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.
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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-----
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-----has published a strategy on.
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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-----
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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.
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The time is up. I thank the Taoiseach. I call Deputy Cairns.
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I will come back in a minute.
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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.
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By the entire Dáil, including Deputy Cairns's party.
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Let us park that for a moment.
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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.
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There is a very telling phrase in the article.
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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.
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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.
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That is the issue. It is not where they-----
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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.
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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.
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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-----
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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-----
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-----and that is delivering well, so why create a new one?
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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.
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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.
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How do we get from 40,000-odd to 50,000?
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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.
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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-----
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-----fertility hubs and specialist menopause services. All that helps to gain greater access for patients.
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We can see from the Deputy's demeanour that he is doing very well.
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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-----
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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.
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We have had a particularly significant investment in more GP places in our colleges and clinical placements thereafter.
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