Pearse Doherty (Donegal, Sinn Fein)
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Tá seacht mbliana ann ó thug an Taoiseach nuair a bhí sé ina Aire Sláinte gealltanas nach mbeadh aon pháiste ag fanacht níos faide ná ceithre mhí le haghaidh máinliacht scolóise a d’athródh an saol a bhí acu. Briseadh an gealltanas sin arís agus arís. Tá a fhios againn anois nach bhfuil an t-airgead a chuireadh ar fáil in 2022 caite chun na seirbhísí seo a sheachadadh. Teip eile é seo ar an Rialtas. Is scannal é atá ag ligean síos páistí agus á bhfágáil i bpian.

In 2017, the then Minister for Health and current Taoiseach, Deputy Harris, made a commitment that no child would be waiting longer than four months for life-changing scoliosis surgery. That promise was broken over and over again. In February 2022, the Minister for Health, Deputy Donnelly, doubled down on the Taoiseach's broken promise when he made the same commitment that children would not wait more than four months for this surgery and he provided €19 million to Children's Health Ireland, CHI, to achieve that. This was also another broken promise.

Immediately, both parents and patient advocates had serious concerns that CHI intended to spend this money differently from the purposes for which it was allocated. They first raised their concerns with the Minister for Health and his advisers in March 2022, just weeks after the funding had been announced and he had made his promise. They made clear their concerns that this money would not be spent as intended and they asked the Minister to investigate this issue. They had a meeting with one of his advisers on 11 March but said, "After our meeting on 11 March, we never received a response and all our emails and queries remained unanswered", which is disgraceful. They refused to accept the Government's silence and continued to raise their concerns in June, July and August 2022 but to no avail. Their main concern was that the €19 million that was allocated to meet the target for patients with scoliosis was not going to be spent on its intended purpose but would be spent on previously sanctioned and funded staffing and infrastructure measures that were being rolled out. Shockingly, it took until February of this year for the Minister for Health to order an audit.

Since he was ignoring their concerns, patients, families and advocacy groups reached out to the Taoiseach when he took office, to the same man who made that broken promise seven years previously that no child would be waiting more than four months to receive life-changing surgery. The Taoiseach wrote back to them. What did he say? He said that he would meet the advocacy groups but, three months later, they still have not had a meeting or received even a date for a meeting with the Taoiseach.

Yesterday in the Seanad, the Minister for Health confirmed that the majority of the €19 million in funding intended for spinal services was allocated more broadly across CHI. He said that the €19 million announced did not result in the eradication of the over four-month waiting list by the end of the year "which was deeply frustrating and disappointing to me". It is worse than disappointing and frustrating; it is an absolute scandal. Where is the accountability? These patients, their advocates and their parents reached out to the Minister and his office over and over again. They told him that this money was not going to be spent on the promise that he gave them and their children. They pleaded with him to investigate this matter two years ago. They asked his official to do that and contacted him over and over again but he ignored them, yet the Taoiseach still will not met with them. When is this going to end? What is the Government going to do to address the ongoing scandal of years-long waiting lists for children with scoliosis and spina bifida who are being forced to suffer in agony with no light at the end of the tunnel? What does the Tánaiste have to say about a Minister who ignored what has been proven true, which is that the money would not go to treat these children and would be spent elsewhere? The Minister ignored the pleas over and over again.

Micheál Martin (Cork South Central, Fianna Fail)
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Ar dtús báire, caithfidh mé a rá go bhfuil an Rialtas sásta agus den tuairim go gcaithfimid gach aon iarrachta a dhéanamh chun liostaí feithimh na leanaí atá ag feitheamh ar obráidí scolóise a ísliú chomh tapa agus is féidir linn. Is é seo aidhm an Rialtais agus aidhm gach éinne sa Teach seo. Tá an tAire Sláinte ag déanamh gach iarrachta é seo a dhéanamh agus chuir mé sé i bhfad níos mó airgid ar leataobh nó ar fáil do CHI chun go bhféadfaí i bhfad níos mó a dhéanamh. Is léir go bhfuil i bhfad níos mó obráidí ag tarlú anois ná mar a bhí, ach caithfimid níos mó a dhéanamh agus é a dhéanamh níos tapúla. Tá an Rialtas ag coimeád an bhéim ar an mbuncheist nó ar an mbunaidhm sin, is é sin na liostaí feithimh a ísliú chomh tapa agus is féidir linn.

The Government's commitment is to do everything we possibly can, as quickly as we can, to reduce the waiting lists for children waiting for scoliosis operations. That is what the families and the children, above all, deserve and require. As far as I concerned and as far as the Minister for Health is concerned, we will continue to do that. The allocation of €19 million in funding to CHI was genuinely allocated with a view to significantly reducing those lists. Activity levels have gone up significantly in the past number of years in respect of spinal procedures. Compared to 2018 and 2019, they were up by 34% in 2022 and by 22% in 2023 but that is not enough for those who are still waiting. There was a reduction in the list in 2023 and now there are approximately 70 patients waiting for more than four months for operations. That is not satisfactory and I acknowledge that. There have been issues within the service, as we know, which were unexpected and which have affected capacity. The €19 million has been spent and it is important to say that. It was allocated to both current and capital spending and facilitated the recruitment of more than 200 additional clinicians, a new fifth operating theatre in Temple Street, a new second MRI facility for Crumlin, approximately 20 additional hospital beds and additional resources for Cappagh hospital. Those resources were to be used for spinal services. While there was a reference in the allocation to "other" services also, the money was primarily for children's spinal services.

CHI informed the Minister that its plan would mean that by the end of 2022 the number of children waiting over four months would be reduced to zero. That is what CHI said to the Minister and the Minister funded the plan on that basis. The investment did result in an increase in the number of surgeries performed but the reduction in the waiting list was modest and was nowhere near what was promised. The Minister did engage on this in 2023, contrary to what the Deputy said. He did not ignore the issue but engaged directly with spinal surgeons and advocacy groups. It became clear that the additional resources of €19 million had been allocated far wider than just children's spinal, or even children's orthopaedic, services. He then asked the Department to ascertain exactly how the resources were being allocated across different services but, unfortunately, CHI did not provide this information. The Minister raised the issue with the CHI board but that did not resolve it either. Then he asked the CEO of the HSE to send in the HSE's internal auditors to get this information and that work is nearing completion. However, based on ongoing detailed engagement between the Minister, CHI's new interim CEO and the spinal clinical lead, Mr. David Moore, it is clear that the majority of the additional resources were not ring-fenced for the purpose intended by Government.

Pearse Doherty (Donegal, Sinn Fein)
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I am not sure whether the Tánaiste has just listed out the incompetences in terms of the Minister for Health. Let us boil this down to what happened. The Minister was told by CHI that if he gave it €19 million, it would reduce the waiting list so that nobody would wait more than four months.

The Minister gave CHI the money. Within weeks, the parents and the advocates were telling his office that this money was not going where it was needed. They were begging him to investigate this. They had a formal meeting. They followed up with emails in March, June, July, and August. It is not me but them saying they got no response.

Stephen Donnelly (Wicklow, Fianna Fail)
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They did get responses.

Pearse Doherty (Donegal, Sinn Fein)
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When did the Minister carry out an audit? He carried out an audit in 2024, two years later. Within weeks, the flags were going up. Within weeks, the parents knew. The parents have enough on their plate. Parents and families from right across this State were outside the Dáil in February. They told us about the pain and the hurt and about patients in my constituency who need these surgeries. The Minister allocated the money - fair play - but the money did not go where it was needed. He was told, begged and pleaded with over and again - I have the emails - and he did nothing, or if he did something, it was completely ineffective because two years later he still does not know where this money has gone. The problem is these parents warned him back in March of 2022 that this money would not be spent in this place. If we had a competent Minister for Health, he or she would go in and say, "You told me you needed €19 million. I gave you €19 million. Make sure that it is spent in the area." It is not acceptable that we are in this position today and that the Minister still does not know where that money went.

Micheál Martin (Cork South Central, Fianna Fail)
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An audit, by definition, happens after a particular programme of action has taken place. You cannot audit something within three weeks of the money being allocated. That does not make any sense.

Stephen Donnelly (Wicklow, Fianna Fail)
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It is nonsense.

Micheál Martin (Cork South Central, Fianna Fail)
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That is what the Deputy is suggesting.

David Cullinane (Waterford, Sinn Fein)
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We are not suggesting that.

Pearse Doherty (Donegal, Sinn Fein)
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The money is not being spent in the right place.

Micheál Martin (Cork South Central, Fianna Fail)
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The whole idea of auditors going in is-----

David Cullinane (Waterford, Sinn Fein)
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Does the Government have a plan?

Micheál Martin (Cork South Central, Fianna Fail)
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Money has been spent; therefore, we go in and diligently, in a detailed way, find out where the money was spent. We do know that an additional 200 clinicians and so on were appointed and that there is a fifth theatre there. That is not all not directed to scoliosis. Of course, quite a significant amount of that will be of benefit to scoliosis patients. There have been other issues within the scoliosis world, as we know, which have had an impact. The Deputy has not referred to them, but we all know the current unfortunate situation. There are issues in respect of CHI's oversight of this also, but those issues cannot be interrogated without having a comprehensive audit in terms of facts.

Pearse Doherty (Donegal, Sinn Fein)
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No, no, no. That is not it at all.

Micheál Martin (Cork South Central, Fianna Fail)
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That cannot be done three weeks in.

Pearse Doherty (Donegal, Sinn Fein)
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Families were telling-----

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Please, Deputy.

Micheál Martin (Cork South Central, Fianna Fail)
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The most important issue for us now is, through existing capacities within CHI and the hospitals and whatever other means in terms of-----

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Your time is up, a Thánaiste. Thank you.

Micheál Martin (Cork South Central, Fianna Fail)
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-----external work, to get these lists down as quickly as we possibly can.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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We are over time.

Pearse Doherty (Donegal, Sinn Fein)
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Families are in desperate need and the Minister has sat on his hands for two years.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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I call Deputy Holly Cairns.

Stephen Donnelly (Wicklow, Fianna Fail)
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That is a total misrepresentation, and the Deputy knows it.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Can we please desist?

Stephen Donnelly (Wicklow, Fianna Fail)
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That is totally disingenuous.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Please. I call Deputy Holly Cairns.

Stephen Donnelly (Wicklow, Fianna Fail)
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It is of no benefit to the families to hear the Deputy's dishonesty in Dáil Éireann.

Aengus Ó Snodaigh (Dublin South Central, Sinn Fein)
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Mutter away there.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Please, Minister, can we-----

David Cullinane (Waterford, Sinn Fein)
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The Minister's time would be better spent meeting the families rather than shouting over at us. Meet the families.

Stephen Donnelly (Wicklow, Fianna Fail)
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We have met them many times.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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If Members want to have a private discussion about this, have it outside, please, not here. We have a programme to follow. I call Deputy Cairns.

Pearse Doherty (Donegal, Sinn Fein)
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For the record, I am only putting the words of the families on the record; they are not my words.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Deputy Holly Cairns, please.

Holly Cairns (Cork South West, Social Democrats)
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Everyone in this House agrees that sexual and gender-based violence is an epidemic. No part of society or sector is immune. We all know that tackling it and eradicating it is not easy. Sometimes, however, it seems like the State is not even trying. Let us take, for instance, what is happening in the Defence Forces. We know that 68 members of the Defence Forces either have been convicted of crimes or are before the courts charged with criminal offences. It is bizarre that we need to appoint a senior counsel to tell us that Defence Forces personnel who are convicted of serious crimes like sexual offences should not be serving, but that is apparently what the Government proposes to do. That is not an approach that screams zero tolerance. The reality is that we do not see much in the way of zero tolerance outside of it just being a slogan. It is hard to find evidence of a zero-tolerance approach anywhere.

We learned this week that a Dublin taxi driver, Raymond Shorten, convicted of raping two young women had previous convictions for sexual offences. One of his victims said she thought she would be safe when she hailed a taxi. That is what we are told is the safe option. The reality was that she had got into a vehicle being driven by a serial predator. Why did he have a taxi licence? Why did the regulator not act? How many other taxi drivers have similar convictions? Do we even know? At least the regulator, the National Transport Authority, NTA, actually has powers to disqualify taxi drivers convicted of serious crimes. The question is: is the NTA using them or do those powers need to be enhanced?

This is not the case in other professions. The Dental Council of Ireland has been begging successive Governments for years to give it powers to take action against rogue dentists, but nothing has been done. We know that at least one dentist convicted of sexual assault was able to practise in Ireland because the regulator had no power to stop them. Those powers still do not exist and those powers can only be given to the Dental Council by the Government.

Counselling services are also a wild west when it comes to regulation. The reality is that there is none. Vulnerable sexual abuse victims will often seek counselling support. They are exposed to unnecessary additional risk because of the complete absence of regulation.

The Tánaiste said last week that any member of the Defence Forces charged with sexual assault or rape would be put on immediate leave. Did that happen? How many Defence Forces members were suspended? Does he also believe that taxi drivers, dentists, counsellors and members of other professions who have close contact with members of the public should be similarly suspended when facing serious sexual offences and, if so, is he going to do anything about it? Has anyone in government written to the NTA about the Raymond Shorten case? Does he know why that predator had a taxi licence? When will the Government do more than talk about zero tolerance and give professional bodies, such as the Defence Forces, the Dental Council and others, the power they actually need to make zero tolerance a reality?

Micheál Martin (Cork South Central, Fianna Fail)
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I thank the Deputy for raising this issue. The Government published in 2022 a five-year zero-tolerance strategy and has established Cuan, the agency which we agreed with all involved in the sector would deliver on this ambition. It has an overall budget of €59 million for 2024. I pay tribute again to Natasha O'Brien and Bláthnaid Raleigh and others who have come forward to tell their stories. More and more, the focus has to switch more to the victim's journey in the criminal justice system. The O'Malley report identified significant improvements that could happen in respect of the victim's journey through the entire criminal justice system. In Bláthnaid Raleigh's case, five years of her life were suspended, in essence, before justice could be served. That is too long. There are very serious issues with that entire system in alleviating and reducing trauma and ensuring the trauma is not prolonged.

This is not just all talk. Members on all sides of the House have families. Some are married; others are not. Some of us find it incomprehensible that men can visit such violence upon women. The nature of the attacks we have witnessed are absolutely appalling. We have discussed this as to what is happening with our younger population in terms of their access online to a whole range of materials which could either reflect brutalising attitudes or create new attitudes. These are fundamental issues that society collectively has to work on. The Government has the major responsibility, which I accept, in dealing with this issue, but it is multifaceted.

The Deputy referenced the Defence Forces. The 68 cases do not all relate to gender-based violence. Approximately six cases relate to domestic incidents or breaches of barring orders, and approximately 24 cases relate to assault generally. Approximately five relate to sexual assault and one is pending. In respect of any conviction, even before an appeal is heard, I did make an instruction, and that has been followed through, because there was an inconsistency in application of the local leave mechanism.

However, they are all on local leave. I just wanted to make sure there was no doubt about that. I have to make the point that not all 68 are in that category. While I do not mean to distinguish them in any way, as those in society who are charged with protecting society, there is a special onus on the Defence Forces and An Garda Síochána and we have to apply certain standards.

Holly Cairns (Cork South West, Social Democrats)
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I can only presume from his reply that the Tánaiste did not understand the question or the contribution that I made in the first instance so I will do my best to explain again. We hear more about women being told not to walk home alone at night than we hear about men being told not to assault or rape women who are walking home alone at night so many women decide to take a taxi. The thought that the person driving that taxi could be a convicted sexual offender is the stuff of nightmares for women. I am asking the Tánaiste about regulation in that sector through the NTA. I am asking about regulation for dentists. This is something the Social Democrats raised in our latest Private Member's motion and nothing has been done. I am also asking about regulation in the counselling sector. The Tánaiste has not touched on a single one of those issues in his reply. I know that the issue is multifaceted. The Tánaiste says that the Government takes an overall approach. The Government is the only thing that can give those overarching bodies the power to suspend people who have committed offences like that. That is what I am asking the Tánaiste to look at. Will he please respond to it directly? Will he also tell us the number of people who have been suspended from the Defence Forces?

Micheál Martin (Cork South Central, Fianna Fail)
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The Deputy has this tendency to suggest in a very self-righteous way-----

Róisín Shortall (Dublin North West, Social Democrats)
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Come on, you have been asked about regulation.

Gary Gannon (Dublin Central, Social Democrats)
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Just answer the question. You cannot keep on waffling.

Micheál Martin (Cork South Central, Fianna Fail)
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Through the Chair please.

Róisín Shortall (Dublin North West, Social Democrats)
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Stop dodging the question.

Micheál Martin (Cork South Central, Fianna Fail)
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She has a tendency to suggest in a very self-righteous way that everybody else in the House has a somehow inferior approach to what is a very fundamental issue for all of us.

Róisín Shortall (Dublin North West, Social Democrats)
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She asked the Tánaiste to answer the question.

Gary Gannon (Dublin Central, Social Democrats)
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Is this Leaders' Questions or is the Tánaiste just commenting on the Deputy?

Micheál Martin (Cork South Central, Fianna Fail)
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I will deal with the question.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Will the Deputies pleases let the Tánaiste answer?

Pearse Doherty (Donegal, Sinn Fein)
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Blame the person.

Micheál Martin (Cork South Central, Fianna Fail)
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Deputy Cairns raised the issue of the Defence Forces and I answered on the Defence Forces. She said that it was all talk on this side of the House. I made a response, which I am entitled to make, that it is not all talk. I acknowledged that every Member in the House has a shared objective and I outlined what the Government is doing in response to the Deputy's assertions that it is doing nothing. That is a fair response.

On regulation and the Dental Council, a dentist convicted of sexual assault cannot continue in dental practice.

Holly Cairns (Cork South West, Social Democrats)
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That is not true.

Micheál Martin (Cork South Central, Fianna Fail)
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That is the case. Come on. In the past, I have seen investigations into horrific child abuse in respect of dental practice.

Holly Cairns (Cork South West, Social Democrats)
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This is waffle.

Micheál Martin (Cork South Central, Fianna Fail)
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There is no question but that the taxi regulator should have a role in ensuring that no rogue taxi driver, particularly a taxi driver involved in sexual assault, can ever drive a taxi again.

Róisín Shortall (Dublin North West, Social Democrats)
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They are, however.

Micheál Martin (Cork South Central, Fianna Fail)
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While I will not go into any individual case, in my view, any taxi driver who has committed an assault should be in prison.

Holly Cairns (Cork South West, Social Democrats)
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It is not about the Tánaiste's view. This is his responsibility.

Micheál Martin (Cork South Central, Fianna Fail)
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Across society, we have regulated extensively.

Holly Cairns (Cork South West, Social Democrats)
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There is no regulation in the Dental Council.

Micheál Martin (Cork South Central, Fianna Fail)
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We have regulated extensively. With regard to the Medical Council and the Dental Council, we will continue to see if we can enhance that regulation.

Róisín Shortall (Dublin North West, Social Democrats)
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That is pathetic.

Marian Harkin (Sligo-Leitrim, Independent)
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I will raise the case of a person who spent five years of his early life in Nazareth House, Sligo. While his situation is unique to him, many others found themselves in the same circumstances so my ask is a general one. Nazareth House was an orphanage and care home but this person was not an orphan. Some three days after giving birth to him, his mother was forced to emigrate by her family, local clergy and, indeed, wider society, who did not want what was then called a "fallen woman" in their midst. A three-day-old motherless child was therefore put into care. This was back in the early fifties. A few months ago, this man became aware of the mother and baby institutions payment scheme and asked me to submit a parliamentary question asking whether Nazareth House could be included in it. The response I received was very clear. It stated: "Nazareth House was not an institution that provided ante and post-natal facilities and therefore not included in the scheme." Needless to say, this man is very disappointed. He spent five years in Nazareth House and while he emphasised that he himself was not abused and was indeed shown some kindness, he is well aware that many other boys suffered horrible abuse at that time.

That is not the end of his story, however. One day, when he was six years old, a priest and a couple came to see him. The next day, he was told to pack his little bag and was put into the back of a small van and brought to live with total strangers. His last memories of Nazareth House are of waving out the small windows at the back of the van to his friends and them waving back at him as he travelled down the avenue. His life from then on was hard slave labour on the farm he lived on and on neighbouring farms. Nobody ever came to see how he was doing.

I have read the legislation on the mother and baby homes and the negative response I received is accurate. However, now that the scheme is up and running and is recognised as a positive gesture by the State towards those who were grievously wronged in its care, will the Government consider extending the scheme to include all of those children who found themselves in institutions that were identical to mother and baby homes with the sole difference that their mothers did not give birth to them in those institutions and did not spend any time nursing them there afterwards? In many ways, this is, if possible, more cruel to all of those babies who were seen as a stain on our society. Their sense of loss, desolation and rejection never leaves them. It was just as grave for them as for anybody who spent time in a mother and baby institution. I know it is a big ask to extend this legislation to include institutions like Nazareth House but I hope the Tánaiste will consider it.

Micheál Martin (Cork South Central, Fianna Fail)
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I thank the Deputy for raising this case and this issue. The life story she outlined is harrowing. I accept the presentation she has made in respect of that life journey and what happened in our past as regards institutionalisation and how our society evolved in respect of children who were subsequently adopted and children who were placed in less than ideal situations. The Deputy said that the child in question was brought to a farm and essentially used as slave labour in shocking conditions.

The commission of investigation set up in 2015 was tasked with examining the use of mother and baby institutions and county homes. Their establishment was shameful. I find it very difficult to comprehend the mores of the time and how county homes evolved into mother and baby homes over the decades but the terms of reference were focused on those institutions, the mother and baby homes, that sought to provide a place of antenatal and postnatal residence to both mother and baby. That was the remit of the commission. All of that was associated with shame, blame, judgment and subsequent very harsh treatment. It took five years for the commission to complete its work. The report was voluminous in itself. The Government of the day may not have anticipated that it would take that long to complete its work. The commission's work essentially did not cover other institutions that were also associated with stigma, trauma and abuse. Going back over the past two, three and four decades, we have been investigating various institutions including industrial schools, Magdalen laundries and mother and baby homes. There has been a very substantial excavation of our past as regards the institutionalisation that was rife in how society dealt with issues in the past. It has been very traumatic for many people.

It has taken a long time. It inevitably does.

The Deputy identified one institution. There may be others in different categories. It is very difficult to encompass various scenarios. In other scenarios - orphanages, and it is essentially an orphanage - other orphanages had more benign impacts or would have been of assistance to particular families as well. We can review and look at this but in fairness, in the context of the mother and baby homes, that was what the commission was asked to investigate and the redress scheme was very much in response to the commission's recommendations.

Marian Harkin (Sligo-Leitrim, Independent)
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The Tánaiste and I us agree on the historical aspect. My question is about how the State in some way tries to compensate a little bit for some of the awful experiences of those children in its care. I looked at the review clause in the legislation and I am not sure there is actually a possibility to extend it. However, section 49 states that the Minister, in considering whether an institution shall be inserted, because the Minister has that power, shall have regard to the circumstances experienced by persons resident in an institution and whether these were comparable to those experienced by persons resident in institutions specified in the current legislation. There is a tiny opening there for a Minister to look at in the future. While I understand this would be a significant expansion of the scheme, in view of the fact that it is now seen as a just and good course of action, I am asking the Tánaiste just to look at that. I am not asking him to make commitments on the floor of the House today, just to confirm that he will not close the door on this.

Micheál Martin (Cork South Central, Fianna Fail)
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Review mechanisms have been built into the legislation. Doors are not finally closed. However, I would offer this point as well. I set up the commission into industrial schools. I remember meeting on day one with the survivors, who actually never looked for a redress scheme. It was clear to me that future housing, healthcare and constant counselling were important - so lifelong. At times, that can sometimes be a better response from the State.

Marian Harkin (Sligo-Leitrim, Independent)
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Yes.

Micheál Martin (Cork South Central, Fianna Fail)
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Having been through this for 20 or 25 years now, I have seen that in all of the various commissions and investigations, lawyers get involved very quickly and it moves very quickly to redress. We do it, and the State owes redress, but the more substantive response in my view is lifelong provision of counselling, housing and supports for people who have been through terrible ordeals in their lives because of institutionalisation or whatever. That is a view I have formed over a long time dealing with many cases of this kind.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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I apologise to Deputy Shanahan as I should have called him earlier.

Matt Shanahan (Waterford, Independent)
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I raise the lack of State delivery to Waterford and the south east. I must first congratulate the Tánaiste on a great European election in Ireland South. Billy Kelleher romping home was expected, but having Cynthia Ní Mhurchú pipping Grace O'Sullivan was somewhat surprising. It must have been very pleasing for the Tánaiste, if not for his Green Party colleagues. Of course, Cynthia's big marketing push in Waterford was a video in front of Waterford Airport calling for the runway extension to accommodate passenger jet aircraft to the south east. This is the long awaited runway extension for the south east that was approved at Cabinet in 2007, only to be pulled in the unpleasantness that followed when promised full State funding of €25 million was withdrawn. The contrast for many in Waterford, watching the Tánaiste steer and cheer on the runway renewal in Cork Airport at the start of this Government was quite stark. This Government pulled €350,000 annual stop-gap funding to Waterford Airport in 2020. The Tánaiste was pictured eating a big slice of cake on the €40 million completed Cork runway, which was the quickest capital project in the history of the State. That prompted me to ask whether Deputy Martin was a Cork Taoiseach or a Taoiseach from Cork.

Cynthia Ní Mhurchú cleaned out Grace O’Sullivan with 2,000 voters from Waterford who were simply disgusted at the Minister, Eamon Ryan’s dismissive treatment of the Waterford Airport business case, telling the Dáil that he had not seen it, despite it being six weeks in his Department.

The bottom line is, the runway extension is not happening, just as the promised South East Technological University, SETU, capital investment is not happening and just as our promised cardiac care expansion and investment in our stroke services and acute care capacity is not happening. There is no investment in University Hospital Waterford at all. The truth is that Waterford is being played by this Government. Fianna Fáil is living on borrowed political time, with promises given but undelivered in our city and county, such as the fresh ones Cynthia Ní Mhurchú used to take out Grace O’Sullivan. She was talking from the Fianna Fáil playbook. The Tánaiste stood in that infamous 24-7 photo, with a political promise made in 2016 that got the Minister of State, Deputy Mary Butler, elected and got Fianna Fáil back in Waterford. He knew exactly what he was doing when he had that poster printed it and stood for that photo with that promise. The intervening period of confidence and supply has sailed by, as has Deputy Martin’s time as Taoiseach and four and a half years of Fianna Fáil senior and junior health Ministers directing national health policy. Yet, 24-7 provision and equal funding of our model 4 hospital is no further along. I have a brutally simple question. Will 24-7 provision and the airport be done at the time of the next general election? Will the Tánaiste keep his promises to the people of the south east?

Micheál Martin (Cork South Central, Fianna Fail)
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I have listened to the same Leaders' Questions from Deputy Shanahan for four years now. I do not believe he is being fair in his description of the economic, educational or health development and expansion in Waterford. In terms of employment Waterford is in very strong employment. Employment is up 26% across the south east. We are in an era of full employment. Enterprise Ireland client companies across Waterford, Wexford and Kilkenny are doing extremely well. The local enterprise office has a very strong budget. Foreign direct investment is up 25% in terms of IDA clients increasing, with 86 IDA client companies employing 15,000 people in the south east. The north quays project represented a Government approval of €170 million investment in Waterford's north quays. Every time the Deputy speaks on Leaders' Questions, he just ignores that. He says the Government has no commitment to Waterford. It is now over a year since the ground was broken on that north quays project, which is a very significant project in terms of the regeneration of Waterford. Irish Rail is also investing in Waterford.

In regard to South East Technological University, SETU, I remember at the beginning of this Government the Deputy raised that issue. It has been an ongoing issue. That has been established. The Government announced on 9 November last year the approval of the purchase of the Waterford Crystal site. Final contracts to purchase 20.3 acres of that 37 acre site were signed on 20 November 2023. That will allow real expansion of SETU's Waterford activities. I recall the Deputy saying to me that it will lose out to Carlow or somewhere else. It is expanding and growing. It has grown ever since I bought the land for Waterford technological college at the time.

Schools across Waterford are getting higher investment. Staffing at the hospital has gone up 44% since 2019. That represents 841 extra people working in the hospital. The figure went from 1,949 to 2,805. There are 47 more consultants, 100 more non-consultant hospital doctors, 370 more nurses and midwives, as well as 123 more health and social care professionals. In 2019, Waterford University Hospital had a budget of €201 million. In 2024, that is now €290 million. That is an €89 million increase in the budget to the hospital. The Deputy also knows that the opening hours for the first cath laboratory were extended to 8 a.m. to 8 p.m., Monday to Friday, in September 2022. In regard to pay and provision, in 2024 there are 22 staff in total to complement existing services and to extend the opening hours of the cath lab. There is also a review ongoing.

In 2019, approval was given in principle of an expression of support for an expansion proposal at Waterford Airport. The Minister of State, Deputy Lawless, is very open to the presentations that have been made. I will come back to that in a supplementary response.

Matt Shanahan (Waterford, Independent)
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I do not want to accuse the Tánaiste, in reading out those statements, of living in a parallel universe when it comes to Waterford but they do not reflect the reality of the situation.

Trust and integrity are fundamental parts of what we should be doing in politics. We are not seeing that with regard to the delivery in my city and county.

The next day I come in here, maybe I will bring all of the figures for all of the acute model 4 hospitals, and the Tánaiste will see a similar rise and similar headcount, all of which is because the health budget has moved on. That is not unique to Waterford, and Waterford University Hospital remains the lowest funded model 4 hospital in the country. It a year since the Minister, Deputy Donnelly, who is seated beside the Tánaiste, came to Waterford and announced that the seven-day cardiac expansion would begin at the end of last year. It is six months since the Minister of State, Deputy Butler, said recruitment would begin in January of this year. To date, there has been no recruitment and no seven-day expansion. We still do not have weekend heart attack services in the hospital.

Regarding the airport, this Government withdrew €350,000 in annual stopgap funding to shore up losses at the airport, yet the Tánaiste tried to tell us that the Government is supporting the project.

With regard to SETU, an engineering build that has been on the capital programme since 2009 is still not done. The total expenditure in the university the Tánaiste says is done has been €4 million on a land acquisition, and the Government is allowing the private sector to step in to provide student accommodation. Nothing has been done by way of courses, professorships or new faculties. That is the reality on the ground.

Micheál Martin (Cork South Central, Fianna Fail)
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I disagree with the Deputy on the impact-----

Matt Shanahan (Waterford, Independent)
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Disagree away; those are the facts.

Micheál Martin (Cork South Central, Fianna Fail)
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The university has come on in leaps and bounds over the last decade or two. Sometimes you also have to promote institutions-----

Matt Shanahan (Waterford, Independent)
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Where is the investment?

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Let the Tánaiste answer, please.

Micheál Martin (Cork South Central, Fianna Fail)
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-----and not always be negative.

On the airport, there has been ongoing engagement between the Department and Waterford Airport. An updated submission was received as late as 23 April. Some of the matters raised by the Department had been addressed. Some detail remained outstanding. I think that came in on 27 May and further detail was also provided on 2 July. A business case has to be made for the proposals because they will require a significant degree of State aid. Any plan must be supported by robust empirical evidence. The Minister of State, Deputy Lawless, will now consider this. There is a public-private aspect to this proposal and obviously, there are issues there. It is not comparable to existing State airports that have been there for decades but the Deputy is trying to make that comparison. Dublin, Cork and Shannon airports have been there for a long time.

Matt Shanahan (Waterford, Independent)
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In the past three years, €200 million was put into the national aviation sector and not a penny went to Waterford.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Please allow the Tánaiste to answer.

Micheál Martin (Cork South Central, Fianna Fail)
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The Deputy and I both know that it is not as simple an issue as just saying, let us allocate a sum of money and it all happens.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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Time is up now. We are way out of time.

Micheál Martin (Cork South Central, Fianna Fail)
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That is not the way it works in the real world. It is fair to say-----

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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We are way over time.

Micheál Martin (Cork South Central, Fianna Fail)
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-----there has been huge progress in the economy in Waterford, with regard to investment in the infrastructure, the public realm, the north quays, the university and the hospital as well.