I welcome the Minister of State.

The Minister of State, Deputy Butler, is very welcome to the House. I am delighted she is taking this Commencement matter because I know her commitment to health issues and the work she has done over recent years, particularly since becoming Minister of State with responsibility for mental health and older people. This is a very important issue. This month is cardiovascular month. It is a month when people are reminded to mind their cardiovascular health. Unfortunately, too many people in this country die and suffer serious illness as a result of issues to do with cardiovascular health. This month, therefore, is an opportune time for us, as a nation, to look at what we are doing in this area.

I have always believed that screening is very useful and very important and saves countless lives. However, one never really sees the headlines about the lives that are saved because people just get on with it. That means the programme is achieving what it is meant to achieve. Of course, we have had scandals as a result of screening not working, but they have been a minority of cases. Overall, screening works, and one would like to see a lot more screening, particularly when it comes to the early detection of cardiovascular health issues. It would be very useful if we had a national screening programme in this area. We need an overall national cardiovascular strategy anyway, not just from a screening point of view, even though screening is critical. From an educational perspective, a personal health perspective and a fitness perspective, there are a myriad of areas that would tie into a national strategy to reduce the number of people who suffer death, bereavement and long-term illness as a result of this issue.

The Minister of State will be aware that HIQA carried out a report into this area. It was asked by the Government to do so. It has recommended that TAVI, which is a medical intervention system, be used as an alternative to SAVR. It would reduce the number of bed nights people would require. While it is being used at the moment as an alternative in some cases to open-heart surgery, HIQA believes it should be rolled out in a much more focused way and to a much greater number of patients. That HIQA report is there and, like many reports, I do not want to see it just gaining dust on a shelf. HIQA did the report, it did good work on it and, as such, the report should be implemented. That would be another element and another cog to a national strategy. A national strategy on cardiovascular health should include education, awareness, health promotion and proper dietary awareness. It should also include the roll-out of a national screening programme to people a lot younger than those who may benefit from it at the moment. Such a strategy should look at full implementation of the HIQA report, which was carried out some time ago.

I know the Minister of State will join me in wishing the people who work in this area all the very best and thanking them for the work they do daily, particularly with September being the month when we acknowledge, appreciate and get a better understanding of our own cardiovascular health.

I thank the Senator and acknowledge his persistent advocacy in all health matters. I have come before him in this House many times. I join him in acknowledging and marking the fact that September is cardiovascular month. It is very important we continue to put a focus on that. I am taking this question on behalf of the Minister, Deputy Donnelly.

The national review of cardiac services was established to recommend the best service configuration, clinical governance and performance requirements for national cardiac services for the next ten to 15 years. The review is finalised and the Minister has reviewed it. He wants to secure funding for the strategy via the Estimates process and plans to bring the review to the Government for consideration. The former Chief Medical Officer advised that reform of cardiac services should extend beyond a hospital-based focus. Therefore, the next steps for implementing the review and developing a new cardiac strategy will be situated within a holistic context which reflects all aspects of cardiovascular disease, including prevention and rehabilitation. That is exactly what the Senator has spoken to as regards education, informing people about their cardiovascular health and a more holistic approach. We all know prevention is better than cure. The holistic reform approach includes integrating cardiac services to deliver a more comprehensive systems approach to cardiovascular health in meeting the needs of our population.

The review represents a significant and comprehensive piece of evidence-based work, resulting in a detailed report, and the recommendations of the review will inform the future provision of cardiac services nationally.

It has taken some time for the review to reach this point however, considering the requirement for data and consultation to progress a major reform programme. This is understandable, and the results will be worth it.

In parallel, within a year, the HSE will be tasked with reform in several priority areas to address the immediate cardiac service needs of our population. These initial priorities will deliver results in the short term and will be developed in parallel with a longer-term implementation plan for the review’s recommendations when they are published. My understanding is that there are 23 recommendations.

Cardiovascular disease is multifaceted and incorporates a myriad of disease conditions which include, as the Senator has mentioned, transcatheter aortic valve implantation, TAVI, among other heart disease conditions and stroke. Plans to develop a new strategy will be informed by the review’s recommendations once published. This will include structural heart diseases. The implementation plan for the review’s recommendations will be the most appropriate way forward in progressing structural heart disease interventions such as TAVI. Operational leadership for Ireland’s complex cardiac services is provided by the HSE’s National Heart Programme. The National Heart Programme focuses on the design and delivery of the full spectrum of care for cardiovascular conditions. Underpinned by a whole-system approach, in line with Sláintecare, the National Heart Programme aims to improve population health, reduce health inequalities, improve patient outcomes and reduce the burden of cardiovascular disease in the population.

Beyond cardiac services, the Government is fully committed to supporting improvements and advances in other cardiovascular areas. The Minister has allocated a total of €7.3 million to fund the HSE National Stroke Strategy 2022-2027 over the last two budgets to support the development of stroke services. The overall aim of the strategy is to modernise and reform stroke services in line with Sláintecare policy and to help sustain and improve upon the significant achievements already made to date. I will come back to the Senator about screening in my closing comments.

Gabhaim buíochas leis an Aire Stáit. That is a comprehensive reply and I note the fact that work is being done. The Estimates process is coming to its conclusion now so, hopefully, we will see some resources identified for this. I would like to see the strategy launched, if possible, in the lifetime of this Government but certainly committed to by the various parties in their manifestos. Hopefully, it will be something committed to in the programme for Government with whoever makes up the combination that will run the country for the next number of years.

I believe strategies work. I have long been calling for a national strategy for the elimination of preventable blindness because four out of five people who suffer sight loss do so unnecessarily. There are unfortunately 20% who just go blind and nothing can be done about it. There is a great number of people who go blind and suffer severe sight loss and do not need to. If they just checked their eyes once every two years, that would be incredible. The number of people between 40 and 60 years of age who only check their eyes when they need to get a driving licence and then discover that they have a problem is phenomenal. The same is the case when it comes to this particular issue. If there was screening, we would see a dramatic reduction in the number of people who suffer from this condition.

I will agree with Senator Conway on screening, which is very important. This is an early detection and population-based screening programme for early detection of cardiovascular disease. The Minister for Health is fully committed to supporting our population screening programmes which are a valuable part of our health service. As the Senator may be aware, decisions on whether to introduce new screening programmes are made on the advice of the National Screening Advisory Committee. The committee is an independent, expert committee that makes recommendations to the Minister. I cannot reiterate how important screening is, whether one is called to BreastCheck or another screening service. It is very important that people attend because early intervention is key. As the Senator has said, many people - and we can all be guilty of this - put it on the long finger sometimes, as the Senator spoke there about blindness and sight loss, and wait until it is too late. I thank the Senator very much for his question.

We all know how bad the situation is in University Hospital Limerick, UHL, which has become infamous, being possibly the worst hospital when it comes to trolley numbers, accident and emergency services, and chaos. I want to ask if the Minister for Health will make a statement on the extension of opening hours of the injury clinic in Ennis Hospital to help reduce pressure on the emergency department at University Hospital Limerick. So many injuries are happening at night time and this is plain to be seen if one is ever down in the accident and emergency services, in Limerick. It usually kicks off after 8 o'clock, much of which involves limbs being wrapped up and bashes where people are out.

While we are waiting to solve the problems of UHL, the more we can do within the counties around the hospital, including my own county, the fewer people will have to go to the accident and emergency services in Limerick. We have a good new medical centre and and primary healthcare unit in Ennis. I am also wondering about the primary healthcare centres which were due in north, east, and west Clare also. In the meantime, there is a brilliant injury clinic in Ennis hospital. It will not solve all of the problems but I want to find out if there is any plan and, if there is one, when will it extend the opening hours of the injury clinic so people around Clare can go there if they happen to fall or hurt themselves after 8 o'clock at night? The period from 8 a.m. to 8 p.m. covers 12 hours but many accidents happen at night time, especially with older people who may fall out of bed. The last place they want to go is down to the accident and emergency department. People now live in fear of going there and, in particular, our older population. I just want a clear answer on any plan to extend the opening hours of Ennis Injury Clinic.

I thank Senator Garvey for that question and I absolutely share the concern she has expressed in a very important question. I call the Minister of State to speak now again, please.

I thank the Senator for her question and it is fair to say that the senior Minister, Deputy Donnelly, working with Bernard Gloster and Sandra Broderick, the new regional executive officer, REO, is trying to use every available lever in the area to improve the situation in University Hospital Limerick. It is also fair to acknowledge that a huge amount of great work is done in that hospital too with very many good people working there.

The development of injury units, IUs, is a strategic initiative for this Government to assist with alleviating pressures in our emergency departments. As a result of this strategic plan a national injury unit review was undertaken by the HSE in 2023. The recommendations from this review were: to expand all existing acute hospital governed IUs to operate from 8 a.m. to 8 p.m. and to expand geographical coverage and prioritise locations for the provision of IUs.

Resources are provided under the national service plan to standardise all IUs to open from 8 a.m. to 8 p.m. by quarter 4 of 2024. I must note that Ennis injury unit is already operating to the hours recommended by the review. In addition, an implementation plan for the expansion programme is under development.

Demand for urgent and emergency care in the region has increased year on year, which includes activity in injury units and medical assessment units in the three model 2 hospitals of Ennis, Nenagh, and St. John’s. To address this increasing demand, this Government has invested significantly in additional capacity in the region and at UHL.

The Minister, Deputy Donnelly, has asked HIQA to lead a review into urgent and emergency care capacity in the mid-west region to determine whether a second emergency department is required. While this is ongoing, the Minister, Deputy Donnelly, announced an additional package of reforms and supports for the mid-west region in April of this year. Progress is being made on delivering these improvements, with some services, such as the new nursing and residential home triage tool already being implemented by the National Ambulance Service. Some 150 new beds have been opened in the University of Limerick Hospitals Group since January 2020 and 108 of these beds have been in UHL. Additional health service capacity is being provided through: a new 96 bed block at UHL where it is anticipated that this will provide additional capacity for the region from mid-2025; a second 96-bed block at UHL, the enabling works for which are under way; a rapid build 16-bed unit at UHL, for which completion is expected at the end of December 2024; an additional 84-inpatient beds are being planned at UHL through the Acute Hospital Inpatient Bed Capacity Expansion Plan; and medical assessment units, MAUs, as I have already said, at Nenagh, Ennis and St. John’s Hospitals are extending their service to 24 hours a day, seven days a week on a phased basis.

Currently, the MAUs are operational from 8 a.m. to 8 p.m. This will be extended to 16 hours per day, from 8 a.m. to midnight, by the end of quarter 3 2024, which is soon.

The community rehabilitation unit in Nenagh is now operational, delivering 50 beds in Nenagh as a temporary step-down facility. The procurement process for the community rehabilitation unit beds in Ennis has been finalised and the group will now focus on operationalising the additional 25 beds at Ennis. That is in Cahercalla, which I visited a couple of years ago. Bed capacity is being expanded throughout the region through the acute hospital inpatient bed capacity expansion plan, with 24 new beds at Nenagh Hospital, 48 new beds at Ennis Hospital and 42 new beds at St John’s Hospital.

Every effort is being made to increase capacity and build confidence in the region again. That is what everybody wants to see.

I thank the Minister of State. I take it from her answer that the opening hours will not be extended past 8 p.m. I reject the findings of the HSE working group. To say all injury clinics should be treated the same and all should open from 8 a.m. to 8 p.m. is not good enough for us in County Clare. We are the only region in Ireland that does not have a model 3 hospital. There should be a special case made for Ennis Hospital, unless the HSE wants to provide us with a model 3 hospital. I do not see that happening because it has not been mentioned by anyone in the HSE.

The Minister of State indicated that the medical assessment units will open for 16 hours a day by the end of quarter 3, which is in six days' time. Does that mean I can tell everyone in Clare they can relax because we have been told by the HSE working group and the Minister of State that we will see this happen in six days' time?

The answer is not satisfactory. We need the injury clinics expanded to later hours. We have no model 3 hospital. After 8 p.m. people in Clare have to go to Limerick hospitals. To say the HSE working group finds that opening the emergency department until 8 p.m. is sufficient does not give me and the people of Clare any solace.

When I criticise UHL it is never a criticism of the staff. The staff are killing themselves. They are so stressed out and in such a difficult position because they are stuck dealing with patients who sometimes take things out on them. We cannot shoot the messenger. There are huge issues in UHL and we are trying to find some solutions. This is one.

I understand exactly where the Senator is coming from. Based on the answer I provided, everyone has to acknowledge that more investment and staff have been put into University Hospital Limerick than in any other hospital in Ireland in the last four years. That is a fact. Unfortunately, there are issues that take a long time to deal with. There are cultural issues and the way things are managed.

To take University Hospital Waterford as an example, while I am not saying everything is perfect – it is not – it never has anyone on a trolley. The reason is that when someone goes to the emergency department of University Hospital Waterford, there are 16 specific pathways. If it is an issue with a limb, for instance, the person goes directly to the area where that is sorted. Again, I am not saying everything is perfect there but for a long time, senior management have been in the emergency department from 7 a.m. until 10 p.m. Four senior managers in the hospital rotate every weekend to ensure people are discharged.

Ms Sandra Broderick is now the regional executive officer and Bernard Gloster and the Minister for Health have focused on this whole area. A huge amount of work has been done. There is the pathfinder, for example, an emergency department avoidance programme run by allied health staff and the National Ambulance Service. The pathfinder aims to deliver safe alternative care at home and is working very well. The extra beds in Cahercalla will make a big difference, as will the 50 extra beds in Nenagh. We are also doing work on hospital avoidance because some people do not need the acute hospital.

I will bring back the issue the Senator raised about the 8 a.m. to 8 p.m. service. I understand where she is coming from, especially the point that Ennis does not have a model 3 hospital and it is a long drive from west Clare to UHL. I appreciate that. I thank the Senator for her advocacy. I hear her speak on this subject constantly.

I raise the issue of medication for ADHD. ADHD is a condition that is real. It is not something that does not exist, although I think there is a traditional view that it is just badly behaved kids and they will grow out of it. We know now that is not true and that it is something that is identifiable. It is a chemical imbalance that can be dealt with by medication. The importance of having that medication for children with ADHD, and indeed adults with ADHD, cannot be overstated. When ADHD and a whole other range of similar conditions go untreated, those who suffer from the condition are left behind. If they are children, they get left out of education or they certainly do not benefit to the fullest extent from education. They get left behind and excluded. The treatment for these conditions is, therefore, extremely important.

Currently, medication like Ritalin, which covers ADHD, is provided for under the long-term illness scheme by the Department of Health. Parents with children who have ADHD can avail of that scheme and they receive that medication for free. I am told it costs about €50 a week. Obviously, the cost depends on the medication, the dose, etc., but that is the level we are talking about. However, for some reason that is either inexplicable or, if the reason I have been given is correct, outdated, that cover stops at 16 years. Where a child with ADHD is going into leaving certificate at 17 or 18 years, it is one thing if his or her parents can continue to pay for the medication but there are many kids whose parents cannot pay for it. A situation could arise where a child is doing fine in school, working away, benefiting from a medication that is keeping the condition in check, functioning within the educational system and availing of all the opportunities that normally come the way of every child, but for some reason the Department has decided that at 16 years, there is a barrier and once the child has crossed that line, it no longer accepts responsibility for providing that treatment as part of the long-term illness scheme. That is a real mistake and missed opportunity by the Department.

This applies not just to ADHD. There is a whole spectrum, if I can use that term, of conditions that are covered by the long-term illness scheme only up to 16 years. This is an important scheme, which provides for people who, through no fault of their own, have conditions that endure throughout their lives. For some reason, in the case of ADHD, the coverage the State gives to parents of children who suffer from the condition stops at 16 years. That is a mistake.

As we head into the budget next week, I ask that the Department of Health reconsider its position on this issue. That is not a huge financial ask or an unreasonable ask. More important, I do not think proper consideration has been given to the effects of not providing these medications to children aged 17 and 18 years, as well as young adults in their 20s who suffer from ADHD. Why on earth should they be disadvantaged or excluded? Let us be reasonable about this when we know that it is a life-long condition, the same as diabetes, which is covered by the scheme, or COPD and other conditions for which medications are provided throughout the person’s life. It seems there is a misguided view within the Department. Whether that is the case or not, I do not know but the evidence suggests that people think kids grow out of ADHD. They do not. It is a life-long condition. Let us recognise that and the expense burden placed on those people throughout their lives by compensating them for the medication they require throughout their lives.

I thank Senator Ward for raising this important issue. The answer I have was prepared by the Office of the Minister for Health, Deputy Donnelly, but ADHD comes under my remit, as Minister of State with responsibility for mental health. Therefore, I will deal with it in two separate ways. I will speak first to the long-term illness scheme. Established in the 1970s, the scheme provides for the supply without charge of medicines and medical appliances to persons suffering from any of 16 prescribed conditions, including mental illness in a person under 16 years. That is the point the Senator raised and it is a fair one.

While there are no plans to extend the scope of this scheme, it is important to reflect that the long-term illness scheme exists within a wider eligibility framework. This Government has put a significant focus on improving access to and the affordability of healthcare services, advancing substantial policy, legislation and investment to deliver expanded eligibility and services in line with Sláintecare. Among these are the removal of public inpatient charges in public hospitals. We have also focused on reducing costs in primary care and have delivered one of the largest expansions of free GP care. The two GP access measures provide eligibility for approximately 500,000 additional people. Some 52% of people in the country have either a medical card or a doctor-only card.

People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines.

We know that can be very difficult. We all know that from dealing with it in our constituency offices. Of course, the drug payment scheme threshold now stands at €80 per month. All of these measures work.

The point the Senator raises is very fair. I say that because 40% of all children who attend CAMHS have an ADHD diagnosis. I know that from speaking to the consultants and from the review of the audits we did over the last couple of years. We have 1.2 million children in the country aged under 18. Approximately 2.5% of those children attend CAMHS and, of those, 40% have ADHD. The medicines used in the treatment of ADHD are available under the long-term illness scheme and are also available to medical card holders and those eligible for the drugs payment scheme, subject to the payment of the statutory charge.

Attention deficit hyperactivity disorder has long been recognised as one of the most common psychiatric disorders in children and it is now known to persist into adulthood. When I came into this role, I discovered very quickly that there were no supports for adults with ADHD. I launched a clinical programme in 2021 which is really important. To date, starting from nowhere, we now have seven teams funded. Five are in place and two will be operational by the end of this year. Five more teams will roll out the full clinical programme across the country. I am hoping to do more in next year's budget and two more years will conclude it. It is really important that we do that.

Working with ADHD Ireland I secured recurrent funding for the understanding and management of adult ADHD programme called UMAAP. It is a six-week programme run by ADHD Ireland which has proven highly beneficial and effective for adults who have completed it. Before I leave this role, whenever that may be, I wanted to make sure that the funding for that was recurring. It will be available every year. The funding was stopped earlier this year but I reinstated it.

The Senator's point about those young people who are 17 or 18, who may be in college before they start working their way through life, is very valid and I will consider it further.

I appreciate the Minister of State's bona fides on this and welcome the fact that she is telling us about expanded services for ADHD sufferers. I particularly welcome her acknowledgement of those in the 16 to 18 age cohort. They are still children. Many of them are still in school while some of them are going to college and it is really important to support them. I hope she will do that. This was brought to my attention by a young councillor in my area, Councillor Dan Carson, who is newly-elected in Blackrock, and by Ms Emma Weld-Moore who heads up Neurodiversity Blackrock which is part of Neurodiversity Ireland, an organisation that does so much good work for children, young people and adults afflicted by a condition that is treatable. The Minister of State has acknowledged that and I appreciate what she has said. Maybe we could bring this in on a means-tested basis or just for that 16 to 18 cohort. Let us do that first and then expand it because it is entirely worthwhile from the point of view of the State and wider society, but particularly for the people who benefit from it. It is entirely worthwhile to put this in place so that we do not lose out and they do not lose out. They have so much to give and we are just disadvantaging them and losing out as a country.

To conclude, I do not have a medical background myself but one thing I have learned from speaking to clinicians is that 40% of young people who are in CAMHS have ADHD. Their condition can be dealt with very well with medication. Once they get that diagnosis and they are put on the correct medication in the correct dosage, they can do extremely well. The situation we had was that when they turned 18 there were no follow-on supports but we are rectifying that. I take on board the point the Senator has made about the 17 to 18 year old cohort for whom it can be very difficult but as I understand it, a lot of them may be eligible under the medical card scheme. I will certainly consider this further, specifically in relation to ADHD. We have made great progress in the last few years on the clinical programme. We now have a model of care for ADHD that we did not have previously. We need to support the 16 to 18 year olds. I would hate to think that any person who needed medication but could not afford it would be left without it. I thank the Senator for raising a really important issue.

The Minister of State is very welcome to the Chamber. The safe routes to school programme was developed by the NTA in partnership with An Taisce's Green-Schools in 2020 as a response to the need to support schools to increase walking and cycling to school. The aims of the programme are to improve safety at school gates by providing front-of-school treatments to alleviate congestion and improve access; to improve access routes to schools by improving walking and cycling infrastructure; and to increase the number of students who actually cycle to school by expanding the amount of cycle parking available. Parked cars on footpaths create dangerous situations and restrict access for everyone, especially young children, parents with buggies and wheelchair users. The scheme has helped to transform the accessibility of schools up and down the country and should be expanded further. I can think of many schools in Tipperary alone where there are dangerous situations at pick-up and drop-off times.

The programme opened in 2021 and there has been good uptake in the two funding rounds. Approximately 900 schools applied for funding under the programme and 170 were notified on 30 June 2021 that they were successful. There was a second round and just over 100 schools were successful but obviously, there are thousands of schools across the country. As with any scheme that is set up, and we saw this with the hot school meals programme, some schools do it quite quickly while others do not. Some schools are not sure and a lot of people did not understand the programme at the time but there is definitely a demand for it right across the country, especially in rural areas.

In the context of next week's budget, I am calling for additional funding for this programme. The view in the Department seems to be that all of the schools that apply for funding will be successful over time but there are thousands of schools that have yet to apply for it. Given the impending reduction in speed limits to enhance road safety, this programme is much-needed and there is huge demand for it. There is an opportunity here for us to do more. We all know of schools in our area where it is extremely dangerous. I just started bringing my child to school two weeks ago. It is a lovely country school but I can see the danger every morning and the possibility of something happening. The more we invest in safe routes to school and in improving the ease of access into schools, the better. I ask that something is done on that in the forthcoming budget.

I thank the Senator for raising this matter. When one is parked outside the school gate or one is walking to school, it really focuses the mind on the safety of children going to school. I am dealing with this matter on behalf of the Minister of State, Deputy Lawless, who has given me a comprehensive answer. As we all know, the Government is committed to achieving a modal shift in transport and increasing the number of active travel journeys over the coming years. This is evidenced in both the commitments made under various policy documents, including the programme for Government, the climate action plan and the Department of Transport’s national sustainable mobility plan, as well as the significant increase in funding for walking and cycling measures over the past four years. It is important that we move quickly to reduce our carbon emissions and in doing so, we must promote a modal shift away from private car use. This will not be achieved without the provision of alternative transport modes such as active travel.

The programme for Government sets out an ambitious and wide-ranging set of commitments in relation to walking and cycling and has committed that €360 million in cross-government funding will be spent on walking and cycling per annum over the lifetime of the Government, equivalent to 20% of the 2020 transport capital budget. This investment will help support the planned delivery of almost 1,000 kilometres of improved walking and cycling infrastructure by 2025 as well as additional investment in greenways.

The active travel infrastructure programme also funds the safe routes to school programme which specifically targets schools around the country and provides them with safe, connected walking and cycling infrastructure projects at various scales. The programme is funded by the Department of Transport through the National Transport Authority and An Taisce's Green-Schools is co-ordinating the programme. Invitations to express interest were sent to all primary and secondary schools in the country. I acknowledge that it was launched in March of 2021, when we were in the middle of Covid. Schools were not open at the time and it probably took until the end of 2022 and into 2023 before schools started applying at scale. A total of 932 schools applied to the scheme, equating to around a quarter of all schools in the country.

Some 170 schools were selected for round 1 of the programme in the summer of 2021. Subsequently, two schools deferred their applications and one withdrew, leaving 167 schools in round 1. Round 2 of the programme, consisting of 108 schools, was announced on 12 December 2022.

Despite being launched in 2021, just 77 of the total 930 remaining safe routes to school programme schools have had projects completed. This is due to various factors, including the initial time spent setting up the programme and developing the various resources for stakeholders involved, as well as the time it has taken to progress projects through the earlier planning stages, which are now nearing the construction and delivery stages. The rate of delivery is now increasing, though, as local authorities have become more skilled at delivering safe routes to school projects. However, scheme acceptance and funding are still challenging factors.

A note was provided on active travel investment grants in 2024. The allocation for Tipperary County Council amounted to €4 million. While the note does not provide a breakdown between north and south Tipperary, this is significant funding. I have seen some of these schemes in my constituency. Although it takes a while to put them in place, when they are in operation they work really well. The whole focus, as I know, is to keep children safe as they go to school and to make sure they can cycle or walk if they so desire.

I thank the Minister of State. I appreciate the response and I understand the challenges. I understand the funding challenges and that this scheme started in 2020, but it is disappointing that only 77 of the 930 projects have been done. While I fully understand that Covid happened, when a scheme is put in place people want it to be delivered as quickly as possible.

This has not only happened in Tipperary. The issue has been raised with me by Councillor Gareth Scahill in Roscommon, who has seen it in schools in Castlerea. He also has a young family and he knows the challenges facing parents. He made the very good point that there is a suggestion that the council can pay for this through its roads funding. Councils have their own challenges with roads funding, including what they can pay for and how much they have each year. They seem to be losing money as opposed to receiving extra money for new funding schemes. If we are going to do this scheme, it needs to be done through Department funding rather than council funding because most councils cannot allocate funding to it.

While I welcome this programme, it has been slow to get off the ground. It makes a big difference to schools and parents dropping kids to school. The more it is used and the quicker it is done, the better. As the Minister of State said, its implementation has been speeding up in the last year or so, but the more we can do, the better.

While there was an enthusiastic response to the initial call for applications under the programme in 2021, with approximately one quarter of schools in the country registering to apply, this naturally means that three quarters of schools were not enrolled in it. It should, however, be noted that because a school is not currently in the programme, that does not mean it will not receive any new or improved active travel infrastructure. While there are currently no plans for an additional call for schools to join the programme, funding for active travel infrastructure for schools is not confined to the safe routes to school programme alone. In some cases, schools outside the programme are included in wider active travel projects, if they are in the vicinity of these works. In fact, all active travel funding looks to improve links to schools, where possible, and this will be provided through the programme for Government commitment of €360 million.

I detailed the amount provided to the Senator's area. We should give any assistance we can to schools. Voluntary boards of management are trying to progress these issues and this funding will be welcomed by them. I thank the Senator for raising this important issue.

I, too, thank Senator Ahearn for raising this extremely important issue, on which I hope we will see progress. I thank the Minister of State for taking all the Commencement matters. We know she is busy, so her time is appreciated.