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Dáil Éireann díospóireacht -
Wednesday, 30 Sep 2026

Vol. 1091 No. 4

Saincheisteanna Tráthúla - Topical Issue Debate

Motor Fuels

Gabhaim buíochas leis an Aire Stáit as ucht teacht isteach chun an cheist seo a fhreagairt. HVO is hydrotreated vegetable oil. Essentially, it is a substitute for diesel. The interesting thing about HVO is that it does not require engine modifications or new infrastructure. People who wish to use it as a substitute for diesel do not need to spend money on changing their engines or modifying systems in order to use it. What is even more interesting is that it can achieve a 90% reduction in carbon emissions when it is utilised and it emits far less carbon monoxide, nitrous oxides and soot generally compared to diesel. As a fuel it is incredibly advantageous to us at a time when we are trying to cut emissions. We know that transport is particularly targeted for emissions cuts. Although it has decreased emissions in the past year by 1.8%, the sector is about 8% behind where it is supposed to be.

As we talk about climate emissions and climate targets, and we talk about trying to put in place systems to help us meet these targets, this is a key tool. It will not do it on its own but it is a key way in which we can do it. The difficulty is that we have no incentive for people to use HVO instead of diesel. There is not nearly enough information out there for people using diesel cars to allow them to understand that HVO is there as an alternative. I know Government policy relates to EVs and the infrastructure that goes with them, and I support the proliferation of electric vehicles as they are a hugely important part of our climate solution, this will take time. We have seen a ramp up in the purchase of electric vehicles and this is very welcome but this is the here and now.

This issue goes across a number of Departments, including transport, energy and finance. In the week that is in it, next week there will be a real opportunity for us to incentivise HVO as a fuel for all cars. What can be done? HVO is subject to VAT and the same mineral oil tax as diesel and other fuels. VAT is obviously something that cannot be modified or changed in relation to one product or another subject to the VAT directive of the European Union, so I understand it is not something the Government can tinker with. However, the mineral oil tax is something that can be changed. We can change the liability in relation to HVO in mineral oil tax and the extent to which it is liable. This is something we are permitted to do under European law and it is not restricted by the VAT directive.

There is a key tool at the Government's disposal now. We can incentivise the use of HVO. We can incentivise for people a fuel that does not require them to change their engines or require new infrastructure, and which would reduce carbon emissions by 19% and reduce harmful emissions from carbon monoxide and the soot that comes out of diesel engines. To my mind this is an obvious thing to do and I do not understand why we have never done it. This is not the first time I have raised it here. There is an incentive to do it from the point of view of the State because we want to reduce emissions. There is also a situation whereby very few people are using HVO. There would not be a massive revenue impact from it if we were to incentivise it.

We are now in the context of a fuel crisis. We are aware we cannot control the wholesale price of fuel in this country because of wars in Iran, in the Middle East and in Ukraine. We understand the crisis is there. We came back at the end of August to vote to ensure the reduction in the excise on fuel continued because we know we have to safeguard it. We are talking about doing this and reducing the carbon tax but here is an intensively positive carbon measure that we can incentivise through the budget next week to reduce the liability for people using HVO, and to do so in tandem with a campaign to show people who are driving diesel cars. We recognise the reality that diesel cars are necessary but that there is an alternative there for them that is better for all of us.

I thank Deputy Ward for raising this matter in the House today. The Government recognises the environmental benefits of incentivising the uptake of transition fuels such as HVO in place of heavier pollutants such as auto diesel. While HVO has a part to play in the here and now, Ireland must, nevertheless, move to more sustainable methods of transport in the medium to long term.

In relation to private transport the Government remains committed to incentivising the uptake of more electric vehicles, something which Deputy Ward also welcomed, on the road in place of internal combustion engines. This must remain the ambition. In the first half of this year electric vehicles were the leading individual fuel type for new car registrations. That being said, the Government understands the transition to decarbonise Ireland's existing vehicle fleet will take some time.

As Deputy Ward may know, the mineral oil tax treatment of biofuels, including HVO, already financially incentivises biofuels over fossil fuels such as diesel. Biofuels produced from biomass qualify for a full relief from the carbon tax, thus incentivising the uptake of more sustainable and renewable fuels. In the case of blended fuels the biofuel relief applies to the biofuel portion. The rate of the carbon tax relief for biofuels such as HVO used in place of auto diesel is around 23 cent per litre on a VAT inclusive basis. This, it must be acknowledged, is already a significant relief. As biofuels are relieved of the carbon component of mineral oil tax, they are not impacted by annual carbon tax increases. As a result, the mineral oil tax rate differential between biofuels and fossil fuels will continue to widen as the ten-year carbon tax trajectory up to 2030 is implemented, thus incentivising further uptake of biofuels.

Furthermore, the renewable transport fuels obligation scheme under the remit of the Minister for Transport obliges suppliers of mineral oil to ensure that a percentage of the motor fuel they place on the market in Ireland is produced from renewable resources. The target by 2030 is to deliver a 20% biodiesel mix, which will help to significantly reduce emissions.

The programme for Government also committed to examining the taxation of HVO used for commercial freight to support sustainable transport solutions and decarbonisation of road freight and commercial coaches with fuels such as HVO, hydrogen and biomethane. Work on these commitments is ongoing, including the examination in this year's and last year's tax strategy papers published by the Department of Finance.

However, it must be pointed out that the availability of renewable transport fuels, including HVO, will remain constrained given the current global product production capacity, the need for sustainable feedstock and increasing demand from various sectors to use renewable fuels in the decarbonisation journey. While tax levers can support policy measures, it is important to acknowledge that there is a limit to the role they can play in terms of price leverage.

The price of HVO is dependent on many factors. However, I assure the Deputy that the Government is conscious of the programme for Government commitment and it will continue to examine the potential to increase existing supports for HVO in recognition of the positive role it can play in our decarbonisation journey, as he set out.

I thank the Minister of State. I acknowledge what she has said. I note what she said about the commitment in the programme for Government to examine taxation in relation to HVO. I agree with her in relation to EVs, and I welcome that EVs were the more sold vehicles in 2025. I presume, and hope, that this will be even more the case in 2026.

In relation to carbon tax, I acknowledge what the Minister of State said regarding it not applying to biofuels, as is appropriate. The notion that this is the only incentive that we are really willing to countenance to encourage people to use HVO is, I think, shortsighted. This is particularly the case if we are going to be talking in the budget next week about reducing carbon tax generally to alleviate the burden on individuals and households. If that is the case, then we will be eradicating the incentive that is there to use HVO. When we have HVO as a fuel that emits less carbon, 90% less carbon, and reduces harmful gases like nitrous oxides and carbon monoxide, as well as soot, there is so much behind the idea that we should incentivise the use of HVO.

I do not think it is enough to say, then, that the incentive will be the widening gap over time, as the carbon tax increases, between ordinary, standard auto diesel and biofuels or mixes with HVO. We can take positive action now. We can reduce the mineral oil taxation when it comes to biofuels, particularly in the case of HVO. We know that is something that will directly impact our attempt to meet our climate objectives in terms of reducing emissions and to encourage people to use HVO, which is a much better and sustainable fuel and one we can somewhat control in a way we cannot control the imported petrochemical products that come from the Gulf and other parts of the world.

An obvious track is available to us next week. If we actually take the step of saying that HVO is something that people should be using, it will benefit everyone. It will benefit the State, the environment and the individual citizen. We have an opportunity next week to do that. It will be a real missed opportunity if we do not, and it does not make sense if we do not do so.

I thank the Deputy for his further comments. As mentioned, the tax treatment of 100% HVO used in place of diesel is already incentivised through the tax system. On a VAT-inclusive basis, 23% less excise duty is charged on 100% HVO fuel when compared with auto diesel. The renewable transport fuel policy also sets out a pathway for the achievement of the climate action plan biofuel targets and EU renewable energy directive targets for an increased share of renewable energy in transport. This is achieved through the renewable transport fuel obligation, RTFO, which obliges mineral oil suppliers to ensure that a percentage of the motor fuel they place on the market in Ireland is produced from renewable sources.

Sustainable renewable transport fuels, such as HVO, provide immediate climate mitigation benefits, as the Deputy outlined, utilising the existing vehicle fleet. They will, therefore, continue to play an important transitional role in the decarbonisation of transport in the coming years as the shifts to electrification and further increases in public transport and active travel are fully realised.

I note that a study on the hierarchy of the use of HVO across transport and other sectors has recently been finalised by the Minister for Transport. The report addresses the most efficient use of HVO relative to available renewable energy and zero-emission alternatives across all transport modes, as well as HVO use in non-transport sectors. The report produced a hierarchy of use of HVO, which aligns with several existing policies and measures, including the sustainable aviation fuel task force report, the road haulage strategy, the renewable transport fuel policy, the ports policy and the design of the renewable heating obligation. This will also inform ongoing policy for renewable energy in transport.

Ultimately, HVO is a commodity traded on the open market, the price of which is susceptible to global market supply-and-demand factors like crude oil, and there is only so much the tax system can do to incentivise its use. The Government, though, has acted to ease the burden of recent increases in fuel prices, as we saw last April.

Health Services

Can the Minister of State imagine a person's husband or partner being diagnosed with Alzheimer's disease in their late 50s, then having to search for a nursing home with an Alzheimer's-specific dementia unit when they are 65, and just when they have settled into their new home, they are being evicted? Can the Minister of State imagine that? Can he imagine a person whose mother had passed away over the summer then being told their father has to find a new home after eight years of living in the Sarsfield Court dementia-specific unit? This is a unit where the patients are loved and cared for by the staff and their families do not want to see them moved from it.

A man in his 80s contacted me. His wife is in the Sarsfield Court dementia unit. He lives not far from it, and he walks to it or gets a spin from his neighbours, brilliant neighbours, who bring him there. He goes there four or five times a week now. If his wife is evicted from Sarsfield Court on 10 or 12 October, he might not be able to visit her that often. He might only be able to go once or two times a week. This is the love of his life. Margaret is her name. She worked in Sarsfield Court for 20 years, and when she went in there as a patient, the nurses and staff brought her in with the love of friends. It was like a family. Her husband, Eddie, tells a beautiful story about when they were together. They are 50 years married this year and 54 years together, and now Margaret is facing eviction. This is the love of Eddie's life and at a time when she needs him, he is trying to stand up for her because he believes that to move her and the other seven or eight patients out of Sarsfield Court is wrong.

Can the Minister of State explain to me why the Government is closing the Sarsfield Court dementia unit? The reality for people who have family members there is that not one of them wants to see their family members moved. Sarsfield Court has about 99 acres of green fields and trees. This is a beautiful setting. I know the Minister of State is going to tell me the mental health unit is being moved down from the second floor because those patients do not have access to the outside area but that is the HSE's fault. There is another unit very close to it in Sarsfield Court. You could puck a sliotar to it. It is unit five. If a small bit of investment was put into it, the mental health patients could go in there and the dementia patients could stay in their home.

This is their home. Moving these patients is an insult to their families. It is an insult to people who have worked all their lives and now they are suffering from Alzheimer's disease and dementia, which is an absolutely horrible disease. The State, the Minister of State and his Government are evicting people from their homes. How can the Minister of State stand over it? I plead with him today to stop the closure of Sarsfield Court dementia unit in Glanmire. I could fill that unit today.

The Minister of State will know that I have also raised the issue of Heather House, where a new unit is to be opened with 17 beds. What is the point of closing 16 beds in Glanmire to open 17 in St. Mary's? We need more beds for people with dementia and Alzheimer's disease. Since 1954, Sarsfield Court has been a hospital. That is as long as I have been alive.

Slowly but surely, the Government and the HSE have taken the decision to wind it down. I am looking for answers as to why.

I thank Deputy Gould for raising this important matter. As he is aware, unit 1 in St. Stephen's Hospital in Glanmire, County Cork, is a designated centre for older people registered by HIQA. Eight residents are residing in the dementia-specific unit. Unit 1 is the only older persons' residential facility on the grounds of St. Stephen's campus because all other operational units on the site are being utilised to deliver a range of services under the registration of the Mental Health Commission.

HSE south has advised me it has taken a decision to deregister unit 1 as an older persons' residential facility with HIQA, with a view to re-registering the unit with the Mental Health Commission to better co-ordinate the mental health services on site because they will now come under the registration of the Mental Health Commission. The Deputy spoke about his constituents. I fully appreciate this is a difficult time for residents of unit 1 and their families. The HSE has advised me that all eight residents in unit 1 will be transferred to residential care facilities deemed to meet their particular care needs, preferences and choices. Furthermore, all residents will also transfer to the new accommodation in a phased and planned manner.

This will be done very much in consultation with the residents and their families. Nothing will happen until they are satisfied with the move. The HSE has advised me that it is engaged in a comprehensive process of engagement, consultation and planning with residents, family and staff, which commenced on 28 July. Once all residents and their families have had an opportunity to look at alternative accommodation options and a full assessment of each resident's individual care needs has taken place, the HSE will commence transferring residents to their new homes in a safe and respectful manner.

The HSE expects that the eight residents will transfer to older persons' residential facilities in the Cork city and east Cork area. Significant works have taken place in recent years to provide additional places for older people in the south west, allowing HSE South West to provide the best possible care for older people in high-quality environments. These include the new state-of-the-art 50-bed Midleton community nursing unit, which opened recently, and the 105 beds in St. Finbarr's community nursing unit in Cork city, which is expected to open in quarter 4 and will include 30 new dementia-specific beds. This is in addition to what the Deputy has already referenced.

A new 17-bed dementia-specific unit in Heather House in Gurranabraher in Cork city has recently been registered with HIQA and is expected to open in quarter 4 of 2026. It is something I have taken a personal interest in. I want to see it opened. I agree with the Deputy that we need additional dementia-specific beds. Seventeen will come on stream in Heather House and another 30 will be available in the new unit in St. Finbarr's in Cork city, which is scheduled to open in quarter 4.

The opening of new community nursing units is an absolute priority for me, the Department of Health and the HSE. I am absolutely committed, along with the Department and the HSE, to ensure that the care needs, preferences and choices of the constituents the Deputy represents are fully respected. I hope their transfer to new state-of-the-art residential facilities happens in a phased, safe and considered manner with the full consent of all residents and in line with the wishes of their families.

I want to be clear about what the Minister of State said. He said that nothing will happen until the families are satisfied and the situation has been worked through. I have met the families privately and there has been a public meeting. The families do not want their loved ones to be moved out of the unit. They fear for the health of their loved ones if they are moved. They were given a list of places in Cork and Kerry where they were advised to take their loved ones. Why would someone leave a place where they are safe, looked after and minded? It is not just a bed. The dementia unit is specifically for dementia patients and is their home.

The Minister of State and HSE have not answered my questions. Why are dementia beds being closed when there is a dementia bed crisis across the State, but especially in Cork? Will the Minister of State give me one reason that is happening? Families are looking for answers from him, but no one will give them answers. They do not want their loved ones to be moved. There is talk about being moved and transferred and care needs. We know their care needs are being met in Sarsfield Court. Why would patients be moved when they are being looked after?

There are eight empty beds in Sarsfield Cork right now where eight people with dementia could be cared for by staff. People love the staff there. The Minister of State said nothing is going to happen until the families are happy. They are not patients; they are residents. This is their home. I ask for a commitment from the Minister of State to keep the unit open. Will he explain why he and his Government are closing dementia beds? The families cannot explain it. Will he explain how this affects the rights of these citizens as human beings? They are being evicted. It is completely wrong.

Once again, I thank Deputy Gould for raising this important matter. I appreciate it is a difficult time for the residents and their families. As already stated, HSE South West has advised me it has taken the decision to deregister the dementia-specific unit for older persons in St. Stephen's campus hospital, with a view to re-registering the unit with the Mental Health Commission. I reiterate that the HSE is engaged in a comprehensive process of engagement, consultation and planning with residents, family and staff to arrange alternative accommodation for all eight residents residing in unit 1.

Residents and their families continue to engage with the general manager with responsibility for unit 1. The general manager remains available to meet any resident or family member to address any queries they may have. As I said, I assure the Deputy, the residents and their families that the HSE will only commence the transfer of residents to their new homes in a safe and respectful manner once all residents and families have had an opportunity to look at alternative accommodation and a full assessment of each resident's individual care needs has taken place.

The transfer of residents will depend on the assessed care needs of each resident and their choice and preferences. I welcome the assurance from the HSE that it expects the current residents in the south-west area to be transferred to older persons' residential facilities in east Cork and Cork city. A new 50-bed unit has opened in the community nursing unit in Midleton. There will be 30 dementia-specific beds and a new community nursing unit is expected to open in St. Finbarr's. Moreover, a new 17-bed dementia-specific unit, Heather House, in Gurranabraher in Cork city has recently been registered and is expected to open in quarter 4. Once again, I reiterate that the HSE, the Department and I are absolutely committed to ensuring that all eight residents can be moved to a new home of their choosing in a safe and timely manner.

Special Educational Needs

I want to raise an urgent and deeply concerning issue regarding the opening of a new special school in Balbriggan and the 18 children who have been allocated places there. Parents were given the news to a fanfare of local government and Oireachtas Members tripping over themselves back in April to be the first ones to announce on social media that the school would open in the 2026-27 academic year. Because applications had been made, places were allocated and families made decisions based on the information they were given at the time.

The parents I have spoken to have said securing special school places for children with additional needs has been hugely important to them. Families have waited and hoped for these places and when their child was finally offered a place, parents understandably believed that the arrangements were in place for their child to attend. In this case, however, that confidence has been completely undermined by a serious failure in communication. Throughout the summer, parents repeatedly sought updates. They were told that a meeting would take place in early August and that information about the opening arrangements would be provided, but no clarification came.

Towards the end of August, families were told to keep their children in their existing education placements. At that stage, however, it was too late. Instead, families were left believing the children were about to transition into their new school, only to discover at the last minute that this would not happen as expected.

If families had been clearly advised at the beginning of the summer that they needed to retain their child's existing school place as a contingency, they would have made those arrangements. They have also been offered home tuition, which my office has done its best to try to find but, unfortunately, that is also completely full. We are now talking about 18 children with additional needs who have already faced weeks without appropriate education provision and now could be facing into months of this. That is not a minor administrative inconvenience.

For a child with additional needs, school provides more than just a classroom education. It provides structure, routine, communication opportunities, social interaction, special support and a sense of security. When that is suddenly removed, there can be serious consequences. One family described their child as crying themselves to sleep, has asked through his communication device for his old school friends and has watched his siblings go off to school in the morning while he stays at home. His mother told me she feels completely lost in trying to advocate for her son. Since being out of school, that child has experienced increased distress, severe meltdowns, difficulties with sleep and regression in toileting skills that had taken huge time and effort to establish. That is the real-life impact of this situation.

It is important to recognise parents cannot simply recreate a special needs school environment in their home. Many of these parents are already providing huge levels of care. They are being asked to manage children whose routines and supports have been disrupted while trying to care for other children and maintain their own family responsibilities. I promised my constituents I would ask the Minister of State to confirm an opening date for the school.

When will these children be able to take up the places they have been allocated? Parents should not be left in limbo and expected to simply manage the consequences themselves. If a child were absent from education for weeks without proper explanation or arrangement, questions would be rightly asked. It is then equally reasonable for parents to ask who is accountable when their child is left without appropriate education provision because of a failure in planning or communication.

Will the Minister of State urgently provide a clear response to these families and a firm timeline for the opening of the school? These 18 children have waited long enough. They deserve their education, their routine, their friendships and the specialist support they need.

I thank the Deputy for bringing forward this very important Topical Issue today on behalf of the parents and children involved.

This Government is committed to the provision of additional special places for children with special educational needs. Budget 2026 has already provided funding for over 400 new special classes and at least 400 new special school places for the 2026-27 school year. It was intended this would create almost 3,000 new special education placements for 2026. This would be in addition to placements created due to the natural movement of students, such as those transitioning from primary to post-primary or those completing school.

In April 2026, the Government agreed to additional funding for the provision of special education services for children across the country. This money will fund special education teachers, SETs, additional SNAs, increased capitation, access to school transport for children in special education settings and start-up grants for schools opening new special classes and inclusive special classes. The year 2026 represents the largest ever expansion of specialist education in the history of the State. Through the combined efforts of the Department and the NCSE, 587 new special classes have been sanctioned for the 2026-27 school year, including 70 inclusive special classes. This represents an increase of over 40% in the number of special classes being provided in 2026.

The earlier sanctioning of new classes provides clarity for parents and allows schools more time for the planning and establishment of new special classes. The vast majority of new special classes being announced are being provided in available school accommodation which is being reconfigured as a special class. In total, over 4,300 special classes will be operating in mainstream schools next year, an increase of 130% since 2020. In County Dublin, 845 special classes are now in operation providing capacity for 5,070 students. This includes 140 new special classes for the 2026-27 school year. In April 2026, the Minister, Deputy Naughton, and Minister of State, Deputy Moynihan, announced the establishment of four new special schools, including the Deputy’s school in Balbriggan.

Dedicated working groups including the Department, the NCSE and relevant patron bodies continue to meet to support the establishment of the new special schools, which include a dedicated group for the school in Balbriggan. Offers of places have been made, as the Deputy pointed out, and new principals, teachers and SNAs are being recruited. It is intended that these new schools will open later in term 1 of this school year. The NCSE continues to advise parents at local level on developments. These bring to 20 the number of new special schools established in recent years.

As the Deputy is aware, an earlier notification deadline was introduced this year to support forward planning and to earlier equip the NCSE with local information as to what students would be leaving school, transitioning to post-primary specialist places or those seeking specialist placement or entering the education system for the first time. This information is critical when examining where provision needs to be placed to meet demand. The attentions of the NCSE and the Department have now turned to the 2027-28 school year and forward planning is already under way. The Minister of State, Deputy Moynihan, continues to meet the NCSE and senior Department officials each week to monitor the progress being made in providing planning for the 2027-28 school year.

I want to speak to the parents now. We have seen a 130% increase in school places since 2020, but that does not sit well for a parent or child who does not have a school place. I want to let them know the Minister of State, Deputy Moynihan, is doing everything he can to work with the Department and the NCSE to ensure no child is left without a school place. I acknowledge the angst those parents and children are going through in having their education disrupted like this, but I will make sure I speak directly to the Minister of State on this matter. I again thank the Deputy for raising it today.

I thank the Minister of State. Unlike some others here, I acknowledge more funding has been put into special schools and education this year. Budget 2026 has expanded service provision within the sector. However, I also know we are coming from such a low baseline that we have a lot to make up for. I know Minister of State, Deputy Moynihan, is doing his best - I have no argument there - but we saw the documentary this week with Alison Field having to go through 19 different special schools to find a place for her son. Some funding has been used to educate students in cupboards so funding must be used for quality education, which I am sure the Minister of State is doing his best to do, rather than piecemeal to give ourselves a pat on the back.

I previously suggested to the Minister of State that we could use the AIM model for children with additional needs transferring from early years into primary school, so we know the numbers we are dealing with. That should be seriously looked at, with this school in particular. I know from having been a councillor that expectations need to be managed so that scenarios that have played out with the announcement of this school and the miscommunications do not repeat themselves. The old adage, "If you cannot be best, be first", cannot be used, particularly when dealing with vulnerable students.

I thank the Deputy again. I outlined all the work the Minister of State, Deputy Moynihan, is doing. It is important to remember the vast majority of students with a special educational need are supported to attend a school, most of them in mainstream with a cohort attending special schools.

I once again acknowledge the parents. It is very important we bring issues like this to the House. I will make sure the Minister of State, Deputy Moynihan, is aware of this school and that the NCSE reaches out to those parents again. I think the Deputy's main message today was the miscommunication from the Department and that has to be addressed. I will make sure I bring that back to the Minister of State.

Health Services

Is the Minister of State taking the next item?

I am taking the fifth Topical Issue proposed by Deputy Cahill.

The next one is to the Minister for Health. We will wait for the Minister of State.

I am sharing this Topical Issue with Deputy McGrath about the crisis in community ophthalmology in south Tipperary. I have raised this repeatedly in the Chamber in other Topical Issue Matter debates and numerous parliamentary questions. This follows the planned retirement of Dr. Hillary, the community ophthalmologist working out of south Tipperary in August 2024. For reasons unknown to me, three recruitment campaigns have failed to recruit a new community ophthalmologist consultant. In the meantime, there are more than 2,300, I think, on the waiting list in south Tipperary. It may surprise the Minister of State to hear that 1,500 of those are children under the age of four, some waiting as far back as 2021. He can appreciate it is very difficult for me as a Teachta Dála representing south Tipperary when parents contact my constituency office - what do I tell them? I am sure as a parent himself the Minister of State will agree that when it comes to ophthalmology, early intervention is crucial. We were promised blitz clinics and a collaboration with the eye and ear hospital in Dublin. There is no evidence any of those initiatives have commenced. I am looking for an update on recruitment as well. We need that multidisciplinary team at the earliest opportunity so that the 2,300 on the waiting list can be dealt with as soon as possible.

I thank the Ceann Comhairle for choosing this Topical Issue. It is an important issue. Deputy Murphy put the figures on the record. I will do it again. Some 2,300 people are waiting, 1,500 of whom are children. It is an appalling vista two years on from Dr. Hillary's retirement, who was an exceptionally wonderful practitioner. She gave a year's notice she was leaving so this has been going on for three years. Why is the HSE so incapable of filling this position? We are told Waterford is now holding extra clinics to accommodate south Tipperary patients but this is not happening. Delays in identifying and treating eye conditions can and will lead to long-term eye problems. That is scientifically and medically proven. They have to be treated before the age of seven, which is a vital cut-off.

Why can we not have private fully qualified eye specialists do these tests on young children, to be reimbursed by the HSE? Clinics call to schools. A school in my area was called to recently. An initial screening is done and they are referred on but then they cannot get a test so they have to go private, which costs €50 minimum and then €300 to €500 for glasses. Will the Minister of State commit to ensuring children who require glasses, following private assessment, can still access HSE funding? It is a simple solution. I think it suits the HSE not have this position filled. It is appalling. The system works in other parts of the country. Surely it is in the interests of our children - mol an óige agus tiocfaidh sí. It is very basic that our children have a right to have their eyesight checked and treated if necessary. There is a roadmap by which it could be paid for until we get a permanent position or even a temporary one. Something is very wrong if after three recruitment campaigns the Government cannot seem to recruit a person, or does it want to?

I thank Deputies McGrath and Murphy for the opportunity to address the House today on an issue that I know has had an ongoing impact on many patients in south Tipperary. I am taking this Topical Issue on behalf of the Minister for Health, Deputy Carroll MacNeill, who I know is committed to reducing waiting lists for both adults and children across all our services be they provided in acute hospitals or in the community.

It is important to highlight that the HSE provides free optical services to preschool and national school children referred through child health and school health examinations as having sight problems. These services continue until a child reaches 16 years of age. The community ophthalmic services scheme allows medical card holders and their dependent children aged 12 and over to access eye care from contracted ophthalmologists, optometrists or dispensing opticians.

In relation to the Deputies’ specific question, the HSE has confirmed that the community ophthalmic physician post in south Tipperary became vacant in October 2024 following a retirement which they both referenced. In 2025, this post was regraded to a consultant in medical ophthalmology to align with the HSE’s national clinical programme for ophthalmology. This clinical programme for ophthalmology developed a model of care to realign eye care services from hospital settings to the community. The HSE has been developing multidisciplinary integrated eye care teams in accordance with this model of care. These teams facilitate assessment, diagnoses and treatment, enabling most patients to be seen in their own locality. The service provided by the previous community ophthalmic physician for south Tipperary operated across HSE south east community services with clinics in both Clonmel Community Care Centre and Cashel Medical Centre.

Since the vacancy arose in October 2024, the HSE has maintained a sustained focus on securing a permanent consultant ophthalmologist for south Tipperary. The post has been advertised on three occasions to date and recruitment efforts remain active. The position is currently being advertised nationally and internationally including through specialist Irish and UK ophthalmology publications. The HSE continues to pursue all available recruitment opportunities to attract suitably qualified candidates and restore permanent service provision to the south east.

Recognising the importance of maintaining access to care while permanent recruitment efforts continue, the HSE south east community service has worked closely with University Hospital Waterford to put interim service arrangements in place. All parents of children were notified of the temporary pause to the service and were offered appointments in University Hospital Waterford. The HSE has also explored other options to ensure service continuity, such as the use of external providers to increase capacity, overtime of existing HSE staff and the possibility of weekend blitz clinics at University Hospital Waterford. Funding has been secured to support delivery of the clinic and engagement with additional staff from another integrated health area is under way to support delivery of the clinic. The HSE has also sought to progress the multidisciplinary model of care, seeking to recruit optometrists and orthoptists to support the delivery of ophthalmology services. Furthermore, the HSE has undertaken a comprehensive validation exercise of all ophthalmology waiting lists in south Tipperary to support the prioritisation of patients and the planning of additional clinical activity.

The HSE remains fully committed to restoring a sustainable ophthalmology service in south Tipperary and will continue to pursue all available recruitment and service delivery options to achieve this objective as a matter of priority.

I thank the Minister of State for his reply. We now entering the third year of this crisis. These figures were made available to me back in December. There are 1,449 children under the age of four, 334 children between the ages of five and 17 and almost 600 adults on the waiting list, yet into the third year of this crisis we are still exploring other options. I was told in January or February of this year about the idea of a blitz clinic but that is still not in place. My appeal to the Minister of State is to engage with the Minister for Health to explore something I previously asked for, which is private provision, the temporary contract, and using the capacity in the private sector to outsource in particular for the children long on the waiting list until the blitz clinic in Waterford is up and running.

To read out that statement is totally out of touch with the situation. The figures are stark. Many of us are directing elderly people to Belfast to get cataracts done - the Belfast or Blind bus. I have eye issues. I understand how difficult it is. We are not even talking about the 500 adults waiting. It is pathetic that three years on, with Dr. Hillary giving a year's notice and with plenty of time that this position is still not filled. Something else is going on.

I demand that we use the private resources that are out there, as Deputy Michael Murphy said, to deal with our youngest and brightest people and give them a fair chance in life. We have Children First legislation and everything else here. These are basic needs that are being deprived to children in south Tipperary. It is not acceptable. The reply the Minister of State read out here today is totally unacceptable into the third year of this crisis. He talks about exploring options. There must be an emergency blitz. It is not correct to say that they are being dealt with in Waterford. They are not.

Gabhaim buíochas leis an Teachta. I call an tAire Stáit.

They do not even take them out of the hatch. They have too many there themselves.

Once again, I thank Deputies Michael Murphy and Mattie McGrath for raising this important issue, which I am taking on behalf of the Minister for Health, Deputy Carroll MacNeill, on the need for strengthened ophthalmology services in south Tipperary. I will make sure to let her and the officials in the Department know the specific views that were made here today in the House on behalf of their constituents in south Tipperary.

While recruitment of a permanent consultant has been challenging, I wish to assure the Deputies that sustained and proactive efforts are ongoing. A further recruitment campaign is now progressing and, informed by previous experience, it is focused on securing a successful appointment. In parallel, there has been progress on service delivery. The expansion of multidisciplinary teams, including additional optometry and orthoptic resources will help improve access and patient flow.

Collaboration with University Hospital Waterford is also delivering practical benefits through the evaluation of waiting lists and the provision of additional clinics. Taken together, these actions demonstrate a co-ordinated focused response. Urgent cases continue to be managed to ensure that patients with the greatest needs are protected while long-term solutions are advanced. The HSE remains fully committed to restoring a sustainable ophthalmology service in south Tipperary and will continue to pursue all available recruitment and service delivery options to achieve this objective as a matter of priority.

Like Deputies Murphy and McGrath, the Minister for Health's clear objective remains the appointment of a permanent consultant and the full restoration of ophthalmology services for south Tipperary. Work continues, including interim arrangements, to achieve this. I will personally bring the points made by both Deputies here today back to the Minister for Health, Deputy Carroll MacNeill, and departmental officials. The Minister for Health and I respect the mandate of the Deputies to come in here and represent their constituents in this particular matter.

Beidh an chéad ghnó eile ag tosú ag a 10 a chlog. We will suspend until 10 o'clock.

Cuireadh an Dáil ar fionraí ar 9.52 a.m. agus cuireadh tús leis arís ar 10 a.m.
Sitting suspended at 9.52 a.m. and resumed at 10 a.m.
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