Marie Sherlock
Dublin Central · Labour Party · Ireland
“That is why I want to see our local authorities moving from being just bystanders that license waste collection companies to actually controlling how the service is delivered.”
“That is why I want to pay tribute to all the people who are here today, including Stoneybatter Pride of Place, Phibsboro Village Tidy Towns and all the people working within their communities to keep them clean.”
“Panda’s parent company, Beauparc, sold for €1.3 billion in 2021 to an Australian investment firm. It is also co-owned by a US private equity firm. They are not in Ireland for the good of their health. They are here because they know they can make serious money. We know Greyhound’s parent company is registered on the Isle of Man.”
“The other important thing to say is that we did not hear any new ideas today, and I say that with the greatest respect to the Minister of State. We did not hear any ideas with regard to the profound challenges we have regarding our plateauing recycling rates and all the other issues that are there. That is disappointing.”
“I pay tribute to a lot of the work that many officials and workers in Dublin City Council do because, in some ways, their hands are tied behind their back. They recognise the issue with regard to landlord responsibility. I am very disappointed to hear the Minister of State's comments about landlord responsibility.”
“Dublin City Council was able to negotiate for the installation of ten-tonne compactors in the commercial areas, yet when it came to the residential areas, I understand the council tried to negotiate with the bin collectors on the roll-out of shared collection systems, but to no avail. That pretty much sums up our dysfunctional system.”
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“The worst feature for me in all of this is that the HSE does not really have a grasp or handle on the level of demand out there. There is no centrally maintained waiting list. All of this culminates in the fact that we have no statutory right to home care support and to healthcare in the home. It has been promised for years and I know it is a promise of this Government, but we have yet to see it. The reality is that disability and long-term illness can come to any home. I know that all the money in the world will not make up for the impact on family members when that comes to a home, but money can make life easier. We have a reality that those with money have some capacity to buy support if they need it. However, those with nothing have no backup.”
“We have fewer public health nurses than we did five years ago. There are just 1,500 public health nurses across the country. What does that mean for the young carer and their family? There are fewer nurses in the community checking in on those patients, their families and their needs. If the public health nurse is not checking in on those families, who is? We have a horrendously long waiting list for home care support of more than 5,500 across the State. In Cork and Kerry, there are more than 1,000 people on the waiting list. In Clare and Limerick, there are 860. That means young carers are having to step in when the professional support should be there. Respite beds are the lifeline of so many families and yet we have dire shortages.”
“I thank my colleague, Deputy Wall, for bringing this important motion before us today and I acknowledge the incredible work of the children and young adults across this country who day in, day out provide support to their family members. I know they do it out of love and loyalty. I know that many do not even consider themselves under the label of carer. It is a way of life. It is their life and they do it out of necessity. It is to that necessity that I want to speak today. There are children in this country, teenagers and young adults, who are in caring roles and shouldering the burden of care because of an abject failure by this Government and successive Governments in this State to provide sufficient healthcare in the community. We have a creaking system of community healthcare out there.”
“As it is, rents are exorbitantly high and we have REITs complaining that they are not even getting the market rate that they should be entitled to. We need to put in place greater protections. It is not even talking about tenure or anything else; it is talking about ensuring that a rent is a rent and that this is clearly defined in legislation.”
“We want to look after those small landlords, those who are doing the right thing, but for those who are engaging in egregious behaviour like the behaviour I set out by IRES REIT, we need to make sure that the RTB has a mechanism to flag to the public that egregious behaviour, at least to send a warning. We understand that if there is a complaint and an investigation under Part 7A of the legislation, the RTB has the power to publish the sanction, but if it goes to mediation, it is a secret deal and nobody knows about it. Only the renter who is brave enough to stand up gets the benefit from that arrangement and nobody else. That has to change. My appeal to the Minister of State is a tiny thing, a drop in the ocean, in terms of the greater need with regard to housing out there. We cannot allow renter exploitation to continue.”
“That was never taken on but that would resolve a huge number of the issues with regard to the exploitation of desperate renters out there. It would also resolve the annual head-scratching that goes on when we see that rents are increasing by rates that are multiples of what is provided for within the RPZ legislation, even when we factor in the share that goes to new tenancies. The other key and more immediate demand we would make here is that the RTB also has to play a role in publicly flagging to renters when there are landlords of a particular size.”
“That is what the landlord put on her form but, of course, then a secret deal was struck where she has to pay €100 per month extra for storage. She is distraught. She does not have that money but she also has no choice here. If she walks away from that arrangement, she has nowhere else to live because again, there are so many landlords not accepting HAP out there, particularly with rents well in excess of €2,000 in the Dublin city area. That woman has no choice. She could complain and she could get it resolved, but is she going to do that? She will try to find that extra €100 because, effectively, she has nowhere else to live. Back in 2021, the Labour Party brought forward legislation, a renters' rights Bill, to provide for a rent register which would effectively provide rent transparency.”
“There are 61 units and some new tenants have been charged €150 in additional common area charges. One tenant, late last year, actually challenged the landlord and it went to mediation in the RTB. Guess what? IRES REIT backed down. Now, our understanding is that IRES REIT has persisted in charging other, unsuspecting renters that same charge. Even though it backed down when it was challenged in the RTB, for others who have not fought back, it has continued in trying to pursue and persist with charging others. It is a reflection of the level of desperation on the part of renters out there that they are paying whatever they are being charged but it is not right. It is pure greed on the part of the REIT. I have a second example of a woman who came to me to say she was offered HAP at €1,937 per month.”
“Obviously, the Residential Tenancies Act 2004 was specifically set up to govern how rent is set in this country but over the nine sections of that Bill and the 148 references to rent, there is not a single definition of rent. For the vast majority of people, the concept of rent is a relatively straightforward concept in terms of the payment covering the roof over their head and the ability to use the amenities in the house or the apartment. For some, the lack of a definition of rent has been exploited by landlords to put in vague concepts of additional charges. The absence of a definition of rent is leaving vulnerable and desperate renters wide open for exploitation. A case in point are the School Yard apartments in Dublin 1, owned by the Irish Residential Properties Real Estate Investment Trust, IRES REIT.”
“It needs to meet the city council standards before the local authority can consider purchasing it, thereby excluding the vast majority of people who go in housing distress. Despite the willingness of the owner of that house to sell to Dublin City Council, they are rejected because the house simply is not up to standard. These people have nowhere else to go and we need to see a much greater investment into the repair and lease scheme because that is the game-changer for those houses in distress that qualify for HAP and are liveable, but maybe are not up to local authority standards. This would afford people the chance to stay in those houses. The issues I want to go into this evening are some we are seeing in the rental sector.”
“We hear all the talk about the first-time buyers grant or whatever but that is not even relevant because you cannot even buy a first-time home in the constituency in Dublin city centre and in the areas adjoining it. We need to see a much greater number of cost-rental and affordable purchase schemes. We have only one such scheme in Dublin Central at this point in time. The last big point I will make before getting into the issue is on the Government supports to those in distress. It is a pity I will not be able to contribute to the Sinn Féin motion on cost rental this evening, but there is the issue of funding and also the issue of standards. While the tenant in situ scheme is great in theory, my experience on Dublin City Council is that it very much fails in practice because the standards are set so high.”
“They simply do not have the money to go on and renovate it. The second key thing is on the dominance of institutional investors, particularly in this city. We need know we need apartments and that apartments are the future of living in Dublin but we have to ask a serious question. Do we want it dominated by institutional investors or do we want a different model? When we listen to the Government, it seems it wants to encourage greater institutional investor dominance with regard to the ownership of private rented accommodation in this country. I do not believe that is the way to go because of the impact that has in terms of the raising of rents and the potential exploitation of renters. In Dublin Central, 49% of people are in private rented accommodation.”
“The Government is not serious about dereliction and there are communities finding themselves increasingly broken looking at properties where there has been no action taken year in, year out. It is because we have a derelict site tax that is not worth the paper it is written on. In fact, it has been designed to fail - that has been acknowledged by the Department of Finance - in terms of the amount of money it expects to raise. It is because of the weakness of our CPO laws and the initiatives that are currently there and how the funding is put in place. Effectively, people need to have that money up front to avail of the vacant home grant and the €20,000 extra for a house if it is derelict. That needs to change. Ultimately, people are at the pin of their collar as it is to buy a house, even if it is vacant or derelict.”
“We are expected to be grateful and wondrous that social housing output is supposedly back at 1970s levels or back to the early 2000s levels but that is not something to celebrate, that is something to be ashamed of. The reality is that social housing output per capita now is approximately a third of what it was back in the 1970s. If we consider that household size is considerably smaller now than what it was then, our social housing output relative to the enormous need of our country appears to be all the more anemic. There has been an awful lot spoken about the Housing Commission recommendations and I do not propose to go into great detail on them other than to say a number of key things before the point I really want to get to which is in terms of the constituency I represent, Dublin Central.”
“I very much welcome the opportunity to speak on what was a groundbreaking report by the Housing Commission. I join in acknowledging the members of that Housing Commission who gave their time and service to the State. While we might not necessarily agree with all the recommendations in that report, certainly the time and effort that went into it was enormous and it is a huge disrespect that the Government has effectively ignored that report since publication. Listening to Leaders' Questions today, I found myself almost getting increasingly upset at the clap on the back attitude we see from Government week in, week out on its own efforts to meet the huge housing need in our State.”
“That report is sitting on a shelf and nothing has been done. That needs to change because of the number of stories that have come into my office, to the people around me and, I know, to many of my colleagues, and because of the demand that exists. People have gone through horrendous situations, such as going through early miscarriages, where the workplace has not provided for or recognised those. This was a campaign initiated by the INTO and it is important to pay tribute to it. We in the Labour Party will continue to pursue and to campaign for that Bill to be enacted. I hope the Minister will respond positively towards that.”
“While we now have State support in a way we did not previously, it is still very narrowly confined to a small number of women and couples. That needs to change because far too many people are being deprived of the right and opportunity to have a family because of the exorbitant cost of going through fertility treatment. We in the Labour Party brought forward a Bill in the Seanad - I know it was brought here to the Dáil as well - back in 2021. It provided for a right to workplace leave for those experiencing early miscarriage or those going through fertility treatment. The Minister's predecessor commissioned a report led by Professor Keelin O'Donoghue in UCC. That report set out very clearly what should happen and made a series of recommendations with regard to workplace leave for those experiencing early miscarriages.”
“Will the Minister take on responsibility for ensuring we have a far higher number of refuge places, not only in every county but within counties, to make sure there are a sufficient number of places? I wish to highlight the issue of access to women's health services, in particular the treatment of endometriosis and the numbers of women who have to travel to Romania and other countries every year because of the lack of services in this country. Admittedly, there has been some marginal improvement, but we need to see an awful lot more improvement for a condition with which women have been suffering in silence for many years. A huge amount of work needs to be done there. An issue close to my heart is the provision of, and State support towards, fertility treatment.”
“There are fantastic gardaí dealing with women in domestic violence situations, but the reality is that there are other gardaí who have not received the appropriate training. There is no mandatory training for front-line policing in this country with regard to domestic and gender-based violence. That is an issue. It is an issue that we continue to have such a low number of refuge places. Ireland signed the Istanbul Convention in 2011. We had 131 refuge places then; we have 159 now. We are literally running to stand still. There is no meaningful increase in the number of refuge places in this country when we consider that our population has grown by almost half a million during that time. It is wrong that we have so few refuge places. The ambition and target of 240 places set out in the programme for Government is still woefully inadequate.”
“It is not good enough when we consider that we in this country have the highest number of jobless disabled persons in the EU. The right to flexible work would have afforded an opportunity to these people to ensure they had a chance to get work and flexible work arrangements and ensure a higher income into their household. Yet, unfortunately, the previous Government and the Government of which the Minister is a part have walked away from that. I hope she will revisit that in time. Many of us in this Chamber spoke last week on a motion on domestic and gender-based violence in this country. Many of us spoke about the experiences and the interactions we have had in particular with women who have been let down by our system in their interaction with An Garda Síochána.”
“What is shameful on the part of the previous Government and, indeed, the Department the Minister has now gone into, is that there was an opportunity and the potential to allow women, in particular, but men and women, the ability to have flexible work arrangements. We could have legislated for that. Instead, the Minister's Department has decided to legislate for a very narrow set of rights. There is a right to request remote work, which is not really worth the paper it is written on, and a set of flexible working rights that is confined to those caring for children under the age of 12 or for immediate family members. That is not good enough. It is not good enough when we consider that Ireland has the highest number of lone parents unemployed when you compare Ireland to every other EU member state.”
“It is having a really appalling impact on women's careers. We talk about the gender pay gap. The lack of childcare contributes to that hugely. Approximately 30% of women in this country's workforce are in part-time employment. Some are there voluntarily but the vast majority are there because of the shortage of services, but with regard to childcare and elder care. We sometimes see figures put out that there is a 14% gender pay gap in this country; that is not accurate. It is far closer to 24% when you look at the gap between the weekly wage of the average male income relative to the average wage of a woman working in this country because it is both hours worked and the hourly rate that we have to look at. Of course, the pension pay gap is much greater again and is in excess of more than 30%.”
“That is having an impact on the child, on the school environment and, of course, on family life. Women and mothers, in the main, bear the brunt of the lack of childcare that we have in our country. I am glad to see the Minister is in the Department of children now but we have a huge amount of work to do - not just looking at affordability, which I know is the main focus of this Government looking at the programme for Government - on expanding the number of places. In the constituency I represent, affordability is an issue but the far bigger issue is that people cannot access places. In the survey we conducted last year and the year before, 40% of parents were waiting 18 months plus to try to get a childcare place. What impact does that have on women's working lives, on families' lives and on their ability to earn and pay their bills?”
“They are bearing the brunt of the failure of this Government to ensure we have enough affordable housing in this country. It is women and mothers, in particular, who are bearing the brunt of the shocking lack of access to therapies and supports for children with additional needs in this country. Last Friday, when families camped overnight outside the Department of Education, it was mainly mothers who were there. They are the people who are bearing the brunt, along with the children, of the shocking lack of support to families - the 2,596 families. Indeed, in my constituency of Dublin Central, they have an agonising wait for the assessment of needs, knowing it will take three to four years and, of course, it will be another three to four years before they have access to therapies.”
“Indeed, it was the Bread and Roses strike in Massachusetts in 1912 that fought for better wages, shorter working hours and respect for women in the workplace that has commenced that true marking of International Women's Day that we have had ever year on 8 March. I know many people will use the world "celebrate" for International Women's Day and, in some ways, I prefer to say the word "mark" that day because it feels that in 2025, in particular for many women in this country, we are going backwards, not forwards. When you look at women and mothers in the main bearing the brunt of the increase in our housing crisis and that three of every four families made homeless since the eviction ban was lifted are single parent families - the majority of these are mothers.”
“Is léir go bhfuil dhá cheiliúradh an tseachtain seo, idir Lá Idirnáisiúnta na mBan agus Seachtain na Gaeilge. Cé go bhfuil iliomad dúshlán os ár gcomhair, tá sé tábhachtach go bhfuilimid ag caint faoinár ndul chun cinn. Sa Dáil seo, tá níos mó ban tofa mar Theachtaí Dála, agus cé gur rud dearfach é sin, is léir go bhfuil a lán le déanamh. Tá gá mór ann chun níos mó tacaíochta a thabhairt do mhná ionas go mbeidh níos mó ban sa pholaitíocht go gineareálta, sna local authorities agus i dTeach Laighean. I am glad to have the opportunity to be here today to mark International Women's Day. It is worth recalling its history because it was first marked by the socialist movements in the United States and in Germany, well over 100 years ago.”
“The reality, as we understand it, is that the changes instigated in the 2023 Act were designed to try to tackle corporates taking over private GP practices. As I understand it, they have found a loophole, and yet the people who should not be affected by these medical charities are being affected. That is wrong.”
“I thank the Minister. There is obviously goodwill on all our parts towards the practice but what I am not hearing today is a sense of urgency with regard to this situation. The chair and the practice manager are in the Public Gallery and they are waiting to hear answers from the Minister. The reality is that the 2,600 patients in the practice include some of the most vulnerable people in our community, as the Minister and I know. The practice is turning away ten to 15 patients per day. The stalemate at present is preventing the opening of a further list in this community. With regard to the plans in Finglas and other parts of the country, there are people who are not accessing GP care at all. I ask the Minister to bring a sense of urgency to this.”
“At present, the only way we can ensure GP care in some of the most socially deprived parts of our communities is for the HSE to recruit directly or to let medical charities continue in operation. We need to join the dots. Even The Lancet this week pronounced on how we need to change. It devoted an editorial in its March edition on how Ireland is an outlier with a private system of GP care, how our inaccessible primary care system places tremendous strain on hospitals and how this is a political choice.”
“If it does close, the impact will be devastating, and not only for the 2,600 patients in the practice. This is not just about Summerhill. It is about Finglas, where there are 14 GPs on the GMS schemes in east Finglas and no GP in west Finglas. It is about the dire shortages we see throughout the country in terms of timely access to GP care. It is about the impact of these shortages, including delayed diagnosis, the deterioration of people's conditions, increased hospitalisations and premature deaths. The reason we have these shortages is the private system of GP care in Ireland. Time and again when we speak to GP trainees they tell us they want to work as clinicians and do not want to set up businesses.”
“Two of these solutions were vetoed by the HSE. We have a farcical situation whereby the HSE has paid for legal and accountancy advice to be given to the Department of Finance and we have heard nothing back from the Minister's Department, the Department which instigated this mess in the first place. Last November, in the middle of the election campaign, the former Minister for Health, Stephen Donnelly, went on RTÉ's "Prime Time" and said there was no way we would let this practice close. He said not only would it not close but that it would be used as a pilot project and a practice would be opened in Finglas. What is happening here? The five GPs tell us they cannot stay open past June if the double income tax payment issue is not resolved.”
“I hope the Minister and I can agree we need more GP care in this country and, in particular, in Dublin's north inner city in the constituency we are both elected to represent. My question to the Minister today is what he is going to do as Minister for Finance to stave off the closure of the GP Care For All practice in Summerhill in Dublin 1. As he and I know, this GP care practice is run by a medical charity. It directly employs GPs because no one else has been willing to set up a GP practice there. This is because the partnership model of privately owned GP practices would not work there. The double taxation issue with regard to the GP practice arose in early 2024. It has already been well aired. The reality is that in 2025 we have had no progress. We have had unworkable solutions from the Department of Health.”
“When are we going to see that review? We have been waiting for these beds. They were promised quite a number of years ago now, but we have not seen them. It is good that there is a review, but we need urgency on it. The reality is there are too many people in this situation. It is simply unacceptable that the State is spending money on sending people suffering with this condition abroad. We need to be providing for these individuals here. This is particularly the case given the length of inpatient stay required for many of these individuals.”
“We also know the number of those concerned, especially for the under-18s, has increased by about 43% in a short period between 2019 and 2023 in respect of those requiring inpatient stays. I welcome the 20 CAMHS beds, but there need to be an awful lot more. We do not have sufficient provision for people with eating disorders in this country now.”
“I look forward to that response from the Minister of State concerning the adult beds. What I am hearing from the initial contribution of the Minister of State is that there is no intention to make good that commitment from 2018 regarding the 20 adult beds. The reality is that it is a very complex psychiatric condition. When we look at the data from the Health Research Board, it can be seen that eating disorders require the longest inpatient stays of all psychiatric illnesses. The reality in this country is that we have outsourced care for some of the most severe eating disorder conditions to the private sector and charities. Some 76% of inpatient admissions for eating disorders are to private facilities and private charity providers. Quite a number of people have to go to England. Now, that is shameful in this day and age.”
“My question relates to the 2018 commitment regarding inpatient beds for those with an eating disorder. It is important to say there was a significant amount of hurt at some of the previous comments made by the Minister of State about the need for these beds. We met some of those suffering from eating disorders last week. The reality is that while we very much welcome an expansion of community care, there is a desperate need for an increased number of inpatient, specialist beds for those suffering from an eating disorder.”
“I do not doubt the goodwill there is regarding ensuring GP services, particularly to the 2,600 people on the list in GP Care For All, continue but the reality is that the HSE funding is only for the 2024 liabilities, nothing is in place for 2025 liabilities and I am not hearing any solution. We have a private system of GP care in this country with the result that we have significant gaps across this country in some of the most socially deprived areas and this Government is not coming forward with any solution as to how we put in place GP care in those communities. The medical charity model was a solution to the problem but now, it is being upended and facing closure because of those changes in the Finance Act. I am asking the Minister to make sure that this medical charity can survive and that other ones can be set up across the country.”
“The onus is on the Department of Health to ensure that the Department of Finance actually acts to ensure that medical charities can continue providing these services because nobody else is providing these services in some of the most disadvantaged areas in the country.”
“I wish to put on record that three options were offered to GP Care For All, none of which are operable. Option one was the partnership model, which is simply not viable because of the risk GPs would have to take on. Almost 97% or 98% of this practice is GMS-reliant. The second option, which was the hybrid model, and the third option, which was direct subsidy, were not acceptable to the HSE. The options put forward by the Department of Health are not workable and the HSE has paid for Western Urgent Care to come up with proposals to send to the Department of Finance and we have heard nothing back.”
“Last week, I raised with the Minister the issue of the GP Care For All practice in Summerhill, Dublin 1. In the Visitors Gallery today, we have the chair and the practice manager of that GP practice. It is a very serious situation because, by June of this year, this practice will be facing closure unless there is direct intervention by both the Department of Health and the Department of Finance. In particular, I want to ask about the plans of the Department of Health for the continued existence of medical charities in providing GP practices across the country.”
“The reality is that this country has outsourced inpatient care to charities and private providers. Some 76 admissions for eating disorders in this country were to charities and private providers. The vast majority have to go to England. A woman talked today about a child, who is now an adult, being an inpatient in Britain for seven years, who cannot leave yet because she is not fully treated. We know from the Health Research Board that those with an eating disorder have the longest inpatient stays of all psychiatric illnesses, yet we have a Minister of State who says there is no need for additional inpatient beds in this country. It is not either of the two Ministers present in the Chamber, it is the other Minister of State. There is a need. I ask the Minister to change that. There is a commitment to 20 beds since 2018.”
“She had to speak to five or six different providers in the area. The public health nurse was helpful but could not provide her with all the oversight or detail she needed to try to care for her husband in the home. She is saving the State an enormous amount of money, yet there was no single point of contact. As there is no statutory right to a home care package, the reality is that we have an utterly haphazard system. In the remaining minute and a half of my time I wish to pick up on what Deputy Conway-Walsh spoke about. I too met the Cared Ireland organisation today, which presented on eating disorders. The expansion of community hubs is very welcome, but anybody who understands eating disorders in this country knows that it is a matter of life or death. It is not a minor health issue that can be just treated in the community.”
“It is a complete waste of money in the general scheme of things, and that needs to change. Ultimately, there is a wider question here about the future of GP care in this country. A charity was set up because it is impossible to get GPs to set up a practice. When I talk to trainees they tell me they want to be clinicians; they do not want to set up a business. Cracking the nut of having more GPs in this country must be about direct employment. If we are serious about primary care, then we must look at home care packages. Deputy Cullinane is correct in what he said about a statutory right to home care. At the moment we have an utterly haphazard system that has grown up in a bizarre way. I remember talking to a woman in her 70s a number of months ago, who spoke about the absolute torture of trying to get help for her husband.”
“Twelve months on from discovering the change to the finance Act that is putting this vitally important GP practice in jeopardy, and after many letters going to the HSE, the Department of Health and the Department of Finance, there has yet to be a face-to-face meeting between the Minister for Health and a serving Minister for Finance. I ask the Minister to change that. More crucially, I ask her to personally intervene to ensure that this GP practice survives, because if we were without it, it would make a mockery of our discussion about healthy lives. To add to the farce, the HSE has had to come in to provide funding to an accountancy practice to try to put forward a solution to how the finance Act might be amended. It is also providing funding to the double PAYE payment that is going to become liable by the end of this year.”
“It has more funding again to set up a practice in Finglas west, but it cannot do anything at the moment because of the limbo it finds itself in because of the tax changes to the finance Act last year. It is crucial to say that nobody is beating down the door to start a GP practice in the north inner city. Almost all the patients in this practice are on the GP scheme so there is no incentive or profit in this practice. I ask the Minister to look at the weighting for GMS patients, which prioritises or weights in particular women of childbearing age and older patients. However, when we look at the typical profile of people attending the practice in Summerhill in Dublin 1, the life expectancy is much lower. The practice tells me it does not have patients in their late 60s, 70s or 80s, and there is a reason for that.”
“How can the Department of Health stand over this? There are significant questions about inequality of access to timely healthcare in certain communities. I wish to raise the situation of a GP practice in Dublin Central - the Summerhill Family Practice - GP Care For All. I hope the Minister is familiar with the situation. It is in operation since 2016. It is a charity model operating in an area that is crying out for GP care. Since February last year that practice has been put in jeopardy because of a change to the Finance (No. 2) Act 2023, which changed section 1008A of the Taxes Consolidation Act 1997. The change effectively precludes the practice from operating as a charity. This charity practice that provides services has a list of 2,600 patients. It has the funding in the bank to extend the practice list by a further 1,200 to 1,500.”
“Instead, the State has outsourced the first point of contact in our health system to a private system of GP carers. That is not to say we do not have brilliant GPs, but the reality is that it is a for-profit model, and there are significant implications in that regard for who gets care. When we look at certain areas, especially in my constituency in Dublin Central, the reality is that we do not have enough GPs. We do not have enough GPs across the country, but especially in the most deprived areas. In Dublin 1, for instance, we have nine GPs on the GMS scheme. In Dublin 7 there are 17. Finglas, if anybody knows it, is typically divided into two - Finglas east and Finglas west. The west has far higher levels of deprivation. There are 14 GPs in Finglas east but there is not a single GP in Finglas west.”
“Furthermore, it goes on to say that people living in disadvantage areas are twice as likely to have a disability compared with those living in affluent areas. In my constituency in Dublin Central, research conducted by the HSE profiling the north side of Dublin and based on the 2022 census found that the numbers reporting good health was just 38.3% - more than a third of all people. The national average is 53.2%. How is the State responding? Let us take GP care. This is the first point of contact for almost all persons seeking healthcare in this country. We have a private system of primary care and a public system of hospital care. There are no GP to patient ratios. There is nothing to say we should have GP practices in every community in our country.”
“We know that the share of over-65 year olds is expected to grow by almost 24% by 2044. We also know that age is not the clear-cut determinant of health need, rather it is the proximity to death and the incidence of morbidities among the population. Therefore, it is not about life expectancy but a healthy life expectancy. As I understand it, the reality is that in this country that is going down rather than up - from 69.6 years in 2019 to 66 years in 2022. When we throw economic circumstances and the level of deprivation into the picture, we begin to get a much more stark situation. In 2024, Pobal research into disability and deprivation found the people in the most disadvantaged areas are four and half times more likely to report not having good health than those in affluent areas.”
“The Irish Cancer Society has made a particular call to reinstate the Laura Brennan catch-up scheme for HPV vaccination, which expired at the end of January 2024. I ask the Minister to please try to do that. As she said in her comments, small things can make a big difference and impact on people's lives. The HPV vaccination has proven to have a big impact to people's lives and we must continue with the catch-up programme. The issue I want to talk a little about this evening concerns primary care. We have a twin issue in Ireland of a growing life expectancy and an ageing population. Perhaps the single greatest challenge for the Minister is ensuring that we have a primary care system of supports that is both fit for purpose and sufficiently equipped to respond. Average life expectancy is now fifth highest in the EU at 82.6 years.”