An important report on the deaths of single people experiencing homelessness was published earlier this month. The interim report by Dr. Austin O’Carroll found an increase in the number of people experiencing homelessness who died in 2020 compared to 2019. The findings of the report reinforce that poverty and social exclusion are key causes of homelessness. The report makes a number of recommendations including a multi-agency critical incident review of deaths of people experiencing homelessness, greater access to Housing First, increased access to primary care and mental health services, improved data collection and the extension of overdose and suicide prevention programmes. Will the Tánaiste agree to implement in full the recommendations of this important report?

I pay tribute to Dr. O’Carroll, who does fantastic work in the provision of services to marginalised groups. We need to listen to what he is saying.

I join the Deputy in commending Dr. Austin O’Carroll. I have worked and spend a bit of time with him through various charities and organisations in which he has been involved. I would listen to what he says in this regard. The Minister is considering the report and will respond in a reasoned way.

The most recent monthly homelessness report shows that the number of single adults accessing emergency accommodation has fallen for the second consecutive month to 4,533. We have seen roughly a 40% fall in family homelessness since its peak. It is still a serious problem and a lot more has to be done.

Senator Bacik and I have been campaigning since February for a catch-up fund for children. The Government must invest in education for children who have lost out on in-school learning over the past year and a half or so. The Minister for Education, Deputy Foley, announced two weeks ago she was working on a multimillion euro fund to this end. She said she would announce it shortly. She was not in a position to say when or how much.

The Tánaiste will be aware that a major controversy has arisen over the catch-up for children fund in the UK. The catch-up tsar resigned over the fact the fund was only £1.4 billion. Does the Tánaiste agree with me that whatever summer programme is rolled out this summer will not be enough to help children to catch up, particularly those in disadvantaged areas or with learning challenges? When will this catch-up fund be announced and how much will be in the fund?

We are over time. I call on the Tánaiste to respond.

I may have picked the Deputy up wrong, but I think he is asking me to agree with him that whatever is announced will not be enough. Perhaps that was a Freudian slip, because that is what he is going to say no matter what is announced. Leaving that aside, this is something that I have called for too, and it is something the Minister for Education, Deputy Foley, is working on. We should be able to publish that in the coming weeks. It has not gone to the Cabinet yet. What the Deputy may have been trying to say - I agree with him on this - is that a summer catch-up fund will not be enough. It will need to go beyond the summer and into next year because, unfortunately, those most at risk of educational disadvantaged are the ones who have missed out the most and have fallen behind the most. It is in our interests as a society to make up for that and that is what we intend to do.

The cost of the pyrite remediation scheme will be more than €160 million and the cost of the mica redress scheme will be well over €1 billion. The potential cost of addressing fire safety defects and construction defects in apartments will run into well over €1 billion. The human cost for homeowners who through no fault of their own are living with the stress and anxiety of seeing their homes literally fall apart around them is measurable. The National Building Control and Market Surveillance Office, which checks and tests building material from quarries and other suppliers, does crucial work and it is operating at only 50% of its required staffing levels. Why is the Government operating this crucial function at only 50% of its required minimum staffing capacity? If the Government is serious about protecting homeowners and taxpayers, would it not make sense to resource this crucial function properly?

Tá an tAire ag bunú grúpa oibre dírithe faoi theorainn ama idir oifigigh Roinne agus ionadaithe ó údaráis áitiúla Mhaigh Eo agus Dhún na nGall. Aithneoidh an grúpa oibre saincheisteanna atá fós gan réiteach agus rachaidh sé i ngleic leo. D’fhéadfadh an grúpa tuairisciú ar ais don Aire faoi dheireadh mhí Iúil lena gcuid gníomhartha. Cuirfidh an tAire na gníomhartha sin faoi bhráid an Rialtais. I will have to find out what the facts are and come back to the Deputy on the National Building Control and Market Surveillance Office, but I will do that and provide him with a reply as soon as I can.

I want to start on a very positive note on the vaccine roll-out. The uptake of the vaccine has been very good and logistically it has gone very well also. There will be kinks and vulnerabilities in its implementation. One of the vulnerabilities is the cohort of those aged over 60. A cohort of nearly 450,000 is in that bracket. It seems counter-intuitive that those people have been left vulnerable. For example, I will be fully vaccinated by next week but somebody that is 20 years older than me will possibly not be fully vaccinated for another five weeks. How concerned is the Tánaiste and what will the Government do to try to address the anomaly and the vulnerability relating to that cohort?

This is a significant concern at the moment. It is an issue many of my constituents are raising with me and I imagine Deputy Kenny has had the same experience. What I can confirm is that the Government has agreed to reduce the gap between the first dose and the second dose of the AstraZeneca vaccine from 12 weeks to eight weeks. We cannot reduce the gap to anything shorter than that, as the licence and the manufacturer state there should be a 56 day gap or more between the first two doses. We are doing that, but it will take a few weeks to operationalise it and it does depend on supplies. We anticipate having all of the people in that cohort fully vaccinated probably around the middle of July and certainly by the end of July. That decision has been taken and it will happen.

Vaccine registrations are going to open on Sunday for people aged 35 to 39. We expect next month to get further advice from the national immunisation advisory committee, NIAC, and the National Public Health Emergency Team, NPHET, on heterologous vaccination, that is the mixing of vaccine doses – getting one type for the first dose and a different type for the second dose. It does appear that the efficacy of that approach is very good, but the data on safety is limited at the moment and we expect to have more information next month.

I welcome the commitment to sport in the programme for Government. Accordingly, I would like to raise with the Tánaiste the matter of the disused and closed ice rink in Dundalk Institute of Technology, DkIT. This is a facility that was purchased in 2014, using public funds but, incredibly, has lain idle since then. It is the only ice rink in this jurisdiction and because it is not open it means that the Irish national ice hockey team must train in Belfast rather than in this jurisdiction. I am sure the Tánaiste can fully appreciate that is a less than ideal situation.

I am reliably informed that a number of attempts have been made in recent years to either purchase or lease the facility from DkIT, and all the attempts have been unsuccessful. Will the Tánaiste have a discussion with his colleague, the Minister for Further and Higher Education, Research, Innovation and Science, Deputy Harris, to see if he could look into this matter and intervene if appropriate? Let us get this facility open and let us support our national teams.

I thank Deputy Berry for raising the issue of the Ice Dome at DkIT. It is an excellent piece of infrastructure and it is sad that it has been out of use for so long. I have been advised that DkIT is actively engaged in a process to secure a lease arrangement for the Ice Dome. I understand that the intention is to enter into a lease arrangement with a sporting organisation but, as these discussions are private and confidential, I do not know which sporting organisation that is. The conduct and the process to secure the lease arrangement is a matter for the IT directly but I will certainly mention to the Minister for Further and Higher Education, Research, Innovation and Science, Deputy Harris, and the Minister of State at the Department of Tourism, Culture, Arts, Sport, Gaeltacht and Media, Deputy Chambers, that Deputy Berry raised this important issue in the House.

I want the Government to bring Mr. Paul Reid before it to get clarification on hospital visits and especially the accompaniment of partners for childbirth, labour or scans, which is not allowed in various hospitals. The hospitals are operating like independent republics. Following the cyberattack, they will not even respond to letters. It is utterly ridiculous that partners are not allowed into hospitals. Thankfully, hospitals now have a limited number of patients. There are only 60 or 70 patients in hospital altogether. For that matter, at least one visitor from a family should be allowed to visit elderly patients. Nobody is allowed into South Tipperary General Hospital. It is shocking that older people have to die alone without the company of a member of the family. Why are all the hospitals operating different policies? Surely one law should apply to everyone. Given the reduced numbers at least one visitor per family should be allowed and partners should be allowed in when a wife or partner is having a baby. A sibling or somebody should be allowed to visit people. It is totally unfair and it needs to be clarified. Paul Reid needs to give an instruction to all the HSE hospitals to have one plan, not different plans for different hospitals.

My understanding is that Paul Reid and the HSE have given general guidance on maternity hospitals saying that it is allowed and indeed advised that partners should attend the birth of their child and attend scans and paediatric or neonatal ICU if their child is in there. However it is the case – it has always been the case and will always be the case - that on occasion we must allow decisions to be made by local hospitals themselves, by the senior nurse or consultant who is the person in charge of infection control, because we will have situations where there are outbreaks or issues in certain hospitals and therefore they need to be able to have autonomy in making those decisions. I hope this will not be a problem for too long.

Gabhaim buíochas leis an Tánaiste. Táim ag bogadh ar aghaidh.

Staff are vaccinated and increasing numbers of adults are vaccinated and I hope we will be able to get beyond this point quite soon.

Back in 2017 Orkambi was reimbursed for market distribution here in Ireland and it was a great boost for the cystic fibrosis, CF, community after a long campaign. A new drug, Kaftrio, has been approved in the USA and by the European Medicines Agency, EMA, in April of this year. I tabled a question to the Minister for Health in early May and I was told the applicants had put in the rapid review dossier for the drug. I flagged this with the Tánaiste yesterday because I hope the CF community will get some clarity today on when the Health Products Regulatory Authority, HPRA, will reimburse the drug and market it.

I thank the Deputy for raising this issue. I know how important it is to the CF community. As a country, we should endeavour to be among the first to approve and reimburse new medicines. It makes sense from a health point of view and it also makes sense from an economic point of view. If we are asking pharmaceutical companies to invest and employ people here, we should be among the first to approve and reimburse their products. At the very least, we should not fall behind our nearest neighbour, the United Kingdom. As a country, we invest heavily in medicines to the tune of €2 billion annually and additional funding of €50 million provided for new medicines this year will support the introduction of a significant number of new medicines. To date this year, 26 approvals for new drugs and new indications for existing drugs have been made.

On Kaftrio, the HSE advises me that, on 26 April, the European Commission approved the EMA’s recommended licence for the extension of Kaftrio to patients aged 12 years or older with CF who have at least one F508del mutation. In line with the agreed formal process governing the reimbursement of new medicines or new indications for existing medicines, the assessment process commences when the applicant submits a rapid review dossier of evidence to the HSE. The HSE has confirmed that it has received the rapid review dossier for the extended indication from the applicant company. It is not possible at this time for the HSE to commit to a precise date for commencement but it advises that the reimbursement is expected to be in place in the coming months for the cohort covered by the EMA decision.

As the House will not be sitting tomorrow, I would like the Dáil to recall the late Detective Garda Colm Horkan, who died while on duty in Roscommon on 18 June 2020.

Irish citizens living abroad who received the Sinopharm vaccine, among others, and who are now considered fully vaccinated by the World Health Organization, are facing discrimination by EU and Irish authorities by being compelled to enter mandatory hotel quarantining if returning to Ireland from various countries. What does the Government intend to do to vindicate their rights?

Like the Deputy, I have been getting a number of representations from people living in the Middle East and the Gulf area who are caught by this issue. At the moment, we are only recognising people as having been fully vaccinated if they have received a vaccine that is approved by the EMA, but it is open to the Government to recognise other vaccines, including those approved by the WHO. We are giving consideration at the moment to whether we can include Sinopharm, Sputnik and other vaccines in that regard but, unfortunately, I do not have a date for a decision as yet.

I want to raise an issue on behalf of the Mayo industries which are incredibly disappointed to learn of the decision by Dublin Port to cease facilitating the rail freight service from Ballina. I understand Dublin Port took this decision without prior consultation with Irish Rail and its customers. The service has not operated since this day last week. Irish Rail has confirmed it is seeking the restoration of these services and will continue to engage with Dublin Port to achieve this. There is increasing demand for rail freight services from Mayo and a new Ballina to Waterford rail service is set to commence next month. This should not happen at a time when climate action is seen as a key priority for society. We should be promoting more sustainable mobility and decarbonisation, not moving away from them. I urge the Government to remind Dublin Port of previous investment in rail. I recall that a new rail spur opened by the Tánaiste in 2011. It is foolish to reduce rail services for what appears to be operational convenience to free up parking spaces for HGVs.

I thank the Deputy. The Minister for Transport, Deputy Eamon Ryan, is very concerned that the question of continuation of rail services into Dublin Port should arise at a time when the focus is on ensuring that our transport modes are environmentally, economically and socially sustainable. The ultimate aim is that rail freight continues to be facilitated by Dublin Port in line with Government policy, particularly having regard to the strategic review of rail freight under way at present. It is also acknowledged that freight by rail can make a significant contribution to climate action and in reducing road congestion in Dublin.

Neither the Minister for Transport nor the Department is directly involved in decisions taken by what is a privately operated terminal in Dublin Port; it is not operated by the Dublin Port Company, which is State-owned. The Minister understands, however, that discussions are continuing to explore a number of options to resolve the current situation. He encourages all parties to engage to ensure difficulties are resolved as a matter of urgency so Irish Rail can maintain and develop its services.

Up to the age of 65, people on invalidity pensions are eligible for medical cards and free GP visit cards regardless of spousal income. At the age of 66, however, they are transferred to the State pension and they lose eligibility. This has presented a cliff edge for a number of my constituents, including Margaret Ede, who has been contacting me regularly. Margaret and others like her are reliant on the medical card due to the cost of medicines and GP visits. She will have to wait four years to be eligible again through the over-70s medical card scheme. This is a financial barrier to older citizens accessing the care they require, when and where they need it. Can the threshold be looked at for those who were previously on invalidity pensions when they are transferred to the State pension? They were on invalidity pensions for a reason.

I thank the Deputy. In the last budget or perhaps the one before, we increased the income limits for access to the full medical card, although that was probably for the over-70s, not those between 66 and 69, and I imagine the Deputy’s constituent is in that bracket. I can see how it could be a difficulty that somebody moving from invalidity pension or carer’s payments would then lose eligibility for a three-year period, even though their income is exactly what it was before. I can see there is an issue there. There is definitely an anomaly. I will commit to examining the matter in conjunction with the Ministers for Health and Social Protection, Deputies Stephen Donnelly and Humphreys, to see if we can do something about it in October.

A number of weeks ago, I raised the proposed acquisition of Smurfit Kappa News Press in Kells by KIP Limited, a wholly owned subsidiary of News Corp. The matter is currently with the Competition and Consumer Protection Commission. At that stage, I told the Tánaiste there were concerns the terms and conditions of employment and redundancy would be under threat and he said he would ask his officials to contact the company. Now, regrettably, those concerns have been heightened and it is feared the company will close immediately after a transfer, at least for a period, and that those terms will be reduced. Have the Tánaiste's officials contacted Smurfit Kappa and News Corp? What assurances can the Tánaiste provide workers that they are not going to be the victim of a company offloading its redundancy responsibilities, particularly as commitments in respect of those responsibilities were hard-won in negotiations?

I thank the Deputy. On foot of the Deputy raising it the last time, I asked my officials to engage with the company. I am afraid I do not have a recent update on that but as the Deputy has raised it again, I will get that and pass it on to the Deputy as soon as I can.

Huge progress has been made with the vaccine roll-out. Some 3.75 million vaccines have now been administered, almost 60% of adults have at least one vaccine and Ireland has the highest vaccine uptake rate in Europe. However, in the past week I have been flooded with queries from people in their 60s who received just one dose of the AstraZeneca vaccine, people who are concerned, people who are frustrated, people who are feeling left behind. They got their first vaccine early in the roll-out plan because we deemed them to be at higher risk than people in their 40s and 50s, but it is people in their 40s and 50s who are currently getting their second jab. How can we better protect our 60-somethings against Covid and the Delta variant?

I thank the Deputy. She is absolutely right that the take-up by Irish people of the vaccine is very encouraging. There is very little vaccine hesitancy in Ireland. It is going to stand to us in a few months' time, I think, that Irish people have been so willing to get vaccinated. In some countries, refusal and hesitancy rates are as high as 30% or 40%. That is going to be a problem for all of us, not just for them, in a few months' time.

To answer the Deputy’s question, I understand the issue and I am getting the same calls from my constituents, people who had their first shot of the AstraZeneca vaccine and are keen to be fully inoculated as soon as possible. These vaccines are subject to licences and rules by the manufacturer and the EMA. In that context, it is possible to give the second dose of the Pfizer vaccine and the Moderna vaccine after four weeks but it is actually not possible or allowed under the licence to give the AstraZeneca vaccine until 56 days after the first dose, which is approximately eight weeks. We are now going to bring that back to eight weeks. Although people were told they would have to wait 12 or 16 weeks, that is not going to be the case and we are going to try to bring it back as quickly as we can to eight weeks. There are logistical and supply issues but we will get there.

I have raised the issue of resources for mental health clinics in north Tipperary a number of times. We have three mental health clinics in north Tipperary, including Thurles, Nenagh and Roscrea. General practitioners have contacted me this week who are extremely frustrated about the lack of resources there. Two consultants are assigned to them but retaining those consultants is virtually impossible because of the lack of teams behind them. We need psychiatric nurses, counsellors and psychologists. Without this back-up team for consultants, these mental health clinics will not work efficiently. I ask the Tánaiste to ensure that the HSE provides enough resources for those mental health clinics in north Tipperary to work efficiently.

The mental health budget in Ireland is at the highest level ever at well over €1 billion. The Minister of State, Deputy Butler, is making great changes and great progress in the area. I acknowledge that the need is greater than it ever was before. I would be doing the Deputy a disservice if I gave him an answer now about north Tipperary specifically, but I know how important it is to him and he has taken his time in the Dáil to prioritise it, so I will certainly ask the Minister of State, Deputy Butler, to contact him directly with a detailed reply specifically on north Tipperary.

I will speak today on behalf of the families whose loved ones attend the Camphill Communities facilities in Duffcarrig in County Wexford. I understand that Camphill is in discussions with the HSE about transferring the Duffcarrig service to another provider following notice of registration cancellation by the Health Information and Quality Authority. I appreciate that the overall objective here is a properly regulated, managed service for service users and their families, but I have received much correspondence from families who are genuinely concerned that their family members who are service users will be relocated to other areas and that this disruption will have serious consequences for their mental health and well-being. I ask the Tánaiste to use his office to engage with the HSE to ensure continuity of this service for existing service users and, in the short term, to minimise disruption to families and service users and ensure that a suitable replacement provider is found without delay.

I am afraid that I am not familiar with the details of the issue but I will certainly inform the Minister of State, Deputy Rabbitte, and the Minister, Deputy Donnelly, that it was raised here today and ask them to reply directly.

Last November, I was delighted when the Minister, Deputy Donnelly, announced the establishment of an inquiry into the prescribing of valproate to pregnant women. This was a key point in a long and tortuous journey for mothers and families in their search for the truth about the now widely acknowledged impact of Epilim on their unborn children, including the setting up of the redress scheme in France and Baroness Cumberlege's report, First Do No Harm, in the UK. The inquiry was to uncover the truth of who knew what, when they knew it and why nobody did anything to prevent more than 1,200 children being born in this State with a wide range of disabilities that was completely avoidable. It is now ten months from that announcement and there are still no draft terms of reference. When will this inquiry get under way?

I am afraid that I do not have an update on that but the Government commitment stands. I will see the Minister, Deputy Donnelly, later, let him know that Deputy Conway-Walsh raised it, and ask him to reply to her as soon as he can.

Many issues will impact on the Dublin Bay South by-election. One that Brigid Purcell, the candidate for People Before Profit, has been campaigning on for some time and that we hope will feature relates to the commitment in the programme for Government to deal with the wastewater problems in Dublin Bay and the ongoing discharges of untreated sewage effluent, both from the water treatment plant at Ringsend, which is under capacity, and also from multiple locations around Dublin Bay, especially when it rains. There are many aspects to this but I want to ask about one which I did not know about. There is an ultraviolet treatment facility in Ringsend that reduces the microbiological effluent in the discharges into the bay, where one in five bathers are getting sick as a result of poor water quality.

I thank the Deputy.

It is only being switched on between June and September. Will the Tánaiste or the Minister ask Irish Water to switch on the ultraviolet treatment of discharges into Dublin Bay for the entire year?

I thank the Deputy. I was not aware of that. I will certainly check it out. There may be a good reason for that that the Deputy and I do not know but it sounds strange. I will make inquiries and get back to the Deputy when I have a reply.

The establishment of a State developer to use State lands to develop and deliver affordable housing is a breakthrough policy. Will the Tánaiste urge a quick decision on the Minister's request to increase the budget by 50%, which I think is a minimum? Will he arrange for the Land Development Agency, LDA, to publish urgently the supply chain of sites designated for housing and not confine itself to building out existing sites? Will he develop a rapid clearing house so that reluctance of State bodies does not hamper the release of sites and there is not an excessively bureaucratic process for approving projects in the Department of Public Expenditure and Reform and elsewhere?

The LDA was established on an interim basis in 2018 by way of an establishment order, pending the enactment of primary legislation, when it will be established as a commercial State agency - a State-owned developer. Once the primary legislation is in place, equity funding of €1.25 billion will be made available to the LDA through transfers from the Ireland Strategic Investment Fund. The investment will be effected through a subscription of share capital in the LDA by the Minister for Housing, Local Government and Heritage, and the Minister for Public Expenditure and Reform. It is intended that the LDA will have the ability to borrow up to €1.25 billion to fund its activities but this borrowing limit is now under review in the context of the development of the Housing For All document. On establishment, the agency will have access to an initial tranche of eight sites that have near-term delivery potential for 3,400 homes. Significant preparatory work related to these sites is under way, with feasibility planning and other work under way. That includes the Central Mental Hospital site in Dundrum; Hampton, Balbriggan; Hacketstown, Skerries; Devoy Barracks in Naas; the former Meath Hospital in Dublin City Centre; St. Kevin's Hospital in Cork; Columb Barracks in Mullingar; and Dyke Road in Galway.

I was recently informed by the HSE that in CHO 7, which includes my constituency, Dublin South-West, the waiting time for speech and language therapy was at 38 months. Occupational therapy was at 27 months and a psychological assessment was 32 months. The Tánaiste will probably recall that I raised this issue in the previous Dáil and in this Dáil. We appear to have a broken system with regard to speech and language therapy in CHO 7. In the last Dáil, I was told that key personnel were missing and so on. Is the Tánaiste aware of the situation? Can he find out what is the problem? Does he accept that a 38-month wait for speech and language therapy for any child is unacceptable? People are being forced to go to court to get assessments. This is totally unacceptable.

The Tánaiste said in response to a previous question that he is concerned about the ownership of the land for the new national maternity hospital and so am I. He said he is concerned about governance issues and so am I. We both want a resolution. He mentioned the gifting of the land to the State. Why is that not an option or solution? If the Religious Sisters of Charity are prepared to set up a private company with a 99 year lease, because they say they want a completely hands-off approach, then why not gift the land to the State? Has that been sought? What is the impediment? Surely that is the obvious solution. There will a protest outside the Dáil next Saturday. How can we get a resolution to this? There is a seemingly obvious resolution of gifting the land to the State.

I acknowledge that the waiting times for therapies are very long and far too long in many parts of the country. Although I may be incorrect, I think that CHO 7 was part of a pilot where we are going to move therapists into schools, which we think might be a more effective way of providing these services than through the HSE. I will seek an update on that and come back to Deputy Crowe about it.

In response to Deputy Cullinane, the Government and people of Ireland recognise and appreciate the phenomenal work that the Religious Sisters of Charity have done over the years in providing healthcare and education when the State did not. Bad things happened too and they were absolutely wrong, but we should not lose sight of the good things that happened. They are proposing to gift the land to a charity, not to the State or the people. We would much prefer that it be gifted to the State, to the people, in that way. We would even be willing to purchase it because that would be a better option too. However, it is complicated. It is on the site of another hospital which is a voluntary hospital and not a State-owned hospital. We need to work it out. Let me say very clearly that it is the absolute view of the Government that it has to be 100% clear, and legally clear, that all procedures lawful in the State should be performed in that hospital. We also need to get the governance and ownership right.