Dáil Éireann debate -
Wednesday, 6 Nov 2024

I thank the Ceann Comhairle for his forbearance and patience, as ever.

The Government is a serial waster of the public’s money. Its waste leaves people shaking their heads in disbelief. The lack of accountability angers people. There has been no accountability for the €336,000 bicycle shelter, nor for the €1.4 million security hut or the doubling of costs for modular housing for Ukrainians, and that is before we even mention the children’s hospital. Fine Gael and Fianna Fáil squander taxpayers’ hard-earned money and when they are caught out or challenged, they just shrug their shoulders and dismiss the public’s anger. Perhaps, though, the most mind-boggling example of its waste is its decision to spend €9 million on phone pouches for secondary school students. Contrast this with its failure to fund schools correctly as they struggle to keep the lights and the heating on. There was only €10 million additional money for that. Worse still, the Government could only find less than €3 million for youth mental health services, which are on the floor.

When the Taoiseach was called out for this waste, he claimed this €9 million pouch investment was a once-off cost. The big message in the Minister, Deputy Norma Foley’s article on thejournal.ie. defending the Government’s decision was that "€9 m for phone pouches is a significant once-off investment". That is not true, as we have learned from documents obtained by my colleague, Deputy Pearse Doherty, through freedom of information, FOI. What the Minister failed to tell the public was that there will, in fact, be a cost of almost €2 million for these pouches annually. The Government knew this, yet it continues to peddle the spin that this was a once-off investment.

To make matters worse, these documents also show that the Government was presented with several other common-sense options for dealing with mobile phones in schools. Option one, that phones be left in students’ bags with students not allowed to use them during the day, had a cost to the public purse of zero euro. Option two, that phones be handed in at a central point, had a cost to the public purse of zero euro. Option three, the placement of phones in student lockers, had a cost to the public purse of zero euro beyond the cost of the locker. So, the Government turned down three common-sense solutions that would not have cost the public a single red cent and instead went with an option that will cost taxpayers €9 million initially and then a further €2 million every single year. You could not make this up. The incompetence is off the charts.

Dressing this up as a mental health measure is so insulting to young people in mental health crisis who are locked out of the services, care and supports they desperately need. What this shows again is that this Government cannot be trusted to spend the public’s money wisely, cannot be straight with people about its waste and refuses to be accountable for its mess.

Dúirt an Rialtas linn gur costas aon-uaire a bheadh sa chaiteachas €9 milliún ar phócaí d'fhóin phóca. Ní raibh sé sin fíor. Tuigtear anois go mbeidh costas bliantúil beagnach €2 milliún anois ar an phobal. Why do the Taoiseach and his Government continue to tell people that the €9 million spend on phone pouches is a once-off cost when they know this is not the case? I appeal to him to scrap this scheme and invest the money in mental health services for our young people.

I thank Deputy McDonald for raising this issue. I will make a number of points. First, when the Deputy talks about the state of our economy in terms of the use of taxpayers' money, she leaves out a number of facts. She leaves out the fact that this is a country running a budget surplus and that we have managed to put aside billions of euro to protect people from future economic shocks. That decision is looking even better today than it was yesterday in light of global issues. The Deputy forgets that we are able to give people back some of their own money as well. I look forward to debating this Government's record on managing our economy and the public purse versus Sinn Féin's policy of spending it all and leaving nothing for the buffer times or if there is any transatlantic trade shocks, a policy which, quite frankly, looks utterly foolish and ridiculous today.

My second is that the issue of phone pouches was not invented in the Department of Education, in government or by any political party. This came about by listening directly to school principals. I am sure that Deputy McDonald, like me, listens to the radio and I am sure she heard the students on "Morning Ireland" a couple of days back after this announcement talking about the benefit they have found from these pouches. I am sure the Deputy has met school principals, including the principal of De La Salle College in Churchtown which introduced these self-locking pouches after staff reported an increase in disruption and how time-consuming it was. The principal highlighted how this initiative had improved the social skills of the students and had seen an increase in participation in extracurricular activities.

This is a Government that is listening. Deputy McDonald talks about listening and how important it is to listen to people on the front line. We have listened to school principals, teachers and students. We have had feedback from many students - I am sure they will be in touch with the Deputy today - in schools that have benefited from this initiative. That is where the idea came from. This is not an obligatory or mandatory measure. Nobody is going to demand that schools take school pouches. If a school wants to avail of this, it will cost about 20 quid per student. That is a €20 investment in the mental health and well-being of a student.

Please do not say to me that it is in any way insulting to link this to mental health. It is not me linking it to mental health; it is the young people themselves. This is about a Government listening and responding because right across the country, different schools have tried different initiatives to deal with smartphones. Deputy McDonald is right that some schools have adopted the suggestions she made, while other schools have tried different approaches. It is important that we help and assist in that regard.

The next point I will make is this. Deputy McDonald suggests this all happened in isolation and it was the only investment in education when this Government has invested a huge amount in education, including in the most recent budget. We have allocated €12 billion to the Department of Education. This will help students, parents and education staff and it includes €51 million to extend the free school book scheme to students, benefiting 940,000 students. Sinn Féin called on us to increase the capitation rate and we have increased it from €200 to €224 per student in primary school and from €345 to €386 per student in post-primary school. This 12% increase will assist schools with increased day-to-day running costs because I know running costs are a real issue. In addition, we have provided €45 million in cost-of-living supports for all primary, special and post-primary schools in the free scheme to help them deal with costs. We have employed more special needs assistants, special education teachers and teachers in general.

The most breathtaking thing about Deputy McDonald's presentation today is that in Northern Ireland, where Sinn Féin holds the Department of Finance, it is rolling out a similar initiative and, you know what, it is costing a hell of a lot more.

The Taoiseach talks in billions when it suits him but then penny-pinches on the essentials. The Government increased capitation for schools by €10 million. The capitation money is what keeps the show on the road.

A sum of €10 million is not enough and well the Taoiseach knows it. There is €10 million for that, to light and heat schools, and then €9 million and an additional €2 million year on year for phone pouches. I listen very carefully to people. I have not met one teacher who approves of that use of public money.

As a matter of fact, people are outraged by that and all the more outraged when they discover a mere €3 million from all the Government's billions has been provided for youth mental health services at a time when we hear a lot from young people, their families and their educators about how desperately people need these services and the fact they wait and wait.

Is it the Deputy's position that phone pouches are bad here but phone pouches are good in Northern Ireland? If it is not, will she call on the Sinn Féin Minister for Finance in Northern Ireland today to speak to her Executive colleague and stop the roll-out of the phone pouches in Northern Ireland? In Northern Ireland, Sinn Féin has already spent £250,000 on the provision of phone pouches, so phone pouches are clearly good for children-----

The second point is the Deputy says she has not met these people. She must not be listening to the radio because there have schoolchildren on the radio talking about the benefit in their schools. I referenced a school principal there from De La Salle College, Churchtown. On Tuesday, 5 November an article by Ken Foxe referenced six different schools contacted about their experience of pouches and all of them described it as very positive. This idea is coming from the schools.

I thank the Ceann Comhairle. Time is pretty much up for this Government. When Fianna Fáil and Fine Gael’s alliance started they were the Civil War parties, but now it seems they are more like the phoney war parties. For weeks there has been sniping in the media. It is not about policy, because it does not seem like there are many policy differences between them, but about personalities. Political debate has been reduced to petty insults and desperate jostling for position in advance of an election. It is a fairly ridiculous end to what has been a disastrous Government for so many people. There are hundreds and thousands of people out there who have lost hope in a better future here and who are utterly disconnected from the success story this Government is trying to spin. Instead, the Government should be talking about the 500,000 adults living in their childhood bedrooms and how to address that. How does the Taoiseach think they feel when, for example, they hear the Tánaiste say we have turned a corner on housing? They do not see a corner but a dead end. They see their ability to build a life and put down roots in their communities destroyed by disastrous housing policies. Average house price increases of €85,000 in just four years are not a success. For individuals and families desperate to own their own homes, it is a betrayal.

Disabled people have also been let down. When this Government took office it said disability was a priority. When the Taoiseach assumed his role he even set up a new Cabinet subcommittee to focus on this issue. What has it achieved? Nothing. Services are worse than they were when this Government took office. People no longer even have any kind of expectation they will get the critical supports they need. They have learned by experience the only things they are guaranteed from the State are waiting lists and excuses, yet its members somehow still claim disability was a priority for this Government. This is why the Social Democrats are making a full Minister for disability a dealbreaker in any programme for Government talks. We need the political weight of a Ministry and the political will that has so blatantly been missing for so long. Until that happens I do not believe anything will change.

I am sure that during this election campaign, the Taoiseach will insist his plans in housing, disability and a whole range of other areas are working or that somehow they will start working and that all that is needed is a bit more time, a few more years, and we will begin to see the results. However, we have been listening to the same lines from Fine Gael for nearly 14 years. Fine Gael has been in office for almost my entire adult life and the Taoiseach has been a Minister for most of that time. The party has had more than enough time and more than enough money to address these issues and it has not. Why should anybody believe Fine Gael will solve the crises facing the country when it is Fine Gael policy that has led us to them?

I would never age a colleague, but I do not think there is that big a difference in our ages so I am not sure how I have been a Government Minister almost all the Deputy's adult life. Leaving that aside, she likes to portray this Government's record in a certain way. That is fine, it is her job and I look forward to debating that on the campaign trail. This is the Government that steered the country through Covid, steered the country through the biggest inflationary crisis, created jobs for people, has been able to give people back some of their own money including additional child benefit payments as recently as this week, and has been able to take a range of measures that have made children's and parents' lives better. These include the roll-out of free schoolbooks and hot school meals. Now that the risk of a transatlantic trade shock is rising, we have managed to set aside resources to ensure my children never have to live through the austerity our generation did, so I am proud of much of the progress we made.

Moreover, when it comes to moving people out of their childhood bedroom, 50,000 people have been able to avail of the help-to-buy scheme. That is a scheme I do not think the Social Democrats support, meaning they would pull the rug from under first-time buyers.

The Deputy asked a very direct question, namely, what difference has been made since I decided to chair the Cabinet committee on disability. I will tell her four things. The first is we have ratified the optional protocol to the UN convention, which is something she feels strongly about. We got it done. Second, we have managed to adopt a proposal from the Labour Party on assessments of need and utilising private capacity to ensure more than 1,000 additional children got assessments of need they would not have got otherwise this summer. That happened. They are real children and those benefits have happened as a result of our work together. Third, we have managed to start the process of putting therapists back in special schools. That work is under way and is making a real difference. It is not saying to a parent of a child with special needs they must go from the school to a health waiting list, but actually putting therapists in the schools. We will continue to roll that out. Fourth, under that Cabinet committee on disability, we have worked across Departments to expand the number of training places in Irish universities to ensure we train enough people to work in speech and language therapy, physiotherapy and occupational therapy. No matter who is in government or what the Department is called, we need more people to be able to work in this area.

The Deputy’s suggestion of a dedicated stand-alone Minister for disability has merit. The only counterpoint to make is that work somewhat started this time with the Minister, Deputy O’Gorman, and then we had a migration crisis and the likes of that as well, in terms of the breadth of issues that Department is now dealing with. The Social Democrats’ suggestion about a stand-alone Minister for disability is a constructive, sensible one, but I would like to see how we would make that Department work to cut through the silos and deliver for people with disabilities.

The thing that is difficult for me to believe or that I do not really buy or that, to be honest, is not really credible is that somebody who was the Minister for Health with responsibility for disability when nothing improved and things got worse then comes in as Taoiseach and sets up a Cabinet subcommittee when we have already had loads of committees and reports and know all the things we need to do. Then, when he is pointing at things that have happened, he says now we are offering more private solutions rather than investing in the public services we need to address disability services. It is brazen to claim that somehow Fine Gael or the Taoiseach is going to be the solution to these issues without acknowledging that things have got worse, that people cannot access special education, that people are travelling potentially two and a half hours and not being able to go to school at all. It seems the Taoiseach thinks the threadbare services are some kind of a given, when Ireland is a rich country that should be able to provide these services. Fine Gael has had a really long time to try to address that and the Taoiseach has not even acknowledged that. I hope people see through the fact this is a tried, tested and failed Government on this issue and on housing.

This election is about choices and we can choose differently. We can choose to vote for parties that will invest in public services and not splash the cash around in a giveaway budget to try to buy an election. There are parties that will invest in services like these and I hope people will use their choice.

I listened to Deputy Cairns. I presume when she talks about splashing the cash, the Deputy is in favour of the double child benefit payment. I presume she would not begrudge someone the additional old-age pension this month and again before Christmas. I presume she would not stop the fuel allowance payments or the lump sum payments for carers or people with a disability or the working family payment. When the Deputy talks about splashing the cash, I talk about giving people back a bit of their own money to help them because this country's economy is run well.

I look forward to having a debate but the Deputy does not need to lecture me. I know my lived experience. I know exactly what it is like to have to fight every single day for a service. I know exactly what it is like to watch my mother have to get in a car and drive for two hours to get my brother to school. I do not need a lecture from her on what the lived experience is like. I also do not need to suggest that any one human being can fix this. We must work together on this. I stood up and said the Deputy had a good idea regarding disability and I said I would work with her on that. The disappointing thing is all she wanted to do was slag me off.

I want to raise with the Taoiseach the serious traffic issue at present in Galway. As everybody knows, Galway city is the centre of the west of Ireland but the way it is currently progressing, it is running into trouble with traffic. We have the outer ring road which has been on the books for at least 15 to 20 years. About €30 million has been spent on it and we have nothing to show for it.

A report came out last week or the week before regarding Gluas, a light rail project for the city.

The problem is that in the east of the county, many of our young people and workers go to work in Galway city every morning and come out in the evening. They probably spend about an hour and half in traffic every day of the week trying to get in and out of work. There is no guarantee they will arrive on time. This is coupled with the fact we have been talking about putting in place a bus lane from Claregalway into the city since 2007. I think Noel Dempsey was the Minister for Transport at the time and it still has not happened. We need to do something about the traffic and the flow of traffic into the city.

When you look at the road from Castlebar or Shrule to Galway through Headford on the N84, there is a very poor road network with very little public transport. I met the NTA on this particular issue this week and I was told what it can do and that it will carry out a review. We have a situation where traffic is piling up on the outer edge of our city and is not getting in or around the city. We need a comprehensive plan and to put in place certain instruments that will start to build traffic flow into our city. Otherwise, we will be losing jobs and we will be losing sight of ourselves. In a region, the northern and western region, that is in decline according to the EU, we need to make sure we have proper investment in our infrastructure to allow us to reach our full potential.

Dexcom is being built in Athenry at present, which is great news, but we need to make sure we have the traffic and infrastructure to allow workers to get there. It is important we look at this as a comprehensive crisis in the west of Ireland that needs to be resolved. I ask the Taoiseach to give me his comments on this issue.

I thank Deputy Canney for raising a number of matters. First, I agree with him on the need to continue to invest and deliver more projects around Galway city and county and to address the huge congestion issues. I would point, and my colleagues have reminded me, to some of the progress that has been made in recent times. The Minister, Deputy Ryan, has made the point to me that the cross-city bus link has just gotten planning permission from An Bord Pleanála. When the Minister of State, Deputy Naughton, was working in that Department, we saw significant investment in Oranmore and Ceannt train stations. These were significant measures that I know have made a difference.

We have invested heavily in our national road network with an extensive motorway system now in place. The motorway network has seen an almost tenfold expansion since 2000. The Galway city ring road is something I support. It was approved by An Bord Pleanála with conditions in December 2021, as Deputy Canney's constituents are all too aware of, but subsequently three applications for judicial reviews were submitted to the High Court, which imposed a stay on progressing the scheme. An Bord Pleanála subsequently decided not to oppose the judicial review taken by Friends of the Irish Environment against the decision to grant planning permission. On 30 January 2023, the High Court quashed the An Bord Pleanála decision to approve the scheme and remitted the application back to the board. An Bord Pleanála is to reconsider the application and make a new decision. It has requested further information from the county council, including an updated environmental impact assessment and a Natura impact statement. That project has now been remitted to An Bord Pleanála for consideration.

I want to see progress on this and the Galway city ring road is a really important part of that. It is a component of the Galway transport strategy and I hope this is something we can make progress on. As the Deputy rightly said, €3 million of taxpayers' money has been allocated by TII for this project this year. This is something I hope we can progress, subject to the planning issues. I assure the people of the Deputy's region that investing in both this road and in public transport remains an absolute priority.

I appreciate what the Taoiseach has given me there. It is a history lesson, let us say. What I think can and should be done is to first look at the work the Minister, Deputy Ryan, has carried out in the all-island rail review. The western rail corridor can be reopened without having to go through all the processes on which we spend millions. It does not need a rail order or planning permission. It can and is ready to go ahead. It is important we get that moving as a matter of urgency. It is something that can be delivered in a very short time and that will help commuters. It will help our rail freight and will also alleviate the traffic congestion we have going into the city.

I know that a passing loop between Athenry and Galway city is being put in at Garraun but it has taken so much time that we are only at planning permission stage now. We need to be able to fast-track these projects and to give some sort of hope to the people working in the city every day that they will be able to get to work on time and in the shortest time possible.

I definitely was not trying to give the Deputy a history lesson but what I was trying to politely push back against the assertion that we are not investing in the transport infrastructure. I know those works I referenced in Oranmore and Ceannt are under way and I know the Deputy and others will welcome that.

When it comes to Dexcom, the idea of its potential for a rail freight siding there could also assist the company and we are happy to engage constructively on that. The western rail corridor is an exciting proposition and I know the recent all-island strategic rail review recommended we reopen the western rail corridor. This will be seen in time as a pivotal milestone in this regard. I note it is a review that has been very warmly welcomed in Galway and Mayo. I point out that the project has been highlighted in the review as one that the Deputy has correctly noted the Government can progress in a short timeframe. It is unlikely we can progress it in the next 24 to 48 hours but what it does give a very strong case to those of us fortunate enough to be elected or re-elected to Dáil Éireann to have the progress for that in any future programme for Government, whosoever may make up that Government. I believe the work done on the rail review puts the western rail corridor in a really strong position to progress.

Is mian liom díriú isteach arís ar an ospideál i gcroílár na Gaillimhe. I dtús báire, is mian liom cúpla focal a rá le cabhair a thabhairt don méid a dúirt an Teachta Canney.

The traffic congestion in Galway has been allowed to develop as a crisis in the interest of a lobby group. The best and one of the most effective ways to deal with that is to put in a light rail system, a park and ride, which has never been rolled out even though it was in the development plan 20 years, and a comprehensive school service. When the Taoiseach gave the history lesson on the judicial review, he forgot to mention the reason the decision was quashed was because An Bord Pleanála had failed to take into account what its duties were under climate change. That is an important point.

I will now use my other two minutes for the hospital in Galway. It is good that the Taoiseach is here because he was there back in 2017 regarding the hospital and I am shocked to say that the pressure on that hospital remains the same, notwithstanding the glowing reports for the staff. We have HIQA, and I will stick to HIQA. The Minister of State, Deputy Naughton, is telling the Taoiseach about the latest progress of Merlin Park and I welcome that. Let us deal, however, with what I am telling him about the regional hospital, which services more than a million people in a population from Donegal down to Galway. The latest HIQA reports tell us there were 29 patients awaiting an inpatient bed. That is 29 people. The term "boarded out" is used. A year ago, it drew up a report which told us it was grossly overcrowded. This year it is worse, so I do not know what language is left if it was grossly overcrowded last year. In addition, we now have 31 patients in hospital who are ready to go out but there are no beds in any step-down facilities or nursing homes. That is the regional hospital in Galway.

In addition, when three of the wards were looked at, one of them, St. Finbar's ward, was found to be grossly understaffed. Different themes were looked at, which are extremely important, namely, infection prevention and control; medication safety; and transitions of care. Transitions of care are not being complied with because I have provided the Taoiseach with information on 31 patients waiting to get out.

What is not recorded is the impact of care not given, notwithstanding the great efforts of the staff. Imagine if we recorded the impact of people on trolleys. Dr. Fergal Hickey tells us ad nauseam that there are at least 350 premature deaths every single year directly related to the time spent on trolleys. When I was here as a newly elected TD in 2017 and when the Taoiseach was the Minister for Health, he provided me with a detailed answer about an options appraisal, which he told me would be published in 2018. That options appraisal was duly published. A brand-new hospital was strongly recommended; not an elective hospital, although I welcome that. A brand new hospital was recommended and the elective hospital was to be part of that.

I will use my remaining time to talk about a letter I have on oncology and waiting lists. Imagine a waiting list of seven weeks for treatment for a patient for chemotherapy and radiotherapy when the recommended waiting time is 14 days at most. I ask the Taoiseach to avoid telling me about the progress in Merlin Park, which I welcome on record, and instead deal with the situation of the hospital, the lack of staff, the delayed discharge and the awful pressure on staff, not to mention patients.

I thank Deputy Connolly. In the interests of time, I will take her comments on board with regard to the roads and their accuracy. It is important all of those processes are followed.

As for University Hospital Galway, I welcome the fact that HIQA carries out inspection reports, publishes them and shines a light on areas on which we need to continue to try to make progress. HIQA holding our feet to the fire is a good thing, in terms of learning the lessons of the past with regard to health services in Ireland. The inspection reporting function exercised by HIQA is an important tool as well. I know the Minister is committed, as is the HSE, to engaging directly with the hospital group and with University Hospital Galway in relation to the latest HIQA report.

While I do not wish to frustrate the Deputy because she told me not to talk about this or that in my answer, and I understand that point, it is somewhat of a jigsaw because the investments we are making to try to develop services in Merlin Park and decouple certain services that are, let us call them, non-emergency or non-acute, are an important part of increasing capacity and improving patient flow in the hospital.

Deputy Connolly asked directly about staffing. Staffing at the hospital has grown by 751. There was a total of 3,787 staff in the hospital in 2020 compared with a total of 4,538 staff now. Staffing has grown in University Hospital Galway by 20%. There are 121 more nurses and midwives, as well as 46 more medical staff. The budget has also grown for that hospital, going from €398 million in 2020 to €496 million in 2024, which is a 25% increase. Bed numbers have grown too, as 30 new beds have been opened at University Hospital Galway, meaning bed numbers have risen from 684 in 2020 to 714 in 2024. Under our hospital bed expansion plan, a total of 247 new and replacement beds are due to be delivered to University Hospital Galway out to 2031, of which 198 of them will be delivered between now and 2028. Staff numbers have grown, the budget has increased, bed numbers have grown and are due to grow much further.

As the Deputy rightly said - I will just mention it in passing - the cystic fibrosis unit and the outpatient department at Merlin Park University Hospital opened only last week. The importance of that, apart from the incredible care for cystic fibrosis patients, is that it will enable the transfer of outpatients services to Merlin Park. That will allow the hospital to progress the planned work on the new emergency department. In the lifetime of this Government we have seen the new radiation oncology facility, a new cardiothoracic ward and the opening of the temporary emergency department.

The Deputy referenced my time in the Department of Health. One of the things we talked about back then was the delivery of the elective hospital. The elective hospital is now being planned at Merlin Park. The design brief is currently being completed and, crucially, it is due to receive patients by 2027. I accept and know when I go to Galway that there is a lot more to do with the hospital. We now have, however, a clear plan in terms of the development of services between the current site and the Merlin Park site.

I try to deal with the actual reality on the ground. I wish to highlight that due to severe staff shortages and lack of property facilities, there is now a seven-week waiting list to start chemotherapy in University Hospital Galway. There are now 31 patients in the regional hospital in Galway with nowhere to go while beds in Carraroe and the Aran Islands are empty. There is a waiting list for patients for those locations but they are not opened. A total of 29 patients are awaiting an inpatient bed as we speak, while 43 people are on trolleys today. The Taoiseach is quoting figures but we are in a Republic where we should have a public health system for all.

I welcome any progress any made. No progress has been made following the options appraisal, however, which recommended the building of a brand new hospital, because the Government did not respond. It went for a lesser option and a jigsaw approach, as the Taoiseach said, with no overall vision. We have St. Finbar's orthopaedic ward with five staff missing, between nursing care and assistants. We have an accident and emergency department that has no planning permission and as a result, in desperation, a temporary one was put up in the meantime for €16 million. A whole new block is to go up but it is nowhere to be seen.

The Minister, Deputy Donohoe, is beside the Taoiseach and we talked about changing the system to allow these steps to be much easier. Two former taoisigh have said that the accident and emergency department in Galway is not fit for purpose. I and other colleagues have stood here and talked about step 1, 2, 3 and 4 while the Government told us it was changing the process. In the meantime, the public hospital in Galway is absolutely under the most appalling pressure due to lack of staff and facilities, with no dignity or privacy.

First, as regards cancer care, there is an important issue to acknowledge. I want to acknowledge, on the record of the Dáil, that there are clinical specialist radiation therapists and radiation therapy posts in the hospital that are currently vacant. Approximately 25% of these posts are vacant. I want to be absolutely crystal clear; those posts are funded and there are two open recruitment campaigns for those posts. I hope and expect to see progress because I know how important that is.

As for the options appraisal, we have a made a policy decision, which is very much in line with Sláintecare, to decouple emergency care from elective care. We sometimes lose people with those words because what do they mean? It means decoupling people who need to go into our hospital emergency from the people who need planned hospital procedures. That work is now under way. I am not standing here suggesting everything in relation to the health service in Galway is as it needs to be. I am saying, however, with genuine belief and facts, that in the lifetime of this Government, there are more nurses and doctors working in the hospital, staff numbers have grown, the budget has increased, and trolley numbers are down. There are more beds and there is much more to come.