Micheál Martin (Cork South-Central, Fianna Fail)

I move:

That Dáil Éireann has confidence in the Tánaiste and Minister for Foreign Affairs and Trade and Minister for Defence, Simon Harris T.D.

I am conscious that at the centre of all of this is real human anguish. There is the grief of Harvey Morrison Sherratt's parents, Gillian and Stephen, and his wider family circle and there is the anguish of too many children and young people and their families who are in the process of trying to access services or who have struggled to access services in the past. I want to begin my contribution by offering my personal condolences again to Harvey's family on their terrible loss and by acknowledging that as a country we need to do much better when it comes to healthcare services, and in particular spinal services for our children.

I respect Deputy Tóibín's good faith and acknowledge his genuine concern, as I do with all Deputies in this House. My only frustration with the course of action that the Deputy had indicated he was going to take is that motions of confidence or, indeed, of no confidence do not in and of themselves provide services or address the challenges that we are all concerned about.

I want to assure the House and the families listening to this debate that as a Government we are steadfast and determined in our efforts to address these challenges. These efforts include strengthening governance and oversight, driving down waiting times and ensuring increased engagement and timely communications with families of patients with a view to building a better and responsive service.

This latter point is important because, quite apart from the quality of care provided to children, the level and quality of communication between clinicians and parents in many cases has been far short of what should reasonably be expected. We know this through a succession of existing and pending reports about the corporate and clinical governance concerns at Children's Health Ireland, CHI. Most recently, in response to this, governance and oversight structures have been strengthened at CHI with the appointment of Dr. Yvonne Traynor as chairperson of the board and two additional board members, Fergus Finlay and Suzanne Garvey. This builds on four previous appointments earlier this year. I thank those involved for their contribution.

In addition, the Minister for Health recently announced her intention to fully integrate CHI into the HSE, given that the National Children's Hospital Ireland will be the central hub for paediatric care. I strongly support the Minister in this decision. Indeed, the Minister and the Tánaiste have been engaged with families and advocates in respect of the structure and need for an inquiry into the overall issues pertaining to CHI. This step, bringing CHI under the aegis of the HSE, will bring coherence of governance across paediatric services and support smoother pathways of care for children, delivering lasting benefits for families across the country, and it will be an important step in the continued reform of the provision of health services for children and young people.

The HSE CEO has also established the CHI improvement steering group to co-ordinate oversight of the range of matters of focus in CHI, including the implementation of recommendations from completed reviews, upcoming reports, spinal services and the commissioning of the new children's hospital. It will continue to strongly invest in services and in tackling waiting lists, particularly for spinal procedures, by increasing capacity and substantial resources, and several initiatives are under way to improve access to those services, including a ring-fenced theatre, additional outpatient clinics and national and international outsourcing to maximise capacity. There are additional procedures every year, but not enough and we need to do much more.

A new orthopaedic spinal surgeon has started with CHI since 11 August and is already having a significant impact on waiting lists. The paediatric spinal services management unit is now ensuring that patients are prioritised correctly for surgery and works to reduce waiting times, and has now dedicated pathways for GPs to refer a patient to CHI, which ensures that urgent cases will be prioritised. Spinal services remain a priority under the waiting list action plan in 2025 and every effort is being made to reduce the time children and families are waiting for spinal procedures.

For many children and young people, successful surgery can significantly enhance their lives and can really improve prospects and so forth, but for many, it is the beginning of a long journey living with disability. As a Government, we are committed to doing more and doing better when it comes to disability. That means a step change in how services are provided and in how disabled people and their families are supported to live their lives to the fullest extent possible.

The primacy of the family and the interaction of services with the family is something that has to be dramatically transformed and enhanced. It is not good enough at the moment. There are many people working extremely hard and with the best of good will in our services and we will continue to increase funding and resources to meet the challenges ahead.

The new national human rights strategy for disabled people is a significant step forward and represents a commitment that all disabled people should be able to live the lives of their choosing without barriers. We are determined to deliver a transformative programme of work across the full range of issues that affect people in their daily lives, such as education, employment, income supports and active participation in society through culture, housing and sport. We are backing those commitments with record levels of investment as part of the updated national development plan, and the budget represents a further step in this direction.

In all of this and much more, the Tánaiste has been an active and steadfast partner. He has been a diligent and very dedicated and effective Minister for foreign affairs and Defence in an uncertain and increasingly fraught geopolitical world. He has articulated Ireland's commitment to human rights and the rules-based international order eloquently and without fear or favour. Together we have provided unparalleled leadership in Europe in response to the war in Gaza, we have been strong in our support for the people of Ukraine following Russia's invasion and we are steering our country through the perils of ever-changing US trade policy.

We are improving our health service for the better. We are making the investment necessary to build the houses the country needs and to deliver the core energy, water and transport infrastructure that will be the bedrock of our country's success for generations to come. We are investing in our Garda and Defence Forces to keep our people safe. We are tackling inequality and ensuring our young people are among the best educated in the world. We understand the fundamentals that underpin our economic success and we are committed to protecting and promoting them. We are committed to eradicating child poverty. We are building the country's financial strength to withstand further economic headwinds. We are doing all of these things and more based on a strong mandate, a relationship of trust and respect and an ambitious programme for Government.

It is worth pointing out that we went to the country less than a year ago. The Government is about nine months old. The Irish people made their judgment in that election on the performance of the previous Government. I respectfully suggest it was at variance with Deputy Tóibín's approach. This led to the re-election of the Fianna Fáil Party and the Fine Gael Party, along with Independent Deputies, into government to deal with very unsettled times. We got a very clear mandate from the people only less than a year ago. That is an important point when motions of no confidence are indicated. My Government is responding with a vote of confidence.

Fundamentally we have to focus on the provision of services. I get that fully, but I respectfully suggest the tabling of motions of no confidence in themselves is not going to do that. We need a very clear focus on resources and on how we structurally change the delivery of health services, particularly for children and those who need spinal services at the right time in their journey, recovery and what is clinically indicated as being the right time. The Tánaiste and I, and the entire Government including the Minister for Health, are very committed to doing that. I commend the motion of confidence to the House.

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