Leo Varadkar (Dublin West, Fine Gael)
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This is an important issue and I appreciate that Deputy Doherty and his colleagues have raised it previously. I do not have an up-to-date report on that but I will make sure that I get one from the Department of Health and that the Deputy gets an update either today or tomorrow.

Duncan Smith (Dublin Fingal, Labour)
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I wish to raise another important issue related to women's health, namely CervicalCheck and the Scally report recommendation that a national cervical screening laboratory would be fully up and running by September of this year. The Tánaiste will understand the utter outrage and disgust of the women of Ireland and activists on CervicalCheck when the Minister could not give any update on when this national laboratory will be set up and operational. Furthermore, not one sample is currently being tested in Ireland at this time, despite the fact that the Coombe Women and Infant's University Hospital returned to full operational capacity in December 2021 following the cyberattack. While we do not have exact figures on delayed diagnoses of cancer, at a conservative estimate cancer diagnoses dropped by between 10% and 14% in 2020 and in 2021 only six in ten patients were referred, as against the HSE's own service plan target of 95%. I ask the Tánaiste to provide an update on when the laboratory will be up and running.

Leo Varadkar (Dublin West, Fine Gael)
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While the Coombe Women and Infant's University Hospital is not currently processing cervical screening samples for the CervicalCheck programme, current services are not affected as an alternative laboratory is able to provide testing for 100% of samples. CervicalCheck is currently up to date with invitations for screening and by the end of 2021, it had screened the same amount of people as in any other two year period, notwithstanding the cyberattack and the pandemic.

A sum of €20 million has been committed for the construction, fit-out and staffing of a new national cervical screening laboratory. The cyberattack in 2021 meant that the Coombe hospital lost IT connectivity with CervicalCheck and could not accept samples for testing. Prior to that, the Coombe hospital was processing about 10% of community samples. CervicalCheck has increased its capacity with the main provider of the testing programme and is currently meeting all testing standards and turnaround times. The Coombe hospital has recently restored its IT connectivity and it is envisaged that it will be in a position to recommence sample taking in the next few weeks.

Gary Gannon (Dublin Central, Social Democrats)
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Like the Tánaiste, in recent months I visited Colombia. I did so with the human rights organisation, Christian Aid. While there I visited the La Guajira region and the notorious Cerrejon coal mine, from which Ireland, through the ESB, purchased much of its coal supply until 2018. As a consequence of the Russian invasion of Ukraine, we rightly will not be engaging with Russia on the purchase of coal but is it our intention to purchase coal from Colombia once again? Will that coal come from the Cerrejon mine? If so, has a human rights assessment been carried out or will the Government commit to one?

Simon Coveney (Cork South Central, Fine Gael)
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My understanding is that the ESB will not be sourcing coal from that particular mine but I can provide more detail on that to the Deputy.

Paul Murphy (Dublin South West, RISE)
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Mortgage holders could be facing extra mortgage charges of €1,000 per year as interest rates rise. This is the latest part of the cost of living crisis. We hear from the CSO that inflation has hit 7%, making this the sharpest cost of living crisis and squeeze for ordinary people since the 1980s. Irish banks are already charging the second highest rates for mortgages in the eurozone, with average borrowers paying €2,000 more per year than their counterparts in other European countries. These are the same banks that were bailed out by the public and are now again hugely profitable. This is profiteering, pure and simple and it should be stopped.

The Government is pushing ahead with privatisation of AIB when the banking sector should be brought into public ownership and run on a democratic, not-for-profit basis as a public utility. Will the Government, at the very least, act now to empower the Central Bank to cap the interest rates that can be charged for mortgage holders?

Leo Varadkar (Dublin West, Fine Gael)
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In case Deputy Murphy had not noticed, a large number of banks are leaving the country. At the moment, tens of thousands of individual customers and business customers of Ulster Bank and KBC are trying to find a new bank. Among the reasons those banks are leaving the country is that while they can make profits here, they actually would make more profits for their capital in other countries. That is one of the stated reasons they are leaving Ireland.

It is true that interest rates are higher in Ireland than in other eurozone countries. It is also true that bank charges are lower. There are signing fees that do not exist in Ireland. It is the case in Ireland that we have a much lower level of repossessions, which is a good thing by the way. That has a knock-on effect of socialising the cost of that in higher interest rates. There are many reasons as to why interest rates in Ireland are higher than in other European countries.

Matt Shanahan (Waterford, Independent)
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Evidence I have received in the past ten days shows the worsening clinical situation for heart attack transfers in the south east when the Waterford cath lab is closed. In the three years from 2019 to 2022, of 134 blue-light ambulance transfers from University Hospital Waterford to Cork University Hospital, not one arrived within the 90-minute treatment window. In fact, the time from call of ambulance to Cork University Hospital patient hand-over averaged three hours and 14 minutes. A three-year audit of heart attacks by the National Office of Clinical Audit, NOCA, has just been published and supports the evidence on transfer times.

As a doctor, the Tánaiste knows well the catastrophic damage resulting from this delay to emergency cardiac intervention. Will he, as a clinician and the leader of Fine Gael in government, immediately designate University Hospital Waterford a 24-7 cardiac centre and commit the requisite funding to fulfil a 24-7 service plan?

The pending Nolan report now has overwhelming evidence from the HSE and NOCA. In the opinion of clinicians, any counter conclusions to 24-7 service delivery at University Hospital Waterford would amount to snake oil. The evidence is clear. Will the Tánaiste designate University Hospital Waterford a 24-7 cardiac care centre?

Leo Varadkar (Dublin West, Fine Gael)
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I appreciate this is an important issue in Waterford and the south east. The Deputy will be aware of the work being done to construct and fit out the second cath lab in University Hospital Waterford. Obviously, when the laboratory is ready staffing it will be a challenge. Finding staff to staff two cath labs 24-7 will be a real difficulty. It is in large cities and it will certainly be a difficulty in Waterford too.

I cannot make any commitments of the nature the Deputy requested. I do not have the authority to do so. I will certainly let the Minister for Health, Deputy Stephen Donnelly, know that Deputy Shanahan raised the matter again and ask him to speak to the Deputy directly.

Mattie McGrath (Tipperary, Independent)
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I support Deputy Shanahan. It is a scandal that people have to wait that length of time. It is a two-tiered system for the people of the south east, Tipperary included. There is a further problem, apart from the cath lab not being open. There is a huge problem with the National Ambulance Service and waiting times. People are dying on the roadside and in their homes while waiting for three, four, five and six hours. Ambulances are flying all over the country because boxes are being ticked regarding the time a 999 call is responded to. The ambulance service may have responded but it will not say the ambulance could be 120 miles away in Donegal. A farcical game is being played with people's lives. It is not good enough.

This issue has been raised countless times in this House. Ambulance staff and personnel are fatigued. Ambulances are becoming burned out with the distances they travel. They are doing nothing but meeting each other on the road and failing to collect sick patients. People have lost their lives. We are going to continue with this farce. It is disgraceful. The people of Ireland, rural and urban, are entitled to and deserve a better service. The two issues are linked. The Tánaiste knows that 90 minutes is a crucial time for heart attacks and any other service. People have to wait or go by car.

Leo Varadkar (Dublin West, Fine Gael)
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It is increasingly understood that with heart attacks, or myocardial infarctions, the time period that is most relevant is the point from which the person starts to experience symptoms, rather than the 90 minutes from the time the call is made. There is a better understanding of that in recent years. I appreciate the comments the Deputy made but perhaps the best place to raise this matter would be during health questions with the Minister, or perhaps as a Topical Issue matter.

Catherine Connolly (Galway West, Independent)
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When will the third national strategy to tackle domestic, sexual and gender-based violence be published? It is self-evident as to why we need it. A report from the Department of Justice found a lack of effective oversight of the implementation of the second strategy, a fragmented approach and a lack of action on decades of recommendations. In 1997, we had a task force and here we are in 2022. Specifically, when will the report be published? It was due before the end of last year. We were promised it at the end of April and now we are into May.

Leo Varadkar (Dublin West, Fine Gael)
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I understand it is intended to publish the new strategy on 21 June. I take Deputy Connolly's point entirely that a strategy on its own is not enough, the strategy must be implemented and implementation in the past was fragmented. The Minister is very keen to establish a new dedicated agency to deal with the matter of the epidemic of gender-based and sexual violence. She believes the best way to do this is under a new agency, which she intends to bring forward.

Bernard Durkan (Kildare North, Fine Gael)
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Hepatitis C has always been regarded as a serious issue in Ireland. In the past few days, it would appear that a new form of the disease has been identified. Tragically, this has resulted in the death of at least one child. Will the Tánaiste indicate the extent to which the health services in general have been made aware of this particular issue and how best to combat it in the near future?

Leo Varadkar (Dublin West, Fine Gael)
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Hepatitis C is a very serious illness that has affected a lot of people in Ireland, including women and, in particular, people who suffer from haemophilia. Thankfully, hepatitis C can now be cured. There is a tablet for it that eliminates it from your system. It is an extraordinary miracle of modern science that this is now possible and available. It appears, however, that there is a new form of hepatitis in the world. It is not hepatitis C. We do not know exactly what type of hepatitis it is. I am sad to report that the HSE has confirmed that at least one Irish child who was being treated for this new form of hepatitis has died. A second child who is being treated for the same illness has had to receive a liver transplant. Both children were considered to be probable cases of an unexplained type of hepatitis that has been reported in children worldwide. The Health Behaviour in School-aged Children, HBSC, network reports that over the past two months, six cases of children with hepatitis of an unknown cause have been detected in Ireland. The six children were aged between one and 12 years and all were hospitalised. None of the Irish cases tested on admission to hospital had any evidence of Covid-19 infection at the time. Ireland is liaising very closely with our European, UK and World Health Organization colleagues in an effort to identify the cause of this illness. It is a matter of concern that we are very much aware of and plugged into. I thank the Deputy for raising it.

Darren O'Rourke (Meath East, Sinn Fein)
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Medical scientists provide essential diagnostic services for our hospitals and general practice. They are essential workers and are expertly trained. They deliver a 24-7 service 365 days a year. Next Wednesday, in frustration at long-standing pay and career development issues that are affecting recruitment and retention in the sector, they are taking industrial action. They have engaged in negotiations but these have been unsuccessful. The Medical Laboratory Scientists Association, MLSA, which represents medical scientists, is seeking meaningful talks. It should not have come to this. It sends a terrible signal to young people who might be considering entering STEM, or science, technology, engineering and mathematics. What is the Government doing to resolve this dispute as quickly as possible?

Leo Varadkar (Dublin West, Fine Gael)
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Medical scientists are an essential and crucial part of our health service. The Government appreciates the work they do in our laboratories and other facilities around the country. They may not be seen by patients very often but without them, there would be no patient care. It is essential that we support them in their work and recognise their role.

The issue raised by the Deputy is an industrial relations matter and there are mechanisms by which disputes such as this can be resolved. These include the Workplace Relations Commission, WRC, and the Labour Court, which are offices of my Department. Both the WRC and Labour Court would be ready to assist in finding a solution if the various partners want us to intervene.

Ruairi Ó Murchú (Louth, Sinn Fein)
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Following Liz Truss's threat to Maroš Šefčovič of British Government unilateral action to undermine the Irish protocol, what level of Irish Government engagement has there been with the British Government?

Has the Tánaiste spoken to Boris Johnson? Obviously, we cannot have a return of the spectre of a hard border in Ireland. The British may be looking for a game of chicken with the European Union. Hopefully, they are only grandstanding to keep certain sections of the British Conservative Party happy. This does not help, however, given the cul-de-sac politics being followed by the DUP following the historic Northern election.

Simon Coveney (Cork South Central, Fine Gael)
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I thank the Deputy. I can understand the concern with regard to this issue. Secretary of State Truss and Vice President Šefčovič had a telephone call this morning. We will get a detailed read-out from that telephone call later today. Clearly, what the British Government has now said is that it intends to move ahead with domestic legislation of its own if it does not see the compromises it is demanding in the context of the protocol. That is deeply unhelpful and has gone down very badly across the European Union. It has ratcheted up tension between the UK and the EU at a time when we do not need it in context of the bigger issues we are trying to deal with together, in partnership, in respect of Ukraine.

Our message is simple. We want partnership, dialogue and negotiation. We believe there is a landing zone that can deal with legitimate issues that have been raised regarding the implementation of the protocol by the unionist community and business community in Northern Ireland, representatives of both I met yesterday in Belfast. We will continue to maintain that position in dialogue with the British Government.

Pádraig O'Sullivan (Cork North Central, Fianna Fail)
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I raise with the Tánaiste the issue of knife crime. Recently, not only in Dublin but right across the country, we have had a number of incidents that have led to a number of deaths. Last year, a number of colleagues and friends of mine in the Fianna Fáil Party met the family of Jennie Poole, whose case is well-documented. My friend, Deputy Jim O'Callaghan, is bringing forward legislation to combat the issue of knife crime. What does the Government intend to do with that legislation?

Leo Varadkar (Dublin West, Fine Gael)
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I thank the Deputy for raising this issue. The Government is very concerned about incidents of knife crime in Ireland. I am aware of the sad case of Jennie Poole and extend my condolences to her family and friends. As a member of the Government, I have not seen that legislation yet. I am not sure what its status is or whether it has been published. I do not think it has been published yet, but once the Government sees it, we will be able to give it consideration. We are certainly happy to take on board any helpful suggestions that might help us tackle this problem.

Neale Richmond (Dublin Rathdown, Fine Gael)
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In light of Deputy Ó Murchú's intervention and the very enlightening response from the Minister, after what has been yet another awful couple of days on the six-years long Brexit merry-go-round, I ask quite simply whether the Government can trust this British Government, and, if we cannot trust it, who in the world can trust it in these very difficult times?

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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I thank Deputy Richmond. Is it rather difficult now?

Simon Coveney (Cork South Central, Fine Gael)
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I see I am being designated again. We need to work on the relationship between Britain and Ireland on these issues. The British and Irish Governments understand better than anybody else the complexities of politics in Northern Ireland in the context of what we have just seen in an election that was quite polarising on certain issues. We have a partner in the European Commission, and many other partners across European capitals, to help us do that. As I said earlier, I believe there is a landing zone that can be negotiated and agreed through partnership, where both parties agree to compromise and move towards middle-ground positions. The EU has been trying to do that now for well over a year, with new papers, new ideas, new concessions, more flexibility, extended grace periods and all the other things it has been trying to do to build partnership and trust with the British Government to try to resolve these problems.

Unfortunately, what we have seen, particularly over the last 48 hours, is a completely unnecessary ratcheting up of tension at a time when it is not needed or wanted, and a threat of unilateral action and legislation, which will be a breach of international law and will undermine trust. Instead of the European Union focusing on solutions and compromises, it will be forced into a reaction to a British unilateral breach of international law, which is the last thing we want.

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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I raise an issue that is very different from those we have just discussed. In two months' time, the Clondalkin Equine Club, which promotes urban horse ownership and equine education, will close. This is incredible because thus far the Department of Agriculture, Food and the Marine has spent €800,000 building and funding the project. I cannot fault the Department whatsoever; it has done a brilliant job. We are in a situation where 20 young people will have nowhere to stable their horses come July. This is a travesty when we consider the amount of money - up to €70 billion - that has been paid to the horse industry. The club is looking for a fraction of that. We speak about young people's health and well-being. In July, this club will have to close for the sake of a small amount of money. I appeal to the Government to come together and develop an interdepartmental response to fund this project.

Leo Varadkar (Dublin West, Fine Gael)
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I thank the Deputy very much. I know this is a very important issue in Clondalkin. Deputy Higgins also raised it with me and the Minister, Deputy Coveney, has been to visit the project in the past. I am sure we will find a mechanism to fund the project so that it keeps going. I am not sure whether that will be done through the local authority. I know that in my part of Dublin, Fingal County Council funds such projects, so perhaps the local authority is the solution. However, we are happy to work together to try to find a solution-----

Gino Kenny (Dublin Mid West, People Before Profit Alliance)
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The council said it will not do that.

Leo Varadkar (Dublin West, Fine Gael)
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-----because nobody wants to see the project close.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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I thank the Tánaiste. Deputy Dillon is next. Is Deputy Carroll MacNeill substituting for Deputy Dillon?

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I am next on my list anyway.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Deputy Carroll MacNeill is not on my list; Deputy Dillon is.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I thank the Ceann Comhairle. I raise again with the Minister of State, Deputy Rabbitte, the need for residential and respite care for people with profound disabilities in Dún Laoghaire in my constituency, in particular the case of 28-year-old Louisa Fitzgerald who has been profoundly disabled since birth and requires 24-hour care. Her parents are in their 60s and both have been through cancer twice. Louisa suffers from severe epileptic seizures and needs residential care. At the very least, her family need respite care. I have written to and spoken with the Minister of State about this case and I thank her for her support. I am embarrassed for the HSE to have to raise and press Louisa's case with the Minister of State in the Dáil to try to get respite and some comfort for her parents as they continue to look after her in advance of getting residential care.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Deputy for her continuing work on this particular case and for highlighting to me that the respite house in question was not working at full capacity. The respite house has come into full capacity in recent days. I have been reassured by the HSE that Louisa's family will be contacted about the reinstatement of her respite care.

Johnny Guirke (Meath West, Sinn Fein)
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I raise the issue of Enfield Community College. We have been told the new school will go to tender later this year and will be delivered by the Department's design and build team. While this is promising news, has the school project been identified under one of the current project bundles in the National Development Finance Agency, NDFA, and, if so, which one? Following a review of the project bundles for Project Boyne, Project Dargle and Project Nore under the devolved schools building programme, DSBP, 2, on the NDFA website, I note that none of these lists features Enfield Community College, yet all are at pre-procurement stage in preparation for tender in 2022-23. Will the Minister of State indicate if the tender documents for Enfield Community College are being prepared? Will she provide details of the project team and project managers working on behalf of NDFA and the Department of Education?

Josepha Madigan (Dublin Rathdown, Fine Gael)
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I thank the Deputy very much for his question. My understanding is that the Minister for Education, Deputy Foley, had a meeting with the Minister of State, Deputy English, and Senator Cassells this week, and the project will be going to tender this week. I hope that is of importance to the Deputy.

Claire Kerrane (Roscommon-Galway, Sinn Fein)
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I raise the current and ongoing crisis in home care and the 412 people approved for home care in counties Roscommon and Galway who are not receiving it. Some, of course, receive some level of care and have been approved for more, while others have been approved and are not receiving anything. It is now being reported that some older people are staying in bed all day. Frankly, it is heartbreaking that this is happening in this day and age.

I understand the Minister has established the workforce advisory group, which is welcome. However, I understand the group is not due to report until September.

In the meantime, can immediate measures be put in place through the Minister engaging directly with providers who know the challenges and the solutions? There are issues with pay and terms and conditions. Mileage costs, in particular, have become an issue. The sector is growing commercially but there are no regulations or HIQA standards. I appreciate legislation in this area is under way. Could we have an update on that? This is a very important sector. There is clearly a recruitment and retention crisis and it needs to be addressed as quickly as possible.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for her question and her continued interest in the matter. As she said, this is a very important sector. Currently, 55,000 people receive home care in their own homes. The Government is very serious about home care and I have a budget of €670 million to deliver it. Last year, we increased the level of home care by 2 million hours, bringing the total to 21 million hours delivered in that year. Unfortunately, we are challenged from a workforce point of view. Approximately 5,300 people are awaiting home care. That figure increased by 1,000 in April alone, even though we had delivered 7% more hours than we had by the same point in the previous year. More people are being referred for home care.

The strategic workforce group, which is meeting, will not report until September, as the Deputy noted, but we are trying to make home care a viable career choice such that we can encourage more people to go into it and to see it as a long-term career opportunity. I will bring that legislation to the House before Christmas.

David Stanton (Cork East, Fine Gael)
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The Tánaiste is making very welcome job announcements almost every other day. Will he comment on the employment permit waiting lists? When will the employment permits (consolidation and amendment) Bill be published?

Leo Varadkar (Dublin West, Fine Gael)
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We have had a huge increase in the number of applications for work permits and work visas and, in response, we have trebled the number of staff working on issuing work permits and work visas and are automating some processes. We are starting to see improvements in waiting times. For critical skills permits, the waiting time is now back to six or seven weeks, which is pretty good. For the general employment permit, it is still about 20 weeks, but we expect that to fall in the next few weeks. It is something we are getting on top of. We have trebled the resource behind it and many more staff are now working on the issuing of permits. The waiting times are a function of the huge increase in demand for work permits, given how difficult it is to find staff not just here in Ireland but throughout European Union at the moment. The legislation is with the Minister of State, Deputy English, and while I do not have a date for its publication, we expect it to be brought to Cabinet in the next few months.

Marc Ó Cathasaigh (Waterford, Green Party)
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Last week, in the company of representatives from Waterford LEADER Partnership, I visited two new office buildings in the Blackwater Valley economic development zone, in Lismore and Tallow, both very fine new buildings that offer a company all it would need in the centre of these historic towns. Injecting good jobs and salaries into rural towns such as these throughout the country has the capacity to transform local economies and drive on the goals set out in both Our Rural Future and our town centre first policy. While remote working and hot-desking will be an element of the offering, the partnership needs anchor tenants to provide that stable revenue stream. Does the Tánaiste see a role for Enterprise Ireland in helping to direct the demand for high-quality office spaces to those in the likes of Lismore and Tallow, rural towns where that economic boost would be most keenly felt?

Leo Varadkar (Dublin West, Fine Gael)
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The short answer is "Yes". I think there is a role for Enterprise Ireland in that regard, and for IDA Ireland because sometimes, when new companies invest in Ireland for the first time, they want to set up in an available premises with a small number of staff before they develop their headquarters. There is definitely a role for both agencies in that regard and that will form part of my discussions with them.