Dáil debates

Thursday, 8 December 2022

Ceisteanna ar Pholasaí nó ar Reachtaíocht - Questions on Policy or Legislation

 

12:30 pm

Photo of Pearse DohertyPearse Doherty (Donegal, Sinn Fein)
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Last night, there was a very important debate in the House. I must put on record again that Sinn Féin welcomes the fact that the Minister for Health accepted some of our concerns regarding the Patient Safety (Notifiable Patient Safety Incidents) Bill 2019 and has now agreed to bring forward an amendment to deal with one of the issues we raised. That is very much welcome.

I am also conscious that, as I speak, this is a very difficult day for Stephen Teap, who has just agreed a settlement in relation to the laboratories and the HSE. He never gave up and never stopped battling on behalf of his wife, Irene. It is for people like Irene and Stephen Teap, Vicky Phelan and so many others that we have a huge weight of responsibility to work together and collectively get this legislation right.

There are other concerns with this legislation regarding the anonymised audits that would take place in that there is no duty to inform the women or individuals in that case. It is up to the individual to seek a review if he or she so wishes. I ask the Government to engage with us and others and with the campaign group to make sure we get this legislation right on behalf of everybody who has battled for such causes.

12:40 pm

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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I understand the Dáil agreed last night that the Report Stage debate of the patient safety Bill would be adjourned until January. That will allow preparation of a new amendment which will place on a statutory basis the requirement for all patients to be informed of their right to a patient requested review of cancer screening. The Minister for Health will want to engage with the Opposition on the detail of that and on the issue of audits. It is a complicated area. We are all on the same side when it comes to this issue. We all want a cancer screening system that works well. There is value in anonymised audits but risks also arise from them. It is a tricky one but there will be engagement from the Government with the Opposition on this because we want to get it right.

Photo of Ivana BacikIvana Bacik (Dublin Bay South, Labour)
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All of us will want to send our thoughts and sympathies to the families of the four-year-old child in north Dublin and the five-year-old child in Belfast who died from strep A in recent days. All of us will be thinking of their families, communities and young classmates who have suffered such devastating news of this terrible loss. There are huge levels of fear, particularly among parents and families of young children, at the rising rate of viral infections in the community and at the HSE communication asking for children with signs of illness to be kept at home. We are all conscious that our children's hospitals are under extreme pressure. On Wednesday, they were at critical capacity with so many presenting to emergency departments. It is vital that we see the urgent roll-out of free GP care to six- and seven-year-olds and the phased expansion to children aged 12 and under, as was promised in the Government's budget. We welcomed that announcement, although we in the Labour Party felt it should have gone further. At such a crucial and concerning time, we ask that the roll-out be continued apace. Can the Tánaiste give a deadline for it?

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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I join the Deputy in extending my deepest condolences to the families, friends and school communities of the children who died from strep A. It must be any parent or family's nightmare to have a healthy child one day who gets an illness and is gone a few days later. I cannot imagine what that must be like.

The Government is committed to extending free GP care for children. I never felt children should be means-tested based on their parents' incomes. One of the things the former Minister of State, Kathleen Lynch, and I achieved together in Government was the extension of free GP care to the under-sixes. It has been extended to some other groups since, for example, carers, people with terminal illnesses and children with disabilities, but we have not managed to get beyond under-sixes and I am frustrated about that. I am sorry we did not write it into the law at the time that the age would go up by one year every year. If we had, we would be at 12 years by now. Over the last period, discussions of the consultant contract took precedence. The Minister for Health will now want to move on this issue as soon as possible.

Photo of Jennifer WhitmoreJennifer Whitmore (Wicklow, Social Democrats)
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The plan to suspend teacher career breaks was apparently signed off on at an incorporeal Cabinet meeting on Tuesday night. Incredibly, the Department and Minister for Education believe the best way to recruit and retain teachers in the system is to reduce their terms and conditions. Does the Tánaiste agree with the proposal to suspend career breaks for teachers?

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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There was no such incorporeal meeting that I was party to and no decision has been made that I am aware of to suspend teachers' career breaks.

Photo of Jennifer WhitmoreJennifer Whitmore (Wicklow, Social Democrats)
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So this is not a Government proposal.

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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Let me say this. I think the provision for career breaks is a very important one. There are lots of good reasons people may need to take a career break, often personal and family reasons, as the Deputy appreciates. The fact that the provision for career breaks exists in the public service helps encourage people into the public service and is more likely to make them stay than leave. While there may be an examination of some of the exact terms, conditions and rules around that, there is not a proposal to stop career breaks. I want to make that clear.

Photo of Paul MurphyPaul Murphy (Dublin South West, RISE)
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United Against Racism is holding a rally today at 5.30 p.m. at the Spire to state clearly that we have a housing crisis, not a refugee crisis, and that refugees are welcome here. It is an expression of unity and solidarity in response to the division and hate being spread by the far right. People who arrive here are fleeing wars, climate change and brutal oppression. They are not responsible for the housing crisis, which existed well before they arrived. Blaming asylum seekers plays into the hands of those profiting from that crisis, namely, corporate landlords and big developers. Instead of being divided, we need to unite, welcome those coming here and fight together for the homes and services we all need. When will the action plan against racism be published? I understand it was submitted by the independent anti-racism committee on 27 June but still has not been brought to Government.

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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The plan has not yet been brought to Government but I am informed by the Minister, Deputy O'Gorman, that we will publish the national action plan against racism early next year, hopefully in January or February. I note the Deputy's comments. Migrants are welcome in Ireland. If it were not for migrants, we would not be able to staff our public services. Many of the big companies that employ many people and pay a lot of tax would not be here if it they could not recruit people from abroad. Migrants enrich our society and make it a better place. It is an old-fashioned trope for centuries among people on the far right and others that if there is unemployment, crime or a housing crisis, migrants are to blame. That is totally wrong.

Photo of Matt ShanahanMatt Shanahan (Waterford, Independent)
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I brought the issue of hospital and cardiac care in Waterford to the Dáil a number of times and I am glad to report the second cath lab is more or less completed. There is a commissioning phase to be completed over the next eight to ten weeks. The efforts of University Hospital Waterford should be recognised. It is now the stand-out hospital in the country in having the lowest trolley count and most significant impact on its long-term waiting lists, which are down by over 20% this year. However, the hospital is still struggling with resourcing. We have no cath lab beds dedicated for the day ward. I spoke to the Minister for Health last night and he said this is being progressed but we need additional effort. There has been discussion for almost a year about additional capital supports to the hospital. None of them have been provided. We have HSE estates talking about new designs but nothing has been delivered and there are no project managers or funding. I ask the Government to give us the additional cardiac day beds.

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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I can give a commitment that the Government will examine that. A lot of progress, as the Deputy said, has been made in Waterford in recent years, particularly with the major improvement in trolley waits. It is now one of the best performing hospitals, in part because of the good clinical leadership and management there, but also the additional resources in the Dunmore wing. With a rising and ageing population, if we do not continue to expand the hospital, we will fall backwards again. We will examine what can be done to extend bed capacity. I am pleased to hear the second cath lab is nearing completion. It has been a long saga. I am determined to work with the Deputy, the Minister for Health and everyone involved to make sure it is commissioned and operating if not in the early part, certainly in the first half of next year.

Photo of Richard O'DonoghueRichard O'Donoghue (Limerick County, Independent)
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Last night we debated an important Bill on patient safety. How can we have a good hospital system if the HSE investigates itself? Why can we not have an independent body to investigate serious complaints against hospitals like University Hospital Limerick? Some 70 health professionals - the Tánaiste is also a health professional - came forward on Q-Pulse to report incidents. Some 140 incidents related to one medical practitioner, yet none of them has been investigated. When they are investigated, it is by the HSE, which has people on every board. No matter which way you go, there are HSE representatives, past and present, on it. We need an independent public body to investigate serious incidents in our hospitals.

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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When a complaint is made, it is appropriate that in the first instance there should be an internal investigation, and that is often what is done. There are, however, independent bodies. HIQA, for example, is an independent body that can carry out investigations in certain circumstances.

Photo of Richard O'DonoghueRichard O'Donoghue (Limerick County, Independent)
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There are HSE members on it.

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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We are also, at the request of the Ombudsman, examining his proposal to allow his office to examine clinical matters, which is not currently allowed.

Photo of Richard O'DonoghueRichard O'Donoghue (Limerick County, Independent)
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They are made up by HSE bodies.

Photo of Michael McNamaraMichael McNamara (Clare, Independent)
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The Shannon Group was set up with three components. It has been successful in running two of those, notwithstanding much adversity. It has been less successful with the heritage sites and the group's management seems to be of the view that it is not a good fit with the Shannon Group, which has a commercial remit. Clare County Council has offered to take over these sites.

They have identified capital needs and they have set out a detailed paper on what those needs are. I have written to four Ministers and to the Taoiseach to ask for a high-level person to be appointed to bring them together. There are four Ministers involved, and it is bouncing around between them. There are State agencies, such as Fáilte Ireland, and of course Clare County Council,involved. It now looks like the deal is in jeopardy and there is a lot of toing and froing in the media between the Shannon Airport Group and Clare County Council. Does the Tánaiste, as incoming Taoiseach, think that we now need to appoint somebody high level to bring these groups together to get this over the line to bring finality?

12:50 pm

Photo of Catherine ConnollyCatherine Connolly (Galway West, Independent)
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The Tánaiste to respond.

Photo of Michael McNamaraMichael McNamara (Clare, Independent)
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The heritage sites either stay or they go.

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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I thank the Deputy for raising this issue, which I know he has raised before. Deputy Carey has also been briefing me on it in the past couple of weeks. It is a good thing Clare County Council is agreeing to take on these heritage sites. They will need money because work needs to be done on those sites and we want to bring them up to standard. There is a process ongoing to resolve this. I am not personally across it, so I do not know whether the right thing to do at this stage is to appoint an arbitrator or not. However, I do understand that this has been going on for a long time and that it has been bounced through different public bodies and that is not a satisfactory situation. I will look into it again and we will try to get to a resolution sooner rather than later.

Photo of Pádraig O'SullivanPádraig O'Sullivan (Cork North Central, Fianna Fail)
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I have raised the issue of orphan drugs and rare diseases with the Tánaiste before. It is fitting that I raise again this week, given the announcement in relation to Kaftrio this week and the disappointment that that has caused for that cohort of patients.

The Minister for Health, Deputy Donnelly, has previously given me a commitment that he will publish the Mazars report into the reimbursement process and that is welcome. While I welcome that, there is so much more we can do, including risk sharing and conditional reimbursement. All these steps are being taken in other EU countries and we are laggards in that regard. I am just asking that when the Tánaiste assumes the office of Taoiseach in the coming weeks he will give this issue the attention it deserves and will prioritise it.

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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My grandmother always told me not to tempt fate so I prefer not to assume that I will be elected Taoiseach again on Saturday week, but I thank the Deputy for his kind words. I agree that this is an issue that we need to turn around, next year hopefully. I have served as Minister for Health, I am a Deputy and I am Minister for Enterprise, Trade and Employment, and I find it very hard to explain to parents and to patients why there are treatments that are available in Britain or in other European countries that are not reimbursed here. I find it hard as a Deputy as well as a doctor. As the Minister for Enterprise, Trade and Employment, I find it hard to explain to companies why medicines that they produce here and develop here are not available to patients here. We have seen some big improvements in the past couple of years. Money has been set aside that has been dedicated to new medicines. I think 30 or 50 molecules were approved in the last year, but it is clearly still a problem, and it is a matter in which I will take a personal interest.

Photo of Richard BrutonRichard Bruton (Dublin Bay North, Fine Gael)
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This week, we were reminded at COP15 that material use is now heading towards three times what nature can replenish in a year. I welcome yesterday’s publication of the Tánaiste’s enterprise White Paper, which stated that the transition to carbon neutrality and environmental soundness will be a central plank and that you do not see it as a threat to our competitiveness but rather as an opportunity. I would like to ask the Tánaiste if we have the policy tools to deliver this transition. Offshore wind is quoted as a once-in-a-generation opportunity. We have the second lowest circularity rate in Europe. We have a lot of ground to make up and I am interested to hear how we can develop the tools to make it happen quickly enough.

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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That is a very good question and like a lot of the best questions, it is hard to answer. It is fair to say that we have some of the tools but not all of them. That is what we will have to focus on now that we have the new enterprise White Paper. We set out the ambition very clearly in that regard. We need to move towards implementation, and we will do that as soon as possible.

Photo of Darren O'RourkeDarren O'Rourke (Meath East, Sinn Fein)
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Dublin Airport’s north runway is welcome, but it is operating contrary to its planning permission. The flight paths that are being operated are not the ones that were agreed. Houses were insulated to mitigate against the noise of low-flying planes. Incredibly, many of those homes are not now on the flight path, while hundreds of others, as well as schools and businesses which were never insulated, have to live with the noise nuisance of low-flying planes for hours each day. This appears to be a spectacular error by the Dublin Airport Authority, DAA, the IAA, and by Fingal County Council who have responsibility here. What measures is the Government taking to address this? Will the Tánaiste ensure that the DAA is not allowed to operate contrary to its permissions?

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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I am afraid that I do not have up-to-date information on that issue at present, but I will let the Minister of State, Deputy Naughton, know that the Deputy has raised this issue in the Dáil, and I will ask her to come back to him directly.

Photo of Jennifer Murnane O'ConnorJennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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This week I will be meeting with the community employment, CE, supervisors in Carlow. The remuneration package that is currently on the table needs to take into account that CE supervisors have not had a pay rise in 13 years, which means that their pay does not now reflect their level of responsibility. When the issue is raised here, the answer is that the Department is not their employer. Supervisors were never asked not to be seen as public servants and they never gave up the right to be seen as such. CE supervisors were never included in the Financial Emergency Measures in the Public Interest (FEMPI) No. 2 Act 2009 and, although they were due an increase at that same time, they never received it. Therefore, I believe that they have taken a pay cut. Their workload has doubled in 13 years and, given the recent increase in the cost of living, they cannot afford to live on their wages. The budget has done very little to alleviate their plight. Pro rata, they are working for less money than many of the people they are supervising on the scheme. They are providing a vital scheme and they are being shortchanged. What are we doing for them to make sure that they get their proper wages?

Photo of Joe O'BrienJoe O'Brien (Dublin Fingal, Green Party)
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I thank the Deputy for raising the issue of CE supervisor pay. In my answer I will also include assistant supervisors and supervisors of rural social scheme, RSS, and Tús schemes, who we also need to look at. My Department has been in negotiations with unions this year. Unions have gone to the Workplace Relations Commission, WRC, to open a conciliation process. The Department of Social Protection has been invited to that conciliation process. We should engage in that process, and we are ready to go into that and to make an offer. Before we can do that, we need the backing of the Department of Public Expenditure and Reform. We need its sanction to take the next step. We should do it as soon as possible.

Photo of Paul KehoePaul Kehoe (Wexford, Fine Gael)
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I am delighted the Minister for Children, Equality, Disability, Integration and Youth, Deputy O’Gorman, is present. I have previously raised in the Dáil with the Taoiseach the issue of moneys outstanding to hotels, bed and breakfasts and guesthouses who are accommodating Ukrainians and refugees. There are a number of them in my own constituency and these people are in serious financial need. There are outstanding moneys going back three and four months, when their mortgages, loans, food supplies, electricity, heating, staff and refurbishment costs are all outstanding and their credit ratings are on the line. I plead with the Minister, Deputy O’Gorman, to speak to the Secretary General at his Department on this issue so that it can be sorted as soon as possible. The Government should not be letting these people down. They rose to the challenge, and they are providing a fantastic service-----

Photo of Catherine ConnollyCatherine Connolly (Galway West, Independent)
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I thank the Deputy.

Photo of Paul KehoePaul Kehoe (Wexford, Fine Gael)
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I ask the Minister to talk to the Secretary General at his Department on this issue.

Photo of Roderic O'GormanRoderic O'Gorman (Dublin West, Green Party)
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I thank the Deputy and I know that he has been contact with my Department and directly with me about some local providers. We have over the last number of months started over 650 individual contracts with hotels, guesthouses and bed and breakfasts. We have needed to upscale our ability to deal with that number of contracts. When the Deputy and others have asked, I have had additional resources transferred within my Department to specifically resource getting invoices out and paid. That has been done. We are working through a backlog and we have made significant progress. I believe in the next two or three weeks we will be fully caught up. I thank the Deputy again for raising the issue, which I will discuss again with the Secretary General to make sure we are doing all we can to get people paid as promptly as possible.

Photo of Patricia RyanPatricia Ryan (Kildare South, Sinn Fein)
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I wish to raise the state of KDoc and the out-of-hours GP service in Kildare. On Monday evening, a constituent phoned the helpline at 6 p.m. for a sick baby. She phoned six times and she was put hold between ten and 34 minutes before being cut off. She finally got an answer at 9:49 p.m. to be told that there were no appointments left and that she would have to go to her own GP the next morning. She expressed concern about her child, and she was told that she could go to A&E if she wanted. She rang KDoc in Carlow at 10 p.m., was answered straight away and she was given an appointment at 11.20 p.m. She was lucky that she could go, that she could give a relative’s address and that she could drive the 50-minute journey. Others may not be so lucky.

Will the Tánaiste please ensure that the right resources are directed towards the Kildare service?

We have heard people this morning talking about strep A and the concerns of parents.

1:00 pm

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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I thank the Deputy for raising this issue. I am sorry to hear about that lady's experience. I worked in KDoc in Naas once upon a time and it is a good service most of the time. Perhaps particular issues relating to staff or some other matters arose. If the Deputy passes the lady's details to my office, with her permission, we will follow it up with KDoc and the HSE.

Photo of Neale RichmondNeale Richmond (Dublin Rathdown, Fine Gael)
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I was contacted this week by approximately a dozen businesses in my constituency. Their energy bills have landed and in many cases they are five times the amount they were this time last year. We welcome the new temporary business energy support scheme. What will the Government do to maximise not only awareness of this scheme but also participation in it to ensure those businesses can keep their doors open after Christmas?

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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The scheme is now open to applications. We expect businesses will receive the first payments before Christmas or by the end of the year and they will be backdated to September. Payments will cover approximately 40% of the increase in electricity or gas bills. I know that still means a big increase for businesses, but it is significant help and it is what was approved under EU state aid rules. We are doing our best to ensure people know about it through business organisations, through the Revenue Commissioners and through accountancy practices, as accountants will want to let their customers know it is available.

Photo of Johnny MythenJohnny Mythen (Wexford, Sinn Fein)
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I have been engaging with some of the retained firefighters in County Wexford. A national survey indicated that 60% of them intend to leave soon. A new fire station recently opened in New Ross, which is welcome. However, it cost €1.6 million and due to staffing it is only operating as a one-pump station and must rely on other stations such as Enniscorthy, which is at least half an hour away. That is a long time to wait if a person has a serious house fire. What is the Government's position on improving the conditions and further recruitment of retained firefighters? At present they are on call 24-7 with little or no incentives or prospect of promotion and are haemorrhaging experienced personnel who are not being replaced.

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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We appreciate that the retained fire service is stretched. The Minister is examining the matter at the moment. I will let him know the Deputy raised it in the House and ask him to revert to him directly.

Photo of Gino KennyGino Kenny (Dublin Mid West, People Before Profit Alliance)
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A constituent has contacted me about an unlicensed drug called Cariban, which is used to treat hyperemesis. Deputy Richmond raised this matter with the Minister of State yesterday. The situation with this drug is slightly unclear. This condition, as the Tánaiste will be aware, causes extreme vomiting in pregnancy and is dangerous for both the baby and the mother. In this year's budget, the Minister announced that the drug would be reimbursed and that is welcome. However, it is only reimbursed when prescribed by a consultant and not a GP. The condition generally begins in the first few weeks of pregnancy. Most women will only see a consultant after 12 weeks of pregnancy. The women who have contacted me, and probably other Deputies, say they want GPs to be allowed to prescribe the drug so that it becomes accessible and will be reimbursed more quickly than it is at present.

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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I am aware of the medicine. It is a treatment for hyperemesis gravidarum, which is a serious and debilitating illness in pregnancy if someone has the misfortune to experience it. I do not know the rationale for not allowing GPs to prescribe it. GPs routinely deal with pregnancies of all kinds, especially in early pregnancy. I am not sure whether there is a good reason for it and being unaware, I will not comment any further. I will certainly ask my office to take it up with the Minister for Health's office and revert to Deputy Kenny with a further reply.

Photo of Claire KerraneClaire Kerrane (Roscommon-Galway, Sinn Fein)
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Earlier this week I received an email from a CE scheme supervisor who has been left with no option but to resign. She was running a scheme with 32 participants, supporting 20 sponsors, covering an area of 85 km and responsible for €500,000 in Government funding through the scheme. She was working without the support of an assistant supervisor because they have not been able to recruit anyone due to poor pay. She is not the only one. I heard what was said with respect to the Department of Public Expenditure and Reform and I ask that this is treated with a sense of urgency before more good people go. These are critical supports and services in our communities and many of the services would not exist without the schemes. I ask that all schemes be reviewed, including the RSS and Tús, because they are so important to our communities. The Department of Public Expenditure and Reform needs to give the go-ahead for engagement to begin. A sense of urgency is needed in this matter.

Photo of Joe O'BrienJoe O'Brien (Dublin Fingal, Green Party)
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I appreciate the Deputy pressing that sense of urgency. There are approximately 1,200 CE supervisors and assistant supervisors around the country. They provide an enormous service to their communities. They open pathways to work for people, provide a social inclusion service locally for people who would not otherwise be looked after and run key local services. We need to look after them. As the Deputy has said and as I said earlier, we need to look after Tús and RSS supervisors as well. We have had quite a bit of communication with unions this year. It is being dealt with by the WRC now and we are waiting for an invitation to a conciliation process. It is important we engage in that conciliation process but there is no point in us walking into the room unless we have sanction from the Department of Public Expenditure and Reform to negotiate in a realistic way with some funds.

Photo of Bríd SmithBríd Smith (Dublin South Central, People Before Profit Alliance)
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I spent half an hour with the Iranian community outside the gates of the Dáil today. It is three months since Mahsa Amini was killed in police custody. The regime made an announcement at the weekend that the morality police had been disbanded. According to those activists, this is utterly untrue. It is propaganda and another young activist was executed by the regime this morning. On behalf of that movement, I ask the Government to express its solidarity with the movement and, in concrete terms, to give a commitment that it will not reopen the embassy in Tehran while the regime continues its brutal onslaught against women, mainly, but also the entire community. That regime is not acceptable and has to go. The Government should express its solidarity in some way, today and in the long term.

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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The Government expresses its absolute solidarity with the people of Iran who are seeking democracy and human rights and fighting for equality for women, LGBT people and people of all religions. I express our solidarity with them. We raise these issues with the Iranian Government and with the Iranian ambassador to Ireland.

Regarding our plans to reopen an embassy in Tehran, a chargé d'affaires has been appointed and is representing Ireland in Iran from the German embassy. In general, we take the view that it is better to have lines of communication with other countries even if those countries have different values from ours. That is why we have embassies in many parts of the world that are not democratic. We think it is better to be able to talk than not to be able to talk at all. However, the decision on whether we will open a physical embassy in Iran is under review, as the Minister for Foreign Affairs has said.

Cuireadh an Dáil ar fionraí ar 1.07 p.m. agus cuireadh tús leis arís ar 1.51 p.m.

Sitting suspended at 1.07 p.m. and resumed at 1.51 p.m.