It is no exaggeration to say that primary care services for children around the country are at breaking point. Figures obtained by my colleague, Liam Quaide, revealed the depths of the crisis. The longest wait time for speech and language therapy in primary care services in Dublin is six years. In the north Lee area of Cork, one child has been waiting seven years for physiotherapy. For occupational therapy in primary care, there are huge waiting lists. A child in Meath has been left waiting for nine years and a child in north Dublin ten years. When it comes to psychology services, a child in Galway has been left waiting nine years, while one young person in Dublin has been on a waiting list for more than 13 years.

Leaving children on waiting lists for six, seven, nine, ten and 13 years is utterly unacceptable. How can the Taoiseach possibly defend someone waiting for psychological services since 2012? How can he let this happen? He has been in office since 2020. He has had more than enough time to sort this out. The impact on children, young people and their families has been catastrophic. Early intervention, as he knows, is crucial and makes all the difference so that children can reach their full potential. These waiting lists mean that thousands of children all over the country are suffering unnecessarily. They are having problems communicating, having difficulties at school and co-ordination challenges. These are all things that could be made more manageable with timely intervention.

These services have been run into the ground by the Taoiseach’s Governments. During the last Government, he stood over a recruitment embargo in the health service. At the time, the Irish Association of Speech and Language Therapists said it was aware of vacancy rates of up to 45%. That embargo was replaced with another barrier to recruitment - the pay and numbers strategy - in July 2024. This capped employment at December 2023 levels. It meant previously funded positions that could not be filled during the recruitment embargo were simply abolished. Critical services in primary care were just expected to cope with soaring referrals and reduced staffing but, of course, they could not and children all over the country paid the price for this.

The only thing children are guaranteed is a place on a waiting list. This cannot go on. Not only has the Government not addressed this crisis, but it has made it worse. How can the Taoiseach stand over someone having to wait 13 years on a waiting list? Does he accept responsibility for these waiting lists and will he commit to an urgent recruitment drive for primary care services?

First of all, Deputy, we have had the biggest expansion of access to free GP care in the history of the State, which the Deputy did not reference in his presentation on primary care services. It is the biggest expansion of access to free GP care in the history the State. Some 2.3 million people are now eligible in this country for free GP care. I would ask the Deputy to forward me the details of the individual cases he instanced.

The Deputy mentioned a recruitment embargo. There has been no recruitment embargo. We do need to get a bit real here. We have had close to 30,000 extra people in our health service in the last five years and the Deputy talks about an embargo. Six thousand more will be employed in 2025 and thousands more will be employed next year. These will be additional.

Maybe a more pertinent question to ask is whether we are getting the outputs for the significant investment that has gone into health over the last five years.

Clearly not.

That is a separate question,-----

Whose responsibility is this?

-----but the Deputy never asks it because he does not want to fall out with anybody, which is understandable coming from the Opposition. There are issues in terms of how we deal with therapists. We have set up a new in-school therapy service for children in special schools that will start in September. We have already allocated money for that additional to the Estimate that was provided. That will be significant. Recruitment is increasing significantly for the CDNT teams in terms of recruitment of therapists and filling more posts but we want to increase upon that in 2025 and 2026. We are dramatically ramping up places, and have been for quite some time, in our colleges to produce more therapists to come out on an annual basis. We do need to look at how we deploy therapists. That is why we have said here in the House that we want to bring in legislation to prioritise access to therapies and amend the existing situation pertaining to assessment of need because that is not serving children well. We have acknowledged that.

There are issues with delays in terms of accessing vital services but we are prepared to do something about it. I would appreciate the Deputy's support in respect of that legislation when it comes before the House because it will prioritise access to services and access to therapies as opposed to waiting to get the assessment of need first and then accessing therapies. The existing legislative template has not worked in practice and, in my view, legal decisions subsequently have obliged us to act to deal with that difficult issue. The nettle has to be grasped on that to bring about an improvement in terms of how we best use our therapists in this country, because we have increased the number of therapists in employment by a lot more compared to five, six, seven or eight years ago.

I asked the Taoiseach about primary care teams and the Government's failure to staff them properly, which has led to a situation where waiting lists for primary care for children can be up to 13 years in the worst case scenario. That is what I asked him about. He did not address the shortages in primary care teams in his answer. He addressed other issues but he did not address primary care teams. Does he take responsibility for this or is he just pointing the finger at others? He has been Taoiseach and Tánaiste for six years, so does he take responsibility for this? Is he going to fix it? Is the Government going to start recruiting to fill these empty posts in primary care teams? Is it going to tackle this? Alternatively, does the Taoiseach think that it is somehow acceptable for children to have such extreme waiting times for primary care teams? Does he stand over it or will he fix it?

We will continue the work to recruit. We have been recruiting. There has been an increase of €6.71 billion in expenditure in health. This is a 35% increase in health spending since 2020, so do not say we are cutting back or are not allocating. The Deputy cannot say that with credibility.

Does the Taoiseach acknowledge it is happening-----

Sorry, Deputy. Allow the response.

We have allocated, which is a fundamental point.

By the way, we have made huge impacts across a lot of areas in health in the last five years, to such an extent - though this would be over a longer period - that our mortality rate fell by 11% over the decade from 2014 to 2024. We now have the second lowest mortality rate among the European 27, so the investment is having impacts of a positive nature.

What about the child who has been left waiting for 13 years?

Are there significant issues? Yes, especially with access to some primary care services, mental health services and, above all, therapies, but we are allocating. There have been issues in the HSE with recruitment and retention in some areas and those are being worked on.