Dáil Éireann debate -
Wednesday, 2 Nov 2016

Vol. 927 No. 1

Topical Issue Debate

Beef Industry

Deputy Jackie Cahill

The decision by Brussels to allow ABP Group to take over Slaney Meats is inconceivable. The State reneged on its responsibility in this regard and the decision was left to Brussels to make. Farmers cannot understand how this decision was allowed to be made. It is the view of the vast majority of farmers engaged in the beef industry that this group controls a monopoly interest in the industry as it stands but it has been permitted to take out one of the remaining independent players in the industry. We have our problems with the British decision to leave the EU given the fluctuation in currency, but competition is being taken out of a trade that has been lacking in proper competition for a long number of years. Cattle drops have dropped significantly over the past number of weeks. Live exports reduced by 58,000 head last year and it looks like they will reduce further this year while, at the same time, calf registrations increased by 132,000. We have the twin prong of more calf registrations and fewer live exports, meaning more cattle coming through the system. The cattle kill over the past few weeks has been 35,000 or 36,000 head. It has been proven over a long number of years that when the cattle kill rate exceeds 30,000 head per week, prices paid to farmers fall significantly.

I also question the commitment of many people in the industry to the live export trade. The Minister of State will quote figures about the percentage of the industry ABP Group has and he will refer to the various markets open around the world. Thankfully, the Turkish market opened in recent weeks but what it has taken is only a drop in the ocean. Significantly more live exports are needed to generate competition in the trade. I attended my local mart last Monday. The price of Friesian stores has dropped over the past month or six weeks by between €200 and €250 per head. There is a complete lack of confidence in the beef industry. The British decision is partly to blame for the lack of confidence but the fact that Slaney Meats has been taken out of the equation and another independent outlet is gone has greatly added to the lack of confidence.

Farmers' confidence in the industry has been shaken. The beef forum made a number of recommendations, none of which has been implemented. We were promised a review of the beef grid, the lifting of weight restrictions and an examination of the age restriction under the 30-month rule. None of this has happened and, therefore, farmers' confidence is at an all-time low. This is a vital industry for the country and it is imperative that the primary producer has confidence in the industry. However, confidence is evaporating by the day. Farmers selling Friesian cattle into the factories are lucky to receive €3.30 per kilogram. That is nowhere near break even. Unfortunately, the ABP Group is taking over an increasing number of feed lots, which have many cattle, around the country. In previous years, cattle became scarce approaching Christmas and the new year but now the group is releasing cattle from its own feed lots and manipulating the market to ensure there is no price surge. This happened last winter and prices remained static throughout the spring. There was no price lift for winter finishers. Unfortunately, winter finishers have taken so many batterings that they have no confidence to purchase stores, which is a huge contributory factor to the fall in store prices over the past month to six weeks.

Farmers cannot understand how this decision was made to allow Slaney Meats to be taken over by the ABP Group and why responsibility for the decision was relinquished to Brussels.

Minister of State at the Department of Agriculture, Food and the Marine (Deputy Andrew Doyle)

I thank the Deputy. I will take him through why this happened in the way it happened.

As a primary beef producer, I am acutely aware of the importance of competition in all sectors, including the meat processing sector, in ensuring an economic return to primary producers. There is a well-established regulatory process involved in the assessment of takeovers to ensure that consumers, other businesses or, indeed, agriculture does not suffer or that the proposed takeover does not lead to a reduction in competition in the beef sector.

The State through the Competition and Consumer Protection Commission, CCPC, has an existing and well-established infrastructure for the assessment of mergers and acquisitions of business organisations generally. As part of this assessment, the CCPC examines proposed mergers or acquisitions involving business organisations to ensure there is no "substantial lessening" of competition. However, in situations where a proposed merger or acquisition exceeds certain thresholds, the matter must be notified directly to the EU Commission. This merger has been investigated by the Commission through DG Competition and they have found that the acquisition would not adversely impact effective competition in any of the markets where these companies are involved, for example, the purchasing of live animals for slaughter, downstream selling of fresh meat or the collection of animal by-products. The Commission’s investigation focused on the beef and sheepmeat sectors in Ireland and a comprehensive questionnaire was sent to stakeholders in the industry, farming organisations and State bodies. My Department responded to this by providing detailed statistics on these sectors, especially in respect of slaughter numbers, prices and live exports.

The structure of the beef processing sector has been the subject of much discussion over the years and one of the recurring themes has been the question of rationalisation in the processing industry. However, the issue of rationalisation must be discussed in the context of ensuring that the question of competition within the processing industry is not compromised. This is why the process of examining this takeover was of the utmost importance. The process of the investigation by the relevant authorities, in this case the European Commission, is detailed and robust, with a core objective being to ensure competition within the sector is not unduly affected by the proposed takeover. The Commission is anxious to ensure that the process is sufficiently transparent with details of any new notifications being published on the Commission’s competition website, which will allows any interested parties to make a submission.

I am very conscious of the need for competition in the beef sector in Ireland, as for any sector of an industry, to ensure that producers and all those involved in the different stages of production can achieve the best price for their product. I emphasise that in addition to the number of meat processors, competition in the marketplace is dependent on a number of factors, including the number of markets available for sellers of Irish beef on which to place their product and of course a vibrant live export trade. To that end, the Minster, Deputy Creed, has worked tirelessly since taking office on opening up new markets to Irish beef with the assistance of relevant State bodies, including Bord Bia, as did his predecessor.

Additionally, 2015 saw Irish beef exports increase by 6% to €2.41 billion from 2014. Access to new international markets including the US, Canada, Oman, the Maldives and Iran was secured during 2015.

Acting Chairman (Deputy Bernard J. Durkan)

I thank the Minister of State.

Deputy Andrew Doyle

This year the Minister, Deputy Creed, and I undertook a trade mission to China, South Korea, Vietnam and Singapore in order to progress our efforts to open these markets to beef and sheep meat from Ireland. As we speak, the Minister is commencing a trade mission in North Africa as one of the key objectives in the promotion of both Irish beef and live cattle. Regarding the latter, to which the Deputy referred-----

Acting Chairman (Deputy Bernard J. Durkan)

I thank the Minister of State.

Deputy Andrew Doyle

-----1,700 heavy bulls and 3,300 weanlings have been exported to Turkey, and another boat is supposed to load in the next week or so.

Acting Chairman (Deputy Bernard J. Durkan)

I thank the Minister of State.

Deputy Andrew Doyle

I will address the remainder of the question and some of the other issues in my final minute.

Deputy Jackie Cahill

I appreciate the Minister of State's answer, but farmers out there do not believe that this decision was good for the industry. This group has stopped live exports to the UK being economically viable. We cannot get quality assurance for our cattle in the UK to have these Irish forward stores slaughtered there. This group has purchased a significant number of calves in the last few years in this country to rear them so that it will control the market from start to finish. Every decision the group is taking shows it is looking for a monopoly within the industry. Unfortunately, this is being allowed to happen. How much of Bord Bia's budget is being spent on securing live exports? As I mentioned, the fact that we cannot get our forward stores into the UK on a level playing field is a huge detriment to the marketplace. While I accept that the Minister is trying to get extra outlets for our cattle, by this decision we have allowed an independent player to be taken out of the industry. In addition, this group controls the rendering industry in the country, has a controlling interest in that sector and the large amount of tonnage and offal created by beef processing and can control the number of cattle killed on a given week. It is inconceivable that this one group can be allowed to control the marketplace to such an extent.

As I said, figures produced last week have shown that since 2010, €78 million has been taken by the beef grid out of farmers' pockets. We were promised when the beef grid was introduced in 2010 that it would be cost-neutral, but all the analysis now shows that the beef grid costs farmers roughly €20 million per year. As I said earlier, we have had the beef forum and its recommendations, but none of those recommendations, which would be beneficial to the primary producer, has been implemented. As a matter of urgency, the beef grid needs to be reviewed and the age and weight restrictions reconsidered, as the beef forum recommended. It is absolutely imperative that the sanctions against our forward stores in the UK are lifted and that we get a level playing field, irrespective of the British decision to leave the EU.

Deputy Andrew Doyle

I appreciate the Deputy's commitment to this industry and I fully agree with some of the opinions and concerns he has outlined. I cannot answer his question about the budget for live exports but I can try to find that out. I do not know how it breaks down. The trade mission to Morocco and Algeria, which will be led by the Minister, people from the Department and Bord Bia, will be multifaceted. Beef and sheep meat exports and live exports are part of it. As the Deputy will be well aware, the beef grid was an agreement between the meat industry and at least one farming organisation. I do not know if any more than one farming organisation was involved. I think the forum has agreed that this be considered, and I think the Deputy is correct when he says the forum is the best chance of securing a long-term industry. It is my sincere opinion that all stakeholders in the industry, from primary processors and secondary processors right through to the retailers, should sit down and decide that there is nothing wrong with the product but that everybody in this production chain must have a decent, reliable, steady income. Volatility, no more than we have seen in the dairy industry, is the enemy of securing a future for the sector. Everybody should sit down, whether that involves some form of forward selling or contract selling, as is being talked about in the milk industry, to try to give people certainty when they look at their options and go to their creditors and banks and decide that this is the industry they want to finance. We all must be part of this, and producer organisations are very important if we can get them off the ground. They offer an opportunity for Ireland's beef farmers, who are probably by far our biggest industry, and I hope that sector can be put on a professional footing all the way from the farm gate to the table plate.

Animal Breeding Regulations

Deputy Maureen O'Sullivan

If the Dog Breeding Establishments Act were working, I would not have been submitting this issue for consideration as a topical issue over the past two and a half weeks and I would not have had the opportunity to discuss it now, which is great, albeit without the Minister, Deputy Coveney. However, I do hope to meet him about these issues at some point over the next week or so.

The Dog Breeding Establishments Act is not working and, consequently, there is absolutely scandalous treatment of dogs, very particularly of puppies in the so-called puppy farms, and I want to highlight a number of concerns in this regard.

There is no upward limit on the number of breeding bitches on a puppy farm. I have seen figures of over 400 bitches on one farm. Many of those premises seriously underestimate the number of dogs present. Inspections are by appointment, with several weeks notice being given to these establishments. When the premises are found to be non-compliant, they are given what is called an improvement notice and then invited to comply. Those who carry out the inspections lack the resources to do the work effectively. Instead of the authorities here working proactively, we are being shamed into doing something by the likes of the recent BBC programme on the puppy farms in Cavan. However, the animal welfare groups have been trying to rectify this and have been highlighting it for years. For example, a licensed puppy farm in Carlow passed inspections by the local authority but it had multiples of the permitted number of dogs, and those dogs were living in absolute squalor.

A massive trade in puppy farm dogs is facilitated by online sites and Internet sales. I know the Minister, Deputy Coveney, when Minister for Agriculture, Food and the Marine tried with his officials to rectify this with the Animal Health and Welfare Act, but it does not address certain aspects of animal welfare. For example, much was expected of the microchip legislation, but it is not being enforced. At a recent fair there were numerous dogs for sale with no microchip or paperwork. If there is no traceability, there is no accountability. The pounds and the rescues are taking the dogs that are microchipped to the breeder, but the breeder has no record of whom the dog is sold on to.

Counties Limerick, Cavan, Cork and Carlow are particularly bad when it comes to these puppy farms. Even though there are puppy farms well known to authorities, they can continue for a number of years in spite of their convictions for animal-related issues. One, for example, still had a type 2 transporter licence to transport dogs abroad. There are county managers in breach of the law. They are being compelled into initiating enforcement procedures so they are not being proactive. There are councils that resist Irish Society for the Prevention of Cruelty to Animals, ISPCA, involvement. The puppy farm at the centre of the TV programme had been passed by the county vet. A member of the family operating the puppy farm was stopped more than 20 times smuggling dogs, but the business continues. There is a puppy farm where the owner was legally obliged to tell the authorities that he was moving the dogs; he did not. I have seen inspection reports on these premises, several over a period of time before any improvements were made. There is no urgency on this.

Where there have been ample grounds for the council to take action, nothing has been done. For example, one dog breeder was using wooden crates for whelping bitches, which were totally unsuitable. The inspection notes show that the crates were seen several times before the local council did anything. Why are councils refusing to provide copies of the inspections they conduct? There are frequent breaches of the law. Failure to comply with the law should have resulted in closure, yet we have these flagrant breaches of the law.

Our pounds and shelters are overflowing and Ireland is overpopulated with dogs, yet we continue to license people to breed dogs with abandon, and it is the rescue community that picks up the pieces. There are many dogs from the puppy farms with very serious health problems. The more popular the breed, the more they are churned out by the breeders. One year it was cavalier King Charles spaniels; another year it was Yorkshire terriers; the latest are the Dalmations and the huskies, all very cute as pups, but they have much greater needs when they are older, and they are being brought to the pounds and the rescue centres afterwards.

The registration of puppy farms is not working. Puppies are being bred in appalling conditions which affect them physically and temperamentally, and huge sums of money are being made by the breeders, but the mess the breeders leave is left to the rescue groups.

There is little or no political will to deal with this. There is an attitude of, "Ah sure, they are only animals". It is totally unfair and unjust.

Minister of State at the Department of Housing, Planning, Community and Local Government (Deputy Damien English)

I thank Deputy Maureen O'Sullivan for raising this issue. The regulation of dog breeding establishments is a matter for local authorities in accordance with the Dog Breeding Establishment Act 2010. Each local authority must maintain for public inspection a register of dog breeding establishments in its functional area. This must include the name and address of the applicant seeking entry onto the register, the address of the dog breeding establishment and the maximum number of breeding bitches that may be kept at the dog breeding establishment or premises. The Dog Breeding Establishment Act 2010 provides a robust regulatory framework for, inter alia, the licensing, monitoring and inspection of dog breeding establishments by local authorities and, where a serious and immediate threat exists to public health or animal health and welfare, for the closure of such establishments. A joint inspection regime of dog breeding establishments, involving the Department of Agriculture, Food and the Marine and the local authority veterinary service was inaugurated last year for the purpose of inspection and follow-up action. The discovery of individual problematic dog breeding establishments, and the taking of action by An Garda Síochána, the Department of Agriculture, Food and the Marine and local authorities in an integrated manner in the most serious cases is a matter for the enforcement authorities concerned.

Guidelines on welfare standards for dog breeding establishments, published on the commencement of the Dog Breeding Establishment Act in January 2012, are available on the Department’s website and set out the required standards for such establishments. The current guidelines were announced by the then Minister on 21 December 2011, as provided for under section 15 of the Dog Breeding Establishments Act 2010, with the aim that they would help increase awareness regarding welfare standards and would aid good practice in dog breeding throughout the country. The guidelines became effective from 1 January 2012 following enactment of the legislation. Local authorities are responsible for monitoring compliance with these standards and are empowered to issue improvement notices where appropriate. A local authority may also issue a closure notice if a serious and immediate threat exists to public health or animal health and welfare. As the Deputy stated, however, there is general consensus that the scope of the existing guidelines needs to be enhanced as they are quite benign and represent a minimal standard that is probably no longer acceptable, particularly in view of recent issues that have arisen regarding some of the establishments. The rules and regulations in other countries are more rigid than the current guidelines. While many countries have primary legislation in respect of commercial breeding dogs only, the Dog Breeding Establishment Act 2010 covers a variety of situations, with breeding and non-breeding scenarios captured by the same piece of legislation.

Consequently, in late 2015, following engagement between the local authority veterinary service and the then Department of the Environment, Community and Local Government, it was agreed with the County and City Management Association, CCMA, to begin a process of review of the guidelines in January 2016. The work undertaken to date has been to produce a first draft revision of the guidelines, which is currently under consideration in the Department. I expect that a revision to the guidelines will be available to the Minister, Deputy Coveney, for consideration very shortly.

Deputy Maureen O'Sullivan

I will start by talking about dog poop. Can one imagine a puppy farm with between 200 and 500 dogs and the amount of dog poop that would be produced? Where are the guidelines for the disposal of that? It cannot go into a normal septic tank, it cannot be spread on the ground and there are dangerous consequences if it goes out into the atmosphere. How many inspections are carried out with that particular aspect in mind? I accept what the Minister of State said about there being a robust regulatory framework. However, that is on paper and is not being seen in action. He says it is a matter for the enforcement authorities, but they are not enforcing the regulations. He said that the local authorities are responsible for monitoring compliance. There are too many examples of local authorities that are doing absolutely nothing. The Minister of State really must engage with the county managers on the enforcement of the terms of that Act.

The Minister of State mentioned that the independent review is taking place. The scope of that review needs to be widened. For example, the independent rescue centres that deal with the fallout in these situations are excluded. They are the groups with real experience that pick up the pieces. There is a need for a dog behaviourist in the review process. There is also a need for independent vets to be part of that review process because the dog breeding industry itself is very well represented.

If we look at the finance, Canine Breeders Ireland estimates that the dog breeding industry is worth in the region of €350 million a year. On the basis that there are 200 registered breeders, it figures that each must be averaging approximately €1.75 million in yearly income. However, according to the statistics, only €95,000 was collected in fees last year for all the dog breeding establishments in Ireland. There has to be a targeted audit of the puppy farm industry. The dog breeders should maintain records that can be provided to Revenue to ascertain that the tax paid is in compliance. In the United States, there are what are called "puppy lemon laws". These are laws aimed at ensuring the good health of any dog purchased. It is the responsibility of the breeder or the dealer. We need an enhanced inspection regime and the Minister of State has to be proactive.

Deputy Damien English

The Minister, Deputy Coveney, and I fully understand the concerns of the public about the problems highlighted in the media regarding a number of dog breeding establishments. Deputy Maureen O'Sullivan has referred to some of those issues again tonight. That is why the Department, an expert group within the local authority veterinary services and other expert stakeholders have undertaken to engage in the ongoing review of the dog breeding establishment guidelines. They will take the time to address some of the issues the Deputy has raised as well. The suggestion to review the guidelines was made by an expert group within the local authority veterinary service and was accepted by the Department, with meetings hosted by the CCMA under the auspices of its dog working group. Officials from the Departments of Housing, Planning, Community and Local Government and Agriculture, Food and the Marine, the local authority veterinary service, the Irish Society for the Prevention of Cruelty to Animals, the Dublin Society for the Prevention of Cruelty to Animals and officials from the Department of Agriculture, Environment and Rural Affairs in Northern Ireland all participated on a working group to draft the revision of the guidelines. The main stakeholders, Canine Breeders Ireland and the Hunting Association of Ireland, were consulted as part of that process.

More generally, the enforcement of welfare standards regarding all animals is a matter for the Minister for Agriculture, Food and the Marine under the Animal Health and Welfare Act 2013. As I informed the Deputy earlier, the guidelines will come before the Minister, Deputy Coveney, very shortly. There will be a chance to discuss the matter even further and to thrash out some of the issues the Deputy has raised. I will undertake to have that conversation with the Minister on the Deputy's behalf and to ensure all of these issues are addressed. We will publish the new guidelines in the near future.

Hospital Services

Deputy Brian Stanley

I welcome the opportunity to raise this very important issue. It is the most important issue in Laois and surrounding counties. It is the issue of the hospital services. There has been a threat hanging over key services at Midland Regional Hospital Portlaoise for years. We have had leak after leak. One leak came out in early summer 2015 that indicated that the emergency services were to be removed. The Department of Health and the HSE then commissioned a report in response to the campaigning of local people under the tutelage of Dr. Susan O'Reilly. That report was to be published in September 2015. We are now in the month of November in the year of our Lord 2016 and heading for Christmas, yet we still have not seen that report.

In the interim, there have been more leaks and spin around the issue. One leak was regarding a recommendation that the emergency services be removed. It is time for the HSE, the Department and the Government to tell us what is planned for Portlaoise hospital. The emergency department is one of the busiest outside Dublin, busier than Mullingar and Tullamore. The absence of full consultant cover is often cited as a reason to downgrade the unit. The strategy of the Department and the HSE seems to be to keep the unit under constant threat of closure and consultants will not apply for the job as long as that is the case. In that way, the Department and the HSE get the outcome they want.

Resources are the issue in Portlaoise. That has always and ever been the case. A positive story from the point of view of the Government, the Department and the HSE has shown this in the last year. When the staff allocation was granted for the maternity unit, there were improvements. There has been a huge increase in the number of staff. They were operating with little over half the staff that was needed. We have seen the improvements in outcomes at the maternity unit. It can be held up as a good example. There were deficiencies there and the staff was operating under huge pressure. That has been improved. In a reply to a question of mine from 18 October, the Minister, Deputy Harris, acknowledged that there are far better outcomes now.

It is a busy but excellent service.

There is also a busy paediatric unit at the hospital. If any of the key services in Portlaoise is closed, there is nowhere to send people. I do not need to tell the Minister of State, Deputy Corcoran Kennedy, that one cannot send accident and emergency patients or those requiring paediatric services to Tullamore. The maternity services for Offaly are based in Portlaoise. Has the Minister read the important set of proposals issued in the summer by GPs and senior medical and clinical staff at Portlaoise hospital? These highlight the interdependent nature of the main services at the hospital in Portlaoise and the fact that if the emergency department were removed, other services would go with it because they are dependent on having a functioning emergency department. I refer to maternity and paediatric services in particular and the concerned professionals who manage, operate, staff and look after primary care and hospital care services in the midlands. They acknowledge the benefits of networking with the larger Dublin hospitals. Staffing is one of the issues affecting the maternity unit. The fact that it is now networking with the Coombe hospital is another benefit. The staff say that approach should be used as a template for the other services at the hospital.

There are people in the Gallery from County Laois. Jackie Cuddihy is one of them. As she has said publicly, she would not be here today but for the fact that we have an accident and emergency unit at Portlaoise hospital. That is an indication of the importance of the service.

Minister of State at the Department of Health (Deputy Marcella Corcoran Kennedy)

I thank Deputy Stanley for bringing this important matter to the attention of the Minister for Health, who sends his sincere apologies that he cannot be here and has asked me to respond on his behalf. This is a good opportunity to update the Deputy and the House on the future of services at the Midland Regional Hospital in Portlaoise. I acknowledge the presence in the Gallery of the people from the constituency to whom Deputy Stanley referred. Sadly, the constituency is no longer part of my constituency but I suppose what I have lost, others have gained and vice versa. The situation might revert at some point.

I assure the Deputy that the Minister, Deputy Harris, is committed to securing and further developing the role of Portlaoise hospital as a constituent hospital within the Dublin Midlands hospital group. The most important issue in relation to any changes at Portlaoise hospital is that patient safety and outcomes must come first.

As the Deputy acknowledged in his contribution, there have been a number of reports on the Midland Regional Hospital, Portlaoise in recent years. The reports have pointed to the need for reconfiguration of some services to ensure that patients are treated in the most appropriate setting by specialist staff that can safely meet their needs. Since 2014, the focus has been on supporting the hospital to develop and enhance management capability, implementing changes required to address clinical service deficiencies, and incorporating the hospital into the governance structures within the Dublin Midlands hospital group. Significant work has been undertaken to strengthen and stabilise current arrangements for services at the hospital to ensure they are safety-assured and adequately resourced. Governance and management arrangements in Portlaoise hospital have been strengthened, additional clinical staff have been appointed, and staff training and communications have improved.

The Dublin Midlands hospital group recently produced a draft plan which sets out a proposed service design for a new model of clinical service delivery at Portlaoise hospital. The draft plan has been discussed with the Department of Health and is currently the subject of further work and consideration within the HSE in advance of further necessary consultations with stakeholders, including GPs and consultants. No decisions have been made in respect of Portlaoise hospital but any changes, once approved, will be undertaken in a planned and orderly manner and will take account of current use of services, demands in other hospitals, and the need to develop particular services at Portlaoise in the context of overall service reconfiguration in the Dublin Midlands hospital group.

I again assure the House and Deputy Stanley that this work is being done to strengthen services at Portlaoise from a patient safety and quality point of view. I am confident that the changes will improve services for patients at Portlaoise hospital. Patients are at the centre of everything we do in the Department of Health and within the Health Service Executive. Their needs must be prioritised, which is exactly the standpoint from which we are coming.

Deputy Brian Stanley

While it is acknowledged in the reply that there are significant concerns, we now have a draft plan but GPs locally say there has not been meaningful consultation with them. There has not been any consultation with local Deputies. When will we see the draft plan? With all due respect to the Minister of State, we are going around in circles. Today's response is the same as we received months ago. We have not moved one jot further forward. The plan was to be published in September 2015 but we have not seen it to date. A delay of one month or even three months is reasonable but the plan is 15 months late at this stage. Meanwhile, we hear the argument that we do not have the clinical staff required at the hospital. As I set out in my introductory comments, one needs to have the clinical staff in place, but there must be some certainty for the future of the hospital.

Senior HSE managers and bureaucrats will come and go but we must be able to see a clear way forward. Surely the people of Laois and the surrounding counties are entitled to that at this stage? HSE management might make decisions but the Government is not a bystander. The Minister of State in the Department of Health, Deputy Corcoran Kennedy, is not a bystander. We need certainty on the matter. Is it Government policy not to have busy regional hospitals strategically located? One could not but argue that Portlaoise hospital is strategically located. Is it Government policy to act on a wing and a prayer and not to secure the future of such hospitals? The Minister needs to make a policy decision to resource and staff the hospital.

Despite the fact that Portlaoise hospital is busier than either of the hospitals in Mullingar or Tullamore, its funding is €30 million less than that which is provided for Tullamore hospital. I do not argue to reduce the funding for Tullamore hospital but I just highlight the fact. It is miraculous what the staff in Portlaoise hospital have done with little resources. They have performed great tasks. It is now up to the Government to clearly set out a plan to secure the future of Portlaoise hospital.

Deputy Marcella Corcoran Kennedy

It is a stretch too far to suggest that the Government is acting as a bystander in this matter. That is especially the case when one acknowledges the improvements that have been prioritised in the hospital. For example, additional consultant posts have been created in anaesthetics, surgery, emergency medicine, paediatrics and obstetrics in addition to physician and midwifery posts. An additional 76 posts have been created since 2014, and a further 38 were converted from agency posts. One must accept that is very positive. Nobody could argue that it is a negative action to have taken.

I understand Deputy Stanley's anxiety about having an input into the draft plan. The plan has been discussed with the Department and it is subject to further work and consideration by the Health Service Executive. When that process is finished, the parties concerned will consult with the GPs and consultants.

Deputy Brian Stanley

Is there a timeline?

Deputy Marcella Corcoran Kennedy

I cannot give it to Deputy Stanley but I will try to find out.

Deputy Brian Stanley

Will it be before Christmas?

Deputy Marcella Corcoran Kennedy

I am keen to see the plan as soon as possible, but it is important that adequate consultation is carried out and that those who wish to submit ideas will be given every opportunity to do so.

It might be helpful for Deputy Stanley to hear that a plan - The Future of Acute Services in the Midland Regional Hospital, Portlaoise: The Local Stakeholder Perspective - was submitted to the HSE and the Department by Laois GPs and senior medical staff at Portlaoise hospital in September. That is another positive for the Deputy to take from today's discussion. I assure him that services at Portlaoise hospital are a priority for the Department, the Government and the Health Service Executive.

Primary Care Services Provision

Deputy Timmy Dooley

The Minister for Health will be aware that it is proposed to reconfigure the Shannon Doc out-of-hours GP services in the mid-west region, which will affect services in west and north Clare and involve the closure of services in Killaloe. This is unacceptable, short-sighted and a betrayal of people who live in rural areas. The areas of east and west Clare that are under threat as a result of the proposal to reduce services are some of the most isolated locations in terms of health care not just in County Clare but in the country as a whole. I suggest that if the Government fails to intervene in this issue, it will be yet another example of the manner in which it has turned its back on people from rural parts of the country. People in rural areas should expect to be able to access the same health services as those living in towns and cities. I refer, in particular, to those who have access to such services.

The out-of-hours Shannon Doc scheme has worked very well by treating patients in their communities. I do not doubt that any attempt to undermine the availability of access to Shannon Doc services on the part of rural communities will lead to delays in diagnosis and will place greater pressure on the accident and emergency department at Limerick University Hospital, which is already over-stretched. The HSE and the local doctors need to sit down to thrash out this problem and find a solution other than that which has been proposed. I do not accept that a small reduction in the number of doctors participating in the scheme is enough to require the drastic closure of the service in west and north Clare and in the east Clare area around Killaloe. Equally, I do not accept that the number of patients attending these services in some way justifies the discontinuation of the current service. I appeal to the Minister to talk to the officials in the Department of Health and to put in place a forum with the GPs and all the interested parties so that a solution to this problem can be found. It is not enough to say to the people in these areas that they must all be pulled into a single area because there are not enough doctors or service users.

My local radio station, Clare FM, recently aired a report about the mother of a three year old child who suffers from severe asthma on a regular basis. When the child had an asthma attack on a recent Sunday night, this woman and her child rushed to the out-of-hours GP service in Kilrush and the child was successfully treated with a strong dose of nebulisers. The nature of what happens to asthmatic children means that this mother and many others regularly need to make such visits. She is deeply concerned about what will happen when such an event in the life and the health of her child occurs again. She absolutely believes she would not have time to get to Ennis, or perhaps Milltown Malbay as is now proposed. Therefore, the closure of the service in Kilrush has the potential to have a very negative impact on her family. The same concerns are being expressed in Ennistymon and Killaloe for a variety of reasons.

This service is funded by the State. This model was put in place to eliminate the need for people to present unnecessarily in accident and emergency departments. That is something we all talk about and we all need to see happen. We are attempting to solve a problem that does not exist in a way that will ultimately drive more people into our accident and emergency services at a time when they are overstretched, overburdened and unable to cater for and cope with the demand that exists. I appeal to the Minister to put the thinking caps on in the Department of Health so that some level of sanity can prevail.

Deputy Marcella Corcoran Kennedy

I thank Deputy Dooley for raising this important issue. I can hear the anxiety he has conveyed on behalf of his constituents. That would be replicated by any of us in these circumstances. As the Deputy knows, GPs who are contracted under the General Medical Services, GMS, scheme must make suitable arrangements to enable contact to be made with them, or a locum or deputy, for emergencies outside normal practice hours. While there is no obligation on GPs to participate in GP out-of-hours co-operatives as a means of meeting the contractual requirement, such services have been developed and expanded over time and are now an essential part of our primary care services. This helps to ensure to the greatest extent possible that urgent care needs are met in the primary care setting.

As the Deputy knows, out-of-hours arrangements in the mid-west region are discharged through Shannon Doc, which is a not-for-profit GP co-operative funded by the HSE. Shannon Doc recently announced that due to a difficulty in attracting GPs, and in particular locum cover, it is no longer able to maintain its existing service across all its centres. Following discussions with Shannon Doc, and in order to ensure the sustainability of the service, the HSE accepted a proposal from the co-operative to change the provision of the service. The most significant changes relate to parts of east and west Clare, essentially affecting Ennistymon, Kilrush and Killaloe, with minor changes in operating hours at two locations in north Tipperary. The Government is committed to ensuring patients throughout the country continue to be able to access GP services, especially in remote rural areas and certain disadvantaged urban areas. It is also committed to ensuring general practice is sustainable in such areas into the future. It is imperative that existing GP services in these areas are retained and that general practice remains an attractive career option.

The development of primary care is central to the Government’s objective to deliver a high-quality, integrated and cost-effective health care system. There is a commitment in A Programme for a Partnership Government to a decisive shift within the health service towards primary care to deliver better care close to home in communities across the country. The programme for Government emphasises the need to focus on enhancing primary health care services by building up GP capacity, increasing the number of therapists and other health professionals in primary care and continuing to expand the development of primary care centres and facilities. The annual GP training intake has increased from 120 prior to 2010 to 172 this year. I know the Minister, Deputy Harris, is anxious to achieve further increases in future years. The Minister has emphasised the need for a new GP services contract which will help to modernise our health service and develop a strengthened primary care sector.

Health service management has made progress with a number of significant measures through engagement with GP representatives. The GP contracts review process will, among other things, seek to introduce further measures aimed at making general practice a fulfilling and rewarding career option into the future. Progress to date includes changes in the entry provisions to the GMS scheme to accommodate flexible or shared GMS-GP contracts, and an enhanced supports package for rural GPs which includes a change in the qualifying criteria for rural supports and an increase in the financial allowance from €16,216 to €20,000. The recent changes to the Shannon Doc out-of-hours service will be subject to a three-monthly review. Their impact will be closely monitored and evaluated by the HSE. I hope the Deputy finds this information helpful.

Deputy Timmy Dooley

I accept that the Minister of State is here on behalf of the Minister for Health. I think she has been as frank as she could be. She touched on the nub of the issue when she spoke about GP contracts. She said that while this is a contracted service, GPs under this contract "must make suitable arrangements" to deal with out-of-hours services. I share the view of many people in the Clare constituency that the solution which has been arrived at is not suitable. The proposed arrangement is not fit for purpose, does not meet the needs of the community and does not ensure safe outcomes for patients who encounter issues like those I have already mentioned. I do not doubt that it will delay some patients in getting access to the treatment they need to save their lives. In other circumstances, it will delay people as they seek to present themselves to the medical system. Invariably, this will mean they end up in accident and emergency units. Some people will require hospital stays as a result of delays in getting to see doctors in the first instance. That is going to put more glue in the cogs of the health system in the mid-west.

I appeal to the Minister of State to go back to the Department to see whether the HSE will reject the proposal that has been made by the doctors. I was taken aback to discover that the HSE had accepted the proposal presented by the doctors. If the appropriate checks and balances had been put in place, and if the interests of the patients whom the doctors are supposed to serve had been taken into account, there is no way the HSE would have accepted this proposal.

In my view, they should have gone back to the general practitioners and the people who run this service and made the case that it was not acceptable, that it does not meet the needs and that it is not a suitable arrangement. Furthermore, they should have made the case that the Minister must put in place an appropriate service and work with them to find a suitable solution.

I appeal to the Minister of State to go back to the HSE, re-engage with the doctors and try to ensure we have a system that is fit for purpose, one that meets the needs of the patients and will ensure that we do not further clog up the accident and emergency departments, which are under such extraordinary pressure at the moment.

Deputy Marcella Corcoran Kennedy

I wish to reassure Deputy Dooley that I will certainly convey his strong and articulate feelings on the matter to the Minister and the Health Service Executive. The challenge facing Shannon Doc, as I am advised by the Health Service Executive, is that the operation is in this predicament due to a shortage of doctors. As a result, Shannon Doc simply cannot maintain the services. I have been told that the Killaloe service will be open during weekdays on a needs basis with a mobile doctor servicing the centre. At weekends, the operating hours will change from between 9 a.m. and 9 p.m. to between 2 p.m. and 6 p.m. Patients will be seen at the Limerick, Ennis and Nenagh centres outside those hours. The Kilrush Ennistymon service will relocate to Milltown Malbay during weekdays with the same operating hours applying, and both centres will be operational on Saturday and Sunday up to 7 p.m. instead of up to 9 p.m. I know that is not what Deputy Dooley wanted to hear, but I am afraid that is simply the way things are at present.

I am further advised that the HSE grant aids Shannon Doc to assist in its operations and that the changes decided by Shannon Doc are not influenced by funding availability provided by the Health Service Executive.

I assure Deputy Dooley that I will certainly convey his disquiet and that of his constituents on this issue to the Minister and the Health Service Executive. Our aim in this regard is to see if further efforts could be made to ensure the services people were used to - Deputy Dooley referred to a particular case - could be provided to his constituents.