GP services around the country are at breaking point. They are oversubscribed and understaffed. It can often take two or three weeks before people get to see their doctors. I spoke to a 90-year-old woman recently. She has to wait three weeks when she needs an appointment. She has a history of dizziness and falls. Oftentimes, she ends up in accident and emergency, which sends her back to her GP. We see the problems there. I also dealt with a child in the constituency the Tánaiste and I represent who needed chemotherapy but the GP list in her new home area was two years long. As a result, she could not get to a GP to get a referral for chemotherapy. This is a ticking time bomb, and it is about to go off. GP services are the foundation of our health service. If they crumble, everything else will collapse. The Government is sleepwalking us into a disaster because it is not treating this with the level of urgency it demands.

A new report this week states that we will need at least 940 GPs over the coming 15 years in order to meet the demand that exists. Where is the Government's plan to deliver these GPs? I acknowledge that some new training posts have been created, but that is just scratching the surface of what is needed. We need instead a sense of urgency. However, there has been nothing but foot dragging. The most recent example of this is the strategic review of general practice. This review started in 2023 and was supposed to be completed that year. More than two years later, there is still no sign of it. How long more will have to wait for action? We do not need more reviews. We know what the issues are. It is blindingly obvious that we need more GPs. We know what the barriers are for GPs. Why is the Government not taking action to address the shortfall?

A critical reform that must be rolled out is the introduction of salaried GPs. This is where GPs would be directly employed by the HSE. When GPs go into medicine, they do so because they have a passion for making people better. They did not necessarily go into medicine to be businesspeople, accountants or employers. What they want is a better work-life balance. Having a salaried position provided by the HSE is the answer to that.

I must also address the issue of the GP "deserts" across the country, particularly in rural areas. These are places, where we are unable to get people to set up their own practices. The concept of salaried GPs is something that most of those in opposition agree with. The introduction of such GPs is also the subject of a commitment in the programme for Government. In light of that, what exactly is holding this up? Successive Governments have talked about the reform of GP services for decades, but the GP contract has largely remained the same for 40 years. At what point will the Government stop talking about it and start doing it? When will it start taking the GP crisis seriously and when will we see the introduction of salaried GPs?

I thank Deputy Whitmore for raising this issue. She is right. It is a real challenge in lots of communities, including the ones we are proud to represent in Dáil Éireann. I am grateful for the capacity review report she referenced in terms of the ESRI and the detailed work it has done, which will assist in workforce planning and which shows the growth in GP capacity that will be necessary in light of the growing and ageing population we will have in Ireland.

In fairness, the Deputy acknowledged some measures that have been taken. I contend that numerous measures have been taken to increase the number of GPs practising in the State. The annual intake to the GP training scheme increased by approximately 80% between 2019 and 2024. Some 350 new entrant training places were made available from 2024, and 346 new entrants commenced training last year. It is encouraging that almost all of the new entrant training, even though the number increased significantly, have been taken up. The intake for 2024 can be measured against the fact that 286 people went into training in 2023. GPs are also being recruited from abroad. That commenced in 2023 under a joint HSE and ICGP international medical graduate rural GP programme. There are currently 118 of those GPs in practice, and a further 18 have completed the two-year course. Funding has been provided to bring the number on the scheme up from 118 to 250.

We have increased investment in general practice to try to address some of the cost issues that many GPs talk to us about. The budget for general practice went to €211 million under the 2019 GP agreement, with a further €130 million under the 2023 piece. There are approximately ten commitments in the programme for Government that relate to supporting general practice, including structured chronic disease management programme expansion and the full national coverage for GP on call. One of the positive developments we have seen in our constituency is the roll-out of the out-of-hours GP service in Loughlinstown. That service did not exist five or six years ago. There is also the provision of additional supports for GP practices in rural areas and areas of increased need because the lack of access is not equal across the country.

I do not have a specific note on salaried GPs. All I can say is that the Deputy is right. Salaried GPs are a good idea. I visited one salaried GP practice in Deputy Gannon's constituency. The name escapes me right now, but he knows the doctor. It is a good model, but we need to see this become more the norm. There is funding provided to the HSE for the roll-out of salaried GPs. As Deputy Whitmore stated, there are many doctors who want to deliver medicine but who do not want the challenge of running a small or medium-sized business, as these practices often are. We can learn a lot from that model. I will ask the Minister for Health specifically to outline to the Deputy her plans to roll this out. However, it is something that the Government and I are very much in favour of. It provides another option to further increase capacity.

The name of the programme in question was GP Care for All. Unfortunately, last year they had to come to the Dáil to campaign to be kept open. Clearly, that small proportion of GP services that follow the model we want, and that was agreed under Sláintecare, have to fight to stay open because the Government has not been supporting them sufficiently.

I will give the Tánaiste some statistics in response to those he provided. Six in ten GPs across the country cannot take on any new patients. They have closed their books. The measures the Government has brought in only scratch the surface and have not resulted in the changes we need to see in the number of GPs. Of those who took up the 350 new entrant positions the Tánaiste talked about, 30% will go to Canada, Australia, the UK and New Zealand. They will emigrate and bring their skills with them. We will train them here and they will move overseas. Those are the facts. Our GPs are crying out for support. Our patients are crying out for medical assistance. Will the Tánaiste please take his head out of the sand and deal with this crisis before it becomes insurmountable?

I assure the Deputy that my head is firmly up in the air. There is a lot of work going on in this area. However, as she and I know from talking to GPs, not just in our county but also across the country, it is not just about the number of GPs. It is also about the supports they want to allow them to hire more nurses, the triaging of patients and out-of-hours services. The Deputy referred to GPs leaving the country. The figures I put on the record show that GPs are coming to Ireland. Some 118 GPs have chosen to come to Ireland and it is their home. They are very welcome, and we are thankful for them being here. They are already in practice and treating patients. A further 18 are in the process of completing the course. There are plans to get the number up to 250.

Let me be clear that I am aware of - and am not in any way disputing - the huge challenges that exist in terms of capacity. People are waiting too long too see a GP. There is a need to ramp up capacity in general practice further, not just the number of doctors but also the number of support staff. The Deputy's point about salaried GPs is a serious and constructive one. I take the point that we were dealing with a new model. We found a way forward in respect of that. I would like to see an acceleration of the roll-out of salaried GPs. I will ask the Minister for Health to liaise directly with the Deputy on that.

In the past two weeks we have seen the very concept of vaccination being undermined by the incumbent Secretary for Health and Human Services in the United States.

It is at times like this that the science-led approach to vaccination we have in Ireland is so important.

The HPV vaccine was first made available to teenage girls in 2010 and subsequently provided to teenage boys from 2019. The Tánaiste might have been health Minister at the time. In 2022, the HSE ran a campaign to provide the vaccine to young women and men who had missed the vaccination when they were in school. The campaign was named after Laura Brennan, a young woman who campaigned to raise awareness of the HPV vaccine and who died from cervical cancer. The scheme was regarded as a success and it was expanded in 2023.

The programme for Government, published in January, pledges to extend the Laura Brennan HPV catch-up vaccination programme to anyone under 25 years who missed the original vaccine. I have been trying to find out when this new programme is going to be rolled out but nobody will tell me. I have been on to the Department of Health with parliamentary questions and I have had replies from the HSE. Each time, I am being told about other stuff. I am being told how important the HPV vaccine is, which I know. I am being told about a new scheme targeting young Traveller and Roma people, which is great, but there does come a stage when one feels that somebody is deliberately not answering the question because they know that the answer is not going to be popular.

The Irish Cancer Society has also raised the status of the catch-up scheme with officials. It was suggested to it that a broad catch-up campaign could undermine the initial take-up of the vaccine by schoolchildren, and that there are some international studies to back up this point.

In order to try to clarify the matter, I raised the future of the Laura Brennan HPV campaign with the Taoiseach on 21 May. He said it was a fair question and he would ask the Department of Health to come back to me. I have not heard anything since.

Could the Tánaiste answer three questions for me today? Is the Laura Brennan HPV catch-up programme going ahead, as was committed to only six months ago in the programme for Government? If it is going ahead, when will it go ahead? If it is not going ahead, could we get a clear statement from the Minister for Health about the rationale for it not going ahead, and why we are abandoning a programme that everyone felt was working effectively to protect young people in Ireland from the scourge of HPV-related cancers?

It seems the Taoiseach stole my line, because I was going to say I would find out. I thank Deputy O'Gorman for raising a very important issue. I will answer the questions directly, but I join with him in talking about the importance of a science-led, evidence-based approach to vaccination.

I am very proud that largely, but not exclusively, in this House we have taken an approach across party lines, where we follow the evidence and listen to the doctors. As a result of that, we have seen lives saved and cancers prevented. I knew Laura Brennan personally. I wrote to her parents as recently as last week. She was an incredible young woman, who has saved countless lives by dedicating her final years to working to promote the vaccine. Her family are very proudly continuing that work.

As Deputy O'Gorman says, we did also expand the vaccine to boys. By the way, this did not happen by accident. There was an organised and concerted campaign to run down the vaccine and to suppress vaccination rates. There was misinformation and disinformation and downright mistruths and online campaigns. Thanks to Laura Brennan spearheading the campaign, we collectively managed to see the uptake rates increase again, working with clinicians and the HSE.

We have given a commitment to extend the catch-up programme. In direct answer to the Deputy's question on whether it is going ahead: we put it in the programme for Government, and it is going ahead. If there is anybody in some part of the Civil Service who thinks they know better, I assure them that we intend to deliver on the programme for Government commitment. I passionately believe in this, as I know Deputy O'Gorman does too.

I did not know this question was coming up, so I do not have a direct answer for the Deputy on when it will happen, but I undertake to speak to the Minister for Health today on the matter and I will come directly back to him on the issue.

I am always open to hearing if there is a particular reason or obstacle that I am not aware of, but this is a very important catch-up campaign. There is a reason it is in the programme for Government. I expect it is something on which there is cross-party support. I will revert to the Deputy directly on it.

I thank the Tánaiste. As he says, Ireland has a good take-up of the HPV vaccine, but at a time when vaccine scepticism is being mainstreamed, our take-up rates have been falling. A rough estimation is that approximately 16,000 eligible Irish kids are not taking up the vaccine each year. That is why the catch-up scheme is so important.

We know the risks from the HPV virus and that it can materialise years or even decades after the initial infection – cervical cancer, oropharyngeal cancer, penile cancer, vaginal cancer – life-threatening and life-altering illnesses. I thank the Tánaiste for his response. Could he commit to a clear statement from the Minister for Health in a reasonable period, perhaps in the next three weeks, telling us that the campaign is going ahead, as the Tánaiste suggests, and giving us a timeline for that? However, if it is not going ahead, could she explain the rationale behind the fact that a public health campaign everyone says is delivering and is protecting young children is not going ahead?

I give that commitment. We will come back in three weeks with a definitive plan on that. While I am on my feet, I suggest, as this relatively new Dáil commences, that every Member of this House would publicly commit to supporting the vaccination programme. There is no room for pseudoscience or wannabe doctors who are not doctors. I want to know if every single elected representative in every single political party is committed to supporting the HPV vaccine for young boys and young girls, one that can effectively eradicate a form of cancer in this country. What an incredible thing to say. We have it within our grasp over a number of years the ability to effectively eradicate a cancer, one that disproportionately affects young people, especially young women, but not just women. We have an opportunity here through vaccination and other means to effectively eradicate it. I invite all Members of the House to use the opportunity of Deputy O'Gorman's question to recommit to vaccination and to push back against the misinformation out there. I will commit to coming back within three weeks to the Deputy.