Mary Lou McDonald (Dublin Central, Sinn Fein)
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The housing emergency has dominated life in Ireland for more than a decade. It is a story of an entire generation locked out of affordable housing and locked out of opportunity. It is a generation that works hard and does all the right things but still sees their aspirations pushed further away. Their lives are on hold and their futures are uncertain.

Over the past four days, I have received an outpouring of despair from people whose crisis housing situation is badly affecting their mental health. Here is just some of what these people had to say.

Amy told me:

I'm a [40]-year-old married nurse. We couldn't afford [to] rent anymore. We’ve had to move in with my parents to try to save for a mortgage, but [now] the cost of living [crisis] has ruined things. Only for my parents I couldn't afford to continue living. I am constantly sad and stressed.

This is Seán’s story:

I’m with my partner of over six years. We are living at home with our parents and sister in a three-[bedroom] house. No room. We want to have kids but where would we put a baby? This is not a life. We both work full time and pay our taxes. We want to start our life, but we can't. My depression is real and it's only getting worse.

Kevin said:

Myself and [my] partner are in counselling and prescribed medication for stress, depression and anxiety due to the rising prices of houses and [the struggle] to make a life while [we are still] living [with] our parents. We’re considering moving to Canada for a chance at a better life.

Edel said:

I’ve been homeless since the start of 2020. Going from house to house, room to room. We’ve lost our furniture, our clothing, and the feeling of having a home again. I’m mentally exhausted and the whole family has been dealing with tough mental health issues. This isn't normal. [This] is not right.

There is stress, anxiety, depression, medication and a housing Minister who said that we do not have a housing emergency. The Taoiseach said that his housing plan is working. He speaks of indicators of success, but each of these stories is an indicator of the Government's housing failure. I have put it to him time and again that the Government's housing targets are too low, but each time he refused to accept this fact. The Department of Housing, Local Government and Heritage has now acknowledged that the targets are wholly inadequate. Finally, last night, the Minister for Housing, Local Government and Heritage, Deputy Darragh O’Brien, was forced to admit that the Government has been working to housing targets that are no where near what is needed. The truth is that this Government falls far short on planning and delivery and people are paying a heavy price. Tá an éigeandáil tithíochta ag cur isteach go mór ar mheabhairshláinte go leor daoine anois. Teastaíonn freagairt éigeandála a dhéileálann le scála na géarchéime.

The Taoiseach said housing is the number one issue for his Government. Yet, after two and half years in office, the housing emergency has only got worse. House prices, rents and homelessness are up and now people’s mental health is on the floor. That is the legacy of the Government’s housing plan.

Does the Taoiseach now accept that we have a housing emergency? When will we see housing targets that match the actual scale of this emergency? We need energy, pace and an all-of-government approach to fix housing.

Micheál Martin (Cork South Central, Fianna Fail)
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I have consistently said that housing is the number one social issue facing our country and it is a priority of this Government. I also said that the Housing for All plan is the most substantive plan document detailed of any plan that has been produced by anyone in this House. No Opposition party has come near it in terms of its detail, variety, breadth and depth. The bottom line is progress has been made. However, for many people, we need to build more houses and build them faster. I have always acknowledged that.

Since this Government came to power, there has been very significant delivery. On social housing alone, more than 18,000 new social homes have been added to the social housing stock under this Government up to quarter 2 of 2022. This year we are targeting an extra 10,000 social houses between build, lease and acquisition. That is on a scale that has not been seen for decades. Not in the first two decades of this century has that scale of social housing been seen. Progress is being made. However, I am very clear that we need to make more progress than that.

On affordable housing schemes, very significant initiatives have been taken. I refer to Sinn Féin's alternative budget, for example.

The Deputy has talked about people who are distressed and I acknowledge that people are in distress. However, under its alternative budget, Sinn Féin would have abolished the help-to-buy scheme, which has supported over 35,000 home buyers. Those are ordinary young people who wanted to buy their first homes. Sinn Féin would scrap the first home scheme, which has been introduced in recent months. It provides an equity share up to 30% in a new property. There are already 640 approvals under that scheme. What would Deputy McDonald say to the Jameses, Marys and Johns who have got those approvals? What would she say to the 35,000 people who got help under the help-to-buy scheme? Sinn Féin would also eliminate the new vacant and derelict property grants of €50,000. There are 419 applicants for that scheme. We are expanding that scheme to rural areas and city centres. Sinn Féin would scrap that scheme despite the fact it will help many people.

Through affordable housing schemes and Croí Cónaithe, we are making significant gains in respect of affordable housing. That is the bottom line. Sinn Féin has now become the party of catastrophe. That is how it labels itself. I have to put it to the Deputy that if she is sincere in her description of the housing situation as an emergency - and I am saying it is the biggest social issue we have - she must reconcile how the Sinn Féin Party can vote against 1,200 social, affordable and private homes in Ballymastone and Donabate. Some 253 of those homes were intended as social homes and another 253 were to be affordable homes. How could Sinn Féin vote against 853 public homes on Oscar Traynor Road in November 2021 if it is the emergency Deputy McDonald says it is? How could Sinn Féin vote against what was then 768 homes in O'Devaney Gardens in 2019? There are now 1,000 homes, including 275 social homes and 248 affordable homes.

Let us think about the language that Deputy McDonald has been using for the last number of months on housing, "emergency" and "catastrophe", and yet she herself objected to 1,600 apartments on the grounds of Clonliffe College, 10% of which are social housing.

Thomas Gould (Cork North Central, Sinn Fein)
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Ten per cent.

Micheál Martin (Cork South Central, Fianna Fail)
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Deputy Gould, it is no laughing matter. If this is described as a catastrophe, then all bets are off in respect of how we provide housing in this country. That is the point I am making. Sinn Féin cannot play it both ways. You cannot say in this House it is a catastrophe and in another chamber vote against housing and housing provision. It is time to get off the fence. I make that point sincerely. I do not think the Deputy can reconcile those two stances.

The Government is making progress. We will exceed our targets for this year. I repeat that we will build more than 24,500 houses this year. We need to do more and build more rapidly.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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It is a measure of how far astray the Government has gone and how badly it is failing that the Taoiseach relies on misinformation and attacks across the floor-----

David Cullinane (Waterford, Sinn Fein)
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Hear, hear.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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-----rather than acknowledging in the first instance the very real mental health consequences of what is a housing catastrophe and emergency. The Minister cannot even accept that it is an emergency. Does the Taoiseach accept that it is an emergency?

The record of the Government, despite the Taoiseach's bluster, is that house prices, rents and homelessness are up. I will try to be of some assistance to the Taoiseach by telling him that the answer to this catastrophe is not to produce houses and accommodation that are way out of the reach and price range of ordinary and average workers. The answer is not to incentivise and roll out the red carpet to international funds, vulture or cuckoo funds, call them what you will funds-----

David Cullinane (Waterford, Sinn Fein)
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Hear, hear.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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-----that build big, fancy apartment blocks in areas such as those I represent. People with no homes look at those apartment blocks, say they are nice and that they will never live in them because they cannot afford to do so and certainly will never own a home there. That is not the answer.

I asked about the targets. Can we please have clarity on that matter?

Micheál Martin (Cork South Central, Fianna Fail)
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The country is on track to exceed the Housing For All target for this year of 24,600. Close to 28,000 homes were built in the 12 months to September 2022. There were nearly 21,000 houses alone built in the first nine months of this year. That already exceeds the total for 2021, which was 20,000. We are projected to reach more than 26,000 homes by the end of the year. It will be the highest number of homes built since 2008. There were more than 16,000 first-time buyers in the past 12 months. That is the highest number since 2007 and it represents 33% of all home purchases, up from 25% in 2015. Construction of 27,400 homes commenced in the year to September alone. More than 167,000 people are now working in construction. That is 20,000 more than pre-pandemic levels and 40,000 more than this time last year. Objectively, people have to acknowledge that progress is being made.

Mary Lou McDonald (Dublin Central, Sinn Fein)
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The targets are wrong, according to the Department and the Minister.

Micheál Martin (Cork South Central, Fianna Fail)
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The Deputy is at it again, trying to interrupt. She should allow me to respond to her sound bites and sloganeering and the absence of substance that comes across time and again. The bottom line is that we have to do more than what we have done already. Let us be very clear that we are making progress. The bottom line is that the Deputy is saying that the figures need to increase and we should be building 40,000 homes per year. My point is that we cannot build 40,000 homes per year if the Deputy herself objects to 1,400 units in her own constituency and her party objects to thousands of houses across the board.

Catherine Murphy (Kildare North, Social Democrats)
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The revelations about the systemic, sustained and grotesque sexual abuse that took place in Blackrock College over many years are shocking and harrowing. We now know that at least 233 men have made allegations of abuse against 77 Irish priests from the Spiritans order. Of that number, 57 have alleged they were abused on the campus of Blackrock College. Some of the abusers were serial abusers who abused with impunity over decades in that school. At night, they roamed freely through the boarding school, abusing their victims in their beds. A culture of omerta and a desire to protect the institution over the children in its care ensured that this dark chapter in the school's history remained shrouded in secrecy until now. We all owe a huge debt of gratitude to brothers Mark and David Ryan who spoke bravely on an RTÉ documentary last week about their own abuse at the hands of Fr. Tom O'Byrne and other priests. Tragically, neither brother knew the other had been abused by the same man until they finally told their parents and went to the Garda in 2002. Their story has prompted many more from a number of different schools run by religious orders to come forward and tell their stories of abuse, trauma and shattered lives. The Irish Timestoday features an interview with John, which is not his real name, who was repeatedly abused by Brother Luke McCaffrey in Willow Park in the 1980s and 1990. John said he still wakes up screaming, "No, Brother Luke. Please, Brother Luke, please, Brother Luke." He goes on to state:

I could never hold down a job, a steady relationship and have alienated all my friends, systematically. I have not met anybody socially in years, and am effectively a recluse, bar walking the dog. I am forever apologising to people for things I haven’t done wrong. I have never been convicted but have always felt like a criminal.

How can we stand over a situation in which those who have been abused feel like the criminals and the perpetrators do not? Many abusers have lived long lives and were respected in their communities until they died.

In the past hour, the Spiritans have announced that independent experts have been appointed to examine abuse in Spiritan-run schools. We need to examine the detail of that. However, this independent process covers just one congregation. The State has an obligation, belatedly, to act. We must have a public inquiry into what went on in these schools. We must know how many children were abused and by how many abusers. Why was it covered up for so long? There have been allegations of paedophile rings operating, which must also be examined. It is long past the time that we in this country finally dealt with our past in which children were repeatedly raped and abused by those who had a duty to protect them. I am asking the Taoiseach to agree to a public inquiry into these matters.

Micheál Martin (Cork South Central, Fianna Fail)
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I thank the Deputy for raising this very serious issue. The level, scale and nature of sexual abuse carried out in Blackrock College and in other school settings is sickening and shocking. Our sympathies, if that is the right word, and thoughts go out to all the victims and survivors of such terrible abuse. Such sexual abuse causes immense trauma for the entire lives of those who have been abused.

It destroys many aspects of their lives. Unfortunately, that has been this story for many people for far too long. It is a stain on our society that so much abuse occurred in settings where people were entitled to feel safe and where they should have been protected and nurtured.

In that context, we have had many inquiries in the past into abuse in different settings, primarily church settings. I refer to the inquiries into what happened in the Ferns diocese, the Dublin archdiocese, the Cloyne diocese and the industrial schools, many of which were run by the religious. We have learned a lot from many of those inquiries, which were very painful and traumatic for many concerned.

We have agreed to a debate on this matter next week. I would be interested in engaging with Members of the Oireachtas and with other parties on how best to go about this. The Government is going to give the matter further consideration in the context of the most effective way to have a victim-led approach to unearthing all aspects of what went on here and if there was a cover-up, the nature of that cover-up. More important is to get a proper understanding of the scale of what went on. I am very conscious that in the past some inquiries took longer than people would have anticipated. I am very conscious that some were more effective and gave outcomes more quickly. The mode and manner in which we go about this is important. We have to learn lessons from previous inquiries in that regard. A bespoke-type of inquiry may be required. As the Deputy knows, the scope and terms of reference of any inquiry are very important. The Government is certainly giving this consideration, but I would like to do it in consultation with other Members of the Oireachtas.

Catherine Murphy (Kildare North, Social Democrats)
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I would appreciate that consultation. It is going to be necessary in order to find the best way to move forward. This is about isolation and people feeling they are the only one. It would not be possible for this to have gone on as long as it did without that feeling of isolation. On last night's "Prime Time" programme, Mark Ryan said, "You think you're the only one who has been abused. What's needed is a true picture of what happened." We need to get to that true picture of what happened, otherwise people will feel there is no accountability and will continue to feel that isolation. Essentially, some people will have spent a the whole of their lives responding to this. That poor man John feels that he is a criminal, even though he has done nothing wrong. I would appreciate having that engagement. The Taoiseach might articulate how that might happen in addition to the debate next week.

Micheál Martin (Cork South Central, Fianna Fail)
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I pay tribute to those who have come forward, including Mark and David Ryan and others. The sexual crime management unit of the Garda National Protective Services Bureau has received a number of new complaints this week. Obviously, the Garda will be fully supported in carrying out its work in pursuing every lead possible.

I agree with what the Deputy said about the need to give support to survivors and victims who are coming forward to let them know that they are not alone and that the State will be there to support them in the context of getting the true picture of what happened in this context. We need to continue to lift the veil of silence over this particular matter and try to give some degree of closure, if possible, but also a sense of justice to those who have been abused and those who have been traumatised by what happened in the college and to end the sense of isolation the Deputy spoke about.

Danny Healy-Rae (Kerry, Independent)
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I wish to raise with the Taoiseach the recent influx of Ukrainian refugees and asylum seekers and the impact they may have on the tourism sector in County Kerry. Many are living in hotels in Killarney, Tralee, Ballybunion and other places. It is estimated that there are more than 6,000 in the county now, with almost 4,000 housed in hotels and guest houses in Killarney. Our town of Killarney is at capacity. If we are to look after our own people and the refugees and the asylum seekers who are already here properly, it is clear that we cannot accommodate any more at this time. Our medical services, GPs and social welfare officers are under immense pressure. Come the middle of February 2023, what alternative accommodation does the Government have in mind for the massive number of refugees who are housed in our hotels and guesthouses at present? The children who have come here have been integrated into our schools.

Our tourism product and our hospitality business in Kerry depend so much on these hotels to provide accommodation for tourists. They are the vital cog in the wheel that keeps the industry going. It is vital for employment for people in craft shops, souvenir shops, tea and coffee shops, confectionery shops, bus and coach tour operators, taxi and hackney operators, jarveys in Killarney and the Gap of Dunloe, the boatmen, the big entertainment venues, such as the INEC and Siamsa Tire in Tralee, small rural pubs that provide music and entertainment, storytelling and culture and tell visitors about traditions, and our entertainers and musicians. All our visitor attractions depend so much on hotel accommodation being available. We have places like Killarney House and Gardens, Muckross House Gardens and Traditional Farms, the national park, our wonderful visitor centres in Ballinskelligs and Dingle and many other attractions.

The Taoiseach has spoken about building modular homes. Where will they be built? Will modular homes be built for our people? We must look after our own. Some people have been on the housing list in Killarney for up to 16 years. We want to treat the Ukrainian people properly but we do not want to treat them better than our own people. We need to look after our own people. We need to realise that the businesses I have mentioned are only barely back on their feet after being closed down for two years. What are the Government's plans. How is the Government going to address the accommodation centre for Ukrainians in Killarney after the middle of February?

Micheál Martin (Cork South Central, Fianna Fail)
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I appreciate the Deputy raising this important issue. However, we are in a war situation on the Continent of Europe. These are not normal times. An illegal and immoral war is being waged by Russia on Ukraine. That war is being carried out in a manner that targets civilians. Putin is weaponising migration, energy and food. This has caused significant economic upheaval. About 14 million people have been displaced. It is the worst humanitarian crisis on the Continent of Europe since the Second World War. I understand that 7 million of those people are internally displaced in Ukraine and the other 7 million have fled the war and moved across Europe. People are very fearful. In the latest phase of the war, Putin has decided to target critical energy infrastructure in order to try to freeze the inhabitants of Ukraine during winter, thereby making life unlivable for them and causing them to flee. It is a deliberate war tactic.

As a nation, we must have some moral values. The entirety of Europe has to hold its nerve and stand up to this. We must not allow ourselves to become fractious or split from each other in terms of rebutting what is happening.

To me, what is going on is unthinkable, as is the manner in which Russia is targeting the war. It has consequences. I think up to 63,000 and maybe more Ukrainians have now come into the country. I want to thank the people across the length and breadth of the country, including in Kerry and the Deputy is correct in saying the numbers have been particularly high in Kerry, who have welcomed people into their communities and who have worked very hard to make Ukrainians feel at home. I do not think the vast majority of Irish people see it as our own versus the Ukrainians who came in. Rather, they see it as a matter of what we can do to help.

It is challenging for many communities, of that there is no doubt. For our schools and in many areas, it is challenging. I pay tribute to many principals across the country, to boards of management and to teachers who brought Ukrainians into their schools and who are working to help those Ukrainians navigate education in this country while also continuing to access education back in Ukraine. Many Ukrainian parents are doing that with a view to the war eventually ending and they can be in a position to bring their families back and to reunite with their families.

We have a whole range of plans. We have started rapid build housing for Ukrainian families. We hope to do 700 by early next year. We will also now do rapid build housing for social housing in Ireland. Advanced manufacturing technology, which is the term in construction technology and is offsite manufacturing, can assist in more rapid construction of housing. That is something we need to embrace more strongly in the country. Given the wider issues that exist in the area of housing we need to build more and at a more rapid place.

Danny Healy-Rae (Kerry, Independent)
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I thank the Taoiseach for his reply, but he did not answer me the question. Yes, we are in a war situation. I recognise that and everyone recognises that and we feel for the Ukrainian people. But we have an industry in Killarney that has taken generations to build up. Many hotels are taken up with refugees at the present time.

I asked the Taoiseach a straight, honest question. How will he deal with the refugees who are supposed to leave those hotels by the end of February? What accommodation has he arranged for them at the end of February? I told him that so many aspects of our tourism sector have only barely started back on their feet again this year. It has been a bare few months. Surely, they should not have to lose out or be compromised because the hotels are not free. They are already taking ye to court for moving them from one hotel to someplace in Wicklow to someplace in Monaghan. Will they leave the hotels? Will the owners of those hotels now want to let them go? The Taoiseach has not answered my important question.

Micheál Martin (Cork South Central, Fianna Fail)
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I answered quite a number of the questions that the Deputy raised in respect of rapid builds and so forth. As I have said, my strong answer is that we are in a wartime situation. That is why so much hotel capacity has been made available to take people, including women and children, who are fleeing war. That is why. There is no easy solution to this, but we have managed it so far. There has been an extraordinary response by the country and the sheer numbers are unprecedented. We will work as we have worked since the beginning of the war to continue to accommodate the people who come in as best as we can. It is very difficult and challenging and it will remain challenging until this war is over.

We are reconfiguring a number of public buildings that are not quite reconfigured yet to take additional numbers. As I said, we are also looking at rapid build to try to accelerate that and to get higher numbers. We are continuing to work with the many people who have made their facilities available. However, we are one of the few economies in Europe that is still growing. The war is having an economic impact and there is no escaping that. This Government was very supportive off the tourism industry during Covid-19, and it has acknowledged that, but we are in a wartime situation that casts significant shadows and clouds over the economic sky of Europe and that will remain so until this war is over.

Michael McNamara (Clare, Independent)
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On 17 December, the Taoiseach’s tenure as Taoiseach will come to an end, at least for now. By that time, he will have been in this House as a Deputy for 33 and a half years. That is some achievement, as is reaching the highest political office in this land and it would be churlish not to congratulate him on that. My question to the Taoiseach is in his experience and in his tenure in this House, can he tell me how the people can effect change? We elect representatives to make decisions on our behalf or we have referendums.

I have repeatedly raised the issue of University Hospital Limerick, UHL, with the Taoiseach and with the Minister for Health, Deputy Donnelly, with the former Minister for Health, Deputy Harris, during this Dáil, as have the other representatives from Clare, Limerick city, Limerick county and the broader mid-west. This week, we learned that 72 non-consultant hospital doctors, NCHDs, made a protected disclosure highlighting a series of near misses at the hospital. They said that patients have to wait more than ten hours for a bed in the unit without any medical attention, while other lost patients are sometimes missed and are left unseen by a doctor for a number of days. They say that many NCHDs do not want to work in UHL and that they actively avoid it because of the working conditions. Many people in my constituency and in neighbouring constituencies do not want to go to hospital there. They are afraid to go to hospital there. Most worryingly, they say that there is a great concern among staff about escalating clinical incidents or important issues to the management. There is a fear of retribution or informal punishments, should a person be identified as suggesting change or discussing pertinent issues in UHL. A similar letter, not a protected disclosure but a letter, was written last year and it is my understanding that there was a witch hunt by senior management to find out who wrote it, where they worked and where they intend to work in the future. That is worrying.

I have raised these issues in UHL with the Taoiseach repeatedly and he has said that it is not for this Government to manage a hospital, but it is a matter for the HSE and for the management. I have repeatedly asked the Taoiseach about cases where they are not managing it adequately. It would appear from this protected disclosure, from the letter that was written last year and from a letter that was written by senior consultants which I also brought to the Taoiseach’s attention, that the system is not working. How then do we effect change? I accept that it is for management in the HSE to run hospitals, but when they are not doing this, what happens?

I could highlight other incidents. I highlighted the National Driver Licence Service, NDLS. A resolution was passed unopposed by this House, but nothing has changed. We got a document from the Ceann Comhairle’s office. It is nice, yellow and it kind of represents parchment, but that is the extent of it. There was a Covid-19 committee on which Deputy Devlin, who is sitting behind the Taoiseach, sat, as did Deputy Donnelly before he became Minister. That produced a report, yet nothing has happened. There has been no accountability for the billions of euro that was spent, a lot of which was squandered, although not all of it. There has been no accountability for the deaths in nursing homes. How, then, can the people effect change? If democracy does not work, then the centre does not hold. An issue the Taoiseach has highlighted often himself is the importance of democracy and the importance of the centre holding, but the centre has to respond to legitimate concerns in order for that system to work.

Micheál Martin (Cork South Central, Fianna Fail)
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I thank the Deputy for raising this very important issue and I appreciate his interest in my longevity in politics. On a serious note, we have to keep working hard to effect change. We all have to keep at it.

It is interesting that in the last 20 to 25 years, health has been transformed. There is no comparison between outcomes and survival rates today when compared with 20 or 25 years ago. I said yesterday in the House that the reason for this was that we took a more strategic approach to the big diseases that were killing people. There are a number of aspects to health. There is access, which the Deputy touched on, and of how people are treated in an emergency. There are also the matters of how we increase life span, how we increase quality of life and how we reduce the burden of disease on people. To me, that is the big story in health that always gets lost in the most immediate headlines and that is frustrating for many people who are working. As I mentioned yesterday, I spoke to a consultant in stroke care who posted a story on Facebook last year about an almost miraculous intervention with a patient through thrombectomy. The patient got to hospital in time.

He got 1 million views. The point he was making to me was that we were not communicating events like that. It just took off. It was a very good story about how a person was saved through modern methods of dealing with stroke, but also a better strategic approach to dealing with stroke in terms of stroke units. The cancer strategies have been immensely successful, with the centralisation of cancer centres and so on. The cardiovascular strategy has been very successful. However, numbers are growing because the population is growing and I feel that services have not grown over the 20-year period to match population growth. That would be a view I would have, and I think that manifests in health.

In terms of the specific issue, my understanding is that the protected disclosure might have been sent in June. I stand to be corrected on that. The Minister has met with the NCHDs concerned. As the Deputy knows, the HSE performance management and improvement unit led an intensive engagement with the hospital group and the mid-west community healthcare organisation, CHO, throughout the summer in response to how the hospital was functioning. To be fair, it was not just NCHDs. I think HIQA also raised issues about the hospital. The unit worked with UHL to support and oversee the implementation of rapid improvements in services in the region. These measures include a renewed focus on hospital avoidance, patient flow discharge planning, and regular and frequent assessments of patients with long stays. The performance management and improvement unit is still supporting UHL. It remains a work-in-progress.

There is a bespoke site-level plan for Limerick as part of the national winter plan. It needs more consultants and the recruitment of extra staff - two emergency medicine consultants and discharge co-ordinators to target patient flow. That is now happening and they have been hired. The plan also includes improving access to diagnostics in the emergency department, the enhancement of GP out-of-hours services, and committing to the presence of senior decision-makers on a 16-hour, seven-day-per-week basis. The workforce in Limerick has grown by 833 whole-time equivalents. That is an increase of about 29%.

Michael McNamara (Clare, Independent)
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This issue was raised repeatedly in the Dáil, so why did it take a protected disclosure for the Minister to meet the staff? What is actually changing? We can list out reams of statistics. The Taoiseach spoke about changes over 20 years, but the single greatest change over those 20 years has been that people in Clare no longer want to be brought to that hospital. That is a major change. People on the street and in the countryside do not have confidence in the hospital and NCHDs do not want to work in it.

At this stage, it should be evident that the hospital is not working. We can pour as much water as we want into a leaking bucket or throw as much money as we want at a system that does not work, but none of that will improve matters. I do not want to speak about individuals, but will the hospital's management structures be examined? Until we do that, the profound change required will not happen.

Micheál Martin (Cork South Central, Fianna Fail)
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I think I understand fully where the Deputy is coming from. There has been huge pressure on that hospital over recent years. The workforce has increased - I went through that with the Deputy - and the budget went up 20% in one year alone. In 2022, it is €315 million, an increase of 19%. Actually, that is since 2019, so it was not in one year. The new 60-bed module was put in in 2021 and has opened. There were rapid-build projects. There will be further developments. Work has just commenced on a new four-storey, 96-single bed acute inpatient ward block. That has to happen. I know the Deputy is saying that we are pouring water, but Limerick is the key hospital in that region, so we have to work to improve-----

Michael McNamara (Clare, Independent)
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And the only one-----

Micheál Martin (Cork South Central, Fianna Fail)
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Yes, and we have to work to-----

Michael McNamara (Clare, Independent)
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-----in the wider region.

Micheál Martin (Cork South Central, Fianna Fail)
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No. In the south west, it is essentially Cork University Hospital, CUH. There is Mercy University Hospital and so on, but CUH is a tertiary-----

Michael McNamara (Clare, Independent)
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A smaller area, though.

Micheál Martin (Cork South Central, Fianna Fail)
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A bigger population. It does not matter. We need to resource and advance Limerick more. We have to. It does need more capacity in terms of personnel, facilities, beds and so forth. The enhanced community care side of it is very important also so that we can reduce the number of people presenting who do not need to go to accident and emergency departments. It is very important they have proper, good-quality care at different sites and different centres.