Dáil Éireann debate -
Tuesday, 23 Mar 1993

Vol. 428 No. 1

Adjournment Debate. - Health and Education Matters.

Mr. B. O'Keeffe

Will the Minister examine the surplus accommodation within our health boards with a view to providing long stay care for the elderly? In doing so he should be mindful of the financial hardship placed on families who are forced to send their parents or relatives into private nursing homes. We are all aware of pensioners who are forced to pay £90 a week towards their keep in a nursing home and unemployed families who must club together to provide £100 per week to subvent a relative in a private nursing home. The elderly are well cared for in those nursing homes, but the cost is beyond the capacity of people to pay. Obviously, there is not an adequate number of places available in public hospitals and some of the provisions of the Health (Nursing Homes) Act, 1990 have not yet been implemented. I welcome the provision of £4 million this year but that will not be adequate. I asked the Minister for Social Welfare if his Department could give any assistance to such people but he stated that this matter is outside the scope of the supplementary welfare allowance scheme.

Many unemployed nurses would be willing to provide a service for the elderly at an affordable cost. If there are vacant hospital wards or surplus health board buildings available, will the Minister ask health boards to perhaps, lease some of those wards to those nurses? The nurses merely want an adequate wage and they have a great deal of expertise, care and compassion to offer and, above all, have great respect for elderly people. They want to give of their services to these people and, therefore the Minister should consider taking this proposal on board.

Minister for Health (Mr. Howlin)

I thank the Deputy for his thoughtful contribution. A substantial amount of private long stay accommodation for the elderly is available in addition to the facilities provided by health boards. At the latest count, there were about 330 private nursing homes providing approximately 6,400 beds for the dependent elderly. In addition, voluntary nursing homes were providing approximately 3,300 beds. Arrangements are already in place under existing legislation whereby health boards subvent patients in private and voluntary nursing homes. Under section 54 of the Health Act, 1970 certain homes are approved for the payment of subvention at a current rate of £52.15 per person per week. Health boards also make arrangements in certain circumstances under section 26 of the Health Act, 1970 to contract beds in private nursing homes for dependent persons who cannot be accommodated in health board long stay accommodation.

The working group on services for the elderly, in its report, The Years Ahead — A Policy for the Elderly, recommended changes in arrangements between health boards and nursing homes in providing long stay care for the elderly. The Health (Nursing Homes) Act, 1990 provides a new legal framework for establishing a closer partnership between health boards and nursing homes in providing long stay care for our dependent elderly. The Act provides for the registration by health boards of nursing homes and for the payment of subvention by boards in respect of dependent elderly people who need nursing home care but who cannot afford to pay for it. The new system of subvention will redress many of the current problems in relation to subvention of nursing homes.

The Deputy suggested that health boards should consider leasing or entering into joint ventures with private nursing homes to provide care for elderly people. There may well be cases where a health board, in the interests of elderly patients, may decide to lease a premises for long term care or enter into arrangements with a private or voluntary home to provide long term care for patients. Health boards do not have the statutory authority to enter into joint ventures, as suggested by the Deputy.

It is perhaps worth noting that the Nursing Homes Act, while providing for the new relationships I talked about between health boards and the nursing home sector, respects in full the private and voluntary ownership and management of nursing homes. A fundamental principle underlying the new legislation is respect for nursing homes as private or voluntary enterprises which have been established by individuals or philanthropic initiative. The main objective of the new legislation is to ensure that all nursing homes have a high standard of accommodation and that care is of the best possible standard. I am arranging for the drafting of the regulations under the Nursing Homes Act and I hope to see full implementation of the Act, with the agreement of the Nursing Homes Association, by 1 May this year. That will bring about a substantial improvement in nursing home care throughout the country.

Mr. Finucane

The Mid-Western Health Board covers Limerick, Clare and north Tipperary, an area with a population of more than 310,000. The flagship hospital in the mid-west is Limerick Regional Hospital. In 1991 Comhairle na nOspidéal recommended the appointment of a cardiologist to this hospital and the medical committee of the Mid-Western Health Board gave high priority to this proposal. Patients in need of heart operations are referred mainly to Cork Regional Hospital and they experience long delays. A recent nationwide survey by Professor Ian Graham of the Irish Heart Foundation showed an average delay of nine and a half hours between the onset of heart symptoms and admission to coronary units. In addition to the appointment of a cardiologist, equipment and accommodation are also required and it is imperative that a specific allocation of £500,000 be provided for this purpose. It is vital to the mid-west region that a cardiologist be appointed.

Mr. Howlin

I am grateful to the Deputy for giving me the opportunity to clarify the position in relation to the appointment of a consultant cardiologist at Limerick Regional Hospital. The appointment of consultants is a matter for the Mid-Western Health Board in the first instance. In October 1989 the Mid-Western Health Board requested Comhairle na nOspidéal to review the consultant manpower requirements of the mid-west region in the light of the large number of consultant vacancies, both current and pending, in the region at that time. Comhairle na nOspidéal established a committee to carry out a wide-ranging review of consultant services and its report was completed in July 1991. The report recommended that four new specialties be introduced into the region — cardiology, nephrology, haematology and dermatology. It is envisaged that the major part of the expansion of specialties will occur through the restructuring of consultant vacancies as they arise. The appointment of a cardiologist is high on the Mid-Western Health Board's list of priorities. However, there would be a significant cost associated with such an appointment, including the capital and staffing costs of a catheterisation laboratory. My Department is discussing with the Mid-Western Health Board management plans for the introduction of additional specialties and the possibility of an expansion of the range of consultant services available in the region. The stage has not been reached where the recruitment process for a consultant cardiologist can be initiated.

I am aware of the urgency with which the Mid-Western Health Board view this matter. I will examine the question of appointing a consultant cardiologist to the Mid-Western Health Board as sympathetically as possible in the context of the health board's priorities and the resources available to my Department for desirable service improvements in the health service.

Mr. Deenihan

I thank the Minister for Education for being present here tonight. I think she is the first Minister for Education to be present in the House for this simple procedure. Tarbert comprehensive school opened in September 1973 but no senior engineering and construction studies rooms were provided then, which was most unfortunate. In 1978 the junior woodwork and metalwork rooms were adapted to take senior studies. In 1985 a major extension was provided which included three classrooms, one music room and a biology laboratory. However the board's request for senior engineering and construction rooms was refused. The school's capacity in 1985 was 575 students while the school's enrolment was 625.

A major campaign was embarked upon by the school authorities in 1987 for senior engineering and construction studies rooms. All stages of planning and costings are complete at this stage. In reply to a similar debate in 1992 the then Minister promised that the project would be considered in 1993, depending on the availability of finance. The Minister gave the go-ahead for 35 projects in 1993. However, the parents and staff of the school were shocked to discover that the extension to Tarbert school was not on this list.

The school enrolment is now 700 even though, as I have pointed out, the school has a capacity for only 575 students. There will be a further increase in enrolments in 1993 with the proposed closure of Mount Trenchard school in Foynes for first year students. The school is finding it increasingly difficult to cater for the demand for technological subjects — indeed the importance of technology is highlighted in the Green Paper on Education and the Culliton report. I appeal to the Minister to make a clear statement to the House explaining her future plans in relation to Tarbert comprehensive school.

Ms Bhreathnach

The project at Tarbert is an extension to bring the school capacity to 625 pupils in total. It will provide mainly specialist rooms for woodwork, metalwork and building construction and some ancillary accommodation. The costs will be in the region of £250,000. Except for some minor architectural details the planning of this extension is complete. The project is not, however, in the 1993 capital programme because of other demands deemed to be of higher priority which had to take precedence. For this reason the project will have to be considered for inclusion in the programme for 1994.

It is intended that future decisions on the progress of major projects through the architectural planning process should be based on objective criteria related to relevant educational, building and financial factors. It is envisaged that the criteria by which projects are selected, prioritised and advanced through the planning process will be disclosed and individual schools advised where they stand on a regular basis. It is not possible at this stage to indicate if Tarbert will proceed to tender in 1993 until the arrangements indicated have been put in place. This will occur as soon as possible and schools will be advised as necessary.

Mr. Finucane

On 19 January 1991 the Sisters of Mercy announced their intention to withdraw from Mount Trenchard School, Foynes, in June 1995. Since then four Ministers for Education failed to make a decision on the future role of this second level school. On 20 March last a large public meeting was held at Foynes and a Department of Education official who attended was asked to bring back to the Minister the strong views expressed by the parents that they want the school to continue beyond 1995. It is vital that the school, which is situated in an area designated for industrial development, remains open. The Minister should stop delaying on this vital issue. The parents, teachers and students have been treated unfairly by successive Ministers and it is now time for action. I hope the report from the Department's official stresses the importance of the continuation of this fine school beyond 1995. I look forward to a favourable response.

Ms Bhreathnach

The Stella Maris school at Mount Trenchard, Foynes, is located in the west Limerick catchment area which is unique in that it has four post-primary schools located in four different centres. The three other schools are: Scoil Mhuire secondary school, Askeaton, the Salesian College, Pallaskenry and the vocational school, Shanagolden.

The Mercy Order has, for some time, made known its decision to withdraw from the management of the Stella Maris school in 1995 and that, from next September, there will be no intake of new pupils into the school.

The Deputy will be aware that a school action committee was formed in Foynes with the aim of keeping the Stella Maris school in operation after June 1995 under a new management, County Limerick Vocational Education Committee. The action committee held a public meeting in Foynes on Saturday last, 20 March, at which a Department official attended and spoke, at my invitation.

The question of how best to cater for those pupils who would formerly have enrolled in the Stella Maris school is under examination in the Department at present and all aspects of the matter, including the Department official's report on the meeting of 20 March, will be taken into account in that examination which will shortly be completed.

The Department's main responsibility is to ensure that there will continue to be a sufficient number of pupil places available to cater for all those seeking a post-primary education in the catchment area. Every effort will be made to meet this responsibility.

Mr. Bradford

I am raising the question of the urgent need for a second science laboratory at Coláiste Chroaibhin, Fermoy, County Cork. The coláiste is certainly one of the most successful vocational education committee schools in the country and has a pupil complement of 569. Under the principalship of Mr. Hennessy, it plays a leading role in the educational and economic life of Fermoy and the entire north Cork community. The vast majority of pupils in this school study one of the three science subjects. Due to the interest in the science subjects there are 96 science classes per week. Unfortunately, due to the lack of adequate science facilities, 56 of the 96 classes are held in either the general classrooms or in the social areas. Fewer than half are held in a proper science laboratory. There are 25 class groups in this school but unfortunately there are only 21 teaching spaces. It is obvious from those statistics that there is an urgent need to provide extra science facilities. There is a request before the Department for funding for a second science laboratory to be built at the earliest possible opportunity. I strongly urge the Minister to make the funding available if at all possible during 1993.

Ms Bhreathnach

The County Cork Vocational Education Committee has applied to the Department for capital funding to provide a second science laboratory at this school. This application is under examination in the Department at present. In fact, officials from the Department discussed the application today in the Department with the chief executive officer of the County Cork Vocational Education Committee.

Arising out of the discussion with the chief executive officer, an inspector from the Department intends to visit and examine the position at the school. The matter will be considered further on receipt of the inspector's report. The Deputy will appreciate that I cannot give any commitment that this project will proceed until the matter has been fully examined.

The Department will be in further contact with the school authorities, the County Cork Vocational Education Committee in due course, when a decision has been reached.

The Dáil adjourned at 9.15 p.m. until 10.30 a.m. on Wednesday, 24 March 1993.