There is a slight change in the running order, so the first Commencement matter will be from Senator Gareth Scahill.

The Minister of State is very welcome to the Chamber. I wish her the very best of luck in her new role. I congratulate her on that. She has always been a great supporter of this Chamber and someone who has always shown up. We hope we can rely on her to do the same in the future. I hope she does not forget her Roscommon roots if there are ever any favours I need called in as well.

Inclusion does not begin in the workplace; it begins in early childhood. If we are to be serious about building an inclusive society then we must ensure that children with disabilities can take part in the early childhood care and education, ECCE, programme not partially or conditionally but fully. The access and inclusion model, AIM, is central to that mission. It is an evidence-based model, evaluated independently, and it works. More than eight out of ten parents say it benefits their child, and providers overwhelmingly report that it strengthens inclusion in their settings. Budget 2026 showed the Government's commitment in real terms, with the AIM budget rising to €86 million, a 50% increase in just two years. That funding will support almost 9,000 children with disabilities next year in addition to the 2,000 already benefiting from AIM+, which extends targeted supports beyond the ECCE hours. The programme for Government also sets out a clear direction to examine and expand AIM and make it available to younger children. That commitment now needs to be carried through with urgency and ambition, because despite the investment and progress, too many families are still falling through the gaps.

I want to share an experience of one family who came to me recently. I will not use the child's name but their situation is, sadly, familiar to too many. Their weekly crèche fee is €170 and, for that, they receive up to 30 hours of childcare, with the ECCE providing a total of 45 hours per week. When their child was identified as having additional needs, the crèche reduced its childcare hours from 30 to 12, and because only 12 hours were now being provided, the crèche could only draw down 12 hours of the ECS grant. Its funding fell yet the fee charged to the parents remained exactly the same. This family is now paying more than €120 extra per month for less than half the childcare hours they had before. Like so many parents, often mothers, they have had to reduce their own working hours to fill that gap. The mother, in this case, works as an occupational therapist supporting children with additional needs, yet the AIM system does not support her own child to access the hours he needs. This is a policy unintentionally making workforce shortages worse in another critical sector and it is a reminder that inclusion must be more than a principle. It has to function in practice.

What this example shows is simple. Parents of children with additional needs are, in some cases, paying more and receiving less, not because services do not care but because the funding model does not align with the real hours children need. We now have an opportunity to fix this so I am calling for the following. We need a full and immediate review of the AIM flexibility. We need a model that supports full-day participation where required, not one that inadvertently incentivises limited hours. We also need full delivery of the programme for Government commitment to extend AIM to younger children. We need a clear timeline and we need actions and accountability on this. We must ensure that no family is ever put in a position where they are paying more for fewer hours simply because their child has additional needs. That is the opposite to inclusion. Inclusion must be embedded in the wider reform of early learning and childcare, including the expansion of State-led services and the additional 700 places planned for next year. These services must be inclusive by design and not retrofitted for inclusion later.

AIM is a strong model with strong outcomes. The direction of travel is right but families need the gap closed. Inclusion cannot be partial or limited by the hours on a funding form. It must be full, meaningful and available to every child. This is the standard we should set. It is the commitment we owe to families and it is what the expansion and enhancement of AIM must now deliver.

I warmly welcome the Minister of State and congratulate her. I know she is already a Minister of State but she has been elevated to a Minister of State attending Cabinet. I wish her well tomorrow, which I think is her first day, but I may be wrong on that. I also welcome the guests of Senator Joe O’Reilly: Darragh Kiernan and Conor Madden. Conor is a Cavan GAA intercounty player, but I have been told both of them are distinguished GAA players. That is the strong endorsement that has come from Senator O'Reilly.

I thank the Cathaoirleach for his warm wishes. I welcome everybody in the Gallery, and particularly Seán Keane, a transition year student who is working with me this week, and who is here to make sure I do a good job on this Commencement matter.

At the outset, I wish to say I am taking this on behalf of the Minister, Deputy Foley. The Minister thanks Senator Scahill for raising this really important issue, and offering me the opportunity to respond on her behalf. Since 2016, as the Senator is aware, the access and inclusion model, AIM, has had a major impact on the lives of children with disabilities and the overall quality of learning and care. The Senator himself cited the statistic that 82% of parents and carers reported that AIM has benefited their child. It has been such a widely welcomed and much-needed support for families up and down the country, including, of course, in Roscommon. More than 35,000 children have received more than 80,000 targeted supports across 4,800 early learning and care services nationwide.

The 2025 budget allocation for the access and inclusion model, AIM, was €80.9 million, which represented a 41% increase on the 2024 allocation. This significant increase reflected the Government's ongoing commitment to supporting children with disabilities and additional needs to meaningfully participate in early learning and care. The 2026 budget, which we just passed recently, further increases AIM funding to €86.5 million. That will ensure continued expansion and sustainability of supports for children, parents, carers and, of course, service providers.

AIM funding provides a suite of universal and targeted supports across seven levels. The universal supports are designed to create a more inclusive culture in early learning and care settings, through training courses and qualifications for staff. Where universal supports are not enough to meet the needs of an individual child, targeted supports are available. These include things like equipment, therapeutic supports, the facilitation of a lower ratio of children to staff in preschool rooms, or funding for an extra staff member as a shared resource where a child with additional needs is present.

Access to AIM is based on the needs of the individual child. In the context of a preschool setting, that means they do not require a diagnosis. In line with the commitment in First 5, a whole-of-government strategy for babies, young children and their families for 2019 to 2028, an independent evaluation of AIM was undertaken in order to inform an extension of AIM beyond the early childhood care and education, ECCE, programme as well as any potential enhancements to the model. This is the review and extension the Senator called for and is something the Government is absolutely committed to.

AIM has, as the Senator is aware, expanded beyond time spent in the ECCE programme, allowing children access to AIM targeted supports for an additional three hours a day during ECCE term and six hours outside of the ECCE term. The programme for Government, as the Senator campaigned for, commits to examining and expanding the AIM model and making it available to younger children. Officials in the Department are currently considering the policy implications and appropriate mechanisms to extend AIM to children aged under three. It is critical that any extension of AIM supports for this cohort are evidence-based and reflective of their needs. It is intended that, over time, all children with additional needs registered in the early learning and care services will have access to supports under AIM. It is therefore intended to also give consideration at a later date to an extension of AIM to children attending school-age childcare. Such an extension will also need to meet the different needs of children in the older age cohort. Both extensions will obviously require additional funding through the annual budget process.

Senator Scahill referenced a family he is working with, where the mam is an occupational therapist providing much-needed services to children and, perhaps, even adults right across her CHO level.

The Senator raised a really important point. The childcare hours of some families in that situation are unfortunately reduced as a direct correlation in relation to their needs. I thank the Senator for raising and escalating this issue here today. As I said, the AIM is under review and this is something I will definitely take back to the Minister, Deputy Foley.

I thank the Minister of State. In relation to the AIM programme, 69% of participants saw an improvement in peer interaction and more than 95% of providers reported a positive impact on inclusion. That is what we want to see. I did, however, highlight that in some cases parents of children with additional needs are paying more and receiving less. That is an anomaly that we cannot stand over and one that we need to address.

In my first call, I asked that the review include AIM's flexibility, so that the Minister would be flexible and that when I raise this issue, I would not get a traditional piece of correspondence that does not reference the individual case. The flexibility should be there to take on board the individual situation like this where the mother is an occupational therapist and we need her working. I would appreciate it if flexibility could be built into it.

That is a really worthwhile idea to explore. Based on the evaluation, and the Senator read out some of the statistics that came from that evaluation, AIM is now being extended on a phased basis as funding becomes available. As a first step in this extension, since the beginning of September last year, all AIM-targeted supports have been available to ECCE children beyond the time they spent in the ECCE programme. It is intended that over time all children with additional needs in early learning and childcare services will have access to supports under AIM.

The next phase of expansion focuses on a redesign of AIM for children under three to meet the specific needs of the younger age cohort. I am not sure if that is the age cohort of the family in question that the Senator raised this issue for, but the design of AIM will ensure that it meets the different needs of children in different cohorts. That will depend on the funding secured through the annual budget process, but we are on a good trajectory for funding. I spoke about the increases in funding this year and last.

An action plan has also been developed to respond to other areas of improvement identified through that AIM evaluation. That includes things like increasing awareness and the streamlining of application processes.

I thank the Minister of State for her time. It is greatly appreciated.

I welcome Minister of State, Deputy Canney, to the House.

I am here to speak about a couple of the schemes that receive extraordinarily small amounts of funding, yet do an incredible amount of heavy lifting in terms of arts and culture. We hear a lot of discussion about the importance of Ireland's cultural heritage, how much that is part of the identity we have internationally, how essential it is to our internal identity and the role it plays in society. However, the funding that allows people to engage with culture and allows actual creativity to flourish within our communities is still deeply inadequate.

I am going to highlight a couple of the areas, two schemes that are of particular concern. Under the cultural capital stream E, the stated aim is the enhancement of the existing stock of the arts and cultural centres throughout the country.

Since 2023, only €996,876, or less than €1 million, has been allocated to the 32 arts and cultural organisations across the country for their capital stock, or their buildings, resources and facilities. This year, there has been an announcement of €271,400 for eight institutions, including Garter Lane Arts Centre in Waterford and the Town Hall Theatre in Galway city. Previous recipients have included the Seanchaí Kerry Literary and Cultural Centre, Tuar Ard arts centre in Westmeath, and South Tipperary Arts Centre. I am listing some of these names because these spaces, art centres and small theatres play an incredibly important role in their communities. All the spaces, such as that in Westmeath and the theatre in Manorhamilton, play an incredibly important role in making creativity and cultural practice visible and possible in local communities. It was a revolutionary thing that they were introduced and that they began to flourish. These spaces also play a vital role in facilitating arts performers and artists across Ireland who do not have the option others might have in New York or London, where a production can run for a year. Instead, they may have two weeks here and one week there. They build a circuit around the country that allows them to fund the development of their theatre, art and performances. The organisations have received only €1 million.

The visual artists workplace scheme gets a maximum of €6 million, provided by the Department, for the development of projects. Counties and city councils can apply for funding up to only €300,000 under the scheme. By comparison, the sports facilities fund, overseen by the same Department, was allocated €230 million last year. For the incredibly important arts organisations, we are talking about €1 million, €6 million or grants in the order of tens or hundreds of thousands of euro. I want to know what is happening to reconfigure and really resource this area. Dublin City Council has shown that of the 126 buildings classed as multidisciplinary community and arts centres, such as Axis Ballymun and The Complex, only 11, or 9%, are developed to a standard sufficient to allow for the production or consumption of professional work. They are not at a standard where they can be used. In my reply to the Minister of State’s response, I will give some positive examples but also some of the areas where more work is needed.

The Minister for Culture, Communications and Sport, Deputy O’Donovan, is unable to be here today due to prior commitments and sends his apologies. He asked me to step in in his absence.

I thank Senator Higgins for raising this important matter and giving me an opportunity to update the House on it. This Government places great value on culture and the arts sector. As outlined in the programme for Government, we recognise that the sector is essential to a well-rounded society, providing opportunities for education, expression and community engagement. A network of cultural infrastructure exists throughout the country, with the majority of the facilities in the ownership of local authorities. Annual support, including programming and revenue supports, is provided for arts and cultural infrastructure by local authorities and the Arts Council.

The Department of Culture, Communications and Sport is focused on providing capital grant funding to assist development and to maintain these arts and cultural facilities. The cultural capital scheme was originally launched in October 2019 with a fund of €4.7 million. An additional stream of funding, stream E, was launched on 14 June 2023, with a fund of €1.4 million. Stream E of the cultural capital scheme focuses on enhancing the existing stock of arts and cultural centres throughout the country. In line with Government action on climate change, the scheme also welcomes projects that reduce the organisations’ carbon footprint, as well as projects that provide additional capacity for artistic production.

Grants of up to €20,000 are available for not-for-profit dedicated arts and cultural organisations, at an 85% funding rate. Larger grants, of up to €50,000, are available at a maximum grant funding rate of 70%. Local authority-owned facilities are subject to a maximum funding rate of 60%.

Since it launched on 14 June 2023, 32 applications were successful and funding of €996,000 has been allocated to date. Some 20 projects have been completed and fully drawn down. This is a rolling scheme and is demand-led with no closing date. It will remain open until the fund is exhausted. The next round of grant awards under stream E of the cultural capital scheme is due to be announced shortly.

As highlighted by the Senator, the Minister, Deputy O'Donovan, is acutely aware of the shortage of affordable creative spaces around the country. His Department currently operates a pilot artists' workspaces scheme for local authorities. This scheme is open and accepting applications. Under the €6 million funding scheme local authorities are invited to propose projects that can accommodate and address the demand for artists' workshops in their regions and produce workshops that are fit for purpose, design focused, accessible and affordable. Funding of up to €300,000 is available for densely populated local authorities. Funding of up to €150,000 is available for less densely populated areas. The scheme has also no closing date and will remain open until the scheme is fully exhausted.

Since it launched in June 2024, there has been one grant awarded to Limerick City and County Council for €221,356. However, the Department has recently received six applications under the scheme. These are currently being assessed and the Minister hopes to make an announcement on these in the coming weeks. This funding will address the critical shortage of performance and workspaces for artists throughout the country.

I would like to inform the Senator that in 2023 the Department of Culture, Communications and Sports allocated Dublin City Council funding of €3 million as part of the Space to Create programme, towards the provision of artists' workspaces in a number of city centre locations. These projects are currently being progressed. Dublin City Council was allocated this amount for the Space to Create programme because, as Ireland's capital city, it has the largest population. As such, it would also have a higher population of artists in need of workspace.

The Senator may be aware that in budget 2026 the Department was allocated €6 million for a new programme of capital funding for arts and culture across the country in line with a commitment in the programme for Government. This will see much-needed capital supports for communities, including funding essential equipment for organisations such as amateur drama groups and musical societies. The Department is in the process of designing the specifications for this scheme, including setting out the eligibility criteria. Depending on demand, it is the Minister's intention to seek an increase in next year's budget.

Before I call the Senator to respond, I welcome to the Visitors Gallery a group of students from Cistercian College Roscrea, who are guests of Senator Maria Byrne. The guys are turned out amazingly well in their jackets and shirts. I also welcome Ms Marceline Coady and Mr. Seamus Hennessy. They are all very welcome. I hope they enjoy their stay.

I am concerned about the mention of demand-led. We know the problem is that there is a capping of very low amounts such as €20,000 or €150,000. We know about that demand, so it is not really demand-led because it is not actually matching the need that is there.

I acknowledge what the Minister of State said in relation to the Dublin City Council partnership. In fact, it has a positive example in the FLUX studios in Chatham Row, for example, where the council owns a space providing affordable workshops for artists and space for workshops, exhibitions and performances and indeed an anchoring place for cultural groups. However, we need far more of that. Perhaps the Minister of State might update me on the Liberties cultural campus, which we heard was to come online in a similar way. What is the progress on that? In terms of demand-led, I am making this demand but also it should not be solely a demand. This should be something driven by the Department as a positive for society and for culture. As has happened across many previous governments, the Department should look to fund and create these spaces because when the spaces are created, the possibilities open up and the artistry and creativity emerge. That is what genuinely leads to a creative society, where everyone can both see and participate in culture, rather than having so many people competing for such small amounts of money.

I thank the Senator. I realise her obvious passion towards this subject matter is true and genuine. This Government places great value on culture and the arts sector. As outlined in the programme for Government, we recognise that they are essential to a well-rounded society providing opportunities, education, expression and community engagement.

Across the country, there is a network of cultural infrastructure, with the majority in the ownership of local authorities. Annual support, including the programming and revenue supports, is provided. The Department of Culture, Communications and Sport is focusing on providing capital grant funding to assist to maintain these arts and cultural facilities, with the infrastructure as opposed to the running costs. It is important to the Minister, Deputy O'Donovan, that he and his Department support this investment in these facilities, both in Dublin and around the country. As I said earlier, two capital streams are currently open, stream E of the cultural capital scheme and the arts workspace scheme, and there is a separate partnership with Dublin City Council.

The new scheme for arts and culture organisations that was announced in the budget will build over time, similar to the way that sports capital funding has developed. That is where the Senator will see the thresholds increased, especially with the costs of construction increasing. I will ask the Minister to come back to him on the query about the Liberties, because I do not have the answer here. While it is demand led, it is important that all organisations engage. Hopefully we will see stronger support in the thresholds going forward.

I thank the Minister of State and the Senator. The Minister of State is staying with us. I thank him for his time. I appreciate it, as does the House.

The last time the Minister of State was in the Chamber, he and I had a conversation about the delays in people getting driving tests. I take this opportunity to compliment him on his work in that area. He set out ambitious targets and I am delighted to congratulate him this afternoon on the work and the progress he has made there. Maith thú in that regard.

Ireland's system of local government has been described as one of the weakest in the EU, with a 2023 Council of Europe report describing it as one of the most centralised countries in Europe. The EU average for tax revenue spent at local level is 23%. In Ireland, it is just 8%. Ireland scores just above Moldova and Hungary on the local authority index. We also fall short when it comes to representation, with 5,196 people per councillor here in Ireland, compared with 412 in Finland and 620 in Spain. We have the second lowest number of elected representatives in the EU because of the abolition of town councils, which were very cost-efficient and represented the citizens and people of their areas. Now the re-establishment of town councils, abolished over a decade ago under the Local Government Reform Act 2014, is outlined in the programme for Government as a priority to provide a focus point for our towns and to co-ordinate activities. The Taoiseach has indicated a goal of having these re-established by 2029. Eighty town councils were abolished in 2014 under the Local Government Reform Act by the then Minister, Phil Hogan. This shifted financial decisions from town councils to county councils, slashed the number of councillors by over 40% and introduced municipal districts.

I understand that the plan is to reintroduce the councils on a phased, regional basis, starting with large towns as a way to improve local representation and accountability. The move has the potential to strengthen the powers of municipal districts and the area committees, providing towns with a dedicated body to raise concerns and co-ordinate actions. The abolition of town councils in 2014 was clearly not fully thought out at the time and has led to a loss of local leadership and accountability. The move did not actually result in the €400 million projected savings at the time, in 2019, and indeed, Labour's Brendan Howlin at the time called the restoration of town councils an admission that it had been a mistake to abolish them in the first instance.

The Taoiseach has suggested bringing back town councils through a pilot scheme in the areas where town councils existed previously and in new locations where populations are increasing. Town councils were very effective entities that ensured that the needs of the urban areas were not forgotten. Former town councillors, of whom I am one myself, will say that town councils were efficient and accountable, because money raised in a town stayed in that town.

The re-establishment of town councils also has the potential to bring more new people into politics at local and ground level, including many women and young people. They were, if you like, a platform for people to dip their toes into political life to see how it went. We need much more of that. Clearly, I understand that restoring town councils is a logistical challenge but I also understand that the local democracy task force set up to fund these functions is due to report shortly. I would be grateful if the Minister of State could provide us with an update this afternoon.

Before I call the Minister of State, I wish to welcome a few people to the Gallery who have come in. This is the second tranche from the Cistercian College Roscrea, who are guests of Senator Maria Byrne. They are very welcome. There are also guests of Deputy Danny Healy-Rae and Senator Teresa Costello in the Gallery. They are very welcome, as are Ms Sharon Hynes and Ms McDonald. They are all very welcome and I hope they enjoy their stay here in the House.

I welcome every guest here. It is an opportune time to listen about local government. I was looking at the young people and wondering how many of them will enter politics in the future. It is an opportune time to listen to local government being discussed here.

I thank Senator Gallagher for raising this matter and giving me the opportunity, on behalf of the Minister, Deputy Browne, and the Minister of State, Deputy Cummins, to update the House on the local democracy task force. At the outset, it is important to note that the Local Government Reform Act 2014 dissolved 80 town councils, which represented just 14% of the population. This town council system had led to duplication, both in administrative and electoral terms. Instead, the Local Government Reform Act 2014 saw the introduction of 95 municipal districts, representing 100% of the population in 25 of the 31 local authorities at sub-county level, with area committees operating in the three cities, namely, Cork, Dublin and Galway, as well as three Dublin county authorities. Each municipal district can include several towns, villages and their hinterlands, with local matters dealt with at municipal district level and the wider strategic issues decided at county level. The result is an integrated administrative structure in each county which maximises operational efficiency while ensuring devolved decision-making throughout the county.

I acknowledge that more work needs to be done to ensure that the potential of the municipal districts is fully realised. As such, the programme for Government recognises the need to strengthen the framework and powers of municipal districts. The programme for Government commits to the establishment of a local democracy task force with the local government sector to finalise a programme for the reform and strengthening of local government. This commitment demonstrates the important role that the local government sector plays in our democracy through the delivery of essential services in Ireland. The task force will bring forward proposals that the Government will consider on matters relating to the structure, finance, functions, governance and accountability of local government.

The Government approved the establishment of the local democracy task force on 4 June and it will make its recommendations in line with its terms of reference. The task force is supported in its work through pillar groups. The pillar groups are comprised of organisations that have a strong footprint within the local government sector, such as the AILG, LAMA, CCMA and LGMA, along with Government Department representatives relevant to the particular pillar theme.

The task force also undertook a targeted stakeholder consultation process seeking input from a range of stakeholders from across the local authority sector. All submissions received by the task force are publicly available online on the Department’s website. The task force will bring forward proposals in 2026 and I know the Minister, Deputy Browne, and the Minister of State, Deputy Cummins, look forward to receiving and considering the recommendations of the task force in due course.

I thank the Minister of State for that comprehensive response. We are, and I am sure the Minister of State will agree, very fortunate to have so many hard-working councillors throughout this country, and we must always strive to expand their role in their local areas and enhance the terms and conditions of those elected members. As these young people leave the Gallery this afternoon, we need more platforms for those young people to enter politics.

Currently, that is cut off from them. By having town councils in place and back in situ , those young people who wish to be public representatives and represent their towns will have a platform, as I said, where they can dip their toe into local democracy and maybe expand on that, if it is what they wish to do.

It is widely recognised it was a huge mistake to abolish town councils. I look forward to the publication of this report in 2026. I look for the Government to progress the recommendations of that report so that towns the length and the breadth of the country can look forward to having their own voice, and having people from their own towns representing the needs and ambitions of those towns.

Well said. I thank the Senator.

I concur with the Senator on the hard work done by our local councillors on the ground with very little recognition for it. Since the time I was a councillor, the workload has increased for a lot of councillors. We need to recognise that as well. If we want to engage with and attract more young people into politics, both male and female, it is important they have access to get into the politics of it.

I thank the Senator for his engagement on this matter and on the process that will see reform and strengthening of the local government sector, which is the beating heart of our democracy. The task force will build on the substantial body of work already completed by the Association of Irish Local Government, AILG, the Seanad and the Congress of Local and Regional Authorities reports. In this regard, I acknowledge the work of the Seanad Public Consultation Committee, chaired by the Cathaoirleach, Senator Mark Daly, and its report on the future of local democracy, which was published in 2024. It is important that we await the findings of the task force, which is chaired by Jim Breslin, who was appointed by the Minister. I too look forward to seeing the report because it is very important for democracy, and for every region and every town, that we have good democracy and plenty of engagement, so every town feels it is being represented and being heard as well, which is important. I thank the Senator.

I once again thank the Minister of State for giving us his time amid his busy schedule. It is always difficult to make time but it is always appreciated when Ministers come to this House.

The Minister of State is very welcome to the House. I thank her for her time. We greatly appreciate her coming to the House to take this Commencement matter.

I am very happy the Minister of State is here today. It is great to have a Minister from the Department answering in response to a Commencement matter.

I will use my time to highlight an urgent and deeply neglected women's health issue, premenstrual dysphoric disorder, PMDD. It is a severe hormone-based mood disorder affecting an estimated 6% to 8% of women. It is debilitating and recurrent but, crucially, is treatable. Yet, in Ireland, many women have never received a diagnosis, let alone received appropriate care. PMDD is a condition that has been hidden in plain sight for far too long. It is a cyclical hormone-based disorder that affects a significant number of women. It can cause overwhelming distress and depression, often with no explanation offered by medical professionals. For many, these symptoms begin for adolescents long before they are equipped with the language or knowledge to understand what is happening to them and to their bodies.

I acknowledge specifically the courage of one young woman. Her name is Shauna Halpin and she has spoken publicly about her experience. I had the privilege to meet Shauna recently and she has given me her permission to tell her story today. After years of severe symptoms, which started suddenly in her teens, including severe anxiety, depression and extreme fatigue, she started to self-harm and experienced suicidal ideation. Even though Shauna knew she did not want to die, she needed the mental suffering to end, such was the severity of her condition. In the absence of answers, she admitted herself into psychiatric healthcare, believing that was the only way to get answers. All Shauna wanted was to feel well again and to live her life again. However, she now describes this as the worst decision of her life. While in psychiatric care, she was medicated so much she could not feel anything but numbness.

She was misdiagnosed with several things, including unstable personality disorder. Eventually she left psychiatric care and for the next five years she spent three weeks out of every four each month floored with symptoms. Shauna undertook her own research online where she discovered she was experiencing undiagnosed PMDD. PMDD has 15 symptoms and one needs a minimum of five of them for a diagnosis. Shauna had all 15 of those symptoms. Despite this, she got no help from the public system. She was simply given the pill, which did nothing for her. I am sure women across the country can talk about being prescribed the pill by a doctor as some sort of magic tool and it does not work. It was only after going private that Shauna got help in the form of hormone replacement therapy, HRT. I believe it is completely unacceptable that she had to go through this unimaginable suffering for ten years. I am very happy to note that Shauna is now doing incredibly well after getting HRT treatment through a private clinician but her story resonates beyond one person. It shines a light on what many women have been navigating silently and that is the question of medical gaslighting. It is an issue I have spoken about before in this Chamber. Unfortunately, we hear almost daily of women who have not been believed about the pain they are living with. Shauna's story is simply one more example of that. We are simply not meeting the needs of women in relation to diagnosing and treating painful conditions.

Today, I am speaking about PMDD but this could extend to things like endometriosis as well as many other conditions where women's pain is minimised and has gone untreated for years by a healthcare system that does not believe them. Despite the severity of PMDD, many clinicians in Ireland receive little or no structured training in recognising or treating it. There is a complete training gap that urgently needs to be filled. I have raised this issue today to seek an update on how Ireland is currently diagnosing and treating PMDD and on the clinical training and guidance across women's' health and mental health services for this specific condition. I am also asking for an update on the public awareness plans around PMDD, including work with the Department of education, so that young people can learn about PMDD in school in an informed and sensitive way because what we see now is girls and young women who are having to navigate this experience by themselves with no information and it is absolutely harrowing. We have made some progress around women's health but PMDD remains a significant gap. What women want and what everyone deserves is clear information, a clear pathway and a health system that understands their condition and meets their needs with compassion and knowledge.

I thank the Senator. Before I call on the Minister of State to respond, I welcome, as guests of the Ceann Comhairle, Tammy Darcy and Michelle McGuirk. They are very welcome.

I am taking this matter on behalf of the Minister for Health, Deputy Carroll MacNeill. I thank the Senator for bringing this matter to our attention. In particular, I thank Shauna, who has spoken very publicly on her challenges and what has happened to her. That is really important for all of us. I again thank Senator Stephenson for raising Shauna's case today.

Today gives me an opportunity to update the House on the ongoing work to improve women's health outcomes and experiences. The Minister for Health has previously said that we cannot be satisfied with anything less than a health service that provides true equality of care and treatment, where gender is not a barrier or a disadvantage. The two women's health action plans, along with the significant investment, have resulted in important improvements to women's health services in Ireland. The women's health task force and these action plans have increased awareness of many women's health issues among the public and healthcare professionals.

The Minister, Deputy Carroll MacNeill, recently approved funding for the development of a menstrual health awareness campaign which is currently being developed by the national women and infants programme in the HSE. She is developing that at the moment. The first phase of this campaign will involve a comprehensive evaluation of current attitudes and knowledge of all related topics. The campaign will aim to balance information regarding what is normal versus what could be abnormal. It will focus on a range of menstrual health disorders and associated conditions. One of the results of the research phase will be the development of a communications strategy with communications for areas requiring focus. The 2022 Healthy Ireland survey included a module on this issue in health and period poverty was the other issue. The results indicated that 51% of women had missed daily living activities on occasion because of period symptoms and that 24% had experienced period poverty. Healthy Ireland and the HSE national social inclusion office teams have recently set up linked websites on the topic of menstrual health and period dignity.

PMDD can have a significant impact on mental health. It is characterised by debilitating emotional symptoms occurring between ovulation and when a period begins. It is associated with an increased risk of problems, including depression and anxiety. Treatment for mental health impacts can include talk therapy and counselling, as well as medication. Both have been found to have a beneficial effect and it is important that anyone suffering with PMDD can access support in a timely way. Women with PMDD can also access a range of mental health supports in the community.

Mental health services are provided by the HSE across community and hospital settings. There is a nationwide network of adult mental health teams which provide multidisciplinary supports. The teams provide specialist supports to those who require more supports than their GP or primary care psychology can provide. GPs are the key pathway for anyone with PMDD who needs support with a mental health problem, including referral to secondary care. GPs also have access to mental health resources at primary care level and can refer patients to counselling services such as SilverCloud. A GP may also refer somebody for more expert input, if he or she feels that is needed.

The national counselling service provides free counselling to those with medical cards. Beyond this, community and voluntary organisations are funded to provide mental health services and supports, including talk therapy, counselling, suicide bereavement services, helpline and crisis support services.

The Senator spoke about education. Female and male health education in schools is supported through the social, personal and health education, SPHE, curriculum. The HSE has resourced developments to resource and update the junior cycle SPHE curriculum, which include developments in supporting, teaching and learning about male and female reproductive systems.

I thank the Minister of State. I appreciate there was a lot to get through there. I am reading it as she is delivering it.

I thank the Minister of State and appreciate her commitment to this. It is brilliant that Shauna has spoken out publicly about this but it should never take women having to expose such personal things in public to get action. Will PMDD specifically be in the HSE campaign the Minister of State mentioned? While I recognise GPs are the first port of call and pathway for many people, the reality is many GPs across the country do not know this condition in detail and are not treating women or outlining the right pathways.

I also want to link that to the question of psychiatric care. Maybe that will work for some but psychiatric care is not necessarily the best step for hormonal imbalance, which is what PMDD is. The idea of institutionalising someone with psychiatric care, or even of them referring themselves to an institution, seems absolutely obscene. It is not getting the point. It is an outdated form of medicine that does not respond to the modern needs of women. That is why I mentioned HRT. I would love if the Minister of State would take that back to the Department for it to be taken seriously as a pathway we should explore. HRT works amazingly for certain things. Postnatal depression can also be treated with HRT.

On SPHE, is that a new update in the school curriculum? PMDD is mentioned in that curriculum but the section on it is minute and does not provide enough to young girls experiencing this. It is about having an open conversation. Between 6% and 8% - almost one in ten women - suffer from this.

I thank the Senator and I want to thank Shauna. Today was just about guidelines for information. The Minister has approved funding for an awareness campaign, which is being developed through the national women and infants programme in the HSE. I will get the Senator more information on that.

The Minister and the Government share the Senator's commitment to providing women in Ireland with a healthcare system that is responsive to the issues raised today. Women account for 51% of our population. We need to make sure we have the conversation, the awareness and the information. The Senator spoke about how well Shauna is doing now and we commend her. We need to make sure we have all the services there that are needed, work around them, have an awareness campaign and work with GPs. GPs play a huge role in this as well.

It is also about all of us working together. The framework for the women's health action plan protects our ambition. It commits to listening, investing, delivering and repeating the process for growth for women's health. It is about all of us working together. I will come back to the Senator with that information. It was really good to talk about this today because it is vital we raise awareness and work on it together.