Micheál Martin (Cork South Central, Fianna Fail)
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As the Taoiseach is aware, before the summer break the Attorney General advised the Government that it could not proceed with legislation to give effect to the people's decision to repeal the eighth amendment. Those cases have taken their course. Will the Taoiseach now confirm when the Government intends to publish the full Bill and when we can expect to take the Bill in this House?

Leo Varadkar (Dublin West, Fine Gael)
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As Deputy Martin is aware, the courts have made their decision, the referendum has now taken effect and the Constitution has been changed. I checked with the Minister for Health and I think we can have the Bill before the House in the first week in October. I will double-check but we are on target to meet our timeline of having the legislation through both Houses before the end of the year so that the new services can be made available in the new year.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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This weekend the President of the Palestinian Authority, Mahmoud Abbas, will make an historic first state visit to Ireland on his way to a meeting of the UN General Assembly in New York. I warmly welcome the President's visit and I hope it will be a very productive one. I understand that in a meeting with the Tánaiste on Saturday evening there will be a focus on a number of issues, not least the ongoing illegal blockade of Gaza, and the State's recognition of the state of Palestine, which is now long overdue. A Sinn Féin motion to that effect was passed by the Dáil in 2014 and the Seanad did likewise.

The Taoiseach will recall that there is a commitment in the programme for Government and yet he continues to drag his heels on this matter.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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I thank Deputy McDonald.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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Now is the time for us to afford the official recognition to the state of Palestine, which is the agreed position of the Oireachtas and a necessary one in international terms.

Leo Varadkar (Dublin West, Fine Gael)
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The programme for Government says that we support the Palestinian state - and we do - and that we intend to recognise the state of Palestine as part of a two-state solution. An agreement between Israel and the Palestinian Authority to bring that about has not yet happened.

We are working on the diary at the moment, and if I have the opportunity to meet President Abbas myself, I will do so. He will certainly meet the Tánaiste. I will use that opportunity to reaffirm our support for a Palestinian state as part of a two-state solution, and I will also use the opportunity to raise other concerns about democracy and human rights in the Palestinian territories, in particular, for example, the fact that homosexuality has yet to be decriminalised in Gaza. It is important that when we meet representatives of the Palestinian Authority and other Palestinian groups, we support their demand for self determination but that we are not afraid to raise serious issues concerning the violation of human rights in the territories that are controlled by the Palestinian Authority and Hamas.

Brendan Howlin (Wexford, Labour)
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The UK Supreme Court ruled at the end of August that the exclusion of cohabitees from claiming widowed parent's allowance was discriminatory on the basis of marital or birth status.

Siobhan McLaughlin and her partner whom she never married lived together for 23 years and had four children together. The widowed parent's allowance in Northern Ireland is payable to widowed men and women with dependent children. In spite of Siobhan McLaughlin fulfilling the required conditions and her partner having made the necessary contributions to the UK authorities, her application was refused. The courts in Ireland may now interpret the paramount interests of the child under the European Convention on Human Rights in the same way as the Supreme Court in the United Kingdom. Has the Government considered this important ruling and does it plan to change the relevant law here to ensure the rights of citizens are fully compatible with the European convention?

Regina Doherty (Meath East, Fine Gael)
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The Government will reflect on the ruling in the United Kingdom, but it is a ruling that affects that jurisdiction. Our laws are different. However, we are reflecting on the ruling and will make a decision on the matter.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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In July the Department of Health produced guidelines for the medicinal cannabis access programme which was first mooted in January 2017, almost 20 months ago. No progress has been made since. The guidelines have been welcomed by patients and doctors and provide some clarity in what is an extremely confusing situation for those who wish to access medicinal cannabis. I ask the Taoiseach to show leadership and say when the medicinal cannabis access programme will be implemented. No progress has been made since it was proposed 20 months ago. If it cannot be implemented, the Government should look to the Cannabis for Medicinal Use Regulation Bill 2016 I put forward and which the majority of Members in this Dáil voted to progress in October last year. The Government must do one or the other. It must provide clarity for patients, doctors and others on whether the programme will be implemented.

Leo Varadkar (Dublin West, Fine Gael)
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I understand from the Minister for Health, Deputy Simon Harris, that people may apply to him for a licence under the Misuse of Drugs Acts 1977 to 2016 and the regulations and orders made thereunder. Guidance on who may apply for a licence under the Misuse of Drugs Acts, as well as instructions on how to apply, can be found on the website of the Department of Health. To date, ministerial licences have been issued for the treatment of nine patients on receipt of valid licence applications from their clinicians.

On the medicinal cannabis access programme, Department of Health officials are working intensively on the issue to ensure supply of appropriate medicinal cannabis products from other EU member states and further afield to meet the need of patients. However, the Department has no control over business decisions taken by product manufacturers and no powers to compel such companies to supply their products to the Irish market. Until cannabis product producers make their products available in Ireland, it will be a matter for the prescribing doctor and the patient to source the prescribed medical cannabis product. Clearly, that is unsatisfactory. However, it is understood patients who have been prescribed such products under ministerial licence have been able to source them from a pharmacy in the Netherlands.

Danny Healy-Rae (Kerry, Independent)
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The health service is in a shambles. People have totally lost confidence in the service in County Kerry. There have been no hip replacement or orthopaedic procedures carried out in County Kerry for at least four months. People who need a hip or knee replacement are in significant pain. The ear, nose and throat section of University Hospital Kerry in Tralee is currently closed. People awaiting a hospital appointment in Cork are choking and afraid to sleep at night. Each day 25 patients on trolleys are awaiting attention in University Hospital Kerry. People are waiting to see consultants who are not even there. We have a Taoiseach, a Tánaiste, a Minister for Health, three Ministers of State at the Department of Health and a Government, but we have no proper health service for the people of County Kerry. That is unfair. The Government is allowing the HSE to blackguard the people of County Kerry and not give vulnerable people the service they deserve. Deputy Leo Varadkar is the Taoiseach and ultimately responsible for this situation, but he is doing nothing about it. The health service is failing the people I represent.

Leo Varadkar (Dublin West, Fine Gael)
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I am afraid I do not have specific information relating to University Hospital Kerry in front of me but I will certainly ask the Minister for Health, Deputy Harris, to provide the information to the Deputies from Kerry, or perhaps it could be raised as a Topical Issue matter.

For the information of the House, when it comes to operations and procedures, it is one of the areas where we are seeing some real progress. The number of people waiting for a procedure - hips, eyes, cataracts, knees and angiograms - is down on this time last year and 59% of patients are now waiting less than six months for those procedures, so it is one of the areas, unlike outpatients, unfortunately, where we are seeing some real progress.

I can also confirm to the House that, this morning, the Cabinet approved the appointment in principle of a new chairperson for the new board of the Health Service Executive, Ciarán Devane, who is a former member of the board of NHS England, and chief executive officer, CEO, of the British Council. He is somebody who has experience heading up a cancer charity and has degrees from both University College Dublin and the George Washington University. I believe it is a very positive appointment and he will go before the Committee on Health for confirmation.

Danny Healy-Rae (Kerry, Independent)
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Appointments for-----

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Please, Deputy. I call Deputy Eamon Ryan.

Eamon Ryan (Dublin Bay South, Green Party)
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Earlier this summer, Deputy O'Connell and the Minister for Housing, Planning and Local Government, Deputy Eoghan Murphy, supposedly had daggers drawn over the development of the Dublin metro. Later in the summer, I happened to be at a public meeting where the Minister, Deputy Eoghan Murphy, and the Minister of State, Deputy Catherine Byrne, who is sitting behind him, had an upfront, full-scale public row on how we would develop St. Michael's Estate in Inchicore. I read that the Minister, Deputy Catherine Murphy, said that Cathal Brugha Barracks would be used as a potential site for public housing, with which I agree and for which this House voted, only to read on Sunday that the Minister of State, Deputy Kehoe, said they can go to Mullingar.

In terms of my question, I welcome that the people of Cork have been given a chance to vote for a directly elected mayor of their city. I would like to know the process for doing that, but why is the Minister leaving the people of Dublin out and leaving our city with chaotic leadership and no co-ordination of transport, housing, planning and development? He is here saying that Dublin City Council should be doing something on the vacant sites levy. Allow it to do it by allowing us to elect a mayor so that we can have leadership of our city rather than have Fine Gael internal rows everywhere and letting the city go into gridlock and a housing crisis, which is what the Minister is doing. Where is our mayor for Dublin?

Leo Varadkar (Dublin West, Fine Gael)
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Perhaps if Deputy Eamon Ryan's party had more than two Members, there would be more disagreements within his party group. I can assure him that when one has 70 public representatives, or whatever the number is now, there will always be a degree of disagreement among members, and as somebody who does not lead with an iron fist, I allow for it. Sometimes one has to allow for people to have differences of opinion within political parties, but the decisions we make will always be the ones that are in the best interests of all the people and not any section of the people or any particular constituency.

The Minister of State, Deputy John Paul Phelan, will bring forward proposals on directly elected mayors in this session. The rough idea at the moment is to hold plebiscites in Cork, Limerick, Galway and Waterford to ask the people if they would like to have a directly elected mayor.

Eamon Ryan (Dublin Bay South, Green Party)
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And Dublin.

Leo Varadkar (Dublin West, Fine Gael)
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Dublin is different. Dublin is complicated by the fact that we have four local authorities-----

Eamon Ryan (Dublin Bay South, Green Party)
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No leadership.

Leo Varadkar (Dublin West, Fine Gael)
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-----and the proposal to have a fifth mayor - a sort of mayor of mayors, super mayor or chair of the mayors - is not one I believe would bring about better governance in the city of Dublin.

Eamon Ryan (Dublin Bay South, Green Party)
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The Taoiseach spoke in favour of it when he was in opposition, as did the Minister, Deputy Eoghan Murphy.

Leo Varadkar (Dublin West, Fine Gael)
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What we propose to do is something different, which is a citizens' assembly to ask the citizens of Dublin how best they would like to see the local government in Dublin reformed. I personally like the Paris and London model, which is a single authority with a small number of full-time assembly members, a powerful executive mayor and, below that, many local councils like boroughs that people would really identify with. I refer to places like Lucan, Blanchardstown, Castleknock, Dún Laoghaire or Dundrum-----

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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Balbriggan.

Leo Varadkar (Dublin West, Fine Gael)
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-----but maybe I am wrong. Let us ask the people of Dublin, not just the politicians.

John Curran (Dublin Mid West, Fianna Fail)
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Yesterday, I went to visit a family in my constituency where I met a boy by the name of Sam. Sam is eight years of age and suffers from spinal muscular atrophy, which is a degenerative neuromuscular condition.

Sam is in a powered wheelchair. His mother explained that he is PEG-fed - that stands for percutaneous endoscopic gastrostomy - and does not eat or drink orally. Extensive physiotherapy on his chest and on all his limbs to keep him supple and free from pain are part of his everyday routine. He has endured so much in his short life. He has had long hospital stays, sometimes for weeks and months at a time, largely because of chest infections.

Sam's mother went on to say, however, that his condition is not without hope and that there is a drug that is available in up to 20 countries around Europe but not in Ireland. That drug is Spinraza. I understand there are 20 families and 25 children in this country suffering with SMA from whom this drug would be deemed to have a positive effect.

SMA is a degenerative condition and timely intervention is very important. While I understand that the Government is looking at making this available, I am concerned that the period of consultation is taking a long time. It is young children who are involved. I appeal to the Taoiseach not to hide behind bureaucracy and procedure. I appeal to the Minister of Health to engage actively with these families.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Deputy Lisa Chambers on the same matter.

Lisa Chambers (Mayo, Fianna Fail)
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On Thursday, the families, friends and supporters of children suffering with spinal muscular atrophy, SMA, will demonstrate outside the gates of Leinster House to make sure we are all aware of the suffering their children are dealing with. Yesterday, I met one of the children, Cillian, and two of the families in my constituency who are affected by this terrible condition. They know it is a costly drug. They appreciate that there are other demands on Government. They have yet to receive any correspondence or response from the Minister for Health, however, whom they have tried to contact and who has failed to meet or respond to them. I am asking that the Taoiseach relay to him that he might respond to those families. They are also aware that this drug is not only a game changer but will transform the lives of their children. It is clinically effective and has been proven to work. It is available in more than 20 other countries and should be available here. I ask the Taoiseach to contact those families and for his Minister for Health to do the same. I also ask that he approve the drug without delay.

Leo Varadkar (Dublin West, Fine Gael)
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I know this is a very stressful and worrying time for people with spinal muscular atrophy and their families. I know the day-to-day challenges these people and these patients face in dealing with a progressive and life-limiting illness. It is important to say that this is not a political decision. Deputies should note this if they do not know it and I hope they do not tell anyone otherwise. It is not a case of anyone hiding behind bureaucracy. It is the law. This is not a political decision. Politicians do not sign off on which drugs are reimbursed and which are not.

The European Medicines Agency granted market authorisation in May 2017 and in October 2017 the HSE received a reimbursement application. The National Centre for Pharmacoeconomics, which is an independent expert body made up of doctors and pharmacologists, conducted a full pharmacoeconomic evaluation and did not recommend that the drug be reimbursed due to efficacy and cost. The application is being processed by the HSE's national drugs committee. No final decision has been made as yet and it is always open to the manufacturer to produce new evidence or a different cost profile that would allow the drug to be approved. So far this year, 23 new medicines have been approved for reimbursement.

Tony McLoughlin (Sligo-Leitrim, Fine Gael)
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This may also be an issue for the Minister for Health. My question concerns a timeframe in respect of the new mental health unit at Sligo University Hospital. It is vitally important. I met quite a number of people over the summer who have been lobbying to ensure this would be an urgent case. I ask that we would get a timeframe as a matter of urgency.

Leo Varadkar (Dublin West, Fine Gael)
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I thank Deputy McLoughlin for raising this important issue. As he will be aware, the capital budget for health increased this year and will increase again next year. In excess of €10 billion has been set aside for investment in new buildings, new equipment and ICT in our health service over the next ten years. As is always the case, it is not possible to complete every project this year or next so it will have to be profiled. I will ask the Minister for Health to give the Deputy an indicative timeline if he has one.

Imelda Munster (Louth, Sinn Fein)
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I wish to raise the setting up of the land development agency, the latest quango. I will give an example which I am sure could be replicated in every county across the State. Louth County Council has 50 acres of council-owned landbanks which would provide 1,000 social and affordable housing units, should the political will be there to fund them.

Under the Government's latest quango, those 50 acres will only deliver 100 social houses and 300 affordable houses or, as it now appears, unaffordable houses. In essence, the Government's land development agency will deprive the citizens of Louth of 600 social and affordable houses on council-owned land banks. Why does the Minister for Housing, Planning and Local Government feel the need to set up a quango that he knows will not deliver, and has no intention of delivering, any meaningful volume of social and affordable housing when he is doing such a perfectly good job himself? Is it because he can hide behind it? Is that why he wants to set it up?

As our housing crisis deepens, will the Taoiseach tell me why he and his Government refuse point blank to fund a State-wide social and affordable house building programme when he knows the misery the housing crisis is causing families across this State day in, day out? Will he give me straight answers to the questions about the quango and funding?

Eoghan Murphy (Dublin Bay South, Fine Gael)
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I thank the Deputy for the question. For decades, we have had the wrong approach and attitude to the use of land in the public interest. As a result of that dysfunctional relationship, we have seen violent and dramatic swings in our housing sector that have hurt many people up and down this country, for example, ten years ago when the crash arrived and today. We know there is an unacceptable number of people in homelessness. This Government has a dedicated social house building programme. The Taoiseach referred to it earlier. A total of 110,000 homes will be built over ten years under Rebuilding Ireland and Project Ireland 2040. It is improper of Deputy Munster to mislead the public and the Dáil by saying that public houses are not being built because they are being built.

Imelda Munster (Louth, Sinn Fein)
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Less social and affordable housing will be delivered. That is a fact.

Joan Burton (Dublin West, Labour)
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Fine Gael's friends, the developers, are back in-----

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Could we have order for the Minister to respond?

Imelda Munster (Louth, Sinn Fein)
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The Minister accused me of misleading the Dáil.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Deputies do not have to agree with what the Minister says.

Imelda Munster (Louth, Sinn Fein)
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I want him to correct that statement.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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The Minister has been asked a question. All Members deserve the courtesy of being able to reply. Members do not have to agree with them but please allow them to reply.

Eoghan Murphy (Dublin Bay South, Fine Gael)
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The land development agency is in the public interest. The State will be the developer of public lands, not the private sector. We will bring forward State land for houses for the general public - social housing, subsidised housing and housing for people up and down the country who need homes. It is important to state that where a local authority has land, that is not our interest. This land is for the local authority to build social and affordable housing on. Louth County Council has been given the policy, powers and money to build housing. We are publishing the targets for those local authorities. It is for the local authorities to do that. A total of €6 billion was ring-fenced in 2017.