Dáil Éireann díospóireacht -
Wednesday, 16 Oct 2024

I thank the senior Minister, Deputy Eamon Ryan, for coming to the Chamber for this Topical Issue. I appreciate it.

As he will be aware, I live alongside the M50 in Scholarstown. When I hear the sirens of emergency vehicles early in the morning travelling along the motorway, I know there is going to be traffic chaos, as there has been an accident. The traffic chaos will stretch out into Knocklyon, Ballycullen and as far as Oldbawn, the N81 and back to Ballyboden. There has been significant residential development in the area, as the Minister will also be aware. That is because areas like Knocklyon, Firhouse, Ballycullen and Oldbawn are desirable places in which to live, make a home and raise a family. More development is under way.

Three years ago, I invited one of the most senior officials in the National Transport Authority, NTA, to the area. I drove them in my car for two to three hours, along the sections of the roads I mentioned in my constituency. I drove them from Firhouse Road West through Kiltipper, Oldbawn, along Killinniny and Oldcourt, Stocking Avenue, Ballycullen, Scholarstown, Stocking Lane, and out through Ballinteer, Knocklyon and Ballyboden. I pointed out my observations and ideas about how traffic management could be improved and ideas that were given to me by local residents' associations and individuals. One point related to how existing bus lanes were underutilised or, in some areas, non-existent, though there was road width to facilitate additional bus lanes. The official took copious notes, and that is where it began and ended. I have not heard a word back in the intervening time. I mentioned this in multiple meetings and briefing sessions with the NTA, and I raised it with its chief executive.

In the meantime, the focus of the NTA and South Dublin County Council has been on the design and implementation of cycleways. As a cyclist, I welcome the development of cycleways, but often they result in the impeding of the movement of public transport. In spite of the road width being available, there has been a failure to provide priority at particular junctions for public transport at specific pinch points along this route. There are ample opportunities at many of the junctions on the roads I mentioned from Oldbawn to Ballyboden to create priority for buses, but there are more plans for cycleways to take that space. Can both not be done? There was certainly no attempt to do both on Firhouse Road West.

Along the route that I have mentioned from Oldbawn, all the way out to Marlay, on routes that are used to access the M50, the N81 and also arteries into the city, there are multiple opportunities and road width to prioritise public transport movement over cars, especially at peak times. At the moment we have buses carrying scores of commuters, which is great. It is a huge improvement. There is a really regular bus service along many of the routes, but the buses are being stalled, along with cars, in long traffic jams. There is scope for significant improvement. Unlike other routes, it is not as if there is not scope for improvement. Metro and Luas are the ultimate solution. I have my beady eye on some of the Apple billions that are coming to the State, but that is in the medium term. I call for some leadership. When I have listened to what the Minister has to say, I have one or two suggestions that I hope he might be able to take on board, even in the dying days of the Government. I look forward to his response to my initial remarks.

I thank the Deputy very much. I know the area he is referring to well.

As Minister for Transport, I have responsibility for overall policy and Exchequer funding for the national roads programme. Once funding arrangements have been put in place with Transport Infrastructure Ireland, TII, under the Roads Acts, 1993 to 2015, and in line with the national development plan, NDP, the operation and management of individual national roads is a matter for TII, in conjunction with the local authorities concerned. TII ultimately delivers the national roads programme in line with Project Ireland 2040, the national planning framework and the NDP.

In accordance with the provisions of section 13 of the Roads Act 1993, each local authority has statutory responsibility for the improvement and maintenance of their regional and local roads. Works on those roads are funded from local authorities' own resources and are supplemented by State road grants.

In the case of the Dublin councils, in view of the arrangements for the retention of local property tax, the council is required to largely self-fund its road programme. The implementation of its annual road maintenance programme is, therefore, the responsibility of the council.

Regarding the M50, in 2014 TII published a report on a study that was undertaken to identify a scheme of indicative demand management measures for the M50. The report, M50 Demand Management, identified a package of measures, including multipoint-variable distance M50 tolling.

I am just looking at the response I have, which relates to the M50 and TII's responsibility for national roads, but having listened to Deputy Lahart's introductory comments, that is not the issue he is looking to address; it is instead the local roads feeding into and crossing the M50.

I will put that response aside because, while it is all very useful information, it does not relate to the issue that the Deputy is addressing, which is local roads, and I know all of the various roads he is talking about. It relates to the M50 in one sense, which is that the M50 itself is at full capacity. There is nothing we can do about all the junctions and other feeder roads on and off the M50, which are at full capacity, and, therefore, there are no other traffic management measures that we can take.

The Deputy said that the key point is whether we can accelerate the bus services to help cope with congestion, which is a very serious issue on all of the approach roads on and off the M50. My answer is that, "Yes, we should". We need to do it because we have real issues around traffic congestion, reducing emissions and the quality of life for our citizens. I will give one example of where that has started to happen. Traffic management measures have recently been introduced in Dublin city centre through a pathfinder project, which will do similar to what the Deputy is suggesting along the quays at relatively low cost and without major civil engineering works. The measures were put in place and, two or three months later, my understanding is that they seem to be working in the sense that bus speeds and bus numbers have increased.

My answer to the question is “Yes.” It is a matter for South Dublin County Council in conjunction with the NTA because it has to come from local leadership and it cannot be centralised. As Ministers, or even as Dáil representatives, we cannot go around the country saying that people have to do this on this road and do that on the other. It has to be the local council. I absolutely support and encourage this. We need to get local councillors to take similar measures, particularly ones that we can introduce quickly. Some of the roads involved are wide distributor roads. My answer is “Yes.” We should be looking for the local council to accelerate this, even for measures that may come under the BusConnects network corridor developments. Could we introduce some of those earlier to accelerate bus speeds?

We should be careful about putting cycling provisions and bus provisions in conflict because both are needed. South Dublin County Council has done a good job with the cycling projects has introduced. Nonetheless, they are controversial. It is never easy to change anything but I would be slightly nervous if it was depicted that the cycle lanes are the problem. The problem is congestion and the number of cars. My primary answer is “Yes” but it is the local authority that will have to do it.

I made the point that we can do both. The Minister mentioned leadership, which is why I raised this issue with him today. I would like him to write to South Dublin County Council to initiate a task force involving not only the council and the NTA, but also local community stakeholders, such as schools and businesses. These roads are not half as congested when schools are not open. We need a conversation locally about how we can all work together with all the stakeholders and the leadership of the local authority and the NTA, which has shown scant regard for getting involved. It was a long and detailed afternoon drive that I engaged in a number of years ago. I am glad the Minister abandoned the official reply about the M50 and addressed the issue specifically. This is extremely stressful for commuters, parents bringing their children to school and everybody along that route. As the Minister said and as I pointed out, unlike other routes, there is scope for significant improvement.

Where does the leadership come from? I am trying to take a lead. While the Minister said he does not have a role, I urge him to write to the CEO of South Dublin County Council to invite him to set up a task force locally involving all of the stakeholders and representatives of residents' associations, community groups, boards of management of schools and local businesses to get all of their ideas. I do not have all of the answers to this, nor does the council. It needs to hear what the reality is on the ground and what might be workable, and then it is up to us, as politicians, to look for funding for the solutions that it may come up with. Plenty of solutions are available on the ground to ensure the quality of life that people experience in these areas continues to be improved. The key piece is leadership. I am trying to lead by raising it today. I ask the Minister to use his role with the county council and the NTA.

As it happens, I am meeting the NTA later this morning so I will raise this and will push for it to look at south Dublin. On another point, the Deputy is right about focusing on making it safe for our children to take the bus, walk or cycle to school. On days like today, when traffic tends to be bad and the weather is not great, 30% of the morning rush-hour traffic is children being driven to school. In many ways, that is very attractive for parents as they are chatting and they are in a safe space with their child. However, when everyone is doing the same thing and everyone is caught in gridlock, it is very debilitating.

We have had a real challenge where some of the safe routes to school programmes were advancing and the challenge has often come down to local opposition. It is difficult. We have created this car-dependent transport system over five decades and when we try to switch towards a safer system where kids might be able to get the bus, walk or cycle, it means changing the road network and that often brings opposition. Our biggest difficulty has actually been local opposition. In many instances, it is not that the council is not willing to do it but that there is no local support. In politics, we all know that local community support is needed. I will talk to the chief executive of South Dublin County Council to suggest it does similar to what Dublin City Council is doing with its accelerated, advanced measures. I agree that we have to bring the community with us on that. We have to be careful that it does not become a massive, long-winded, complicated and legal process where we end up doing nothing in the end. We have to engage with local communities and bring them in, but that is for the council.

My Department will be very supportive. Finance is not always the key issue. To a certain extent, at some of these pinch points where there are wide distributor roads and we might be taking a lane, putting in a bus gate or taking some other such measures, it is political will rather than financial support that is the key. It is time for us to do this. I think people will be surprised. When we introduce the measures, they are very popular. The fear of them in advance is often the biggest obstacle.

I have previously raised in the House the issue of noise mitigation measures along motorways in general. It is particularly pertinent for me because I live 500 m from the Dunkettle interchange and over the years, with the increasing volume of traffic on the motorway and in the surrounding areas, noise has become a definite issue for people. This matter also relates to Harper’s Island, which is a bird and wildlife sanctuary just off the motorway in Glounthaune. The Minister will be very familiar with Glounthaune as he spent time there when he was growing up. I want to introduce that to the debate. It is not just an issue about noise levels but also a health issue for the people who live in the surrounding areas. As I said, it is also an environmental issue because of the environmental implications, which is another reason I am raising it.

I understand from dealing with this issue in the past that the Minister’s script is, more or less, going to tell me that it is fundamentally the responsibility of the local authority and that when it comes to developing new roads, in particular new motorways, any mitigation required at that point should be built into the scheme as it progresses, but any existing road or scheme is essentially the responsibility of the local authority. The difficulty I have with this logic is that roads get busier and noisier, in particular at the Dunkettle interchange, which is a massive interchange with a massive volume of traffic. It is only right that we have flexibility into the future, and that flexibility should be provided for local authorities to mitigate against the worst effects of noise.

I understand that noise mitigation plans must be completed every few years. The current noise mapping shows there are clear breaches of the acceptable decibel limits along this corridor. That has been mapped and is a known fact, yet we are still in this position and no measures are being taken to mitigate against the worst impacts of noise. I understand the EPA has a role in monitoring this and, therefore, between the EPA and the local authority, there are plenty of people making action plans and plenty of people monitoring noise, but nobody has the money or budget to do anything about it.

Deputy O'Dea has an issue with this in Limerick too and has raised it in the past. I think Deputy Lahart has also raised it. We made a plea to various Ministers that this be included as a line item in the budget. Unfortunately that has not transpired. We are burying our heads in the sand thinking this is not an issue for the communities that live particularly close to motorways the length and breadth of the country.

Returning to Harper’s Island, millions of euro in government money has been spent there in grants in recent years on preparing that facility. It is a wonderful facility. People go there for quiet walks and, most importantly, it is the central location in Cork harbour for wintering birds. Anyone in BirdWatch Ireland or anyone related to that site or anyone in the Glounthaune Community Association will say that the constant noise emanating from the motorway is having an adverse effect on the birds in particular and the wildlife there. I can predict the Minister’s script. I do not necessarily blame the Minister but I am just asking if we can find a way to navigate the provision of funding, most importantly, to local authorities and get someone to step up and take responsibility for the issue.

I do know the area. My grandfather grew up there. We had a family farm just on the other side of the Glantane and I absolutely accept what the Deputy is saying about the impact of noise, particularly. It is often forgotten about or it is slightly abstract but it has a huge impact on people’s quality of life and health so it is a real issue.

I will read the response I have because it is important to put on the record where the responsibility lies before coming back to the Deputy. Once funding arrangements for national roads are put in place with TII under the Roads Act, 1993 to 2015, and in line with the NDP, the planning, design, improvement and upgrading of individual national roads is a matter for TII, in conjunction with the local authorities concerned. TII ultimately delivers the national roads programme in line with Project Ireland 2040, the national planning framework and the NDP.

As part of the construction of new roads projects, TII ensures that a detailed noise assessment is carried out at the planning and design phase of the scheme in question. Where necessary, noise mitigation measures are then implemented during the construction of the scheme. However, it is important to point out that the situation differs for existing national roads post construction. The amended European Communities (Environmental Noise Regulations) 2018, under SI 549, deal with the requirements to prepare noise actions plans to be developed for the purpose of managing environmental noise issues and their effects, including noise reduction, if necessary. The EPA is the national authority for overseeing the implementation of these regulations. Local authorities, in their role as designated action planning authorities, are responsible for making and approving noise actions plans. TII’s role in respect of noise mitigation is in the implementation of noise mitigation measures during the construction stage of national roads. With regard to existing national roads, this is a matter for local authorities. TII supports local authorities through the provision of noise maps but it is for the respective local authorities to use the results of these noise mapping exercises to develop noise action plans and to implement such measures as may be identified in these plans to mitigate such noise. As such, it is for local authorities to fund and implement such measures and my Department has no role in this case.

I will put a question back to the Deputy, if I may. With the major development of the Dunkettle interchange over the past three years, which is coming to conclusion, and the tender out for the new motorway section from Ringaskiddy to the Dunkettle roundabout, has the local authority undertaken those noise action plans and noise monitoring on Harper’s Island? What is the local authority saying about fulfilling its obligations under that 2018 regulation under the European Communities noise regulations? It is a matter for the local authority, particularly where it is an existing road. I do not know whether the major road developments in the area might have given or still give an opportunity. I presume it is primarily surface treatment. The alternative is barriers. I do not know whether the local authority has given any indication, particularly in this area where major road developments are taking place, of whether it is doing that mapping or considering any resurfacing - resurfacing would have to be done by TII as a national road in conjunction with a local authority – or whether any barrier systems will be put in place. It is really the local authority that has to take on that function and fulfil the requirements of the regulation.

To address the Minister’s questions, there is provision for replacement surfacing in the immediate areas around the Dunkettle interchange as part of its upgrade in recent years. That is still ongoing. On the Ringaskiddy project and the noise action plans that have been prepared for that, that is on the south side of the river so I do not know whether the remit of the noise action plans extend to the eastern part of the city that I am talking about.

I imagine it is quite a big undertaking noise barriers are needed to be erected the full length of that motorway. I do not necessarily agree that this might be the best course of action here but I am not an engineer. If it is the case, that would be a considerable cost to a local authority. I expect it would cost multiple millions of euro just to erect sound barriers on that 10 km stretch of motorway. Local authorities do not have that kind of funding and they are telling us that year in, year out. That is why we made the ask leading up to the last two budgets that this would be a specific line item in the roads budget. It is not acceptable or realistic that the local authority would be asked to find an extra €10 million or whatever it would be, and that is just for this stretch of motorway. It is not including the dozens of other sections that are adversely affected.

With regard to the ongoing speed limit review under the Road Traffic Acts, which falls under the Minister’s remit, is there a possibility that the speed limit on this stretch of motorway would be reduced from 120 km/h to 100 km/h to hopefully reduce the noise levels there?

The Minister said that this issue is ultimately the local authority’s responsibility. If a local authority is in receipt of information that shows that decibel limits have been breached for the best part of a decade what responsibility is on it to make sure it steps up and does the work? It is grand to publish plans but if local authorities are not making any demonstrable efforts to tackle that, what is their responsibility?

I am interested in whether the resurfacing as part the Dunkettle upgrade has had an impact. That is why mapping is important to measure before and after and I do not know whether that extends as far east. I mentioned the Ringaskiddy development because it is likely to increase the volume of traffic and, potentially, heavy goods vehicles, which are even noisier in terms of their weight they carry. That is the only reason I mentioned that project. I do not expect the response would be that there would be a 10 km barrier system because that would have quite an impact visually and be very expensive. However, the benefit of mapping is that interventions could be targeted around particular houses. Along motorways, we often see houses that are particularly vulnerable to noise pollution. It might be more specific spots where we would look for such barriers for protection.

I am trying to recall the speed limit review conducted almost two years ago, which we will start implementing this autumn. It did not recommend a change in the 120 km/h speed limit for the motorway. The review is available on the Department’s website so the Deputy can go back and check whether there was anything specific or what the reasoning was behind that. However, the changes are primarily coming on non-national roads below the 100 km/h speed limit.

On the third question, it is the responsibility of local authorities. That responsibility first resides with the council as an ability. It is not that there is a lack of funding, if it is a funding requirement. This year, Cork County Council will get an allocation for roads of €61 million. Roughly half of that is just for protecting and renewal. That might be the budget that this road section might need.

Rather than putting in a new road, we will be adapting an existing road. I do not believe funding would be the primary constraint. Obviously, an area always has to be managed. As the Deputy knows, we will have to provide additional funding for flood protection following what happened in Midleton and Glanmire last year. It is a matter for the council and it must be held to account if it is not protecting the citizens in the way it should.

In 2020, the United Kingdom's National Health Service commissioned a report to optimise healthcare for transgender adolescents but it instead produced the Cass review. For some inexplicable reason, the HSE in Ireland is, by all accounts, undertaking its own review of this report. The report is highly politicised, junk science. It is driven by the UK's culture wars and should be allowed nowhere near policymaking in Ireland.

At a time when our health service is moving towards care that is rooted in the person and their rights, the Cass review actively undermines the legal competence of both children and adults to access choice-based medical treatment. It dismisses almost all existing clinical evidence on trans people's healthcare by applying evidence standards which, if applied to other medicines, would effectively invalidate more than three quarters of the existing treatments currently used in paediatric care.

The ways in which the report is flawed, bogus or methodologically compromised include but are not limited to the following: the Cass review does not follow established standards for evaluating evidence or evidence quality; the review casually discusses evidence quality but does not define it; it contravenes standard practice in scientific evaluations of medical research; and the review uses misleading and subjective terminology and misuses technical language regarding evidence quality. In any other field of medicine, this practice would be deemed unacceptable and harmful to patients.

An independent review of the evidence evaluation of the Cass report has described it as pseudo-scientific and subjective. It does not follow best practice or even standard practice in its fields. For example, the review conducted a series of focus groups with healthcare workers of varying backgrounds. It is not clear what expertise these individuals had but 34% of them admitted that their understanding of gender-questioning children came from the media.

The Cass review misinterprets and misrepresents its own data. There are too many instances to recount today but as an example, the review states without evidence that practitioners have abandoned normal clinical approaches to holistic assessment and that puberty pausing medications are available in routine clinical practice. However, the review's own data shows that only 178 young people in the UK with gender dysphoria, as the review describes it, currently receive medications that pause puberty under its definition. It is difficult to see how a medication is routine but also only applies to 0.0024% of the adolescent population.

The Cass review levies unsupported assertions about gender identity, gender dysphoria, standard practice and the safety of gender affirming medical treatments. It also repeats claims that have been disproved by sound evidence. This is where we truly see the political agenda laid bare in the Cass review. While the review places a high value on evidence quality and certainty, its recommendations frequently emanate from insufficiently supported assertions that have been disproven by scientific evidence. For example, the review continually highlights the concept of desistance - I hope I am saying that correctly - in a completely unproven way. Studies in the 1980s demonstrated that most gender non-conforming children would not meet the criteria for gender dysphoria after progression through puberty for a variety of reasons. This is not the same as a loss of transgender identity. Studies that claim high rates of desistance in children rely on data collected before there was a formal definition of gender dysphoria. At the time, children's behaviours were classified as non-gender conforming if they did not adhere to gender stereotypes, such as not wearing enough pink or not playing football.

More concerning is that despite stating opposition to so-called conversion therapy, the review favourably cites literature proposing methods which claim to suppress transgender identity in children and uses the desistance data from this literature unquestioningly. This is a terrifying vista for children, parents and families who are dealing with this - a health service that is willing to suppress you but not meet your needs.

The HSE has to uphold its good name and its commitment to evidence-based policy. It should not go anywhere near junk science or the Cass review.

I thank Deputy Hourigan for raising this important issue and for her passion, knowledge and commitment to the subject. I am taking this Topical Issue on behalf of the Minister for Health, Deputy Stephen Donnelly, who has spoken previously on the topic of gender healthcare. He has acknowledged this is a small and vulnerable group of people who need to have access to proper, appropriate and integrated care, including acute care and community care. He has also acknowledged that they do not currently have access to that in Ireland and he is determined to change that.

The HSE has appointed a new clinical lead who is overseeing a new clinical programme for gender healthcare. Over the next two years, an updated clinical model and implementation plan for gender healthcare services will be developed. Separate from that, following the publication of the interim Cass report in February 2021, the HSE’s chief clinical officer, Dr. Colm Henry, requested the HSE’s national quality and patient safety directorate to review the interim Cass report and how it applies to clinical pathways from Ireland. This HSE review of the implications of the Cass report for the provision of gender identity services for children and young people in Ireland was published in March 2023 and is available online.

Following the publication of the final report of the Cass review in April this year, Dr. Henry asked that an expert clinical group be convened within the HSE to consider the clinical implications of this final report, if any. The membership of the HSE Cass review group was convened based on their expertise and clinical leadership. It expects to complete its work shortly.

The work of the expert clinical group is specific and defined. It is independent of the HSE’s planned update of the clinical model of care for gender healthcare by the new HSE national clinical programme for gender healthcare. It is that model of care that will ultimately make recommendations on the delivery of gender healthcare services in the HSE for both adults and young people.

The development of the model of care will be informed by the best evidence-based clinical care for individuals who express gender incongruence or dysphoria. As well as reviewing the best clinical evidence available, the HSE will also incorporate input from healthcare professionals, patient advocates and those with lived experience. Stakeholder engagement will be a key element of this work and will ensure that people with lived experience will have input into the design of services and can advise on the delivery and evaluation of services. That is the message the Minister has asked me to convey today. He wishes to get across the crucial part of the development of this model of care, namely, the consultation with relevant stakeholders. The Minister is strongly of the view that we cannot have a situation where a model of care is being developed for a group of people who are not involved and whose voices are not heard. I can assure Deputy Hourigan that both the Minister and the HSE are anxious to ensure that all stakeholders are heard as part of this process.

While the model of care is being developed, people will continue to receive healthcare in the community and under the endocrinology service in the adult and paediatric centres in Ireland East Hospital Group and Children’s Health Ireland, CHI. Regarding current services, children and young people who require specialist psychological or psychiatric assessment and support are now referred to the children and young people gender national referral support service in the UK, which will triage these referrals to one of the newly developed services in London, Liverpool and Manchester. This service will work with CHI if an endocrine review is required. The adult gender service, which is based in St. Columcille’s Hospital, Loughlinstown, provides services for people over the age of 16 years. I assure the Deputy that it will be the model of care that will be making policy recommendations on the delivery of gender healthcare in the HSE.

I thank the Minister of State for the response. I acknowledge that the Minister has spoken to me about his commitment to ensuring that while we currently have no service for children and adults who are transgender, he is very committed to having one and I have no reason to disbelieve him. I absolutely agree on that. It is important, however, that we pause that review, the reason being that concerns about the Cass report are such that it is now under investigation by the British Medical Association, BMA. Members of the BMA's council recently voted in favour of a motion asking the association to review the Cass report after doctors and academics in several countries, including the UK, voiced concern about weaknesses in the methodology used in the review. We should not be reviewing something so questionable that it is being questioned in the territory in which it was produced.

We also know from a 2021 EU Tip of the Iceberg report that a significant amount of the political activity we saw in the UK around this issue is funded by foreign entities, including Russia. The intention is to do exactly what the Cass review is helping to do, which is create a culture war rallying point rooted in fear and marginalising vulnerable groups. I hope the HSE will recognise that questioning of the Cass review. If the BMA is undertaking an evaluation of the review and pausing to look at it, we should do the same.

Ireland has a very sad and difficult history in trying to control people's choice around their bodies and policing their sexuality. Nowhere in all of this is the person often heard. It is a top down attempt at politicising people's lived experience. The Cass review is bad science and I hope the HSE will undertake to pause its review.

I thank Deputy Hourigan. She made some valid and interesting points, which I take on board. I will refer them to the Minister, Deputy Donnelly, and ask that he take them on board as well. The Minister wants to ensure that members of the transgender community are given the proper, appropriate and integrated care and support they need to live authentic, fulfilling lives. The new model of care aims to do just that and it will be at the heart of it. The development of the new model of care for gender healthcare services is expected to be a complex process and the HSE and the Department of Health will work closely to support the process, ensure transparency and keep the patient at the centre of everything.

As I said, consultation with stakeholders will be a crucial part of this work. However, as the Deputy said, it is important that the HSE is given time to develop a model of care based on the best clinical evidence that will deliver the best outcomes for the person with gender dysphoria. As I said, the expert clinical group's review of the Cass report is specific. It is a defined piece of work that is independent of the HSE but I take on board the concerns raised by the Deputy and will bring them to the Minister. It is not possible to pre-empt the outcome of the review, but it is possible to say that-----

-----the model of care will be our policy decision on this.

The long-term aim is to provide a wide range of services for all people with gender dysphoria, from care locally in the community to more specialised and complex care. The Minister and the HSE are dedicated to building a service based on experience, clinical evidence, respect, inclusiveness and compassion. I know the Minister is committed to the development of a well-governed and patient-centred healthcare service for members of the transgender community. I thank the Deputy for her input on this issue, on which she is a fantastic advocate.

Ag bogadh ar aghaidh go dtí an tSaincheist Thráthúil dheireanach in ainm an Teachta Pat Buckley. The Deputy wishes to discuss the redress scheme for survivors of mother and baby homes. I was a little lenient with the previous speakers because I did not think this matter would come up. I ask the Deputy to stop after two minutes.

I raise the issue of the redress schemes for survivors of mother and baby homes. A lot of people, survivors of the mother and baby homes, have been in touch with me. They are extremely frustrated at having missed out on redress measures, whether the so-called enhanced medical card or another part of the redress scheme, because the days they spent living in a home fall short of the 180-day requirement. One was nine weeks short, while another was told they missed eligibility for the redress scheme by six or seven weeks. The frustration they have is with the records. The people I spoke to have said the information given by the institutions to the State is wrong. It is incorrect but they have no way of proving it. The Government is obviously taking the information for the redress scheme from the institutions' records, which creates fierce frustration.

We have had social welfare issues in specific cases, including in one I raised in the Chamber about a year ago. In fairness to the Minister, she informed me at the time that there was a one-to-one case worker on that case. That issue was resolved after 25 years. The woman in question had never received a carer's allowance for her child but she did through dialogue. Is any avenue available to survivors to rectify the records? It is bad enough what they went through in the institutions but now they have nowhere else to go to ask questions, correct the record and get what they are entitled to.

I thank Deputy Buckley for raising this Topical Issue on the mother and baby institutions payment scheme. I will provide an update on the progress with regard to the delivery of this important scheme to survivors and former residents on behalf of the Minister, Deputy O'Gorman.

As the Deputy knows, the scheme is the centrepiece of the Government’s action plan for survivors and former residents of mother and baby and county home institutions. It provides financial payments and health supports to eligible people in recognition of the circumstances they experienced in a mother and baby or county home institution. At an anticipated cost of €800 million, it is expected that 34,000 people will be eligible for financial payments under the scheme and 19,000 will be eligible for health supports, making it one of the largest schemes of its kind in the history of the State. The scheme opened in March of this year. By now, more than 5,200 applications have been received, 4,600 of which are fully completed applications which have been processed into the processing system. The payment scheme office is supporting those applicants with incomplete applications who need to provide some additional or further information. Almost 3,700 notices of determination or decisions have issued to applicants, more than 81% of which contain an offer of benefits under the scheme. Applicants have six months to consider their offer before they need to respond. Almost 1,900 payments have been either processed and completed or are in the process of being made. Total awards to date exceed €29 million.

A comprehensive public awareness campaign supports the scheme and the Minister has authorised the next phase of the campaign to commence next month. The Deputy will start to see and hear more about the scheme through local and national media. This is important because we need people to be aware of its existence and how to access it. All information on the scheme and how to apply, can be found at the dedicated payment scheme website at www.gov.ie/paymentscheme. This website includes an information booklet, questions and answers and information, including short "how to" videos. Ultimately, it is quite a straightforward application process. A helpline is also available at +353 1 522 9992, which may be of use to the constituents the Deputy mentioned. The easiest way to apply is using the online application portal. Hard copy application forms are available from the payment scheme office, Citizens Information centres and local libraries, if applicants want to apply that way. Applications can also be downloaded online. Overseas applicants can get an application form from their local Irish embassy or consulate. This scheme has been designed to be straightforward and non-adversarial and will not require applicants to bring forward evidence of abuse or harm.

With regard to the applicant's time in an institution, it is up to an applicant to be able to have the name of institution or institutions they spent time in and the dates they were there or approximate dates, if known. The Deputy raised a particular issue regarding approximate dates. I am happy to take details of that or he may send them directly to the Minister's office to see if anything can be done. Ultimately, the payment scheme office can only undertake searches of institutional records once it has some information. I understand that information can be difficult for people to access or provide. The Department is conscious that despite this, some survivors may still find it difficult to engage with the scheme.

I reiterate that the Government’s action plan response includes the provision of counselling support, through the national counselling service office in the HSE, free of charge to all survivors and former residents. I also reiterate that the free helpline is there for anybody who is having difficulty with their application form. I encourage the Deputy, his colleagues and my colleagues to promote this scheme and access to it so that more people get to know about it and engage with it and it benefits more people.

I appreciate the Minister of State's response. As I said, sometimes no matter how many times we ask questions, we never seem to get the answer but at least there is an option available here. I will go back to the people I have spoken to who will have to call the helpline themselves. I will probably get back to the Minister of State or the Minister, Deputy O'Gorman, in writing to state how they got on. I appreciate that there is some avenue for dialogue to try to resolve these issues.

I thank Deputy Buckley. I will put on record some of the other systems and supports that are in place as it would be good for all Deputies to be aware of them and to promote them to those affected.

First, the national centre for research and remembrance is an initiative that will represent a national site of conscience. It will include a museum interpretation experience, a space for reflection and educational, family and parenting supports. Detailed planning and engagement with survivors and stakeholders are ongoing on what the site will look like and how it will be developed.

The landmark birth information and tracing service, underpinned in this legislation, has now seen more than 14,000 applications for information processed by Tusla and the Adoption Authority of Ireland. Through the Institutional Burials Act 2022, commitments to intervention at the Tuam mother and baby home site are being rapidly advanced, with the office established, a director appointed as well as an advisory board and a scheme for the taking of DNA samples announced. A special advocate for survivors was appointed earlier this year.

These developments, in tandem with the opening of the payment scheme, and yesterday’s announcement by the Minister of imminent legislation to preserve privately held records of Ireland’s institutional past, underline this Government’s commitment to respond to the needs of survivors and former residents of these institutions.

I thank the Deputy for his remarks, his collaboration on this and for raising this important scheme in the House.