Tuesday, 26 April 2022
An tOrd Gnó - Order of Business
The report of the Business Committee has been circulated and can be taken as read. In accordance with Standing Order 35, I call on the Government Chief Whip to move this week's Order of Business.
I want to raise a very serious matter that has been raised by Deputy Catherine Murphy. It concerns the facts that the finance committee wrote to Mr. Robert Watt, Secretary General of the Department of Health, that it has actively sought information pertaining to the proposed secondment of Dr. Tony Holohan to Trinity College Dublin and that it has sought all the information pertaining to the clearance of up to €20 million in public moneys associated with that move. It also concerns the facts that the Department has not provided that information, that the Minister and indeed Mr. Watt himself refused to appear before the committee and that the committee has now written for a second time to the Secretary General of the Department of Health.
This makes a mockery of the business we do. It is wholly unacceptable that a Minister or senior civil servant not only refuses to co-operate with a committee of this House but also acts to actively frustrate its work. We need a substantive response from the Taoiseach on this matter to make it very clear to his own ministerial team and, perhaps more important, the public administration — senior civil servants, including Mr. Watt himself — that Mr. Watt has no authority or role in frustrating the work of any committee, the committee in this case being the finance committee of this House.
I wrote to the Minister for Housing, Local Government and Heritage, Deputy Darragh O’Brien, last week on foot of his request for suggestions on how we should deal with the ongoing housing emergency while at the same time providing the accommodation needed for Ukrainian refugees. I outlined detailed proposals and asked that we discuss the issue this week. We now have a housing emergency on top of a housing emergency; it is a matter of vital urgency. If the Minister is asking for opinions — I have certainly furnished mine — we need to debate them. I understand he has briefed the Cabinet on proposals. Are we going to discuss this matter? I think we can have a win–win whereby we seriously impact upon the housing and homelessness crisis and accommodate Ukrainian refugees, but it will take unprecedented emergency measures. These need to be debated as a matter of urgency in this House. I appeal to the Taoiseach to make time available this week to have that discussion.
As the Ceann Comhairle knows, I have been asking at the Business Committee for weeks to have a full and comprehensive debate on agriculture, including the pig industry – you name it. The Taoiseach said earlier that he believed we would come back relaxed after Easter. We would be only for the Mutt and Turf Show and the Minister for the Environment, Climate and Communications, Deputy Eamon Ryan, talking on every radio station about locking up grannies and anybody who gave a bag of turf to their neighbours. We need a full debate on agriculture and the attack going on in rural Ireland. The Taoiseach seems to think it is doing grand and he acknowledged that he burned turf himself, but we want a debate on this. It is the Government that created this mess. The Tánaiste said banning turf was like taking wine off the people in France, which is kind of a nice catchphrase, and the Taoiseach said he would pour oil on troubled waters. Then we heard some expert on RTÉ the other day saying we were burning wet turf. With a gallon of petrol, you could not burn a sod of wet turf. The Government is on a different planet. We need a debate here on agriculture and all things rural.
-----that I say it because they want to believe people will be stopped. It is a great campaign; it is fantastic. Keep running it on, lads. Keep jumping up-----
However, the substance of the issue is this: people who have their own bogs have no issue in terms of using turf.
They can share turf with their neighbours. The traditional practices regarding turf will continue. This winter there is no issue at all. All of the arguments have been that now is not the time and it should not happen this winter. It will not happen this winter anyway in terms of timelines. I have to make that point. I apologise to Deputies. I want to have a sense of perspective about this, but some Deputies do not want to entertain that at all. That is fine. They are over the top in terms of their presentation.
In terms of Deputy McDonald's points, I dealt with that in my response. The Minister is not refusing to go before any Oireachtas committee. I have made that point. We need to identify which committee, or whatever the Oireachtas wants to decide regarding that. Ministers are clearly aware of their responsibilities in that regard. An external review is under way. That is my view. It is a matter to be resolved. I do not know which committee will deal with it, or if a number of committees will deal with it.
The substantive point is the more relevant point on the Order of Business. People raise issues on the Order of Business normally to change the Order of Business in terms of debating time and getting more hours. I thank Deputy Boyd Barrett for responding to the Minister's request for submissions on the Ukrainian crisis. We have six hours of debate on legislation this week. If Deputies are agreeable, we could agree to a debate on this issue next week. We should have a substantive debate on it, and I would welcome that.
Cathal Berry, Colm Brophy, James Browne, Richard Bruton, Peter Burke, Mary Butler, Thomas Byrne, Jackie Cahill, Ciarán Cannon, Joe Carey, Jennifer Carroll MacNeill, Jack Chambers, Niall Collins, Patrick Costello, Simon Coveney, Barry Cowen, Michael Creed, Cathal Crowe, Cormac Devlin, Alan Dillon, Stephen Donnelly, Francis Noel Duffy, Bernard Durkan, Damien English, Alan Farrell, Joe Flaherty, Charles Flanagan, Seán Fleming, Norma Foley, Brendan Griffin, Simon Harris, Seán Haughey, Emer Higgins, Heather Humphreys, Paul Kehoe, John Lahart, Brian Leddin, Josepha Madigan, Catherine Martin, Micheál Martin, Steven Matthews, Helen McEntee, Michael McGrath, Joe McHugh, Aindrias Moynihan, Jennifer Murnane O'Connor, Denis Naughten, Hildegarde Naughton, Malcolm Noonan, Darragh O'Brien, Joe O'Brien, Jim O'Callaghan, James O'Connor, Willie O'Dea, Patrick O'Donovan, Fergus O'Dowd, Roderic O'Gorman, Christopher O'Sullivan, Pádraig O'Sullivan, Marc Ó Cathasaigh, Anne Rabbitte, Neale Richmond, Michael Ring, Eamon Ryan, Matt Shanahan, Brendan Smith, Niamh Smyth, Ossian Smyth, David Stanton, Robert Troy.
Chris Andrews, Ivana Bacik, John Brady, Martin Browne, Pat Buckley, Holly Cairns, Matt Carthy, Sorca Clarke, Michael Collins, Catherine Connolly, Rose Conway-Walsh, Réada Cronin, Seán Crowe, David Cullinane, Pa Daly, Pearse Doherty, Paul Donnelly, Dessie Ellis, Kathleen Funchion, Gary Gannon, Thomas Gould, Johnny Guirke, Danny Healy-Rae, Michael Healy-Rae, Brendan Howlin, Claire Kerrane, Pádraig Mac Lochlainn, Mary Lou McDonald, Mattie McGrath, Denise Mitchell, Imelda Munster, Catherine Murphy, Paul Murphy, Verona Murphy, Johnny Mythen, Gerald Nash, Carol Nolan, Cian O'Callaghan, Richard O'Donoghue, Louise O'Reilly, Darren O'Rourke, Ruairi Ó Murchú, Aodhán Ó Ríordáin, Maurice Quinlivan, Patricia Ryan, Duncan Smith, Brian Stanley, Pauline Tully, Mark Ward, Jennifer Whitmore.
The Minister for Health and the Secretary General of the Department of Health, Mr. Robert Watt, have both refused - refused - to attend the Oireachtas committee on finance. Furthermore, the Secretary General has failed to furnish that committee with documents it has requested; in fact, he has not even given it the courtesy of a response. I have in my hand a copy of the latest letter from the committee to the Secretary General, in which the committee Chair notes the lack of engagement and the apparent unwillingness to discuss and clarify matters of significant public concern. I put it to the Taoiseach earlier and I put it to him again that this is just unacceptable behaviour.
The Deputy keeps saying the Minister for Health has refused. The Minister for Health this morning said publicly that there is no question but that he will go before a committee.
The Deputies are interrupting again. The truth is simple. I repeat it for them again. The Minister for Health has said there is no question but that he will go before the finance committee or any other committee that asks him to go before it.
He has helpfully suggested that there is an external review, an external independent review which the Deputy and other Members of this House asked for - it always moves on, of course - and that when that has happened and has been concluded, he believes a better conversation could be had before the committee. That is all.
It is completely unacceptable that anybody would try to interfere with the proper workings of the House. It is also unfair and unacceptable that the time criteria set out would be frustrated either. All of it is unacceptable.
I raise with the Taoiseach the issue of ongoing concerns about the independence, ownership and governance of the new national maternity hospital in light of recent reports by Jennifer Bray and by Justine McCarthy that the HSE board has approved the legal framework and constitution of the new hospital, yet two members of the board have dissented from that decision due to unresolved concerns. I note Dr. Peter Boylan, who wrote today in The Irish Times,has suggested that the term “clinically appropriate” will be used in the national maternity hospital designated activity company document to qualify the obligation to provide all medical treatment to women, including abortion services. Will the Taoiseach give a commitment to bring the final documentation before the Oireachtas and before the Oireachtas Committee on Health before it can be signed off? We need to ensure there is a commitment that all the necessary treatments that women require for our reproductive healthcare will be met in the new national maternity hospital and that there will be no qualifying words which might restrict the availability of necessary medical treatments in the hospital.
They will be met and they will be provided. All procedures that are legally available in the State will be provided. The memorandum has not yet come to the Government. It will have to come to Government. It will go before the Oireachtas. We need a new maternity hospital.
Well, it is not agreed, because it has gone on for years, and the pace of construction of new hospitals has not been the strongest area, to be straight about it. Many hospitals that have been built have taken an inordinate amount of time to commission and develop, with arguments about them. I remember that Tallaght hospital took an inordinate length of time back in the 1980s or 1990s. There is another side to this story as well. I do not think that women are being well served by the conditions and the quality. I am not speaking of the clinicians but of the current physical surroundings.
I hope the Taoiseach is aware that Cork has the worst children's disability services in the country. Families are not coping seeing their children deteriorate with the lack of services. There are no words for the suffering families are enduring, not to mind the State’s neglect of children with disabilities. Progressing disability services has failed. Children are worse off than they were before reconfiguration. Not only are these children’s rights being denied, their capacity to live full, independent lives is being removed by the State. A key cause of this is lack of accountability. It is disgraceful that children's disability managers refused to meet the Cork parents' advocacy network and others. Yesterday, we learned these managers also will not meet the Minister of State with responsibility for disability. Where is the accountability? What is the Taoiseach doing in response? In particular, what is he doing to address the disgraceful lack of children’s disability services in Cork?
First, there have been huge advances over time in disability services across the spectrum, in education in particular, compared with how they were. Progressing disability has caused issues in respect of a dilution of services. One of the key areas that need expansion - we have provided the resources - is the provision of therapies. Special needs assistant, SNA, provision, for example, has grown exponentially and dramatically over the years. Resource teaching has grown dramatically over the years. When making an assessment, all that has to be factored in as well. It is the area of therapists and the relationship between progressing disability services and the education services where it is not satisfactory at the moment.
Yesterday, the Minister for Health announced that IVF will be funded by the public system in 2023. For many couples, of course, that is a very welcome announcement. If it happens, it will mean that Ireland is no longer the only country in the EU without any public funding for IVF. It would mean that access to this fertility treatment will no longer be reserved for those who either have enough money or for those who are willing and able to go into substantial debt.
However, I do not want to hold my breath about it, because we have heard this before from the then Minister for Health, Leo Varadkar, in 2016, it is in Sláintecare, it is in the programme for Government, and there has been precious little progress. I am asking the Taoiseach for a guarantee that this will actually happen in 2023 as well as for a timeframe for when that will be within that year. I am also asking for a commitment that sufficient funding will be provided for the public system to ensure it can be done publicly as opposed to being outsourced to private, mostly for-profit, providers.
To be fair to the Minister, Deputy Donnelly, in the area of women’s health, he allocated €31 million in the previous budget for new developments to support women's health. There was additional funding for the national maternity strategy into 2022 and beyond, access to contraception for women between 17 and 25, further developments in menopause care by an increase in the number of specialist menopause clinics from one to four, and increased investments in sexual assault treatment units and a range of other developments. Therefore, the Minister has form in showing his commitment by securing funding. He intends to roll out a model of care for infertility that will see the introduction of advanced assisted human reproduction treatments, including IVF, in the public health system. The Minister plans to commence this in 2023. That is his commitment.
The Taoiseach is aware that the next round of national wage negotiations are likely to get under way shortly. He is also aware that the Commission on the Defence Forces recently recommended that both PDFORRA and RACO should be permitted to associate with the Irish Congress of Trade Unions, ICTU, should they wish to do so. I note PDFORRA has been calling for this for years. Last week, RACO balloted its members, 85% of whom indicated this is something they wish to pursue. Will the Government allow PDFORRA and RACO to associate with ICTU before the next round of pay talks? If so, when are we likely to get that permission?
That matter will be considered by the Minister and subsequently overall by the Government. We also need to think it through as to what is in the best interests of the Defence Forces in terms of pay and conditions. The commission has finished its work. In keeping with the commitment in the programme for Government, the Minister for Defence will now consult the Minister for Public Expenditure and Reform on the establishment of a permanent pay review body. I would like to discuss further with Deputy Berry the best way that would be optimal for the rank and file in our Defence Forces. Just joining may not necessarily result in that in the short term. We need to look at that base and so on and make sure we can create a better situation for overall pay and conditions for the Defence Forces.
The Taoiseach and all Members know the past two years have been a torrid time for both young and old. It has been particularly torrid time for children with additional needs. I am asking the Taoiseach about St. Rita's in Clonmel, which is a respite centre for the holiday period.
There are people in Tipperary and many other areas of the south east who need certainty as to whether they will have a place to go to during the summer to get care. These centres do fabulous work and provide fabulous supports for these children and their families. I am interested in St. Rita's in Clonmel in particular.
I would like to return to the issue of the National Maternity Hospital. The Taoiseach's earlier response was that a memo has not gone to Cabinet yet. He said that when it does, it will then go to the committee or the Dáil. I would like the Taoiseach to be very clear to me now. When it goes to the committee or the Dáil, will the decision have been made by Cabinet?
In his reply, the Taoiseach talked about the delay. All of the women in this House, as well as male Deputies, are unhappy with the delay but it was not caused by debate or questions raised in the Dáil which actually led to a better outcome in terms of clarifying matters on foot of what was raised with us by concerned doctors. The Taoiseach went on about delays but where are we at with this? Is it a foregone conclusion now, notwithstanding our concerns, three motions passed unanimously by the Dáil and the concerns of the two female dissenters on the board? Most specifically, is it open to change when it comes before the Dáil?
The board has made a decision. That is my understanding. When a board meets, there can be people with different perspectives but when a board decides, a board decides. That is how boards work.
I know. I am making a point and challenging some of the assertions. People can have different views but when a board decides, it decides, by a majority or whatever-----
As the Taoiseach knows, from 1 May, the south east will have a technological university with five campuses, 20,000 students and 6,000 graduates per year. This is absolutely excellent and will be a game changer for Carlow. We have two excellent colleges at Carlow IT. I compliment the Taoiseach and the Minister for Further and Higher Education, Research, Innovation and Science, Deputy Harris for their work on this.
I have a question about the integration of Carlow College, St. Patrick's into the Higher Education Authority, HEA. What is the timescale and the plans in that regard? This is a fabulous building and a fabulous college but there is an urgency with regard to its integration into the technological university, which is of the utmost importance.
I thank the Deputy for raising the issue but obviously these changes do not happen overnight. I am very familiar with Carlow College, St. Patrick's, which is an excellent facility. In my view it would serve the public interest well if it was incorporated into the South East Technological University. History shows that any facilities and land we acquire for educational purposes will be well used into the future, in terms of expansion and so forth. I know that the Minister is very committed to this and will work towards that end.
Domestic, sexual and gender-based violence rates have seen a significant increase in recent years, particularly, and regrettably, during the Covid-19 pandemic. The Government is due to publish the third iteration of national policy developed by the Department of Justice shortly. Is the Taoiseach aware of the New Zealand Government's approach to supporting victims of domestic violence by the introduction of domestic violence leave? Would the Government consider the introduction of such a provision here and would it be supported by the Department of Social Protection?
I think it has already been announced that it is the intention of the Government to work in terms of domestic violence leave. That is something we are committed to doing but I will get further details on that for Deputy Farrell.
The HSE has just informed me that it does not know how many GPs in any county, or State-wide, are accepting new medical card patients because it does not collect that data. I have been contacted by a number of constituents who have been unable to find a GP in Mayo to take them on. These constituents were only assigned a GP after they contacted the HSE themselves. This comes on the back of the HSE being unable to tell me how many dentists were taking on new medical card patients. Staff in my office called every dentist in the county and discovered that Mayo has no dentist taking on new medical card patients. It was only then that the HSE confirmed that this was a fact. This is a problem that needs to be addressed. We cannot hope to fix the problems that we are not even measuring. The lack of access to GPs and out-of-hours GP services in rural areas is getting worse by the week and the knock-on effect this is having on Mayo University Hospital and other acute hospitals is extremely worrying and is costing lives.
There are two elements. First, the Government is funding out-of-hours services comprehensively and has been doing so for quite a long time now. That was introduced to ease pressure on GPs generally in terms of weekend cover, rostering and so forth. Increasingly, however, there are issues in rural Ireland with access to GP care and the recruitment of GPs to serve. That is an ongoing challenge.
Second, in relation to dentists, there are ongoing negotiations with the association representing dentists in terms of the State sourcing and contracting services. The State has to get value for money for that and an additional €10 million was allocated in the budget to deal with that. It is my understanding that the negotiations are coming to a conclusion but there are discussions to be had. I will get information on the up-to-date position for the Deputy.
I welcome the announcement by the Minister for Health on the State funding of IVF by 2023 but as the Taoiseach will appreciate, this is not just a matter of putting some money forward. There needs to be an overall and complete package for those undertaking IVF. What preparatory work has begun to ensure that both parents will be eligible for leave, including sick leave, during this period, that eligibility will be inclusive of all of society and that the process will be open and accessible to all very quickly? The uncertainty is already playing on the hearts and minds of so many people around the country.
Obviously the Minister will have proposals in the forthcoming Estimates for the budget. Phase one of the roll-out of the model of care has involved the establishment at secondary care level of regional fertility hubs within maternity networks in order to facilitate the management of a significant proportion of people presenting with infertility issues at this level of intervention. Phase two of the roll-out will see the introduction of tertiary infertility services including IVF in the public health system planned for 2023, at such time as infertility services at secondary level have been developed across the country. The key legislation, the Health (Assisted Human Reproduction) Bill, passed Second Stage on 23 March and has been referred to the Oireachtas Select Committee on Health for Committee Stage. It is important that we get that Bill through to create the legislative base for this.
Unfortunately University Hospital Limerick is making headlines for all the wrong reasons. Last week a national record for the number of people on trolleys was set in the hospital. There has been a very significant amount of investment in the hospital but it does not seem to have reaped the dividends one would expect. Numerous front-line staff have contacted me. They are working in intolerable conditions and are extremely worried about the treatment patients are receiving and the standards pertaining in the hospital due to the severe overcrowding.
The Government must order a full review of managerial practices at University Hospital Limerick. Where is the accountability for these ongoing issues? How many senior management positions are there at the hospital? There is growing concern regarding the filling of senior management positions and a belief that the people who have taken up posts in the recent past in the hospital are not meeting the required standard for senior positions in the HSE. The hospital is under extreme pressure and people in the area are seriously concerned and worried. I would like to see a full review into what is happening at University Hospital Limerick.
I appreciate the issues the Deputy has raised. There has been significant investment in University Hospital Limerick but there are very significant issues there. It is my belief and the Government's view that we must look at further increasing bed capacity there in the short to medium term. I will talk to the HSE about the points Deputy Cahill has made about governance.
On the same issue and as Deputy Cahill has said, University Hospital Limerick is consistently the most overcrowded hospital in the State.
I raised this issue with the Taoiseach recently. Incredibly, 113 people are on trolleys today. This means there are no beds and, unfortunately, not enough trolleys for people. Yesterday 105 people were on trolleys and last Thursday there was an historic high of 126 people on trolleys. There is no let-up in this. The Taoiseach will not intervene but something needs to be done. We cannot wait for the planned 96-bed unit, which is to be delivered in three years' time if we are lucky. It will only deliver 48 beds because 48 will be taken out as well. What will the Taoiseach do? The nurses are calling for an independent HIQA inquiry. Will the Taoiseach support this? It should be done as a matter of urgency. The people and the staff deserve something better.
We need to act to see what we can do in the short and medium term to improve bed capacity. We can do all of the audits and inquiries from here on in but that will not necessarily improve the situation.
I believe we need additional bed capacity in the mid-west. We were able to move very quickly in some areas because the hospitals came forward with good proposals. For example, in Clonmel-----
-----through Deputy Cahill we got something done relatively quickly on bed capacity. There has been a fair degree of investment in University Hospital Limerick-----
The ongoing saga of the temporary replacement for the Dursey Island cable car rolls on, with the announcement last week that the long-awaited replacement ferry service will start this week but can be funded for only three weeks. Many politicians have welcomed this but I am furious. The people of the Beara Peninsula and residents of Dursey Island as well as landowners and visitors are left with only a three-day-a-week service. I have raised this issue on numerous occasions. My colleagues have followed me in doing so. Will the Taoiseach go to the Minister, Deputy Humphreys, and look for a properly funded seven-day service for the people of the Beara Peninsula and Dursey Island? It is only fair.
One in 12 children is now on some form of hospital waiting list. More than 100,000 children are on some form of National Treatment Purchase Fund list. One in three children has been waiting longer than a year for treatment or assessment by a hospital consultant. Over the Easter period, the Irish Hospital Consultants Association issued a press release on these figures. It states children will suffer from health and developmental issues that could have been reversed or mitigated if only they had been seen in time. What does this say about the State and the public health service?
Last week the Government confirmed its plans to fund IVF fertility treatment for public patients from 2023. This is welcome and fantastic news because at present Ireland is the only country in the EU not providing state funding towards IVF. Unfortunately, the statistics show that one in every six couples will struggle to conceive. IVF costs €4,000 to €6,000 per cycle. This is a huge expense that is out of reach for many young couples. Will the Taoiseach outline the Government's plans to ensure middle income earners as well as those on medical cards will get funding for IVF?
With regard to the cable car I will again speak to the Minister, Deputy Humphreys. At least it is a start. I would like a whole new service there. I would like a whole new ferry. I am determined to do this. I believe it is being judicially reviewed at present as there is some objection to what I believe are good proposals to provide a proper modern cable car facility. There are great opportunities there. It should be developed in the fullness of time. This is my view.
With regard to the waiting lists for children, there is an overarching waiting list plan by the Minister. Covid-19 had a huge impact on waiting lists. It exacerbated what were already significant delays. Let us not underestimate the impact of Covid-19 on waiting lists. Significant investment has been put in place to deal with that.
I would like to return to a question raised by Deputy Michael Collins earlier. It is only fair to the House to say there is a process of negotiation and discussion under way with private bus operators. When I was discussing it with the Deputy, the Minister, Deputy Eamon Ryan, helpfully said he had already met them six weeks ago. He was seeing what way he could do something for them with regard to application of the youth card reduction. There is further engagement on that front.
This will be the third time I will answer on the issue Deputy Higgins raised. This is illustrative of the broad views across the House in respect of IVF and the need to provide support and funding for it. I dealt with it in the previous two replies. The Minister will have a more comprehensive account of it as well.