Verona Murphy (Wexford, Independent)
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Before we move on, I ask for all your co-operation with the direction of the Chair to get through the amount of business we have. I welcome all the Members in the Gallery.

David Cullinane (Waterford, Sinn Fein)
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"We are not going to regain any of the abilities we've lost, but Skyclarys will give us time. Time when you're dealing with our progressive relentless disease is everything. We all deserve time with our loved ones." Those are the words of Emily Felix, a 28-year-old trainee solicitor from Kilkenny who is living with Friedreich's ataxia. It is a rare, progressive and life-limiting neurological condition. It gradually takes away mobility, speech and independence. Emily was diagnosed at 12. Since then, she has completed her degree, pursued postgraduate study and begun training as a solicitor. She is doing everything she can to protect her health and her future, but the disease continues to progress.

Yesterday, as the Taoiseach knows, the HSE drugs group met to consider reimbursement of Skyclarys, the first approved treatment that can slow the progression of Friedreich's ataxia. Patients hoped for a positive decision. This process has been ongoing for years. Instead, the drug was referred to a rare disease technical review group for further consideration. This group is not a standing body and must now be convened. This could mean further delays and potentially months before a final decision is made.

For patients, that delay is unbearable. It can mean losing the ability to walk, to speak clearly, to swallow safely or to live independently. Skyclarys is not a cure but it offers something precious: more time with mobility, working, communicating and living independently. Dr. Richard Walsh, consultant neurologist and co-director of the National Ataxia Clinic, has described this drug as a ground-breaking development. He has said that he would prescribe it if it were available in Ireland and that it may reduce the rate of disease progression. Skyclarys has been approved across the European Union since February 2024. It is already publicly funded or accessible in several European countries. Irish patients are watching people with the same condition receive treatment elsewhere while they continue to deteriorate without it. That is cruel.

Yesterday, those living with Friedreich's ataxia gathered at Leinster House waiting for good news. Their hopes were high, but advocates and campaigners were left waiting with no communication. They were left desperately making phone calls, checking for updates, asking journalists and asking politicians if they had heard anything. They were treated appallingly. Then, when the news did eventually filter though, they were left devastated.

Craig Coady from Cork, who has already lost his 13-year-old son, Rory, to Friedreich's ataxia, now watches as his older son, Paudie, deteriorates from the same condition. He took to social media to express his anger. He said:

This is the worst news for my son. The government is kicking the can down the road. We don't have that time because Paudie is getting worse every day. I am so upset and disgusted.

Medicines must be properly assessed, and I get that, but the patient cannot be lost in the process, and that is what happens. In fact, in the programme for Government the Government committed to reviewing that process because it was accepted it does not always work.

The technical review group obviously now needs to be convened and needs to meet urgently.

Emily cannot afford more delays. She is a young woman with a career, ambitions, a family and a future she is fighting to protect. The same is true of every single person living with Friedreich's ataxia in this State. They cannot be left waiting any longer and they deserve better.

Does the Taoiseach accept that those living with Friedreich's ataxia were treated appallingly yesterday, that they deserved to be treated with respect and should have been properly communicated with? Does he recognise that this is a matter of urgency for them and that they cannot continue to wait while time is running out?

Micheál Martin (Cork South-Central, Fianna Fail)
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As this is my last Leaders' Questions of this term, I thank the Ceann Comhairle and all Deputies in the House for their co-operation throughout the year. I thank the entire team that works here, the ushers, the staff in catering and so on, for the manner in which they look after all of us on an ongoing basis. We deeply appreciate that. To the Deputies, while we disagree on many issues, this is parliamentary democracy in action and long may it continue. I just wanted to say that.

I thank Deputy Cullinane for raising this issue. I accept this is a matter of urgency for those with the condition of Friedreich's ataxia. I have met with Craig Coady and with others who have the condition. It is extremely worrying for them to say the least. The experiences they and their families are going through while awaiting the assessment of this drug are extremely traumatic. I appreciate the Deputy saying there has to be a process or a scientific input into whether medicines are effective or not, or suitable for reimbursement. It took a length of time. I think the company was slow over the past two years in responding to the HSE. The timeline is there. I know the Deputy has kept in close contact with the Minister on that. The commercial proposal was ultimately received from Biogen on 27 May. It went through a lot of interactions before that, which, in my view, could have been quicker on the part of the company.

That said, there is a process where first a health technology assessment was published in December 2025. That is public and was not that strong in terms of its assessment of Skyclarys at the time. There was a clear recommendation from that. That was then moved on to the HSE drugs group. I accept there are issues in terms of how this gets communicated. However, up to now since the 2013 Act, there has not been a practice whereby there is a parallel political operation while this group is meeting monthly. I think 70 rare disease drugs were approved in the four years between 2021 and 2025. It was not the case that people were waiting every month. That is something we have to be conscious of. I understand it but we need to work on the communication of all that. These are scientists and people with expert knowledge who meet to assess drugs. They are not politicians. We have to protect that process too in terms of their assessment of the efficacy of drugs and so forth with regard to conditions. This year alone, 26 drugs for rare diseases have been approved and many more drugs outside of that.

It is a serious and urgent situation for the families. Our hearts go out to them. It is a disease that progresses and has severe impacts on those with the condition. It has now been referred to the rare diseases technology review committee and the Minister is taking steps to get that established as quickly as possible to assess this. It is my understanding that some of the national expertise and practising consultants in this field would be on that group, and I hope we can get an outcome as quickly as possible.

David Cullinane (Waterford, Sinn Fein)
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I met many of those patients and people with the illness yesterday. Many of them were here in Leinster House. They told me, as they have in the past, they cannot walk and they cannot swallow and, as the Taoiseach acknowledged, it is also very difficult for their families who have to watch as their condition worsens and the disease progresses. This drug was approved by the European Union in 2024, over two years ago. It is publicly available in many European countries and yet again Ireland lags behind and we are not providing this drug. I see it simply. This is about empowering the clinicians. At the moment clinicians treating those patients do not have the option of prescribing that drug. We should enable them to have that option because this is an issue for clinicians and patients to work out the best treatment for those patients. That is an option available in Italy, Germany and other countries. It is not available in Ireland.

When is that group going to be convened because those people who were here yesterday were really upset? There was no communication. They were making phone calls, and they fear more months of delay before a decision is made.

Micheál Martin (Cork South-Central, Fianna Fail)
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I accept the devastation for families on receiving that news yesterday. This is not the news they wanted to hear. The previous month a drug was approved and that was welcomed across the House. The very same group made that recommendation in respect of that drug. There is an urgency attached to this and we are prepared to work with Members of the House in terms of the processes. We all accept that, ultimately, there has to be a scientific perspective on this. I accept there is also a role for those at the front line clinically in respect of this condition, and in the neurological field more generally who are treating people with this condition. Many drugs have an evolutionary process. In other words, they can get better as they are refined and improved upon in the research. There is much more in terms of clinical trials and so on that the Minister-----

Verona Murphy (Wexford, Independent)
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That concludes the question.

Micheál Martin (Cork South-Central, Fianna Fail)
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-----has published a strategy on.

Holly Cairns (Cork South-West, Social Democrats)
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I want to take up where we left off yesterday. When explaining why the Government was not going to buy Bessborough the Taoiseach said:

Excavation without evidence of location is neither feasible nor lawful [because] Under the Institutional Burials Act 2022, the Government can only [start an excavation] where it is satisfied that burials have taken place and there is evidence that those burials are manifestly inappropriate.

He then said, "I am advised that the legal threshold cannot currently be met because the location of many burials remains unknown." I cannot have been the only person listening who was stunned. The Government knows that 859 children and 19 women who were incarcerated at Bessborough are missing, presumed dead. It knows the Commission of Investigation into Mother and Baby Homes said it was highly likely that burials had taken place on this land. It has all the evidence of abuse, suspicious deaths, disappeared women and children and likely burial, and the Taoiseach is telling us he is powerless to act because legislation his previous Government drafted and enacted is preventing him. This really is beneath contempt. I repeat again what he said yesterday. The Government needs evidence that burials were "manifestly inappropriate" before it can intervene. Is he actually trying to say that these burials were in any way manifestly appropriate, and discarding the remains of hundreds of children without a scrap of paper recording the burial location is appropriate? He now seems to be using that as an excuse for inaction, when what he should be doing is moving heaven and earth to find these children and 19 women who disappeared.

Two weeks ago, the Taoiseach told me that Cork City Council should have placed a compulsory purchase order on the land. Councillors on Cork City Council have now twice voted unanimously to CPO the land, mostly recently on Monday of this week. The councillors have been told that they cannot do that because the council does not have capital. The Taoiseach holds the purse strings. Quite frequently when I ask him an important question he comes back and speaks about how I do not have a monopoly on caring, about his bona fides and about how much he cares.

Respectfully, it does not matter how much the Taoiseach cares unless that is mirrored some way in his actions.

Pádraig Rice (Cork South-Central, Social Democrats)
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Hear, hear.

Holly Cairns (Cork South-West, Social Democrats)
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Can he please refrain from doing that in his reply today and focus on answering the questions? He is the Taoiseach of this country.

Verona Murphy (Wexford, Independent)
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Please.

Holly Cairns (Cork South-West, Social Democrats)
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If he cared about this issue he would act. He could amend the burials Act. He could open the archives. He could negotiate with the developer. He could give money to Cork City Council to secure the land.

Verona Murphy (Wexford, Independent)
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I thank the Deputy. I call on the Taoiseach to respond.

Holly Cairns (Cork South-West, Social Democrats)
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Will the Taoiseach do that? His hands are not tied; he is sitting on them. There is a difference.

Jennifer Whitmore (Wicklow, Social Democrats)
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Hear, hear.

Micheál Martin (Cork South-Central, Fianna Fail)
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A number of years ago, I met with Maureen Considine and some survivors in Bessborough. Deputy Cairns has often said we should talk to survivors. Their perspective is far different from hers in respect of Bessborough. I refer her to an article in today's Irish Examiner by Maureen Considine in respect of this issue. She established the Cork Survivors and Supporters Alliance, CSSA, in respect of this issue - in terms of the burials in Bessborough. The fundamental issue they wanted was to first of all establish where their babies were buried. Their sense was:

The mothers at the heart of our alliance are being overshadowed by an abstract human rights debate. Any demand for further disturbance of remains without their explicit input and consent is not an act of justice; it is a repetition of the original trauma where an institution exerted control over their children's burial. These mothers have inherent rights to privacy and space to grieve in peace.

The Cork Survivors and Supporters Alliance wanted to find out where the mothers' babies were buried. They were involved in legal submissions to a different application and employed experts and so forth. By the way, they do not believe that the current area of lands, which is the subject matter of the current An Bord Pleanála recommendation, is where the babies are buried. That is following their work with the experts they availed of. There are different perspectives from different survivors, which Deputy Cairns has ignored in all of her presentations. I also refer the Deputy to an article by Ann O'Gorman, based in Limerick, who lost her baby when it died 20 minutes after birth. The Deputy should read that article, which was in the Irish Independent some time ago. The point is Deputy Cairns has an extraordinary habit of distorting things that I say and conflating them. We are talking about 60 acres here. The planning permission for housing is not for the entirety of the 60 acres. It is for a part of it. There are two other lots of land. There are State services on the land. One hundred people are working in different services in Bessborough. There is childcare there, and so forth. It has been an active area of human activity for a long time-----

Verona Murphy (Wexford, Independent)
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I thank the Taoiseach. I call Deputy Cairns.

Micheál Martin (Cork South-Central, Fianna Fail)
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-----long after the home closed. I know a lot about it because I have been around a long time in that area. I live nearby.

Micheál Martin (Cork South-Central, Fianna Fail)
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The time is up. I thank the Taoiseach. I call Deputy Cairns.

Micheál Martin (Cork South-Central, Fianna Fail)
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I will come back in a minute.

Holly Cairns (Cork South-West, Social Democrats)
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At the end of the day, there are a few things that we know and a few things that we do not know. We know the commission of investigation found that it is highly likely there are babies buried on the grounds. We do not know why it made that recommendation. Why? Because the archives are sealed. The Taoiseach took exception to that word yesterday. They are closed. He can call it whatever he wants. That is why we do not know why the commission made that recommendation. We know that archaeologists walked the site. We do not know what they said or recommended because the archive is sealed. We know that there was no ground-penetrating radar used. As far as we know, there were no soil samples and no test excavations. We do not know why. We know that we have this information for Tuam and for Sean Ross Abbey. We do not have it for Bessborough. We do not know why. The Taoiseach's whole argument amounts to "We simply don't have enough information to meet the threshold for excavation and examination." Why do we not? It is by design.

Verona Murphy (Wexford, Independent)
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I thank Deputy Cairns. I call on the Taoiseach to respond.

Holly Cairns (Cork South-West, Social Democrats)
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It is very clearly by design that we do not have this information. I take it from the Taoiseach's reply that his answer to my questions was "No", so I will ask him this: will he simply release the archaeological report?

Verona Murphy (Wexford, Independent)
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The Taoiseach will respond now.

Micheál Martin (Cork South-Central, Fianna Fail)
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Deputy Cairns has attacked the Institutional Burials Act. She implied it was imposed by this Government. It actually was agreed by the entire Dáil.

Holly Cairns (Cork South-West, Social Democrats)
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Not by me.

Micheál Martin (Cork South-Central, Fianna Fail)
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By the entire Dáil, including Deputy Cairns's party.

Holly Cairns (Cork South-West, Social Democrats)
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I put forward amendments at every Stage.

Verona Murphy (Wexford, Independent)
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Respectfully, it works both ways.

Micheál Martin (Cork South-Central, Fianna Fail)
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Let us park that for a moment.

Holly Cairns (Cork South-West, Social Democrats)
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The Taoiseach can check the record.

Micheál Martin (Cork South-Central, Fianna Fail)
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It was agreed. When I spoke to Deputy Bacik yesterday, we had a constructive engagement and she asked certain things. Deputy Cairns cannot draw conclusions from yesterday in terms of what the Government's position on this ultimately will be because we said we would reflect on it. That is what I said yesterday and that is what I intend to do. We need to be mindful of all survivors. I think Deputy Cairns has been too dismissive of those I have quoted this morning. I met with them three or four years ago. I was very taken by what they said. They have come to the view that they wanted a proper memorial. They felt their children were within those grounds. By the way, they believe there was a burial ground there and that burials were not ad hoc, scattered all over the 60 acres.

Holly Cairns (Cork South-West, Social Democrats)
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It is the apartments-----

Verona Murphy (Wexford, Independent)
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I am sorry, Deputy.

Micheál Martin (Cork South-Central, Fianna Fail)
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There is a very telling phrase in the article.

Verona Murphy (Wexford, Independent)
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The Taoiseach's time is up.

Micheál Martin (Cork South-Central, Fianna Fail)
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If I could, I will just finish on this very sensitive issue. Their point is that there was not a blade of grass disturbed on that site.

Verona Murphy (Wexford, Independent)
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It may be, but we are out of time. I call Deputy Bacik.

Micheál Martin (Cork South-Central, Fianna Fail)
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The way that site was organised, there would have been a burial ground. I accept the point that we have not located it, but there would have been a burial ground there.

Verona Murphy (Wexford, Independent)
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I call Deputy Bacik.

Micheál Martin (Cork South-Central, Fianna Fail)
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That is the issue. It is not where they-----

Ivana Bacik (Dublin Bay South, Labour)
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The housing crisis continues to cut deep. The numbers in homelessness remain shockingly high. There are over 17,000 people in emergency accommodation, including 5,583 children. That is an appalling statistic and each figure represents an individual human tragedy. While the Dáil is in recess, sadly, many more people are likely to see an eviction notice land in their letterbox, and all of us know of those who are directly affected - like the young man who contacted me this week. He and his neighbours are being evicted at the end of the month with nowhere to go. Or like the young woman I am supporting, who was evicted into homelessness more than a year ago now. She has four children, two with significant disabilities, one of whom requires 24-hour medical care, and she has yet to be housed. She is relying on the goodwill of family and friends to keep a roof over her head. Another mother who is working full time was also evicted into homelessness a year ago. As a result, she has seen a deterioration in her youngest child, who has additional needs. I have supported her as she has been applying to every Government support scheme available but nothing has come good for her. Incredibly, her family has been deemed ineligible for priority treatment on exceptional grounds. Her ordeal should be unthinkable but, sadly, it is no longer a rarity.

All of us know of other families in similar situations because, under the Government, homelessness has sadly been normalised and evictions have continued apace, including mass evictions. The Government's housing policies have failed: policies on shed-sits, on evictions and rent hikes, on vacancy and dereliction but, above all, policies have failed to deliver on homes and social and affordable housing.

Let us take the Irish Glass Bottle site down the road in Poolbeg, where nearly 4,000 homes are set to be provided. At the weekend, letters uncovered by the Irish Independent revealed that the delivery of the social and affordable component of housing there is under threat. The Taoiseach knows there is a long history to this development. He will know it is the subject of a good faith agreement between the Department of housing, the developer, Dublin City Council and local residents. The agreement was to provide for the delivery of 900 social and affordable homes in an area where housing is desperately needed, where people are living in damp, mouldy homes in Pearse House, Markievicz House and other places with stairwells literally falling down. It is an area where market rents are sky high. An apartment on the Glass Bottle site rented privately costs more than €4,000 per month, yet the Minister for housing has been told that provision of much-needed social and affordable homes may now be delayed. Where will my constituents go?

Mere weeks ago, the Minister, Deputy James Browne, wrote that the most powerful tool we have to tackle homelessness is the delivery of social housing. It is possible, if we are determined enough, to use every single lever at our disposal. Will the Government use every lever at its disposal to tackle the housing crisis? Will the Taoiseach ensure delivery of the social and affordable homes promised at the Irish Glass Bottle site, and indeed across every community where they are so badly needed?

Micheál Martin (Cork South-Central, Fianna Fail)
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First, we will use every lever. I accept that housing is the social issue of our time. There is no question about that. We are using every lever but from time to time the Opposition objects to many of the levers that we deploy in respect of housing.

Could I pick the Deputy up on social housing? Between 2020 and 2025, we have delivered 60,000 social homes, through build, acquisition and leasing.

Over 9,000 new-build social homes were delivered in last year. That was the highest annual total in the State's history. We have made huge progress on social housing since 2020 in terms of the numbers of homes that are being built. Close to 23,000 social homes were in design or construction at the end of 2025. We are targeting about 72,000 new social homes by 2030. In addition, we are making progress regarding new starter homes. Some 36,000 houses were built last year. We will build more this year, and we need to build more again in 2027. That is the objective.

If we look at planning permission alone, we can see that the momentum is strong. Permission was granted for 34,000 new homes in the 12 months to the end of quarter 1 of 2026. This was up 8% year on year, with 13,000 commencements for the first five months of this year. That was up 161% year on year. The housing infrastructure fund is going to be significant and will unblock about 86,000 units. Real investment in dwellings was up close to 20% in 2025. Construction employment is up 33%, at 195,000, since 2020. Development land deals are up 55%, with quarter 1 of this year being the best quarter in this regard since 2019 being experienced. Home Building Finance Ireland's loan book has grown by 25% and a €1 billion housing infrastructure investment fund has been announced. The number of first-time buyers mortgage drawdowns in 2025 was 27,500, the highest volume since 2007. In May of this year, first-time buyers accounted for 59% of all mortgage approvals. That is up 44% on 2022. Progress is being made. The issue for us is to get to 50,000 per annum, and to do so on a sustainable basis over a ten-year period in order to meet population growth and demand.

Homelessness is a far more complex issue now than it was four or five years ago. There are many factors in homelessness.

Rory Hearne (Dublin North-West, Social Democrats)
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Fianna Fáil and Fine Gael.

Micheál Martin (Cork South-Central, Fianna Fail)
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Not least among these is the migration issue, which is having a significant impact. Across the board, we have taken significant initiatives, which have been opposed by the Opposition, to deliver housing. I still think that the Government's programme is more substantive, effective and impactful than any proposals that brought forward by other political parties in the House.

Ivana Bacik (Dublin Bay South, Labour)
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The Taoiseach can quote figures, but I have already quoted to him the shocking figure relating to those who are homeless. Let me also quote figures published just this week by the AIB construction purchasing managers index. Those figures show residential building contracting for the third consecutive month. There was a sharp contraction in construction activity in June, down to 45.4% from 50.2%. I use the debacle over the Poolbeg site to illustrate the difficulty the Government is in. The Government's overreliance on the private sector has simply failed to deliver homes at the necessary scale. Construction, including residential construction, is slowing. The private sector has a significant role to play, but the State needs to take on a far more prominent and proactive role. That is at the heart of the Labour Party's proposals and, indeed, the proposals of other Opposition parties. Central to provision is that promises on delivery must be kept. Should the developers of the Irish Glass Bottle site fail to honour the legally binding 15% planning condition, legal action will have to be taken.

Verona Murphy (Wexford, Independent)
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Thank you, Deputy. The Taoiseach to respond.

Ivana Bacik (Dublin Bay South, Labour)
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It is very hard for my constituents and other people around the country who are homeless or facing the threat of eviction to see how little is being done by the Government.

Verona Murphy (Wexford, Independent)
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Deputy, please. At the behest of the Chair, the Taoiseach will respond.

Micheál Martin (Cork South-Central, Fianna Fail)
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That is not real. On the Labour Party's proposal, namely the idea of setting up a new State-owned construction company-----

Ivana Bacik (Dublin Bay South, Labour)
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The Land Development Agency.

Micheál Martin (Cork South-Central, Fianna Fail)
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-----would take years and would not have any impact on house building right now or over the next five years for that matter. The Labour Party has produced a couple of pages on it, with nothing fleshed out. That is the bottom line. We already have the Land Development Agency-----

Ivana Bacik (Dublin Bay South, Labour)
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That is what I said. Ramp it up.

Micheál Martin (Cork South-Central, Fianna Fail)
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-----and that is delivering well, so why create a new one?

Ivana Bacik (Dublin Bay South, Labour)
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That is what we said. Ramp up the Land Development Agency.

Verona Murphy (Wexford, Independent)
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It does not work like that, Deputy. Please respect the answer.

Micheál Martin (Cork South-Central, Fianna Fail)
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It has been ramped up, for God's sake. Billions are going into the Land Development Agency. That is how thin the Labour Party's proposals are. Genuinely, there is no real substance coming from the Opposition on housing in terms of adding to our stock. We did the exemption for back gardens, but those in opposition just dismissed that. We did rural housing and that was also dismissed. The Department also produced guidelines. The help to buy scheme, was opposed by the Opposition. The first home scheme was also opposed.

Conor Sheehan (Limerick City, Labour)
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It is inflationary.

Micheál Martin (Cork South-Central, Fianna Fail)
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That has helped young people and first-time buyers enormously, so much so that the number of first-time buyer mortgages is way ahead now of any other type of mortgage.

Verona Murphy (Wexford, Independent)
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Thank you Taoiseach, time is up. I call Deputy Stanley.

Micheál Martin (Cork South-Central, Fianna Fail)
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How do we get from 40,000-odd to 50,000?

Verona Murphy (Wexford, Independent)
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Deputy Stanley is on his feet. Taoiseach, the time is up.

Brian Stanley (Laois, Independent)
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I want to raise the situation regarding the absence of health cover for a large section of the population. Many middle- and low-income households have either very limited health cover or none at all. Forty-five per cent of the population have some kind of private health insurance. Most people who have such insurance have very limited, partial and restricted cover. A total of 42% have medical cards that provide either full medical cover or just GP care. This breaks down to roughly 30% having full cover and 12% having GP care cover. What these figures show is that 57% of the population have very limited cover. Worst of all, 13% to 14% have absolutely no health cover whatsoever.

These workers and families are typically on low to middle incomes but they live in one of the richest countries in the world. That is a scandal. The facts are that the income thresholds relating to entitlement to a full medical card have not increased in over two decades. The Taoiseach was Minister for Health at the time. The thresholds are of the 1980s variety. The latest figures from this year show that a single person has to be on an income of less than €184 a week in order to qualify. The threshold for a couple to qualify for a full medical card is €266.50 per week. If they have two children, the threshold is €345 per week. For the GP-only card, the threshold is €373 a week for a single adult and €607 - which roughly equates to €30,000 per year - for a couple. This means that many households which cannot afford it have no access to even basic healthcare or GP care. In turn, this gives rise to medical neglect.

I fully support Sláintecare. We are making some progress on that, but it is not happening quickly enough. Ten years were allocated in respect of the implementation of Sláintecare and universal healthcare. Those ten years will run out in 17 months' time. The process relating to full implementation has to be stepped up.

The position relating to discretionary medical cards needs to be examined and improved. As a start, we need to ensure that cancer patients have full medical card cover. On 6 March 2025, the Minister for Health, who is sitting beside the Taoiseach, in reply to a parliamentary question I tabled, stated:

I can assure the Deputy that my Department keeps medical card issues under review ... Over the course of 2025, we will review the existing eligibility framework to clearly assess what is working well ... This is an important step towards delivering on universal healthcare

I agree with her on that, but it is 105 years since independence and the establishment of this State. Budget 2027 will be introduced in 12 weeks' time. I accept that everything cannot be done at once, but will the Government ensure, as the next step towards implementing Sláintecare, that income thresholds will be increased in order to provide medical card cover to the workers and families who do not have any at present? Will it also ensure, very importantly, that cancer patients have full medical card cover? I welcome the fact that the number of training places for GPs has been increased, but will the Government expand the process in this regard further and get the HSE to directly employ GPs in to fill the gap in rural and urban areas where people do not have access to GPs at present?

Micheál Martin (Cork South-Central, Fianna Fail)
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I thank Deputy Stanley for raising this issue. He mentioned that Ireland is well over 100 years in existence as an independent State. There is a great book by Mark Henry, In Fact: An Optimist’s Guide to Ireland at 100. It contains a great chapter on health that I invite Deputy Stanley to read. If he looks at what people were dying of in 1922 and 1923 and the average lifespan at that time and the position today, he will see that there is no comparison. There has been an incredible improvement in the average lifespan. Ultimately, that has to be the measurement of any health service and of a broader societal approach to health and well-being. With a life expectancy of 83 years in 2024, Ireland ranked sixth highest among EU member states. I was Minister for health from 2000 to 2004. We were nowhere near this level of life expectancy at that time. The reason was that we did not have any national strategies on the key killer diseases, namely cancer and cardiovascular disease. We developed national strategies from the late 1990s onwards for cancer and cardiovascular disease. These had very dramatic beneficial impacts.

Those strategies were followed by substantial investment as well. Our mortality rate fell by 16.1% over the decade from 2015 to 2024. Our mortality rate for all circulatory system diseases fell by 28%, with the rate for heart disease and stroke falling by 34% and 42%, respectively. The mortality rate for all cancers dropped by 13.7%, with cancer of the trachea, bronchus and lung and breast cancer dropping by 19.3% and 11.7%, respectively. The mortality rate for respiratory diseases is down by 23%. I just need to make those general points. We are making progress. The investment has been huge. We have invested exponentially now in our health services.

In respect of GP and primary care, we have now had the biggest expansion of access to free GP care in the history of the State. If we take medical cards and GP visit cards, about 2.3 million people are eligible for free GP care, including those with medical cards and GP visit cards. We have reduced the threshold for the drug payment scheme to €80 per month. We did this progressively over the past number of years. We have funded diagnostic scans now for patients. We have introduced free contraception for women up to the age of 35. We are publicly funding assisted human reproduction, including IVF, and free HRT.

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

Micheál Martin (Cork South-Central, Fianna Fail)
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We have also developed a much-needed revolution in women’s healthcare in terms of see-and-treat gynaecology clinics and-----

Verona Murphy (Wexford, Independent)
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I thank the Taoiseach. You will be coming back in. I call Deputy Stanley.

Micheál Martin (Cork South-Central, Fianna Fail)
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-----fertility hubs and specialist menopause services. All that helps to gain greater access for patients.

Verona Murphy (Wexford, Independent)
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I thank the Taoiseach. The time is up. I call Deputy Stanley.

Brian Stanley (Laois, Independent)
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That is all fair and good, and I acknowledge there has been progress. Of course, there has been progress in 105 years. There has been progress in my lifetime, which is a bit less than 105 years.

Micheál Martin (Cork South-Central, Fianna Fail)
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We can see from the Deputy's demeanour that he is doing very well.

Brian Stanley (Laois, Independent)
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I am hoping to get a bit longer than 83 years out of it.

The fundamental question here concerns people who do not have health cover. Progress is being made towards implementing Sláintecare, and I acknowledge, in particular, the stand taken by the Minister in relation to the contracts for consultants. If they are paid to work for the full week by the State, then they cannot do private work during that time. A plumber working for the Office of Public Work, OPW, cannot be off doing nixers during the day for somebody else. We support her in doing that.

Universal healthcare is where we have to get to. We are out of step with other states. The Taoiseach will have to admit, and he has not addressed this, that since he was the Minister for Health, those thresholds have not increased, and I acknowledge all the progress that has been made, although we have a distance to go yet. It is €184 for a single person, €266.50 for a couple and €345.50 per week for a family of four.

Verona Murphy (Wexford, Independent)
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I thank the Deputy. The Taoiseach has the figures. I call the Taoiseach to respond now, please.

Micheál Martin (Cork South-Central, Fianna Fail)
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I again thank the Deputy for raising this issue. The biggest movement in the past couple of years has been the GP access card, the GP visit card, more than the medical card. I acknowledge that point. We have, however, reduced the drug threshold payment as well. We are also building up the public health system as per Sláintecare and Government decisions-----

Brian Stanley (Laois, Independent)
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The Taoiseach himself-----

Micheál Martin (Cork South-Central, Fianna Fail)
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-----which I think are, in many respects, extremely important in terms of the diagnostic hubs and the community-based model that has been evolving over the past number of years. It actually gives people very ready access to diagnostics and treatments in terms of not having to access the acute hospital system all the time.

On growing college and training places, which the Deputy referenced earlier, as he knows, there was a big investment in 2026 enabling higher education institutes to deliver over 1,100 new healthcare course places each year over the next three years.

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

Micheál Martin (Cork South-Central, Fianna Fail)
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We have had a particularly significant investment in more GP places in our colleges and clinical placements thereafter.

Verona Murphy (Wexford, Independent)
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I thank the Taoiseach. I appreciate that there is a lot of information.