Tuesday, 20 September 2022
Ceisteanna ó Cheannairí - Leaders' Questions
Gabhaim buíochas leis an gCeann Comhairle. Workers across the country will be deeply alarmed and angered by the Government's latest plan for the State pension. Let us call this what it is: a Trojan horse designed by Fianna Fáil and Fine Gael to move the pension age to 70 by stealth. The cat is out of the bag. The Government wants people to work until the age of 70. I suppose this will not come as a surprise to anybody because, after all, these are the parties that were hell-bent on raising the pension age to 67 and then to 68 until the weight of enormous public pressure made them climb down. However, instead of doing the right thing and bringing forward a progressive and fair policy, the Government is now presenting a ploy to force people into working until they are 70 years old with the promise of then having a decent standard of living. "Retire at 70 for an extra €60 in ... pension" is how one newspaper summarised it. This, however, is a scam. The pension deferral the Government is proposing means, in reality, that thousands of euro in pension payments will be taken from workers, payments they would now have as of right. We must be clear on this point.
It is not only those approaching pension age who are angered by this plan, but also young workers looking on now and wondering if they will ever get the chance to retire at all. Workers should have the right to retire at 65 with their pension, if that is what they want to do. The Government's proposal completely ignores the everyday reality of those who do hard physical jobs that take a toll on the body. Many of these workers started working at the age of 16 or 17, and some did so at a younger age. I am talking about factory workers, carers, retail workers, those on their feet all day in the service industries, nurses and many, many more. Hundreds and thousands of workers will be left out in the cold under this plan. They are not incapacitated and do not need an invalidity payment; they simply do not have anything left in the tank to keep working beyond the age of 65. They have put in their shift, they have done their bit and they are exhausted. Their right to retire at the age of 65 on a fair pension is not only a matter of public policy, but also a matter of principle and basic decency. One is either for it or against it. Clearly, the Taoiseach's Government is not only against it, but it will move heaven and earth to ensure it does not happen.
Sinn Féin is for the right to retire at 65 with a decent pension. This is what we would deliver in government. By the way, if we were delivering the budget next week, we would back up this commitment with an increase in the State pension of €15. Tá plean ag an Taoiseach chun aois an phinsin a bhogadh go dtí 70 bliain d'aois. Tá daoine ag iarraidh go mbeadh an ceart acu éirí as ag 65 le pinsean réasúnta tar éis dóibh a bheith ag obair go crua ar feadh a saoil ar fad. It is the duty of any Government worthy of the name to provide a State pension that allows pensioners to live a good and secure life. People looking on today will be very worried. I have a straight question for the Taoiseach and I would like a straight answer. Why is his Government so dead against the right to retire with a decent pension at the age of 65?
My first point is a general one.
People get anxious and worried when politicians tell barefaced lies. Generally, as politicians, we should not tell the public barefaced lies. We should tell the people the truth.
The pension age is 66. I do not know where Deputy McDonald is coming from. The Deputy is not telling the truth in her presentation because the Government decision is that the pension age will not rise beyond 66. Under this system, people will still be able to retire at 66 and draw down their full pension in exactly the same way as they can today.
Sinn Féin has been in government for the past number of years in Northern Ireland. Sinn Féin voted to increase the pension age to 66 and Deputy McDonald has the nerve to come in here and attack this Government for retaining the pension age at 66. I do not know how the Deputy does it.
It is a spectacular feat that Deputy McDonald pulls off. Sinn Féin has been in government in Northern for well over a decade and its members voted for 66 as the pension age. This Government has decided the people will retire at 66.
We are creating choice for people as well because people always seek choice in terms of their pension options and in terms of the State pension. The Report of the Commission on Pensions has a range of sustainability measures also. There needs to be a collective engagement by the House on that in terms of making sure the pension system is sustainable over a ten-year, 20-year, 30-year and 40-year horizon.
The Social Insurance Fund is in surplus. It will be in surplus now, I think, to the tune of potentially €3 billion. Original estimates some years ago would have had it at a deficit. That can change too. That can change to the negative. I have to be clear and add that. Every politician in this House has a responsibility to the younger generations as well to make sure the pensions are sustainable. That will involve difficult decisions in the years ahead in respect of PRSI, etc.
Deputy McDonald is desperate to win more and more votes and become more popular than ever but I ask her not to put that one out there. The Deputy should not tell that basic untruth that somehow the pension age is not staying at 66 when she knows full well that the Government decision today is that people will still be able to retire at 66 and draw down their full pension in exactly the same way as they can today.
Let us not cause that anxiety to people. Let us not create a false story. Let us not fake it. Let us not create fake news here. Fake news can worry people and can cause anxiety. There is no need to cause it in respect of the pension age of 66, no need at all. Caithfidh mé a rá gur sin í an fhírinne. Ní chás d’éinne bréaga a insint faoin gcinneadh atá déanta ag an Rialtas maidir leis an bpinsean. Caithfidh mé a bheith dearfach faoi sin. Beifear in ann éirí as an obair ag 66 bliana d’aois.
All of the anxiety that has been caused on this issue has been caused by the Taoiseach and people of his ilk who had plans, bear in mind, to ratchet the pension age up to 67, 68 and beyond. The Taoiseach cited all sorts of reasons and rationale for doing that. Our position has been and remains consistent that the appropriate and fair age to be given the choice to retire with one's pension is the age of 65.
What today's proposal sets out is a system of deferral, an enticement the Taoiseach might say, for people to work on until they are 70. I regard that as a move of coercion, not to incentivise but by stealth to-----
-----ratchet the pension age up to 70, and that is simply wrong. I am not one bit ageist. For sure, there are those who will wish to work beyond the age of 65 and they must be facilitated in that. More power to them.
However, we live in the real world, gentlemen and ladies, and we live in a world where people who have worked from a young age in very physical jobs simply are not able and do not wish to work beyond 65.
Let me repeat my question to the Taoiseach and he might answer without evasion or insult towards me. Why is he so against the simple premise of a retirement age of 65 by choice and why is the Government's proposal today-----
Who made this up for the Deputy? The Government decision is clear. Anybody will be able to retire at 66 under the Government decision, just as they can do so today. Does the Deputy not get that?
Deputy McDonald is deliberately not telling the truth on this one, it seems to me, in respect of the age and the deferral. She moves to the Trojan horse - I do not who made it up-----
The core issue is the age, which is 66.
As for the second issue to which the Deputy referred, she said we all want to facilitate people who want choice and who might wish to stay working.
In addition, as for the 65-year-olds, the Minister has got sanction from the Government to explore avenues to facilitate those who have worked 40 years of their lives, in manual work in particular, and are not in a position to continue working. That is also a decision the Government took today.
Along with the triple crisis of the cost of living, energy and housing, there is another crisis that demands urgent Government action, and that is the crisis in our health service, specifically in our emergency departments. Yesterday the president of the Irish Association for Emergency Medicine, Dr. Fergal Hickey, said that this winter was likely to be "hell on earth" for patients as well as staff and that we face what could be an Armageddon-type situation. We know there have been 40,000 breaches of waiting times this year. That is 40,000 patients waiting more than 24 hours. Last Wednesday there were 596 patients, including 20 children, without a bed. Dr. Hickey went on to say that emergency departments have become warehouses for admitted patients and that this is a 365-days-a-year problem. The Irish Nurses and Midwives Organisation, INMO, described the situation as an entirely predictable surge and called for a laser focus on recruitment and retention.
Staff vacancies arguably pose the greatest threat to our health service. There are almost 900 consultant vacancies and no sense of urgency from the Taoiseach's Government on agreeing a new consultant contract. Our non-consultant hospital doctors, NCHDs, are leaving Ireland in their droves due to the serious issue of excessive working hours, with doctors not even getting paid for that overtime and many reporting burnout, lack of career progression and bullying.
Nursing is equally under pressure to retain staff. Faced with the pressures on our health services, the cost of living and the prohibitive cost of housing, it is no wonder so many go away to work abroad in health services that actually function properly and provide care for patients who need it.
In addition, and importantly, our acute bed capacity is 2.8 per 1,000 population, while the OECD average is 4.3. Ireland has the lowest number of hospital beds in the EU. Over 300 of the beds which were to be delivered by the end of last year have yet to materialise.
Incredibly, yesterday's meeting of the emergency department task force was the first since January.
How will the Taoiseach prevent what is likely to be an Armageddon in our emergency departments when Covid and the flu put even more pressure on our emergency departments this winter? Will he announce a fully funded winter plan along with the budget next week? What will he do about the recruitment and retention crisis in our health service, which needs urgent attention? What action will he take to urgently increase the number of beds to a safe level?
I will first say that the health system went through very tough times during Covid-19, as we all realise. I have long articulated my admiration for all those who worked on the front line during the various stages of Covid. We saw on our television screens the enormous challenges and pressures that Covid put on our health system. Our health system proved itself resilient in the face of an unprecedented pandemic. Over the past number of years since the start of the pandemic, we have dramatically increased the level of funding to our public health service and increased capacity significantly. Approximately 900 acute beds and about 340 community beds have been provided. The number of ICU beds has gone up from approximately 255 to about 306, which is a significant increase.
It will be a very challenging winter. We have watched what has happened in the aftermath of Covid in places like Australia and New Zealand. We did not have the flu for the past two years, essentially, as Covid was dominant. There is now a real prospect of the widespread spreading of flu and Covid-19 during the winter period. Therefore, vaccination is the first line of defence in terms of people's lives and their health. I urge people to get vaccinated, particularly those who are recommended, with both the Covid booster dose and the flu vaccine. I think the flu vaccine campaign will commence in early October.
We have also increased home support hours with about 20.5 million hours delivered in 2021. That was 2.9 million more hours than in 2020, a 17% increase, and there is a higher target for this year. There are issues in terms of home care teams with them having expanded so quickly and in such a significant way. That created a strain and pressure on home care teams.
There will be a winter plan, for which funding will be announced in tandem with the budget. The HSE task force is meeting on a daily basis to prepare for winter. It will be a challenging winter.
I point out that overall staffing numbers have increased by 15,000 in the past two years. That is the largest ever increase on record since the HSE was established. That figure includes 4,500 nurses and midwives, 2,300 health and social care professionals, and 1,400 doctors and dentists. The health service is recruiting at a level it has never recruited at before. That does not mean that there still are not challenges in the recruitment of key professionals. There are but everything will be done to make sure we support the health service in the coming winter.
Does the Taoiseach not believe what the president of the Irish Association for Emergency Medicine is saying? He is saying that we are facing a potential "Armageddon" in our health service this winter, particularly in emergency departments. There are almost 900 consultant vacancies. What is the Taoiseach doing about that, to finalise the negotiations on the consultant contract? What is he doing about the significant loss of NCHDs - about which the Minister has been well warned - because of the dysfunction in the health services, because of burnout, because they are not being paid, and because there is no career progression? What is he doing to hold on to nurses and other key health professionals? This is all coming together. There is virtually no workforce planning going on within the health service at the moment. We have no idea how we will hold on to people and ensure an adequate number of training places.
There is a huge shortage of placements in the health service. The HSE stopped them a number of years ago. I am looking for specifics from the Taoiseach. What exactly will he do to avoid the hell on earth that is being predicted this winter?
I gave you specifics on a whole range of issues in terms of preparing and upgrading the health service. The number of college places has been expanded for all of the professions over the past two years. The Deputy cannot just shake her head. They have been increased-----
-----and in terms of career progression. The winter preparedness plan has adopted a bottom-up approach. It has gone to every hospital group and local plans have been sought. Sanction has being given to hire emergency consultants if the groups so wish. In the plans that have come from the various hospital groups, flexibility will be applied in sanctioning the teams they want to hire. As the Deputy knows, we are implementing measures to help with the flow by avoiding people gong to emergency departments and providing GPs greater access to diagnostic tests. This has been significant in a range of areas. We have developed community integration teams and integrated care teams for older people. Enhanced community care has been very effectively rolled out. All of this prevents people from going into emergency departments in the first place. The other key issue is the flow of patients through hospitals and subsequent discharge. This is key to keeping the emergency departments freer to take people.
Last week, I spoke with the mother of a long Covid suffer who until she contracted the virus was a young and fit woman working as a doctor in a busy hospital. She has not stood on a hospital ward in more than 11 months because she is still recovering from the illness. Based on research conducted in Ireland and the Netherlands, 336,451 adults are experiencing or have experienced a long-lasting impact of this illness, known as long Covid. Long Covid encompasses a broad range of illnesses following Covid infection and is based on three clusters of symptoms. These are fatigue, respiratory issues and cognitive problems. They can range in severity from those who cannot recall the PIN for their bank card to people who are unable to get out of bed. The vast majority of these people did not require hospitalisation at the time of the original infection, with many experiencing only mild symptoms.
The HSE has recognised the need to support these patients and last September, it finalised an interim model of care for long Covid to provide a national approach for the provision of services and supports, yet up to last month only 20 of the 60 health service staff to be recruited to these regional centres for the management of prolonged conditions associated with Covid-19 were in post. We are told that until these regional centres are fully operational, we will not see the establishment of GP referral pathways. Even now there are still no plans to provide a dedicated service for children with long Covid. The eight planned regional clinics will primarily focus on fatigue and respiratory-related issues with a single consultant neurologist appointed to deal with cognitive problems. This is despite evidence presented to the Oireachtas Joint Committee on Health indicating that cognitive and neurological problems are emerging as the most significant long-term issues for those with long Covid.
The only clinic supporting those with long Covid neurological issues, which is at the Mater Hospital, is set to close its doors at the end of next week because of the failure by the HSE to fund it. I firmly believe the failure by the HSE to put in place a comprehensive strategy for those with long Covid is contributing to the record figures we witnessed last month with almost 10,000 patients on trolleys in our hospitals. Unless the interim model of care is revised to reflect the emerging evidence on long Covid and such a strategy for all of our patients, regardless of age and illness, is then delivered, this will compound a dire prognosis for our health service this winter.
I thank the Deputy for raising a very important issue that is affecting quite a number of people. I have tremendous sympathy for those suffering from long Covid. It is one of the reasons that during the height of Covid, when we had the lockdown, I was insistent on taking strong measures. It was not just about mortality. This was a deadly disease. When a person got Covid, it could lead to long Covid and affect a person's health and quality of life for quite a long time afterwards. People were saying we could get by, but this was a disease we had to try avoid people getting, at least, until vaccination arrived. Vaccination has prevented the disease from impacting more severely on people than was the case prior to people becoming vaccinated. Vaccination was the game changer.
That said, there is an interim model of care, as the Deputy described, to provide long Covid services nationally. We want to see a more uniform framework. Considerable research is going on. In the nature of medical research, we will need more research, not just on identifying the features or, indeed, the duration of long Covid and the length of time it will impact on a person. Presumably, the research will also have to look at the model of care. If someone develops cardiac or respiratory issues and there is a long Covid centre in a hospital, ideally, the specialists in the centre of excellence for respiratory issues should then perhaps have to deal with the person's issues. It will at some stage need an integrated, multidisciplinary approach to some of the issues that manifest themselves as a result of long Covid. I will follow up on the matter. The Deputy is correct on the cognitive and neurological implications of long Covid. I do not believe they are disputed. We will follow up on that.
There are long Covid clinics in St. Vincent's Hospital, Beaumont Hospital, University Hospital Galway and, I think, in Cork University Hospital. There are post-acute Covid clinics in Galway and in Connolly Hospital, Blanchardstown. Tallaght University and St. James' hospitals are operating a combined post-acute and long Covid clinic. There is a tertiary neurocognitive clinic in St. James' Hospital, led by a consultant neurologist with a background in neurocognitive disorders, which is accepting referrals from long Covid clinics throughout the country.
We are happy to work with the Oireachtas and the Joint Committee on Health on this. I do not dispute the issues he is raising. They are very serious issues. In the forthcoming health budget, we wish to see whether we can increase the level of resources available, specifically, in a ring-fenced way, for long Covid. Approximately €2.2 million has been allocated so far. An epidemiological survey is being planned that would provide insight into the prevalence of long Covid in the population.
With regard to the prevalence of long Covid, based on my analysis of the social welfare payments for Covid-related illnesses lasting 12 weeks or more following the initial infection, 21,000 people are unable to go to work due to long Covid. This figure does not take into account the tens of thousands who are suffering with less severe forms of long Covid who are going to work but not contributing to the same extent that they did prior to the illness, nor does it take into account the thousands of people who recovered from the initial infection but had a subsequent relapse. Not only is this having a significant impact on our labour force but, as an Australian long Covid study put it, even low rates of Covid-related permanent illness or disability could still lead to significant future burden of disease. We need to act now in a comprehensive way.
I do not disagree with the Deputy. There were clinics on HSE sites that were operational before the model of care was rolled out. The intention is to align all of them towards a national service. It is intended that the interim model of care will be expanded to put in place eight post-acute Covid clinics and six long Covid clinics within hospital groups nationwide.
Additional aspects of the service have been delivered, including supports within the GP and community settings and online supports. As I said earlier, epidemiological survey is planned that will provide insight into the prevalence of long Covid in the population. Again, the HSE is putting together the metrics, including waiting lists, number of patients treated and number of clinics operating to fully understand the extent of the need. The executive also recently commissioned a HIQA review to further inform development of the service.
I am told the incidence of long Covid in children is rare and of short duration, but that is something we must keep a very watchful brief on. At present ,for children and young people suspected of having long Covid-----
As the Head of Government, will the Taoiseach explain to the people why the Government continues to take VAT on goods and services that are at an inflated rate? I will break it down into three simple examples and explain to him how his Government is crippling businesses in the country, putting our householders into poverty and going to drive the country into a recession.
The first example is one I gave him last year but I will give it again. The tax the Government takes on fuel, which is €57 of every €100, is based on tax once you break down all the different charges. At that time, I and the Rural Independents asked the Taoiseach to cap the price on which the Government would tax fuel. We understand the Government needs tax to run the country but it is taking tax at an inflated rate and getting in more earnings.
The second example is the cost of electricity. We saw recently that for the first six months of the year the ESB made a profit of €390 million. Over 12 months that will be €780 million. Under the laws that are there, the Government will automatically take 12% of that, which equates to approximately €93.6 million. The Government will take 12% in tax as it does from any company that makes a profit. The Government reduced the VAT on electricity to 9% but its intake is still up 30% on this time last year. I will break this down to simple brass tacks for the Taoiseach. Last year, a householder who used 1,341 units at a price of 13.2 cent per unit had a bill of €244.03. The same person today for the same usage will pay a bill, including VAT, of €457.83. The Government's 9% VAT take on that bill alone is up 30% on this time last year, so the Government loves inflation. Everyone else in this country is on the poverty line trying to survive. A business that had a €600,000 electricity bill last year is now faced with a €2.7 million charge this year. It employs 100 people and has told me it is not viable. Every business in the country is under pressure to put food on the table and keep the employment they have and our Government's VAT take on energy is up 30%. The Government is the only business in this country that is up 30%. Everyone else is down 30% as they try to keep people at work and have children go to school and college. What does the Government do? It has 30% more than it had this time last year.
It was fundamentally brought about by the war on Ukraine; there is no question about it. The price today for United Kingdom gas on the wholesale markets is 287 pence. By the way, it was 463 pence last week.
The future markets do not look good, either, as a therm of gas to be delivered in January will cost 533 pence and March deliveries are priced at 506 pence. That all indicates the enormous crisis not just Ireland but every country in Europe and, indeed, across the world by and large is currently facing.
The Government has taken measures and we have reduced the excise duty on petrol, diesel and green diesel until mid-October. We will deal with issues in the budget relating to all of that. People save between €9 and €12 each time they fill their tank. We have also given energy credits back to people to cut their bills. I refer to the €2.5 billion basically that was allocated between the budget and the cost-of-living packages. We are planning a multibillion euro cost-of-living package now in the forthcoming budget to alleviate pressures on households, to protect jobs in terms of the cost of this crisis on enterprise itself, and to support a range of entities that provide services to the people in terms of education in particular, in terms of schools. The Deputy said Government loves inflation; Government hates inflation. Inflation corrodes people's disposable incomes but also damages the economy in the long run. It presents challenging issues to Government and is providing challenging issues to governments across Europe. The challenge for us is to maintain and, in some instances, expand services and reduce costs to families, which we will do and have done. We have reduced costs on public transport.
For those people we have reduced costs. We have also reduced costs of health services. The drugs payment scheme, DPS, monthly threshold has gone to €80, which is a significant decline on what it was two years ago.
Through a variety of measures, including pay and tax reductions, we have taken efforts to reduce the pressure on the public and protect jobs. In the forthcoming budget and cost-of-living package we will take measures as well to alleviate the pressures on people who are feeling it heavily out there; there is no doubt about that.
The Taoiseach has just said one true thing, which is that the Government is not a business. He has explained that he does not understand business and neither does any of his Cabinet. If he understood business, he would understand how to live in this country. These are the Taoiseach's own records. I see Deputy Niall Collins over there having a good laugh, the same man who turned around and told the hotels in this country they were gouging. It was the Dublin hotels that were gouging, not the Limerick ones and the other ones. However, no, he did not get his facts right either.
I refer back to the Taoiseach. The VAT take so far this year is a staggering €15.4 billion, 30% more than this time last year, which means the Government has taken in €4.6 billion more in VAT this year than last year. That means in business terms that the State has a massive profit. That means everyone else in this country is at a massive deficit, whether they are in business or wherever they are working; whatever they do, they are in a deficit. That is because the Taoiseach and his Cabinet do not understand business; I do. I am in business. I live it every day in real life. If I ran my business like the Government runs its business, I would not be in business.
No. The Government has to be the key instrument of the social contract in making sure that when a child is born in this country, that child has access to early education, the best of health services, and has an opportunity to progress to primary school, secondary school, further education and third level. That costs money.
The bottom line is this in terms of the revenue that we have raised, the country is in significant debt.
We borrow, and borrowed during Covid. The Deputy can go to any enterprise or business out there. I meet his businesses all the time and I meet businesses that provide services to all of us. What do they say about Government? They say, “Thank you for helping during Covid-19.”