Thursday, 8 February 2024
Ceisteanna ar Pholasaí nó ar Reachtaíocht - Questions on Policy or Legislation
The Government's disastrous mismanagement of our health service hit a new low this week. A staggering 150 patients were on trolleys in University Hospital Limerick yesterday morning in what is being described as the worst day for the hospital in its history since 2006. Yesterday morning, the INMO recorded 710 patients on trolleys and without a bed in our hospitals. We know what is needed to end the trolley crisis. Our hospitals are short 1,000 beds and need 500 more each year to keep pace with demand. Officials in the Department of Health and the HSE have identified sites and suppliers for these 1,500 beds but the Minister's Government has its head in the sand and will not fund them. Will the Minister reverse his disastrous decision to underfund the health service in budget 2024 and will he fund the 1,500 beds so that we never again have to see 710 people on trolleys, each of whom has a story to break your heart?
That number of people on trolleys is not acceptable to the Government, to the Minister for Health or to the HSE. Looking at the overall number of people on trolleys in emergency departments, we have seen a significant improvement. That is not the case in Limerick. The Minister was in touch with Bernard Gloster, CEO of the HSE, yesterday to see what further measures could be implemented to make progress. UHL's hospital group and the hospital itself have made progress on reducing waiting lists for certain procedures. That should be acknowledged. I thank the staff for all of the work they do but the situation in the emergency department there is not acceptable to the Government. In addition to the increased investment-----
-----we have provided more than 1,000 extra people in one hospital since 2019 and opened 150 additional beds, including 98 in UHL itself. There is also another 96-bed block under construction and planning for a further 96 beds is under way.
I recently met with a group of small business owners, mostly restaurateurs, based in my own constituency in south inner-city Dublin and in surrounding areas. They outlined to me the many challenges facing their sector and their concerns about potential closures, job losses and the loss of vibrancy in Dublin city centre and other urban city centres if the challenges for small businesses, particularly in hospitality, are not addressed by the Government. I was glad to have the Minister's engagement on some of the issues in respect of the warehoused tax repayment plan and I welcomed his announcement of flexibility from Revenue this week. That is welcome. However, he has acknowledged that key issues remain, particularly with regard to the availability of staff and labour. Will he therefore consider amending the stamp 2 visa scheme to enable people to seek greater levels of employment in the sector? Has the Government conducted any assessment of the affordability of the work permit scheme for smaller enterprises? These are some of the really serious issues raised with me by small businesses in the hospitality sector. I acknowledge the immense contribution these businesses make to the vibrancy of our urban centres.
It is undoubtedly the case that cafés and restaurants add a great deal to the character of our cities, towns and villages. We want them to be viable and to support them. The Government has been very supportive of the sector over recent years and that has been acknowledged. Labour availability is a challenge. We have unemployment of approximately 4.5%. That is a good news story. Our country is essentially at full employment. Our colleagues in the Department of Enterprise, Trade and Employment are constantly reviewing the employment permit system. There is a plan to move towards an integrated single application for the visa and the permit. That is an important reform. It is complex and will take time but it is important work that will help to bring the labour we need into Ireland in a more time-efficient way.
There are 15 second level schools in Kildare North. Almost all of them are completely full. There has been substantial growth in the population but school places have lagged badly behind. This year, it is worse than ever. There is panic among parents and students are understandably upset. Parents do not want reassurance from the Minister; they want to know how and where accommodation is going to be provided. They want a comprehensive overview of that. They know the situation on the ground. They have had multiple refusals and no offer of accommodation in a school. They will not accept home schooling. We want a comprehensive response for the whole of the Kildare North constituency rather than piecemeal responses.
The Minister, Deputy Foley, is leading a very ambitious programme of school building. The outturn last year in respect of capital spend was that her Department spent its budget and a lot more besides. The Government came to an arrangement with the Minister to enable an acceleration of the school building programme because we recognise the importance of ensuring that school places are provided in the areas where they are most needed. Overall, the data that schools have shared with the Department of Education indicates that there are sufficient places available in the vast majority of areas. Names can be on multiple lists. Schools co-operate and ensure that they allocate their places in accordance with their enrolment policy. We are increasing the provision of school places in the areas where they are most needed but the Minister will take note of the specific location the Deputy has raised.
Institutional investment funds play a major role in the rental sector and I would suggest that this has a very detrimental effect. They bought very cheap about a decade ago and now rent very high. These funds come in many forms with many names. This is a family show so I will not mention some of the names people have for them. In recent months, a plebiscite was held in Berlin with regard to property bought by these large funds. Berliners have, by popular vote, told the state government to confiscate the assets of these large corporate bodies. Is it now time to stop the influence of these corporate funds and confiscate the assets they have essentially robbed from the State?
The State has become much more involved in building apartments through the Land Development Agency and the Croí Cónaithe scheme brought forward by the Minister, Deputy O'Brien. I have seen a number of examples, including in my own city, of schemes happening that otherwise would not have happened, of cost-rental homes being provided and of apartments being offered for sale to owner-occupiers in addition to the full Part V legal obligation being met. As the Deputy will know, we are doing a review of the funds sector, including the structures I believe the Deputy is alluding to. That work is well advanced and I expect to have a report in the summer. The truth is that apartment construction is very expensive and, without an intervention by the State, we will simply not see apartments getting built for sale to owner-occupiers. That is why we have seen a predominance of construction in the buy-to-let sector with institutional capital. It is very expensive to build.
There is a common theme running through the questions here today and it is the level of public service delivery falling well short of demand. GP services are another example of that. The number of GPs is at a crisis level. There are approximately 4,300 in the State, which is 2,000 fewer than what is considered safe to run the health service, and 1,000 GPs are going to retire within the next five years. Last year, 442 GPs out of a class of 725 emigrated to work in other countries. Thousands of people cannot get onto doctors' lists and those who do are waiting up to two weeks for an appointment. This is having the effect of significantly clogging the accident and emergency system. There has been some increase in the number of college places and some GPs are being brought in from abroad but this goes nowhere near what is needed to fix the problems. We have an increased population, an older population, doctor retirements and young doctors emigrating. When will this Government start to look beyond the M50 and make sure that regional and rural Ireland has enough GPs?
To be fair to the Minister for Health, Deputy Donnelly, to his Department and to the HSE they have put in a huge amount of work to increase the training places, working closely with the Department of Further and Higher Education, Research, Innovation and Science. The numbers are certainly going in the right direction. The number of doctors entering GP training has more than doubled from 120 back in 2009 to 286 last year and 350 new entrant training places are planned for this year. That has been matched with an increase in the funding and the budget being made available by the Minister. Back in 2019 the HSE paid just over €560 million to GPs across all the fees and support schemes there. Last year that figure had increased to €790 million, which is an increase of €230 million or 41%. They have a whole range of initiatives to help communities ensure access to GP cover. I acknowledge the point the Deputy is making.
The people in north Tipperary, Clare and Limerick are incensed at what is going on in University Hospital Limerick, UHL. The hospital was promised 630 beds for a population of 350,000. The Minister mentioned figures to Deputy Doherty, which are untrue. The reality is that 150 people were on trolleys yesterday and not just in the accident and emergency department. They are all over the hospital as well. It is just bedlam and it is not fair or right. Three small accident and emergency departments were closed down during the great reconfiguration of the Ennis, St. John's and Nenagh hospitals. I ask that they be looked after and opened up. They have minor injuries clinics there but we hear advertisements on the radio telling us to go to our GP and only go to the hospitals as a last resort. Yesterday, a lady contacted me who was waiting two and a half weeks to get an appointment with a GP. Will the Government wake up and smell the coffee here? They should be hanging their heads in shame. I see the Minister of State, Deputy Butler, sitting behind the Minister. The state of UHL and the mistreatment of the people in that area is an abdication of the Government's duty. It is shameful. If the Ministers cannot do it they should call an election and get out of office. It is just not acceptable.
For balance, I should point out that overall we have seen a significant reduction in the number of people on trolleys last year compared to the previous year overall across the country. What were we are witnessing in UHL is not acceptable to the Government. I spoke with the Minister for Health this morning. He has been in contact as recently as yesterday with the CEO of the HSE and they will be putting in place additional measures to address the issue. When I look at the numbers I see that this hospital alone got an extra 1,000 staff over the last five years and a significant increase in bed capacity with more being built. That kind of number, however, and that experience for each individual who was on a trolley there is not acceptable to the Minister or to the Government.
Last year legislation came into being, the Mother and Baby Institutions Payment Scheme Act 2023, but nothing has happened. That legislation followed on from a report that took five years to report. The Government got that report in October 2020 and it was published in January 2021. That had followed on from Catherine Corless's seminal work from more than a decade ago. Two years and a decade ago she published her article in the Journal of the Old Tuam Society. Here we are now 12 years later, five years after a report, and almost one year after the legislation, with empty promises and no opening for applications for the redress scheme. It is an absolute disgrace. It is unacceptable. At the very least today can the Minister now clarify when that scheme will open for applications, albeit that the scheme itself is appalling, exclusionary and furthers the abuse? Will the Minister please confirm now when it is going to open?
I assure the Deputy there is no political blockage to that scheme getting up and running. The Government fully sanctioned the scheme. It is a very large scheme and will cost approximately €800 million making it the largest scheme of its type in the history of the State. It is the right thing to do and we considered it very carefully as a Government. I will ask the Minister to come back to the Deputy with a comprehensive note on the issue but I am informed that at the moment the Government is currently finalising the administrative structures required for the scheme. I will ask the Minister to come back to the Deputy with as specific a date as he can possibly provide for the actual opening of it. The Government provided the sanction and we want it to happen as quickly as possible. The issue is about administratively getting a complex scheme up and running but we want it to happen as quickly as possible.
Since October 2020 I have had a lot of dealings with the Minister for Health, Deputy Donnelly, and with the HSE around the appointment of locums and the need for the appointment of a permanent GP in Swanlinbar, County Cavan. I have been highlighting the need for the locum GP to have a five-day per week contract instead of the existing four-day service. From speaking to local residents and from the people in the wider Swanlinbar catchment area I know they are adamant and very anxious to have a five-day GP service. Their strong message, which I fully support, is for a locum five-day GP service pending the appointment of a permanent GP. That GP appointment also needs to be a five-day service in Swanlinbar. For many decades GPs and their support staff in Ballyconnell, Blacklion and Swanlinbar have worked extremely hard to provide a good health service to that large and very rural Border region with its own particular challenges. That configuration, including a five-day GP service in Swanlinbar, must continue to ensure adequate and fair access to healthcare for local residents in that very rural Border region.
I thank Deputy Smith for raising this issue. The Minister for Health, Deputy Donnelly, is aware of the specific issue the Deputy has raised. The Department and the HSE are very anxious to make progress there and ensure access to a GP service is made available to the local community. As the Deputy is aware more broadly a strategic review of general practice is under way at the moment, which is looking at issues affecting general practice. The Minister for Health is expecting a report on that issue. In the budget of 2023 we provided €30 million for additional capacity-related supports for GPs in the context of the expansion of services and eligibility for GP visit cards. The Minister will come back to the Deputy on the specific issue and the location that he has identified. We are, thankfully, seeing significant progress now on the number of those seeking to train in Ireland and practise in Ireland as a GP.
The Minister will be aware that a major bogus self-employment scandal was uncovered at RTÉ a number of years ago. The issue continues and the national broadcaster has been settling some of the outstanding liabilities with the various State agencies as a result and this is continuing. It is my understanding that many of the workers who should have been classed as employees but were classed as self-employed have not been settled with in terms of their entitlements and all of the things normal employees would be entitled to. In fact, when they have asked questions and when they have raised their heads they have been treated with the strong arm of the legal department of the organisation. That is not acceptable from any organisation under the remit of the Government. Will the Government take this matter seriously? Will the Government examine the situation forensically to ensure that the workers at the centre of this scandal are treated properly? Will the Government consider whether there needs to be a criminal investigation into this matter?
As Deputy Griffin will be aware the Government does not instigate criminal investigations. Where evidence is provided of alleged criminality to An Garda Síochána it will make the decision as to whether to instigate an investigation. It is important that employment rules are fully adhered to by all organisations. The issue of the difference between a contract of service and for service is one on which employers need to be very clear and can get advice on if they need it. The rules are there and they need to be fully adhered to. A number of State bodies have a role in this because taxation issues can arise. The Revenue Commissioners are very active on the question of bogus self-employment. A number of other Departments are also very active on the issue. Certainly the individuals concerned should not be the subject of any sanction or suffer any punishment. I am sure they did not choose the nature of the relationship with the parent body.
I want to bring up the issue of the regulation of child and adolescent mental health services, CAMHS. This issue was brought to me by a constituent and a member of Families for Reform of CAMHS. They call for support for urgent regulation of CAMHS under the Mental Health Act. My colleague Deputy Mark Ward has legislation that is right to go in relation to this. We all know the issues that exist in relation to CAMHS. We know the ping pong game that can happen around particular silos in the context of primary care, children's disability network teams and all the other issues.
I could read out the information one mother sent me in regard to her two children, an 18-year-old and a 14-year-old.
There are 75 CAMHS teams and 800 people working for the service, with 225,000 appointments allocated last year to children under its care. It is fair to acknowledge that a huge amount of really good work happens in CAMHS. As the Deputy knows, the new mental health Bill will provide for the regulation of all community residences and services, including CAMHS, which will be introduced on a phased basis following the commencement of the legislation. Priority drafting has been granted to the Bill for the current legislative session, which is only nine weeks' long. That is an important factor. The Bill will be ready for publication early in the next session. I look forward to bringing it to the House in the next session.
My constituent, Aimee Campbell, suffers from an illness called functional neurological disorder, FND. She has limb paralysis in both legs and in her left arm. She suffers from extreme pain and seizures. She has been turned down for home carer hours by the HSE on two grounds. The first is that, at 28, she has not reached the age of 65 and is therefore not eligible. The second ground is that her illness is not recognised. The HSE is looking again at her case. I will send the details to the Minister of State, Deputy Butler, and I appeal to her to use her good offices to ensure her illness is recognised and she gets the support she so urgently needs.
I thank the Deputy for raising this really important issue. I am lucky to be in the position that the Government has provided me with €726 million for home care provision in 2024. Today, 56,000 people the length and breadth of the country are receiving home care. It is a fact that they are predominantly older people. If the Deputy passes on the details of the case he raised to me, I certainly will look into it. We do not want a situation where anyone is living at home in pain.
The Government is aware of the enormous damage done in my constituency last October by Storm Babet. Residential homes, businesses and public infrastructure were very heavily damaged, with the cost of road damage alone estimated to be approximately €50 million, according to Cork County Council. The Department of Transport has told the council it does not have the funding to cover this damage, with an intolerable allocation of only €14 million being proposed for repairs during the year. Will the Minister, Deputy McGrath, bring this to the attention of the Minister for public expenditure, Deputy Donohoe? We need intervention from the Department of public expenditure with the Department of Transport to give the local authority, our communities and my constituency the recovery they desperately need following Storm Babet.
I understand Cork County Council has now submitted its assessment of the damage that came from this exceptional weather event. It is not the expectation of the Government that a local authority would, out of its normal funds, be in a position to repair or reinstate roads that were very damaged by a storm. I will take up the issue with my Government colleagues. The practice has been that where public roads are damaged by an exceptional weather event, there would be an additional allocation made to the local authority to cover the cost of that. It is a significant sum but it is important that we fully support the county council to ensure the roads are reinstated to the quality they were at prior to the storm. I will engage with the Deputy and with Government colleagues on the issue.
Ballinspittle in west Cork was hit by flooding last night, with a number of businesses and residential properties affected. I thank members of the local fire service and emergency services who bravely saved many businesses and private properties last night. This is the second time the village has been hit by flooding in recent times. The owner of WILD restaurant woke up this morning to find his premises completely flooded. Owners of businesses and private properties in Ballinspittle need urgent assistance. Will the Minister announce in the Dáil today an extension to the flood support scheme for Ballinspittle?
I am very sorry to hear that properties in Ballinspittle were flooded as a result of the heavy rainfall. As the Deputy knows, the Government set up and activated two schemes in the past when there were similar flood events, namely, the Irish Red Cross scheme and the humanitarian scheme through the Department of Social Protection. I will liaise with my Government colleagues and ask that the Deputy be responded to directly, setting out the supports available for people who have experienced flooding following a weather event.
Today's report from the Residential Tenancies Board, RTB, paints a very bleak picture for renters all across the country. In my constituency of Wicklow, the average monthly rent is a staggering €1,596, which is a 13% increase on last year. Taking a quick look at MyHome.ie to see what is available, there is a one-bedroom property in Wicklow town for €1,800, another one-bedroom residence in Newtownmountkennedy for €1,575 and a two-bedroom property in Kilcoole for €2,500. These are very ordinary premises with incredible prices. I do not know how anyone could afford to pay those levels of rents. It is beyond sustainable. What is the Government's plan for counties like Wicklow that have, in essence, become no-go areas for renters?
This situation is one of the reasons the Government and I made the case for investment in the rental sector in the budget last October. Our proposals did not meet with great support across the House. The view seems to be that we do not need investment and we do not need property owners willing to make their properties available for tenants. However, that measure has been legislated for and is now in place. We should not rely entirely on advertised listings in the rental sector. There are some off-market transactions being entered into, which is a reflection of the fact that if a property is advertised on MyHome.ie or Daft, there will be a huge number of people applying. I acknowledge that is the case. We must increase the supply of rental accommodation. We must incentivise and support the protection of the existing investment in the sector and bring new investment into the sector, not just in cities but also in towns, villages and housing estates where there might be one or two rental properties spread around.
The Ireland women's basketball team has been put in an awful position ahead of today's match against Israel. FIBA previously removed Russia and Belarus in 2022, a move Basketball Ireland supported. They even protested against its own fixture against Belarus on that occasion. FIBA and Basketball Ireland need to be consistent by removing Israel from international competitions. Israeli basketball players posing with guns and Israel defense forces, IDF, members was a deplorable sight. An Israeli player calling her Irish counterpart antisemitic is another attempt to intimidate the Irish team. Taking a stand against mass displacement and the murder of innocent people is not antisemitism. Being anti-genocide is not antisemitism. The behaviour by the Israeli team this week alone should be enough for Basketball Ireland to withdraw from the match. It is not too late to do the right thing. Will the Government support the calling off of the match? Does it condemn Israeli basketball players posing with guns and labelling Irish athletes antisemitic?
The Government's position on what is happening in the Middle East is very clear. We have continued to call for an immediate humanitarian ceasefire, the release of all hostages unconditionally and full and unhindered humanitarian access so the people of Gaza get the essential supplies they need. The Government does not interfere in decisions that are appropriately made by relevant sporting organisations when it comes to fulfilling fixtures. Were the Government to get into that space, it would be completely wrong and inappropriate. The players have been placed in a very difficult position but that is not because of the Government or Basketball Ireland. We need leadership and decisiveness from FIBA, the international organisation. Putting individual players or individual country teams into a position where they have to make the call, which can impact on their careers, their ability to compete in the future and on funding, is not fair on them. It should not fall on them to make that decision.
The Minister may be familiar with the Before 5 childcare service in Churchfield in Corky city, which closed last August.
Its closure left a big hole in the context of the provision of childcare on the north side of Cork city. Alternative childcare had to be sourced for nearly 100 children just weeks before school started again in September. Thankfully, Northside Community Enterprises stepped into the breach and put together a business case for the reopening of the facility. To meet all the regulatory standards, fire regulations and so on, significant investment in the building will be required. The group in question reckons that €360,000 will be needed. It is engaging with the Department of youth and integration and is looking at building block grants, SEAI grants and various other grants for the regeneration of the north side of the city. Nonetheless, some support will be required. I ask the Minister to take the matter up with the Minister, Deputy O'Gorman. I also ask him to liaise with the group to which I refer in order to ensure that it can get the facility viable and open once again.
I thank the Deputy for raising this issue. I am familiar with it, as he is aware. I visited Northside Community Enterprises on the old foreign affairs campus a few weeks ago, and the Deputy was there. We discussed the issue with members of the organisation in question. We are anxious to help because we recognise how important a role the service played when it was in place. We will work collectively as a Government and with the public bodies to do all we can to support the Northside Community Enterprises to get that facility up and running. I will liaise with my colleagues on that.
In the context of family law and its application, I again raise the matter of the ongoing pursuit of parents and children by means of the continued and indiscriminate use of the alien concept of parental alienation, no pun intended, and the lack of any investigation or indication that matters are about to be investigated or in any way ventilated in that light. The in camerarule was originally intended to protect children and families. This cannot happen now, however, because Tusla is barred from any investigations. I ask that a special effort be made to investigate what is going on and to bring an end to the concept to which I refer.
The saga of the driving test centre in Drogheda has been going on for nearly six years. At this stage, it is frankly ridiculous. I raised the matter with the Taoiseach last year. The Road Safety Authority, RSA, has been promising a centre for years. Fourteen sites were identified. The RSA rejected some without even giving a reason and rejected others on the basis that there was too much traffic in the area. How ridiculous is that? Drogheda is the largest town in Ireland. People have an entitlement in this regard but they are waiting over 30 weeks, if they are lucky, to get tests. I ask that somebody in government put pressure on the RSA to get its act together and finally provide a driving test centre in Drogheda.
This issue was raised by previous speakers. Many people who come to my clinics in Carlow cannot get access to GP services. This has become a major issue. As the Minister is aware, if you have no GP, you have no medical card. I am finding that this is becoming a regular occurrence. The Irish Medical Organisation has stated that attracting GPs to rural areas has become significantly more difficult in the past decade.
A HSE nurse range me yesterday. She told me that she applied for an internal post as a schools public health nurse, which involves administering vaccines, particularly that relating to measles. Because of the embargo within the HSE, she is not able to take up her post. This is a very serious matter that needs to be addressed.
I thank the three Deputies. I know that the issue raised by Deputy Durkan around family law and parental alienation is one that he has raised consistently. I will mention it to the Minister for Justice again.
She will not be surprised, but I am sure she will come back to the Deputy.
I thank Deputy Munster for raising the issue of the driving centre in Drogheda. I will ask the Minister, Deputy Eamon Ryan, or the Minister of State, Deputy Chambers, to revert back to her on the issue of the specific site. We are making progress overall on the average waiting times for tests. It was 30 weeks in August of last year; it is now less than 20. That is still too long, but 41 additional testers have joined the RSA. A lot of extra resources are being provided. I am not familiar with the site-specific issues in Drogheda.
I thank Deputy Murnane O'Connor for again raising the issue of access to GP services. This matter came up a number of times in the course of proceedings earlier. I have outlined the work that the Minister is doing around the significant expansion in the number of training places in the various colleges and the increase in the resources being made available to the HSE. Where there is an issue with a specific location, I suggest that the Deputy liaise with the Minister and the HSE to see if a local solution can be arrived at.