In December 2017, I raised with the Tánaiste the case of Anthony Cole, the first person to bring an action concerning Lariam. That action had just been settled after the State sparing no expense in assembling a major legal team, with ten days of hearings over five months, before the Government threw in the towel.

The second Lariam case, of Mr. Patrick Fedigan, was settled two weeks ago, again on the steps of the court and after enormous cost and delay. What on earth is going on here? Not only is the Government not dealing with the existing cases of Defence Forces personnel who have experienced devastating health consequences as a result of taking Lariam but it is actually potentially adding to their number by continuing to force soldiers to take Lariam. That is despite their wishes and a motion passed by this House.

As a result, we have almost 300 loyal but damaged men and women who served this State proudly, and whose papers have been lodged with the courts, facing a lengthy and costly application process before the State will eventually have to settle, as it will. There is not one word about redress and compensation to end this madness. It is a crazy situation. When these cases get to the courts they are, of course, then likely to encounter the 83 cases which have been also been lodged before the courts in respect of Pandemrix. Those cases are mainly the result of children who developed narcolepsy after receiving the swine flu vaccine. Those suffering families have had to fight this State for discovery for years. When I raised this with the Taoiseach last year, he said he would instruct the Minister for Health, Deputy Harris, to bring forward the commitment in A Programme for a Partnership Government to introduce a no-fault vaccine scheme to respond to the needs of people with disabilities arising from vaccination. He also stated the commitment would be implemented by last year. Where is it? The programme for Government is three years old. This scheme was recommended as early as 2001 and these families have been suffering since 2010. We would be forgiven for thinking that the State is engaged in some clandestine plot to enrich the legal profession at the expense of the public and to the detriment of those whose health has been seriously and negatively impacted upon as a result of State actions. There is no justice and accountability for those people. That is appalling.

While everybody moved on to the latest scandal some weeks ago - I think John Delaney was the flavour of the month this time - Dr. Scally produced his latest report. He outlined in that report the problems with the open disclosure approach which, he stated, remains in place despite being judged to be deeply flawed. It is not good enough for the Tánaiste to state the Government is working on it. It has been foostering around with these issues for more than 11 years. We had succeeded in having mandatory open disclosure before this Government removed it two years ago. When will the Government stop talking about doing things and actually start to do them? I was about to say talk is cheap but it is not cheap for the victims or the State. It is about time the Government started delivering on some of the things it tells us it is dealing with.

The Deputy had many questions. I will deal with the Lariam issue first. It is important to emphasise that malaria is a serious disease that has killed hundreds of thousands people. We need to protect our troops when they are in malaria zones in different parts of the world. Let me be very clear with the House, however, that the health and welfare of the men and women of the Defence Forces is the utmost priority for both the Government and the military authorities. I am advised there are three anti-malaria drugs. I remember looking at this issue when I was in the Department of Defence and speaking to many of the families with concerns regarding the use of Lariam in the past.

The choice of medication for deployment overseas for both officers and enlisted personnel, including the use of Lariam and other drugs, is a medical decision made by medical officers in the Defence Forces, having regard to the specific circumstances of the mission and the individual member of the Defence Forces. In other words, it depends on how long members of the Defence Forces will be in a region and what the medical advice is regarding the appropriate use of drugs in respect of frequency, etc. A working group reviewed the Defence Forces approach regarding these drugs to ensure procedures continue to be appropriate and in accordance with international best practice. I also remember reading a number of reports from other countries relating to the use of Lariam or other drugs.

A further case has been listed for hearing in the High Court on 7 May. It would be inappropriate for me to comment on individual cases given litigation is pending. This has, however, been an ongoing debate for many years, with which I and other Ministers have been confronted. The approach of the Government and the current Minister is to try to ensure we are acting on the best advice of doctors and medical personnel, inside and outside the Defence Forces, regarding working groups and protecting the health of our soldiers. That is the only motivation we have on any policy regarding the use of Lariam or other drugs to combat the dangers of malaria.

I have a lot of time for the Tánaiste but I am very disappointed with his response, which is indicative of the reason we are in this mess. I state that because what he has given me is Civil Service speak. The working group on Lariam actually recommended that a medical advisory group be set up to look into these issues. That was in 2017. I recently found out from a freedom of information, FOI, request that the group has never met, not once. Best medical practise would tell us that other defence forces are not using Lariam. The Tánaiste's answer is, therefore, patently wrong.

The Tánaiste did not deal with all of the fundamental questions I put to him. The State's denial has led to a continued over-reliance on litigation and failure to address the serious concerns of those people whose health has been impacted by State actions. The Government is causing those people enormous hardship while enriching the legal profession and failing to make our health service safe. The type of answer the Tánaiste gave me is the same reason we do not have a mandatory open disclosure policy that would make our hospitals safer. He is listening to civil servants and not his instincts. The Government is not addressing the issues it has stated it will address. It is incredibly disappointing and citizens deserve much more.

We are introducing a patient safety Bill that will require open disclosure.

That was said last year.

It is being brought through the system. The Government has committed to that Bill and we will fully follow through on it. Deputy Clare Daly and I have spoken before about the broader issue of the approach to Lariam. She knows this is not a straightforward issue to deal with. Families have made certain accusations and they need to be tested. Those families have chosen a legal route to seek compensation and the truth and they are perfectly entitled to do that. The State also has a perspective on this.

The core issue is whether Lariam is suitable for use. Different countries take different approaches. It is not true to state that all countries are moving away from the use of Lariam. Some countries have and others have not. Some use it in certain circumstances and in certain locations and others do not. I have not been involved with this file for a while because I am outside of that Department. I will follow up on the expert medical group and respond directly to the Deputy on that. On the broader issue, however, is not as simple to deal with as Deputy Clare Daly sometimes maintains.