Television Licence Fee
1. Deputy Joanna Byrne asked the Minister for Tourism, Culture, Arts, Gaeltacht, Sport and Media the timeline for the replacement of the TV licence fee by direct funding from the Exchequer, managed by Coimisiún na Meán; and if he will make a statement on the matter. [10148/25]
I ask the Minister to give a timeline for the replacement of the TV licence fee by direct funding from the Exchequer, managed by Coimisiún na Meán, and to make a statement on the matter.
First, I congratulate Deputy Byrne and wish her well in her role as an Opposition spokesperson. I will make it clear from the outset that there is no intention to replace the television license fee. The previous Government made a decision last July that the licence fee should be reformed and enhanced, not abolished. It is in that context that the programme for Government sets out our commitment to a strong, independent media sector that provides essential public service broadcasting, supports local journalism and upholds the freedom of the press. To achieve this, it commits to ensuring stable, sufficient funding for RTÉ and TG4 to maintain quality programming and public trust, and contains a range of specific commitments to support the independent sector to provide quality public service content.
These commitments are underpinned by the new framework to finance public service broadcasting agreed by the Government last July, which was further reflected in the general scheme of the broadcasting (amendment) Bill, published last October. Under this framework, TG4 will continue to be financed entirely through the Exchequer, while RTÉ will be financed through the licence fee and an additional Exchequer allocation as appropriate. The broadcasting fund will be converted to a platform-neutral media fund to support public service content through the wider media sector.
Public support for public service broadcasting and public service content will be €324 million in 2025. In this context, the television licence remains an important source of revenue which, it is estimated, will contribute more than €204 million in 2025, with more than €120 million of that forecast to be raised through the sale of television licences by An Post and the balance through funding for free television licences. This funding is not only for RTÉ; 7% of the net licence fee receipts will be paid into the broadcasting fund and, ultimately, into the new media fund.
As part of its decision last July, the Government decided that the TV licence system will be underpinned by improvements in collection and compliance to maximise revenue generation. The Government reconvened the television licence technical working group to examine potential enhancements to the TV licence and agreed to provide An Post with an Exchequer allocation of €6 million over a three-year period for necessary improvements in the collection system and technology.
A vibrant, diverse, financially sustainable and independent media sector is critical to any well functioning democracy. Across Europe, the TV licence model is being phased out because it is outdated and does not work. The Minister is aware that in 2022 the Future of Media Commission recommended the TV licence fee be replaced by direct Exchequer funding in 2024. The Minister's Government chose to ignore that recommendation and kicked the can down the road by means of reform.
The Minister is aware that in the previous Dáil term, just last year, the media committee also officially recommended the TV licence fee should be abolished and replaced with Exchequer funding. The Government sat on its hands, again, and did nothing to progress this. Both of these bodies made these recommendations after long and considered discussions and consideration of all of the information required to make such a decision. They were not knee-jerk reactions to the multiple scandals - which are still unresolved in some cases - around governance and spending in RTÉ. In fact, the Future of Media Commission recommendation was made before any of the RTÉ scandals were unearthed.
The RTÉ scandals did have a knock-on effect and there was a total reduction in revenue generated by TV licence sales for the 12-month period between July 2023 and June 2024 that amounted to a reduction of €29 million compared with the year before, prior to the scandals being uncovered. When will the reform happen? We need to get timelines on this from the Minister. I appreciate his response but this issue is not going away.
The opening line of my reply made clear where the Government is on the previous Government decision but, to put it in context for the Deputy, in 2020 the total licence fee revenue was of the order of €222 million. The latest figure for 2024 is approximately €195 million. I am not sure where the Deputy thinks that money will come from in the absence of the licence fee. Does she think it should come directly from the Exchequer? If it is to come directly from the Exchequer, €200 million is a lot of money. Where does the Deputy propose we get that money? Which schemes under my Department that are currently funded to the tune of €200 million should pay the cost?
It is interesting that the Minister asks me where I would get the figures from. I have read the Minister's brief and, in the sections that detail the agencies under the remit of his Department, the annual budget for Coimisiún na Meán is blank. No figure is provided. Is the Minister considering reforming the TV licence before providing this figure or where is he at with it? It is a serious matter. Just because the TV licence is not as prominent in the headlines as it once was, that does not mean the Minister should not be paying it any attention.
I accept that the television licence is very important but €195 million is a fairly big hole. If Sinn Féin is now proposing I abolish it, I wonder where I will get €195 million. Should I get it from health, social welfare, housing or roads? That is a lot of money. If we are advocating for the abolition of a fee, the abolition of a charge, the reduction of a tax and that everybody gets everything for nothing, the Deputy might enlighten me as to where the money will come from. I do not see that substance in her question and I certainly do not see it in my Department. I do not have €195 million. If I did, I know where I would put it. There are a lot of demands for that kind of funding. If the Deputy would like to tell me where I can get €195 million, I will be delighted to know where it is.
State Bodies
2. Deputy Aidan Farrelly asked the Minister for Tourism, Culture, Arts, Gaeltacht, Sport and Media if he will provide further details in respect of his plans to review spending by bodies under his remit and-or aegis. [9994/25]
First, I take the opportunity to wish the Minister well and congratulate him on his new role. I ask him to provide further details in respect of his plans to review spending by bodies under his remit or aegis.
Déanaim comhghairdeas leis an Teachta Farrelly. Go n-éirí go geal leis. I hope he has an enjoyable period of time here and I wish him the best of luck in his endeavours, along with the other Deputies across the House and the new Deputies I see around me.
As Minister, I have recently brought, in quick succession, two annual reports of bodies under the aegis of my Department which have raised concerns in regard to the management of taxpayers' money. The first related to a major expenditure of almost €7 million on a failed ICT project at the Arts Council and the second regarded the expenditure of almost €125,000 on a digital X-ray machine for the National Gallery which has not been useable due to the lack of a proper room to contain it.
I therefore requested the Department write to all the State bodies in the culture, sport and media sectors under the aegis of my Department, seeking information with regard to expenditure on capital projects since 2020 to provide assurances to me and, more important, the public with regard to the management of capital expenditure. Bodies were asked to provide budgetary information on capital projects costing more than €500,000 since 2020.
In addition, bodies were asked to identify if there were other capital projects below this level which should be brought to the Department’s attention for any other reason, such as where there has been significant expenditure on projects which were abandoned or have materially failed to deliver on their objectives. The need to ensure compliance with early warning protocol arrangements between the Department and the State body, as well as with Circular 14/21, relating to arrangements for oversight of digital and ICT-related initiatives in the civil and public service, was also set out in the correspondence.
This exercise, which is designed to provide an additional layer of assurance around spending on capital projects, is in addition to the existing oversight arrangements in place, as well as the annual auditing process undertaken by the Comptroller and Auditor General. It should be noted that the code of practice for the governance of State bodies provides a framework for the application of best practice in corporate governance by State bodies. The board is responsible for ensuring that effective systems of internal control are instituted and implemented in the State body, including financial, operational and compliance control and risk management. I will read the rest of my written reply in a while.
There is a bit of a smoke and mirrors effort happening here; a bit of a damage limitation stunt. I appreciate what the Minister has inherited here is a little bit of a mess but the reality is that his Department already knows what is being spent. That is fair to say. What we have seen though, with both of the incidents the Minister cited, is an abject failure in terms of oversight in governance.
I am really intrigued to see how deep he is willing to go in this regard. Will he get into the weeds of writing to a national governing body, such as the FAI, for example, asking it to write to the Kildare and district underage league, KDUL, asking for reports? What does that mechanism look like? That is a really interesting point.
We have seen reports that the Arts Council flagged this issue three years ago, so there were no question marks over the fact that there were concerns about this many years ago, but the Department was not in a position to provide support. When we see a shortfall in reporting mechanisms within the Department, is it not meritable now to look at what is going on in the Department as much as what is going on within the agencies?
I do not disagree with the Deputy. The committee I have established to examine the governance of the Arts Council is being led by Professor Niamh Brennan. It includes Margaret Cullen and John McCarthy. They have all in their own right plenty of experience of examining corporate governance in other areas as well. I do not disagree with the Deputy with regard to the Department's role but I have to find out first of all the level of detail that is required here. I will bring a report to the Government first and I will lay it before the Dáil. It is in my interests and in the Department's interests to get public confidence in the moneys that are voted from here to the Department in order to make sure that the Department and its agencies spend money wisely on behalf of the taxpayer. I have no issue with that. I am not suggesting that the Deputy is suggesting this, but I am not in any way attempting to hide anything here. The most important thing is that Niamh Brennan's committee be asked to do a body of work by me and get it done as quickly as possible. Separately, I will deal with the National Gallery and any other issues there as well, and I will lay all of them before the Houses of the Oireachtas. There is no issue in that regard.
We all know, having worked in different sectors, that extensive reporting mechanisms are in place already. If we draw down public funds, we have to report at every step of that process. We know that, for example, as regards the IT system, there are what we call decision gates at various stages of expenditure, whereby organisations have to report that back. As for my concern about the committee to which the Minister referred, I would love to see the terms of reference for the committee. Are we going to look only at the responsibility of the Arts Council in this example or are we going to forensically examine, if it was identified that there were issues here but that the Department in and of itself was not in a position to support the organisation, where else that is happening? That is a crucial bit.
As regards that root-and-branch review, will the Minister put on the record of the House today that the arts sector will not suffer financially as a result of what has happened in recent months? That is really important. There was concern out there that the very valuable work undertaken by artists throughout this country will suffer because of this. Will the Minister put on record that that will not happen?
To take the last point first, it is not my intention that anybody who is legitimately doing very good work on behalf of the arts community across the country should suffer. That is not my concern here at all. My concern is the same as the Deputy's concern, that is, that if there is voted expenditure from the Oireachtas to Government Departments, it must be for the purpose that it is for. I will also say - I said this in the course of an interview - that the Minister for Health does not know, nor should she know, nor could she know, how many thermometers are in University Hospital Waterford and how much they cost. We have civil and public servants within the Department and within different agencies to make sure that the moneys that are spent on our behalf as Members of Dáil Éireann are spent appropriately. The first thing I have to find out here is who knew what when, to bring that information before the Dáil and to make the necessary changes in terms of governance and oversight from within my own Department, but as well as that, within the Department's relationship with the bodies concerned. We will do that, and if people have any suggestions, I am all ears and I will not rule anything out.
Sport and Recreational Development
3. Deputy Joanna Byrne asked the Minister for Tourism, Culture, Arts, Gaeltacht, Sport and Media to give an update on and a timeline for the creation of football academies with the FAI and the League of Ireland, as contained in the programme for Government; and if he will make a statement on the matter. [10149/25]
I ask the Minister to give an update on and a timeline for the creation of football academies with the FAI and the League of Ireland, as contained in the programme for Government, and to make a statement on the matter.
I thank Deputy Byrne and congratulate her on her election and her spokespersonship.
In response to the question, the programme for Government, as the Deputy knows, includes a commitment to explore new mechanisms for the creation of football academies with the FAI and the League of Ireland. My Department has provided additional funding to the FAI to enable it to produce a report on developing football academies. This will include a baseline audit of existing academy structures and needs, and that will then inform the development of an academy development plan. This funding will also enable the FAI to appoint an academies administrator, to support the development of new academy programmes and to track their impact. The funding will be channelled through Sport Ireland. I very much look forward to receiving the report from Sport Ireland. It will be a key input to considering the next steps to be taken while noting that decisions in this regard are primarily a matter for the FAI as an independent sports body.
Considerable additional financial support has been provided by the State for the development of football in Ireland, particularly through the 2020-23 memorandum of understanding between the Government and the FAI. That MOU provided for funding of €5.8 million per annum to the FAI during that four-year period up to 2023 for football development. A new MOU was signed last December, which increased State funding to the FAI to €6 million per annum for the period 2024-27.
In terms of State support for the development of facilities, more than €100 million was allocated to Irish football in the second half of last year. That consisted of €54.5 million in November from the large-scale sport infrastructure fund to football stadium projects at Finn Harps, Dalymount Park, Sligo Rovers and Wexford FC. Also, we saw €50.5 million allocated from the community sports and equipment fund to support the development of grassroots club football facilities nationwide.
The Government is committed to supporting the development of Ireland's sporting ecosystem, and the support that continues to be provided for football is a key example of that commitment.
Despite football being the biggest sport in Ireland, I feel it has been overlooked for too long in this country, in particular our footballing academies. The future of Irish football relies on investment, resources and infrastructure to support, build and evolve youth football. Historically, resources have not been there to give players the contact hours with coaches that are necessary. Irish clubs as a whole are fighting to survive and they need support from all relevant stakeholders, including the Government. Statistics outline the difference in training hours for a kid at an Irish club compared with its counterpart category 3 club in the UK. They fall way short. As the ages rise from under-14s to under-17s, so too do the disparity and the imbalance. Alarmingly, staffing levels for our academies are among the lowest in Europe, with ten full-time staff across 24 academies here, Poland boasting 376 staff across 16 clubs and Portugal with 315 over seven academies. Croatia, often hailed in comparison to Ireland due to its having a similar population, has 190 full-time academy staff across ten clubs.
We have seen great momentum and great attendances in recent times in the League of Ireland. There was a great example recently in the Aviva Stadium, with 33,000 people attending. I want to work with the FAI and all in grassroots football to build on that momentum in order to make sure that right across the country the support and development opportunities are there for young children to get involved in this sport, to excel and to develop their participation. At the moment, the Government, through the memorandum of understanding with the FAI, has significant support in place. Significantly increased support started in 2019, following on from the financial collapse of the FAI at that time, which led to a significant increase in the allocation to the FAI, targeted primarily towards coaching and development at grassroots level, particularly with young people. I think there is real potential in developing an academy structure as part of that ecosystem. I want to make sure that any investment we put into that is directed in a way that makes a real impact and delivers real results. I have outlined how we are engaging with the FAI, how we have already provided financial support to do an audit and to put in place an academy administrator and then how we step it out from there.
The FAI has worked tremendously hard in recent years to enhance its reputation as a trusted and respected brand. It has an ambitious facilities development and investment strategy that commits to raising standards within grassroots and recreational football. With nearly 1,200 grassroots clubs and more than 220,000 registered players over 75 leagues, the numbers speak for themselves. Participation and the potential are ever growing. I welcome the Minister of State's contribution today, but kicking the ball down the field and delaying State funding for League of Ireland academies, as was referred to in an interview with the Minister, Deputy O'Donovan, last week, is not an option. As a nation, we are falling short on all fronts when it comes to recognising the potential League of Ireland clubs and grassroots football can bring. The fate of our senior international teams, both male and female, relies on our delivering a fitting future for every boy and girl who enters their own field of dreams. I implore the Minister and the Minister of State to make their mark, be the voice for youth football in Ireland and continue to support the FAI in its endeavours to harness the academies to develop a full-time football industry. I look forward to working with them both in the future to that end.
I see real potential here as to how we can develop an academy system. Obviously, we have to make sure we develop it in a way that is sustainable and makes the biggest impact. The plans are not there yet as to how exactly that would work. I want to see how they would work. We have given some funding to the FAI to do an audit and to put an administrator in place, to see how we can step that out. Then, as to how we follow through from a Government point of view, I want to see real results in that regard and liaise closely with the FAI on the exact plans as to how this might be stepped out.
The Government has massively committed to grassroots sports and to seeing people being able to participate at this level, as well as to excel and develop their full potential. I refer as well to the undoubted potential we have as a soccer nation to improve even further and to see the pipeline coming through, right up to the League of Ireland level and internationally from there on. This is something I want to work on with everyone in soccer and with the FAI to ensure we develop this potential.
Go raibh maith agat.
I am committed to developing an academy structure, but we must be very clear about how we step it out, ensuring it is impactful and there is a clear plan and direction of travel in place for that journey.
Arts Policy
4. Deputy Roderic O'Gorman asked the Minister for Tourism, Culture, Arts, Gaeltacht, Sport and Media the number of artists who have benefited from the basic income scheme for artists to date; the status of research into the benefits of the scheme; and if extending this scheme is a priority for him in budget 2026. [10543/25]
The basic income for the arts scheme is a proud legacy of the Green Party's time in Government. It is benefiting more than 2,000 artists with a monthly payment. I believe this scheme should be maintained and, indeed, enhanced. Can the Minister give us an indication of the research that has been done on its impact at the same time as the pilot is operating? Can he also give us an indication as to whether keeping the scheme or growing it is one of his budgetary priorities?
The programme for Government commits to assessing the basic income for artists pilot research scheme to maximise its impact. The basic income for the arts pilot research scheme will conclude in August this year and the data from the pilot will be fed into the Government's consideration of the next steps. Recipients have been receiving payments and responding to surveys under the scheme since August 2022. Some 2,000 artists and creative arts workers have benefited from the payment of €325 a week since August 2022. There were over 8,000 eligible applicants for the scheme and the 2,000 recipients were chosen through an anonymised random selection process. In budget 2025, the Government made an allocation of €35 million for the basic income for the arts scheme in 2025. It is important to note that the pilot is a research programme and that no decision has been taken as to its continuation. The research evaluating the impact of the pilot scheme is ongoing and it is a priority for me to ensure the research is completed to assess and maximise the impact of the scheme ahead of budget 2026.
While the research phase of the pilot scheme is still ongoing, it is clear from the evidence collected to date under the scheme that it is having a positive impact on the participants. The latest data is available through published reports on the basic income for the arts website on gov.ie. This data shows that the scheme payment is having a consistent positive impact across almost all indicators affecting practice development, sectoral retention, well-being and deprivation. Artists in receipt of the support are typically able to devote more time to their art, experience a boost to their well-being through greater life satisfaction and reduced anxiety, and are protected from the precarious nature of incomes in the sector to a greater degree than those not receiving the support. I will shortly publish a qualitative research paper on the scheme and work is starting to undertake a cost benefit analysis for a more complete assessment of the impacts of the scheme. A Government decision will be required on a successor scheme to the pilot and the future of the scheme will be decided when the final results of the research are available. These will provide the Government with the evidence base upon which to base future policy decisions about the basic income for the arts.
I am glad to hear the Minister refer to the impact assessment his Department conducted after year one of the scheme. I was really impressed by some of its findings, including artists being able to spend up to eight hours a week more on their practice and having the ability to invest up to €550 monthly into their practices for materials, workspaces and the like. There was a 9% increase in the number of artists able to sustain themselves solely in their practices because of the support the basic income scheme provided. The Minister also touched on a slightly intangible aspect, namely, the well-being impacts for artists. We know many types of artistic practice can be tenuous, precarious and lonely, and, therefore, the well-being impacts are something we can welcome too. There is a really strong campaign in this regard. The National Campaign for the Arts, Performing Arts Forum, First Music Contact and Irish Street Arts, Circus and Spectacle Network groups are all campaigning and looking for this scheme to be continued. I would love to get the Minister's sense at this stage in the year in the context of his own priorities of what his thinking is on this scheme.
As the Deputy will appreciate, I have been rather busy since I went into the Department. The total cost of this scheme is €105 million. It was committed by the previous Government of which the Deputy was a member. Undoubtedly, this scheme has certainly had major benefits for the individual artists concerned. Now, we have an opportunity to do not only qualitative but also quantitative research regarding the output from the scheme. From the Deputy's time as the Minister for children, he will know that any decisions taken this far out from a budget cannot be undertaken without the context and input of the Department of Public Expenditure, National Development Plan Delivery and Reform. Once I have the research concluded, however, and have a qualitative and quantitative piece of work I can bring to the Government on the value accrued to the State from that €105 million allocated from the previous Government, I think that will probably colour the decision going forward. I am looking forward to seeing that research concluded soon.
The qualitative research is extremely valuable when we are investing significant amounts of taxpayers' money. The research process was built into this pilot from day one to ensure we were assessing the scheme's actual outcomes. We look forward to seeing the qualitative paper the Minister spoke about earlier. There are options here. The Minister could look to extend the scheme for the existing 2,000 participants, he could look to bring in a new 2,000 participants into the scheme or he could look to grow the scheme in its entirety. A decision will have to be made in terms of the next budgetary process. The Minister's predecessor, former Deputy Catherine Martin, secured funding for the scheme up to the end of this year, I think. From the start of 2026, though, a clear decision will have to be taken. I think the evidence to date points to the benefits of the scheme and suggests we should be looking to grow it. I look forward to engaging further with the Minister when additional information is provided.
I do not disagree with the Deputy, except on his last point. There is no point in having research carried out and then making the decision ahead of it. I have to bring this matter to the Government and, as a former Minister for children, the Deputy will know what this involves. I am not going to pre-empt the outcome of the research, which is looking at the scheme under a variety of headings, including practice development, well-being, deprivation, sectoral retention and others. The benefits of the scheme have been well enunciated. The Deputy is right in saying there are a limited number of people in it and several different options that could possibly be looked at. People outside the scheme now might ask if it is their turn or is it somebody else's turn. All these aspects will have to be looked at in the round. Once I have the research before me and I can bring a memorandum to the Government, which I hope to do soon, there will be clarity regarding the scheme's future.
Foras na Gaeilge
5. D'fhiafraigh Deputy Aengus Ó Snodaigh den Aire Turasóireachta, Cultúir, Ealaíon, Gaeltachta, Spóirt agus Meán cén réiteach sealadach atá beartaithe aige, fad is atá réiteach fadtéarmach á lorg, chun a chinntiú nach mbeidh eagraíochtaí agus grúpaí pobail Gaeilge thíos leis toisc ciorruithe de €800,000 orthu ó Fhoras na Gaeilge; agus an ndéanfaidh sé ráiteas ina thaobh. [10182/25]
Is ceist í seo mar gheall ar mhaoiniú Fhoras na Gaeilge agus an gá go ndíreofaí isteach le teacht timpeall ar an bhfadhb bhunúsach go bhfuil ciorraithe anois de €800,000 ar an mbuiséad a bheas ag na sé cheanneagraíocht Gaeilge de thairbhe chinneadh Fhoras na Gaeilge.
Gabhaim buíochas leis an Teachta. Mar is eol dó, tá cúraimí na Gaeltachta agus na Gaeilge ag aistriú chuig an Aire, an Teachta Calleary, go luath. Is é an tAire, an Teachta Calleary, a bheidh freagrach as polasaí a fhorbairt faoi na ceisteanna seo. Tá mé ag súil go mbeidh an obair go léir críochnaithe go luath chun na feidhmeanna a aistriú go foirmiúil ó mo Roinn chuig an Roinn nua, is í sin, an Roinn pobail, gnóthaí tuaithe agus Gaeltachta. Is í an Chomhairle Aireachta Thuaidh-Theas, CATT, a cheadaíonn buiséid do na hinstitiúidí Thuaidh-Theas, lena n-áirítear an Foras Teanga Thuaidh-Theas. Cuireann mo Roinn 75% den bhuiséad ar fáil d'Fhoras na Gaeilge agus tagann an chuid eile ón Roinn Pobal ó Thuaidh.
Tá méadú curtha ar fáil ag Rialtas na hÉireann i mbuiséad 2025 le cur i dtreo an Fhorais Teanga Thuaidh-Theas. Cuirtear tús le bliain bhuiséid an Fheidhmeannais ó Thuaidh i mí Aibreáin, áfach, agus dá réir sin, níl buiséid na bliana seo deimhnithe go fóill ag an Roinn Pobal ó Thuaidh. Nuair a bheidh buiséad 2025 deimhnithe agus aontaithe ag na Ranna urraíochta, ó Thuaidh agus ó Dheas, cuirfear é faoi bhráid an chéad chruinniú eile de chuid an CATT.
Rinne Foras na Gaeilge cinneadh ag tús na bliana seo ciorraithe a chur i bhfeidhm ar roinnt dá chuid scéimeanna bunaithe ar an mbuiséad a bhí aige anuraidh. Tá na Ranna urraíochta ó Thuaidh agus ó Dheas ag obair go dlúth le chéile chun na roghanna go léir a scrúdú ar mhaithe le teacht ar réiteach sa ghearrthéarma agus san fhadtéarma araon ar na ceisteanna faoin mhaoiniú.
Idir an dá linn, tá sé tábhachtach a thabhairt faoi deara go gcuireann an Rialtas maoiniú suntasach breise ar fáil d'Fhoras na Gaeilge agus dá sé cheanneagraíocht maidir le gníomhaíochtaí eile Gaeilge. Le dhá bhliain anuas amháin, tá dúbailt tagtha ar an sciar den mhaoiniú sin a chuireann an Rialtas ar fáil go díreach do cheanneagraíochtaí Fhoras na Gaeilge, ó €1.8 milliún in 2023 go dtí €3.6 milliún i mbliana.
Cloisim go ndeir an tAire nach bhfuil an buiséad réitithe go fóill ach tá a fhios ag gach uile dhuine go bhfuil an buiséad réitithe mar tá sé soiléir nach bhfuil airgead breise ag teacht ón bhFeidhmeannas toisc cinntí an DUP. Dá réir, ní bheidh aon fhás ar bhuiséad Fhoras na Gaeilge. Caithfimid teacht timpeall ar fhadhb atá cuíosach bunúsach le tamall de bhlianta anuas áit atá an Stát ag rá go hoscailte go bhfuil sé sásta cur leis an airgead agus go bhfuil an fhadhb ó Thuaidh. Is fadhb pholaitiúil í ach is fadhb í sa chás seo atá ag cur as do na sé cheanneagrais go bhfuil €800,000 á tharraingt siar ón obair atá ar bun acu. Na dreamanna a bheidh thíos leis seo ná dreamanna atá thíos cheana féin toisc nach raibh aon ardú sa bhuiséad acu le blianta agus an fhadhb bunúsach seo ann. Caithfimid teacht timpeall air seo ar bhealach. Tabharfaidh mé roinnt samplaí don Aire nuair a thagaim ar ais.
Tá a fhios ag an Teachta an méid oibre a rinne mé nuair a bhí mé mar Aire Stáit ag plé leis an ábhar sin. Tá sé an-deacair. Níl aon amhras orainn faoin bpointe sin. Tá sé an-tábhachtach freisin d’Fhoras na Gaeilge go réiteofar an fhadhb seo chomh luath agus is féidir. B’fhéidir go mbeadh seans ag an Teachta buaileadh leis an Aire nua, an Teachta Calleary, agus an t-ábhar sin a phlé. B’fhéidir go mbunófar na coistí go luath agus go mbeidh an Teachta Ó Snodaigh ina chathaoirleach ar an gcoiste Gaelainne agus Gaeltachta arís. Tá an t-ábhar seo an-tábhachtach, ní hamháin don dream atá ag lorg tacaíochta ó Fhoras na Gaeilge ach d’aon duine le suim i gcúrsaí Gaeltachta agus Gaelainne. Tá sé an-tábhachtach domsa freisin an t-ábhar seo a réiteach go luath.
Gabhaim buíochas leis an Aire as sin. Tuigim go bhfuil, mar a dúirt sé, na feidhmeanna á n-aistriú go dtí an Aire, an Teachta Calleary, ach is an Aire, an Teachta O'Donovan, atá os mo chomhair inniu agus tá sé anseo thar ceann an chórais mar sin. Is teachtaireacht é seo don chóras. Caithfimid uilig teacht ar bhealach timpeall air. Ní rud polaitiúil atá i gceist go bhfuil mé ag spochadh as an Aire, an Teachta O’Donovan, nó as an gcóras. Tá mise sásta cuidiú in aon bhealach gur féidir liom ach caithfimid smaoineamh ar bhealaí cliste más gá le teacht timpeall ar an bhfadhb ionas nach bhfuil na heagrais thíos €800,000 nach bhfuil ar fáil dóibh. Mar shampla, tá an scéim tacaíochta gnó agus beidh an chéad glaoch eile ann do scéim na bhféilte. Beidh an scéim seo thíos €140,000. Tá a fhios agam go raibh an-spéis ag an Teachta O’Donovan i gcur chun cinn na Gaeilge i measc an phobail. Tá €140,000 bainte as scéim dírithe ar fhéilte. Is féidir linn, is féidir leis an Aire agus is féidir leis an Roinn tograí aonuaire a mhaoiniú agus b’fhéidir gur sin an bealach timpeall air seo láithreach bonn chun cuidiú leis na féilte seo sa bhealach sin.
Cinnte. Tá a fhios ag an Teachta go bhfuil an fhoireann Gaeltachta agus Gaelainne imithe ó mo Roinn agus mar sin is é an tAire, an Teachta Calleary, atá ag plé agus a bheidh freagrach as na polasaithe a bhaineann le cúrsaí Gaeltachta agus Gaelainne. Ach tuigim go bhfuil mé os comhair an Dála inniu agus beidh mé in ann an t-ábhar sin a phlé leis an Aire chomh luath agus is féidir. Níl aon amhras orm ach go bhfuil sé sin an-tábhachtach do na daoine ar fad sa tír seo a bhfuil suim acu i gcúrsaí Gaelainne agus Gaeltachta. Tá sé an-tábhachtach an t-ábhar sin a réiteach go luath.
Health Services
64. Deputy David Cullinane asked the Minister for Health when she will publish the review of specialist cardiac services; when she will publish a comprehensive cardiovascular health strategy; and if she will make a statement on the matter. [10077/25]
Will the Minister outline when the national review of cardiac services conducted by Professor Nolan and his team will be published? I sat in a meeting in 2019, when Deputy Simon Harris was the Minister for Health, with Oireachtas Members from across the south-east and at that point, that review had been commissioned. Here we are, in 2025, and it still has not been published. It was sitting on the previous Minister’s desk for at least nine months. I got a commitment last year that this would be published very quickly - within a matter of weeks - yet it still has not been published. When will it be published?
The national review of adult specialist cardiac services is finalised. The review provides a detailed, evidence-driven analysis of cardiac services across the country. A wide range of stakeholders - clinical, patient and public - were consulted as part of the review. The review provides recommendations around cardiac health policy, specifically: patient-centred care integrated with Sláintecare; increased cardiac care in community settings; a focus on prevention; capital investment for non-invasive diagnostics and imaging, including ehealth; structural reform to develop regional cardiac networks and national comprehensive cardiac centres; and leadership and governance.
Publication of the review, which is very important, will facilitate the development of the new national cardiovascular strategy. That will take time to develop and will require significant reform to ensure effectiveness and sustainability. I am reviewing the report and I hope to meet the authors shortly. Yesterday, at St. Michael's Hospital, we met Professor Ken McDonald, who is one of the people involved, and I hope to have the opportunity to meet with them when I return from my St. Patrick's Day engagements. I would anticipate publishing it shortly thereafter.
The problem is that I have been told that on at least three occasions. I know the report was with the previous Minister for Health for most of last year. Deputy Carroll MacNeill is a new Minister coming in but there is continuity in that this report has been sitting on the Department's desk. It is not going to be the new national cardiovascular strategy because that strategy has to look at prevention, diagnosis and rehabilitation care, whereas this report was specifically set up to look at acute services and, as the Minister said, the regional cardiac networks. As the Minister knows, part of that is relevant to my constituency in the south east. We still do not have 24-7 emergency cardiac services. If people are unfortunate enough to have a heart attack at 9 p.m. or 10 p.m. on any day of the week or at the weekend in Waterford, their only option is to be sent by ambulance to Cork or Dublin. Obviously, and rightly so, there is a campaign for a full 24-7 cardiac service.
This needs to be published as quickly as possible. The Minister has not answered the question as to why it has taken so long. The review was commissioned in 2019 and it is now 2025. It has been sitting on the Minister’s desk and we are now told again that it will be a number of weeks.
I cannot answer why it has not been done to date but I commit to the Deputy that it will be done and, naturally, I would welcome his engagement on it when it is published. I will be meeting the people involved when I come back from the St. Patrick's Day trip. I look forward to getting it published then because, as the Deputy says, it is incredibly important that it is done.
Recent trends in the demand for cardiac services reflect the changes in population and the health needs of an ageing population, which considerably changes the profile of need. The demand for emergency cardiac interventions is declining but the demand for non-acute services, such as the management of chronic disease, is increasing and we need a balance in terms of how to deliver the best service. We will need to carefully consider the number, location and resourcing of emergency heart attack centres to ensure that a balance can be achieved between accessibility and the provision of safe, efficient services. Cardiovascular health is a major pillar of the health funding announced in budget 2025, which included over €9 million in full-year costs to support important cardiovascular health initiatives. As the Deputy said, the publication of this review is a precursor of that, which I recognise.
Both the Taoiseach and the Tánaiste previously said several times in this House that, in principle, they support 24-7 cardiac services for the south east. In fact, the current Taoiseach stood behind a banner essentially saying that his party would deliver the 24-7 cardiac service. I know that is going to require additional resources and additional consultants but we need a policy decision. I am asking Deputy Carroll MacNeill a straight question. She is now the Minister for Health. Is she committed in principle to a full, 24-7 cardiac service in the south-east? That is the first question.
Second, it was stated in the programme for Government and also during the course of the election campaign that the Government is in favour of multi-annual funding for the health service. If we are in favour of multi-annual funding, then I hope the Minister will set out a very clear five-year strategy of ring-fenced funding for cardiovascular care and the many other national strategies that are needed to ensure that consistency and certainty of funding are there. Cardiac problems are the second biggest killer so this is very important. We have not had a strategy since 2019 and this report has been held up. The Minister said she will look at it. I accept that she is new in the role but there is an urgency here. I hope that when she comes back from the St. Patrick's Day visit, she will publish that report and move to the next stage of developing new strategies as quickly as possible.
I could not agree more about the need for a dedicated cardiovascular strategy and the multi-annual funding to facilitate that. With regard to Waterford, I have a small update. After an extensive recruitment campaign, we now have two labs open. One of those, from 18 March, will open with extended, albeit not 24-hour, 8 a.m. to 8 p.m.-----
I am aware of that.
I know the Deputy is aware but I want to inform the House more broadly. The other lab will provide elective services five days a week and the two labs together will protect better against both emergencies and elective issues. That is a major step in what the Deputy correctly acknowledges is a long-standing need.
With regard to 24-hour care, I am very open to providing the best care possible. I want to see what is in the cardiac review and to make sure we have the resources there, but I also want to ensure they are doing enough procedures to ensure that patient safety is encompassed within that. I am keen to work with the Deputy on delivering both of those things as we move to that point, while recognising that enough procedures must be happening all of the time to ensure it is a safe place to do that.
General Practitioner Services
65. Deputy Marie Sherlock asked the Minister for Health the actions taken by her Department to ensure the continued existence of a practice (details supplied) in Dublin 1 which is currently facing closure due to provisions introduced in the Finance (No. 2) Act 2003 amending section 1008A of the Taxes Consolidation Act 1997; her plans to support the existence of medical charities operating GP practices in socially disadvantaged areas; and if she will make a statement on the matter. [10130/25]
Last week, I raised with the Minister the issue of the GP Care For All practice in Summerhill, Dublin 1. In the Visitors Gallery today, we have the chair and the practice manager of that GP practice. It is a very serious situation because, by June of this year, this practice will be facing closure unless there is direct intervention by both the Department of Health and the Department of Finance. In particular, I want to ask about the plans of the Department of Health for the continued existence of medical charities in providing GP practices across the country.
Following the Deputy’s question last week, and prior to that, my Department and the HSE have had extensive engagement with the organisation concerned. That engagement has focused on identifying ways the organisation can continue to deliver services, which is what we want, how it can be supported by the Department and the HSE, notwithstanding the tax treatment, and finding what other solutions are possible. Several solutions in line with tax legislation and the provisions of the Health Act have been developed and presented to the organisation concerned, which might have the opportunity to reflect on that. Those solutions identify different business models that are practical and implementable and my Department is confident they would allow the organisation to continue its operation in line with all relevant legislation and the GMS contract. We both want the service to continue.
In addition, the HSE provided for a third party to independently advise the organisation on the matter. I understand that this advice built on the solutions presented and further developed the organisation's understanding of what implementation of those solutions would involve, including the identification of any additional costs and resources required. The Department and the HSE remain committed to engagement to ensure it can continue to provide services. That engagement includes working with it to implement the developed solutions and identify any additional supports recognising patient need in that community.
Issues relating to tax administration are a matter for the Minister for Finance but I am aware that section 1008A of the Finance Act allows, under certain circumstances, for the GMS income of GPs in medical partnerships to be treated as that of the partnership for income tax purposes rather than income of the individual GP. The introduction of this section did not change how GMS income of GPs who are not in medical partnerships, such as those in the organisation concerned, should be treated under tax law. Tax treatment is a matter for the Minister for Finance. What I am trying to do is ensure that this service remains open, that it has concrete solutions that are implementable and that it gets the resource support it needs to provide the patient care I know the Deputy wants for her constituents.
I wish to put on record that three options were offered to GP Care For All, none of which are operable. Option one was the partnership model, which is simply not viable because of the risk GPs would have to take on. Almost 97% or 98% of this practice is GMS-reliant. The second option, which was the hybrid model, and the third option, which was direct subsidy, were not acceptable to the HSE. The options put forward by the Department of Health are not workable and the HSE has paid for Western Urgent Care to come up with proposals to send to the Department of Finance and we have heard nothing back. The onus is on the Department of Health to ensure that the Department of Finance actually acts to ensure that medical charities can continue providing these services because nobody else is providing these services in some of the most disadvantaged areas in the country.
The Deputy set out the different options that were proposed. They were proposed in good faith with a view to keeping the service open and working. At some point, there is a finite number of options that can be proposed and try to be supported. They are really trying to work to find a solution. The Department and the HSE are ready to continue to engage with the charity regarding the proposed structural solutions. It will require some adjustment as to how GP Care For All operates or is structured but the HSE has also made a commitment to cover any funding shortfall arising from a change in the charity's operating model and to work through the implementation of the viable solutions that can be developed. More broadly, I am concerned to ensure that north-east inner-city Dublin is well served and better served by GP services. It is an area that needs GP services and support, as the Deputy and I discussed previously. We are very committed to trying to keep this service open but it will require some adjustment on both sides and we are working to find a solution. The current model will have to change a bit and be flexible in that way.
I do not doubt the goodwill there is regarding ensuring GP services, particularly to the 2,600 people on the list in GP Care For All, continue but the reality is that the HSE funding is only for the 2024 liabilities, nothing is in place for 2025 liabilities and I am not hearing any solution. We have a private system of GP care in this country with the result that we have significant gaps across this country in some of the most socially deprived areas and this Government is not coming forward with any solution as to how we put in place GP care in those communities. The medical charity model was a solution to the problem but now, it is being upended and facing closure because of those changes in the Finance Act. I am asking the Minister to make sure that this medical charity can survive and that other ones can be set up across the country.
I do not accept that no solution has been attempted. I know it is not quite what Deputy Sherlock is saying but for the benefit of the House, proposals have been presented to GP Care For All. One is a partnership model, which is a traditional model of service delivery within general practice and also works in other areas. Another proposal is a hybrid model where the HSE contracts individual GPs to provide services to specific patients and a model around that. Another proposal is a more direct subsidy model. A few different options have been on the table. I appreciate that we have 29 seconds to work out the details and I do not wish to read it all into the record of the House but I am certainly happy to try to understand why not one of these models can work. I am also interested to see what flexibility GP Care For All can facilitate as well. The offer here involves structural solutions not just from the Department and the HSE but with an independent third party to try to find a solution, offer of additional resources and offer of direct subsidy. I am certainly not saying, "How much more can we offer?" but I do want to know what we can do to get this resolved because that is our intention. It cannot be that only one side is trying to work it out, however. There must be a certain measure of flexibility.
National Children's Hospital
66. Deputy David Cullinane asked the Minister for Health if she has ensured that plans are in place to safely and appropriately staff the new children’s hospital to ensure there are no delays following handover from the contractor and if she will make a statement on the matter. [10078/25]
This question concerns the new national children's hospital and the preparedness of the State, the Government and CHI for what will be a decanting of staff from three hospitals into the new children's hospital. People want to be assured that the June deadline for completion will be met but also that the Minister and the Government are on top of the project, the contractor, the board and the handover because it is really important that we have as smooth a transition as possible from those three hospitals to the new hospital.
There is a significant ongoing programme of work to prepare for the opening of the new hospital, including integration of the three hospitals and operational commissioning. This operational commissioning includes the clinical fit-out for the entire hospital, total digital integration and staff training to ensure the hospital can open and accept patients safely and also that the workforces and cultures of the three hospitals come together.
There are approximately 4,500 staff working across Children's Health Ireland. This is an increase of 26% since 2019. An extensive training plan is under development to support the transition of current staff to the new hospital. Since the definitive business case was finalised in 2017, the workforce plan for the hospital has been revised multiple times to take account of service developments. I am advised that there is active engagement between the HSE and CHI to revise this plan to take account of further service developments and ensure the right workforce is in place to staff the new hospital. This is something that will need to be revised continually as the population grows and as we build capacity, so I anticipate that the workforce plan will continue to evolve and grow.
I understand that there is broad agreement on overall numbers required and every effort is being made to bring this process to a conclusion as soon as possible. Any additional staff needed will be sought as part of the annual Estimates process in the context of overall prioritisation of available funding. Over the next number of years as the population grows, that must grow with it and that is our intention in an appropriate way but, for the moment, the workforce plan is there.
Regarding the opening of the hospital, I am assured by the builder that we will have the building at the end of June. I received that assurance verbally when I was there last week with the Northern Ireland Minister of Health, Mike Nesbitt. I am assured by BAM that we will have the hospital at the end of June, which is what it committed to publicly in January. The hospital has advanced very considerably - even since I was there last October. We have agreed early access for CHI. I might pick that up in my supplementary reply.
I very much hope it is a case of 15th time lucky regarding that commitment and we see it handed over in June. I have a letter from 12 surgeons who work in the department of paediatric surgery, which I raised previously with the Government. In it, they talk about how the national model of care for paediatric surgery clearly outlines the need for 17 paediatric surgeons by 2028. It goes on to say, "we are very concerned that the recommended workforce of 17 paediatric surgeons has not been included in either the definitive business case for the new Children's Hospital, nor in any of the estimates over the last few years". It went on to state that, "this repeated lack of engagement and commitment to address the concerns of the department of surgery has left us with no option but to refer the letter to you [and many others in the HSE]". Is that the case? We cannot have a situation where we have a state-of-the-art hospital but we do not have the paediatric surgeons needed. All of us in this House know about all the surgeries for children with scoliosis and spina bifida and many more that urgently need to be carried out so we need to be assured by the Minister that those 17 consultant surgical posts will be in place by 2028.
I am advised that there is active engagement between the HSE and CHI to further revise the workforce plan. The question of staffing in all the specialisms has to come within the workforce plan. I appreciate that between now and the opening of the hospital, we might get several such letters from different specialists who are, understandably, trying to make the best case they can for the best resources for their area but this can only be delivered within an overall workforce plan and the budget for that.
While we might have different instances over time, that workforce plan is absolutely essential and that is what we have to work towards in the first instance.
On the broader commissioning of the hospital, early access in April has been agreed. I am currently assessing the CHI plans to move in and what will be done on a month-by-month basis to ensure that we have delivery of the hospital for patients in 2026. At the earliest possible safe time in 2026 patients will be moved. I am assessing that pretty rigorously at the moment.
If we do not have enough paediatric surgeon consultants, it creates problems. The Minister knows we have the ongoing Nayagam review and the review by HIQA into the use of springs. There was a media report this week of an audit that was commenced in April of last year conducted by an NHS consultant on the back of very serious allegations made by whistleblowers, including that operations on children were being done purely for financial gain, that osteotomies in two of the three children's hospitals have now been suspended and that potentially there could be a recall of up to 561 children. Is that the case? Has she, as Minister for Health, investigated this? It is a very serious issue on top of all the other reviews which are ongoing and it feeds into the need for more consultants, more staff, proper training, proper oversight and proper accountability. I am alarmed that we have this report, which I have not heard Government respond to yet, that potentially operations which were unnecessary have been carried out on children. We need to be assured that this has been properly investigated. Has the Minister seen this audit report which has been published? Has she sought it? What action will the Government take on the back of the allegations which have been made?
I am anticipating that report but I have not received it yet. I have not been presented with it yet. Of course, I will look at it immediately. There are a number of different issues that are not the same thing. One is the report, and we will look at the issues that are particular to that. The others are the resources and the increase in the number of consultants, which is quite considerable as the Deputy is aware, and making sure that we have the best workforce plan for the hospital in the first instance and into the future. They are two distinct things and I would not like to conflate them because no matter how many consultants we have, of course, we have to make sure that every consultant and every person working in the health system is working in the correct way. We may need to separate the issues in the review, which we will look at and I am sure the House will look at in great detail, from the overall workforce plan for the hospital for the future.
If there is a draft report, the Minister should have seen it and she should be asking for it.
Yes, but-----
Sexually Transmitted Infections
67. Deputy Pádraig Rice asked the Minister for Health the reason the new national sexual health strategy has still not been published; her plans to address rising rates of sexually transmitted infections and increase capacity in sexual health services; and if she will make a statement on the matter. [10514/25]
There is currently no active sexual health strategy for Ireland. The previous strategy was launched a decade ago by Leo Varadkar when he was Minister for Health. We have long been promised a new strategy but it has not been delivered. For the third year we are lacking a comprehensive strategy or vision for sexual health. The sexual health services are thin on the ground and starved of resources. Will the Minister of State commit to prioritising sexual health? When will this long overdue strategy be published?
Sexual health is a priority for this Government. Following expert advice, the second national sexual health strategy underwent an additional round of stakeholder consultation and feedback, which is now complete. The good news is that the strategy was approved to progress to design stage at the end of last week. Once design is completed, the strategy will be submitted for ministerial and Government approval, then launched. It will be launched quite soon. The strategy will be supported by an action plan that will map out implementation in more detail for the first three years of its term.
HIV and STI rates have been rising both nationally and internationally. Consequently, we allocated funding of €550,000 for 2025 to support the HIV pre-exposure prophylaxis scheme, bringing the total allocation for HIV PrEP to €6.45 million. This funding includes €200,000 for additional PrEP drugs and €350,000 for additional staffing in public STI clinics providing PrEP from July 2025. These measures will increase capacity for in-person PrEP appointments. Furthermore, an additional €600,000 has been allocated to support the free STI home-testing scheme, bringing funding for STI home-testing to €4.82 million in 2025.
A lot of work has been done on this and I assure the Deputy that this will be done as soon as possible when we get the go-ahead.
It is welcome to hear that this strategy is to be launched but this is not the first time it has been promised. As the Minister of State knows, there was a review in 2023. The Minister of State, Deputy Naughton, promised a strategy in 2024 and the then the Minister of State, Deputy Colm Burke, followed up by promising a strategy in Q1 of 2025. I welcome that progress has been made but it is urgently needed.
As the Minister of State said, sexual health infections have increased by 31% and the incidence of gonorrhoea rose by 60%. Last month the European Centre for Disease Prevention and Control reported that Ireland had the highest rates of gonorrhoea in Europe and among the highest rates of syphilis. At the same time services in the ground are really thin, particularly outside Dublin. Ten counties across the country have no STI clinics - ten counties with no services whatsoever. In the counties where there are services, some of them happen very rarely. In Kerry, for example, there is a clinic every fortnight. There are very poor services on the ground.
The Minister of State mentioned the online services. We know from research that these are not available to many people who are excluded because of literacy, digital exclusion or language barriers. They are not the solution; we need real services on the ground for people.
The rates of gonorrhoea and chlamydia had reduced slightly by the end of 2024 in comparison with the last two years. Better access to testing may be reducing onward infections. The national sexual health strategy supports positive sexual health information. It will have education, research, prevention and information, particularly on stigma. All this will be in the strategy.
In her opening response the Minister of State mentioned PrEP, which could be a game-changer for HIV. The same is true for PEP and rapid testing. It can take 18 months for someone to be seen in a PrEP clinic in this country. In Dublin, over 1,000 people are waiting for an appointment at one of the PrEP clinics. It took a year and a half to replace the nurse specialist in the South Infirmary in Cork. At the same time, the UK has same-day walk-in clinics and screenings. We can talk about increased funding but the services are not there, particularly on PrEP. We have seen that 39% of new HIV infections were late diagnosis. We now know that 50% of the transmissions are among heterosexuals. Both these findings result in poor outcomes and the likelihood of ongoing HIV transmission. With these kinds of results there is a serious risk that we will not reach that target of eliminating new HIV infections by 2030.
Great work is being done by some of the NGOs and some of the people working in sexual health, but the services and funding are not there. We need the new strategy and we need to protect sexual health because it has been neglected for far too long.
The funding includes €200,000 for additional PrEP drugs and €350,000 for additional staffing in public STI clinics providing PrEP from July 2025. I understand the Deputy's concerns. As I said, this strategy is urgent for us. I assure him that hopefully in the next few weeks or maybe two or three months, I will definitely come back to him with this strategy. As he said, education and information are really important. Stigma is a big issue that we need to address. I will be delighted to work with the Deputy and do whatever I can to help and support him.
Dental Services
68. Deputy Ken O'Flynn asked the Minister for Health if there is a mandatory requirement for dental practices to accept patients with medical cards for treatment; and if not, the measures that are in place to ensure access to dental care for medical card holders. [10370/25]
I ask the Minister to clarify if there is a mandatory requirement for dental practices to accept patients with medical cards for treatment. What measures are in place to ensure access to dental care for medical card holders? What are the current procedures for emergency dental treatment for children under the age of 16 when dental clinics, such as the dental clinic in Cork city, are closed at weekends? What plans does she have to improve accessibility to urgent dental care for patients under the age of 16?
Over €200 million is invested in public oral healthcare services annually. The dental treatment services scheme provides oral healthcare, free of charge, to medical card holders aged 16 and over, as the Deputy is aware. Services are provided by dentists and clinical dental technicians who hold a contract with the HSE.
It is not mandatory for a dental practitioner operating in the State to hold a contract to operate the DTSS. However, it is the Government’s continued intention to support and incentivise practitioners who choose to do so, in order that medical card holders can access vital oral healthcare.
In May 2022, the care available under the DTSS was expanded and the fees paid to contractors significantly increased by 40% to 60% to incentivise that across most treatment items.
Those measures did improve access to care and more than 44,000 extra patients were treated in 2024 compared with 2022. I know well, however, that there are some towns with no or limited DTSS dentists who have sufficient capacity to accept new patients. In those areas local HSE services can assist patients to access a dentist, and in exceptional circumstances where emergency treatment is required, the HSE can directly contact private providers or arrange treatment to be provided by HSE-employed dentists.
The Government is committed to reforming oral healthcare services through the implementation of the national oral health policy, which is particularly important for children. I might come back to that on the supplementary question. The programme for Government contains commitments to implement that policy and reform care for medical card holders. The first phase of implementation to end in 2027 is currently being finalised and it includes reform for services of medical card holders as one of several priority actions. Of course, the real differentiation relates to children and a model of prevention. Perhaps we will catch up on that in the supplementary question.
I appreciate the Minister's response and I understand the response but the DTSS programme just is not working. For instance, the working-class town of Mallow that I come from, which has 13,450 adults living there, has no medical card provided dentist practice. Nobody is accepting a medical card in Mallow. You must travel to Cork city or to Charleville, to Limerick or down to Kerry. Many practices have given up because the system is not working. Would the Minister agree that what we need to be doing now as a Government, or what the Minister needs to be doing as part of the Government - I am not in the Government yet-----
Soon.
Some day. Could we not start looking at a programme where medical cards are accepted in the same way as when a person goes to the GP and the dentist would be paid in the same way GPs are paid, so everyone is covered and there would be buy-in from everybody?
The other reality is that there are situations in Cork city where if a young child falls off their bike and breaks their teeth, they have no access to the dental clinic on the weekend and therefore it is either accident and emergency or the mercy of a dentist who might accept a medical card. The reality is that a lot of them do not so children are without teeth or parents are faced with bills of €4,000 or €5,000 to replace them.
I accept there has been an issue with the DTSS and the contractors numbers, notwithstanding the increase in fees and the increase of 44,000 in the number of patients being treated, which is something. Nevertheless, our figures for contractor numbers have gone down very considerably, from 1,500 in 2019 to 813 in 2024. In Cork and north Cork those numbers have gone from 35 to 26. I accept that. The new policy is designed to try to reflect this and reform that service delivery. The new policy sets out detailed descriptions of envisaged service reforms, which are about prevention, routine and emergency care, and oral health evaluation. That reform of the DTSS will be impacted by this new policy. It sets out for the first time that there will be comprehensive modern and clinical infrastructure supporting oral care. The child oral health examination programme, which is delivered by HSE-employed oral healthcare professionals, is to provide examinations and treatment identified as necessary from the age of seven up to when a child is in sixth class. Emergency care is also available from the HSE for children up to the age of 16.
I thank the Minister but, as I pointed out, emergency care is available but is not available all the time. What does a parent do when their child is suffering? Parents have to find the money somewhere and they will beg, borrow and steal to protect or save their children. In my constituency of Cork North-Central many people have come to me and said they had to borrow money from friends or family because they had no access to dental care for a child over the weekend due to an accident. That is €2,000 or €3,000. It is simply not good enough.
No, it is not sustainable and that differential in money is not fair. This is why the emergency services are attempted to be covered by the HSE. We really do need to move to that new oral policy which provides fair and open access to people across every community and in a targeted way. That is about prevention as much as about emergency care. I appreciate what the Deputy has said about accidents, which is a slightly different thing, but this is about general oral healthcare. We need to focus on the implementation of that new policy, which is aligned with Sláintecare in providing care where it is needed and when it is needed at the right time.