I propose to take Questions No. 1 to 18, inclusive, together. The Cabinet committee oversees implementation of the programme for Government commitments in relation to health, receives detailed reports on identified policy areas, and considers health reforms, including Sláintecare, the reform of public health and health system preparedness for future health threats. It also receives reports in relation to programme for Government commitments in the areas of mental health and drugs policy. It is attended by the Minister for Finance, the Minister for Public Expenditure, Infrastructure, Public Service Reform and Digitalisation, and the Minister for Health. As for Sláintecare 2025+, our latest Sláintecare strategy published in May of 2025, it aims to forge the way towards accessible, affordable, high-quality healthcare for the people of Ireland when and where they need it. The waiting time action plan 2026 published on 30 January, represents Government’s continued commitment to improving access to hospital care. Since commencement of the multi-annual action plan approach, significant progress has been made in reducing the length of time hospital patients are waiting. The new regional structures within the HSE have been established with the six new health regions and 20 integrated healthcare areas. Health and social care services are planned and delivered around the specific needs of local populations, leading to better co-ordination of care and access to services. Capacity in emergency services is continually reviewed. There has been an increase in the number of public-only consultants in emergency medicine and more senior staff are rostered in emergency departments during weekends and public holidays for better decision-making. The workforce will continue to grow through the recruitment of key roles, retention measures and additional college places for key disciplines. Care is being delivered closer to home in 180 primary care centres through 96 community health networks, 27 community specialist teams for older persons, and 26 community specialist teams for chronic diseases, all now operational. There are 23 community intervention teams which are operational, with national coverage secured. A new era of innovation and digital transformation is under way. The national patient app has been rolled out. The national shared care record will be developed throughout the year and the electronic health record, recently agreed by Government, will also be progressed. Additional projects that are key to the increased digitalisation of the health service include a national system for electronic prescribing, remote health monitoring and virtual care solutions. In mental health, workforce and infrastructure in community-based services will be further supported. Budget 2026 sees increase in funding for mental health services for the sixth year in a row, bringing the budget to almost €1.6 billion, an increase of 50% since 2020. The findings of the report on the review into child and adolescent and mental health services, CAMHS, in north Kerry are deeply concerning and unacceptable. Government's main focus has to be on the children, young people and families who have been impacted by this report. A public apology has also been issued by the HSE, including in letters to impacted families. A dedicated helpline and access to the clinical liaison support team remains open to all those affected. HSE South West intends to carry out a clinical review of files of young people who have accessed north Kerry CAMHS over a defined period and details of this further phase will be developed shortly. It is important to note that the issues raised by this report and more broadly by the 2022 Maskey report continue to be the focus of significant reform and service improvements in youth mental health services in this country. Much has changed since 2022. North Kerry CAMHS has introduced new standard operating procedures, care planning policies, file systems and prescribing guidelines. The two Kerry CAMHS teams in place today have a significantly increased multidisciplinary clinical staff complement, higher than any of the other eight CAMHS teams in the region. Over the past three years, an additional €44 million, which is an increase of 32%, has been allocated to support CAMHS to increase core staffing, reduce waiting lists and expand CAMHS hubs to improve crisis cover for services. In budget 2026, funding has been allocated to develop a new CAMHS emergency liaison service, increase out-of-hours on-call, and to establish a new CAMHS eating disorder team and two new CAMHS mental health with intellectual disability teams. Government recognises that recruitment is challenging. There is no denying that; however, progress is being made. Investment in national clinical programmes and models of care have led to significant service improvements, including the full implementation of a specialist perinatal mental health network and the ongoing expansion of specialist mental health teams for eating disorders, attention deficit hyperactivity disorder, ADHD, in adults and dual diagnosis. In older people's services, older people will be further supported to live at home within their own communities and we will also strengthen the nursing home sector. The work of the independent commission on care for older people is currently under way and the national policy on adult safeguarding for the health and social care sector, a programme for Government commitment, was launched in December. In disability, budget 2026 allocated a record €3.8 billion to the HSE for the provision of specialist disability services. This 20% year-on-year increase will provide permanent and dedicated funding to essential disability services, including residential respite and therapy services, ensuring that disabled people continue to be supported. All these commitments build on the investment and reforms undertaken over the past number of years, including the delivery of approximately 1,480 acute beds; an increased workforce of approximately 32,000 since 2020; more affordable healthcare through reductions in the drug payment scheme threshold to €80; removal of hospital inpatient charges; extension of the eligibility for free GP cards for all children under eight and to all earning no more than the median income; State-funded in vitro fertilisation, IVF; free contraception for women aged 17 to 35; and free access to hormone replacement therapies, HRT. The Government will continue to invest in reform, changing the way health services deliver this year and into the future. The HSE capital plan 2026 and the HSE digital for care plan were approved by Government this morning. Funding of €1.54 billion has been made available to the HSE in 2026 for health capital expenditure. Building and equipment projects include surgical hubs, elective treatment centres, the National Children’s Hospital Ireland and the National Maternity Hospital. Transformative digital projects include the HSE's health app, the national shared care record and the development of the national electronic health record. Disability capital projects include residential, respite and day services. In addition, in 2026, €43 million has been provided to support specialist community-based disability services, representing a €16 million increase in funding on 2025.
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Is it the principals of schools?
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The Deputy referred to beds. It is an elective hospital.
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I thank the Deputies for the questions. We began with Deputy Boyd Barrett in terms of special needs mental health and basically the recruitment issue. Yes, recruitment is the issue. We have allocated resources and what has stymied our endeavour to expand capacity has been actual recruitment itself. In fact, going back over the last two decades, we have increased places fairly significantly in allied healthcare professionals, particularly in the therapists, for example. Of those who graduate, not all go into the health services. Many go elsewhere. Some go abroad, some go into different services. There is an issue there in terms of those additional places that we are creating in third level and have expanded places. Even in Northern Ireland we have procured places from the third level colleges there. There have been challenges in transforming that student cohort into a workforce subsequently. That is just reality. There is no point in nodding your head; that is it.
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The other key challenge has been clinical placements in terms of people pursuing various disciplines. We are expanding that too. This morning, the Minister received further sanction for additional places in all our third level colleges in respect of medicine and allied healthcare professionals. The Deputy had a specific query in terms of clinical psychology and the short number of places. Again, you cannot overnight turn nine into 25 or 30 because we need lots of capacities downstream to facilitate, both within the college and in terms of clinical placements and so on. I will raise the issue with the Minister for higher education in respect of clinical psychology itself. To a certain extent, if there was that many applying, we should see how best we can use that talent pool for the disciplines because we need more and more people and we need more multidisciplinary teams. Part of the issue with psychiatry was the absence of multidisciplinary teams historically in the mental health arena. I am very open to that and will talk to the Minister in respect of it. Deputy Murphy raised what I consider to be a horrific story, a very sad story for the family, a very challenging and traumatic diagnosis. For it to be followed by the biopsy and so on - I cannot clinically call that. I presume that was CHI?
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I am not clear but I would have hoped that there was a multidisciplinary team that would oversee the conduct of biopsies, either recommending them or not recommending them with a view to both the diagnosis and also the trauma on the child and the potential implications, negatively, obviously, as the Deputy has outlined and articulated.
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I might take that offline with the Deputy and we will see if we can pursue it. Deputy Quaide raised the issue of long Covid. I would be open to meeting the group again. I did meet with the group last June, as the Deputy said. He knows the narrative in terms of the position in that the Labour Court made a ruling in respect of this. I will again engage with the Ministers responsible. There are complexities around consequentials and so on like that. The healthcare service and the Department of public expenditure are saying that the public service sick leave scheme follows then, which is full pay for three months followed by half pay for three months. I get that the issue is the capacity of people with long Covid to participate in the workforce and the fact that it was, without question in my view, contracted on the hospital site. I do not dispute that. There can be a general argument as to where one contracts Covid, given the prevalence of Covid in society more generally. In the early part of Covid, there was no question that many healthcare professionals contracted it onsite in the hospitals. While one can never be totally definitive on that, it is a fairly plausible scenario that many did, particularly in the earlier phase when we had lockdowns and so on. Particular variants were more infectious than other variants. I will revisit this. To Deputy O'Rourke, that is tomorrow and it is in respect of the issues. The services are going to be provided. My understanding is that they are available. Obviously there will be a lead-in. There was a list of issues that were raised in the discussions I had with the group. One of those was an apology in respect of the boarded-out and we are going to be faithful to the agreement that we reached. The survivors concerned had been notified in respect of this. We will proceed with that tomorrow. To Deputy Peter "Chap" Cleere, the issue is that it is offsite. Is there a project in place to bring it back onsite or are we at a greenfield situation?
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Is there a project in the offing? I did not pick up----
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I could not disagree with what the Deputy is saying. If you are onsite it is more seamless and faster, and better facilitates everybody working together on the situation. I will explore that and see what we can do. It is a good hospital, St. Luke's, with a very good track record in many areas and always was an innovative hospital in terms of how they do things. To Deputy Martin Daly, I will have to investigate----
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No, he is not actually; he is after Martin Daly.
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I have my notes here. I do take notice.
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That auld bit of paper does not do you good but I would say it does not lead you astray too much.
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Deputy Daly raised the issue of the failure to go ahead with a ten-bed rehab unit in Roscommon hospital, and that it was in the capital programme for 2025 and taken out in 2026.
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That is crazy.
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It clarifies the issue. I will pursue it. I do not think that should happen. I think we need certainty. If we are putting something into a capital programme in 2025, it should be in there in 2026 if it has not been progressed. I will pursue that with the Minister and with the HSE. Roscommon has proven itself to be a very good hospital for services. I remember the row we had back in 2016 on the emergency department. If we are all honest, once that row was dispensed with, the hospital got on with a whole load of services that have proven of real value to the people of the area and this clearly would be another. I thank Deputy Cullinane for welcoming the €50 million for the surgical hub. He followed that up with a list of about four other projects that need to be completed as well.
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I appreciate that he will be pursuing and advocating on behalf of them. On the 24-7 cardiac care, I will have to go back with the Minister. The commitment is there. I remember it going through Cabinet last year. We were told by clinicians for a long time and all the expert groups that it could not be done. Now it can be done, following the reviews, and I am determined that we pursue it and fulfil it. There has been progress made in terms of extension of the cover and all that. The commitment has been made and we will pursue that. I jumped ahead there. Deputy Michael Cahill is saying there needs to be a stand-alone unit for Kerry hospital in Tralee. Again I would support that. I think there is a project in train there, as the Deputy articulated. I will talk to the Minister in respect of that. I want to join with the Deputy in expressing sympathy to the family of Brian Sugrue, who I met myself and knew. He was a very strong advocate for such a unit in Kerry hospital. I know he was a very close friend and confidante of Deputy Cahill. We sympathise with the Deputy too on his loss and the loss in the area. If Deputy Ó Murchú could give me an extended note on that case, email it to me or whatever, it is an interesting case. I am very interested in finding out examples of where we are not looking after those in the deaf community or the visually impaired community. These are very serious, lifelong disabilities, to lose your sight or to lose hearing. I think we can do better, particularly on the employment front. It is great that this couple are working. The Deputy is saying that the cost for them for the hearing aid is €5,800.
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I will look at that because I think we should be in a position. Very often the health service is not responsive because it wants to do general approaches to supports but I have often had a view that visually impaired and hearing impaired should be carved out somewhat, particularly where it facilitates employment. We should really support employment. We do not do that as well as we should. I will pursue the matter Deputy Whitmore raised. Was it health guidance? They should be banned from schools in my view.
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We have to get tough again on tobacco. In the manifestation of all these new technologies, we are witnessing the revenge of tobacco following the smoking ban and other smoking cessation initiatives. The Public Health (Tobacco) Act 2002 was comprehensive. It was not just about the smoking ban; it was about getting rid of ten-packs and the sale of single cigarettes and putting cigarettes out of sight in shops in order that they were not next to confectionary items or children's sweets. In other words, it came down to denormalising tobacco. Vapes and other products constitute a counter-move aimed at renormalising tobacco. The health impacts are significant, serious and bad according to health experts. It bewilders me that products of this kind can get on the market without due diligence. We were talking about food and other stuff, and medicine has to go through the FDA and all sorts of other food safety authorities. This stuff gets on shelves very readily. It is doing terrible damage to our young people. The Minister of State, Deputy Murnane O'Connor, is bringing forward legislation to ban the use of vapes for young people under 18 and other measures. We need to re-examine the whole area, because it is creeping back in. Deputy Geoghegan referred to the primary care centre in Rathmines. He is right; it will have a significant impact on that community. We will continue to invest in primary care centres. As I said earlier, there has been somewhat of a transformation. It took a bit longer than people anticipated in terms of getting the finances right, be it private sector capital or public sector capital or a marriage of the two, but now we have about 180 primary care centres, I think, as I outlined in my opening remarks, plus other forms of community centres and of healthcare. That is something we will continue to do. I am not clear as to the mixed messages regarding Merlin Park to which Deputy O'Hara referred. My understanding is that the elective unit is going ahead. The Government committed to elective units in Galway and in Cork. They are at various stages. I am keeping a bit of pressure on for both, as well as the two earmarked for Dublin. These are commitments I want to see honoured. The sites are there. They are State owned, which should facilitate the development of the elective hospitals. The idea is to take all of that out of the acute then. It is not to be an acute hospital; it is to be an elective hospital. Not all but much of the work will be day-case procedures. Deputy Heneghan welcomed a lot. Inevitably, however, when there is a welcome, there is a but. The Deputy wants a timeline - so the narrative goes on. I will follow through on that. We are committed to all of those projects. I will check with the Minister for Health about the matter raised by Deputy Mark Ward regarding developmental checks in Dublin Mid-West more generally. He said a lot of children are not getting them until many months later.
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I will discuss that with the Minister for Health in order to see what we can do. Developmental checks are very important in terms of early diagnosis. We can prevent a lot if developmental checks are done earlier.
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I will go as fast as I can.
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I propose to take Questions Nos. 19 to 31, inclusive, together. On 5 December, I attended the 44th British-Irish Council summit hosted by the Welsh Government in Hensol in Wales. The theme of the summit was a creative future and unlocking the potential of the creative industries across these island, with a particular focus on the screen sector. I was joined at the plenary by a number of Ministers. The Minister, Deputy McEntee, and I updated council members on latest political developments, including in regard to Ukraine and the Middle East. On the margins of the summit, I had bilateral meetings with United Kingdom Prime Minister, Keir Starmer, Northern Ireland First Minister, Michelle O’Neill, and deputy First Minister, Emma Little-Pengelly, First Minister of Wales, Eluned Morgan, and Chief Minister of the Isle of Man, Alfred Cannan. British-Irish Council work sector groups are structured around three pillars, namely climate and decarbonisation, culture and heritage and economic and social inclusion, encompassing ten individual work sectors. Ministerial meetings in 2025 included one on transport in Belfast in April, an environmental ministerial in London in May and an early years ministerial in November. An energy work sector ministerial meeting hosted by the UK Government took place in London on 12 February. The meeting was co-chaired by the UK and Scottish Governments. The Minister, Deputy O’Brien, represented the Government at that event. I look forward to attending the next British-Irish Council summit to be hosted in Guernsey later this year. At the UK-Ireland summit held in Liverpool last year, Prime Minister Keir Starmer and I agreed a wide-ranging programme of new and enhanced strategic co-operation entitled UK-Ireland 2030, to be taken forward by both Governments through to 2030. At our meeting at Chequers in September, the Prime Minister and I discussed progress under UK-Ireland 2030 six months on from the summit. We discussed infrastructure delivery, protection of subsea infrastructure, emergency planning, cultural partnerships and achieving renewable energy targets including across this island, North and South, as areas of shared interest. The next UK-Ireland summit due to be held in Ireland next month will be a key opportunity to take stock of our bilateral relations and to identify areas for greater co-operation to benefit people across these islands. As we continue preparations for the upcoming Presidency of the Council of the European Union, we are committed to working with all concerned to advance European Union-United Kingdom relations as set out in the common understanding agreed last May, recognising, in particular, the benefits that an sanitary and phytosanitary, SPS, agreement will have for businesses and consumers in Northern Ireland. We further welcome the agreement of the EU security and defence partnership. We welcome the joint statement by the European Commission and the UK in December signalling their intention to reach agreement on SPS, emissions trading systems linkage and an EU-UK youth experience scheme by the time of the next EU-UK summit, which is due to be held later this year.
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On Deputy Coppinger's contribution, the one person who was convicted was Jeffrey Epstein, and rightly so in terms of the horrific crimes he was found guilty of. With others, such as Ghislaine Maxwell, it seems he ran a very depraved criminal network trafficking young women. The law must take its course on that.
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Yes, and children.
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It was young women as well, and children. The Deputy does not have a monopoly of horror on what happened. I will simply say that the law must take its course. There should be thorough and comprehensive investigations before we arrive at conclusions in terms of anyone else named in that. That is what is happening in the United Kingdom, although it is on a different issue in terms of material that emerged in respect of the former Prince Andrew and the former UK ambassador to the US and former Minister, Peter Mandelson, who have been arrested. It is a matter for the police forces to pursue that. In our view, that is what has to happen. There is no doubt that people are shocked about what has been revealed. There are more files to be revealed. The sooner that they are released in a wholly transparent manner the better. Regarding Deputy Murphy's case, in many ways what that reveals too are the checks and balances within every political system and democracies. The authoritarian governments have been long established. There is increasing authoritarianism. In the United Kingdom, the Supreme Court ruled, so the checks and balances worked at the end of the day. That does not happen in every other country. There is a growth and increase in authoritarianism in countries like Hungary, Russia, Belarus and some African countries including the Sahel, where Russia has intervened and established essentially puppet governments. There have been coups d'état in these places, getting rid of democratically elected governments. The increase in authoritarianism is a worry. Deputy McGreehan point was very interesting even though she did not get enough time to elaborate on it. I refer her to a shared island initiative called Shared Home Place.
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There is an application in for support. That is designed to capture exactly what the Deputy articulated regarding the story of Omeath, the Irish language and the migratory pathway to west Belfast. That would be very interesting. I presume the county council or somebody has submitted this and it can be covered. We will keep an eye out for that. That is exactly what was envisaged by the Shared Home Place initiative out of the shared island initiative. On Deputy Moynihan's point, the Welsh approach to the rejuvenation of the Welsh language is the gold standard template that we should all endeavour to emulate. We have, as a country, in terms of TG4, which was really inspired by Welsh TV. There is Raidió na Gaeltachta and the other initiatives we have taken. I fully support full immersion Gaelcholáistí but the aonaid have a place too. I do not think it is an either-or all the time. From an educational perspective, there are pluses and merits. In Cork, we have quite a number of full immersion and we have aonaid that have worked extremely well also. There is a strong tradition in our part of the country in the whole Gaelscolaíocht area and Gaelcholáistí. It has made a lot of progress. On Deputy Ó Murchú's point on taxation and remote working, it is an issue that we discussed recently in the Labour Employer Economic Forum, LEEF, group, which is the Irish Congress of Trade Unions, ICTU, group of unions, IBEC and the Government. We meet regularly on labour market issues but we discussed this. This is an ongoing issue - the taxation treatment of workers North and South - and I am concerned about it. If I am honest, we have not made a whole of progress on it. The Department of Finance is working on it. It is meant to be developing a paper for us. I will pursue that with it. It is a fair point. On Deputy O'Hara's point, what I said as Gaeilge was that there was a lot more substance in the shared island project than the Sinn Féin platform. For decades, I have been listening to Sinn Féin saying that Government must do this and Government must do that. It has not even produced a paper. It has not produced a single paper on its vision other than slogans. The shared island-----
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I am talking to Deputy O'Hara. Deputy Mac Lochlainn did not ask the question.
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The shared island initiative is the most substantive initiative in 50 or 60 years in terms of investment in Northern Ireland by a Government in the Republic. Those are facts. I get on with the pragmatic connecting of people in every aspect of life. It is not just about building roads, which we are doing, building bridges, which we are doing with the Narrow Water Bridge, or the Ulster Canal. It is about the investment in research. It is about the investment in Cuilcagh, for example, and geopark. It is about investment in Irish language in terms of different traditions of music. The musical archive has been a wonderful, funded project from the shared island initiative. A lot of people are responding very positively to it, without any prejudice to the constitutional future of the island, which is well laid out-----
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-----in the Good Friday Agreement as how we proceed. Fianna Fáil has always believed in substance on the North. We had a critical role to play-----
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-----in the Good Friday Agreement. Now, we are in a modern era. We are living out the Wolfe Tone ideal of connecting people and reconciliation. That is a very important thing to do.
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Over the past five years, we have invested very significantly in the creative industries and in the arts. This Government will continue to do that. I believe passionately in the arts. The arts have a central and civilising role within society. They create opportunities for analysis, reflection, critical inquiry and diversity. It is wonderful to witness the flowering of talent and ability from generation to generation. A new generation is coming on the scene. It was fantastic to see Jessie Buckley recently being awarded a BAFTA. I also think of the success of Cillian Murphy. I am sorry; I did not mean to knock over Deputy Dooley's notes. It was just a creative flourish. The basic income scheme is a first. It has not happened in every sector but it has happened in the arts sector. Overall, we have constraints but there has been a tremendous flourishing of writers and in the worlds of drama, film and music. We need to maintain, sustain and celebrate that. Britain has always created wonderful opportunities for Irish artists. I hate using the word "market" but it provides a very important opportunity for our creative people. It is very often a testing ground before we go further afield. Our relationship with the US is also important as regards the arts.
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