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Dáil Éireann debate -
Tuesday, 27 Jan 2026

Vol. 1079 No. 4

Saincheisteanna Tráthúla - Topical Issue Debate

Road Traffic Offences

I am taking this on my own. I think this is my third time today speaking about scrambler bikes. I spoke initially with the Taoiseach today, I spoke with the Minister in committee and now I have the opportunity to raise it as a Topical Issue. The reason it is topical is because of the tragedy that occurred in Finglas two nights ago when a 16-year-old lost her life in a manner that was despicable and heart-wrenching. Yesterday, we all watched a mother, who had to place her grief and her devastation alongside courage that the whole country could only see as unimaginably brave, stand in front of her community - a part of Dublin that I do not represent but one that I know quite well - and find the strength in her voice to say that we, and she herself, would campaign to remove scrambler bikes from her community. It was awe-inspiring to see that level of courage. We are all devastated that she had to find this courage, given the grief that she had suffered only the day previously.

The Minister said in one of his last contributions that this should be seen as a line in the sand and I absolutely believe him. Regarding the enactment of section 35 of the Road Traffic Act, there was actually a lot of good in that in terms of the capacity of gardaí to intervene. We have seen the seizure of more than a few hundred scrambler bikes over the last number of years. However, I live in the city centre. Each morning and night, I walk my dog through various parks around the area and, without question, I hear the rev of a scrambler bike at some point in the week. When I hear that rev, I look around and see parents grabbing their children. If there is a football match going on, it will stop. I have been walking down the street and seen scrambler bikes coming up through bike lanes. I have been walking home from the Dáil in the evenings and have seen them going up and down O'Connell Street.

We have to take scrambler bikes out of our communities. We have to simply ban them from urban areas. I say urban areas because, obviously, they are the areas I understand well, but I am conscious this is an issue that impacts communities the length and breadth of the country. There is no justification for a person to be on a scrambler bike in an urban environment, or any road in a public area, yet they persist. The Garda has done a great job in terms of seizure and apprehension of the bikes, despite the fact that there is a grey area in terms of whether gardaí can pursue. I am conscious that the previous Commissioner said that gardaí had that power but it was left up to individual gardaí to make that decision. That was wrong.

I understand that section 35A, which would mandate the prohibition of scrambler bikes, has yet to be brought into regulation. We discussed that today. However, we need to go further and go at the sale of these bikes. There is the idea that a scrambler should only be used in an environment where there is a club associated with it. If it has a role in some sort of rural vocation, that is fine, but we cannot have a scenario where you can go onto Snapchat and buy a scrambler bike second-hand. Gardaí have told me they are seizing these bikes and the same people they are seizing them off are getting more two or three days later. We absolutely need to ban these bikes.

I will trust them because I saw the determination in the Minister's eyes and the Taoiseach's eyes today but we need to go further. We need to regulate the sale of them and make them much harder to purchase because there is no justification for what we see with our own eyes. There are kids on scrambler bikes. Let us be very clear: people are transporting drugs on them, the bikes are seized and they are back on a different scrambler within a couple of days.

I would like to understand the timeframe by which section 35A will actually come into force and maybe we can go beyond that and regulate their sale.

I thank the Deputy. I was humbled and in awe as well at the strength of Siobhán Lynch in what she said, having gone through such a traumatic event in her life. The Taoiseach said today that there is nothing we can really say that will alleviate the pain she and her husband, Martin, are going through. I received an email this afternoon from Grace's aunt, Rachel, who raised a number of issues with me. There is a change because there is complete determination and agreement across the House that the provisions within section 35A need to be invoked and regulations need to be made. The Taoiseach was straightforward here today when he said that probably should have been done earlier. There is now clearly widespread, universal support in this House for regulations to be made that will restrict and prohibit the use of scrambler bikes in public places and public parks. That is a priority.

The reason there is political consensus about doing it is that it can be done so immediately. Section 35A has been enacted. The regulations being prepared by the Minister for Transport are in an advanced stage of preparation. We now need to just do it and put in place regulations that will prohibit and restrict the use of scramblers on public roads, in public parks and public places. I agree with the Deputy. There used to be a form of sport where you would see scramblers on television going around a track or they would be in a certain area out in the countryside. People would put them on a trailer on the back of their car and bring them to the location. That is where they would use them. They were never intended for use on our public road system. In fact, it is an abuse of the system that people have been using them but this change, by putting in regulations pursuant to section 35A, will change circumstances.

The Deputy said we should go further and regulate it. The Deputy talks about regulating their sale. I have no doubt the Government will give consideration to that but the Deputy knows that when it comes to something like that, we will need legislation in place for regulation. That takes time. That takes consideration. When you are going to regulate the sale of them, presumably people who want to use them for sporting purposes on tracks or up the mountains where it is permitted will be permitted to buy them. We just need to think of the consequences of that. That is why the immediate focus and immediate pressure should be on the commencement of regulations under section 35A.

The legislation that was enacted in 2023 introduced some additional amendments to strengthen our legislation in relation to the misuse of scramblers and other vehicles. First, as the Deputy knows, it extends the dangerous driving offence to cover all locations and not just public places. Second, it gives gardaí the power to seize a vehicle being driven dangerously in any location. This legislation also creates powers to restrict the use of specified vehicles or classes of vehicles, which is now being considered. It has always been an offence to drive scramblers dangerously. I can assure the House that gardaí have enforcement powers to stop and seize the vehicle where this is the case. Members can see they have seized vehicles.

In terms of the pursuits policy that was introduced in 2024, it provides direction to gardaí who engage in pursuit tactics and pursuit management to reduce risk. Obviously, nobody in this House wants to see gardaí not pursuing people who are engaged in criminal activity but as the Deputy will appreciate, if the gardaí are pursuing somebody on a scrambler bike going through a residential area at speed, there has to be some discretion on the part of gardaí to be able to think if this is creating a more dangerous environment for the community. It requires a certain amount of thinking on their feet and discretion by gardaí, but the policy is that they can pursue.

I know it has always been an offence to drive scramblers dangerously in a public environment. I also know that in a public place, there is absolutely no safe way to drive a scrambler. That is what the difference is. There is no safe way to drive a scrambler in an urban environment. I trust the Minister on the enactment of regulation that will bring through the provision. I would like a sense of the timeframe from the Minister because we all watched Siobhán Lynch last night. The pain in that mother's voice is an absolute line in the sand moment for us.

There is a mother and a family who are grieving but also committed to changing a situation that is impacting their whole community, their whole city and beyond. They deserve a sense of a timeframe for the regulations to be advanced. Will it be a month or two months? That is a justifiable ask. If the Minister cannot shed light on that today, maybe he could make a public statement on it by the end of the week. However, we have to go further. I understand legislation takes time but as the Minister said, there is cross-party agreement. There is nothing stopping us from getting emergency legislation through, if necessary.

If a person seeks to buy a scrambler for sport, I absolutely understand that. There are still clubs. There is one up on the Alfie Byrne Road and I am sure there are others around the country. I am also conscious people need them on farms and in other rural environments. There is no reason why that cannot be linked to some form of identification number from a registered supplier so that when you purchase them, there is a number allocated. That way, they are a restricted vehicle. All of us would agree with that. They do not belong in any public place.

Let us ban them. I understand that is happening and we need a timeframe but let us go further and regulate them. These are the vehicle of choice for the transportation of drugs in my community and others. Let us get in front of that now and start the process.

The Government and everyone in this House is committed to banning them on public roads, in public parks and in public places. That has to be done. The Deputy asked me for a timeline. I am not supposed to reveal what is discussed at Cabinet.

However, I can tell the Deputy, having been at Cabinet this morning and having listened to the Taoiseach, there is a real commitment to ensuring this is done urgently. These are regulations that are being prepared in the Department of Transport. They will be signed by the Minister of State, Deputy Canney, who has delegated responsibility for road safety. There is a real urgency coming from the top of Government, from the Taoiseach, and all of us, to ensure that is done as quickly as possible.

I cannot give the Deputy a timeline but the advantage of having the legislation in place is that all we require is for the regulations to be drafted, sent to the Office of Parliamentary Counsel and the Attorney General's office, stamped and signed. There is an urgency and real pressure on Government to do that, as there should be, and ensure those regulations are signed promptly.

In terms of how the Deputy talks about regulating it, in many respects, it is not dissimilar from the discussion about nitrous oxide. Nitrous oxide can be used for legitimate purposes. It can be bought for legitimate purposes. Similarly, scramblers can be used for legitimate sporting purposes. If we are going to introduce a system of regulating the sale of them, we will have to set out a mechanism as to what will be required in order for someone to be able to purchase them and where they can be used.

We will still have the issue for which regulations need to be put in place so that they are banned on public roads and in public parks. I have to say to the Deputy that if we could achieve that and get them banned on public roads and in public parks, that meets the cry from the Lynch family in terms of what they want. It meets the demands of this House as well.

Telecommunications Infrastructure

I thank the Minister for being here. I raise the issue of section 254 licence applications, under the Planning and Development Act 2000, which permits the installation of telecommunications masts in communities. I believe this is a fundamentally flawed process and I will explain that in a moment.

Of course, we need to improve our telecommunications infrastructure. There is no doubt about that. However, we need to do so in a sustainable manner and one which does not adversely affect our communities.

The section 254 application process is a secretive process. It is non-transparent. There is no statutory obligation on the applicant to publish a site notice, for example, to let a community know that such an application is being made. There is no statutory requirement on the local authority to publish the fact that an application has been made under section 254 for a telecommunications mast to be installed in their community. Because those requirements are not laid down in legislation, it is up to local authorities to interpret how they should approach this. Many do not publish them and there is no requirement for a site notice. In my experience, most residents only become aware of such masts being installed in their communities when they see the construction work taking place. That is deeply unfair. Residents do not have a say in the process. Because they are not aware of it, they are not able to have an input. In fact, even if they were aware of it at a local authority level, there is no mechanism for them to have a say. They can appeal if they are aware that an application has been made and permitted. They are entitled to appeal that to An Coimisiún Pleanála. However, in many cases, residents are simply not aware that an application has been lodged with the local authority or, indeed, granted. It is deeply unfair that residents will not have their voice heard in this respect.

Because there is no requirement in terms of distance from a family home or a residential property, many of these masts, which are 18 m high in many cases, are installed within a distance of only metres from people's properties. That is totally unacceptable. If any of us in the Chamber woke up tomorrow morning and saw one of these 18 m high telecommunications masts being installed within a matter of metres of our front door, back door or bedroom window, I know full well we would not be happy and we would be asking ourselves how this is possible. It is possible under the current rules, however, and that has to change because it is deeply unfair and inequitable. People’s homes are so important to them. They are their sanctuary. They are where they want to spend their time. The fact that their house and what is precious to them can be impacted in such a way by one of these masts being installed is totally unacceptable.

The local authority does have to take certain criteria into account to ensure it is proper and sustainable planning and that it is consistent with development plans and so on. It looks at things like the density of such telecommunications masts in the area. There is a fourth criterion as well in relation to public safely, such as the obstruction of footpaths and so on. However, these are very vague requirements for the local authorities to take into account. Nowhere does it state that they have to take into account the distance from a residential property. In fact, I understand they are prohibited from taking that into account because it is not part of the application process. This needs to change urgently. I ask the Minister of State to please take that message away tonight so that communities will not wake up with these masts being imposed on them without their knowledge or input.

I thank Deputy McGrath for raising this Topical Issue matter relating to section 254 licence applications for telecommunications infrastructure and proximity to residential properties, which I am taking on behalf of the Minister for Housing, Local Government and Heritage, Deputy Browne.

Under section 30 of the Planning and Development Act 2000, as amended, the Minister with responsibility for planning is specifically precluded from exercising any power or control in relation to any planning-related matter with which a planning authority or the board is or may be concerned. Section 254 of the Planning and Development Act 2000, as amended, provides for a licensing system for appliances and structures placed on, above, under or along a public road, including footpaths. The Act provides that a public road has the same meaning as in the Roads Act 1993, which defines it as "a road over which a public right of way exists and the responsibility for the maintenance of which lies on a road authority".

A person applying for a licence must provide the planning authority with such plans and other information concerning the position, design and capacity of the appliance, apparatus or structure as the authority may require. A licence may be granted by the planning authority for such period and upon such conditions as may be specified, including conditions in relation to location, design, space taken up by the appliance and the need to protect protected structures, etc. Within the statutory framework, licensing is a matter for each individual local authority and the Minister with responsibility for planning has no role in the matter. In considering an application for a licence under section 254(5) of the Act, a planning authority shall have regard to the proper planning and sustainable development of the area, development plans, the number and location of existing appliances and the convenience and safety of road users, including pedestrians.

Section 254(5A) of the Act outlines the licensing process in respect of an application for a licence to erect, construct, place or maintain overground electronic communication infrastructure and any associated physical infrastructure, including telecommunications poles. If a planning authority fails to make a decision within a period of four months commencing on the date of receipt of an application, a decision of the planning authority to grant a licence shall be deemed to have been made on the day following the expiration of that period of four months. Where a planning authority requests additional information from the applicant and has not made a decision within a period of four months of receiving the applicant's response to the request, a deemed decision to grant a licence shall be deemed to have been made. A deemed decision to grant a licence shall be subject to the condition that the network operator concerned, in advance of commencement of the works, shall inform the planning authority concerned and the National Roads Authority or road authority where applicable.

Under section 254(6), any person may, in relation to the granting, refusing, withdrawing or continuing of a licence under this section or to the conditions specified by the planning authority for such a licence, appeal to An Coimisiún Pleanála under section 30 of the Act.

I thank the Minister of State for his reply. I respect the fact that he is here this evening but, unfortunately, that reply does not in any way address the issues I raised in relation to these telecommunications masts being installed and erected close to residential properties and the fact that there is no provision whatsoever in the rules and regulations to ensure a safe and respectable buffer distance. The landscape of our communities and streetscapes are changing in urban areas because of the installation of these 18 m high steel poles and telecommunications masts. Residents and communities are absolutely shocked when one of these appears in their area and they realise they have had no input or say in the matter and their voice could not be heard. Of course, they turn to public representatives, but we have no answers for them because, as I said, this is a secretive and non-transparent process. The fact that local authorities do not even have to publish these applications is fundamentally wrong. The fact that there is no site notice is fundamentally wrong. It is about restoring some trust in the system here. This is under the Planning and Development Act. It is a licence application, not a planning application. However, we have to restore public trust in how these applications are administered, processed and so on. While we are all in favour of technological advances, it should not come at the total abandonment of our communities in terms of sustainable planning.

I put it to the Minister of State, as I said earlier, that if this happened to any of us in the House and we woke up to one of these 18 m high telecommunications masts being put in front of, behind or alongside our house, I am sure we would a lot have to say on the matter. I simply cannot understand how it is not provided for in the legislation that the installation of these masts should be a safe distance from a family home or a residential property. Again, I ask the Minister of State to please take that away so that this issue can be looked at with urgency.

Once again, I thank Deputy McGrath for raising this Topical Issue matter, which I am taking on behalf of the Minister for Housing, Local Government and Heritage, Deputy Browne. The Planning and Development Act 2024 was signed into law by the then President on 17 October 2024. The Department is putting arrangements in place to implement the phased commencement of the Act of 2024 to transition to new legislation across the planning system, taking account of the need to liaise with local authorities, planning bodies and other stakeholders. The existing provisions of the Planning and Development Act 2000 will remain in place until the relevant provisions of the Bill are commenced.

Section 254 of the Act of 2000 will be replaced by sections 13 and 14 of the Act of 2024 on commencement of those sections. Section 13(4B) of the Act of 2024 was added on Seanad Report Stage to include a regulation-making power for the Minister to prescribe certain classes of licence requests as requiring public notification. The amendment takes account of the input on Seanad Committee Stage in relation to a licence for telecommunications masts and ensures there is public notification process for such licence applications. Specifically, I will bring the further points Deputy McGrath raised to the attention of Department officials and the Minister, Deputy Browne.

Commercial Rates

Ar dtús báire, tá an cheist seo an-dáiríre. Baineann sé le gnólachtaí a chuireann seirbhísí cúnamh linbh ar fáil ar fud Contae Phort Láirge. Tá sé thar a bheith deacair dóibh leanúint ar aghaidh ag cur na seirbhísí sin ar fáil de dheasca billí a bhfuaireadar roimh an Nollaig ó Chomhairle Cathrach agus Contae Phort Láirge ag eascairt ó athluacháil de chuid Tailte Éireann.

This is a really serious issue affecting childcare providers in County Waterford. I have no doubt similar issues, if they have not arisen, will arise in other counties. Almost a dozen childcare providers I have been in touch with received astronomical rates bills from Waterford City and County Council just before Christmas. These are private businesses solely providing the early childhood care and education, ECCE, scheme, funded entirely by the State, which were never liable for rates in the past and did not expect to be liable. Three days before Christmas, they were hit with rates bills of €4,280 in some cases and, in other instances, of an eye-watering €12,040. I am glad the Minister of State is sitting down for that figure. These operators are telling me they cannot continue if they have to pay these rates bills.

There has been discussion in the Chamber in the past few weeks about the issues affecting the childcare sector, how many providers are closing their businesses, letting staff go and leaving the industry, and how many parents are finding it hard to get childcare spaces. Every provider that leaves the industry places a greater burden on parents seeking to access childcare. That is before we get into the costs of running these businesses and the affordability for parents of having their children cared for in those settings.

The rates bills came as a surprise, as I said, because these businesses had never before been liable for rates or received such a bill. They operated on the legitimate understanding that they were exempt from rates because they provided purely ECCE services. They did not operate additional childcare services or, indeed, any other commercial operation from their premises. They were operating on the basis of a circular issued by the Valuation Office in 2010, which stated that to be exempt from rates required compliance with certain qualifying criteria. These were that the property be used exclusively for the 38-week sessional ECCE-funded preschool services and for no other purpose, such as childminding, crèche services funded by private fees or any other commercial use, and that the expenses incurred in providing this ECCE preschool sessional service must be defrayed wholly or mainly out of moneys provided by the Exchequer.

The providers satisfy those criteria and have always done so. Nothing in their business operation or service provision has changed, yet Tailte Éireann took it upon itself at the end of last year to conduct valuations of their premises and then to issue notice to Waterford City and County Council, which was duly bound to issue bills to them seeking what I would say are extortionate rates. Those rates will put them out of business, thereby reducing a level of service in rural areas and small towns in County Waterford, much-needed employment in those communities and a vital service for parents who may have to commute to work in Clonmel, Waterford or as far as Little Island in Cork.

I am hoping to hear that the Minister of State, Deputy O'Donnell, and the Minister, Deputy Browne, have a plan of action. I am seeking clarification as to whether there has been a change of policy and whether these businesses that were previously exempt from rates are now rateable. What has changed, when was that policy changed, by whom and for what reason, and how was it communicated, or if there has been no such change in policy, how will the issue be resolved in order that these businesses can keep providing the services that are so badly needed?

I thank the Deputy for raising this matter and giving me the opportunity to clarify the position regarding early childhood care and education facilities, commercial rates and the role of Tailte Éireann in that regard. I am taking this Topical Issue on behalf of the Minister for Housing, Local Government and Heritage, Deputy Browne.

Tailte Éireann is an independent Government agency that provides a property registration system, property valuation service and national mapping and surveying infrastructure for the State. It is independent in the exercise of its valuation functions under the Valuation Act 2001, as amended, and neither the Minister for Housing, Local Government and Heritage nor his Department has any function in decisions in this regard.

Tailte Éireann has overall responsibility under the Act for the maintenance of all valuation lists used by local authorities in the calculation of rates liabilities. Under the Act, all property is rateable unless it falls into one of the exempt categories listed in Schedule 4 to the Act. There is a very specific range of exemptions that can be applied and Tailte Éireann has no discretionary latitude to grant exemptions not covered by Schedule 4.

Paragraph 22 of Schedule 4, which was inserted by the Valuation (Amendment) Act 2015, refers specifically to early childhood care and education facilities and provides an exemption for: "Any land, building or part of a building used exclusively for the provision of early childhood care and education, and occupied by a body which is not established and the affairs of which are not conducted for the purpose of making a private profit". Therefore, while the Act provides that early childhood care and education facilities that are operated on a not-for-profit basis are exempt from rates, it does not provide a general exemption from rates for all childcare or childminding facilities operating on a for-profit basis. To avoid ambiguity, if an early childhood care and education facility is operated on a for-profit basis, then it does not fulfil the criteria for exemption under paragraph 22.

As a matter of course, Tailte Éireann examines all properties on their individual merits by reference to the relevant statutory provisions governing the operation of the Act and case law arising from the independent Valuation Tribunal and the higher courts. There are a number of avenues of redress for an occupier of a rateable property who is dissatisfied with a determination of valuation by Tailte Éireann made under the provisions of the Valuation Act 2001, as amended. First, before a determination is made, there is a right to make representations to Tailte Éireann in relation to a proposed valuation. Later in the process, if the occupier is still dissatisfied with the determination, there is a right of appeal to the Valuation Tribunal, which is an independent body set up for the purpose of hearing appeals against determinations of Tailte Éireann. Thereafter, there is a right of appeal to the higher courts on a point of law.

Under Irish law, there is a distinct separation of functions as between the valuation of rateable property and the setting and collection of commercial rates. The commercial rates payable on a particular property are a product of the valuation of that property, as determined by Tailte Éireann, multiplied by the annual rate on valuation, ARV, which is set annually by the elected members of the local authority as part of its budgetary process. The billing and collection of rates is solely a matter for the relevant local authority. Tailte Éireann has no function in that regard.

I thank the Minister of State for his response. It clarifies the situation in that he stated explicitly that for-profit childcare providers are liable for rates. However, there has been a change of policy. It may have taken place several years ago but there has been a change of policy and that policy was not executed in County Waterford. These businesses were not liable for rates in the past but they have now been hit with these bills. Nobody has communicated this change of policy to them. Several of them, if forced to pay these rates bills, will have no option but to shut down.

The Government is missing a trick here. These might be private commercial operators in one way but, on the other hand, they are providing exclusively a State service that is paid for exclusively by the State. In effect, they are agents of the State and their existence and their provision of the ECCE service is precisely because they are filling a gap the State has left in rural communities such as Lemybrien, Kilmacthomas, Lismore, Abbeyside and Touraneena. They are facilitating people, particularly women, to have their children looked after in order that they can go to work in rural Ireland, contribute to the local economy and have that level of independence. They are providing a service the State has never provided, paid for by the State, yet they are being hit with rates bills of €12,040 in some cases.

I take it from the Minister of State's answer that there has been a change in policy and it happened several years so but is only now being executed and put into effect in Waterford, where it is creating havoc. There is a gap here and it is something the Government needs to address. In effect, these agents for State services are being put out of business when the sector is already in freefall.

I again thank the Deputy for raising this matter and giving me the opportunity to clarify the position regarding commercial rates liabilities for ECCE facilities and the role of Tailte Éireann in the matter.

As I said earlier, I am taking this Topical Issue debate on behalf of the Minister, Deputy Browne. Tailte Éireann is independent in the exercise of its valuation functions under the Valuation Act, as amended. The Act provides that early childhood care and education facilities that are operated on a not-for-profit basis are exempt from rates. It does not provide a general exemption from rates from all childcare or childminding facilities operating on a for-profit basis. There are a number of avenues of redress for an occupier of a property who is dissatisfied with a determination of valuation by Tailte Éireann. The billing and collection of rates is solely a matter for the relevant local authority and, as I said, Tailte Éireann has no function in that regard.

Hospital Services

I am thankful for the opportunity to speak this evening. Before I start, I want to reflect on how far we have come as a nation in the last 25 years in relation to health. Our budget in 2000 was €5.6 billion and this year it is €27.4 billion, which is a fivefold increase. We see improved individual outcomes, economic growth with a healthier and more productive workforce, increased life expectancy and greater equity and social well-being across the population. However, multidisciplinary primary care was first discussed here as a concept in the 1980s. The first strategic plan, Primary Care: A New Direction, was introduced in 2001. We saw our first primary care centre nine years later in Mallow, and since then we have seen over 180 new primary care centres delivered nationwide. I firmly believe it is an infrastructural development area that is not recognised half enough when it comes to the delivery we have seen in the area, with many more in the development pipeline.

In my county we have seen Tullamore up and running. We officially opened Banagher Primary Care Centre with the Minister, Deputy Carroll MacNeill, last year. Birr is nearing completion and I recently visited it. Edenderry is at the planning application stage and I hope, once we get approval on that, the HSE will prioritise it for development.

We have the bricks and mortar and now it is a matter of ensuring adequate human resources capacity. I acknowledge Dr. Velma Harkins in relation to the introduction of the international medical graduate rural GP programme, which has made a material difference in relation to providing GPs in rural areas. We heard from many in opposition in this Chamber about how we were never going to see a GP again and services were lost. This has taken the pressure off but we need more. There are problems which remain and I hear about them regularly from my constituents. Occupational therapists, physiotherapists, speech and language therapists, psychologists and chronic disease supports are seriously lacking. There are a number of vacancies in these roles that need to be filled as a matter of priority in my area. There are long waiting times and waits for assessment and intervention. People are literally waiting for years, so I ask the Government to prioritise this, working with the HSE.

Elective surgery is a growing problem and the statistics speak for themselves. Midland Regional Hospital, under the stewardship of Louisea Burke, has proven itself to perform at every level, and there are plans for further development of dialysis, an oncology day ward and an extension to the existing emergency department. It proudly boasts some of the lowest emergency department, ED, trolley numbers in the country. I visited recently and saw this at first hand. The urgent need for an ED is backed by the fact that, in 2025 versus 2024, there was a 3% increase in ED attendees, with 9% of those being over 75 and 11% over 90. This is a bed capacity challenge which brings a significant increase in surge requirements and that is impacting on elective surgery. We have seen insufficient protection of elective beds, underutilised theatres due to staffing and schedule constraints, high cancellation rates because of emergency demand, and elective surgery constantly crowded out, not because the need is not there but because emergency takes priority. We have seen increases as high as 48% and 27% in inpatient and day cases, respectively, as well as in endoscopy year on year. This is something that needs to be addressed by the Government as a matter of priority.

I thank the Deputy for raising this really important topic. I am taking this on behalf of the Minister.

The Government acknowledges many patients are waiting too long for care, but we are committed to improving access to hospital care and reducing waiting times for patients, including through the multi-annual action plan approach. Building on the progress made to date, we will continue to focus on reducing waiting times for scheduled care in our hospitals through a range of measures, including service reforms and innovation, as well as targeted increases in capacity. The Government is also committed to increasing elective care capacity across Ireland to ensure high-quality and timely scheduled care is available to all.

In order to meet medium-term demand, we are delivering the first phase of increased elective capacity through a national network of surgical hubs. The two surgical hubs at Tallaght and Mount Carmel in south Dublin are already open and are having a real impact on day case waiting lists. There are due to be five more surgical hubs opened in 2026 at Cork, Galway, Limerick, Waterford and in north Dublin. Hubs at Sligo and Letterkenny will then follow, with design for both now under way. In the longer term, and to meet the needs of our growing and ageing population - the Deputy is right to note it is ageing - we are also delivering a national network of elective treatment centres in Cork, Dublin and Galway. These new facilities will make a real difference to those who are waiting for access to elective treatments while also freeing up capacity in other hospitals to deal with more complex and emergency cases. Patients in the midlands will have access to these elective treatment centres on an equal basis to everyone else in the country, that is, based on clinical need. This will help to reduce waiting times for elective procedures and ultimately lead to a more efficient and responsive system for everyone.

Long waiting times are not unique to the hospital system, however. To address the long waiting times for primary care therapy services, the Department of Health is currently engaging with the HSE on a focused approach to these waiting lists. Under this programme of work, in September last year the Minister asked the HSE to put measures in place to address the long waiting lists for physiotherapy, occupational therapy and speech and language therapy. This is expected to remove over 60,000 people from these three waiting lists throughout the country. In addition, to ensure the necessary resources are available to maintain waiting lists below that target, the HSE is prioritising recruitment of permanent staff to primary care therapy services, with approval of an additional 200 whole-time equivalents in the national service plan for 2026. It is therefore about recruitment too, which the Deputy spoke about, through the different areas.

An additional 12 posts have been allocated to the midlands integrated healthcare area, including posts to address vacancies in occupational therapy and physiotherapy for children’s services in Offaly and Laois. I am also very pleased to advise that additional primary care infrastructure is in development in County Offaly following on from the opening of primary care centres in Tullamore and Banagher in recent years. Birr primary care centre is due to open in the first half of this year. It will include an extensive GP practice and allow the HSE to consolidate its primary care and mental health services under one roof, and this will be of real benefit to the people in the area. The Edenderry primary care centre is in the early planning stage and a planning application was submitted for this development to Offaly County Council this month. All of these measures are showing significant investment in the area and will have a very positive impact on the people of the midlands.

I appreciate the Minister of State's response but the options that will be given to patients in the midlands are already in every geographical location around the country except the midlands and that is exactly what needs to change. Sláintecare commits to reducing waiting times, bringing care closer to home and regional delivery. We want to see all three delivered in the midlands. On a basic human level, behind every waiting list number is a person living in pain, struggling to work or watching their quality of life deteriorate. If you are living in the midlands or in Offaly, you are expected to commute or get a train in order to avail of those services and that is simply not acceptable in 2026.

In 2018, A Trauma System for Ireland: Report of the Trauma Steering Group recognised Tullamore for its 24-7 emergency department with trauma, orthopaedic and general surgery on call. That is a strategically important location. As recently as July 2024, a report commissioned by the HSE exploring the options for increasing hospital capacities in the midlands identified the need. Yet, in the response this evening, there is no recognition of that.

We are seeing population growth. We need to future-proof for it. It took 30 years to deliver the concept of primary care centres. The midlands and Offaly cannot wait 30 years for elective capacity to be brought there. We need to move away from a model under which we are expected to go to Dublin or Galway. We want that capacity to be brought to the midlands and to take the pressure off the other areas. I propose that the Government look strongly now at forming some kind of dedicated stakeholder task force to work on the issue as a matter of urgency to ensure patients in the midlands who want and need elective surgery can get it in the midlands.

I thank the Deputy for raising this important issue. I assure him the Government is committed to providing access to the best care for the people of Ireland. We are clear that no matter where the facilities are located, everyone should have access to adequate and appropriate care based on their needs. Through the delivery of this programme, we are increasing capacity to meet short- and long-term needs, but the surgical hubs and elective treatment centres together will form a national network. These facilities will enable the delivery of care for all patients. Geography will not be a barrier. Instead, consultants and other doctors will be able to refer on the basis of patient need.

I see where the Deputy is coming from but the Minister welcomes the news that the development of the primary care infrastructure in County Offaly is progressing, offering a real example of the investment the Government is making in community-based health infrastructure, providing a single point of access to healthcare services for patients.

I assure the Deputy that there is currently no barrier to recruitment to primary care services and an additional 200 staff for primary care therapy services have been prioritised in the HSE national service plan. I will be speaking to the Minister, Deputy Carroll MacNeill, tomorrow and I will highlight the concerns Deputy Clendennen raised tonight.

Vaccination Programme

I thank the Minister of State for coming this evening to take this Topical Issue matter.

Over recent months, there has been ongoing debate about the merits of providing enhanced influenza vaccines such as high-dose or adjuvanted formulations for people aged 65 years and older. The Health Information and Quality Authority, HIQA, conducted a health technology assessment, HTA, which found that enhanced vaccines are likely to provide greater protection than standard influenza vaccines in older adults, with the potential to reduce severe illness, hospitalisation and influenza-related mortality in this high-risk group. Despite these findings, the HSE did not proceed with a tender for enhanced influenza vaccines last year, citing cost-effectiveness concerns. However, the scale and severity of the influenza outbreak in recent weeks, characterised by high levels of community transmission, significant pressure on hospitals and a disproportionate impact on older people, raises questions about whether the current approach adequately reflects the true cost of influenza to the health system. Hospital admissions, bed occupancy and delayed discharges during peak flu periods carry substantial financial and operational consequences. Preventing even a modest proportion of these admissions through improved vaccine effectiveness could offset the higher upfront cost of enhanced vaccines.

In addition, vaccine uptake among older adults remains suboptimal in some communities, suggesting that availability alone is not sufficient. Public awareness, confidence and timely access all play critical roles in determining vaccination rates. Clear public messaging, earlier seasonal campaigns and stronger engagement through GPs, pharmacists and community organisations may help to improve uptake, particularly among those at risk of severe outcomes. In light of this year's flu cases and associated hospitalisations, what consideration has been given to funding an enhanced flu vaccination programme for older adults ahead of the next flu season? What measures are being considered to improve public awareness, confidence and uptake of the flu vaccine among older people to maximise the impact of the vaccination programme and reduce preventable illness and hospital pressure?

We are not a million miles off the vaccination target for the age cohort of 65 and older. However, another concern I have is for those aged between two and 17. The HSE has a target that 50% of children in that cohort will be vaccinated, but we are way below that, at below 20%. Will the Minister of State give consideration to improving uptake of the flu vaccine among children?

I thank the Deputy for raising this matter in the House this evening. The Minister for Health shares his concerns about the protection of older adults against influenza. For those in recommended groups, the influenza vaccine reduces the risk of serious illness and death from flu. Ensuring high vaccine coverage is a priority in order to reduce severe illness from influenza, RSV and Covid-19 over the winter period.

Ireland’s immunisation programme is based on the advice of the National Immunisation Advisory Committee, NIAC. The committee's recommendations are based on the prevalence of a disease in Ireland and international best practice. NIAC routinely revises recommendations to facilitate the introduction of new vaccines and to keep on top of changing patterns of disease. Therefore, the immunisation schedule will continue to change over time. The vaccination programme provides a free flu vaccine to those most vulnerable to the impact of flu. Every year, the WHO reviews global surveillance data and recommends the specific strains that manufacturers should include in the season's vaccines based on the flu strains that are considered most likely to circulate. All licensed influenza vaccines included for the 2025-26 season comply with WHO and NIAC recommendations.

In 2024, HIQA carried out an enhanced flu vaccine health technology assessment, which found there were limited studies on the effectiveness of enhanced flu vaccines, along with a lack of data over multiple seasons. Due to the variability of seasonal influenza, a single study may misrepresent average vaccine effectiveness. Based on the limited data, the HTA determined that switching from a standard to an enhanced flu vaccine for those aged 65 and older was likely to reduce the burden of flu. However, whether such a switch would represent a good use of public money would depend on the price of enhanced vaccines when compared with the standard flu vaccine.

The European Centre for Disease Prevention and Control reported overall low to moderate relative vaccine effectiveness for the enhanced influenza vaccine against laboratory-confirmed influenza-related hospitalisations. It concluded that evidence specific to the relative effectiveness of enhanced influenza vaccines when compared with standard vaccines was still limited and that further studies were necessary to allow more substantial conclusions on the potential benefits of enhanced influenza vaccines.

The HSE is responsible for the procurement of vaccines in line with EU and national procurement rules. It was asked to commence a tender process to determine if enhanced flu vaccines could be purchased at a cost-effective price and within its existing budget. It carried out an analysis of the tenders received and on 4 February 2025 advised the Department of Health that neither of the available enhanced vaccines for older people met the criteria set out in the HTA for net monetary benefit compared with the standard flu vaccine.

The HIQA HTA estimates that procurement of the enhanced influenza vaccines would cost between €4 million and €19 million per year. However, the actual costs remain commercially confidential and are not known until tenders are evaluated each year. Decisions regarding increased spending in one area could impact the provision of other technologies and treatments in the healthcare system. Therefore, cost effectiveness must be considered in any decision-making process.

It is important that the Department and the HSE adhere to the value-for-money obligation set out by the Department of public expenditure in relation to the efficient and effective use of public funds and resources.

I thank the Minister of State. I know she is here instead of the Minister, Deputy Carroll MacNeill. She has probably heard me in parliamentary party meetings in recent years talking about access to drugs in the round. It does not surprise me that the response from the Department is that we need to do more research because that is generally what it does when it comes to expanding and rolling out drugs across the board for patients.

There is one thing that annoys me. As a Government, we have made a political decision to expand the respiratory syncytial virus, RSV, programme. It is a commitment in the programme for Government. While my question does not directly relate to RSV, it is on the spectrum when it comes to flu vaccinations. RSV vaccination is right in there. We have made a political decision as a Government to expand that. NIAC has recommended that the RSV vaccine be expanded. However, we have not done that yet. I am not discounting the fact we might do it in the future, and I hope to God we do, because it will prevent some of the chaotic scenes we see in our emergency departments over the winter months in particular.

I would lay down the gauntlet to the Department of Health that it is time it got off its chair and made these decisions and big calls. NIAC has recommended that the RSV vaccination be expanded to older people. We already do it for children. It has recommended this. The Minister of State has said that it will cost between €4 million and €19 million for flu. Obviously, there are many caveats in that. I assume it involves many different age cohorts and whatever. I ask the Minister of State to consider rolling it out to people in nursing homes who may be vulnerable, to see if that is effective and cost efficient to begin with. Obviously, cost effectiveness is more important that people's health; that is what I keep being in told here when I raise these questions. As regards cost effectiveness, has the Department estimated to the Minister of State, or would she be able to find out in writing afterwards, what the cost of people who present with flu or RSV, for example, is during every winter period? I guarantee it is far less than the €4 million to €19 million range given to us this evening.

Certainly, I will get those answers for the Deputy. I am pleased to note that in this flu season, the uptake rate for the vaccine among adults aged 60 and older was 66%, and for fair deal residents it was 83%, which is high. This is very positive and has been a factor in ensuring hospital and trolley numbers for flu this year are lower than previous years. It is important that we protect ourselves and each other from infection during the winter season by availing of the flu vaccine when it is offered. The introduction of an enhanced vaccine can be reconsidered when the cost effectiveness is more favourable. I will get the Deputy those answers.

I urge all those who are eligible for any vaccine under the national immunisation programme, at all stages of life, to take the opportunity to be vaccinated. It is important that we tell anyone who needs to get their vaccine that they need to get that as soon as possible.

Again, I thank the Deputy for highlighting this matter. I will certainly bring his questions back to the Minister and get answers, particularly with regard to children. It is important we look at that again.

Cuireadh an Dáil ar athló ar 11.54 p.m. go dtí 9 a.m., Dé Céadaoin, an 28 Eanáir 2026.
The Dáil adjourned at 11.54 p.m. until 9 a.m. on Wednesday, 28 January 2026.
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