On behalf of Sinn Féin, I also want to wish Teresa well and thank her for her years of service to all of us in this House. I wish Noel and Liam well in their new posts.

Today, some 84,000 people over the age of 75 are languishing on hospital waiting lists, an increase of 80% since 2014. The Government cannot blame the pandemic on this because before we knew about Covid, these lists were rising rapidly, by a shocking 10% per year. More than 25,000 people over the age of 75 are waiting a year for a first hospital consultation. Hospital overcrowding is now at record levels. Emergency departments are overflowing. We should all bear in mind the shocking fact that 4,500 people aged over 75 have been waiting in emergency departments for over 24 hours thus far this year. The CEO of the HSE said yesterday that the Government waiting list plan is already challenged by this overcrowding. What is the Government going to do to tackle the lengthy waiting lists and deliver timely health care for our older citizens who it is clearly failing?

At the outset, I want to join with the Ceann Comhairle in offering my thanks and congratulations to Teresa Doolan. I worked with her in the Department of the Taoiseach, over here in the Oireachtas. She now moves across St. Stephen's Green to the Department of Justice. I wish her and the new officers taking up their roles the best.

If I may, I would like to take this opportunity to, on behalf of the Government, express our condolences to the friends and family of Oleksandr Zavhorodniy, a 45-year-old Ukrainian man who lived in Ireland for the past 20 years and worked in Aldi in Sandyford. He lived in Stillorgan and sadly lost his life defending his home country of Ukraine from Russian attack. I want to express our condolences to his friends and family on his death and acknowledge his bravery in going to Ukraine to fight for his country. He fell as a hero on the battlefield.

Regarding the question raised by the Deputy, I acknowledge that waiting lists for healthcare in Ireland are far too long and have been for a long time, long before the pandemic and the cyberattack. In the past few weeks, the HSE published a waiting list action plan that sets out in detail the actions that will be taken to reduce waiting lists. We are confident that, through its implementation, we will see the tide turn before the end of the year and start seeing waiting times falling. It is to be hoped we can action that plan, make it happen and see the tide turn before the end of the year.

I join with the Tánaiste in congratulating Teresa and wishing Noel and Liam the very best in their new roles.

We are led to believe it will be six months until the Government produces a budget. I think the Tánaiste will agree with me that over the course of the pandemic it was proven that when the Government needs to or feels it can intervene in a swift fashion, it can do so. The Tánaiste knows there is a cost of living crisis and we are welcoming refugees from Ukraine who deserve and need our support. Surely the Government must recognise that we cannot wait six months to have a budget. We need an emergency budget. Can he commit to having such a budget between now and the summer? Is it his intention to wait six months? Families cannot wait six months for the type of intervention that is now needed.

I thank the Deputy. The budget happens in October every year, and will happen in October this year. The demand for a mini or emergency budget has to me elements of sloganeering. Taking action does not require us to have a budget. People will know that during the pandemic we introduced the pandemic unemployment payment, which cost €9 billion. We did not have a mini-budget for that. We implemented the employment wage subsidy scheme to save jobs. We did not have a mini-budget for that. We have already taken €200 off people's electricity bills and brought about the biggest cuts ever to petrol and diesel prices. We did all of that without a mini-budget. It is not the case that an emergency budget or a mini-budget is required for a Government to take action. We can do that anyway. We have done that to date in responding to the emergency of the pandemic and the refugee and cost of living crises.

On behalf of the Social Democrats, I thank Teresa Doolan for her service and congratulate Liam and Noel on their new appointments.

Yesterday, the Committee on Health discovered that a business case for the implementation of regional health areas, RHAs, was presented to Cabinet on Tuesday. This is obviously a central element of Sláintecare. Three options were set out. The first was to do nothing, the second was to take a minimalist approach which, as we know, is favoured by Robert Watt, and the third was to implement Sláintecare, have a leaner and more effective centre to the HSE and devolve power, responsibility and decision-making to the six regions. Can the Tánaiste clarify which of those three options the Cabinet decided on? It was suggested to us yesterday by Robert Watt that the Cabinet came down in favour of the minimalist approach. Can he is the clarify whether the Government will implement Sláintecare or take a minimalist approach?

I thank the Deputy. I am not sure I would characterise the three options presented in the same way as she did. I would have to read the Sláintecare report again to remind myself exactly how prescriptive the report was in terms of how the regional health areas should be structured. I heard the Deputy say on the radio that she did not think they should be a recreation of health boards, an option that would involve boards, CEOs and all of the rest.

No.

We have not gone for that. Rather, we have gone for something in between, which is establishing regional health areas within the HSE on an administrative basis with the intention of devolving power and budget to them. That is the plan.

That is minimalist.

I also offer my thanks and best wishes to Teresa Doolan, and my best wishes to Liam and Noel in their new jobs.

The Government has committed to supporting artists, in particular after Covid-19. I am glad the Minister for Tourism, Culture, Arts, Gaeltacht, Sport and Media is in the Chamber. I wrote to her on Tuesday about the plight of 20 artists in a studio on Richmond Road near Drumcondra. They have been there for about 20 years and to their shock, on 8 February bailiffs from a receiver came to the studios and told them they had to get out. It would appear that the receivers had no idea that the artists had paid rent, had contracts with a landlord and had been there for 20 years. They and I are asking the Minister for urgent intervention to support them. They will be evicted from their studios and will be homeless unless intervention and support is offered.

That letter has to be brought to my attention. I will read it this afternoon when I go back to the Department and will refer back to the Deputy as soon as possible.

On behalf of the Regional Group, I wish Teresa Doolan the best of luck in the Department of Justice. When I became a Deputy 11 years ago, Noel Murphy was the first person to introduce me to the Dáil. I would like to wish him and Liam the best of luck.

The Government announced that a new national energy upgrade scheme will offer increased grant levels of up to 50% of the cost of a typical deep retrofit to a B2 home energy standard. He said the target is to retrofit 500,000 homes to a B2 home energy standard by 2030. This is about 30% of the homes in the State. People need more information, updates and communication. How do people qualify for the scheme? People want to know who will do the work and when it will start. The scheme is being administered by the SEAI. It is a fantastic scheme, but can the Tánaiste give us more information?

I thank the Deputy. The plan is to have a hassle-free home energy upgrade scheme. One-stop shops are being established to take the stress and hassle out of the process so that people can get this work done quickly.

At the moment, there are two one-stop shops registered but there are another two that will be approved shortly, bringing us to four. There are a further 15 companies in the middle of the application process. We anticipate in the relatively near future having approximately 19 one-stop shops around the country up and running to which people can go to get all the information they need. It is a great programme. The only constraint on getting it done will not be money or interest, it will be finding skilled workers to carry out the work.

On behalf of the Rural Independent Group, I too wish Teresa Doolan the very best in her new role, as well as wishing Noel and Liam the very best in working with us going forward. I welcome Councillor Frankie Daly from Limerick, and the students from Limerick, to the House.

There is a massive issue in respect of passports. I presume that, like me, every Deputy, their constituency offices and staff are inundated with requests to get passports for people. For the past two years, people were unable to take a break or go on holiday. In some cases, infant children are now unable to get a passport for 40 days. If there is a small problem, the process goes on for two months. It is very unfair. Some people have cancelled their holidays. In one way, I cannot blame the Minister for Foreign Affairs for this problem because he has been very helpful with many cases, but there is a lack of staff in the Passport Office and that needs to be corrected. I would appreciate the Tánaiste addressing this matter.

I thank the Deputy. This is a significant issue coming through my constituency office as well as his. I presume all Deputies have the same experience. The situation with renewals is actually now pretty good. Renewals are happening quite fast. There are significant delays, however, with new passports and passports for children, particularly foreign-born children. Some of that is down to the work that has to be done before the passport can be approved. What has happened in simple terms is there has been a huge surge in passport applications and passport renewals. The staff of the Passport Office are working very hard. There are more of them than there used to be. There has been a big increase in staff. We are actually now producing more passports every week than ever was the case before but the pent-up demand or snap-back demand, if one likes, from the pandemic has put us in a difficult position in terms of both passports and work permits. We are putting lots of extra staff into those areas and we will get over the backlog at some point.

Last year a special envoy position was created especially for Katherine Zappone. There may well have been merit in the position and she may well have been a suitably qualified candidate - unparalleled, according to some - but the issue was a lack of competition and transparency in the use of taxpayers' money. The Tánaiste stated it was a mistake. This year, a professorship was created for Dr. Tony Holohan. There may well be merit in the professorship and he may well be a suitably or uniquely qualified candidate but there is a similar lack of transparency and openness in the use of taxpayers' money. The only difference I can see between the two situations is that the new position of Dr. Holohan, if he goes ahead with it, will cost the Exchequer 14 times more than the position of Katherine Zappone. At least the Tánaiste's colleague, the Minister for Foreign Affairs, took ownership of the issue of the position for Katherine Zappone. The Minister for Health seems to be a passenger in what is happening in his Department. Is the Tánaiste happy for this appointment to go ahead without an open competition and funded by taxpayers' money?

The new role of the Chief Medical Officer is an open-ended secondment funded by the Department of Health. Dr. Holohan is being seconded to Trinity College Dublin under the same terms and conditions as his existing contract. Secondments between organisations are a regular and common feature across the civil and public service to encourage interdepartmental and inter-agency co-operation and the sharing of knowledge and skills across the public service.

Trinity College Dublin is not in the public service.

I think all present will acknowledge that it would have been far preferable if the full details around the secondment had been put in the public domain at the outset. That should have been done. I know the Minister for Public Expenditure and Reform, Deputy Michael McGrath, is not satisfied with how this has been done and he is engaging with the Department of Health on it at the moment. That is not in any way casting aspersions on Dr. Holohan - I know the Deputy did not do so either - who is an excellent public servant, or on the fact that Trinity College Dublin is creating this post. It is important, however, to follow procedures. The Minister, Deputy Michael McGrath is pursuing the matter.

Is the Tánaiste happy for it to proceed?

It has been three months since there was a free bed in St. Luke's General Hospital, Kilkenny. I am receiving calls from families regarding older people being discharged because of overcrowding. The other issue that is coming up is that some doctors now are actually not seeing their patients. Some are being sent down to the accident and emergency department in Kilkenny. I had a lady in my office the other day. She has three children under the age of three and was in the hospital in Kilkenny for hours. She said the staff could not have been nicer and everyone was very helpful but the concern remains. Sláintecare was to transform the health service. What is happening in that regard? The reality on the ground is that there are significant issues. I know everyone is doing his or her best but we need to see what else can be done on this issue.

I am sorry to hear of the experiences that the Deputy's constituents are having in St. Luke's General Hospital, Kilkenny. It is a very good hospital most of the time but has suffered from increased overcrowding in recent years. The best thing I can do is to inform the Minister, Deputy Stephen Donnelly, that the matter was raised in the House today and ask him to speak to the Deputy directly.

I add my voice to those wishing Teresa, Noel and Liam well. I have the privilege of representing two of them, so I pass on particularly good wishes to them.

I welcome the offsetting measures the Tánaiste has indicated in the context of the May increase in carbon tax. I ask him to look at other measures that could be implemented far more effectively than the bogus and unsustainable zero VAT rate that has been called for. The measures are sustainable and entirely consistent with our climate obligations. One example I ask him to consider is obliging all utilities to give consumers timely notice of upcoming opportunities to switch, as well as including a QR code on all bills to make it easy to make comparisons and see exactly how one's personal situation could be delivered more cheaply. In addition, there should be a curb on so-called dropped calls. More than 50% of calls from people trying to make changes to their arrangements fall away because there is simply no one to answer the calls.

We are examining some of those options at the moment, both in terms of putting people on preferential tariffs, doing what the Deputy suggested in respect of switching, and the move to time-of-day pricing. The truth is energy prices will go up and down in the course of the coming couple of years. The thing that can be most helpful to people are the kind of sustainable solutions he mentioned - making sure people get proper notice of increases, making sure they know how to switch and making it easy to do so. Many people do not switch and, therefore, do not get the best value. We are also considering moving to things like an auto-enrol opt-out system for time-of-day pricing, which can help to bring down bills by a lot.

As the Tánaiste will be aware, planning permission has been granted for the former Irish Glass Bottle Company site in Ringsend and preparatory works have already started, although they have stalled. The planning permission means that 900 public and affordable homes must be delivered on the site. For residents in Ringsend and Pearse Street who have been on the housing list for many years, it is essential that public homes are delivered on the site rather than on the other side of the city. Dublin City Council management has indicated the prices of homes there will range from €600,000 to €700,000 per unit. Obviously, that is not affordable. Can the Tánaiste assure the community that there will be both public and affordable homes delivered on this key site?

I am afraid I am not up to date with the detailed plans for the site but I will ask the Minister, Deputy Darragh O'Brien, to revert to the Deputy on it.

I refer to the ongoing atrocious situation in Ukraine. I commend the Ceann Comhairle on his initiative in inviting President Zelenskyy to address the joint sitting of the Houses yesterday. It was a momentous and worthwhile occasion. Further to the remarks yesterday of President Zelenskyy, what additional leadership can Ireland show in respect of this situation? Will we be pushing for further sanctions against Russia to try to help bring this awful conflict to a conclusion? Will we be considering following the lead of Lithuania in terms of its expulsion of its Russian ambassador? Will we revisit that decision? Are there other measures, further to what we are already doing, that we, as a country, can take to try to help the people of Ukraine?

I echo the Deputy's remarks in respect of Ukraine and our need to support the Ukrainian people in their battle against Russian aggression. One of the main things we are doing is putting together a deeper and tighter set of sanctions to be imposed on Russia. That is the fifth package of sanctions and it is currently under development. The Minister, Deputy Coveney, is very involved in that. We are also going to provide increased humanitarian and financial aid to Ukraine and, through the European Union, are providing military aid through the peace fund, which will also continue.

I am glad the Tánaiste is present. Given that he is a former Minister for Health, he may be able to provide some insight on the ongoing difficulties about rare diseases and orphan drugs, and, in particular, the commitment in the programme for Government for a successor to the national rare disease plan.

In addition, I am also interested in the publication - this has not yet happened - of the Mazars report, which will hopefully give us some insight into the health technology assessment process and how we are lacking on that side. That report was put together in late 2019 or early 2020 and is sitting somewhere on a desk gathering dust. I raise this matter in the context of the drug Luxturna, which could possibly benefit four people in the country, three of whom are children who will inevitably end up blind unless they receive doses of that necessary drug. Can the Tánaiste provide any insight regarding the publication of the rare disease plan and comment on the availability of Luxturna?

I thank the Deputy for his question. It is important that we should improve our performance when it comes to licensing and reimbursing new medicines. We have fallen behind many of peer countries in that regard. It is not right or fair that patients in Ireland cannot get a medicine that they would be able to get via the NHS in Britain or in similar health services elsewhere. We need to up our game in that regard. Many of these medicines were invented and are being produced in Ireland. It is, therefore, a bit strange for us to encourage pharmaceutical companies to invest here and for us then not to purchase their products. It is something the Government is working on. We are providing additional funds this year for new medicines. Some 20 to 30 new medicines have been approved this year so far, which is what one would usually see in a full year. The situation is improving.

I do not have an update on the particular medicine the Deputy mentioned. I will ask the Minister for Health to provide an update on that and also on the publication of the two reports.

I raise an issue today with the Tánaiste and perhaps the Minister of State, Deputy Rabbitte, who is present, may be in a better position to answer this question. It relates to the progressing disability services for children and young people. A number of families in my constituency and outside it have raised the lack of services with me. These families have children with Down’s syndrome. They have painted a very stark picture in respect of the interventions they were meant to receive. The Minister of State will be aware that these children have not got those interventions for the past couple of years. These are the basic services required for any child’s development. I refer to speech and language therapy, physiotherapy and occupational therapy. If we cannot provide for the most vulnerable children, then there is something very wrong not only with the Government but also with the whole system.

I thank the Deputy for asking that question. For the past two years the Government has provided way more the amount of money required. We have been extremely successful in our budgets. The Deputy is correct in that the progressing disability services for children and young people, in its current format, is not meeting the needs of children. That is why I am engaging with parent forums. I have travelled around the country to hear about what is happening first-hand and to try to understand how exactly we can break down the barriers in order that the money gets directly to the children and that services are delivered. I plan to continue doing this over the next six months. It is a direct intervention by me. I am asking and pleading with the HSE to join me in engaging with these forums and to be part of the solution in understanding where the barriers lie.

I thank the Ceann Comhairle. A public meeting was held in Meath the other night regarding the lack of services for children with disabilities. One woman spoke about her ongoing fight for basic services for her child from childhood into adulthood for the past 23 years. Another child was diagnosed with autism on the day of the meeting and the parent wondered if she will she be fighting the same battle and dealing with the same concerns in 20 years' time.

Another matter discussed at the meeting was the number of vacancies in the disability network for Meath and Louth. There has been a vacancy for a paediatric psychiatrist there for more than 14 years. Surely that is not good enough. When will these vacancies be filled.

This issue is not unique to the Deputy’s area; it is right across the country. I was in Cork on Tuesday night with Deputy O’Sullivan. On the psychologist post, I introduced the post of assistant psychologist. This is the first time that we have had a commitment from the HSE on that grade. The news in that regard was announced here three weeks ago. That is the start of the process in addressing the waiting list of people waiting to see psychologists.

On the issue of children progressing from their late teens into adulthood, transition planning is being put in place at present. I am working with the Minister for Education, Deputy Foley, and the Minister of State, Deputy Madigan, to ensure that there will be a proper care pathway in order that those families will be correctly directed all the way through the process. Work in this regard is ongoing.

My question is similar to those of Deputies Guirke and Gino Kenny. Enormous funding has been put in place by the Government to deliver these services but they are not being delivered by the HSE. That is an ongoing difficulty. I thank the Minister of State for her help and support in my constituency, where I am raising matters relating to early intervention and trying to get Ballyowen Meadows Special School to offer to do a second early intervention class. I have, however, not received any responses from the HSE. This is hard to understand. Earlier, I participated in the first meeting of the specially dedicated Joint Committee on Autism. It is great that it has been established, but the HSE needs to respond to our ongoing questions about delivery of services. I am aware of the work that the Minister of State is doing but I use this opportunity to ask her to urge the HSE to step up and to get the area assessments done in my constituency, provide the extra early intervention class and respond to the ongoing questions from special schools when they are looking for help?

I thank the Deputy for raising this issue. I also thank her for giving us the opportunity to discuss the matter last night. Since I met with the Deputy yesterday evening, we have made arrangements to facilitate a meeting at that school at which representatives of the HSE will be present. When schools and the likes of the Rainbow Club in Cork are coming forward and stating that they have the ability and capacity to recruit, we should be working with them. We know that there is a problem with recruitment within the HSE. It is amazing that we do not have that challenge with other organisations. In that context, we have to wonder as to why the HSE is not able to recruit people. I will work with the Deputy on this issue.

I also take this opportunity to wish the new Joint Committee on Autism the very best of luck. It is an extremely important structure to have in place and it will give Members of both Houses a good opportunity to work on this issue. We need to work across Government, and across the various Departments, in a collaborative way in order to arrive at solutions.

The programme for Government is very clear in its aims for equality and it also sets out strong ambitions on increasing participation in sport, including the prioritising of increasing female participation. Women’s rugby has experienced a turbulent time recently. Last week, Ballincollig Rugby Football Club outlined its shock and disappointment that the steps to grant the club All-Ireland League, AIL, senior club status was stopped at the Munster AGM. The club has outlined very understandable frustration and disappointment that equality is still something that needs to be fought for and that not all Munster rugby players are considered equal. The rules at the moment mean that one club out of the 60 AIL clubs does not have senior status. The reason for that is down to the gender of the players on the team. Is the Tánaiste aware of this situation and can engagement take place with the rugby authorities to ensure that all players are considered equal and that whatever rules need to be changed will be changed?

I thank the Deputy for raising this important matter. This is a matter for Munster Rugby and the IRFU, as the national governing body, but I would ask them both to reflect on the decision they have made in respect of this matter and to review it. Neither the Government nor the Minister for Tourism, Culture, Arts, Gaeltacht, Sport and Media have any role in this. It is important that we respect the autonomy of national governing bodies to run their sports. However, equality in sport is Government policy. Ministers want to achieve a sporting landscape where women have an equal opportunity to achieve their potential, while enjoying lifelong involvement in sport. With that in mind and while respecting their autonomy, we ask both Munster Rugby and the IRFU to think again.

At a meeting of the Joint Committee on Health yesterday, the Secretary General of the Department of Health, Mr. Robert Watt, confirmed that it is not intended to appoint a new chair to the medical consultants contract negotiations. The chair who was there, Marguerite Bolger, was appointed to the High Court last September. Seven months later, we still have no chair. There are 838 consulting vacancies at present around the country and no progress has made in getting consultants appointed. In addition, there has been no progress in the negotiations. Was the decision not to appoint a new chairperson taken by the Government. What is the intention with regard to progressing these negotiations in order to ensure that we have an attractive contract for people who want to work in Ireland but who believe that the current terms on offer are not suitable in the context of either their experience or of how they want to work in the Irish health system?

There has been no Government decision on this per se. Talks were convened under an independent chair. They went on for some time. That independent chair has now been appointed to the courts. Unfortunately, those talks were not successful. It is now intended, therefore, that the Government will re-engage in the coming weeks with the Irish Medical Organisation and the Irish Hospital Consultants Association with the revised offer. I hope they will accept it. I think most Members of the House would agree that €252,000 a year is not a bad salary. That is what is on offer. Some modifications to that will be offered, which I hope consultants will find acceptable.

The figure of 800 vacancies is a little misleading. Most of those positions are filled by locums or people on temporary contracts. The impression is sometimes given that a vacant post means that nobody is there doing the job. That is not the case. In any walk of life or any business, there will be people whose positions involve temporary contracts or who operate on a locum basis.

Last but by no means least is Deputy Munster.

I wish to raise the non-existence of paediatric ophthalmology services in Drogheda and the entire south Louth area. More than 2,000 schoolchildren still have not received appointments since last September. That includes children with conditions such as strabismus. There are no appointments and no follow-ups. There is only one ophthalmologist in Dundalk, who is seeing a restricted number of as few as six to seven children each day. It looks like there has been a complete abandonment of children who need and use these services. Can the Tánaiste indicate what is being done to ensure that these services are resumed as a matter of urgency? Is this the HSE's failure to prioritise recruitment? If so, is that being addressed urgently? We heard earlier of other cases in which the HSE does not appear to be prioritising recruitment, although there is, as I am sure the Tánaiste would agree, a massive problem with it.

I thank the Deputy for raising this issue. Deputy O'Dowd has raised it as well. I do not have an up-to-date note on it, and I do not want to give the Deputy information that might be misleading. I will inform the Minister for Health, Deputy Donnelly, that she raised the matter as a priority and ask him to provide her with a report directly.