Dáil Éireann debate -
Tuesday, 5 Mar 2024

Vol. 1050 No. 6

Saincheisteanna Tráthúla - Topical Issue Debate

Medicinal Products

Deputy Joe Flaherty

I want to discuss a rare and uniquely Irish disease. Hereditary ATTR amyloidosis is a genetic condition. The disease was brought to my attention by a lady who lives in County Longford. There are several manifestations of this amyloidosis worldwide, but it includes a specific Irish variant that originates in north-west County Donegal. The condition is known locally as Donegal Amy. While my constituent's mother is from County Leitrim it shows the condition is not necessarily confined to the Donegal areas. Amyloidosis became know as Donegal Amy due to its prevalence along a 15 mile stretch of coastline between Carrigart and Burtonport in County Donegal. Its origin has been linked back to Conall Gulban, an Irish king and ancestor of the Cenéi Conaill, who founded the kingdom of Tír Chonaill, which we now know as Donegal. Until recent times the disease was aggressive and fatal. Innovative new treatments such as gene silencing are slowly becoming available. My constituent and her siblings inherited the condition from their late mother who sadly passed away in 1995 at the young age of 71 years. When my constituent's mother was diagnosed there was no treatment available. Moving to the present day my constituent and her siblings are now lucky that there is much greater awareness among medical professionals about this disease and there are also treatments available. There was a lifesaving breakthrough in 2021 when the HSE approved the use of a new treatment for hATTR. That drug is known as Onpattro, or patisiran, and it is supplied to them by the HSE through a managed access programme. The patients receive the infusions in their home, but the cost of receiving this medication for each patient is in the region of €400,000. It is estimated that 1% of the population of Donegal has the hereditary condition. The late mother of Sinn Féin's Martin McGuinness hailed from the Inishowen peninsula and she died as a result of the disease.

Many of the patients availing of the current treatment are aware of a newer version from the manufacturers of patisiran. This new drug is called vutrisiran, with the proprietary name Amvuttra. Both drugs are manufactured by the same company, but crucially the new drug is administered to patients on a three-monthly basis. That is four times annually as against the 17 administrations for the current drug. This would be more cost-effective for the HSE, but also less restrictive for patients and their families. However, patients were dealt a terrible blow in August last year when the National Centre for Pharmacoeconomics completed a rapid review of the new drug, with the recommendation that the drug should not be considered for reimbursement by the HSE. The Minister of State will also be aware that patisiran became available in Northern Ireland in 2019, a full two years before it became available in the South. It regrettably appears we are seeing a similar scenario play out with the new drug, which was approved in the UK in January last year. We are playing a waiting game here again.

I hope the Minister of State will engage with the necessary authorities and that we will see progress on that. We do not want patients to play another waiting game.

Minister of State at the Department of Health (Deputy Mary Butler)

I thank Deputy Flaherty for raising this issue and for his comprehensive explanation. It is not a condition I am overly familiar with. I will first provide some background for our colleagues and then address his question. This medicine is used to treat polyneuropathy - nerve damage - caused by hATTR. The European Medicines Agency, EMA, granted marketing authorisation for this product in September 2022. As hATTR amyloidosis is a rare disease, the EMA has also designated this an orphan medicine. The company marketing this medicine made an application for addition to the HSE’s reimbursement list in July 2023.

The HSE has statutory responsibility for medicine pricing and reimbursement decisions under the Health (Pricing and Supply of Medical Goods) Act 2013. HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics. There are formal processes, which govern applications for the pricing and reimbursement of medicines, and new uses of existing medicines to be funded or reimbursed. In August 2023 the NCPE completed a rapid review of vutrisiran. Factors evaluated during rapid review include the cost of the drug relative to potential comparators, uncertainty relating to comparative clinical effectiveness, uncertainty relating to cost effectiveness and the potential drug budget impact. On this occasion, the NCPE did not recommend a full health technology assessment. Their recommendation was that this medicine not be considered for reimbursement at the price proposed by the company marketing it.

The NCPE’s recommendation is importantly only one component considered by the HSE in making a decision on the reimbursement of a medicine. The Health (Pricing and Supply of Medical Goods) Act 2013 requires that nine criteria be considered in reaching a decision. These include the health needs of the public and the clinical need for the medicine. Following engagement with the manufacturer of this drug, the HSE has decided to approve reimbursement subject to a managed access protocol. These protocols identify patients who would most benefit from the specific treatment being reimbursed. The processes necessary to implement this are currently being developed by the HSE. I reiterate that the HSE has decided to approve reimbursement subject to a managed access protocol.

The State acknowledges the importance of access to medicines and has made considerable investments in new medicines in recent years. Last year, a record of more than €3 billion of public funding was spent on medicines for patients in Ireland. This represents almost €1 of almost every €8 spent by the State on healthcare. This level of investment is unprecedented in supporting patients through the availability of the latest and wide-ranging medicines. The last three budgets have included dedicated funding for new medicines of €98 million. This has enabled the HSE to approve reimbursement for almost 150 medicines, including 61 for treating cancer and 39 for treating rare diseases. For 2024, funding of €20 million has been allocated to enable access to new medicines. The HSE has, in addition, been instructed to identify and realise a further €10 million of efficiencies. When achieved, reinvestment in new drugs will be a possibility. I am delighted that the Deputy will be able to go back and tell his constituent that the HSE has decided to approve the drug for reimbursement.

Deputy Joe Flaherty

I think we will all agree that it was well worth waiting until 10.15 p.m. tonight for that good news. After that good news I almost feel I should move constituency to Donegal. There is at least 1% of the Donegal population who will probably view that as better news than Jim McGuinness returning as team manager. It is excellent news and I applaud the Minister of State for her work on this to date. The HSE has obviously decided to allow the drug based on a managed access protocol. I know when they started using the current drug it was limited to nine people and phased in over a similar length of time.

If we can see the same progress, initiative and conviction behind the roll-out of this drug, it will be very positive. It is probably unique that we have a rare disease like this. Ironically, this particular variant of it was only first discovered in Ireland in about 1986. Affected patients have a 50% chance of passing on the genetic susceptibility to their children. Until recent times, many people with amyloidosis were misdiagnosed as having heart disease due to other more common symptoms such as high blood pressure. It is getting late in the evening, but I will finish with a little bit of history. A 1995 study of the County Donegal cases found that nearly all those affected were direct descendants of a man called Conall Gulban. His descendants subsequently founded what we now know as Tír Chonaill or Donegal. It is timely as we come up to St. Patrick's Day that we should note that Conall Gulban was, in fact, a son of Niall of the Nine Hostages, who became the first nobleman to convert to Christianity. With a mix of good news for the patients affected and a solemn burst of history, I will finish up on that. I thank the Minister of State for that good news.

Deputy Mary Butler

I thank the Deputy very much. I will bring his comments to the attention of the Minister for Health. As I said, the State spent more than €3 billion on medicines last year, which is a new record. This is in the context of a total health budget of €22.5 billion, which is another record. At the same time, however, it is a person who needs that orphan drug, for example, and it will make a difference to that person's life. The Deputy said that in August 2023, the NCPE completed a rapid review of Vutrisiran, the factors of which are evaluated during rapid review. On this occasion, it decided not to recommend it. Importantly, that is only one component of nine. The decision was taken by the HSE. At the same time, 1% of the population in Donegal is a large number of people, so I am delighted to be able to confirm again that the HSE has decided to approve reimbursement subject to a managed access protocol. Hopefully, that will happen very quickly. I thank the Deputy again for raising this really important issue.

Mental Health Services

Deputy Louise O'Reilly

I thank Deputy Connolly for facilitating the swap.

I want to talk to the Minister of State about a young woman in my constituency by the name of Rebecca. Rebecca has ADHD and she is a also a mental health service user. When Rebecca turned 18 fairly recently, she was discharged from the child and adolescent mental health services, CAMHS, into the adult mental health service. This is not going to come as a surprise to the Minister of State and I am not telling her anything she does not know, but it does seem to have come as a surprise to the HSE or the system. Rebecca's diagnosis of ADHD did not stop when she turned 18. However, she found herself discharged from CAMHS at the age of 18. I am not trying to be smart, but there is nothing more certain than that a 17-year-old is going to turn 18 and, therefore, why the HSE was acting almost shocked that this happened is certainly beyond me and most definitely beyond Rebecca's mother. Seven months on from being discharged from CAMHS, she got her first appointment with the adult mental health services, but they are not in a position to prescribe her the drugs she had been receiving under CAMHS. Now, those drugs are being prescribed by her GP who is not a specialist in the area but is trying to help. It seems as if the mental health supports that are there are almost not acknowledging the complications caused by the ADHD. Rebecca's mam asked me if I could speak to the Minister of State. I know the Minister of State knows this, and I am not being smart, but I was asked to pass it on.

ADHD is a lifelong condition, but the really good news is that if it is treated, it can be managed very successfully. It can be treated very well. Unfortunately for Rebecca, she finds herself stuck in a position where it seems like the adult mental health services are not equipped to deal with ADHD, which would be fine if it was only a childhood condition but, obviously, Rebecca takes the condition from childhood into adulthood. She found herself for months and months really without any support at all.

Why were no supports available for ADHD sufferers when transferring from the child and adolescent services into the adult services? The Minister of State might outline for Rebecca's mam and anyone else who would be interested in what supports are there. It does seem that parents are left struggling. At 18, technically, a child is an adult. Both the Minister of State and I have children that age and they are adults, and they are not. Technically, they are and, of course, they can vote and do all those other things but still, Rebecca's mam is really worried about the fact that she does not seem to be getting any supports for the ADHD, which is further complicating and compounding the mental health issue. Any guidance the Minister of State can give us would be very much appreciated.

Deputy Mary Butler

Can the Deputy confirm what community healthcare organisation, CHO, she is in?

Deputy Louise O'Reilly

She is in CHO 9.

Deputy Mary Butler

Okay, great. I thank the Deputy for raising this really important issue this evening. As she said, ADHD has long been recognised as one of the most common psychiatric disorders in children and it is now known to persist into adulthood. Core symptoms include inattention, hyperactivity and impulsivity. It can cause many issues in areas such as personal and social relations, education and occupation, managing money and organising life in general. There is also an increased risk of having other mental health difficulties with it such as anxiety and depression.

Children can access ADHD assessments through the National Educational Psychological Service. In addition to this, as per the CAMHS operational guidelines, CAMHS takes referrals for children up to age 18 with moderate to severe ADHD. As the Deputy said, that is exactly what happened to Rebecca. I am aware that prior to the inception of the national clinical programme, NCP, for adults with ADHD, which I launched in 2021 - it was one of the first things I launched when I came into the job - no specific ADHD public services were available for adults in Ireland. The NCP for ADHD is delivered as part of the HSE’s mental health service provision to ensure an integrated, person-centred response to adults with ADHD. The programme includes both assessment and treatment of the disorder and works collaboratively with voluntary agencies, including ADHD Ireland. It envisages a national service of ADHD teams with each team comprised of a consultant psychiatrist, senior psychologist, senior occupational therapist, clinical nurse specialist mental health and an administrator.

Enhancement for specialist mental health services such as ADHD is a key priority for me as Minister. Since 2021, more than €3 million has been made available for funding ADHD posts from programme for Government funding. This has enabled the set-up of five ADHD teams with recruitment of more than 25 posts, and two more teams are currently in development with posts funded for them. The two teams that are currently in development are in CHO 8 and CHO 7. We currently have five teams in place and the proposal is that we will get to 12 teams in total. I currently have five in place and two are being recruited. I want to be able to make sure the postcode lottery stops and that we have an adult ADHD team in every single area. I have prioritised it year-on-year to build it up and seek the funding. I have also allocated €150,000 this year to continue the collaboration with ADHD Ireland and the University College Dublin, UCD, school of psychology to develop an ADHD app and the understanding and managing adult ADHD programme, UMAAP. Both the ADHD app and UMAAP are two very positive resources for people experiencing ADHD. The app provides specific information for people who have or think they have ADHD, and it is very good with regard to self-care and signposting. UMAAP is delivered in a five-week workshop format and its aim is to provide education and tools on how to manage ADHD.

I am pleased to confirm that further to recent discussions between the Department of Health and the HSE to finalise that funding, it has been approved. I will launch that programme in April, as agreed with ADHD Ireland. Hopefully, it might be good for Rebecca. That is why I asked the Deputy about CHO 9. Currently, there is no team in CHO 9. We are missing a team in CHO 2, CHO 5, which is my own area, CHO 9 and CHO 1. There are seven in place with five more to do. I will announce another team shortly. I will go back and look at this again. It is really important for all the Rebeccas out there who do not have that particular support. She would be able to engage with ADHD Ireland and maybe do that UMAAP course. There is no doubt about it, however, that if a person has ADHD, it does not stop on his or her eighteenth birthday.

Deputy Louise O'Reilly

Rebecca's mam will be delighted to hear the Minister of State say that and maybe say it loud enough for all the people in the mental health services to hear it as well.

I absolutely welcome the establishment of the teams. I press the Minister of State for a date on when we will see one in CHO 9, as I am sure she would expect me to do. However, there are issues in the short term in advance of the establishment of the team. As the Minister of State says, there is no team in my area - no more than there is in her own area - and there is a need for one. For Rebecca, vital months were lost where she had no support at all and that happened at the transfer from the child and adolescent services into the adult mental health services. Are the teams going to be fully integrated into the adult mental health services in order that there can be the additional supports that might be required, as well as the ADHD supports? Rebecca's mam wrote to the Minister to outline the case and I know if she is listening to this, she will be glad to hear a person in the Minister of State's own position acknowledge that ADHD is a lifelong condition but also one that can be managed and managed very effectively. There is no reason people with ADHD cannot live full lives but they do require those supports. I am pressuring the Minister of State for a little bit more information on when we might see that in CHO 9 but also in the intervening time, whether there may be supports there. I have spoken to Rebecca's mam and I am happy to pass the details on to the Minister of State if she wants the details of the case. I will do that following this. In the intervening time before the team is set up, is there anything Rebecca might be able to access?

Deputy Mary Butler

I thank the Deputy again. I am conscious that Rebecca and her mam might be actually watching tonight so I will say it again. ADHD does not stop when you turn 18. In 2021, one of the first clinical programmes I launched was in respect of ADHD for adults and I have visited a number of the teams already. The teams are separate to the general adult mental health services. It is a separate team. As I said, the reason we were able to put the teams in place so quickly was because it only takes five to make up the team, whereas for a CAMHS team it can be between ten and 12, and for some reason we were able to recruit into these teams really quickly. Staffing was not an issue we had, which was really welcome. As I said, we have five full teams in place with two more being recruited at the moment in CHO 8 and CHO 7. Currently, there is none in CHO 2 Galway, Mayo, Roscommon; in CHO 5 Waterford, Carlow, Kilkenny - my own area - or in CHO 9. There is a partial team in Cavan-Monaghan. We are currently looking at the €10 million spend. I have prioritised ADHD because I want to get this postcode lottery sorted and that there is a team in every single area. I would love one to go into my own area as well. I will give the Deputy a commitment and will come back to her. We are just finalising the details. There is going to be an expansion of another team and I want to set out exactly when we can see the teams for the other three areas. The commitment from the start was always to built it incrementally year on year. It is one of the areas in which we have a good story to tell. At the same time, I recommend that if the Deputy wants to pass me on the details, I can write to Rebecca and her mam. However, I would like them to engage with ADHD Ireland and maybe do that five-week online course while Rebecca is waiting for the specialist team. Her mam might be able to take part in it as well. It is very effective and works very well.

Hospital Facilities

Deputy Catherine Connolly

Faraor géar, tá orm an t-ospidéal sa Chlochán a ardú arís. Tá a fhios ag an Aire Stáit go bhfuil sé faoi bhagairt agus i mbaol le beagnach dhá bhliain anois. An rud a chuireann isteach orm ná go bhfuil sé dúnta faoi láthair agus ní bhfuaireamar aon teachtaireacht beag ná mór faoi. Chualamar ar na meáin chumarsáide go raibh an t-ospidéal dúnta arís. Is ospidéal é atá thar a bheith tábhachtach don cheantar mar is eol don Aire Stáit. Tá an scéal seo ag dul ar aghaidh le beagnach dhá bhliain anuas. Bhí neart cruinnithe agus neart cumarsáide, ach ag an am céanna, tá an chumarsáid ag teastáil. Mar a dúirt mé, níl aon eolas agamsa ach amháin go bhfuil sé dúnta agus tá an t-eolas sin agam ó na meáin chumarsáide. Chomh maith le sin, tá sé deacair a thuiscint cad iad na fáthanna go bhfuil sé dúnta. Deirtear gur easpa foirne is cúis leis ar leibhéal amháin. Ansin, deirtear linn go bhfuil painéal acu ó thaobh altairí de ach amanta eile, agus tá sé seo tábhachtach, go bhfuil siad ag fanacht ar chead ón Rialtas le daoine a earcú. I am back again. We are into our second year now. Different colleagues has raised this at different times. We thought we had made some progress regarding Clifden District Hospital. There were meetings and one particularly fruitful meeting in Clifden where we sat down with the previous woman who has retired. It was extremely fruitful and positive. We thought we were getting some place. As we headed out of that meeting we got a prewritten press release that confirmed they were closing the hospital. That meeting sticks out in my mind. It is over a year ago now. As we went out the door we heard. The previous wonderful two-hour meeting was all at naught and then we had more meetings.

My point is I am raising the fact that Clifden District Hospital is closed once again. I learned that from the media, which is most unhelpful, and I have no idea what is going on. Going back almost two years ago, there was a union dispute. We were told the staff did not want to work between the district hospital and St. Anne's community nursing unit. We were told there was no demand. We were told of all sorts of contradictory reasons. We were told they could not get any nurses. Then we had meetings and one of the local doctors confirmed that there was a demand for respite beds and for convalescent beds.

I will put that perspective with the hospital in Galway city. Around this time last year, HIQA visited the hospital and said it was grossly overcrowded with 28 patients on trolleys. I will link it back to Clifden now. A hospital in Galway was grossly overcrowded with 28 patients on trolleys. It was the third busiest hospital and the third worst - no reflection on the staff - for waiting lists and for numbers of people on trolleys. That was a year ago. With 28 patients on trolleys, HIQA thought it was grossly overcrowded. Does the Minister of State know what the figures have been for the last while in University Hospital Galway, a year after they called it grossly overcrowded at that stage? On Monday, 12 February, there were 55 people on trolleys. To take days up to the present at random, the numbers of patients on trolleys were 60, 65 and 45 and HIQA had called it grossly overcrowded. It failed on four conditions, was partially compliant on two and was non-compliant on the others. Why am I saying all of that? In addition to that, there were over 20 patients who were ready to leave but had nowhere to go and yet we are closing down a district hospital that could provide a service to take the pressure off the regional hospital, which HIQA said a year ago was grossly overcrowded with just 28 people on trolleys. Now, it has 50 and 60 such people.

Deputy Mary Butler

I thank Deputy Connolly for raising this really important matter. She referred to how she learned the news about the hospital. I learned from the Deputy's question and from a media query I got today. I am not happy with that at all. I would expect to be informed of any decision to close a ward or a hospital.

I begin by acknowledging, as the Deputy has, the vital healthcare role that Clifden District Hospital plays and the excellent level of care and support which it provides to patients and their families in the Clifden community and surrounding areas. As the Deputy has said, Clifden District Hospital has been primarily designated to provide convalescence care to patients stepping down from acute hospitals such as University Hospital Galway, as the Deputy mentioned. It cannot be underestimated how important these step-down respite beds are. This afternoon, I met Dr. Emer Ahern, who is the clinical lead for older people across the whole country and we spent a long time discussing respite, rehabilitation and the pathways for patients out of acute hospitals back home again. As we know, Clifden District Hospital provides respite beds to allow family carers in the community a welcome break.

At present, admissions to Clifden District Hospital have unfortunately been paused due to the lack of staff availability. HSE community healthcare west is actively working to recruit nursing staff. When I found out today through the Deputy's question and the press briefing that had come in, I looked for an update immediately. We are actively working to recruit nursing care and support staff in order to safely reopen the short-stay beds available in Clifden District Hospital. This also includes efforts to hire agency staff as an interim measure in order to resume services. I have been informed that no agency staff were available this week but that efforts will continue to recruit in the short term. I acknowledge that agency staff are not ideal because you need that continuity but at the same time if we can get them in the short term, that would be very important.

As the Deputy knows, Clifden District Hospital is located alongside St. Anne's community nursing unit on a shared campus in Clifden. There are 21 registered long-stay beds with HIQA in St. Anne’s community nursing unit and all beds are currently occupied. Clifden District Hospital has been operating seven beds over the past 12 months and these beds have been utilised for short-stay and respite admissions. As I stated, admissions to Clifden District Hospital have unfortunately been paused due to staffing constraints.

In the Clifden area, there have been significant challenges over many years to secure sufficient nursing staff, despite national, international and local recruitment drives. There are currently challenges in keeping both Clifden District Hospital and St. Anne’s community nursing unit open. However, staffing St. Anne’s community nursing unit has been prioritised as it provides long-term care to the 21 residents living in the facility who are there under the fair deal scheme.

I am acutely aware Clifden District Hospital is a vital element. I visited there last August and met Deputy Connolly on the same day. I was delighted to visit and to announce that there would be a new state-of-the-art 50-bed unit with en suite rooms. I am aware the planning application has been submitted and I think we expect word this week about that. At the same time, I am very conscious of those seven respite beds that have been lost. I will continue to focus on this to make sure those beds are opened as soon as possible and I will be updated weekly on the staffing situation.

Deputy Catherine Connolly

I thank the Minister of State. I mentioned the regional hospital - I still call it that - because it is bursting at the seams. According to HIQA, it is affected by so many issues, despite the good work of the staff. We then have a facility, Clifden District Hospital, which has, without a doubt, been run down for more than two years, with conflicting reasons given to us.

Let us look at the staff and what they told the press. I am not sure if they told the Minister of State. They said there are currently no patients in Clifden District Hospital. Day services are not affected but step-down and respite services are not available in Clifden. Can you imagine that there are no step-down and respite services? Suddenly, people can be accommodated in Merlin Park University Hospital. In Galway city, when we tried to get people into Merlin Park University Hospital based on clinical decisions, we were told there was no space but suddenly people can go to Merlin Park.

In regard to the stage the recruitment campaign is at and whether staff been hired, community healthcare west has three panels in place from which nursing staff can be recruited. Two are specifically for Clifden - and this is the best part - but they are awaiting a derogation to proceed. This derogation is presumably from the Government embargo. I presume that is what they mean there. Maybe the Minister of State can enlighten me. They said they hope to receive approval for same. They then went on to talk about planning permission. I am a bit disappointed that the beds went from 50 beds to 40 beds but that is where we are at.

I received a similar answer now, which seems to be a trend. It depends on what mood they are in as to which answer they will give us. Let us look at Áras Mhic Dara community nursing unit i gcroílár na Gaeltachta, which I have raised over and over. There is a rolling recruitment campaign, which includes Áras Mhic Dara community nursing unit. Interviews are currently in progress but the further progression of posts are subject to the recruitment embargo being lifted. The HSE is telling us this but the Taoiseach is telling us there is no recruitment embargo. Here we have two different responses, one in regard to Clifden and one in regard to Áras Mhic Dara, telling us there is a recruitment embargo and that they are awaiting Government approval.

Deputy Mary Butler

I feel the Deputy's frustration because I feet it as well. The situation is that when those seven respite beds were opened over the last 12 months, the staffing for those seven beds were funded. I do not see any reason they were not funded last week. My understanding is that they are funded and this is the reason they were looking for agency staff to support that. As I said, I will request a meeting tomorrow to discuss this. When Deputy Connolly asked her question and when there was a media query, I was slightly at a disadvantage this afternoon. I got a written answer to questions that were submitted. At the same time, I know there are challenges with staff. In one sense, I am glad the 21 beds in St. Anne's community nursing unit were not affected but the importance of respite beds cannot be underestimated.

I do not often speak out as clearly as this but I know we have been challenged in the Galway area to get respite beds reopened since Covid. The meeting I had this afternoon with the clinical lead for older people was specifically with regard to respite beds and other issues. This was one of the areas we discussed and if the Deputy will give me a day or two to make more inquiries, I will come back to her in person.

Sports Facilities

Deputy Frankie Feighan

Applications are eagerly anticipated for the large-scale sports infrastructure fund by regional sporting organisations. I am trying to find out when the Minister expects this fund to open. Sport plays a huge role in people's lives and one such sports club is Sligo Rovers Football Club in my area. The Acting Chair will know how important it is to the community. It is a community-based football club with a long and proud history. It is one quarter-owned by the people of Sligo and is supported by people in Sligo, in the north west, from Sligo, Leitrim, Mayo, Roscommon and Donegal, and by people all over Ireland. Only last week I was asked by a man in Ennis, County Clare, to get him a Sligo Rovers hat. That is how football is appreciated around the country.

Sligo Rovers Football Club got the final grant of planning permission for a state-of-the-art stadium and related facilities. It is hoped all of these will be in place for the club's centenary in 2028. There is huge support from the local authority and the FAI. It will be a UEFA category 3 stadium. What that means is that there will be 6,000 multipurpose-seat stadium with a restaurant, pharmacy, crèche, gym, doctor's surgery, club house and offices. It is hoped it would host Republic of Ireland underage matches and when the League of Ireland has an off-season, it could be a location for provincial rugby matches given this new hybrid surface, which is 95% grass and 5% artificial.

Sligo Rovers Football Club is owned by the community and it is the cornerstone of the League of Ireland. I see what is happening in the capital city. Bohemians Football Club has a €40 million-plus development. It is getting public funding and Dublin City Council is very much part of that. Shamrock Rovers Football Club has a brand-new stadium that is effectively owned and run by South Dublin County Council. I do not begrudge those clubs their success.

We have a women's senior team in Sligo. We are fighting against the odds. I pay tribute to the players, supporters, volunteers and the wider community because it is a regional club. It is not privately-owned and it is one of the last fully-owned supporter's clubs in the country. When this fund is up and running, we want parity of esteem in the west and north west and we want public funding to match this incredible and exciting innovative development that will bring a lot of joy and hope to Sligo and the north west.

Minister of State at the Department of Housing, Local Government and Heritage (Deputy Malcolm Noonan)

I thank the Deputy for raising this important issue. The Department of Tourism, Culture, Arts, Gaeltacht, Sport and Media operates two capital funding programmes for sport, namely, the large-scale sport infrastructure fund, LSSIF, and the sports capital and equipment programme, SCEP. Both of these capital programmes are demand-driven and, as the Deputy can imagine, there is significant demand for them.

The national sports policy published in 2018 provided for the establishment of the LSSIF. The aim of the fund is to provide support for larger sports facilities where the Exchequer investment is greater than the maximum amount available under the SCEP. The first allocations under the large-scale sport infrastructure fund were announced in January 2020 with €86.4 million subsequently awarded to 33 different projects.

Additional funding of €37.6 million was announced for 27 existing LSSIF projects last December, due to delays experienced by grantees arising from the pandemic and construction inflation, bringing the total awarded to date under the fund to €124 million. Since June 2023, the following LSSIF projects have opened to the public: the linear walkway and playing fields project in Meath; phase 1 of Walsh Park GAA ground in Waterford; and the regional athletics hub in Limerick. A number of LSSIF projects are due to be completed this year or significantly progressed. For example, St. Conleth's Park GAA ground, Kildare, is due for completion later this year and will include a new 3,000-seater stand, while Connacht Rugby recently announced that enabling works have begun on its new high-performance centre and north stand.

Successful applicants to LSSIF were decided following a rigorous assessment process with the highest-scoring applications receiving grant offers. The priority given to projects by the relevant NGBs or local authorities was one of the key determinants of the assessment score along with factors such as the likelihood of increasing sport participation, how the proposed project would improve high performance and whether the proposed development would benefit spectators.

A new round of LSSIF, the Deputy will be glad to know, will open for applications in the coming months, with the dates, terms and conditions to be confirmed in due course. Engagement with the Minister for Public Expenditure, National Development Plan Delivery and Reform with regard to the Department's capital allocations for the coming years is ongoing and the outcome will inform the level of funding that will be available for allocation under the new round of LSSIF.

A fundamental aim of the Government’s national sports policy is to increase the levels of participation in sport and physical activity across the population, with a specific focus on less represented groups, including women and girls. A lot of good progress is being made, not just with regard to increasing participation by women and girls but also in the important areas of leadership and management roles in sport. It will be a requirement for all successful LSSIF applicants to publish their similar access policy, in respect of men and women having access to the facilities on similar terms in order for LSSIF funding to be awarded.

I understand that Sligo Rovers Football Club has received planning permission for the development of The Showgrounds. This was hugely welcome and a really significant step in the implementation process of the master plan for The Showgrounds redevelopment. As the Deputy said, it is a community-owned club and the community ethos in the region is very strong, very significant and hugely important to the club, players, management and all involved. I encourage all eligible projects to consider applying for this really competitive application process when it opens in the near future.

Deputy Frankie Feighan

I thank the Minister of State, and I look forward to the application process. He said that the Government's fundamental aim in its national sports policy is to increase the levels of participation in sport and physical activity across the population. This has a specific focus on less represented groups, including women and girls. A lot of good progress has been made in Sligo, and I want to pay tribute to the women's and men's teams, and the many youth teams there.

We have seen a lot of funding going around the country, and I am delighted that the Minister of State mentioned playing fields in Meath, Walsh Park in Waterford, the regional athletics hub in Limerick, Connaught Rugby and St. Conleth's Park GAA ground. However, I am interested in Sligo, the west and north west, and I believe this project is and will be of huge benefit not just to Sligo but to the north west.

I pay tribute to all the supporters, players, volunteers, the wider community and especially the committee there. They are very professional, and I think the Cathaoirleach Gníomhach understands that. They would have a very professional application in because they believe they are of the community. I know, having served in the Department, that it wants good governance and data, and Sligo Rovers has that in abundance. I look forward to the opening of the LSSIF, and I also look forward to Sligo being successful when this is out.

Deputy Malcolm Noonan

In the national sports policy, we outlined an aim to double Exchequer funding for sport by 2027. In this regard, it is my firm belief that money spent on sport should be viewed as an investment that will reap a variety of dividends over a long period for all communities.

In the first half of the ten-year lifespan of the national sports policy, there has been clear progress in sports funding, and we are well on track to achieve our target. In budget 2024, the Government announced an overall budget allocation of €183.3 million for sport in 2024. When the national sports policy was published in 2018, the budget for sport was €111 million.

Finally, more than 13,000 projects have benefited from sports capital funding since 1998, bringing the total allocation in that time to more than €1.15 billion. From the Government's perspective, if we are to achieve our ambitious targets and get as many people participating in sport as possible, we need the necessary facilities that are currently being provided under the SCP and LSSIF. Similarly, if we are to develop elite sportspeople, we need to invest at grassroots level, and it is at grassroots level that clubs such as Sligo Rovers develop players - men and women, boys and girls - who can go forward and onto national teams, and perhaps overseas as well. It is hugely important that Sligo Rovers continues its really good work in respect of inclusion and participation, and the really exciting developments at The Showgrounds, which are going to be important and valuable for football in this country and not just for the Sligo region.

I welcome this next round of LSSIF funding, and I hope that Sligo Rovers will be in a position to apply when the grant rounds are announced.

Cuireadh an Dáil ar athló ar 10.56 p.m. go dtí 9.10 a.m., Dé Céadaoin, an 6 Márta 2024.

The Dáil adjourned at 10.56 p.m. until 9.10 a.m. on Wednesday, 6 March 2024.