Pearse Doherty (Donegal, Sinn Fein)
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Yesterday, a terrible fire broke out at Wexford General Hospital, which has led to the evacuation of more than 200 patients. Our thoughts this morning are with the people of Wexford. I commend everybody involved in the emergency response. In particular, I commend the Wexford fire brigade, all of our front-line healthcare workers, those in the ambulance service in the hospital and nearby hospitals and all of those who responded to the tragedy yesterday. The priority now must be to support patients, their families and the staff in our healthcare service. Their safety must come first. I offer our full support to the crisis management team and to our front-line heroes in Wexford, Waterford and Kilkenny and right across the State who have been asked, once again, to step up and respond to a crisis. I have no doubt they will continue to keep the health service running under immense pressure, just as they have always done, whether during the Covid pandemic, the cyberattack or what is now the constant year-long winter overcrowding crisis.

Tá ár smaointe ar maidin le muintir Loch Garman. Tugaim ár dtacaíocht iomlán dár laochra ar an líne thosaigh sa réigiún atá ag déileáil leis an ngéarchéim. Níl aon amhras orm ach go leanfaidh siad ar aghaidh ag coinneáil an tseirbhís sláinte ag dul, seirbhís atá faoi bhrú ollmhór, mar a rinne siad i gcónaí, fiú tríd an phaindéim Covid, tríd an chibirionsaí agus tríd an phlódú geimhridh.

It is essential that, while the healthcare service responds to the crisis, the Government responds quickly to support the health service and to put in place additional capacity and alternative care plans for these patients. As we know, it may be some time before full service resumes at Wexford. Appointments and procedures have necessarily been cancelled until it is safe for them to proceed. The disruption will undoubtedly cause much distress and anxiety to people in Wexford and the surrounding region. There are two important steps that must now be taken. First, the families must be kept fully informed. There needs to be really strong lines of communication with them throughout this crisis. This is particularly important for those who have been transferred a considerable distance, including as far as Drogheda, which will be difficult for their families, their loved ones and themselves. These families need to be engaged with, involved and supported right throughout this process.

Importantly, as the Tánaiste will know, our hospitals are already stretched thin and full to the brink. Overcrowding is systemic and widespread right across the State. In the south east, occupancy rates are as high as 95%. This will undoubtedly put significant additional strain on a healthcare service that is already at breaking point in the region. Not only must we restore Wexford hospital to full operational capacity as soon as is practically possible, but we must inject much-needed additional capacity into that region to manage the fallout. The Government needs to look at all options available in the short term. It needs to look at community capacity, private hospitals and nursing homes. The full healthcare capacity of the region must be marshalled and mobilised to support the State's response. As the Tánaiste will know, there are proposals for an additional 90 beds at Wexford and expansions for other hospitals in the region. These proposals now need to be fast-tracked and delivered at pace.

Can the Tánaiste confirm that there will be open, considerable and ongoing communication with the affected families? Can he confirm that his Government will go above and beyond to support Wexford and the region, to mobilise healthcare resources and to rapidly inject additional capacity into the region? Will he ensure that the crisis management team and the HSE have the full support and authority of the Government in doing everything they must as quickly as they can? Will the Tánaiste ensure that sufficient time is allocated as early as possible next week to ensure we have a proper, rounded and full debate on the response needed as a result of this incident?

Micheál Martin (Cork South Central, Fianna Fail)
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I thank the Deputy for raising this issue. We were all shocked at the potential impact of such a disastrous fire in one of our major acute hospitals. If you stand back and think about what the implications could have been, it is clear we owe an extraordinary debt of gratitude to all of the essential services involved, especially the fire service and Civil Defence personnel who got there quickly and marshalled their resources expertly to reduce the impact of the fire, but also everybody working in the hospital and the HSE who managed to take out 207 patients under very stressful circumstances with no fatalities. We should pay tribute to all involved, first responders and emergency services. I will add to that the National Ambulance Service, which did incredible work in transporting patients from a very acute and stressful scene to other hospitals. At times, we can be rightly critical of our services but, at other times, we need to salute the bravery and courage of our fire service and all involved in activating the local and area emergency plans so effectively and efficiently. That underlines the importance of emergency planning and everybody putting the shoulder to the wheel to prevent disaster. I say that sincerely in respect of all involved.

Gabhaim buíochas leis na seirbhísí éigeandála agus gach éinne a bhí páirteach aréir as ucht an mhéid a dheineadar. Gan amhras, tá an ceart ag an Teachta go gcaithfidh an Rialtas gach aon rud is féidir linn a dhéanamh chun cabhair agus tacaíocht a thabhairt do mhuintir Loch Garman, pobal an ospidéil, gach éinne atá ag obair ann agus na hothair ach go háirithe. Táimid agus beimid sásta é seo a dhéanamh. Tá sé sin ríthábhachtach.

It is a big blow to the health services in the south east. It will have an impact on existing services as regards capacity to absorb and develop. Everything that can be done will be done to restore services as quickly as possible. A helpline has been established and can be reached at 053 9153012. It is for patients and families of patients. The Deputy is correct when he says that communication with families and with people awaiting appointments and so on in the coming days is very important. The HSE is aware of that. In many ways, the services are still in an emergency phase in managing the patient aspect and dimension of this. I refer not only to those who were in the hospital, but also to those who were scheduled to come to the hospital and those awaiting outpatient treatment. The HSE and the Minister will work with Government colleagues to determine how service provision - I am particularly thinking about diagnostics and outpatient care - in the interim period can be organised as quickly as possible, potentially in different locations, to get certain basic things done. I refer to things such as the restoration of minor injuries units in the quick phase. Obviously, the implications of this fire for the general structure of the hospital and its impact on services will have to be assessed but we are focused on and conscious of the need to get services back as quickly as we can. There is a significant continuum of services involved, ranging from outpatient care and diagnostics right through to acute and emergency care. It will be challenging. There is no point in saying it will not. However, I would like to think that, as we rebuild from the ashes of this fire, we can create a modern 21st century facility in Wexford.

Pearse Doherty (Donegal, Sinn Fein)
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It is at times like these that we recognise the value of the emergency services. I saw it myself, standing at the lines in Creeslough where people were rushing in to a building that could collapse and, again, yesterday evening, as people risked their own lives to make sure that other lives were saved. Thankfully, we are standing here today with a plan that was executed without fault in relation to the safety of patients. That needs to be our focus in the time ahead.

We are conscious that this is still, as the Tánaiste said, an emergency phase but we need to hear of some actions now in relation to where we go forward. There are the concerns, as the Tánaiste will recognise, of people who have had appointments cancelled. Is there any information that we can provide them in relation to whether they are likely to be rescheduled in other hospitals over the intervening period?

In relation to capacity in the region, as the House will be aware, for eight years this 90-bed ward has been talked about. It has not been delivered. Is the Government committed now, as the Tánaiste mentioned, that from the ashes of this here we can ensure that the capacity is injected into the region to make sure that we support it? Crucially, can we provide adequate time next week to look at the response and to make sure that we respond in an appropriate way when we have more information?

Micheál Martin (Cork South Central, Fianna Fail)
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First, I take the points that the Deputy has made in good faith, of course. On the earlier point the Deputy made, it is worth reflecting that the Health Service Executive, which comes in for criticism from time to time, in the context of Covid, the cyberattack and now this, has responded in a coherent, effective way to real emergencies. These have been three that we can identify. That needs to be put on the record. I thank all of the HSE staff, from the leadership down, for the magnificent manner in which they have responded as a service to this terrible event that has happened.

Second, in terms of the 92-bed unit-----

Brendan Howlin (Wexford, Labour)
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Ninety-six.

Micheál Martin (Cork South Central, Fianna Fail)
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In terms of this opportunity, by which I mean we are building now anew and fresh, we should examine how we deal with the future needs of the hospital in Wexford. That is my view. Obviously, the Cabinet will discuss this. There are opportunities. Also, it is an emergency. We have to look at the planning situation and see what we can do to expedite the return of permanent facilities here.

In the interim, we have to allow the HSE do the assessment. Following that assessment, it can plan out the programme of interventions.

Pearse Doherty (Donegal, Sinn Fein)
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Can we have time next week?

Micheál Martin (Cork South Central, Fianna Fail)
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Hopefully, yes, but we might discuss that. We want to give those at the coalface the opportunity to get the main work done first and, of course, to come back to us then.

Brendan Howlin (Wexford, Labour)
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There is a palpable sense of relief in Wexford this morning. What could yesterday evening have become an historic tragedy was averted by the calm, dedicated professionalism of the emergency services in Wexford. Our fire brigade, local authority staff, Civil Defence, ambulance services, hospital staff and management, the voluntary sector and, indeed, private ambulance operators all immediately rallied to the cause supported magnificently by the entire health community. All are due remarkable praise for an outstanding response.

The emergency plan that the Tánaiste has indicated was activated and, more importantly, worked and now, I understand, has been stood down.

Understandably, the focus now moves to dealing with the consequences of this terrible fire. Two hundred and twenty-one patients were in Wexford hospital yesterday evening. Over 180 have now been dislodged to hospitals from Waterford to Navan. The challenge now is how we are to continue with their care plans in a seamless and uninterrupted way ensuring their medical charts are available and that their families are kept fully informed of their medical progress.

Clear information has to be provided for the 165,000 people of Wexford who depend on their hospital for vital services. Expectant mothers are looking forward to delivering yellow bellies in their hospital. What is to happen? What arrangements are made for them? There are patients in the middle of treatment for cancer or for any number of life-threatening illnesses. Of course, the people of Wexford will continue to experience, today, tomorrow and the day after, heart attacks, road traffic accidents and other urgent issues that require timely medical responses.

Responding to this, as the Tánaiste says, will be enormously challenging. The crisis management team has been in session in the hospital since early morning and we will learn further of its plans today.

For the Government, the requirement is to act with the same speed and determination as the emergency services did and with the same clarity in its response. The asks I put to the Tánaiste today are to commit, on behalf of the Government, to provide whatever resources are needed to bring Wexford Hospital back into use - that means temporary provision plant equipment to get services up and running in those parts of the hospital that can be brought immediately back into use and the immediate sanctioning of the resources for construction and replacement of the damaged infrastructure; the deployment of whatever ambulance resources are needed, including emergency medical technicians, EMTs, and vehicles to ensure that there is a timely medical response in the county; and to commit to the fast-tracking of the long-promised 96-bed unit that officially is still awaiting a strategic assessment report - that must happen urgently.

The community rallied to this tragedy. We must do the same. Wexford, as I say, has responded magnificently to this destructive event. I am asking for the same determined, clear and unequivocal response from the Government.

Micheál Martin (Cork South Central, Fianna Fail)
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I thank Deputy Howlin for raising the issue. The Deputy is personally committed to Wexford Hospital, as he has been for all of his political life, as indeed all of his colleagues representing the county have as well.

Deputy Howlin is correct. A disaster, on one level, has been averted in the sense of no loss of life and injury. It is quite incredible to comprehend the degree to which the fire services, the first responders and the ambulance service all got together so quickly to prevent disaster from unfolding in terms of human fatality and injury as a result of this fire.

Mar a dúirt an Teachta, ní neart go cur le chéile. Bhí spiorad na meithle le feiscint agus le brath aréir i Loch Garman. Táimid go léir buíoch de gach aon duine a ghlac páirt chun cabhair agus tacaíocht a thabhairt do dhaoine aréir.

As the Deputy said, the crisis management team is meeting today. The Government is clear and is determined to do whatever it takes to provide services for all those impacted in Wexford as a result of this and in the hinterland the hospital serves. We are determined to do everything we possibly can to help to assist and provide for services.

This is an emergency that has arisen because of this fire and we have to allow those at the coalface to put the nuts and bolts together in terms of the pathways for the patients and the protocols in respect of emergency responses to cardiac situations and how we deal with cancer patients. The entire health service nationally has to rally to this cause now because we have to respond in the manner that the Deputy has suggested.

As I said earlier, we should take the opportunity, in terms of a new build or a rebuild, to encompass additional capacity as well in terms of the 72 beds or 76 beds that have been promised -

Brendan Howlin (Wexford, Labour)
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Ninety-six.

Micheál Martin (Cork South Central, Fianna Fail)
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-----sorry, 96 - the additional capacity as committed - because the population is growing. One of the big issues in terms of public services more generally over the past decade has been the growth in population. As we configure our services into the future, we have to think about that increased population. It is growing fast now and will continue to.

I trust the clinicians and those at the coalface to map out for us in government their recommended pathways and approaches to deal with an emergency situation of this kind. The first responder service will be crucial and we need to engage with the National Ambulance Service. In a cardiac situation, in particular, or in other accidents, that first response is the key response to eventual survival and to outcome in respect of particular sudden medical emergencies that can emerge. Sometimes that role of the first responder is under-appreciated in such a context.

Brendan Howlin (Wexford, Labour)
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Bhí spiorad agus cumhacht muintir Loch Garman sofheicthe tráthnóna inné. Tá an spiorad céanna ag teastáil ón Rialtas inniu. The commitment must be that whatever emerges today from the emergency planning task force, which is sitting as we speak, whatever is requested in terms of additional vehicles for the ambulance service will be provided. It is a long way from the south-east corner of Wexford to another hospital if Wexford General Hospital is not available so that must be provided, along with interim steps. There must be a commitment that whatever resources are required in the medium term to bring Wexford General Hospital, which is important and vital infrastructure for the county of Wexford and the south east, back into full function as speedily as possible, will be provided.

The Ceann Comhairle visited Ukraine and I visited a war-torn area where a hospital had been destroyed and was replaced by a field hospital provided by Denmark instantly. These things are possible where there is a will. I want that same warlike determination to be applied to this to assure the people of Wexford that nobody will die. After the heroic work of the firefighters and others yesterday, nobody should die because of the medium or long-term consequences of this disastrous event.

Micheál Martin (Cork South Central, Fianna Fail)
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As I said, the Government will respond with clarity, commitment and resources to do everything we can to make sure we look after the patients who have been discommoded significantly as a result of this tragedy and meet the broader health needs of those served by the hospital, the consultants, the various clinics and so on. We expect that an assessment will be made quickly, both physically and in terms of what programmes and services we can get back more quickly. That is the approach I envisage and anticipate.

Brendan Howlin (Wexford, Labour)
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The Government must do what is required.

Micheál Martin (Cork South Central, Fianna Fail)
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We must have a multidisciplinary approach and examine what can be done without patients and what can be done with various different services. We should allow the experts at the coal face to come back to us. The Government will respond to say what we think is the best way to deal with oncology, diagnostics and outpatient appointments, for example. That is immediate-----

Brendan Howlin (Wexford, Labour)
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The clarity that is required is that the Government is committed that everything that was in Wexford General Hospital will be back.

Micheál Martin (Cork South Central, Fianna Fail)
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We have said that and there is no issue around that. No one anticipated that what happened last night would happen; it was quite shocking. As we have all agreed, when you think about it the implications could have been horrendous. We cannot get around that; it is just incredible that our services worked so well and that is the relief I take from it. Our response has to match that; I agree on that point.

Mattie McGrath (Tipperary, Independent)
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On behalf of the Rural Independent Group I want to thank gach éinne a raibh ag obair go crua inné agus a rinne sárobair san ospidéal i Loch Garman. We support the ongoing efforts there, which included Irish Red Cross units and the likes of Kenneth O'Connell and others from as far away as Tipperary town. That is the spirit of the meitheal that we like to see and hopefully all will end well.

Often times when we discuss the disaster of housing policy in Ireland, we focus on the plight of the homeless, first-time buyers and renters. Today, however, I wish to highlight the plight of a vulnerable cohort of our population that is also caught up our housing crisis, those being our elderly and people with disabilities, who rely on grant assistance to upgrade, adapt or repair their homes. The importance of the housing aid for older people grant, the mobility aids grant scheme and the housing adaptation grant for people with a disability, which enable people to live independently in their homes for longer, cannot be overstated. These grants have improved people's lives and well-being in the past and have seen them have long and happy lives at home but unfortunately, the grants are outdated and way behind what they should be.

First, the grant ceilings have not been increased in 13 years, despite the unprecedented increase in construction costs. The rising costs of materials and the shortage of skilled labour in Ireland are putting the cost of these upgrades and associated essential works beyond the reach of the recipients of these schemes, who the schemes are designed to assist, and that is very serious. Second, there are considerable waiting times for people waiting for grant approval nationwide, which is keeping people out of their homes until these essential adaptation works are completed. Today, 14% of our population are in the over-65 bracket, which will go up to 23% in the coming years. Therefore, these grants will be increasingly crucial for a growing cohort of individuals and their respective families to ensure our nursing homes and hospitals are not overwhelmed. That is the urgency of the matter. Third, the fixed-price grant rates for housing adaptation grants are no longer fit for purpose. The maximum grant levels are €8,000 under the housing aid for older people grant; €3,000 under the mobility aids grant scheme; and €30,000 under the housing adaptation grant for people with a disability, and these have not been increased for over 13 years.

The costs of building, labour and materials have increased as we all know. Therefore, I demand that these grant schemes be urgently reviewed with a drastically increased maximum grant rate. I fully support the calls by disability groups for the grant ceilings to be doubled, which would result in a maximum grant aid of €60,000. People want to do these works, they are happier in their homes and they have better health and life expectancy outcomes in their homes. We need to have realistic figures so that people can do these grant schemes and apply for the grants in a timely manner.

Micheál Martin (Cork South Central, Fianna Fail)
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I thank the Deputy for raising this important issue. Tá an ceart aige arís; caithimid gach aon rud gur féidir linn a dhéanamh ó thaobh na daoine is aosta agus is sinsire sa tír seo a chabhrú ó thaobh cúrsaí tithíochta de. Tá an Rialtas ag díriú air seo agus táimid ag cur níos mó áiseanna ar fáil do na bardais aitiúla ar fud na tíre. We have allocated substantial resources to housing and housing need more generally. I am familiar with many of these grant schemes and I think they have been effective. Many people have used them to good effect; for example, senior citizens have used them for adaptation. There is a wide continuum for adaptation; it can involve fairly basic provisions to enable mobility around the house with stairlifts and things like that or it can involve the conversion of bedrooms and shower facilities, including downstairs, to prepare for the future.

I will ask the Minister for Housing, Local Government and Heritage to review the grant thresholds. These are thresholds and in many instances people will not have to use the maximum amount available, depending on what they are applying for. It is the objective of the Government to keep people in their homes for as long as possible and to prevent falls in homes, for example. The Government wants to ensure that those with disabilities have independent living and that the wherewithal is there to facilitate that through capital works, adaptation programmes, independent living assistance and other supports of that kind. The Deputy has identified three grants, including the housing aid for older people grant, the mobility aids grant scheme and the housing adaptation grant for people with a disability. I will go back and get the precise numbers but, depending on the local authority, there has been a consistency of use of these grants on an annual basis. The Deputy is raising the fact that with increased costs and so on, the gap between the grant and the cost of a particular adaptation is making it too challenging for people to avail of the grants in the first instance. I will ask the Minister to review those thresholds in the context of the next budget and to take on board the issues that have been raised in that respect.

Mattie McGrath (Tipperary, Independent)
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I agree that the grants have been good and widely availed of but times have surpassed them. Due to increased energy, material and labour costs, people cannot get the work done within the schemes. The eligibility is also too low in the first instance - it has not moved on in 13 years, as I said.

Ireland is a signatory to the UN Convention on the Rights of Persons with Disabilities, which places a serious onus on its signatories to fully recognise equal rights for all persons with disabilities to live in the community and have equal choices to others. We have obligations under that convention. I understand the crisis in housing but this is an area where we must keep people in their houses and out of nursing homes and hospitals. We must keep them happier in their homes and nearer to neighbours, friends and family.

All we want is a tweaking of the scheme because it has not been tweaked in 13 years. The eligibility levels have not increased, first of all, to avail of it, and then the amounts granted and matching are nowhere near catching up to where they should be. There are huge shortfalls of perhaps, €10,000, €12,000 or €15,000. Quite frankly, people with disabilities and elderly people cannot get that money.

Micheál Martin (Cork South Central, Fianna Fail)
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We adhere to and support the UN human rights aspect the Deputy articulated. There has been progressive decongregation over the years, which has sometimes been controversial, as we seek to ensure people with disabilities can live in their communities and homes. It is extremely important that we continue with that, although we must do it sensitively and in full consultation with families. Over the past two decades, there has been substantial de-institutionalisation in the entire disability sector. Into the future, the objective is to facilitate people living in the community. There have been very good schemes in which that has been organised and facilitated. Likewise, we must provide the necessary supports for people living in their own homes. With regard to the grants, the Deputy raised the issue of eligibility thresholds for those who may be excluded from availing of this. Local authorities always prioritise medical needs in the allocation of funding under these grant schemes. We will continue to keep these matters under review.

Michael Fitzmaurice (Roscommon-Galway, Independent)
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We all need to acknowledge the work done by the emergency services in Wexford yesterday evening. I will comment on another part of the country, community healthcare organisation, CHO, 2. I am specifically dealing with County Roscommon, where we have been inundated over the past eight to ten months by parents of children aged between three and 15 or 16 regarding CAMHS services, ADHD and children with autism, where the whole system seems to be in disarray. A child aged three and a half had a blood test done that had to be sent to England for a diagnosis. Ten months later, those parents have still not got a reply or result, as the Tánaiste will be aware, because questions have gone to him over the past six to eight months. There are children who have not been assessed and no care plan has been put in place. Many children have no occupational therapy services or speech and language therapy. The reply when we write to the Minister is that he will send it to the HSE. Then, we wait a few more weeks and we get a lovely letter back saying it is due to staff shortages. In his reply to Deputy Mattie McGrath, the Tánaiste spoke about embracing the UN convention and treating all people the same. With regard to how these children are being placed, families are being put in a situation they do not want where they have to go to the courts to get what their children rightly deserve. I do not care whether there is a shortage or not in the HSE. The HSE needs to make decisions that if families can go privately, they should be told that their children, whatever services are required, will be paid for privately, if that is required. We have been going around in circles for the past six to eight months with parents getting frustrated. When I talk about frustrated, I have had parents crying on the phone, desperate to get services they are not getting. In the Roscommon area, it appears to be in total chaos. The letters we get back are constantly about staff shortages and retention of staff. Funnily enough, if you have enough money in your pocket, you can still get these people, depending on your income. I ask the Tánaiste to look at those cases and talk to the Minister beside him. Will he make sure the children in County Roscommon are treated the same as other children around the country?

Micheál Martin (Cork South Central, Fianna Fail)
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I thank the Deputy for raising a range of issues under the umbrella of CAMHS and the availability of therapies and disabilities. Will he send me details of the individual child he mentioned?

Michael Fitzmaurice (Roscommon-Galway, Independent)
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There are ten or 12.

Micheál Martin (Cork South Central, Fianna Fail)
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The specific assertion relating this case that a child had to have a blood test sent to England causes me great concern. It could be for specific reasons. I presume our labs cannot pick up the particular condition. That no one has contacted the family for ten months after the blood test being sent should not happen because we have primary care services. We need to get to get to bottom of that quickly. Will the Deputy send me the details of that case? It calls for clarity and a response.

On the other main point regarding children accessing therapies, seven or eight years ago, or perhaps longer, the progressing disability services, PDS, model was adopted. It did not get the resources in the early years because of the circumstances at that time. Resources have started flowing somewhat. There has been considerable disagreement regarding the PDS model. I have had considerable engagement with the HSE, particularly last year in my capacity as the Taoiseach. I convened a series of meetings around health and education, with the Minister of State responsible for special education in particular, on the need for children to access therapies far more quickly than is the case. It is working in some areas; in others, it is not so much. We have asked, in the context of special schools, which was agreed, that therapists lost to special schools be restored on a phased basis. That needs to happen more quickly and more in line with the dates agreed with the HSE. Access to therapies is a key issue and there is a problem with recruitment and retention of therapists in the area of children, paediatrics and in child services. There is catching up to be done. Other sectors of the health service seem to be recruiting therapists more easily than the child disability area, which is something I have observed, and it is not satisfactory either. We must get to the bottom of why that is the case.

More fundamentally, the responsibility for disabilities has transferred from the Department of Health more generally and from a policy perspective to the Department of Children, Equality, Disability, Integration and Youth. The Minister of State, Deputy Rabbitte, is at the Department responsible for children. There will be strong memorandums of understanding drawn up and agreements between the HSE and the Department responsible for children on how that will be rolled out, the allocation of funding and so on. We want a sharp focus on the provision of a sufficient number of therapists to enable children to access therapists far more quickly than they are. I acknowledge the issue. We have to try to solve it. It has built up over a long period.

Michael Fitzmaurice (Roscommon-Galway, Independent)
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I will furnish the Tánaiste with the details of that blood test and the ten-month wait.

Regarding services for speech and language and psychology, there is a ferocious deficit at the moment. Perhaps the Tánaiste did not pick up my point. If the HSE is not able to provide a service in the area and the parents are willing to drive somewhere they can get it, I ask that those parents be facilitated. Unfortunately, I know one autistic child near me who has regressed over the past six to eight months. That should not be. That child has regressed due to a lack of services. While I acknowledge there can be problems recruiting people and with retention, at the end of the day, we must invest in the future of those children and give them the services because there is a small window of opportunity to help them as best we can. I ask if the HSE is not able to do what it is supposed to and those parents are willing to source the service somewhere else, that they be paid.

Micheál Martin (Cork South Central, Fianna Fail)
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Under the waiting list initiative, there is funding in that envelope for access to private care in the context of long waiting lists for access to therapy services.

This was provided for. Perhaps the Minister can engage with Deputy Fitzmaurice on how best to utilise the provision in the waiting list funding overall. The fundamental response ultimately has to be recruitment and retention on one level and working through the model to make sure it is fit for purpose in responding to the needs of the children in the first instance. As Deputy Fitzmaurice said, there is a short window of opportunity and developmentally it is crucial that these interventions happen early. Families and parents also need to be part of the input into the models that get developed. It is my view that parents have not been brought into play early enough since the model was developed originally. Parents have not been consulted adequately.