Excuse me?

I am sharing time with the Minister of State, Deputy Butler. Today, which is International Nurses Day, I would like to recognise the presence in the Public Gallery of Caroline Gourley, president, and Phil Ní Sheaghdha, general secretary, from the Irish Nurses and Midwives Organisation, INMO. Ms Ní Sheaghdha has been president of Irish Congress of Trade Unions since last July. I congratulate here on that. I understand that we also have in attendance the CEO of the Nurses and Midwifery Board of Ireland, NMBI, Carolin…

I welcome the opportunity to address the House on statements on Michael Shine, and much more importantly, his victims and survivors. The abuse of trust and attack on the dignity and the person of patients by Michael Shine was a terrible betrayal. I have the deepest sympathy and concern for all the victims. I acknowledge the many people affected, including several I have been fortunate enough to meet. Reports suggest that the total number of those impacted is in the high hundreds and it ranges across a huge age span…

I do not think anybody wants to be involved in strikes of any kind. That is not how we do things, which is why we have the very comprehensive industrial relations architecture we have painstakingly built over some time. The HSE and my Department have engaged extensively, constructively and in good faith, as have the National Ambulance Service representatives, for more than two years to address the issues raised within the National Ambulance Service. That engagement has taken place through the State’s established in…

It is important to acknowledge that there has been 30% growth in the staff of the National Ambulance Service, which is a larger proportional increase than the health service received overall. We have invested an additional €75 million in the service since 2022 and staff members have increased by 761 since 2022. The total workforce is now 2,500. Further investment planned for 2026 will deliver 21 extra crewed ambulances at peak demand. I understand that 134 of 168 posts have been recruited, so recruitment is progres…

I am very invested in resolving disputes, and that is why we put so much effort into the industrial relations architecture that we have. It is important to highlight some of the models of the proposed reforms under the agreement reached between union representatives and State representatives in those structures, for example, a modernised pay and allowance structure, which replaces a complex pay arrangement dating back to the late 1970s with a simpler, transparent structure aligned to wider HSE norms. It standardise…

I am sorry. I have this question as "not submitted".

I do not have a Priority Question from the Deputy. I will try to get an answer for her, but we have this question as "not submitted".

I will do my best to answer.

My apologies for the mix-up, whatever the source. I will get the Deputy a full and more official answer. Nevertheless, I will speak from my own experience. The focus on delayed transfers of care is an integral part of the focus on trolleys - the whole thing goes together. What we are really talking about is patient flow. Hospitals that experience ongoing delayed transfer of care, DTOC, problems include Letterkenny University Hospital, for example, where the number was in the 40s, but is now down in the 30s and movi…

The Deputy is 100% right. It does not necessarily lie with the hospital management. For example, in Cork, with the IHA managers, there is no governance element to this. They are not CUH beds or Mercy Hospital beds, and nobody had better tell me that they think they are. They are beds for the south west, and they have to be managed from a single centre, which happens to be in CUH at the moment, but we will see about that. They have to have visibility over what is the situation in Blarney, Bantry, Mallow, South Infir…

I understand. For example, I visited a facility very like that. Please forgive me; I do not have the name in front of me but it is in the north of Dublin, an acquired brain injury-----

That is exactly it. Forgive me. It is looking to build the facility adjacent to the primary care centre.

Exactly. What we can do is work with an approved housing body, AHB, to build that residential. The HSE is for delivery of healthcare and we try to make it work as well as we can but here are the things we are not: we are not a transport company and we do not build homes. What we can do is partner with AHBs to make sure we are developing long-term residential that is adjacent and appropriate for needs of that kind. On that site in particular, what we are looking at is what capacity we can have for people who need to…

I would rather it did not.

I thank the Deputy, and I join him in thanking the Secretary General, Mr. Robert Watt, and the previous CEO of the HSE, Mr. Bernard Gloster, who both did outstanding work in the Department of Health and the HSE in different ways. They have really stabilised and improved the service more broadly since 2022 in particular and I thank them for that. I also wish both the new Secretary General, Mr. Derek Tierney, and the new CEO, Ms Anne O'Connor, well in their new roles, which are very significant roles for everybody. N…

I know.

I agree and I thank the Deputy for his support on these reform programmes. He is right about the elective hospitals but before then, we have the opportunity with the surgical hubs, which will be delivered in 2026. The delivery of the surgical hubs is going to create all sorts of different waves. We are looking at what procedures need to go there immediately and what that will free up in the hospitals where they would otherwise have been done. How is that going to be staffed and when? I am looking at the National Tr…

I totally agree with the Deputy and I think we will get there with Galway and Cork much more quickly. I would like to discuss with all Deputies options around Dublin because clearly we have the option in relation to Connolly hospital. The Deputy may have noticed that we put in some high-dependency unit, HDU, beds in advance because that is really going to be an important enabler. We did that in the past number of weeks. We put the staff in to have significantly expanded HDU capacity in Connolly hospital with a view…

I thank the Deputy for his ongoing engagement on this. As he knows as well as I do, this makes a huge difference to families around the country. Much progress has been made now. The Health (Assisted Human Reproduction) Act 2024 was signed into law by the President in July 2024. I have a difficulty with a definitive timeline as to the complete commencement of the AHR legislation as there are a number of interdependencies and considerations involved, not least the timing that I do not control over a Supreme Court cas…