Dáil debates

Wednesday, 9 July 2025

Ceisteanna ó Cheannairí - Leaders' Questions

 

4:55 am

Photo of Mary Lou McDonaldMary Lou McDonald (Dublin Central, Sinn Fein)
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There is an immediate need for the Government to intervene to end the delay in evacuating very sick and injured children from Gaza to Ireland for urgent medical treatment. Last year, as the Taoiseach knows, the Government agreed to evacuate 30 of these children. There were two successful evacuations of 12 children in December and May. However, the vital evacuation of the remaining 18 children has been stopped due to bureaucratic wrangling within Government Departments over visas. At least eight children were identified by the World Health Organization and the HSE for urgent medical evacuation in early June. A month on, they are still waiting. Their medical assessments are complete, the doctors are ready, the hospitals are ready to receive and treat these children, but the Government is stalling.

Time is of the essence here. It is a matter of life and death for these children. They survived a genocide being carried out before the eyes of the world. I have corresponded with both the Tánaiste and the Minister for Health to advocate for their immediate evacuation. The Minister, Deputy Carroll MacNeill, tells me she is bringing a memo to Cabinet to seek Government approval for what she calls a more humanitarian approach to the evacuations and that she fully expects, in her words, to welcome the next group of children in the autumn. That is months away. That is an eternity away. The only humanitarian approach is to get these children out now. It is important the Government memo does not solely identify Egypt as the evacuation route for these children. The Rafah crossing is closed and there is no direct route from Gaza to Cairo. Countries such as Jordan must be included. As the Taoiseach knows, Jordan is already facilitating evacuations and has offered to help.

Every week, every day and every hour their evacuation out of Gaza is delayed puts these children's lives at increased risk. There is every chance that these children will be killed as they wait, while Government Departments push paper around, tick boxes and argue among themselves. That threat and likelihood is very real, very present and very immediate for these children. We know that children from an earlier group previously identified for medical evacuation from Gaza to Ireland have died while waiting to come here in the horror of Israel's genocide. Doctors in Ireland who are standing by to treat these children and are ready to save their lives are very worried for them. Dr. Morgan McMonagle, a trauma surgeon who has worked on humanitarian missions in Gaza, puts the reality for these children in very stark terms. He said that by autumn, there is a very good chance that Gaza simply will not exist at the rate things are going.

It is unacceptable that the Government puts bureaucratic wrangling over the lives of very sick, injured children. Tá mé ag fiafraí den Taoiseach a ladar a chur sa scéal agus a chinntiú go mbeidh na leanaí seo, atá tinn agus gortaithe, slánaithe ar an bpointe boise ó Gaza go hÉirinn don chúram leighis atá de dhíth orthu. The Government's proposed timeframe of autumn will be too late for some, or perhaps even all, of these children. This is a matter of life and death. They have been waiting since early June. It is vital that the Taoiseach, as Head of Government, intervene and expedite their arrival in Ireland with no further delay. I ask him to do this with urgency.

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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I thank the Deputy for raising this important issue. One of the appalling features of the war on Gaza has been the indiscriminate slaughter of innocent children. The serial killing of children as a result of indiscriminate bombing, attacks and shootings has shocked the world. The scale of injuries suffered by so many children is truly appalling.

As a country, we have a strong tradition of providing humanitarian assistance. In September last year, following an appeal from the World Health Organization, the Government approved our participation in an initiative to evacuate a number of sick children from Gaza for treatment and care in Ireland. Four flights were agreed. Two have been successfully carried out. Approximately 12 children in total have arrived safely so far to receive medical treatment facilitated through those two evacuations, one in December last year and another in May this year. The children were accompanied by 12 mother-carers and 21 accompanying family members, so approximately 45 people, between adults and children, were facilitated. Ensuring the appropriate supports are in place to facilitate paediatric patients and their families is obviously key to the success of the overall operation. Planning is ongoing for the next medical evacuation operation.

There is no delay. Nothing has been stopped. There is no bureaucratic wrangling. This is not subject to any Government memo. A Government memo will emerge that will, in many respects, adopt an even more generous response in terms of the number of family members, or siblings of an injured child, who can come. The presentation of a memo is not material to the next flight. It will regularise what has been happening already. The original Government decision allowed for one child and one person but, in practice, we have actually been doing much more than that. The amendment in the next memo the Minister will bring will regularise all that. It is as simple as that. It is not stopping anything. No one is saying the next flight cannot happen. There are obviously huge logistical issues in getting children out of Gaza. The WHO, medevac and others are working with us in co-ordinating that. There have been no delays in the processing of Irish-entry visas in this regard. No current applications under this scheme are awaiting processing. The Minister is here and can confirm all of that.

I would respectfully say that before making allegations and assertions, we should get the facts rights. As far as I am concerned, we will do everything we can to honour and fulfil what we have committed to, and do what we can to help children who desperately need treatment, care and wider supports because of the extraordinary trauma that has been visited on so many of them as a result of a horrific war that has no moral justification whatsoever any more in its assault on children. We want all the hostages released and an end to the war in Gaza. As a country, we will continue to provide humanitarian assistance to Gaza, the West Bank and the various agencies that support Palestinians in Jordan and Lebanon.

We work with Jordan on a continuing basis wherever the children are. There is no issue for us in terms of the particular border crossing, the mechanism or the route out of Gaza. That is not an issue for us at all.

5:05 am

Photo of Mary Lou McDonaldMary Lou McDonald (Dublin Central, Sinn Fein)
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No child is safe in Gaza. The Israeli genocide has mercilessly slaughtered children with abandon and the international community has watched on. The commitment made by this State and Government is a very modest one to take 30 children. They should be evacuated with all due haste. According to the medics who will treat these children, not alone have eight children been identified by the World Health Organization and the HSE as needing urgent care, but the assessments are complete, the doctors are ready and the hospitals are ready. If as the Taoiseach says, there is no bureaucratic wrangling and no blockage, why are they not here? That is my question. My challenge to the Taoiseach is that he must quickly ensure that the evacuations of the remaining children - eight of whom are ready to travel with full medical assessments complete, along with a further ten - happen without any further delay.

Photo of Verona MurphyVerona Murphy (Wexford, Independent)
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I thank the Deputy.

Photo of Mary Lou McDonaldMary Lou McDonald (Dublin Central, Sinn Fein)
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By the way, I have been in contact with the Tánaiste and he informed me that there was in fact a necessity-----

Photo of Verona MurphyVerona Murphy (Wexford, Independent)
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Time is up.

Photo of Mary Lou McDonaldMary Lou McDonald (Dublin Central, Sinn Fein)
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-----for a memo to Cabinet. I do not know what the communications are like within government; I am not really interested in that. I am interested in the children-----

Photo of Verona MurphyVerona Murphy (Wexford, Independent)
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The Deputy's time is up.

Photo of Mary Lou McDonaldMary Lou McDonald (Dublin Central, Sinn Fein)
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-----and the need to evacuate them now for the treatment they need.

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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Is oth liom a rá nach bhfuil an Teachta McDonald cruinn leis an eolas atá aici agus leis an méid a dúirt sí ar maidin faoin gceist seo. Táim dearfach go mbeidh an Rialtas ag déanamh gach aon iarracht na leanaí seo a thabhairt isteach chomh tapa agus is féidir linn. Tá-----

Photo of Mary Lou McDonaldMary Lou McDonald (Dublin Central, Sinn Fein)
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Anois.

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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----- roinnt déanta againn ach tá níos mó le déanamh againn.

In respect of the Deputy's case, she has moved on now because the earlier assertions were wrong.

Photo of Mary Lou McDonaldMary Lou McDonald (Dublin Central, Sinn Fein)
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They are not wrong.

Photo of Verona MurphyVerona Murphy (Wexford, Independent)
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Sorry, Deputy, allow the answer.

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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They were fundamentally wrong. While there is no issue with raising questions and so on, the absolute motivation on the Deputy's side all the time seems to be to seek to sow doubt over the bona fides of-----

Photo of Mary Lou McDonaldMary Lou McDonald (Dublin Central, Sinn Fein)
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This is not about me; it is about the children in Gaza.

Photo of Verona MurphyVerona Murphy (Wexford, Independent)
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Please, Deputy McDonald-----

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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-----Government on a fundamental humanitarian question. That is not acceptable. From the very beginning of this war we did everything to get Irish citizens out of Gaza. Our embassies and our diplomats did everything possible to do it. Why does the Deputy think we would try to delay children coming out of Gaza? How dare you make that assertion.

(Interruptions).

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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That is not on my agenda and it is not on the Government's agenda. A Government memo is immaterial. We discussed this on Monday evening - the Tánaiste, the Taoiseach with the Minister for justice. There is no delay in this respect.

Photo of Ivana BacikIvana Bacik (Dublin Bay South, Labour)
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I begin by welcoming an important young visitor Minnie McDermott to the Visitors Gallery.

I again welcome yesterday's announcement about the establishment of a commission of investigation into sexual abuse in schools. I pay tribute, as I know we all do, to the Ryan brothers, David and the late Mark, for their bravery in stepping forward and speaking out about their experiences of abuse. We owe an immense debt to them and to all those survivors who have spoken out and shone a light into the dark and shameful past of abuse in schools. Their courage provided the impetus for Mary O'Toole's scoping inquiry which has now led to this commission.

However, we must learn lessons from past investigations and inquiries, some of which we know failed to deliver truth, justice, accountability and indeed healing for victims and survivors. As a barrister, I represented survivors of abuse in court and before the Residential Institutions Redress Board in the past. There I witnessed the deeply traumatic impact that flawed procedures can have for survivors in bringing complaints of childhood abuse. Many survivors described to me their experience of being retraumatised by flawed and unduly complex and cumbersome processes, for example, before the redress board in the 1990s.

More recently we know the terms of reference of the Commission of Investigation into Mother and Baby Homes excluded a great many people who had suffered immensely. In addition, when the work of the commission was completed, its findings found their way to survivors through a leak to the press, which was unacceptable. Even now it is really unfortunate that victims have been left waiting years for appropriate redress. We must ensure this new and welcome commission avoids the mistakes of the past.

I welcome that the Taoiseach has spoken of an inclusive and survivor-led approach, which is vital. However, we also need to ensure that religious orders that were complicit in the sexual abuse of children should be required to provide appropriate redress to survivors. One survivor Louise O'Keeffe told "Morning Ireland" today that the framework is there. We must also ensure access to redress for survivors on a timely basis. I raised this with the Taoiseach during the Taoiseach's Questions session yesterday. I raised the question of a parallel redress process. I think he might have misunderstood me because in his reply he said it would not be possible to set up a redress scheme in advance of an inquiry; I accept that. However, we asked that a redress scheme might run in parallel with the commission. We are conscious the commission will run for at least five years and we do not believe survivors should be forced to wait a further five years for the outcome of the process.

Returning to the question of redress, survivors need assurance that organisations, religious bodies, religious orders and the church that were accountable and responsible for abuse should be made to pay. Church and State and also religious orders played a shameful role as we know. In particular within religious orders, clerics were allowed in some cases to perpetrate appalling crimes against children with impunity. We need to go further than condemnation; we need to remove legal obstacles to pursuing religious orders. Labour produced a Bill to do that. Will the Government accept that Bill and move forward? Will the Taoiseach ensure redress is available to survivors within five years?

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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I thank the Deputy for raising what is a very serious issue. I agree with her about the work of the Ryan brothers, in particular, as a catalyst for the decision by the Minister, Deputy Norma Foley, to set up the scoping inquiry which led to the Minister, Deputy Helen McEntee, yesterday bringing to Government proposals for the establishment of a commission of investigation into the handling of historical child sexual abuse in schools. Yesterday the Government agreed to the appointment of Mr. Justice Michael McGrath, a judge at the Court of Appeal, as chair of the commission. The principal recommendation of the scoping inquiry was to establish such a commission. There will be a period of consultation prior to formal commencement. When the commission is ready to hear from those who wish to contribute to its work, it will be widely advertised.

We have also accepted further recommendations of the scoping inquiry with regard to the remit of the commission, child protection issues, the legal system and memorialisation. It is clear from the scoping inquiry that many survivors view financial redress as an important measure of accountability for those who ran schools where sexual abuse happened. The Government is pursuing a very detailed examination to ensure that those responsible, including religious orders, are held accountable and make redress. The Office of the Attorney General with the Department of education and other relevant bodies is examining legal options that may be available to the State. We are examining changes to the Statute of Limitations on civil claims and changes to the status of unincorporated associations, as well as looking at the assets that religious orders have. An examination of how to ensure compensation from religious orders will run in parallel with the commission of investigation. It is complex work, will require detailed consideration and may take some time to complete. We will be open to engaging with the Deputy on any constructive proposals she has on this.

Back in the late 1990s we amended the Statute of Limitations but it is acknowledged that more is needed. Some of the survivors' accounts in the scoping inquiry were quite horrific. Many of them were very clear that they want those who were responsible to be accountable and to contribute - more than contribute.

Photo of Ivana BacikIvana Bacik (Dublin Bay South, Labour)
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We all want to see those accountable to be made to contribute. I welcome that the Government is exploring and examining legal options. However, this is not a new phenomenon; we have known about this issue for years. The Labour Party produced a Bill to ensure that we can pursue religious orders and unincorporated associations. I have sent the Taoiseach a copy I will send him another copy. We need this urgently. As we know, for years religious orders have been carrying out a perfectly legal practice of transferring their assets and their properties to associated lay-run trusts.

I have described this as the developer's wife syndrome. In some cases it puts assets out of the reach of State authorities and it is not acceptable. As of September 2024, religious orders have paid just 16% of institutional redress costs that were owed but we know the money is there. Religious orders involved in historic abuse have sold more than 75 properties worth a total of over €90 million since 2016. We know these orders and their associated trusts own vast quantities of property and assets around the State. We are simply asking, as are survivors, that they be made to pay the redress they so clearly owe to survivors who were denied justice for so long.

5:15 am

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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That is the Government's intention, commitment and determination to do. The specific issues the Deputy has raised are being examined in considerable detail with a view to enabling Government to have the powers, ultimately, to deal with those particular mechanisms that have been used. We want to make sure that the financial capacity is retained in the country and made available to provide compensation.

Photo of Cian O'CallaghanCian O'Callaghan (Dublin Bay North, Social Democrats)
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What is the Government at when it comes to personal injury awards? For weeks now we have been hearing about a memo that the Minister for justice is bringing to Cabinet. It concerns a review of awards by the Judicial Council which recommended a 17% increase. Initially it was reported that the Minister was going to rubberstamp that increase. This memo was due to go to Cabinet last week. Then it was reported that it was going to go to Cabinet yesterday. Now we hear that it might be next week after it first goes to a Cabinet subcommittee today. Can the Taoiseach tell us what is going on?

I should not need to tell the Taoiseach that a 17% increase in awards would be absolutely disastrous and the fact that the Government is even considering this is reckless. Personal injury awards in Ireland are already much higher than in other countries. Awards here can be more than four times higher than in the UK and still we are hearing that the Government is contemplating jacking them up even further by increasing awards by nearly one fifth. This will have an immediate knock-on effect on insurance premiums, not just for every household but for community groups, sports clubs and small businesses too.

Prices are soaring across the country. Grocery prices, rents, energy and transport costs are all sky rocketing and this is putting a huge strain on households. Wherever possible the Government should be doing everything it can to reduce costs, not further inflate them. A 17% increase in personal injury awards would do just that. It would drive insurance costs even higher at a time when so many people are struggling to get by.

Insurance costs in Ireland are already far too high and are often the reason community events end up getting cancelled. Sports clubs run by volunteers are under huge stress trying to meet constantly rising costs. Costs are an extra burden on households. Motor insurance premiums are now shooting up month after month. Increasing personal injury awards will add further fuel to this inflationary fire. Why is the Government even considering increasing them? Its sole focus should be on getting insurance costs down. Government dithering on this issue is causing huge concern. There are now fears it is delaying a decision until the Dail goes into recess, to try to avoid Dáil scrutiny and questioning on it. Can the Taoiseach level with us and give us a straight answer? Is the Government going to increase personal injury awards by 17%? Will the Taoiseach give a commitment that the Government will not go ahead with this increase?

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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It is intriguing how the Deputy presents the case. In one sentence he says that the Government is going to jack up insurance awards and in another sentence he says that we are dithering. He is apparently urging us to bring clarity but I do not think he is urging us to bring clarity. I think he is urging us to fulfil maybe entirely the implications of the Act so that he can then start attacking the Government for political reasons. The reality is that the Oireachtas has created this situation. The Oireachtas provided the Judicial Council with the powers to propose amendments to the personal injuries guidelines in 2019. Those provisions were introduced by the then Minister for Justice, Charlie Flanagan, and were supported by all parties at the time, including Sinn Féin, the Deputy's party and the Labour Party. It had a torturous progression and then, as the Deputy may recall, the Supreme Court became involved through the Delaney v. The Personal Injuries Board and Ors case. The court essentially said, in the context of the separation of powers, that it had to come back to the Oireachtas. If the guidelines recommended by the Judicial Council were to have effect, they would have to be affirmatively passed by the Dáil.

Again, for the interests of the public watching in, this is not something that the Government is bringing to the Dáil to jack up prices. It is unusual to frame it that way, to say it lightly, because the Supreme Court took a decision. It was a four to three majority ruling, which was tight, by the Supreme Court. I observe the separation of powers absolutely and believe in it.

Let us have a bit of realism and clarity about the debate. For me, there is a need for a review of the Judicial Council Act 2019 and the Minister for justice has committed to reviewing that Act. The Minister will also bring a memo to Government which will lay the guidelines before the Houses but he will not be bringing a resolution seeking their approval. The Deputy should not believe everything he reads in the newspapers.

Photo of Cian O'CallaghanCian O'Callaghan (Dublin Bay North, Social Democrats)
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The Taoiseach has clarified that there will not be an increase of 17%. He is giving that commitment to the Dáil now that the Government will not be putting forward an increase of 17%. I welcome that if that is the case. Awards here are four times higher than in the UK, so it would be a regressive move. If the Government is not doing that, that is welcome. The Taoiseach gave a history lesson on the legislation relating to this but the Judicial Council committee itself said that it could not carry out any meaningful analysis on the quantum of awards given under the guidelines to date that might inform this review. The committee itself was saying that it did not sufficient data to be able to make an informed, good decision. I welcome the Taoiseach's confirmation that he is giving a commitment that there will be no increase brought to the Oireachtas by the Government on insurance awards. The Taoiseach is giving that commitment.

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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I have just said it to the Deputy. It will be laid before the House but there will be no accompanying motion to the House to approve. However, this is something that the Oireachtas in its entirety has to reflect on. There will be implications in that decision for the Personal Injuries Assessment Board because essentially now we have a vacuum here in terms of personal injury awards. There is a legislative framework there which had to be amended because of a Supreme Court decision. This has led to a situation where the Dáil has to approve whatever the Judicial Council recommendations are if they are to take effect. If the Dáil does not do the approval, they do not take effect but that could lead to consequences within the courts and within cases. It could ultimately have the impact of undermining the Personal Injuries Assessment Board. We need to reflect on this.

I get the short-term politics. The Deputy would probably have loved it if we came in and had an approval motion. Then he would have, from the comfort of Opposition, attacked us day in, day out for, as he put it, jacking up insurance premiums.

Photo of Gerald NashGerald Nash (Louth, Labour)
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Do not be so cynical.

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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That was the agenda. I know it.

Photo of Verona MurphyVerona Murphy (Wexford, Independent)
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Thank you, Taoiseach. I call Deputy Tóibín.

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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We need, as an Oireachtas, to deal with this more soberly.

Photo of Peadar TóibínPeadar Tóibín (Meath West, Aontú)
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Where one lives in Ireland is a significant determinant of whether one will survive cancer or die from it. In Ireland today counties and postcodes should have Government health warnings. When a cancer diagnosis happens in a family, a dark cloud descends. While there obviously is hope in terms of treatment, there is no doubt that for serious cancers, every moment of the day is consumed with whether or not one is going to make it. Today the Irish Cancer Society released damning information which shows significant variations with regard to access to cancer diagnostics and treatments. Life-saving chemotherapy and radiotherapy treatments are being denied to patients because of where they live.

On Monday I met with doctors in Letterkenny and they told me that just 12% of cancer patients in that hospital receive treatment within the recommended 15 working day timeframe.

Patients are waiting seven to eight weeks for treatment in Galway at the moment. The National Cancer Control Programme has written to Aontú to say the HSE is failing to meet its own radiation treatment targets. In the year to August 2024, treatment targets were met only once in Galway and only once in Cork. Cancer services in the north west are being shut down and cancer services in Galway, Waterford and Limerick do not have the necessary PET scanners. We have antique radiotherapy equipment breaking down. Treatment is regularly being cancelled because certain scanners are breaking down over and over again.

I have had cancer. I know what it is like to have cancer growing inside you. I know the stress it creates. I know the first thing you want to do is to get it cut out and to get chemo to zap it if you can. I also know that delayed treatments mean radically worse outcomes for people. Delayed treatments mean cancer can spread throughout your body. People are dying in this country for the want of treatment. The Irish Cancer Society has said that the Government has met only one of the six targets it set itself.

Aontú has also discovered that there is a 12% differential in breast cancer survival rates in public and private hospitals in this country. A woman who is diagnosed with breast cancer in a designated centre has an 85% chance of survival. If she is diagnosed in another public hospital, she has an 81% chance of surviving but if she is diagnosed in a private hospital, she has a 93% chance of survival. If you diagnosed with breast cancer in Sweden, you are 7% more likely to survive than if you had been diagnosed in this State. If you are diagnosed with breast cancer in England, you are 5% more likely to survive than in this country. It is an incredible situation. When is the system going to stop dividing patients by postcode and income? When is the HSE going to deliver cancer treatments on an equal basis throughout the country?

5:25 am

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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Balance and perspective are required in discussing this issue, which is very serious. The Government is very committed to continuing investment in cancer care. It has invested very hugely in cancer care in recent years. It invested up to €645 million between 2021 and 2024 alone. New treatments such as CAR T-cell therapy, radio-labelled therapy and specialised radiotherapy are now available in Ireland for the first time. We now have top-class radiation and oncology equipment that we did not have five, six, seven or eight years ago. Let us not brand the entire cancer treatment system as antique. That is not fair.

Cancer survival rates are improving. More people are living after cancer than ever before. Today more than 220,000 people in Ireland who are living with cancer or after cancer. I appreciate the Deputy's own personal experiences and how he has properly articulated them to highlight issues because cancer diagnoses put enormous pressure on individuals and families. However, that 220,000 is 50% higher than the equivalent figure a decade ago. That is a huge transformation. Survival rates have increase progressively over recent years because of the development of national cancer strategies, which have improved screening services. Over the past two decades, our screening has expanded enormously. I refer particularly to BreastCheck, cervical screening and bowel screening. We have hugely increased staffing and there is greater access to diagnostics and survivorship programmes.

The funding will continue. I will not go through all the figures in terms of those who have been recruited. On capital funding, approximately €140 million has been used over the past eight years. We now have state-of-the-art radio-oncology facilities in Galway and Cork. They are not antique but state of the art. We have a new national cervical screening laboratories and various cancer infrastructure, including chemotherapy wards and lab facilities, across the country. That will continue this year with the oncology units at Cavan General Hospital, Tallaght, Kerry University Hospital and the Midland Regional Hospital in Tullamore. There is further chemotherapy infrastructure in Kerry, Cork University Hospital, Letterkenny University Hospital and so on. We will continue to invest.

On the county-by-county breakdown, one of the better developments of the past two decades was the development of proper cancer centres in the major tertiary hospitals, where the bulk of treatment should occur. I am aginm concerned about the proliferation of treatment in private hospitals-----

Photo of Verona MurphyVerona Murphy (Wexford, Independent)
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I thank the Taoiseach.

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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-----because all the experts told us that centres of excellence were the way to go. I would appreciate greater clarity from the Deputy in respect of his assertion that 93% of patients attending private hospitals had a better outcome as against those attending public hospitals-----

Photo of Verona MurphyVerona Murphy (Wexford, Independent)
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I call Deputy Tóibín.

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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----because the view was - and we have done this at St. James's Hospital, the Mater and Cork University Hospital-----

Photo of Verona MurphyVerona Murphy (Wexford, Independent)
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You are 30 seconds over, Taoiseach. You can come back in.

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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We have put centres of excellence there. That is where people should go.

Photo of Peadar TóibínPeadar Tóibín (Meath West, Aontú)
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We do not have centres of excellence in many places; we have centres of waiting lists. Today, the Irish Cancer Society said that we have centres of bare adequacy. Those are the words it used. The Taoiseach mentioned extra resources but these do not keep up with inflation, with population increases or with the ageing population of the country and, in many areas of the HSE, they are not getting to the front line. They are getting caught up. We also do not have the necessary staff. We in Aontú found out that 13,000 nurses have left this country in the past five years. That is an incredible figure. In some years, the majority of graduating doctors leave the country. Thankfully, cancer survival rates are increasing but that is in large part because there are better medicines, better technology and improved treatments and not necessarily because of the extra services the Government is providing throughout the country. Will the Taoiseach deal with the facts? The facts are stark. The Irish Cancer Society said today that there is a geographic determinant in relation to whether people get the treatment they need on time. Waiting lists in certain counties are five or six times the targets.

Photo of Verona MurphyVerona Murphy (Wexford, Independent)
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I thank Deputy Tóibín and call on the Taoiseach to respond.

Photo of Peadar TóibínPeadar Tóibín (Meath West, Aontú)
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People are dying as a result of that geographic difference.

Photo of Verona MurphyVerona Murphy (Wexford, Independent)
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Deputy, your time is up.

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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We have more work to do. That is acknowledged. In his commentary, the Deputy has acknowledged that there have been improvements but he gives no credence to the fact that there has been very significant investment in cancer services. The number of staff in our health service has expanded dramatically.

Photo of Peadar TóibínPeadar Tóibín (Meath West, Aontú)
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So has the number of patients.

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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The Deputy has just created an image of thousands fleeing the country.

Photo of Peadar TóibínPeadar Tóibín (Meath West, Aontú)
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Some 13,000 nurses have left.

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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He should concentrate on the increases in numbers in the health service. He cannot and should not ignore that because to do so reduces his credibility. He is making good points on one level but he is also using language like "antique" and suggesting that everyone is feeling the hospitals when there are increases in the number of staff year after year. We have invested hugely in increasing the number of people. Close to 30,000 extra people have been employed in our health services over the past four or five years. That is additional people coming in.

With regard to the west, we had issues in Galway, where infrastructure and further investment are required. There is no question about that.

Photo of Peadar TóibínPeadar Tóibín (Meath West, Aontú)
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What about Letterkenny?

Photo of Micheál MartinMicheál Martin (Cork South-Central, Fianna Fail)
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On Letterkenny, we did work on Altnagelvin, which helps people in the north west both in cardiology and cancer care, which we invested in.