I welcome the Minister of State, Deputy Christopher O'Sullivan, to the House. He is most welcome to Seanad Éireann.

I thank the Minister of State for being here and taking this matter. This issue concerns the need for the Department of housing to set out what mechanisms are available to local authorities and approved housing bodies, AHBs, when dealing with repeated breaches of tenancy, particularly concerning antisocial behaviour that affects neighbouring tenants. Across the State, but noticeably in areas that I represent, tenants are reporting ongoing issues of antisocial behaviour. These are not isolated instances but repeated patterns that undermine community safety and the right of residents to live in peace. The tools to deal with antisocial behaviour exist in legislation. Under the Housing (Miscellaneous Provisions) Act 2014, local authorities and AHBs can issue tenancy warnings, seek possession orders where breaches continue and apply for excluding orders that can remove offenders. While these are significant powers, it is not clear how consistently they are used, how effective they are and what oversight is in place across both local authorities and AHBs.

In my constituency, South Dublin County Council operates a detailed antisocial behaviour strategy. It sets out prevention, mediation and enforcement. The council has systems for complaints, timelines for investigation, multiagency co-operation and the option to apply for excluding orders. Yet, the volume of complaints remains high. In the past three years, South Dublin County Council has received almost 2,000 complaints related to council-owned properties. While some cases progress to warnings and termination, the reality on the ground is that many tenants live beside persistent antisocial behaviour for prolonged periods.

Approved housing bodies now house thousands of families across the country and are subject to the AHB regulatory authority. They also have the power to seek excluding orders and to enforce tenancy conditions. However, there is little transparency around how often these powers are used, how complaints are handled and what level of consistency exists between AHBs. Tenants housed through an AHB should not have weaker protections, nor should AHBs be operating without proper scrutiny when dealing with recurring breaches. Tenants are doing everything right yet are living with the consequences of repeated antisocial behaviour from others. They are reporting it and engaging with the process. What they see in return is a system that is slow, inconsistent and often unclear. For many, the process feels endless while their day-to-day quality of life deteriorates.

I ask the Minister of State to outline the mechanisms that are available to local authorities and AHBs and crucially, how the Department monitors the use of those mechanisms. What guidance or direction is issued to AHBs to ensure that their approaches are aligned with local authorities and the expectations of the Department? It is not enough to have legal powers on paper; we need data. How many tenancy warnings are issued? How many lead to excluding orders? How many lead to full repossession? I call on the Department to commit to publishing annual disaggregated data on antisocial behaviour inventions by local authorities and AHBs, and to review whether the strongest powers like excluding orders are being used to protect communities. Every tenant deserves to feel safe in their home. The law provides tools to protect them. What we need now is clarity, consistency and oversight so that these tools are used when tenancy breaches become a pattern that harms others.

I thank the Senator very much for raising this issue. It has been my experience that the vast majority of tenants, such as social housing tenants or tenants of AHBs, are exemplary. They are model tenants. That certainly seems to be the experience. In a small number of situations, there are tenants who may partake in antisocial behaviour. We have to admit that we have scenarios where they make their neighbours' lives hell. It is very difficult. It is apparent that some local authorities are better than others at dealing with that and using the powers that are available.

I will outline the legislation and the tools that are available to local authorities to deal with these situations. My colleague, the Minister for justice, has overall responsibility for policy and legislation relating to serious incidents of antisocial behaviour through the criminal code, which is enforced by An Garda Síochána. My Department also has a key role to play in this by providing a framework of legislation giving social housing landlords a range of tools to tackle antisocial behaviour being perpetrated by their tenants. Local authorities are responsible under the housing Acts for the management and maintenance of their housing stock and the management of their estates, including taking appropriate measures to counter antisocial behaviour. The Housing (Miscellaneous Provisions) Act 1997 provides for the issuing of court orders to exclude a household member engaged in antisocial behaviour from the dwelling and, if appropriate, the estate in question. The Senator has already mentioned this power. The 1997 Act also empowers a housing authority to refuse to allocate or sell a dwelling to a person engaged in antisocial behaviour. The powers of local authorities in this area were significantly enhanced by Part 2 of the Housing (Miscellaneous Provisions) Act 2014, which provides for the issuing of a tenancy warning requiring that tenants cease any antisocial activity. Part 2 of the 2014 Act also gives local authorities the power to recover possession of their dwellings from households in serious breach of their tenancy agreements, including engaging in antisocial behaviour.

In the AHB sector, the Residential Tenancies Acts regulate the relationship between AHB landlords and their social tenants and set out the tenancy rights and obligations for both parties. AHBs are responsible for enforcing the obligations that apply to their tenants under the Residential Tenancies Acts. Where a tenant is engaged in antisocial behaviour or allowing others to engage in such behaviour, the Residential Tenancies Acts allow an AHB to terminate the tenancy, subject to a notice period of seven days in the case of serious antisocial behaviour or 28 days in the case of less serious but persistent behaviour.

The Residential Tenancies Act also provides that a third party affected by antisocial behaviour may take a case to the RTB against an AHB which has failed to enforce its tenant’s obligation not to engage in antisocial behaviour. The forthcoming residential tenancies (amendment) (No. 2) Bill 2025 will broaden the type of evidence of antisocial behaviour that the RTB can consider in its dispute resolution service.

My answer sets out the tools that are available and the legal status in relation to AHBs and social housing. It is important to say as well that it is not just in social housing situations where we see this type of antisocial behaviour where tenants or residents of a house are causing issues within estates. It does happen. Thankfully, I still think it is the minority but, obviously, if it is persistent, especially in certain areas like the Senator highlighted in south County Dublin, then it is something we need to address. I have set out the legislation and policy. In fairness, the Senator also asked for the reporting mechanism. I think that is very fair to ask for how we monitor the implementation of these rules. That is absolutely something we will look into.

I thank the Minister of State very much for that. I commend South Dublin County Council. I know it is the minority, and it spans far wider than the local authority housing. Obviously, the Department would have the figures for the local authority housing and that is why I framed it in that manner. On antisocial behaviour, one of the most common complaints I hear that really distresses people is the illegal dumping and burning of rubbish within estates. I have had situations in apartment complexes where instead of going to the bins, people are repeatedly throwing rubbish in the corridors. I am dealing with residents and tenants who are absolutely distraught. It is an ongoing issue. I would like to see action on that and an end to it because people are really distressed about this. As we said, it spans beyond the local authority, but I would have thought the Department would have had the figures. That is why the Commencement matter was related to that.

That is absolutely fair enough. That is a fair ask to be able to provide data. It is about protecting people's and individuals' privacy, etc., but we could provide data so that we can monitor the level, identify the areas where it is more prominent and see what action is being taken to stop it. I know that in some instances there are high levels of intimidation. I imagine it is not easy for council housing staff to get in there and address those issues when there is that level of intimidation that sometimes exists. Maybe they need to be supported and enabled more in addressing it. We all know the situations where the actions of one ruin it for the majority of really peaceful law-abiding citizens, but that is something at which we need to look. The Senator's question specifically in relation to monitoring is very fair, and we will look into that. Then, perhaps we can try to enable local authorities and AHBs to be able to address it and not step back, which is often the case.

The Minister of State is very welcome. I raise an issue that has come past my desk a couple of times over the last few weeks. There seems to be an increased pressure on families, especially vulnerable families, some of them headed up by women, in relation to rent arrears. In one of two cases of rent arrears, one for €12,000 and another for €10,000, the person has been put out onto the street with their family. They have been in the house over 42 years. A figure of €12,000 is a drop in the ocean compared to the fact that the Dublin Region Homeless Executive stated that it can cost up to €180,000 per year to put a family in emergency accommodation.

However, what has come to my attention in supporting some of those families who are facing court proceedings in relation to rent arrears is that rather than, obviously, wrapping the supports around them, children are receiving court summonses from Dublin City Council and South Dublin County Council in relation to the rent of their parents being behind. Can you imagine being ten years old, some letters come through the door, your name is on that post, and you pick that up and open it. What it says on that letter, that is effectively penalising, criminalising and shaming the child, is:

Dear ... [so-and-so; I will remove the name],

As an occupant of the property ... [again, I will remove the address], we wish to inform you that there is matter before the courts in relation to the above premises. The matter will be before the court on ... [it gives the date] in District Court No. 23, Four Courts, Inns Quay, Dublin 7. We recommend that you, as the occupant of the property, attend court on this date.

We are literally sending requests for children to come to court. A mother, if she has anybody to seek support from, may say that she is not bringing her child to that. However, if the child opens it, then the child is asking, "Am I in trouble? Am I poor? Can mammy not afford the rent? Are we going to be homeless?" Then the child brings the letter to the mammy, who has probably been trying to shield the child from the struggles they are experiencing within the home in terms of being able to pay the bills, and she is then forced and shamed into having to explain to the child the struggle they are in in terms of rent arrears. What if the mother brings the child to court? Why are we making a spectacle of families in the courts where the children have to sit by and watch?

It makes absolutely no sense as to why we would be effectively creating a potential criminal sanction for child occupiers. They have no responsibility. How can a ten-year-old pay the rent? They are on the rent, of course, because they live there in terms of how many people live in the house, but the only person responsible for making sure that the tenancy is paid and the rent is up to date, or to come up with a new rent agreement, is the leaseholder or parent.

That situation was in relation to a ten-year-old. Another situation was in relation to a 17-year-old. This person turned 18 and the parents were put out on the street. The 18-year-old went to put themselves on the housing list at 18 - they had just left school - and the local authority told them they could not go on the housing list, that they were now barred for two years because they broke their tenancy agreement. This was a child occupier. A child occupier was banned from going on the housing list because their parents could not deal with the cost-of-living crisis they were in being able to keep up with their rent. One of those families had been in the home for 42 years. It makes absolutely zero sense.

I am hoping the Minister of State is going to tell me it is an automation system and that it is not a human making this decision to send a child to court or ask a child to attend court or force a mother to have to explain to that child the difficult situation they are in. What I am hoping is that an automation system has spat these out and sent them to everyone in a house and that we can send some sort of ministerial direction to the local authorities to make sure the message is loud and clear that a child occupier who is under 18 should never receive one of these in the post. No family should be shamed and potentially criminalised for struggling. We want to deal with intergenerational poverty, inequality and all of those things, and this is definitely not the way to do it.

I thank Senator Ruane for raising this issue. In my view, there are no circumstances in which a ten-year-old child or anyone underage should be getting a court order or formal order to appear in court, especially when it comes to the issue of rent arrears. I have a formal response which outlines the situations where, potentially, someone who is under the age of 18 may receive a formal letter. Certainly, I do not think there is any justification for the situations the Senator described. Clearly, there needs to be flexibility or, at the very least, a review of the process of where this happens so that we can protect the type of person about whom the Senator is talking.

Obviously, it is my understanding that it would be the clerk of the court who would issue formal invitations to appear-----

The letter was issued on council-headed paper.

All right. We will go through this, and we can absolutely discuss further how we are going to prevent this from happening in the future.

The general administration of the court system is underpinned by legislation within the responsibilities of my colleague, the Minister for justice. I thank the Senator for clarifying that she is seeking a review of the housing legislation to ensure children do not have to attend court proceedings in respect of local authority tenancies where they are occupiers. Obviously, there is a place for housing legislation within this to try to address it.

Local authorities are responsible under the Housing Acts for the management and maintenance of their housing stock and the management of their estates, including taking appropriate measures to counter antisocial behaviour. The Housing Acts 1995 to 2024 contain a number of provisions whereby a local authority tenant and their household may interact with the District Court. A number of provisions relate to instances whereby the local authority is seeking a possession order to return the property to the local authority in cases of rent arrears, antisocial behaviour or other serious breaches of the tenancy agreement. There was no possession order in the situation the Senator highlighted.

There are also provisions whereby the local authority or, indeed, the tenant themselves are seeking to exclude a person who they believe to be engaging in antisocial behaviour, and in these situations the person in question may be under the age of 18.

That does not cover the ten-year-old who received the letter in the case Senator Ruane spoke about.

Section 3 of the Housing (Miscellaneous Provisions) Act 1997 provides for the issuing of an excluding order through the District Court to exclude a household member, including juveniles, engaged in antisocial behaviour from the relevant dwelling, the vicinity of the dwelling and, if appropriate, the housing estate in question for a period of up to three years. An excluding order may also, if the court thinks fit, prohibit the respondent from causing or attempting to cause any intimidation, coercion, harassment, obstruction of, threat to, or interference with the tenant or other occupant of any house concerned. Breaching these orders, once in place, is an offence, with the person subject to the order liable to penalties, including fines or imprisonment, or in the case of a person under the age of 18, detention in a children detention school.

The Housing Acts allow the local authority or the tenant to apply to the District Court, but they do not prescribe that a child occupying a local authority tenancy is required to attend the subsequent proceedings. It may be that any formal invitation to attend such proceedings comes directly from the courts in order to allow that individual to respond to any allegations made which may potentially result in the issuing of such an excluding order or, indeed, a possession order.

That response says to me that the situation Senator Ruane described was wrong. It should not have happened. It was rent arrears, which is not covered unless there is a repossession. It did not involve antisocial behaviour, so it is not covered. Senator Ruane also said the letter was issued on Dublin City Council headed paper. According to this answer, the courts are responsible, so there is an anomaly. Something has happened that needs to be looked into further. I could not agree more with the Senator. She presented a situation where a vulnerable young child got a letter in the post. I can imagine the fear and anxiety that would cause. Fair play to her for raising it because it is clearly something we need to look at.

My hope is that it is an anomaly. My thoughts were that it is an automated system that does not pick up the differences, but it is from the law agent in the council. I do not have the other one in front of me that is from South Dublin County Council, where there was a similar situation. The person who was a child occupier was then banned from going on the housing list when they were in school and obviously could not pay rent. It is clear that an anomaly is happening.

I am hopeful this can be addressed simply, without having to look at legislation because it is not part of the legislation. I hope the Minister of State and I can follow up in the next week or two to figure out a simple solution to this. Thankfully, in this situation, the mother got to the letter first, but she was distraught at the thought more letters might come. She was watching for the postman and terrified she would have to tell her child that they were in trouble with rent arrears, with the lack of safety that would have caused for the child and shame for the mother. She is still watching the post because these proceedings will not take place until next year. Therefore, I would love to receive some feedback in the next week or two about how we can address this. There is probably a simple solution.

Without knowing the exact details of the case, I can say from the way it was presented that if a parent, in this instance a woman, is struggling with rent arrears, it must be dealt with in the most sensitive manner. First, the different scenarios and potential ways in which the rent arrears can be addressed should be worked through. That should be the first port of call. The blunt issuing of a letter addressed to a child, in this instance a ten-year-old, does not make any sense. Like Senator Ruane, I hope this is an anomaly. We will try to find out and get a bit more detail. However, even the response I just gave clearly sets out that rent arrears is not an excuse and does not trigger a letter to a child as happened in this case. That sets it out clearly, but we will certainly get more feedback about whether it is appropriate for the letter to be on local authority headed paper as the Senator said it was. We will try to find out more.

I thank the Minister of State for being with us today. I raise this Commencement matter to ask why inflammatory bowel disease, IBD, which includes Crohn's and colitis, which are the two most common forms of IBD, remains excluded from the long-term illness scheme, despite being a lifelong, incurable, medically managed condition that affects more than 40,000 people in Ireland. According to Crohn's and Colitis Ireland's 2025 report, Uncovering the Hidden Costs of Crohn's and Colitis, the financial and personal toll of living with IBD is staggering. The average person spends €3,252 per year out of pocket on IBD-related care, including medication, dietary needs, travel and consultation. A total of 60% of people have experienced financial hardship in the past year due these costs, 47% have avoided seeking medical care and 26% have delayed taking medication to make it last longer, all because of cost. It is incredible to read these statistics that show, in a country as developed as ours, people are avoiding seeking medical care because they cannot afford it.

The burden goes beyond treatment costs. It can affect employment. A total of 82% of working people with IBD report financial hardship due to missed work or lost wages. A total of 58% have had to take five or more days off work each year because of their condition. A total of 67% say their IBD has limited their career or promotion opportunities, and many are forced to attend work when unwell. A total of 86% say they have worked through illness because they could not afford to take time off. These people are contributing to our economy and paying taxes while managing serious illness, often in silence and without support. Yet, when they need the State to step in, they are left behind.

The means-tested system for medical and GP-visit cards is simply not fit for purpose for those suffering with IBD. This is a condition that can flare and recede. Someone may appear well on paper one week but be hospitalised the next. The current assessment methods do not reflect the unpredictable and cynical nature of this illness. People with IBD have contributed to society. They have worked while unwell. They have switched to cheaper, generic medication to save the State money, but when they get sick the support is not available. People living with IBD are not asking for special treatment. They are asking for equal treatment. The reality is that, because their illness is not one of the 16 conditions listed in the long-term illness legislation from 1970, which has not been amended since, they are expected to pay out of pocket, while others, rightly, receive support. That is not equity. It is not fair. It is outdated.

I acknowledge there are other supports, but this is not a standard disease where people are unable to work all the time. We need to acknowledge the crucial difference between it and some of the long-term illnesses which are already acknowledged in legislation. I ask the Minister of State to acknowledge that this exclusion is a policy decision, commit to a formal review of the long-term illness scheme to look at including IBD in it, to include IBD in the chronic disease management programme and to look at reforming the medical and GP-visit card system so that it reflects that disease burden and clinical need are a factor, not just a person's income.

I welcome the national school from County Cork. It is my county. I welcome them to Seanad Éireann.

I thank Senator Lynch for raising this important issue. In her contribution she covered it all, including that the long-term illness scheme is dated and has not been updated in a long time. In terms of her hope that the condition would be covered, the best opportunity would be a review. I am answering this on behalf of the Minister for Health. However, from listening to what she said, I think that is the way forward. I will outline some of the supports that are available, which the Senator is already well aware of. She knows all this already.

The long-term illness, LTI, scheme was established under section 59 of the Health Act 1970. Regulations were made in 1971, 1973 and 1975. They prescribed 16 conditions to be covered by the scheme, but there have been no additions or deletions to the list since that time. That is a long time and there has been such change to people's health, diets, quality of life and so on. It seems a bit rich and it is high time for a review. That is just me speaking. I will outline the position of the Department of Health. Under the LTI scheme, patients receive drugs, medicines and medical and surgical appliances directly related to the treatment of their illness free of charge.

While there are no plans to extend the scope of the scheme, it is important to recognise that the LTI scheme exists within a wider eligibility framework. 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. Eligibility for a medical card is determined by the HSE, primarily based on an assessment of means. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness, so that is a potential avenue. The HSE affords applicants the opportunity to furnish supporting documentation to determine whether undue hardship exists and fully takes account of all relevant circumstances that may benefit them in assessment, including medical evidence of costs and certain expenses.

The issue of providing a patient with medical card eligibility on the basis of illness or disability was previously examined in 2014 by the HSE expert panel on medical need and medical card eligibility. The group concluded it was not feasible, desirable nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the expert group’s advice, a person's means remains the main qualifier for a medical card. However, over the past several years, there has been a significant focus on improving access to, and the affordability of, healthcare services. This has been advanced through the substantial policy, legislation and investment to deliver expanded eligibility and services in line with Sláintecare. Major expansions in eligibility include the removal of public inpatient charges in public hospitals, for children in 2022 and for adults in 2023, and the provision of free GP visit cards to include children aged six and seven and those earning no more than the median income. These changes impact up to 500,000 people. The reduction in the drugs payment scheme, DPS, threshold, which caps monthly expenditure for approved prescribed medicines, was reduced to €80 euro per month in March 2022. Other measures have been introduced to try to increase accessibility and affordability.

It comes back to the main point the Senator made. The long-term illness scheme was developed a long time ago. The prescribed illnesses were decided on decades ago. I appreciate that the prepared response states there is no plan to review that. However, in my view, that would be the prudent thing to do. It is all well and good for me to outline the other supports available, but the Senator is talking about a specific condition that seems to me to merit inclusion. That, of course, is up to the Minister for Health.

Before I allow Senator Lynch back in, I welcome the group from Dromahane National School from County Cork. Senator Lynch tells me the school recently got a new school building. I was a teacher myself in the past. I took up a job and, six months later, moved from an old school building to a new one. I know the excitement involved in that. Congratulations to you all.

I welcome the group from Dromahane National School today. I am delighted to have them here.

I thank Minister of State for his reply. I acknowledge and completely accept this is not within his Department's remit, so I again thank him for taking this Commencement matter today. He referred to section 59(3) of the Health Act, regarding long-term illness, but what that provision actually states - again, while the Act has been amended, it still refers to the health board - is that the "health board may make arrangements for the supply without charge of drugs, medicine or medical surgical appliances to persons suffering from a prescribed disease or disability of a permanent or long-term nature.” That provision does not specify conditions as to the inclusion of other illnesses. It says they may be included. To my mind, there is no legislative barrier to improving, increasing or reviewing the long-term illness scheme. It seems the provision actually allows for further inclusion by use of the word “may”. It is simply political will that has prevented this.

I note the other measures outlined in the Minister of State’s response in terms of things that are available but, as I outlined in my initial statement, IBD is a disease that can flare up. A patient might be absolutely perfect today and incapacitated tomorrow. He or she may be unable to work for a week. While he or she may be working, potentially earning more than the means-test allowance for the medical card, that does not mean he or she can continue to work. As I said, when we see the statistics from Crohn's & Colitis Ireland, there are so many people suffering from Crohn's or colitis or another form of IBD who are afraid to take time off work and are saving their medication because they cannot afford to buy more. It is not fair to say a person can go for medical card. They can, but these people are working and contributing, and while they may be working today and be in perfectly good health, they could absolutely be incapacitated tomorrow, which could lead to them taking time off work. That difference has to be recognised.

I thank Senator Lynch. She is right; there is no legislative obstacle to expanding the scope of the long-term illness scheme. There is probably no policy obstacle either. The prepared response says there are no plans to extend it, and I hope that is just for the moment. The Senator is right that with a bit of political will and pushing and presenting the case for inclusion of conditions like IBD in the way the Senator has, which makes sense given how debilitating it is, how costly it can be and the impact it has on people's lives, surely it is time for review. Does that potentially open it up for a whole range of other diseases to be included? I do not know, but it is worth pursuing further. At the moment there are no plans but, as we know, in politics things can change, and if we keep the pressure on, it is worth pursuing.

We have done great things in terms of increasing access to medical cards and GP visit cards. Sláintecare is slowly edging towards achieving a lot of its goals. Expanding the scheme does seem it would be worth pursuing, if nothing else because the range was defined back in the seventies. I appreciate Senator Lynch raising the matter today.

The Minister of State, Deputy O’Sullivan, is very welcome to the Seanad. If I had known it was going to be him, I would have a completely different Commencement matter. I appreciate that he is here representing the Minister for Health. It is always important that we have a Minister present. It can be frustrating from our end, and I appreciate it is frustrating for Ministers too when they have to fill in for a different Department. As per the conversation we had the last time the Minister of State was here, I still look forward to welcoming him to the Curragh. We look forward to putting the date in.

The issue I raise is in relation to the problem with getting appropriate time-bound appointments for cardiology in Naas hospital. Naas hospital is excellent. The staff are second to none. I know of so many people who have attended the hospital, both inpatients and outpatients, and they speak very highly of the staff. I want to start with that because, unfortunately, sometimes when we stand up here, we talk about the negative stories, but I know of so many positive situations. Only last night I was speaking to somebody on the phone who had come through Naas for their care and was very happy with it.

What I am about to talk about is not a good news story. A number of people have been in touch in relation to the delays in cardiology appointments, but I was very concerned to hear about one case that came across my desk this week. An 81-year-old lady who had a stroke last year was told by her team that she needed to a cardiology checkup. In July, the request was made. When she contacted Naas hospital last week, she was told it would take another 12 months. For an 81-year-old who is vulnerable and has had health issues to have to wait 18 months for an appointment is simply not good enough. It is not giving appropriate care to the person. In one contact with me over the past few days, her words were that she assumed it did not matter because she was an older woman. That absolutely is not what we want to see within our health service. It is not acceptable. This is not elective care. It is a really important cardiovascular follow-up, and such a delay puts this patient and other patients at real clinical risk. It is very distressing for this lady and her family. It was distressing for me to hear that, and I am sure it is distressing for the Minister of State as well.

We have to ask why cardiology waiting times in Naas are stretching to 18 months. It is simply not acceptable that high-risk patients are left waiting for an appointment that could be critical to their health and, indeed, life-saving. When older patients with a history of TIAs or high blood pressure are placed on waiting lists of this length, it is potentially dangerous. It is not just inconvenient; it really adds to the stress. Timely access to specialist care should be a fundamental part of our health service. It is not something people should have to wait over a year for.

I thank the Senator. I absolutely promise I will visit the Curragh. There is no doubt about that whatsoever.

We will get it into the diary. I am looking forward to it because it is such a gem of a place.

Clearly Senator O'Loughlin is passionate about Naas hospital. She started by saying what a wonderful hospital it is, and I am sure it is a bustling hospital. It has a large population to cater for and we can imagine how important it is. The response I am about to read out will talk about how much we have reduced waiting times but what it probably will not cover is Senator O'Loughlin's knowledge on the ground of instances where people wait too long. I am not speaking out of turn by saying the Government accepts that, as it stands, waiting lists are too long and too many people are waiting too long on waiting lists. This is something we acknowledge.

The Government is committed to improving access to hospital care and reforming and reducing waiting times for patients through a range of measures, including those to increase capacity such as the establishment of surgical hubs. Since 2021, this commitment has been reflected in a series of multi-annual waiting list action plans aimed at sustainably reducing both the number of people waiting and the length of time that they wait. The ultimate aim is to achieve the maximum wait times as set out in the 2017 Sláintecare report of ten weeks for a first outpatient appointment and 12 weeks for an inpatient or day case procedure. The situations outlined by Senator O'Loughlin are far beyond this. In February of this year, the Minister for Health published the waiting list action plan for 2025, representing this Government’s continued commitment to reducing waiting times for patients and improving access to hospital care. With the 2025 plan, the Government is continuing to build upon the progress delivered to date under the multi-annual action plan approach.

In relation to Naas specifically, the most recent National Treatment Purchase Fund waiting list figures are for October and they were published on 14 November. They show that 465 patients are waiting for an outpatient cardiology appointment in Naas hospital. Of these, 406, or 87%, are waiting six months or less and 454, or 98%, are waiting 12 months or less. Twelve patients, just 2% of the total waiting list, are waiting over 12 months. The total number of patients waiting has also shown significant improvement compared to the same period last year and in the year to date. The waiting list has decreased by 55% since October 2024 and by 36% in the year to date.

The number of patients waiting, and the time they are waiting, have also shown substantial improvement since the adoption of the multi-annual waiting list action plan approach in September 2021. Since then, the total waiting list has decreased by 74% and the number waiting over 12 months has decreased by 99%, that is 982 patients. As we progress towards the ultimate Sláintecare targets, the 2025 waiting list action plan has a target of 50% of outpatient appointments to be undertaken within ten weeks. I am very pleased to be able to say that currently Naas is significantly exceeding this target, with 63% of patients waiting no longer than the Sláintecare ten-week target time.

As I said earlier, we all acknowledge that many patients are waiting too long for hospital appointments and treatments. Since 2021, the Government has adopted a multi-annual approach to addressing the problem, and while no patient should have to wait 12 months for an appointment, the figures for Naas show that considerable improvements have been made. It is fair to say improvements have been made, and this is down to pressure from the likes of Senator O'Loughlin, working with the previous Government and the previous Minister for Health, to ensure the waiting list action plans were rolled out. Waiting times have reduced and there are some good figures but Senator O'Loughlin is on the ground meeting people and dealing with constituents who are having a different experience. We can get bogged down in statistics and patting ourselves on the back. There have been improvements but we have to take seriously serious incidents involving older people in particular, as Senator O'Loughlin has highlighted, because it can be dangerous if they are left waiting too long for an appointment. I appreciate Senator O'Loughlin raising the issue.

I thank the Minister of State. I appreciate that the numbers are moving in the right way. The former Minister, Stephen Donnelly, did exceptional work on this. We had many conversations about Naas hospital. It is still unacceptable that people are waiting more than 12 months. In this case there are 2%, which is 12 patients. This in itself is shocking. Our older people deserve dignity and urgency. They deserve proper access to care. I appreciate the Minister of State taking an interest in this. For me, the lived experience is always the most important experience and the despondent tone of this lady upset me. She felt that nobody cared. I would appreciate if I could give these personal details to the office of the Minister of State so he may bring them back to the Department of Health, which asked him to take this issue, to look into this particular situation, particularly because this lady had a TIA last year and has been waiting seven months to this point. I would appreciate the Minister of State doing this. We need to have better outcomes, particularly for those who are older and vulnerable.

I thank Senator O'Loughlin. If she passes on the details to my office, I absolutely commit that they will make their way to the Department and the Minister and ensure it is prioritised. Despite all of the great improvements in the reduction of waiting lists, the fact that 12 people have been waiting over 12 months cannot just be a footnote. These are 12 individuals with stories, families and loved ones. We cannot just put it to the bottom of a page as a footnote. It is very important and they are the ones we really need to get to and improve. I thank Senator O'Loughlin for raising the issue. We will get the details to the Department and I hope we will have a good outcome on it.

I thank the Minister of State for taking all four Commencement matters this morning.