Barry Cowen (Offaly, Fianna Fail)
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Now that Fine Gael has allowed the Taoiseach six weeks to make up his mind, perhaps we can get back to priorities and the issues that affect people's daily lives. In the aftermath of Storm Doris, the ESB is working hard to ensure that people have power restored to their homes. We wish it well in that task.

What I want to deal with briefly is people who, unfortunately, do not have homes. I am conscious that there have been many announcements and plans to deal with the challenges facing the housing sector. We gave the Minister for Housing, Planning, Community and Local Development, who had the best of intentions and who engaged in a wide-ranging consultative process involving stakeholders - which was fed into by an Oireachtas committee - time and space. We allowed some time to see if what was envisaged could be implemented. Considering the abject failure of the previous plan under the same people in Government, it was always going to be about implementation and we wished it well. It is time that we begin to engage in an honest appraisal of what is being delivered. Records continue to be set in the context of the number of people who are homeless, the cost of rent and the gamut of factors associated with the housing construction sector and the provision of housing. On Monday, Focus Ireland showed that last month a child became homeless every five hours. That is a shameful statistic. We in this House are obliged to seek to remove whatever obstacles are preventing the implementation of any plans that are envisaged. On Tuesday, the Taoiseach waxed lyrical about the fact over 8,500 units are under construction at present.

I lost my head trying to point out to him that this was not true. I do not want to be losing my cool but we have to impart the frustration felt by those who come into my clinic and the clinic of every other Member to the Members in government. Of those units he referenced, only 1,829 are under construction, the rest are going through various stages of the process and the majority were approved more than two years ago. A total of 652 units is all that was built last year. By 2020 the majority of the houses we are talking about will not be built and, at best, the 8,500 units will be built. Many local authorities did not build any houses last year.

The Government seems to be obsessed with announcements in the hope that they will bamboozle people with volumes of details so that they will not see what is going on, but we all are quite aware that progress is not being made.

Pat Gallagher (Donegal, Fianna Fail)
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Time, Deputy.

Barry Cowen (Offaly, Fianna Fail)
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If I could continue, as it is important that we get back to basics regarding this issue because there has been too much deflection in recent weeks.

Pat Gallagher (Donegal, Fianna Fail)
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The Deputy will get another opportunity.

Barry Cowen (Offaly, Fianna Fail)
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The Minister, Deputy Coveney, in his recent quarterly report said that 1,000 units would be built this year. That compares to 5,000 units set out in the plan last year.

A Fianna Fáil Dublin county councillor said to me last night that there are 500 acres zoned for residential use that are available for construction that are not being used. Why is that the case when 7,000 people are homeless?

Pat Gallagher (Donegal, Fianna Fail)
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I call the Tánaiste to respond.

Barry Cowen (Offaly, Fianna Fail)
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Why is the Government not consulting with the credit unions which have €8 billion available that it insists must be left with pillar banks on deposit earning nothing while they are prepared to invest in this sector?

Pat Gallagher (Donegal, Fianna Fail)
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The Deputy is one minute over time. I call the Tánaiste to reply.

Barry Cowen (Offaly, Fianna Fail)
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A final question-----

Pat Gallagher (Donegal, Fianna Fail)
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No. The Deputy will have another opportunity to raise it.

Barry Cowen (Offaly, Fianna Fail)
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It is a direct question.

Pat Gallagher (Donegal, Fianna Fail)
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No. I cannot allow this to happen.

Barry Cowen (Offaly, Fianna Fail)
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The Tánaiste can just tell me why there is-----

David Stanton (Cork East, Fine Gael)
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The Deputy's time is up.

Pat Gallagher (Donegal, Fianna Fail)
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I ask Deputy Cowen to resume his seat. I call the Tánaiste to respond.

Barry Cowen (Offaly, Fianna Fail)
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-----500 acres that is available for construction that is not being used.

Pat Gallagher (Donegal, Fianna Fail)
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The Deputy has had three minutes. I call the Tánaiste.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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As Deputy Cowen well knows, this country was in an extraordinarily difficult situation just a number of years ago. Yesterday we saw the employment figures again improving and we saw the level of unemployment being reduced to 6.8%, a figure which the Deputy's party said would never be reached, and it also said that the targets in the Action Plan for Jobs would never be reached. That is the position from which the Deputy is coming in terms of his view of the various actions that have been put forward-----

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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-----but the figures speak for themselves when it comes to employment.

In regard to housing, the approach to it has been spelt out clearly by the Minister, Deputy Coveney. We have more money, more input than ever before and more detailed work with various local authorities to provide housing. We accept the seriousness of the situation. That is why we have a Minister with particular responsibility for housing. The budget in that Department has increased more than the budget in any other Department in order to reflect the seriousness of the crisis. Today, €32 million will be announced to deal with the repair and leasing scheme and local authorities will work around the country to make sure that more properties are available for those in need of housing. Also this week, the four Dublin local authorities have confirmed that we will meet a point that the Minister, Deputy Coveney, has said, namely, that children and families will not be using hotels in the Dublin area. It has been confirmed by the four local authorities that this will be addressed by mid this year.

What have a targeted social plan. The Deputy spoke about 8,500 units. There are 8,500 social housing units currently being built across the country, with 509 different organisations engaged in different projects delivering those houses. That is real, it is happening on the ground and it is about providing housing. It is about making sure that we can deal with the huge demand for housing that exists. We have new people coming into the country and families looking for housing. We accept the seriousness of the situation. That is why it has been a priority for the Government That is why the budget is there to deliver and why so many different units across the country, local authority, public and private providers, are delivering those houses.

Just as the jobs have been delivered over the past few years and the target in that regard has been met and exceeded, we will meet the housing targets which have been outlined but this takes time, as everybody recognises. The plans are under way, the money is there, the budget has been allocated and the matter has been prioritised by Government.

Barry Cowen (Offaly, Fianna Fail)
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Were the Tánaiste aware of or interested in the urgency of this situation, were she as frustrated as everybody else with the lack of real progress, she would ask questions at Cabinet and be aware of the matter and be in a position to answer the question I am asking her. If 8,500 units are under construction, the majority were approved two years ago, and many of them are not even on site yet. I am taking as an example just one local authority area where many would say the crisis is at its worst. Why are 500 acres of zoned residential land in south County Dublin lying idle, with no specific local authority plans to deal with it? These are State-owned lands. Why has the Government not recognised the obstacles not allowing these lands to come to fruition much more quickly than it should? Why will the Government not consider any authority other than the local authorities and the Department, which have failed miserably in the past number of years? Fine Gael is depending on conventional methods that have failed to deliver a plan it said would be the greatest ever when it was in government last year.

Pat Gallagher (Donegal, Fianna Fail)
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Go raibh maith agat.

Barry Cowen (Offaly, Fianna Fail)
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The Tánaiste needs to be able to tell me the position. It should be her job to do so and she should do so instantly and as a matter of course.

Pat Gallagher (Donegal, Fianna Fail)
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I call the Tánaiste.

Barry Cowen (Offaly, Fianna Fail)
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Why are 500 acres lying idle when 7,500 people are homeless and when a child-----

Pat Gallagher (Donegal, Fianna Fail)
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We cannot allow this slippage. I call the Tánaiste.

Barry Cowen (Offaly, Fianna Fail)
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-----is becoming homeless every five hours of every day?

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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There has been detailed engagement, as the Minister, Deputy Coveney, has often outlined here, between his Department and local authorities to ensure that housing is built as rapidly as possible. It is worth looking at some of the initiatives that have taken place and have been delivered already. In 2016, 18,380 social housing supports were provided to people, exceeding the target of 17,240, with expenditure of €935 million on housing that year. This is a very positive start to meeting the targets.

Barry Cowen (Offaly, Fianna Fail)
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There are 500 acres lying idle.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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The Deputy talks about whether the Government is meeting the targets that have been outlined. He might now listen to some of the targets-----

Barry Cowen (Offaly, Fianna Fail)
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There are 500 acres on the Tánaiste's doorstep.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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-----that have been met.

Pat Gallagher (Donegal, Fianna Fail)
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The Tánaiste, without interruption.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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Under the housing assistance payment homeless pilot in Dublin-----

Barry Cowen (Offaly, Fianna Fail)
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The Tánaiste does not know.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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-----810 stable and supported housing tenancies for homeless individuals were delivered by the end of 2016.

Barry Cowen (Offaly, Fianna Fail)
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She does not know the answer.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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Housing assistance payment has been introduced in nine local authority areas. At the end of 2016, 350 rapid-build homes-----

Barry Cowen (Offaly, Fianna Fail)
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Does she not know the answer?

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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-----and, wherever possible, housing was delivered by local authorities and land made available.

Barry Cowen (Offaly, Fianna Fail)
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Five hundred acres.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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As I said, 8,500 units are under way at present.

Barry Cowen (Offaly, Fianna Fail)
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She obviously does not know the answer.

Pat Gallagher (Donegal, Fianna Fail)
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I call Deputy McDonald, without interruption.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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This morning, parents across Ireland have woken up to the shocking fiasco of the spiralling costs of building the national children's hospital. They read this morning with horror that the situation has spun so far out of control that the estimated cost has ballooned from an initial €404 million in 2012 to a mind-boggling figure of more than €1 billion today. As it stands, Ireland's national children's hospital - if built - will be the most expensive children's hospital to be built anywhere in the world. This infuriating saga is now a sorry tale of bungles, incompetence and broken promises stretching across two decades. In that time, we have seen Governments led by both Fianna Fáil and Fine Gael make big announcements to the Irish people but deliver very little. Today, 24 years after the idea was first proposed in 1993, the national children's hospital is still a project wrapped in uncertainty and chaos. However, we should probably expect little else from a Government whose entire approach to health care is based on the fostering of crises, havoc and confusion. As our health system creaks, the Tánaiste's party has spent the past two weeks gazing at its navel, indulging its obsession with the question of who might be its new leader.

I have a newsflash for the Tánaiste: both Fine Gael and the Government are bereft of leaders. The abject failure to get a handle on the astronomical costs of the children's hospital and to allay the fears of parents is proof positive - if further proof were needed -of that fact.

This week, 1,486 patients have found themselves on trolleys in our hospitals and this should rightly cause shock and outrage. The truth, however, is that 500 people lying on trolleys daily has become normal under this Government. We have seen through recent "RTE Investigates" programmes the horrifying stories of children as they wait in agony for vital scoliosis surgery. On 7 March, nurses and hospital support workers will proceed with industrial action because of the stressful and unacceptable working conditions created by this Government. Through its arrogant treatment of nurses, this Government is again putting the health and welfare of our children at grave risk. Whether it is Deputy Varadkar or Deputy Coveney or anyone else in the hot seat, ordinary people have no faith in this Government to deliver a fair health service and accessible health care. Can the Tánaiste tell me how she can stand over the outrageous and spiralling costs of the children's hospital and indicate when the facility will be built?

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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There have been decades of discussion about the need for a new children's hospital and, in the aftermath of that, the country is about to get a new children's hospital that it badly needs and that the children in this country deserve. This Government has ensured that a child-friendly, high-specification, proper hospital for our children based on a world-class design will be completed.

Peadar Tóibín (Meath West, Sinn Fein)
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World-class mess.

Mattie McGrath (Tipperary, Independent)
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No helipad.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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The hospital and its satellite centres will be a research-intensive academic health care institution providing the very best of care day in, day out. This Government has ensured that a site has been selected and the works have begun on that site.

The original estimate was €630 million-----

Mattie McGrath (Tipperary, Independent)
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It is going up by €300 million.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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-----which was the core building cost of the hospital at the time. We all know that there has been building inflation. This was expected to be 3%. Everyone in this House knows it is running at 9%. That figure did not include some of the issues being spoken about at present in connection with the cost. The information technology, IT, cost was always going to have to be taken into account. There is also a new education and research centre as part of the development.

Peadar Tóibín (Meath West, Sinn Fein)
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That is another €200 million.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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That has been included and will be funded other than from that €630 million, which was the original cost of the build.

We have moved the situation to the point whereby there is clarity about the site, work has begun and people are on site doing those early jobs that are required. In addition, we have a hospital design that everybody agrees is world class. We will have a world-class children's hospital in the next couple of years. The core estimate was made when construction inflation was estimated to be 3% and, as we know, the latter is running at higher than 9%. The updated capital costs have been incorporated into the final project brief and submitted recently to the HSE and are under consideration. The Minister for Health will bring forward an updated memorandum in respect of the hospital. That memorandum will outline the new costs and full details relating to the project and will be brought forward shortly. We must not lose sight of the vision for the new hospital, which will facilitate care for the very many sick children in this country. It will cater for the 25% of the population comprising children. We need that hospital because one in four citizens is a child.

Peadar Tóibín (Meath West, Sinn Fein)
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That is over €1 million per bed.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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I am sure the Tánaiste's reference to the Cabinet as "hospital" was not deliberate. Perhaps the chaos in both has been comparable in recent days. The only thing that is clear here is that the Tánaiste is continuing to equivocate on the matter of costs. Is she happy that the children's hospital, if and when it is completed, will be the most expensive children's hospital built anywhere in the world? A new children's hospital in Finland, which is a comparable jurisdiction, will cost half what our children's hospital is apparently going to cost. What does the Tánaiste intend to do about those costs? Is the Government planning to sit on its hands again? Will it leave it to the Committee of Public Accounts to call authorities to account for spiralling costs and to account for how public moneys are spent? Everybody understands the need for the children's hospital. As I said earlier, this debate has run since 1993. The reality is that decades have passed and there is no hospital. Now we read accounts of spiralling costs that are outrageous and indefensible. I will repeat my questions. What about the costs? What does the Government intend to do about the €1 billion bill that is being presented to the taxpayer? When will the hospital be completed?

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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I have already outlined the approach that is being taken in relation to the increased costs. The Minister will bring a memorandum to the Cabinet in that regard. There has been building inflation and that has to be taken into account. Extra facilities that were not in the original plan are now being provided. I refer to the educational and research centre, for example, which will be funded from elsewhere. There will also be an input from philanthropy. The Government is committed to ensuring the funding will be available. On the subject of capital costs, it is quite clear that many of our major projects have had cost overruns. When it was proposed to develop a second terminal at Dublin Airport, there was a great deal of discussion about the site, the building and the costs, but the terminal is now there and nobody is questioning it.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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I am asking about the children's hospital and not about the airport.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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We absolutely need to have our children's hospital. Is anybody suggesting we should not go ahead with our children's hospital?

Mary Lou McDonald (Dublin Central, Sinn Fein)
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The Tánaiste should not be ridiculous.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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Of course we will go ahead with it.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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When?

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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It has already begun. It will be delivered in the near future. It will work according to the plan that has been outlined.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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So it will take another decade or two.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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As I have said, the Government has taken a decision about the site and has provided the funding.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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By the way, the Tánaiste's remarks are not answers.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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We will continue to provide the funding. That is a commitment.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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A Leas-Cheann Comhairle, the Tánaiste has not provided answers. We are getting used to this.

Pat Gallagher (Donegal, Fianna Fail)
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I have no control over the Tánaiste's answers.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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We need our children's hospital and we are committed to delivering it.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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As Minister for Justice and Equality, the Tánaiste has been getting a lot of heat recently on the question of justice, but I want to turn the heat up on the question of injustice and inequality. Two reports that were published recently by PricewaterhouseCoopers and Morgan McKinley show that the gender pay gap in this country is widening. Interestingly, the figures show that the pay gap between the earnings of men and women has increased dramatically while Fine Gael has been in government. The gap was 8.3% in 2012, but it increased to a high of 15.2% in 2015. The cost of child care in this country, which is one of the most expensive in Europe, is one of the factors contributing to this. It is supposedly planned to deliver a proper child care plan for female workers, 40% of whom are in low-paid, flexible or part-time contracts precisely because of the cost of child care. The reports I have mentioned show that 3,000 women are being driven out of the workforce each year because of the cost of child care. Another interesting fact set out in these reports is that in the last year or two, profits in the retail and hospitality sector have soared to over 40% above pre-crash levels. The workers in this sector are predominantly women. Equally, it is predominantly women who are on low pay, which is connected to low hours. It cannot be denied that as women work fewer hours on lower levels of pay, they are driven further and further into poverty and therefore the gender gap widens even further. There are scientific studies to show that this is the case.

This drives women further into poverty so the gender gap opens in this way.

I know the Tánaiste is not responsible for all those areas but she is responsible for dealing with the question of equality, and this indicates a large and growing equality gap affecting women in this country. As well as enduring discrimination in pay, hours and contracts through working life, women who are now retiring are finding their contributory pension is being cut drastically because of banding and averaging of hours. I know a couple, Paul and Pauline, who are related. Paul has half the contributions of Pauline but she earns 30% less from her contributory pension. Both of them have worked all their lives. The Tánaiste is presiding over inequality as Minister for Justice and Equality. Therein lies the injustice.

What will the Tánaiste do about the growing gender equality and pay gap? What will she do about the visible discrimination against pensioners, which is known to the Department? When they retire, they are discriminated against on two grounds: age and, mostly, gender. Women are primarily the homemakers and have been so through the years.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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The first point is about gender equality. I saw the details of the report mentioned by the Deputy and they need examination. There were quite a number of areas where it was highlighted how well Ireland is doing. In terms of child care, the Government is investing more than has ever been invested in child care. The Deputy quite rightly states that for women combining work and family life, we need access to high-quality, affordable and accessible child care, and that is what the Government is committed to doing. We have introduced the second free preschool year and we have also dealt with the very important issue of young children in preschool who need access to special needs services. For the first time, the Government has ensured those children will have access to special needs supports and assessment, which is very important. Primarily, this is about increasing the number of affordable places, and that is happening with the second free preschool year. There are more children than ever - approximately 120,000 - availing of those two free preschool years. That will be rolled out in September. There is also the matter of after-school places and the Minister, Deputy Zappone, has been doing much work in ensuring more child care is available. That will help reduce the gap that the Deputy mentions.

I refer the Deputy to another survey on income and living conditions, which indicates income inequality decreased last year. That has been going absolutely in the right direction as a result of the decisions taken in recent budgets. It is a fact that income inequality has been decreasing and one would have to go back to 2009 to see that difference.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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What are the figures?

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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I made the point earlier that the best way out of poverty and to be able to sustain one's family is having a job.

Eoin Ó Broin (Dublin Mid West, Sinn Fein)
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Tell that to the working poor. Their numbers are rising.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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I know the Opposition does not like to acknowledge it but unemployment has decreased from 15.5% to 6.8%. Perhaps that is a statistic that should be focused on. It makes a difference to people's lives if they have an opportunity to be in a job and supporting their family. Most people want the opportunity to work. Tens of thousands of people have gone back to work, so the Deputies might occasionally acknowledge that this makes a difference to the quality of people's lives and household incomes. The evidence is that income inequality has been reducing in this country and we are becoming a more equal society, albeit with much work still to do.

John Brady (Wicklow, Sinn Fein)
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Some are more equal than others.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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I remind the Tánaiste that the headline from the report I mentioned is not that this State ranks well but rather it ranks 25th of 33 OECD countries in a table illustrating overall female economic empowerment.

This is the startling fact.

The Tánaiste has just said the good news is that people have jobs, any kind of a job. Not if they are Tesco workers on pre-1996 contracts, most of whom are women. Their contracts have been arbitrarily torn up by the Tesco bosses, which is breaking the law. Will the Minister for Justice and Equality bring the Tesco bosses in here and tell them they cannot break contract law and that given that she is in charge of legislation, they are not going to rip up legislation under her nose? Will she defend those workers who are out on the picket line daily, in lashing rain, standing steadfast in solidarity with those 250 people, mainly women, who are being discriminated against? Again, I call on everybody who gives a damn about justice, equality and solidarity to get down to the picket lines at Tesco on Saturday at 12 noon to support the workers and insist that Tesco will not get away with breaking the law, as it is doing, on the Minister's watch.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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I have been highlighting a range of actions which we need to take, and are taking, to deal with the Deputy's point about the gender pay gap. By this series of actions, we will arrive at a point when there is more equality on the gender pay gap. Many things can be done. Reversing the cuts to the minimum wage makes a difference. Promoting wage transparency by requiring companies with more than 50 employees to complete wage surveys and giving a strengthened role to the Low Pay Commission regarding the gender pay gap all make a difference, as well as what I said about child care.

Regarding Tesco, we appeal to, advise and encourage the parties to use the offices of the Workplace Relations Commission, WRC, and Labour Court. That is where this will be dealt with.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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Tesco is breaking the law.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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Tesco is breaking contract law.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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We want management and unions to continue to work together to find a solution. That is what will happen in this dispute, the same as every other dispute.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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The Government has nothing to do with it.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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What about the law?

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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We have a good history in hundreds and thousands of situations of using the WRC and the Labour Court, and this is clearly what needs to happen in this situation.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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The law is the law.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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The Tánaiste can make history, step in and do something about Tesco breaking the law.

Thomas Pringle (Donegal, Independent)
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I have raised the issue of diabetes care many times in the House. Despite that not much investment is needed, diabetes treatment seems to be left idle. We spend €1.3 billion per year on diabetes treatment, €800 million of which is spent on treating the complications of the illness. This €800 million could be significantly reduced with proper management of diabetes care. It is not often that savings can clearly be made in health spending. Proper care of diabetes is one of these opportunities.

In Donegal, of 666 adults with type 1 diabetes, only 20 attending Letterkenny University Hospital have access to an insulin pump. This week, I received a letter from a constituent who, after living with diabetes since he was eight years old, was approved for a pump. However, Sligo University Hospital is the only place adults from Donegal can have a pump fitted. Letterkenny University Hospital does not have staff to fit pumps. My constituent was delighted to get a quick appointment for Sligo hospital and even more when he was told his pump would be fitted before the end of January this year. Given that he was due to start a new job in Scotland on 1 March, the timing could not have been better. However, ten days ago he received a call from Sligo telling him the diabetes nurses hours had been cut by 15 hours per week and that they could not now fit his pump. There are seven insulin pumps in Sligo that will not be fitted and that are gathering dust at a cost of €4,700 each. In his letter, he said:

I can go to Dublin and have a pump fitted privately, but I won't, and it's not because of the money. I should not even have to go to Sligo. These services should be provided here in our local hospitals where they have all our history and the staff know us. I have now lost a great career opportunity in Scotland because of this, as I need the security of the insulin and the blood glucose sensor before starting my job and this opportunity is now gone.

As the Tánaiste knows, there is little hope of this man getting a job in Donegal. The Government has made many claims that health spending is at record levels.

No doubt the Tánaiste will quote that back to me in response to this question. Despite this, we see the hours of diabetes nurses in Sligo University Hospital being cut, meaning that insulin pumps that would save the health services money are not being fitted and, due to staffing shortages, the pumps cannot be fitted in Letterkenny University Hospital either.

What will the Tánaiste say to Ciaran, the writer of that letter, and to the six other patients who have not had their pumps fitted? Why is it, when savings can clearly be made in the health service through proper management of diabetes care, the Government will not make the resources available to ensure the proper management of this disease?

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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I will ask the Minister for Health to communicate directly with the Deputy on this situation in Donegal around patients who have diabetes. The Minister will be able to give a detailed reply on the particular local issues in Donegal and Sligo for those cases highlighted by Deputy Pringle today.

The goal is to provide high quality service to patients, such as those the Deputy has described, in their own homes or with local services and local GPs where possible, as opposed to having to travel farther to get those services. The Government has made a commitment to ensure those services are available and this is reflected in the highest health budget that has ever been agreed, at €14.6 billion. This demonstrates the Government's commitment to ensure patients, such as those described by Deputy Pringle, will have those services available to them.

There are issues around recruitment. The Deputy highlighted the subject of the nurses in the area and every effort is being made to recruit more nurses. The initiatives being undertaken by the Minister, such as the bed capacity review which is under way, the increased budget, the new GP contract and the recruitment campaign, are to make sure we have the kind of local health services that are needed. We also have the all-party committee working on the ten-year plan for the health services and this is due to be received in April this year. Additional funding of €18.5 million has been given to primary care centres, including enabling the support of various paediatric cases and the type of situation specialist intervention that is needed for diabetes. Clearly, every effort has been made to make sure services are available locally for specialist conditions such as diabetes. The new GP contract will ensure there is an even more flexible service available to people in local areas and given by GPs.

I will ask the Minister for Health to liaise directly with the Deputy on the situation in Donegal, but with regard to the overall approach to development and making sure people have the very best health services, I have outlined to the Deputy the various initiatives the Minister is taking to arrive at that situation. There is ever-increasing demand on our health services, as the Deputy knows, but equally there has been an ever-increasing budget to meet that demand.

Thomas Pringle (Donegal, Independent)
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I welcome that the Minister will make contact with regard to the local issues, but that is only part of the problem. The Tánaiste has outlined the record spending, and I anticipated this response to my question. The issue, however, is not about staff in Sligo University Hospital but about the hours of the staff being cut. It is not a recruitment issue but rather bad management, bad planning and complete neglect by the Government and the HSE in dealing with these issues. Installing the pumps for patients will save money. It is clearly outlined. Some €800 million per year is spent on dealing with problems from lack of treatment and lack of management. All these problems can be prevented by proper management and treatment. This is what is necessary for people. The Tánaiste's response about the record levels of spending will ring hollow to those who are without diabetes pumps. They rely on the pumps, which means they do not have the security to be able to get a job when they are without the pumps.

In 2017, there will be 11 children in Letterkenny University Hospital who will transition into adult services for diabetes care. There is a waiting list of 21 months for an appointment to see a consultant. This is unacceptable. All the Tánaiste's talk of extra funding makes no difference to those people's lives.

Frances Fitzgerald (Dublin Mid West, Fine Gael)
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The Minister for Health is also taking an initiative with the National Treatment Purchase Fund to ensure waiting lists can be dealt with more effectively than at present.

It is an extra initiative to ensure that patients' needs are responded to. While I do not have the details, I will ask the Minister to link with the Deputy. Clearly, the focus is on recruitment and there has been a change in regard to trying to recruit more staff on permanent contracts as opposed to agency staff. That may account for the situation the Deputy has described concerning nurses in the local area. I will ask the Minister to come back to the Deputy about that change in regard to the nurses because I do not have the details.

I want to assure the Deputy that the focus is on recruiting permanent full-time nurses who will be in a position to deliver the kind of services he has outlined. Every action is being taken. It is an international problem in terms of trying to recruit and retain nursing staff. The Minister has taken every action possible and has shown as much flexibility as he can in the context of ensuring that we can recruit new nurses.