DTSS. That does not exist and has not existed for some time. It is not possible - for a long time it has not been possible - to access the scheme because there is simply no dentist providing it. In that case, what is the HSE doing? What did it spend on it last year? What was the spend on? We might also ask what is being done to fill that gap. In fairness to local management or middle management, it did run a recruitment competition and put out an advertisement to try to recruit people, and it has been unsuccessful. Where is that at now? Has there been a second competition? Has consideration been given to other options in trying to recruit dentists into that public scheme who can provide it? There is substantial funding going into it, and here is the budget for it and there is no cap on it. It states that there is no cap on spending in CHO areas, yet we have no service. We will see where that goes.

That concludes consideration of correspondence.

Moving on to the work programme, at our next meeting, 25 May, we will engage with the Department of Justice to examine its appropriation account 2021, with a focus on expenditure and governance of international protection assessments. That question we are putting to the Department is timely. If the Department is before us next week, we might tell it to come in with an answer to that for us. On 1 June we will engage with the Department of Housing, Local Government and Heritage to resume our examination of its appropriation account. We will focus on the funding, governance and oversight of the cost-rental housing sector and expenditure on social and affordable housing. The following meeting, on 15 June, will be with Sport Ireland. On 22 June we will engage with the Department of Tourism, Culture, Arts, Gaeltacht, Sport and Media. Does any Member wish to raise any matter in respect of the work programme? Members have a draft work programme in front of them. I ask them to take a moment to look at it because it is important we fix the programme. We have a good schedule of work set out. Even between now and the end of the meeting, anybody who wishes to bring up anything should feel free to do so.

Is there any other business not on the agenda for today's public session? No.

We will now go into private session briefly before adjourning.