Saincheisteanna Tráthúla - Topical Issue Debate – Dáil Éireann (34th Dáil) – Wednesday, 18 Feb 2026

Saincheisteanna Tráthúla - Topical Issue Debate

Hospital Staff

Deputy Colm Burke

In the south-west area, which includes Cork and Kerry, there is no consultant dermatologist employed. This issue came to a head recently when a consultant wrote to parents advising that appointments could not be given because no consultant paediatric dermatologist is employed in the Cork-Kerry region. I understand funding was granted for eight additional posts in Dublin, bringing the total number of posts there to more than ten.

The number of patients referred to dermatology consultants in the south-west region was more than 17,000 in 2024. There were 10,000 new cases and 12,000 returning cases in that year. There is a huge volume of work being done, with the whole Cork-Kerry region being covered by a total of 7.4 consultant posts. There are more than 750,000 people in the region, a percentage of whom are being referred.

Parents of children with a particular dermatology issue are having to travel to Dublin from the south-west region. This is a huge concern for parents. The first worry for them is that their child has a medical condition that requires an appointment with a consultant, and the planning that requires. In the Cork-Kerry region, they have no alternative but to travel to Dublin. In fairness, there are very few dermatology referrals from Cork to Dublin in an overall context. However, the volume of referrals has increased substantially. The manner in which the service is run in the South Infirmary Victoria University Hospital, SIVUH, is such that it also provides care in Bantry, Tralee and Mallow.

How can we deal with this challenge? I understand a submission has been made to the HSE in the south-west area seeking appointment of a consultant dermatologist. A clear case has been set out that if this person were located in the Cork-Kerry region, a huge volume of work currently being referred to Dublin could be dealt with in the region and the need for referral would not arise. I ask that this issue be examined by both the Minister of State's office and the HSE at national level. The HSE in the south west cannot make the decision on this; it must be approved at national level. I ask that a consultant paediatric dermatologist be appointed to look after children with a skin disorder or other dermatology issue, which would mean parents do not have the expense of having to travel all the way from south Kerry, west Cork or Cork city to Dublin to access that care.

Minister of State at the Department of Health (Deputy Mary Butler)

I thank the Deputy for raising this really important issue and giving me the opportunity to provide an update to the House on paediatric dermatology services in the HSE south west. Those services are provided through primary care services, regional dermatology services and specialist dermatology services based in Children's Health Ireland, CHI, in Dublin. Paediatric dermatology services in the south-west region are primarily provided in Cork from the South Infirmary Victoria University Hospital, which serves as the regional hub for the specialty. As the regional centre, it treats a wide range of conditions in infants, children and adolescents, including eczema, psoriasis, acne and rare genetic skin disorders.

While SIVUH is the regional hub, Cork University Hospital also hosts outreach clinics and integrated care for children with complex needs. Public dermatology services from the regional hub centre also extend to Bantry General Hospital and University Hospital Kerry. In addition, CHI manages and delivers paediatric dermatology services across the three paediatric hospitals in Dublin. CHI is currently focused on reducing the numbers waiting, as well as reducing the waiting times, on the dermatology outpatient lists.

I acknowledge the impact on patients and their families who have to travel to Dublin. I am not sure whether those having to do so are those accessing the specialist dermatology services based in CHI. I assure the Deputy that the delivery of high-quality patient-centred care and best practice remains at the centre of all hospital activity. Having said that, I see exactly the point he is making. I checked this morning and the waiting lists are extremely high, especially for children seeking dermatology supports. There has been a small reduction in the waiting list of 58 young children and adolescents. In January 2026, there were 227 people waiting between six and 12 months and 601 waiting from nought to six months. That shows the massive demand for this service.

On the Deputy’s question regarding the recruitment of paediatric dermatology consultants to the south-west region, the HSE has advised that while it currently has no plan in this regard for 2026, the matter will be kept under consideration for the future. That seems to be at odds with what the Deputy has said. I certainly will look into it.

Obviously, the HSE will use waiting-list initiative funding to take some of this list down. I will bring back to the regional executive officer, Dr. Andy Phillips, and the Minister for Health the Deputy's contention that there are no plans to hire an additional paediatric dermatology consultant given that it is clear that this waiting list is forever too high, especially for young children.

Deputy Colm Burke

I fully understand that this matter was probably only given to the Minister of State late last night. I will give her the figures as regards the turnaround in dermatology services for the entire country. One of the things she will see in those figures is the efficiency in the south-west region in dealing with dermatology cases. As I said, the volume is over 17,000 referred, while 10,000 were new and 12,000 were returning patients. With 7.4 consultants, a real effort is being made by the entire team, not just the consultants but also the registrars, senior house officers, SHOs, and nursing staff. The problem is that funding was provided for an additional eight paediatric dermatology consultants in Dublin. There are now ten there but none have been appointed to locations outside of Dublin, which is a mistake. When we see the efficiency of the Cork-Kerry region, we believe that a paediatric dermatologist appointed in that region would help to deal with and not clog up the lists, especially as there are long waiting lists in Dublin already. The Department should engage with HSE south west to see how this can be moved forward as regards appointing someone to deal with this issue. That is basically what I am asking.

Deputy Mary Butler

I have a briefing note here that states that CHI has a staffing complement of 8.8 whole-time consultant dermatologists. These are 8.8 whole-time equivalent, or funded recurring consultant dermatologists, across three CHI sites but it is currently operating within 6.3 whole-time equivalents. That is the information I have. I also know from my own area, and Deputy Michael Murphy will be aware of this as well, that in the old CHO 5 area, for example, dermatology consultants are scarce and it is difficult to recruit them.

To return to what the Deputy said about the letter only being submitted last night, I can follow up on that in relation to the additional dermatologist posts that have been sought. Thankfully, with the new regional structure, the six regional executive officers have received their cohort of staffing numbers. There were 3,300 this year: 300 for mental health and 3,000 for all other definitions. They are able to decide and determine whether they want to prioritise a certain speciality. I will certainly follow up on this for the Deputy because it is very difficult for young children with eczema, psoriasis or acne, or teenagers with acne. Looking at the waiting lists, they are quite long. I thank the Deputy for raising this matter; it is a really important one first thing this morning.

Health Services Staff

Deputy Michael Murphy

I raise this Topical Issue because children across south Tipperary, and children across the south east, are being left without access to basic community ophthalmology services due to repeated recruitment failure following the planned retirement of the previous consultant, Dr. Hillery, in August 2024. This is not a new issue. I have raised it repeatedly throughout 2025, in February, April, July, October and December and, most recently, in January of this year. On every occasion, I sought an update on the recruitment progress and, crucially, what contingency arrangements were put in place or are in place. In January of this year, I again asked what immediate measures were operating, yet here we are in February 2026 and still no change.

The latest figures made available to me show that almost 1,500 children under the age of four, and 334 children aged between five and 17, are waiting for basic community ophthalmology services. That is almost 1,800 children in south Tipperary alone waiting for basic ophthalmology care, the majority of whom are under the age of five. As the Minister of State and everybody in this House will know, in early childhood, vision development is time sensitive. Delays in assessment and treatment can have lasting consequences. For every young child, an 18-month wait is not neutral. It can mean missing critical development windows. Parents are being told routine referrals carry waiting times of approximately 18 months. Some children in my constituency whose parents have been in contact with my office were referred in 2023 and remain on the list. In the interim, families are advised to contact the clinic in University Hospital Waterford if concerns become urgent. The reality is that the phone is not being answered. This is not a structured contingency plan. Recruitment failure cannot mean service absence.

I again ask the Minister of State very directly about this. Are weekend clinics currently operating? Has private provision been formally contracted? Are children being systematically referred across HSE areas? Is temporary contracting or emergency outsourcing now in place? Crucially, what is the update on the appointment of the permanent ophthalmologist for south Tipperary to be based in Clonmel? We are now looking for concrete proposals. Children across south Tipperary are entitled to the same access to community ophthalmology services as children anywhere else in our State. After raising this issue throughout 2025, I believe families deserve a clear and concrete answer today.

Deputy Mary Butler

On behalf of the Minister for Health, I thank the Deputy for raising this important matter. I acknowledge the number of times he has raised it. I have answered him several times in relation to this. As I go through the answer, for anyone listening in, it will become very clear that every effort has been made to try to recruit staff, but the HSE just has not been able to do so.

As the Deputy knows, the HSE provides optical services free of charge to preschool children and national school children referred from child health service and school health service examinations who are discovered to have sight problems. These children are referred to the appropriate optical care, which will continue to be provided until the child has reached the age of 16 years. The community ophthalmic services scheme, COSS, is a national fee-per-item scheme which was introduced in 1979. Under the COSS, medical card holders aged over 16 years can be seen by local ophthalmologists, community ophthalmic physicians, optometrists or dispensing opticians who have entered into a contract with the HSE to provide services.

The HSE has advised that the community ophthalmologist physician post, as the Deputy has referred to many times, became vacant in October 2024 due to a retirement. As he knows, our constituencies border each other and this has been raised with me as well. I met one of the nurses while I was out and about one day in west Waterford, close to Clonmel, and it was raised with me. I just happened to come across the nurse working in the services and she explained to me how difficult it had become. In line with the national clinical programme for ophthalmology model of eye care and the modernised eye care pathway - this is important - the community ophthalmologist physician post has been upgraded to the position of consultant medical ophthalmologist. Following a recruitment process to fill the post in south Tipperary, an interim appointment was made in July 2025. Unfortunately, the successful candidate subsequently declined the post prior to the commencement date. I am telling the Deputy everything he knows, but I want to put it on the record. Unfortunately, a second recruitment campaign in late 2025 resulted in no candidates being shortlisted.

The HSE acknowledges the impact on patients, both children and adults, caused by the current vacancy and has further advised that it readvertised this position in the Irish College of Ophthalmologists with a closing date of 21 January 2026 and, positively, several eligible candidates have applied. Shortlistings will commence on 27 February with interviews anticipated in mid-March 2026. The HSE expects to fill the role in the near future. The HSE has also confirmed that a clinical optometrist and orthoptist post were also advertised, with a closing date of 19 January. The recruitment of these positions will ensure the resumption of optical services for those living in the south Tipperary region.

The HSE has advised that patients from the Tipperary south area who have been unable to receive eye care due to this vacancy may, for urgent eye care issues, be referred to the eye service via the emergency department in University Hospital Waterford and that all patients have been notified of this additional referral pathway but I acknowledge that is not a suitable pathway for children. It is difficult presenting to a hospital like that.

The HSE has also engaged with the Royal Victoria Ear and Eye Hospital in Dublin with a view to supporting Tipperary south. It has undertaken discussions with a private agency and a scoping exercise has been conducted in this regard. Personally, I would much prefer to see the consultant in place and services resume. I know that the Deputy wants that as well. For emergencies, a scoping exercise is under way. I am actually pleased to hear that there were several applications which we did not have previously.

Deputy Michael Murphy

I thank the Minister of State. I welcome confirmation that there has been concrete interest and that a number of applicants have applied after the most recent recruitment drive. It is important that a permanent consultant ophthalmologist is in place at the earliest opportunity. I also support additional contingency measures and the scoping exercise referred to by the Minister of State, linking in with the Dublin hospital because we have waiting lists. I alluded to the fact 1,800 children, mostly under the age of five are on the waiting list, including Rory and Aoife, who were referred to my office. They are both under the age of five and were referred back on 10 October 2023. Today, I cannot give them any indication of when they may be seen. In early childhood, delays in vision care can unfortunately lead to damage. Parents should not have to travel to different counties, seek private care or wait a minimum of 18 months for assessment.

As I said, I welcome progress finally being made and I hope that through the latest recruitment process we will have a permanent consultant. I thank the Minister and the Minister of State for upgrading the post to a consultant level. I also acknowledge that the other key appointments are already in place. In essence, children cannot wait. They need appointments and they need them urgently. If we have a permanent ophthalmologist in place, we also need to focus on contingency measures that will assist in bringing down the waiting lists at the earliest opportunity. As I said, the children across Tipperary south need these appointments. It is an emergency.

Deputy Mary Butler

I can confirm that the post was upgraded to that of consultant medical ophthalmologist and obviously that may be one of the reasons it was not as sought after as it was. Several recruitment campaigns have been run and to date the HSE has been unable to fill the post. The post is funded as well, so it is not a financial issue. Several eligible candidates have applied in the latest recruitment campaign, which closed on 21 January. Shortlisting will commence on 27 February, with interviews anticipated to take place in mid-March 2026. The HSE has also engaged with the Royal Victoria Ear and Eye Hospital in Dublin with a view to supporting Tipperary south. It has undertaken discussions with a private agency and a scoping exercise is being conducted in this regard, acknowledging the long waiting list and the likes of the two kids the Deputy mentioned who have been waiting two years which is simply not good enough. I thank the Deputy and I will follow up on this again.

Hospital Facilities

Deputy John Connolly

I recently asked the Minister for Health for an update on the development of the elective hospital at Merlin Park in Galway. Looking back at some documents I have, I note that the elective hospital was first proposed in 2018. It was also included as part of the national Sláintecare programme. It has been included in every HSE capital plan up to 2025. The description in each of those documents has been for an elective hospital. In 2026, when the HSE published its national service plan, I noticed that there had been a slight change of language. It was no longer described as an elective hospital but as an elective care centre. Following that, I put this question to the Minister which was referred on to local HSE officials as commonly occurs but the response I received is quite concerning. It stated:

The HSE have identified the need to refine the scope and budget of the planned Elective Care Centres.

[...]

The result was a substantial reduction in the building area and in turn, overall cost. [The original building area in the scoping document had been for a building of between 60,000 sq. m and 80,000 sq. m] The design team are currently investigating the possibility of expanding or bolting-on the new facility to what will be an Operational Surgical hub.

It is hard to consider that this is not a serious reduction in what had been planned as part of the elective hospital development in Galway. Furthermore, I am advised that the new facility, or care centre as it will now be called, will consist of two operating theatres, where the original plan had been, I think, for 11 operating theatres, five endoscopy procedure rooms, where I understand there had been eight procedure rooms in the initial resource requirements, and ten minor operation procedure rooms. In the elective hospital there were also plans for radiology and diagnostic modalities, outpatient rooms and pre-assessment rooms and there was a proposal for 200 beds - 75 inpatient and 125 day case beds.

It comes as a deep disappointment to me, and I know it will to my constituents and indeed to the wider region, because part of this plan was to facilitate the decanting of the university hospital site in Galway, which is due for significant capital development and investment. I am concerned that not alone are we losing a facility where there was going to be 200 beds but this decision will not facilitate as easily the capital investment and expansion and development of University Hospital Galway, which is so badly needed.

I hope I am misinterpreting the response but I am concerned that I am not. A decision of such significance should have been discussed and debated further and possibly information should have been provided before that. In terms of the elective hospitals, my understanding was that Galway was part of a package that included an elective hospital in Cork and Dublin. Where do they stand as well?

Deputy Mary Butler

I hope I will be able to give the Deputy some clarity. I thank him for asking the question, which I am answering on behalf of the Minister for Health. I acknowledge the Deputy's dedication to the people of Galway and beyond on raising these important health issues. I can assure him that the Government is committed to increasing elective-only day case capacity through the elective ambulatory care programme. This is being delivered in two phases, a national network of surgical hubs in the first instance to meet medium-term demand and capacity and, in the longer term, a national network of elective treatment centres in Galway, Cork and Dublin.

In relation to the surgical hubs, developments are well under way and a new hub is due to become operational at Merlin Park later this year, along with hubs in Cork, north Dublin, Limerick and Waterford. This will build on the success of the two hubs already opened, namely, the Reeves Day Surgery Centre in Tallaght and Mount Carmel surgical hub facility in south Dublin, which have reduced waiting times. The Galway hub will deliver thousands of procedures and treatments every year. As announced last July, surgical hubs are also in development for Sligo and Letterkenny to provide additional day theatre capacity in the west and north west.

In relation to the elective treatment centres, also known as elective hospitals, we remain committed to developing these in Cork, Galway and Dublin. As the programme has developed and evolved, the HSE has determined the most appropriate design for the new facilities. The introduction of the surgical hubs was not originally envisaged when elective hospitals were first proposed. The significant additional capacity being provided by these hubs has been an important factor in determining the model for the centres going forward. I understand the HSE has been considering how best to deliver elective care at Merlin Park. As the Deputy is aware, the HSE is considering extending the surgical hub. I understand that the design team is working through this and further details will be available in due course. The HSE expects to be in a position to apply for planning permission in the middle of this year.

The new elective treatment centre in Merlin Park will have six operating theatres - I think the Deputy referred to two - five endoscopy procedure rooms and ten minor operation procedure rooms.

This is a significant addition of capacity and will make a real difference to patients. This is not a reduction in ambition. I want to be clear about that.

As the Deputy knows, there are no beds at elective facilities and there is no intention to provide them. These are not for inpatient care. These are for people to get the procedure they want and to get them home to their own beds in a timely manner - in and out the same day. The intention is for the elective facilities to provide day case procedures and treatments, for example, those which do not require an overnight stay. Patients will arrive at and leave the facility on the same day. The development of the elective-only facilities I have outlined will also mean that capacity is freed up in existing hospitals for more complex or emergency acute cases.

I understand where the Deputy might have had confusion in relation to how many theatres there are. When the surgical hub was proposed for Waterford, it was designed to have two. It has since been upgraded to four. It will be operational by the end of the year. There is a real push for these surgical hubs. Two of them are open in Dublin. They are being built around the country to take pressure off the acute hospitals. These will be staffed separately. Sometimes elective surgeries are cancelled. This will not be the case.

I hope the Deputy can see that we are committed to improving elective care in Ireland. The plans we have in place are already making a real difference and helping to drive down waiting times. I look forward to the Deputy’s continued engagement on these issues.

Deputy John Connolly

The first thing I should have said is that I appreciate the Minister of State being here as a Minister of State in the Department of Health to take this question and provide an answer. However we present this, it is a significant change in what was to be the provision of a facility that had intended at its outset and up to 2025 to provide for 200 beds. I recognise fully the point she made that these are day procedures but I understand from the documentation that had been provided previously that there were to be 75 elective inpatient beds and 125 day case beds. That had been the position up to March 2025, when I had previously asked for an update. I was advised that the integrated design team was working at pace to progress the detailed design to inform planning submissions on a range of statutory and regulatory approvals to proceed to tender and construction. That was for the elective hospital. It had been perceived to be the development of a 200-bed facility. I understand some of those were only for day case beds.

In terms of my reference to there being two theatres on top of the surgical hub, the information that I received from the HSE describes that the elective care centre will consist of two operating theatres plus four operating theatres in the surgical hub. We were always conscious and always felt that there were two developments here, namely, a surgical hub and an elective hospital. I want to reiterate that the development of the elective hospital was seen as something that could facilitate the increased development at the regional hospital site of the university hospital site. As far as I understood it, the plan had always been that elective non-emergency, non-acute outpatient facilities would all move to the Merlin Park site and that the university hospital site would be for acute, high-tech procedures, cancer care, maternity and accident and emergency. I am really concerned about that plan now. I am really concerned about the progression of that plan. We need clarity on that.

Deputy Mary Butler

I thank the Deputy. In relation to the elective treatment centres, known as elective hospitals, the HSE and the Minister remain committed to developing these in Cork, Galway and Dublin. They will take longer to develop. In the short term, as the programme has developed and evolved, the HSE has determined the most appropriate design for the new facilities. The introduction of the surgical hubs was not originally envisaged when elective hospitals were first proposed. The significant additional capacity being provided by those hubs has been an important factor in determining the model for the centres going forward. I am not in a position to answer the Deputy's question. I have been in Merlin Park previously visiting mental health services but I cannot answer the Deputy's question in relation to where it will be located. I would be of the mind that if you are going to have an elective hospital with overnight beds, that colocation is important beside a model 4 hospital. Maybe that is the reason behind it but I am only thinking out loud. This is my sixth year in the Department of Health. I understand that decisions are made at times. A lot of people are on waiting lists for elective surgery. We have already delivered two new surgical hubs that are operational. A couple more will come on stream this year. I think what is being proposed for Galway is both. This states clearly that the Minister remains committed to developing the elective hospitals in Cork, Galway and Dublin but while we await those, the surgical hubs will be in place. That will take down a huge amount of capacity for his constituents who are waiting for treatment.

Disability Services

Deputy Louise O'Reilly

I acknowledge the presence of my colleague, an Teachta Robert O'Donoghue. Along with our constituency colleague, Deputy Boland, we have been working with a number of groups in our area to try to secure long-term housing solutions for persons with disabilities. This morning, I want to focus specifically on one service. It is an organisation known as Remember Us. I will not try to tell the Minister of State what my view of Remember Us is but I will tell him in her own words what the founder, Nora Roban says. When she was asked why Remember Us, a club for children and adults with special needs, was set up, she said:

The answer is simple. My son Paul has special needs. It is absolutely vital for people with special needs to develop their social skills and self-esteem early in life, to help integrate into society. I instinctively knew that without developing this side of his life he would always feel inadequate and isolated from society. This would inevitably lead to even greater problems as he got older. After years of searching and failing to find such a place, I decided to set up Remember Us, for Paul and for other children like him.

The key here is about integration and that feeling of not being isolated. I know that there are clubs like Remember Us and services like those of Prosper Fingal across the State. They are working really hard to provide services. However, we attended a meeting just before Christmas in the building that Nora runs Remember Us out of. We met with parents there. They all had one concern. This will not be new to the Minister of State and I thank him for being here this morning to take the Topical Issue. They all had one concern. That concern is around what will happen to their loved ones, their adult children, when their parents are no longer able to care for them. We are talking about people who are in their 60s, 70s and in some cases in their 80s and older, who are absolutely terrified at the prospect of their loved ones having to go into a nursing home. I think we can all agree that a nursing home is not an appropriate place for a person. A nursing home is a place for an elderly person, not a person with disabilities, intellectual or physical disabilities.

I, like others, was somewhat shocked when I read Fergus Finlay's column when he wrote that he had seen a letter that had come from the HSE. It advised a parent that they are legally obliged to support their daughter, and that includes the provision of accommodation - accommodation that will go on after the parent has died. It is not within the gift of parents to provide that. What I am asking the Minister of State to do this morning is to perhaps outline for me what kind of joined-up thinking is happening. There is nothing more certain than these young people becoming young adults and older people. There is nothing more certain than that their parents and loved ones will not be in a position to care for them. That is why the organisation Before We Die has been set up.

Some work is going on. I know Remember Us has ambitious plans in terms of establishing a small community of appropriately sized houses but it goes back to the foundation and the reason Remember Us was founded. It is about inclusion. It is about people with disabilities being in their own community, with their friends and in an environment that they are familiar with.

It is about ensuring they have that level of support.

Minister of State at the Department of the Taoiseach (Deputy Thomas Byrne)

Ba mhaith liom buíochas a ghabháil leis an Teachta as ucht an t-ábhar seo. Increasing the provision of disability specialist residential services is a key Government priority and there has been significant investment in residential services over the course of the last number of years. The overall budget increase in recent years, from €1.7 billion at the close of 2017 to almost to €3.8 billion in 2026, reflects the programme for Government commitment to investing in improving the lives of people with disabilities.

In addition to the ongoing funding and lifetime commitment to residential placements for almost 9,000 current residents, €65 million has been allocated to disability residential services in budget 2026 for new developments. That includes €40 million of funding that will provide in the region of 199 residential placements. This includes 72 new planned placements and 80 new unplanned urgent placements, a total of 152 new placements, as outlined in the service plan for 2026. From 2020 to 2025, 955 new residential places were provided to people with disabilities, which has undoubtedly had an impact in Dublin Fingal West. During 2025 alone, HSE Dublin and north east, which includes the Deputy’s constituency in north Dublin, provided 2,046 residential places for people with a disability, including the addition of 55 new placements.

The Government acknowledges that there is significant demand for specialist disability services across all regional health areas nationally. The increased demographics of people living with a disability, coupled with increases in life expectancy and changing needs, have all had a significant impact. In addressing these challenges – and, of course, opportunities, given that increasing life expectancy is an opportunity rather than a challenge - the Department of Children, Disability and Equality is engaging with the Department of Housing, Local Government and Heritage, housing authorities and the HSE to explore means of responding to the need for additional capacity, which can assist forward planning and cost-effective placements.

The national housing strategy 2022 to 2027 places responsibility for the provision of housing with the Department of housing, working in conjunction with the HSE to provide supports related to individual care needs. The HSE and local authorities are working together to map the need and develop and advance plans for delivering housing to people with disabilities. Local housing and disability steering groups and regional forums have been established to progress the implementation of the national housing strategy for disabled people and these forums facilitate collaborative working between local authorities, the HSE, approved housing bodies, AHBs, and voluntary service providers.

The Department of Children, Disability and Equality continues to engage with the HSE to explore various ways of responding to demand while appropriately managing the significant levels of funding provided. Dedicated housing co-ordinators have been appointed to assist with placement planning and identifying housing options for people with all levels of disability.

I am informed that HSE Dublin and north east provides and funds a range of services and supports for people with disabilities, including those residing in Dublin Fingal West. Supports include day services, respite services, residential services, home support and personal assistance. I assure the Deputy that HSE Dublin and north east continuously works to improve the availability of supports to individuals in the area, including the residents of her constituency.

I reiterate the importance of ensuring we continue to support people with disabilities to live meaningful and fulfilling lives, with a person-centred approach throughout the broad spectrum of services provided.

I do not know if I should be declaring an interest because my wife is a nurse manager in this very area, Fingal. I do not know if I am meant to declare that or not.

Deputy Louise O'Reilly

That response was fairly disappointing, and I am saying that with as much respect as I can muster. The Minister of State stated, “From 2020 to 2025, 955 new residential places were provided to people with disabilities, which has undoubtedly had an impact in Dublin Fingal West.” It would have been nicer if he had got the figures and told me how many places relate to that constituency, if any.

The question that was put was about community-based housing. It was not necessarily about residential care. There is a looming crisis, whether the Government acknowledges it or not, that relates to people who are ageing in the community. It is brilliant that people are living longer, thanks to the work of the Minister of State’s wife, her colleagues, the families and all the rest. People are living longer and that is a good thing, but they will outlive their parents. That is also a good thing, but their parents are concerned about what will happen to them.

The Minister of State said dedicated housing co-ordinators have been appointed. In his response, he might explain exactly where they are based. A name and phone number would be brilliant, and while I would not ask him to put that on the record, he can tell me who the person is for my area of Dublin - or rather our area because an Teachta O’Donoghue is here too - Dublin Fingal West. Who is that person and how can they assist with the provision of long-term housing? Residential is extremely important, and if the Minister of State had the exact figure with him, I would be able to match that against the number of people on the waiting lists, but that is only one aspect of what is needed. Community-based housing means people can age and live in their community and be with their friends, which is so important to the families of Remember Us. They told us very clearly that that is where there needs to be some focus.

Deputy Thomas Byrne

I will gladly ask the Minister of State, Deputy Higgins, who cannot be here, to send that exact information to all the Deputies and representatives in Fingal. That is a reasonable request but I just do not have it to hand.

Deputy Louise O'Reilly

No, that is fair.

Deputy Thomas Byrne

Once again, I thank the Deputy for raising this important issue, which is a priority for the Government. The Government recognises that there is more to do to improve the lived experience of those with a disability. The increase in the disability budget for 2026 further demonstrates the multiple commitments made in the programme for Government commitment to improving the lives of people with disabilities and making a difference.

The ambition of this Government is to bring about a step change in services for people with a disability in Ireland and we are committed to the expansion and reform of disability services in order to maximise people’s independence and support them to live ordinary lives in ordinary places like everybody else does. This is reflected in the very significant investment being made in specialist services recently. In 2026, we are supporting another 199 residential supports for people with disabilities.

While the strategy, policy direction and overall allocation are a matter for the Minister, funding allocations to regions and individual service providers at a local level is an operational matter for the HSE. The Department, in conjunction with the HSE, will always strive to ensure disability services are delivered in an equitable manner across all regional health areas as effectively as possible to ensure maximum benefit for those who require services.

I assure the Deputy that this Government is aware of the challenges present across all regional health areas and that the Department is working alongside the HSE to address these challenges and increase the provision of services, including residential services of the various types that have been mentioned in this debate.

Rental Sector

Deputy Danny Healy-Rae

I am glad to get the opportunity to raise this problem at the Topical Issue forum today. I hope the Minister will take it seriously. I do not want to be laughed at like I was last week when I asked a question here. This is serious business for anyone who does not have a home and is trying to find a property to rent. In many instances, they can be hit with a traumatic event that they were never ready for.

Since the Residential Tenancies Bill was mooted last year along with the idea that people would have to rent out houses for six years, many people have decided to get out. Hundreds of people have been to my office after getting a notice to quit and finding themselves with nowhere to go. One fellow came to me out of the back of a transit van, which is where he is staying. I have dealt with a lady with two young children – in fact, I have dealt with several such cases - bawling crying every Saturday in Killarney. A number of them are in to me constantly.

The tenant in situ scheme would be a great scheme if it was working properly, but Kerry County Council says it cannot buy houses with the tenants in them because it is not being funded by the Department for any repairs or works that would be needed for it to buy the house.

This is wrong as Kerry County Council could rent it back to the tenants at local authority rent prices and perhaps later sell it to the tenants when they get on their feet. All of us elected to this Chamber support the tenant in situ scheme to allow families to continue renting. As I said, if the tenants get on their feet, they could end up buying out the council. Will the Minister look at this scheme and sort it out, especially in Kerry? I do not know whether it is happening in other places.

There are many vacant houses in our county. I gave the example previously of there being 54 between Kenmare and Kilgarvan, and within six or seven miles of Killarney town. People could step onto the TFI bus between Kenmare and Killarney, which passes every hour. It is a crying shame that so many of these are vacant when people are looking for houses. Will the Government dedicate a team to go around to see what would help people or incentivise them to rent the houses?

The biggest problem is the fear people have that they will not be able to get the house back if they rent it out. There is a scheme for Ukrainians where €600 is paid by the State to the landlord tax free. The most important thing there is that if the landlord wants the house back, in that instance, they can get it within four weeks, not months and years as happens in many other cases. That has turned many landlords off because they cannot get their houses back when they want them. I will give an example. A man bought a house in Killarney but could not come back from Australia for 12 months. Someone begged him to rent it to them and he did so but when he came back from Australia after the 12 months, he could not get into his house for three years. Those are the blockages that need to be removed to ensure people rent out these vacant houses. There are many of them around the country. I ask the Government to deal with that.

Minister of State at the Department of Housing, Local Government and Heritage (Deputy Christopher O'Sullivan)

I thank the Deputy. Fair play to him for advocating, especially on behalf of those who are coming in to him in desperation and looking for a house to rent. I understand the frustration. We all have it in our constituencies. I will try to outline what the Government is trying to do to free up rental accommodation.

Ireland's new housing plan, Delivering Homes, Building Communities, is a wide-ranging action plan focused on housing supply and targeting homelessness. The plan contains a suite of actions that will increase the supply of much-needed rental accommodation, by keeping existing landlords in the market and attracting new landlords, while ensuring strong and balanced tenancy protections for tenants and landlords. The Government is establishing a more robust legal and policy framework to support increased investment in the rental market, to increase the choice for renters and, over time, reduce market rents. The Residential Tenancies (Miscellaneous Provisions) Bill 2026 is currently passing through the Houses of the Oireachtas.

To support an increase in available rental accommodation, the Government has also brought forward key measures, including a revised national planning framework enabling the zoning of significantly more land, and the revision of design standards for apartments. These measures, along with a reduced VAT rate of 9% on apartments announced as part of budget 2026, are focused on unlocking the delivery of apartments that is key to increasing the supply of rental properties.

The Government is also continuing the development of cost rental as a new tenure type, which means providing homes to tenants at least 25% below market rent by providing significant levels of funding support to the Land Development Agency, LDA, approved housing bodies, AHBs, and local authorities. While it has been asserted that landlords are leaving the rental market, the Residential Tenancies Board, RTB, director's report shows that while 5,405 notices of termination were received by the RTB in quarter 3 of 2025, 18,425 new tenancy registrations were also confirmed for the same period. This figure serves to highlight the consistent churn within the rental market.

The Deputy suggests using the tenant in situ scheme to address the scarcity of rental accommodation. The tenant in situ scheme, as has been referred to, is an acquisitions programme specifically in respect of those who are at risk of homelessness and already qualify for social housing support such as the housing assistance payment, HAP. The Deputy has outlined many of those situations. Some €375 million was provided last year for local authority acquisitions. It is an emergency measure and should only be used by local authorities as a last resort when all other options to prevent homelessness have been exhausted. Our focus must be on constructing new social homes but I note that significant funding will be provided through our acquisition programme of second-hand homes for those at risk of homelessness, again under the 2026 programme, as a response to short-term pressures, affording local authorities the flexibility needed to respond while they scale up their construction programmes.

The Deputy also suggested the vacant property refurbishment grant could be used to address the scarcity of rental accommodation. This scheme provides a grant of up to €50,000 for the refurbishment of homes that have been vacant for at least two years and up to €70,000 where it is a derelict property. It is available in respect of homes for occupation as a principal private residence and properties that would be made available for rent. It, therefore, increases the supply of homes available to rent and it could address the issue of the plethora of vacant houses the Deputy referred to.

In providing a grant to support the refurbishment of vacant and derelict properties, individual landlords, who without the support of the grant would not be able renovate and turn these disused properties into homes for rent, are being incentivised. It has become a vital affordable support, particularly in more rural areas where supply of new housing is not readily available. It is also supporting the regeneration of towns and villages and areas of our cities, as well as supporting environmental objectives. I look forward to hearing more of what the Deputy has to say about this issue.

Deputy Danny Healy-Rae

I ask again about the tenant in situ scheme. The Minister of State said money has been allocated to it. Will he talk to Kerry County Council to see what is wrong and why it cannot operate the tenant in situ scheme?

Elected members in Kerry have been asking the local authority to buy land banks to build local authority houses in small villages, such as Scotia's Glen, Gneeveguilla, Firies, Curragh, Currans and all these places. I hear the council is slow to buy these land banks because it will be hit with the residential zoned land tax. Is that right? That is serious. Where is the proposal to allow granny flats to be built behind residential properties? It was mooted about 12 months ago but nothing has happened since. Where is the proposal on modular homes? I do not see them materialising in Kerry. It was to be a faster way of delivering housing.

The problem, which I raise here continually, is that many people in Kerry cannot build a house of their own because they cannot get planning permission. Who is dealing with that? Is it going to be sorted out? It is time it was. God damn it but if these people go to the expense of trying to build houses for themselves, surely the smallest bit of help we could give them is to give them a fair crack at getting planning permission. This urban regeneration clause is causing severe difficulty far from towns where people who never lived in a town are being denied the right to build houses. Will the Minister of State please do something about those things?

Deputy Christopher O'Sullivan

The proposal on modular homes or small units in back gardens or on the premises of existing homes will come forward shortly. It is really important. It will be an exemption for a certain size of dwelling to allow young people in particular, who want to start off with a home, to build with an exemption so they do not have to go through the arduous planning process. As a west Cork TD, I completely agree with the Deputy about the challenges young people are facing in getting planning permission to build on their land. They have to go through obstacles and barriers and it causes them frustration and headaches and in many cases they are not successful. That has to change. In the next while, we will bring forward the national planning statement, which I hope will address many of those issues.

I will address another issue that has been topical in recent weeks. The Deputy spoke about the number of vacant homes and properties not in use throughout the year. The whole aim of the short-term letting legislation, which is being brought in and which has been controversial - and I can see why - is to try to bring more property into rental accommodation.

The constituents the Deputy has coming into his office and I have coming into my office are struggling to get rental accommodation because they go onto daft.ie or these rental sites and there is nothing to rent. The whole idea is that we get some of these houses back into the rental market and that will release a pressure valve. The Deputy is from Kerry and I am from west Cork; we rely on tourism and on tourism accommodation. It is important we have these short-term lets available for the tourism sector. There is no doubt about that. Someone recently referenced a figure to me that in the region of 6,000 units were available for short-term lets in the west Cork area. If we could even get about 200 of them back into the rental market, imagine the pressure that would take off? I understand the need for short-term letting. I understand people have been doing this for years and we have to clarify the planning requirements but this provides an opportunity to allow people to rent long term, which is a big issue is places like Kerry and west Cork.

Dáil Éireann díospóireacht -
Wednesday, 18 Feb 2026