Ivana Bacik
Question:1. Deputy Ivana Bacik asked the Taoiseach if he will report on the work of the Labour Employer Economic Forum; and when it will next meet. [18694/25]
Ceisteanna - Questions
Industrial Relations
Paul McAuliffe
Question:2. Deputy Paul McAuliffe asked the Taoiseach if he will report on the plenary meeting of the Labour Employer Economic Forum which he chaired on 4 April 2025. [19067/25]
Paul Murphy
Question:3. Deputy Paul Murphy asked the Taoiseach if he will report on the work of the Labour Employer Economic Forum; and when it will next meet. [32309/25]
Ruth Coppinger
Question:4. Deputy Ruth Coppinger asked the Taoiseach if he will report on the work of the Labour Employer Economic Forum; and when it will next meet. [32397/25]
Conor D McGuinness
Question:5. Deputy Conor D. McGuinness asked the Taoiseach if he will report on the work of the Labour Employer Economic Forum; and when it will next meet. [33549/25]
Shane Moynihan
Question:6. Deputy Shane Moynihan asked the Taoiseach if he will report on the plenary meeting of the Labour Employer Economic Forum which he chaired on 4 April 2025. [33558/25]
Tony McCormack
Question:7. Deputy Tony McCormack asked the Taoiseach if he will report on the plenary meeting of the Labour Employer Economic Forum which he chaired on 4 April 2025. [33561/25]
Albert Dolan
Question:8. Deputy Albert Dolan asked the Taoiseach if he will report on the plenary meeting of the Labour Employer Economic Forum which he recently chaired. [33562/25]
Ruairí Ó Murchú
Question:9. Deputy Ruairí Ó Murchú asked the Taoiseach if he will report on the work of the Labour Employer Economic Forum; and when it will next meet. [33611/25]
I propose to take Questions Nos. 1 to 9, inclusive, together.
On 4 April, I chaired the first plenary meeting of the Labour Employer Economic Forum since the formation of the new Government. The LEEF is made up of representatives from the Government, employers and trade unions and provides for tripartite dialogue on economic and employment issues as they affect the labour market. The meeting discussed the latest economic and trade developments, in particular the challenges arising from the US decision to impose tariffs on imports from the European Union. The meeting was also briefed on the potential to strengthen the all-island labour market for the benefit of employers and workers on the entire island. There were also updates on the preparation of Ireland's action plan on the promotion of collective bargaining, on a number of broader labour market policy developments, and on remote and blended working policies. Finally, the meeting agreed to finalise a work programme for the LEEF for the period ahead and to re-establish a number of subgroups.
Alongside plenary meetings, the LEEF also meets in subgroup format, chaired by the relevant Minister. The recent plenary agreed to the re-establishment of the following subgroups: enterprise and employment, chaired by the Minister for Enterprise, Tourism and Employment; apprenticeships, chaired by the Minister for Further and Higher Education, Research, Innovation and Science; early years, chaired by the Minister for Children, Disability and Equality; and pensions, chaired by the Minister for Social Protection. A shared island working group, chaired at official level, has also been re-established.
It was also agreed to re-establish subgroups on health and on housing, following further engagement with relevant Departments and LEEF partners on their respective agendas.
The date of the next meeting of the LEEF plenary has not yet been scheduled.
The Labour Employer Economic Forum is an important opportunity for members of the trade union movement to make representations to the Government with regard to the labour market and the issues which impact it. Legislation has been put forward in this House with regard to the rights of pensioners, particularly pensioners of many State bodies, who after retiring have very little input into the changes to the pension scheme which may impact them. In some cases that relates to increases that may or may not be due, but also we have seen in other sectors changes to the very nature of the scheme itself. Under the auspices of the Labour Employer Economic Forum and the relationship he has with the trade union movement, will the Taoiseach examine ways that pensioners who have retired might have a greater input into the pension schemes which they have paid into over many years?
The number one issue facing many workers is housing, and the Government has repeatedly claimed both that it will deliver new social homes and that the planning system is to blame for the lack of delivery so far. This month, however, funding for the delivery of almost 500 social homes has gone up in smoke. Almost 3,500 planned social homes, many with full planning permission, are in jeopardy now, facing cost reviews. That is almost a third of the annual social housing delivery target. These public-private partnership deals have collapsed for one reason: private profit. The Government has claimed that the costs are now too high, but we knew they would be. They explicity include provision for the developers to make a profit from the arrangement. Every cent of profit is a cost in excess of what is actually necessary to deliver housing. In light of the collapse of PPP bundle 3 and the reviews of bundles 4 to 7, will the Taoiseach finally abandon the failed policy of public-private partnership and fund councils to deliver bundle 3 as soon as possible?
I want to raise with the Taoiseach the issue of union busting and anti-union tactics by companies which are in receipt of huge State contracts and whether he thinks that is acceptable. One of the companies is one of the largest mechanical contractors in the State, Jones Engineering, which has a contract for the national children's hospital and potentially other State contracts.
It has consistently been hostile to members joining the union of their choice, Unite, so much so that it has attached three senior shop stewards to High Court proceedings, subjecting them, potentially, to huge costs and damages. People have also been subjected to unsolicited visits from people knocking on their doors and so on. Does the Taoiseach think these kinds of union-busting tactics are acceptable? Does he not think people working for companies doing State contracts should be entitled to join unions like Unite? Will he make a strong statement on the matter in relation to Jones Engineering?
The people of Waterford are being failed by this Government when it comes to jobs and investment. In the past five years, Waterford has received just a third of the number of IDA visits to Galway, Cork and Limerick. Even counties like Westmeath and Clare are getting more attention than Waterford. This is shown in the figures. Last year, Waterford gained just two new IDA-supported jobs. Over the past two decades, Cork averaged nearly 1,400 jobs created a year through the IDA, Galway 600, Limerick 300 and Waterford just 92. These figures come directly from replies to parliamentary questions I received this week. It is clear we are not seeing balanced regional development in the south east and Waterford; it is neglect. Will the Taoiseach finally admit the IDA strategy is failing in Waterford? Will he outline the steps that he, as Taoiseach and Head of Government, will take to address this imbalance?
We have often discussed the importance of policymakers recognising the effort and energy that goes into running a business and sustaining high levels of employment. The plight of SMEs in particular has been raised on the floor of the Dáil, as has the need for policies to make sure we encourage and incentivise SMEs to scale up to be able to pursue research and innovation for their own benefit and for upskilling their wider workforce.
I also raise the importance of the all-island labour market. It was discussed at the recent meeting of the LEEF and the ESRI also conducted a study recently on it. Will the Taoiseach share his thoughts on how the Government intends to deal with the potential and real divergence in employment standards between the UK and the European Union that will manifest on the Border, in particular for smaller employers trying to employ people who may live on the other side of the Border? There are differing expectations regarding flexible and remote working. How can those expectations be aligned? Has work been done at North-South Ministerial Council level and in direct relationship with the Northern Ireland Executive?
I thank the Taoiseach for his update and welcome the reconvening of the Labour Employer Economic Forum under his chairmanship. It is clear the forum plays a vital role in bringing Government, employers and unions together, especially in times of uncertainty. As someone who engages regularly with small business owners and retailers across the country and in my county, Offaly, I welcome the recognition of the need to support sectors most exposed to global pressures. SMEs and retail businesses in our towns are the heart of our local economies. They create jobs, drive community life and have shown remarkable resilience in recent years. I am encouraged by the Taoiseach's commitment to ongoing dialogue. I ask that the specific needs of SMEs, especially in areas like staffing, digital transformation and access to supports, remain front and centre in the LEEF's upcoming work programme. This collaborative approach is the right one. I look forward to seeing practical outcomes that will make a real difference to businesses on the ground.
I appreciate the update on the Labour Employer Economic Forum. I wish to ask about a separate matter regarding multiple schools in my constituency which have been in contact with me in the past week. National schools spread right across Galway East, including in Castlehackett, Esker, Annagh Hill, St. Oliver's special education school and Peterswell, have raised significant concerns with me around SNA allocations and reviews. A lot of the schools have had reviews and were recommended more SNA support. They have identified needs coming in in September. Is there a plan to ensure these schools are catered to come September?
I back up the comments of Deputy Moynihan. I have brought up previously with the Taoiseach the tax implications of remote working for companies and the impact that has on employees. Action needs to be taken to deal with that. On tariffs and engagement with unions and employers, what are the major issues and worries about what is coming down the line? What does the Government propose? What are the asks? I would like to think the Taoiseach is working alongside the Minister to deal with the apprenticeship issue. There is a fear regarding ETB settings that there will be a delay because of the shortfall in funding. There is a big hole of €40 million to €50 million. I submitted a Topical Issue with Deputy Cullinane about this. It needs to be on the agenda. There can be no delay.
I hope the Taoiseach is aware of the issue regarding the army pensions Act, which needs to updated.
The question is about the LEEF.
I know. This relates to Michael McNeela, who was killed in 1989 on peacekeeping duties.
Time is up, Deputy.
His father was not able to receive the pension after the mother of Michael McNeela died.
Thank you, Deputy. Your time is up.
It is with the Tánaiste at the minute. He seems supportive-----
Deputy, please.
I would like to think the Taoiseach would also be and that this could be delivered.
I think Deputy McAuliffe was the first contributor. He raised pensions and pensioners' input into their pension issues. It has been an ongoing concern for pensioners generally across the economy, particularly for public sector pensioners or those in agencies and so forth. There is a sense that once they leave employment, they lack any real influence over their pensions in the future. I will raise that issue with the Minister for public expenditure, who governs pensions within the public service, and the Minister for Social Protection. There is a pensions ombudsman. A lot of frameworks that were not there in times past can help pensioners to access details about their pensions. It is a growing issue. Recently, the CIÉ pensions issue was resolved through good negotiations and the involvement of unions. That illustrates the degree to which unions can play a constructive role on behalf of workers in respect of their pensions.
Deputy Murphy raised the PPPs. I presume and draw from my conclusions that he supports the decision not to go ahead with PPPs that were too expensive in terms of the cost per house. That is the decision the Minister for housing took when he looked at the figures that came in after tender. They were excessive and could not be justified at that stage.
Deputy Coppinger raised an issue. I cannot comment on any specific company. In Ireland, we are working through the LEEF on a collective bargaining action plan. The directive on adequate minimum wages in the European Union was published in 2022. It was transposed by Ireland by 15 November 2024. Under Article 4, the directive aims to promote collective bargaining on wages in all member states. In addition, each member state with a collective bargaining coverage rate below a threshold of 80%, as in Ireland, shall provide a framework of enabling conditions for collective bargaining and establish an action plan to promote collective bargaining. A technical group was established with the Department of enterprise and social partners in 2023 to consider the possible content of Ireland's action plan. A public consultation was also held on the content of the action plan. That closed in May this year. The Department is now reviewing submissions. They will help to guide the finalisation of proposals, both legislative and administrative, which may be considered for inclusion in Ireland's action plan. It will be published by the end of 2025 in line with the requirements of the EU directive.
Deputy McGuinness raised the question of investment in Waterford. I have to disagree; I think there has been significant investment in Waterford over the past five years in particular. There is now a university in the south east, with a strong campus in Waterford benefiting from significant investment. Waterford University Hospital, likewise, has benefited from significant investment. The North Quays project in the urban regeneration and development fund has been a significant investment. On FDI, the IDA is focused on Waterford. Some good companies have located there, across life sciences and financial services, which is positive. You cannot just go on one year because in some years there could be a significant increase and in others there can be a lapse. An individual company could have a decline.
The trend is over 20 years.
There is going to be a flow and a fluidity in this from year to year, but the overall picture of investment in the south east and in Waterford has been positive and will continue to be in terms of Government commitment to the county.
Deputy Moynihan raised the very important issue of SMEs, and that is covered by the LEEF. Divergence in employment standards and taxation issues between North and South were mentioned. We have more work to do under the shared island aegis in the context of cross-Border workers. The Minister for Finance has been engaging with the Minister for Finance in the Executive. The taxation issues are thorny and complex because they also relate to how cross-border taxation is dealt with in the European Union itself. It is a growing issue since the onset of remote working. Deputy Ó Murchú raised this as well. It is a continuing issue. The Minister for Finance is focused on it. It is something LEEF is concerned about. Supply chains are becoming more seamless between North and South and in some sectors like dairy and energy it is a seamless market or a continuum of trade and so on. It is therefore important we try to get some position that is advantageous to workers, but we do not necessarily want to distort the economy of either jurisdiction, especially the North, in terms of its labour force.
Deputy Dolan raised schools. Schools do not get considered by the LEEF. SNA allocations will obviously have to be fed through the National Council for Special Education, which makes recommendations. On the allocation of SNAs, the numbers have grown exponentially and there are about 20,000 SNAs in the system. I will alert the Minister for education to the Deputy's raising of these issues.
Deputy Ó Murchú raised the tariff and the Army pensions. Again, I will relay that to the Tánaiste. I dealt with remote working. The LEEF has considered that. It is very conscious of the potential implications of tariffs on trade for employment. We have urged that we avoid a knee-jerk reaction. People were immediately looking for subsidies, which would have been the wrong thing because that situation has not unfolded yet. A lot depends on the nature of the trade deal between the European Union and the United States. I hope they reach a headline agreement before 8 July. I am hopeful they will and that the landing zone is one we can all live with, although it will be challenging and difficult for many companies, such as those in agrifood and general exports into the US. If there is a minimum floor of a tariff, that could be challenging for companies, so we will assess it in the round in terms of how we deal with it.
Cabinet Committees
Ivana Bacik
Question:10. Deputy Ivana Bacik asked the Taoiseach when the Cabinet committee on health will next meet. [18695/25]
Martin Daly
Question:11. Deputy Martin Daly asked the Taoiseach when the Cabinet committee on health will next meet. [22200/25]
Mary Lou McDonald
Question:12. Deputy Mary Lou McDonald asked the Taoiseach when the Cabinet committee on health will next meet. [26977/25]
Ruth Coppinger
Question:13. Deputy Ruth Coppinger asked the Taoiseach when the Cabinet committee on health will next meet. [32398/25]
Mark Ward
Question:14. Deputy Mark Ward asked the Taoiseach when the Cabinet committee on health will next meet. [32436/25]
Conor D McGuinness
Question:15. Deputy Conor D. McGuinness asked the Taoiseach when the Cabinet committee on health will next meet. [33550/25]
Pádraig O'Sullivan
Question:16. Deputy Pádraig O'Sullivan asked the Taoiseach when the Cabinet committee on health will next meet. [33563/25]
Michael Cahill
Question:17. Deputy Michael Cahill asked the Taoiseach when the Cabinet committee on health will next meet. [33567/25]
Ruairí Ó Murchú
Question:18. Deputy Ruairí Ó Murchú asked the Taoiseach when the Cabinet committee on health will next meet. [33612/25]
Paul Murphy
Question:19. Deputy Paul Murphy asked the Taoiseach when the Cabinet committee on health will next meet. [33925/25]
John Connolly
Question:20. Deputy John Connolly asked the Taoiseach when the Cabinet committee on health will next meet. [34058/25]
I propose to take Questions Nos. 10 to 20, inclusive, together.
The Cabinet committee on health last met on 4 June 2025 and is due to meet again on 17 July 2025. It oversees the implementation of programme for Government commitments in relation to health, receives detailed reports on identified policy areas and considers health reforms, including Sláintecare and the reform of public health and health system preparedness for future health threats. It also receives reports on programme for Government commitments in the areas of mental health and drugs policy.
Path to Universal Healthcare: Sláintecare & Programme for Government 2025+, our latest Sláintecare strategy published last month, aims to forge the way towards accessible, affordable, high-quality, healthcare for the people when they need it and where they need it. We will continue to build our workforce through the recruitment of key roles, retention measures and additional college places for key disciplines. We have capacity to hire a further 6,105 whole-time equivalents, WTEs, to Department of Health-funded posts during the remainder of 2025. We will deliver faster access to care. Funding of €420 million has been allocated for the waiting list action plan 2025. We will continue to review capacity in emergency departments. We will increase the number of public-only consultants in emergency medicine and ensure more senior staff are rostered in emergency departments during weekends and public holidays for better decision-making. The construction of 297 new and replacement acute beds is expected to be completed in 2025. The surgical hub for south Dublin opened in February this year, with additional hubs becoming operational later in 2025 and 2026. We will continue to invest in a healthier future with a national physical activity framework and action plan due to be published in 2025 and a new obesity policy and action plan to be published in 2026.
We are launching a new era of innovation and digital transformation in health. The national patient app has been rolled out, with additional features to be added later in the year. The national shared care record will be developed throughout the year and the electronic health record will also be progressed. Additional projects which are key to the increased digitalisation of the health service include a national system for electronic prescribing and remote health monitoring and virtual care solutions. In mental health we will continue to build the mental health workforce and infrastructure and support community-based services. In older people’s services we will support people to live at home within their communities and strengthen the nursing home sector. The welfare of residents is at the forefront of Government’s concerns. The forthcoming national policy on adult safeguarding for the health and social care sector, which is a programme for Government commitment, will set out how existing protections will be strengthened. This policy is near finalisation and will be brought to Government shortly.
All these commitments build on the investment and reforms undertaken over the past number of years, including the delivery of approximately 1,282 acute beds, an increased workforce of close to 30,000 since the start of 2020, more affordable healthcare through reductions in the drugs 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 IVF, free contraception for women aged 17 to 35 and free access to HRT therapies. From September 2021 to April 2025, there has been an almost 60% reduction in the number of people waiting longer than 12 months. 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 disease are now operational. Some 23 community intervention teams are operational, with national coverage secured. The new regional structures within the HSE have been established with six new health regions and 20 integrated health areas. Health and social care services are planned and delivered around the specific needs of local populations and this leads to better co-ordination of care and access to services. We will continue to invest and reform.
The Cabinet today approved the patient safety (licensing) Bill. It is long-awaited legislation and one we very much welcome, but will there be minimum staffing numbers in that critical legislation? The INMO has been campaigning on this for a long time.
On cervical cancer, I hosted the 221+ group last week. We saw reports at the weekend that cervical screening is still failing women. Three women have died of cancer and seven more have a positive diagnosis after smear tests were allegedly negligently misread between 2018 and 2021. I ask the Taoiseach about CervicalCheck and the actions the Cabinet health committee is taking to ensure it can provide assurance we can all be confident in the work it is undertaking.
Would it be possible for the Minister for Health and her Department and the Government to reconsider their stance on the shingles vaccine given recent studies that show the administration of shingles vaccine in the elderly population has the added benefit of the reduction of the onset of dementia by about 20%? It is a significant additional piece of data published in Nature magazine and based on a study of the introduction of the vaccine in Wales. The shingles vaccine is now offered to all people aged over 60 in the UK, as well as in a number of other jurisdictions. This bit of data improves the cost-benefit analysis of the introduction of a shingles vaccine programme for elderly people.
Last week, Children's Health Ireland confirmed just 105 appointments have been offered so far to the children potentially affected by the scandal of unnecessary hip surgeries. Only 60 people have been seen so far out of a total of 2,259 children who had hip surgery since 2010 at Children's Health Ireland or the National Orthopaedic Hospital, Cappagh. At this rate it will take more than 20 years for every child to be assessed.
To make matters worse, CHI has also confirmed that it is only conducting a once-off review to assess complications only and determine current clinical state. That means it will not provide answers to the 2,259 families on the question of whether their child's surgery was necessary in the first place. It will not provide answers to the question of whether those children were harmed or wronged by malpractice. There will be no transparency, no honesty and no accountability. Will the Government ensure that Children's Health Ireland gets to the real facts for these children and tells them straight whether their surgery was necessary?
On the issue of children's health in this country, the Taoiseach gave a glowing introduction, but we have the ongoing scandals at CHI. The latest is no disclosure to parents of the failure of CHI to operate or give treatment to boys with undescended testes leading to potential infertility and cancer issues. Yet, that did not meet the threshold for disclosure. I do not have time in this interaction but does he agree that this is now systemic? It is not one thing here and one thing there. One of the issues parents have raised is the idea of a partial ratified independent scrutiny-type investigation prism where parents would have monitoring and oversight of experts because we will keep continuing down this road and eventually have to concede a public inquiry.
The Taoiseach also mentioned in his introduction the announcement of a move to a seven-day operation of the health service. That is all well and good, but there is a shortage of 1,000 beds. There is a shortage of thousands of staff. Staff will be spread over seven days, potentially leading to more mistakes, more bad treatment and more people lying on trolleys.
In my first six months as a TD, I have been asked to intervene in four emergency mental health cases for constituents in Dublin South-Central. Three were for severe eating disorders where the patient's family feared for their survival if appropriate treatment was not provided immediately. The fourth acute patient simply sought a second medical opinion but was discouraged by the HSE at every stage. In all cases, the patients and their families felt they were not being heard by treating physicians and the scenarios were so dire I had to involve a Minister of State's office to procure emergency mental health attention and specialist assessment for the patients. Patients with life-threatening illnesses are having difficulty obtaining appropriate care. I am asking for an update on specialists in the eating disorder section. Why is the HSE not adhering to its national consent policy and established case law to respect a patient's choice to seek a second opinion?
Almost ten years ago the Taoiseach stood outside University Hospital Waterford with a billboard promising 24-7 cardiac care for Waterford and the south-east. Ten years on, the people of the south-east are still waiting. Cabinet approval was announced two months ago but since then there has been no detailed plan, timeline or staffing strategy. Announcements are cheap and it is delivery that matters. We have lost years waiting for that announcement and that go-ahead. Without urgent action, lives remain at risk in Waterford and the wider south-east. Will the Taoiseach confirm if recruitment is completed, and when we will see a full implementation plan with timelines, staffing targets and guaranteed delivery of 24-7 cardiac care at UHW?
The Mazars report stated that the HSE has not been implementing the legal timelines for the reimbursement of medicines. I can refer to at least four studies commissioned in the past year that show legal timelines are not being adhered to. In February last year, the Irish Pharmaceutical Healthcare Association published a paper showing that 86% of all reimbursements did not adhere to the 180-day timeline as outlined in the legislation. The Taoiseach knows I am a long-term advocate for reform in this regard. I am asking that the HSE, its affiliates on the drugs group, the National Centre for Pharmacoeconomics, NCPE, and others just implement the current legislation. Patients with unmet needs are waiting years for decisions in Ireland while the majority of our European counterparts wait months. Does the Taoiseach think, as per those reports, that the HSE and the NCPE are adhering to those guidelines? It is important that he clarifies that today.
The national immunisation programme should include a vaccination for shingles free of charge for all our citizens. A vaccine to prevent shingles would be of great benefit to the entire population but would particularly benefit older people who are more susceptible to viral disease. Shingles can be quite painful and debilitating and these effects are more pronounced in older people. The costs would be beyond the budget of many and as a public health issue, a nationwide free vaccination scheme would benefit the entire population. Given that it is available free of charge in Northern Ireland, it should also be available here. We must support and protect our most vulnerable, those with health issues and those getting on in years. I urge the Taoiseach to liaise with the Ministers for Health, Finance and public expenditure to introduce this vaccine as soon as possible.
I pay tribute to 15-year-old Kofi Owusu from Dundalk, County Louth, who lost his life after getting into difficulty swimming in Laytown, County Meath, last Friday. Our condolences go to his family, his friends and to the wider community. We have all heard the tributes from Redeemer Celtic and Tomás Sharkey in Coláiste Chú Chulainn, the school he attended. We have heard of his diligence, his leadership qualities and his friendship. A huge hole has been left by this. We are talking about somebody who was a spectacular footballer and basketball player but he sounded like an all-round really great kid. This happened just a couple of days following the death of Isobel McCluskey and highlights the dangers of swimming and water. We hope we have a good summer but there is an absolute necessity that we do all we can with regard to information because we have had too many of these tragedies across Ireland.
I want to raise the poor state of healthcare for those suffering with allergies in this country. Many parents are forced to spend huge amounts to travel abroad to get their children the treatment they need. I spoke to a woman a few months ago who had to go to America for six weeks. She had to pay €8,000 for treatment. She was also out of work for six weeks and had to pay for accommodation. That is not unusual. A lot of families go to Britain or America to get oral immunotherapy in particular. This can take the form of a tablet like Palforzia, which contains a tiny amount of peanuts for those suffering from peanut allergies, or oral immunotherapy where people, mostly children, are consuming tiny amounts of the product they are allergic to in controlled environments and they build up resistance over time to have a less severe allergic reaction. The problem is that these are not available within the Irish health system and are not even covered by the treatment abroad scheme. Does the Taoiseach agree we need a multiyear national allergy strategy and that we need to offer oral immunotherapy in this country?
The healthcare sector is one sector of our public service that relies heavily on attracting and recruiting practitioners and staff internationally. In 2024, 6,000 of the 17,000 critical skills permits provided by the State were in the health or social work sectors, 5,031 of which were for nursing staff. In 2023, the OECD said that 54% of nurses working in Ireland had trained in other jurisdictions. The equivalent figure in the UK was 18%. I harbour a guess that many of them are probably Irish. I arrive at two conclusions from this. First, we are not training an adequate number of healthcare professionals, in particular practitioners and particularly nurses. Second, nurses particularly are choosing post qualification to seek opportunities in countries other than Ireland. Both of these conclusions need to be interrogated.
I will start with Deputy Sherlock's questions on the patient safety (licensing) Bill and cervical cancer screening. The patient safety (licensing) Bill came through Cabinet today and the Minister can go through the details with the Deputy in due course, in terms of specifics on safe numbers, safe staffing and so forth. A lot of it has been introduced without legislation in accordance with agreements. The Minister will continue to resource the cervical cancer programme and other cancer screening programmes. It is important to say screening programmes are the first stage. They are population screening programmes designed to intervene early and identify but they are not the ultimate in diagnostic approaches. If people present with symptoms, they may need more detailed diagnostic assessment. We have to get the balance right. The public needs very clear information on screening programmes and what they can achieve and on the importance of always consulting a GP or consultant. That is extremely important because there are limits to screening programmes. There are calls to expand the number of screening programmes in different areas. We have made a lot of progress on cervical cancer screening because of new technology and new methodology but we are open to improving further and engaging with the various groupings to see what issues have been identified as problematic and how they can be improved. I will talk to the Minister for Health about that.
Deputies Daly and Cahill raised the shingles vaccine. My understanding is it is a significantly expensive vaccine. I am struck by the research Deputy Daly cited regarding its impact on the risk of dementia. A figure as high as 20% is very significant. He said the research was published recently in Nature so I will talk to the Minister for Health about that. Generally, I am a supporter of vaccines. As a public health intervention, they have been extremely effective in the history of this country. People are not dying of what people died from 100 years ago anymore, primarily because of the successful introduction of vaccines to deal with a lot of infectious diseases. That is easily forgotten in modern discourse and debates. The Covid-19 vaccine was essential to society coming back to some degree of normality. Without that vaccine, we would still be in deep trouble. It is important to state that. I will go to the Minister in respect of that.
Deputy O'Rourke raised CHI. Every family must be told whether their child required surgery. There has to be complete transparency from CHI in respect of that. There has to be diligent follow-up with all concerned, as it declared. We will ensure that happens. I will talk to the Minister on engaging with CHI on that issue.
Deputy Coppinger raised CHI, again, and the issue relating to young boys. That is a very serious issue, which needs to be addressed transparently and comprehensively by CHI. The HSE and the Department of Health should be involved in respect of that issue. The Dickson report from 2017 on urology services in CHI proposed the consolidation of all paediatric urology services into a single, cohesive centre, the establishment of a multidisciplinary urology team and so forth. That key issue needs to be further examined in light of that report. The issues the Deputy has identified should have been disclosed earlier.
That is a very good agreement between the HSE and the unions. Healthcare staff numbers have risen enormously in the past four to five years, with 30,000 extra. We cannot keep on saying, "Let's get another couple of thousand." There has to be a balance.
There is a huge shortage.
There is not a huge shortage. Thousands of people have been recruited. Let us be straight about it. The seven-day use of hospitals is something that should happen. It should not be dependent on more and more staff. The assets were not being used. Expensive diagnostic equipment was not being used optimally and the hospitals themselves were not being used optimally when there were five-day, nine-to-five services. Productivity matters, as do new devices and new technology. We need a broader approach to get better value for money. We have invested hugely in health and that needs to be acknowledged. Productivity and value for money are also factors. We are recruiting a further 6,000 in 2025, in addition to the 30,000 that have been recruited. I accept the population is increasing and that will create demand for services. It has created a lot of demand for health services. The population is ageing, which is creating further demand for the health service. That deal is a good one and will lead to greater productivity in hospitals and health services.
On mental health issues, the Minister of State, Deputy Butler, has been doing significant work on eating disorders. Deputy Devine could talk to her about the specifics of the cases she has raised. We need more investment in eating disorder centres but we have had some. A lot of progress has been made in that respect.
Deputy McGuinness raised cardiac care. Much progress has been made in the past five years in respect of cath lab investment in Waterford. It has been incrementally building up. There has been quite good investment in the past two to three years. Now we will complete that in terms of 24-7 provision. That is a Government decision that has been taken and that will happen. Recruitment in healthcare takes time. It does not happen within two months but it will happen and that will be developed, as committed to by Government.
Deputy O'Sullivan raised the reimbursement of medication. More progress needs to be made on the reimbursement of medicines. Quite a lot has been made. I met IPHA representatives who represent the pharmaceutical industry here. Understandably, it is promoting this but when I questioned IPHA members two years ago, they were more or less saying they had a good enough relationship with the national pharmacovigilance unit. As a country with a strong concentration of pharmaceutical companies and which produces some of the most effective medicines in the world, we should have a modern, up-to-date reimbursement process. However, that has implications for public expenditure. Progress has been made but we need to make more, and we need to meet the standards and European norms.
Deputy Cahill raised the shingles vaccine. I do not doubt the benefits but the expenditure would be significant. We need to bear that in mind.
I join Deputy Ó Murchú in offering sympathy to Kofi's family. It is heartbreaking that any young person so talented and with so much to offer in life should die in such circumstances. The Deputy mentioned Isobel McCluskey as well. The national emergency forum - there is a more precise title for it - did a lot of work on water safety in terms of swimming in rivers and in the sea over the past two years, and on prevention. One of the most effective interventions in healthcare is prevention. Public health messaging on accidents is a key dimension of that and is a factor in injuries and deaths. Our sympathies go to all in the community and the families affected.
Deputy Murphy raised the issue of allergies. We have multidisciplinary teams involved in allergy.
I defer to medical and professional advice within our own system on the provision of oral immunology therapy. It is a complex area that takes a lot of building up of immunology. A lot of children have spent a lot of time with consultants so I am slightly worried. I am not an expert on this but I defer to proper, professional advice as to when such medicines could be accessed or used. I say to everybody out there to consult their GP and consultant in respect of the utilisation of any therapies in that regard.
Deputy Connolly mentioned nursing and 6,000 critical skills permits, of which I think he said 5,000 were in nursing. There are two ways of looking at it. A lot of young graduates travel and have been travelling for a long time in the medical world. There may be an issue of retention. Some come back to work in Ireland later on and there are huge specialties available to nurses in Ireland. There are huge programmes, including postgraduate programmes and specialist programmes. We have developed the likes of intensive care nursing and cardiac nursing very well with native talent. There has been phenomenal change in nursing in Ireland over the last 20 years, from the degree programmes to the postgraduate programmes. However, there is an issue of retention and retraining people and we have to be more innovative in terms of how we do that into the future and we then attract nurses from other jurisdictions into the country.
I thank the Taoiseach. I am informed the time for Taoiseach's Questions has finished so we will move on to statements on nursing homes and care for older persons. We will wait for the Minister of State to join us.
In fairness, Chair, that is not fair. A lot of us were waiting here for questions and the Taoiseach took an inordinate amount of time to whitter on with those answers. Do the same rules not apply to the Taoiseach as apply to everybody else in this House?
While we are waiting for the Minister of State, Chair.
That is what I have been informed by the clerk.
We might continue, Chair. The Taoiseach has signalled a willingness to continue.
That is very unfair of Deputy Tóibín. He arrived late himself.
In fairness, we get a minute. It is timed and we are told to stop. There was no umpiring of the time on this occasion at all.
I am normally very generous, Deputy. Come on. I am normally very generous.
I am told the rule is 45 minutes. The time is up so I have to proceed to the next item on the Order of Business, which is statements.
Normally, the time is split in a certain way to make sure the three groupings are taken in the 45 minutes.
In the first grouping, there were many questions answered. I accept there are several questions in the third grouping. A lot of people did not turn up at all at the beginning. It cuts each way. All of the Deputies wanted this session------
It should cut both ways. That is the point I am trying to make.
-----but the number of Deputies who were absent at the beginning of this session left me surprised.