2026-02-19

"We have been left with nowhere to turn". These are the words of Máirín Nolan, mother of seven-year-old Roxanne Kelly. Roxanne was born with a serious condition affecting her joints. She was then diagnosed with scoliosis at the age of two. Máirín says she spent years going between her doctors but has been left in limbo. There is no solution for her complex needs. In that time, Roxanne's scoliosis has worsened. Her spinal curve is now 80 degrees. The family are left to fundraise to take Roxanne to Florida, where doctors have agreed to carry out the scoliosis surgery. Roxanne is just but one child being failed. Hundreds of children are waiting. We know that 525 scoliosis operations for children were cancelled in the past four years. Nine years ago, the Tánaiste promised that no child would wait longer than four months for spinal surgery but children are still left in awful situations. When is the Tánaiste going to keep his promise?

I think the Deputy knows I gave that commitment in good faith after significant engagement with the HSE and it being given to me. While it did result in many more procedures being carried out and many more children getting their surgery, I think we have seen a number of very concerning developments in relation to this specialty. That is why I believe there needs to be that full inquiry. We have even seen as recently as last week significantly concerning clinical reports as well. I do not want to comment specifically on an individual case on the floor of the Dáil other than to say I know the Minister for Health is aware of the case of Roxanne Kelly. She has asked officials in her Department to communicate directly with the HSE and CHI on the case and to follow up directly with the family.

Are you keeping your promise any time soon?

I have answered that.

I read the report of the north Kerry CAMHS review last night. It paints a picture akin to a Wild West, with no oversight, accountability or support and incredible god-like decisions. There are very serious questions that need urgent answers. How can it be the case, that with such harm done there is not a single full-time psychiatrist in north Kerry at this point in time? How can anyone with confidence go the HSE now and say they want their case reviewed? When there are a number of psychiatrists contributing hours, how can people expect they will be treated seriously? On the actions the Minister set out yesterday, can the Tánaiste assure us there is now a red flag system in real time that will flag anomalous prescribing patterns? On her talk of a new central referrals system, the reality is it excludes autistic children, assessments of need and children under the age of eight. There are serious problems with the central referral system. What assurances can the Tánaiste provide to the families who are currently engaging with CAMHS and the families who will need CAMHS in future years? There is huge concern about the quality of service at the moment.

I thank the Deputy for raising this deeply and profoundly concerning issue. I join with her and everyone in expressing my profound sympathy and thoughts to the children and young people affected, their parents and their families. The Minister of State, Deputy Butler, is in Kerry as we speak and engaging directly. She briefed the Cabinet yesterday on this issue. She will leave no stone unturned in providing support and answers, and in making sure we extend the likes of the existing non-adversarial compensation scheme in place for families impacted by deficits in care. She has directed her Department to engage with the Attorney General's office and the State Claims Agency to progress this. I will say more broadly, because lots of families are interacting with CAMHS, that it is important to stress the independent national prescribing audit did not identify the fundamental care deficits in Kerry anywhere else nationally. I wanted to say that. I also want to say that a number of improvements to the service have taken place since 2022 in Kerry, including the two teams that are working there. I am also conscious, as the Deputy will be, that a lot of people working today in CAMHS in Kerry are doing a very good job in a very difficult and stressful situation. Once the Minister of State is back from her engagements in Kerry, she will provide further updates on next steps in relation to this.

The Tánaiste is the Minister for Finance and the leader of Fine Gael. In the budget for 2027, there is a promised cost-of-disability payment. In budget 2025, there was a disability support grant of €400 but in budget 2026, there was no one-off payment. In fact, disabled people are €1,400 worse off as a result of the budget in 2026. Many disabled people have said they are choosing between heating and eating. One person with a spinal injury told me that since 1999, he does not remember it being this bad. When my party and I raised this and called for a modest emergency winter payment of €400 last month, we were met with derision by the Government. Disabled people were accused of being alarmist, misleading and dangerous. The Government is now forcing disabled people to take to the streets on 28 February to ask for their basic needs to be met. Will it reverse this disastrous budgetary oversight as a matter of urgency? Will the Tánaiste condemn or at least disavow the hurtful and disgraceful comments of the Minister for Social Protection?

What I will certainly do is accept the Deputy is quite rightly highlighting the issue of disability, as is his party. That is an important and good thing to do. No one wishes to engage in any sort of derisory view. These are important and legitimate issues. The next priority for the Government in terms of the work of the Minister for Social Protection is the development of a cost-of-disability payment. As it happens, coincidentally, the consultation on that payment is due to open tomorrow. I know the challenges people with a disability face. I met many of them in Galway and engaged with their lived experience only two weeks ago. They do not need to be on the streets protesting. We need them to be in the rooms engaging so we get this payment and structure right. I will say more broadly, about any comment, when I hear of people saying they are choosing between heating and eating, I genuinely say to everyone in this House that no one should find themselves in that situation.

They do.

Our community welfare officers, and the Deputy will know this through his office, are there. He will know the names of the people.

They are there to provide exceptional needs-----

If anybody in the Deputy's constituency, or anyone in the country, is concerned about heating or eating, as he said, I genuinely encourage them to engage with our exceptional needs payments. No one should find themselves in that situation in Ireland. That is what those structures are there for. We just need to have that balance in the conversation. The cost-of-disability payment is a priority for the Government. The consultation will open tomorrow. We look forward to engaging with the Deputy and his party on it also.

I will ask the Tánaiste about Connor Green, the surgeon responsible for inserting non-medical springs into children at Temple Street. He is also the subject of the Nayagam report, which recommended that two thirds of the children it looked at have a follow-up clinical review. I understand that he is seeking an injunction to prevent the publication of the Nayagam report. Is the State contesting that and seeking to publish the report? Why is the look-back review, which flows from the Nayagam report, excluding adult patients? Dr. Green had a substantial adult practice and very many of them have had significant complications, including at least one person who has been in touch me. He has a licence to practice in Maryland. How it got that is not exactly clear because the Medical Council has said it did not issue any certificate of good standing for him.

Deputy Murphy, you should not go there, please. You are out of order.

Has the HSE contacted its counterparts in Maryland to warn them about this surgeon and to explain he is currently under investigation by the Medical Council?

Deputy Murphy should conclude. I do not have to tell the Tánaiste that if the matter is in the courts-----

I accept Deputy Murphy used Dáil privilege, as is his right, but because matters are before the courts, I am not in a position to comment further, other than to say the Government's position in general is it wants to see all reports published and to be transparent in relation to this. The legal realities as to what it is possible to publish or not are matters for the Minister for Health to work through, as she is doing. We also want to see a broader inquiry into the workings of a number of issues in relation to CHI and certain specialties. A lot of this work could be helpful to any such inquiry too, but these are matters for the courts to determine.

I welcome the announcement, and the Minister of State, Deputy Cummins, is here, in relation to the likes of modular granny flats and all of that coming in. I thank him for a meeting we had in the past few weeks. I have one question we are getting a lot of calls about, which is the modular unit or small shed at the back that people want to try to get done up. When does the Government envisage the legislation will go through the House so people can plan for it now?

I thank the Deputy for his comments. He will know I moved on the agricultural exemptions prior to Christmas. The next phase is domestic exemptions, which will include modular to the rear. We are finalising those. It does not require legislation. It is regulation and has to go before the Oireachtas joint committee, which I expect to be able to do after Easter. We will get there as soon as we can. After domestic, it will be infrastructure. We are progressing that work. I thank everybody for-----

Will it be ready for summer?

That is the aim.

I want to raise St. Luke's General Hospital in Kilkenny. It is a level 3 hospital with over 1,200 staff and is the seventh biggest medical centre in Ireland serving a catchment area of around 200,000 people. I am looking for an update on the new CT machine, which is vital to support patient flow. A second CT for St. Luke's will result in no downtime and allow specialised tests to be completed on-site reducing the need for patients to be transferred to another hospital, which results in long waiting times for appointments. A strong business case has been put forward and submitted for a new 86-bed accommodation block for the Dolmen wing, including 14 critical care beds, 72 single rooms, a laboratory and a pharmacy. I am looking for a commitment that this wing will be prioritised and delivered as a matter of urgency. St. Luke's is part of the HSE Dublin and South East region, but it currently has no dermatologist, no rheumatologist, no neurologist and no child psychologist, yet they all exist as part of HSE south east. I am looking for a commitment that the Government will engage with the HSE Dublin and South East for a realignment of some of those staff to Kilkenny.

I thank the Deputy for a comprehensive question on St. Luke's in Kilkenny. It is a hospital I know well and have been in many times. I note a number of works have been carried out there, from a capital point of view, including the extension to radiology, the provision of a new MRI, which was completed in 2022, and the new 72-bed replacement medical ward block. I am told the replacement of the existing CT scanner was completed in 2024. An acute inpatient bed capacity expansion plan is due to be completed this year. The HSE capital plan is due very shortly, probably as soon as next week. There will then be an opportunity to update on what is next in the pipeline of projects. There are a number of projects, including mental health facilities. The new 50-bed acute mental health unit, ACHU, is at appraisal stage. I will ask the Minister for Health, once she receives the HSE capital plan, which will probably be next week, to update the Deputy on the specific projects he referenced. I will also follow up with her on the specific specialties the Deputy said are required in the hospital.

I want to ask the Tánaiste about the communication this week from Tailte Éireann on early years service providers and childminders receiving bills for commercial rates. As he knows, they quietly provide a very important public service through the early childhood care and education scheme and other childminding services right across the country. To date, they have not been liable for commercial rates. It is big change. There will be a significant charge on different childminders, particularly early years service providers. I hope there can be engagement between the Tánaiste’s Department, the Department of Children, Disability and Equality and the Department of Housing, Local Government and Heritage on this matter urgently to address it.

I thank the Deputy for raising this issue and for the engagement he had with the childcare sector this week. This is certainly something we intend to examine as a Government. We all know in this House that there is huge demand for childcare places. We need to support our childminders and help them to remain viable and in the sector, not making life harder for them. I am aware that there are legal issues to be worked out and there is also the matter of the Valuation Act, but the Minister for children, Deputy Foley, is engaging with the Minister for housing to seek clarity on how childminders who care for children single-handedly in their own family homes can avoid being disadvantaged. I thank the Minister for children for the work she is doing on this. She will keep the Government up to date as we make progress on it.

Ba mhaith liom ceist a chur ar an Tánaiste mar gheall ar chártaí leighis agus cártaí leighis saorthoilteanacha. Tá bean i gCiarraí agus fuair a fear céile bás, agus i ndiaidh sin, fuair sí ailse. Bhí uirthi rud éigin a dhéanamh mar gheall air san ospidéal. There is a woman in Kerry who applied for a discretionary medical card because she had been refused one. Her husband had died in tragic circumstances. She herself then developed cancer and needed 16 or 17 rounds of radiotherapy at the last count. We applied for the card on her behalf and brought the matter as far as we could go. Her means were over the limit. The last thing a woman in her position should have to do is apply for a medical card. Discretion should have been used in her case, but it seems that decisions are limited on the basis of means alone. Will the Tánaiste do something about it?

I thank the Deputy for raising this. My sympathy to his constituent on all she has been through and for her loss. If he wants to send the details to the Minister for Health, I will ask her to engage directly with the HSE on it. As he rightly said, there are two ways of accessing a medical card. There are the means ground but, above and beyond those, the exceptional burden that illness and loss can place on one is also supposed to be factored in. Without knowing the details, one would hope this could be examined again. I will ask the Minister, Deputy Carroll MacNeill, to engage with the Deputy if he sends on the details.

I might cc the Tánaiste.

Please do cc me on it.

As the Tánaiste knows, Fingal is the youngest and fastest-growing area of the country. We are delivering houses but our education infrastructure needs to catch up. In December 2022, when he was Minister for Further and Higher Education, he visited Swords and announced a college of the future campus. Three years later, we do not seem to be any further on and do not have a timeline for delivery. He might update us and let us know whether a preliminary business case has been concluded and when families in Fingal will see the delivery of the college.

How do I know Fingal is the youngest and fastest-growing area in Ireland? It is because the Deputy keeps telling me so it must be true. I know it to be true. I thank the Deputy for raising this issue and acknowledge that she and our colleague Councillor Luke Corkery are working closely on it. It is something I genuinely care deeply about. The population of Swords is huge, bigger than that of a number of cities. It is one of the ten locations the Government has chosen with SOLAS and the education and training boards to develop a college of the future. The idea that Swords would be without college opportunities is unfathomable at this stage. It has to change and this is the project that is going to change it. We said when we announced the project that such projects take a number of years. They genuinely do. We are trying to develop a campus that will serve 1,000 full-time students and up to 5,000 part-time learners so 6,000 people could benefit. The relevant Minister, Deputy James Lawless, is very committed to this and has given approval for the relevant site. I believe legal due diligence requirements need to be dealt with now. The acquisition of the site is the next aim. I will ask the Minister to provide the Deputy with a specific update. I look forward to visiting Swords with her shortly.

The findings of the north Kerry CAMHS look-back review are deeply concerning. Potential for harm was identified in respect of over 200 children’s files. Behind each number is a child and family who trusted the State. In too many cases, their trust was not upheld. While the review relates to Kerry, the prescribing safeguards must be a national priority. A young man recently came to me about his experience. He was prescribed risperidone at just seven years of age and remained on it for 15 years, with increasing doses and without any adequate clinical monitoring. He experienced significant weight gain and serious mood difficulties. He is now off the medication, thankfully, and his life has improved dramatically but his story raises serious questions about oversight and monitoring. The drug has a legitimate clinical role but the evidence shows that it was not just in Kerry that situations like this arose. We need more investment in primary care mental health services to intervene early and to have stronger supports, particularly for children with dual diagnoses, who are falling through too many gaps in the system. Their cases are very complex and the risks are far greater. I want a review of the national prescribing audit, accounting for safety and standards, as the audit has highlighted areas of improvement in processes and monitoring, and to ensure the recommendations arising from the audit result in an improvement to governance, care and medication monitoring.

I thank the Deputy for raising this and for her considered contribution on it. The first thing I want to say, which the relevant Minister of State, Deputy Butler, would also want me to say, is that the independent national prescribing audit did not identify the fundamental care deficits elsewhere nationally, but that is not the point the Deputy is making. I just wanted to say that because it is important. The Deputy is making a broader point, namely that we need to review the standards more generally. That is certainly worth considering. We are very fortunate that the Minister of State, Deputy Butler, is passionate about and committed to this area. I will ask her to reflect on what the Deputy said and revert to her directly.

There is an active travel proposal for Knockfree and Knockpogue avenues, Farranree, in my constituency. The residents support the majority of the elements, including safety measures, the removal of roundabouts and the renewal of roads and footpaths, but they object to certain elements. At the moment they are protesting and have stopped the work. The Taoiseach himself said there needs to be more dialogue with the residents. Sinn Féin councillors Kenneth Collins and Michelle Gould brought a motion to Cork City Council that was supported by some other councillors but it was voted down by Government councillors. We believe the residents in the community must be heard and mediation is the best path. The residents have agreed to independent mediation. Will the Tánaiste intervene on behalf of the Government and ensure mediation goes ahead because the community is angry and frustrated that it is not being listened to? All it is asking for is mediation and that its voice be heard.

I thank the Deputy. I say very respectfully that he will understand that I am not familiar with the details of the specific project, roundabouts or safety concerns. However, it is important that he has raised the broader issue of the need for consultation and engagement with communities, which is a fair one. It is a serious point. I hear, more than from time to time across the country, that there are many projects that the majority of residents support in the main but that have certain elements that residents have concerns about and in respect of which they feel they are not heard. What I will do, on foot of my not being familiar with the details, is ask the Minister for Transport specifically to examine the issues the Deputy has raised and revert to him directly.

What I will do is send the Tánaiste an email that he can forward on.

I will be very happy to do that.

To follow on from the remarks of my colleague, the Taoiseach has publicly stated further consultation should have taken place on the active travel plan for Knockfree and Knockpogue avenues in Farranree, Cork city. Elderly residents, families, community groups, local businesses and sports clubs have raised serious concerns about the removal of parking and the impact on access to five schools, the parochial hall, Sam Allen Sports Complex and the local church. The main corridor is seriously affected, with 23 mature trees that are approximately 70 years old being removed. Residents, including the elderly and infirm, have taken to the streets to protest in the area every morning. They are not the usual protesters we tend to see in Ireland; they are protestors who are very deeply concerned about where they live, particularly the avenues, and their quality of life. Since the Taoiseach has accepted that the consultation was insufficient and he has stated he had concerns regarding the lack of consultation between the residents, local councillors and Cork City Council, will the Tánaiste formally direct the Minister for Transport and the National Transport Authority to engage immediately with the residents and Cork City Council to address the genuine access and environmental concerns about the works that are planned?

I certainly would not want to contradict or disagree with the Taoiseach on views he has given on this project in Cork but what I will do is speak to him directly about the issue. I hope this is a matter of common sense prevailing in terms of engagement. I say this respectfully, but even the idea of mediation having to take place sounds to me like a process that did not go well in terms of proper engagement. That is based purely on what the Deputy has told me here today. I do not have the details of the project. I will talk to the Taoiseach about it and we will engage with the Minister for Transport. I know the Deputy will send me on the details.

Wicklow parents pay the highest average weekly cost for childcare outside of Dublin at €235.90. It is an incredible amount for anyone to have to pay. In addition we have only 20 community centres out of 161. That is 12%. That can be compared with other counties like Leitrim and Monaghan, where more than 60% of their early learning providers are community centres. I understand that the Government is bringing in a pilot and that a number of community crèches will be established. I ask that Wicklow be very carefully considered as one of those counties. The need is there, as the Tánaiste will know. It is important that parents in Wicklow get support to access work.

I hope Wicklow is there too. I fully agree with the Deputy. We live in a county that is both young and fast growing. We know that through our own work not only on school capacity and the likes but also on childcare capacity. While I fully accept that childcare costs are too high, and we all have a similar view on the direction of travel that needs to take place on reducing childcare costs, one of the big issues we face in Greystones, Delgany, Bray and right across County Wicklow is access to places. I was pleased that the Minister, Deputy Foley, announced a fund to start intervening directly. I believe we must do that. We cannot just leave this to the market. The Department is going through a mapping exercise as to where the need is most acute. I will ask that Wicklow be considered as part of that and revert to the Deputy directly on it.

The image I am holding up is not a real image but an AI-generated image of the front of a house on daft.ie at the moment. Estate agents are more and more posting AI-generated false images on platforms like Daft. This is misleading. It is also predatory at a time when the housing situation is so bad. The response from the advertising regulator, however, has been effectively that it is fine provided there is a tiny label at the bottom. I am very concerned about this practice because it is something we have seen in other jurisdictions and is one of the growing challenges we have in terms of artificial intelligence. With the new AI office being set up in August, what will the Government do about the likes of this? We will see this with rental properties as well, where rental properties will be misrepresented on platforms as being essentially fake apartments or houses.

I thank the Deputy for raising an issue that has not come to my attention before and for bringing it to our attention. A broader point I will make, while not taking away from the seriousness of the issue, is that people generally view a house before buying or renting it, obviously. That is not the point the Deputy is making, though. It is misleading to people, it can waste their time and so on. I ask that I be allowed give some consideration to the matter with colleagues on foot of the Deputy raising it. I take the point that there are meant to be labels about material being AI generated and so on, but we should not all have to squint to find those things. It is also very bad practice. Just showing us what the actual house looks like is a much more decent way of engaging with people. I will engage with both the Minister of State with responsibility for AI and the Minister for housing on the issue.

I strongly welcome the Tánaiste's commitment to developing a national savings and investment strategy. It is the right direction, and there is obviously clear support for it. Irish households are strong savers, but too much of that money is sitting in low-yield accounts quietly losing value to inflation. If we are serious about building a culture of long-term investing, we must remove the barriers that discourage participation. The reduction in the exit tax rate on gains from 41% to 38% in the budget was a positive step. However, as long as the eight-year deemed disposal rule on exchange traded funds, ETFs, remains in place, long-term retail investors continue to be penalised. Taxing unrealised gains and interrupting compounding directly undermines the long-term behaviour we are trying to promote. If this strategy is to genuinely unlock investment, the eight-year deemed disposal rule should be removed. This strategy is a really important step forward. I ask the Tánaiste to continue his ongoing engagement with the industry and to seriously consider removing the deemed disposal rule under the strategy.

This is an area I really want to get right. We have a very strong culture of saving in Ireland but not a strong culture of investment. That is not a criticism of anyone; that is just a reflection of the reality. We have €169 billion or €170 billion on deposit today in Ireland. Lots of people, despite the challenges families face, are trying to put a few bob away for their future, for a rainy day, for their kids or for whatever they are trying to do in their own lives. At the moment, not only are they not making money on this but sometimes they are losing money on it. We therefore need to look at how we can set up savings and investment accounts. I am absolutely committed to this. It is a priority for me in the two budgets I will deliver as finance Minister. As part of that, there are tax rates, tax sequencing and financial literacy. The issue of deemed disposal is valid and important. We just need to consider all of these in the round and how to move forward. The next step is to bring a roadmap to the Government before Easter and to set up a savings and investment forum to engage directly with stakeholders with a view to being able to move forward later this year.

I want to raise an issue under the Tánaiste's remit as Minister for Finance, namely the help to buy scheme and the property price ceiling of €500,000. Despite some reservations about this scheme, I am a strong supporter of it. It has benefited over 60,000 first-time buyers, to purchase homes since its introduction and given them their tax back up to the maximum of €30,000. However, the Tánaiste will have seen yesterday the CSO figures which put the median price of a house in Dublin at €500,000. That is both second-hand and new properties. Many new properties are much more expensive than €500,000. This is not just a Dublin issue; this is also an issue in places like Cork and other main urban areas. Therefore, we need to move the limit above the €500,000. In reality, many first-time buyers are now prevented from benefiting from the help to buy scheme because of the price ceiling. When it was introduced in 2017, nine years ago, it was set at €500,000. There has been 24% price inflation since that period, so it makes no sense for us not to adjust the figure to reflect somewhat the inflationary pressures since then. I ask the Tánaiste to look at this. I appreciate that it probably has to be a budgetary issue but I am flagging it as early as possible.

There is indeed a commitment in the programme for Government to look at this. In that context, we will look at it, and I thank the Deputy for raising it with me. It is a fine balance and we have to consider all these things in the round, in terms of the quantum that may be available for a tax package in the budget and how we wish to deploy that while also making sure that we do not cause undue inflationary pressures on housing or the like. We need to think of all this in the round. There is the question of how the first home scheme operates too. I too am proud of the help to buy scheme. It has helped over 60,000 people. I am pleased that we have confirmed that it will continue for the lifetime of this Government, and there is a commitment in the programme for Government to review that scheme. We will undertake that review and I will revert to the Deputy then.

Disabled people have been protesting outside the Dáil on a number of occasions in recent weeks. They are having a national protest on 28 February. The Tánaiste said earlier in reply to somebody else that they do not need to be on the streets. They genuinely do feel they need to be on the streets. We are in the middle of a cost-of-living crisis. Disabled people tell us they feel their income is €1,400 less this year than last year due to the budget, which has been devastating not only for people with disabilities but for many other workers as well. We have record numbers of people in energy arrears. A total of 303,465 households was the last figure I saw and many of those are people with disabilities. People with disabilities have been telling us that they are choosing whether to heat the house or to buy food. I know that has been rejected by the Government, but that is what they are telling us, and I believe them now. There is a need for an energy payment or a disability payment. Will the Tánaiste, even at this late stage, consider doing that? Then they will not have to go on the streets.

I thank the Deputy for raising the issue. I know how serious these issues are. The context in which I mentioned not being on the streets was not to suggest that people with a disability do not feel extraordinarily strongly on these issues or want to ventilate that. The point was that the consultation for the new cost-of-disability payment will open tomorrow and I want people to be in rooms and engaging in that and given the opportunity to do so. The Government is committed to developing a cost-of-disability payment. The Minister, Deputy Calleary, is working on that and will engage closely with people with disabilities and their representative organisations with a view to getting this right.