Mary Seery Kearney (Fine Gael) | Oireachtas source

It does not happen to the Boyd Barretts; it only happens to me.

The Minister is very welcome to the House. I thank him very much for this Bill. It is really welcome. In a country where we are intentional about universal access to healthcare, it is very important we remove any impediments that may cause people to not access the care they require.

A central plank - there is a "however" coming - of the Sláintecare plans was primary care centres and ensuring there is a primary care centre in the appropriate area. This morning, I tabled a Commencement matter but, unfortunately, no one from the Department of Health was available so the Minister of State at the Department of Further and Higher Education, Research, Innovation and Science, Deputy Niall Collins, took it. It was in regard to services on Curlew Road for the people of Drimnagh. The population of Drimnagh is just shy of the population of Killarney. A decision was made recently to pull public health nurses out of Drimnagh and relocate them to Armagh Road in Crumlin, where there is no direct connectivity by bus for elderly people who live in Drimnagh. A whole population, the size of Killarney, has been left without their public health nurses in their community. While it is a temporary measure, and there are contingency plans to have a very short-term clinic, it does not bode well when people in Drimnagh were promised a primary care centre in 2011, the funding was released for it in November 2019, and a design team was supposed to be put in place, all of which is trundling along but with the sod only expected to be turned in 2024. For the people of Drimnagh, that is not okay.

The supplementary information I got on this morning's Commencement matter shows that the public health nursing vacancy rate in Curlew Road, Drimnagh, and Armagh Road, stands at 53%. In Old County Road, the vacancy rate is 60%. We are dangerously low in the rate of recruitment and the number of people actually delivering services in community care. Inpatient care is brilliant and fantastic but the objective of it was to try to do as much locally and in local communities as possible. Yet, we have a community in Dublin, with its own distinct needs and connectivity, left with even its public health nurses stripped out from under it because we have chronic under-recruitment. I have attended meetings of the Joint Committee on Children, Equality, Disability, Integration and Youth and the Joint Committee on Disability Matters when HSE representatives came in, talked about recruitment and said it could be up to seven years before this is fixed. That is no use to children and elderly people who are missing opportunities because there is a failure to deliver in their community as there is this chronic shortage.

We have the same thing with children's disability network teams, CDNTs. The Armagh Road CDNT in Crumlin is supposed to supply 43 children into a special education school there. Those children were offered two hours a week, but even those two hours cannot be delivered because we do not have occupational therapists, speech and language therapists or psychologists. In fact, the turnover of staff on Armagh Road is shocking. If it were a private sector facility, there would be a special investigation and a HR task force to find out why people cannot be retained in that service. We talk about universal healthcare and yet we have this massive recruitment problem. People and parents are relying on the Armagh Road facility, which is now being bolstered with public health nurses who have been pulled out of Drimnagh. Parents there believe that at any minute that CDNT will be closed down because, effectively, it is not operating as it stands.

On another announcement, Cariban was to be available and accessible to women suffering from hyperemesis from January this year.However, the administrative access to this drug is so difficult and complex that women are being admitted to hospital, put on intravenous drips and treated in a way that would not be necessary if access to the medication could be delivered in a simple way. It is not deliverable in a simple way. You have to wait for a consultant, and you will not see a consultant until you are post 12 weeks. You do not get a retrospective refund on the drugs payment scheme for the Cariban you have already paid for. Even the drug payment scheme has a threshold, and you only get support for one third of the cost. It was announced that there would be free access to this medication for women who are in desperate need of it, but they do not get access to it in many cases until they no longer need it. It is prohibitively expensive for those who desperately need it. It is either difficult to access or is reliant on a consultant dealing with administration, meaning that women are left without actual access to it.

I am delighted to hear the Minister speak about IVF funding. There is no question but that it is desperately needed. I am going to remind the Minister of something I raised with him in the past. When we provide access to IVF funding in this State, we need to make sure the criteria are inclusive. They need to include single parents, same-sex couples and people with disabilities. That last category is particularly important. Some of the exclusions for women with disabilities, and the manner in which they are treated when they present with fertility issues, are quite shocking.

The Minister has always said that as part of the IVF funding, it would be a condition that the regulatory authority would have to be in place and the assisted human reproduction legislation would have to be in place. I am anxious to know how that is progressing. Will that legislation be passed by the summer? A vital part of that is the surrogacy element. There are parents up and down the country who do not have a lifelong legal relationship with their child. As each week passes, they are suffering detriment. There is detriment in the cases of people who are seriously and fatally ill and the mother does not have access to that child. There are second parents excluded from access to their child because they have no legal means to go to court unless they take action in the High Court. We need that legislation and we need a deadline on when it will be delivered.