Dáil Éireann debate -
Wednesday, 4 Feb 2004

Vol. 579 No. 2

Leaders' Questions.

Mr. Kenny

Yesterday the House paid tribute to the family of young Frances Sheridan, whose funeral takes place today. The newspapers today carry further revelations which cause serious concern. On 3 September, Dr. Finbar Lennon, medical adviser to the management board of the North Eastern Health Board, advised that there were concerns about the continuity of patient care and the supervision of non-consultant doctors by locum consultants in Cavan General Hospital. Today we learn of a problem with another appendicitis case, described in newspaper headlines as a grave blunder.

Yesterday I charged the Taoiseach and the Government with political responsibility for delivering a health care system that is effective and meaningful to people. The Minister for Health and Children has the political responsibility for delivering that system and I see no merit in the Minister whingeing in public that he is frustrated because he is unable to do his job. The good health of the nation is something that goes beyond mere politics and it is patently obvious that section 24 of the 1970 Act constrains the Minister from doing his job. It is time for some creative leadership from the Taoiseach and I offer him the support of this side of the House in doing so.

We have an aviation authority and a Health and Safety Authority but why do we not have a patient care authority? It would be similar to a surgeon general's office which would have its own chief executive and staff to cut through the bureaucracy which does not allow the Minister for Health and Children to do his job. It would put patient care and continuity of care at the heart of the system, which is what we want.

An Ceann Comhairle

A question, Deputy.

Mr. Kenny

People are looking for leadership in the health sector and the Minister for Health and Children has fallen down on his responsibilities because of the constraints in the system. I am suggesting a way out of this. We can set up an interim authority to deal with patient care and put that authority at the heart of what people need now. I offer the Taoiseach the support of this side of the House in facilitating whatever time is needed in the Dáil to get that authority up and running.

The Taoiseach

I welcome Deputy Kenny's constructive remarks, as obviously there are limitations within the legislation. Yesterday Members on all sides of the House sent their sympathies to the family of Frances Sheridan and to those involved in the related case. In the Cavan case, according to the legislation the Minister is the one who must set up the inquiry and nominate people for the teams, which seems overly bureaucratic. People may not want to serve on those teams — one person who was nominated had a conflict of interest because of family connections, which should have been obvious from the start. Then there was a row about the expenses to be paid and we set up the team at the third attempt. This seems nonsensical, as the row went on from August until the Minister was able to appoint the team some months ago. I gave those details yesterday. What is appearing in the newspapers is not unconnected to that issue but I do not want to get into that matter in the Houses of Parliament. I should not have to get into it.

On Deputy Kenny's broader point, obviously the Minister does not have clinical responsibility. He has never had that responsibility and never could have. While I know Deputy Kenny is not saying that, this point is at the core of the issue. The health board, medical health officers and clinical professionals are the people who must make the decisions. Obviously the health board has a role and in many cases the Minister gets drawn in, though historically that was not the case. If one has to provide the service then it must be provided and the Minister has met the relevant people — he met the CEO yesterday as well as other officials of the North Eastern Health Board. They informed him that there were approximately 14 adverse incidents reported to the board and that the board's medical advisers are in the process of reviewing all those incidents. The Minister is meeting a representative of the hospital consultants today and other steps are also being taken to deal with this matter.

On reform, this year we are moving from the health board structure to the hospital service executive system and that will cause enormous reforms of the system. I welcome Deputy Kenny's constructive comments on engaging with this process, which will cover the other points he made on aspects of the health system. Those points are noted.

These issues are not just matters of staff or resources. It is a question of reform and that is why the Government is so anxious to implement a reform programme.

Mr. Kenny

This is where I differ with the Taoiseach. As a politician, my objective is to ensure that life in Ireland is affected by political decisions. Health goes beyond mere politics. We would all like to see an effective health service where we can be proud of the quality of the services we deliver. What the Taoiseach said here is what was given yesterday. We know all of that.

Information given to me yesterday indicated that there will be further cases where the Minister will be constrained by section 24 of the 1970 Act in various other counties. I see a political solution that can impact on the work of the Minister for Health and Children. One such solution is to set up a patient care authority. If an aircraft crashes, the aviation authority deals with that. The Health and Safety Authority deals with health and safety issues at work.

We read litanies of misfortune every day in our newspapers; 200 people waiting for beds, nursing crises, patient care crises, grave blunders. While it is not directly the fault of the Taoiseach or the Minister, people die while waiting for treatment. A political response is required to cut through all of this and have an effective response from the Department of Health and Children.

I offer the Taoiseach help in this area. Priority legislation was rushed through this House twice in the past week. Why can the Minister not bring in legislation to deal with this and have a patient care authority the public would welcome? We should not have patients involved as pawns in rows that go on between different internal power factions.

The Taoiseach

There is no difference of opinion between Deputy Kenny and me on this issue so I will not create one. For the past two or three years, all sectors of the health service, consultants, nursing staff, junior hospital doctors, non-consultant hospital doctors and paramedics have worked on what they believed was the best solution for a reformed system. Although the policy reform was organised by Government, it did not generate it. It has been set out. Following the announcements of last year, we have now set up the structures. Various committees and groups are working on this. It has to come back to the House in the form of a new health Bill. The issues raised by Deputy Kenny will form part of it. We are fundamentally changing some systems of the past which were incorporated in the 1970 Health Act. There is no difficulty in this.

We are changing from the health board system to a new regime. The hospital executive services and the role of the Department of Health and Children will fundamentally change. Health boards, as currently constructed, will no longer exist. We will have an opportunity to deal with this at a later stage.

I do not wish to be simplistic about this matter. Hospital cases which give rise to clinical difficulties will still exist, but through reform we can bring a far better and more transparent service to the public.

Mr. Allen

Who is in charge?

The Taoiseach

This is what the Government intends to do. I thank Deputy Kenny for his offer when we bring forward this Bill.

Mr. F. McGrath

The Taoiseach is not delivering. Look at the current waiting lists.

The Taoiseach

I will examine the case in regard to section 24. I will look at the proposal he made.

Mr. Rabbitte

I am sure the Taoiseach will agree that the compliant Irish taxpayer is a very fair person. He and she were prepared to fund the services of the State when their betters had Ansbacher deposits, DIRT accounts, deals with the banks and so on and so forth. The taxpayer wants to see a fair deal for victims of abuse in residential institutions. The taxpayer wants the State to pay its share for its disgraceful neglect in invigilating these institutions, but the taxpayer also wants to see that the primary wrongdoers, those who were in the front line in these institutions, pay their fair share. It was on that point that Ms Justice Laffoy, whose resignation was forced by obstruction and lack of co-operation from the relevant Department and Minister, sought discovery of papers to know on what basis the Taoiseach decided that the Irish taxpayer would pick up virtually the entire bill for this disastrous neglect of the past. On what basis did he decide to cap the liability of the religious institutions at €128 million? That is the information that Ms Justice Laffoy wants to know. On what basis was the decision made and where are those papers?

I draw the Taoiseach's attention to the reply by the Minister for Education and Science, Deputy Noel Dempsey, last night. When asked this question, he said:

I surmise that Deputy Woods based hisopinion that the State was liable on the information that we all had and knew through the television programmes and from various victims' groups and individuals that made contact with us.

Deputy Woods apparently made his decision that the State was liable because of television programmes and other media reports.

I ask the Taoiseach one simple question and I do not want any of his rambling down memory lane and his apology and his baseless allegations about me wanting to bankrupt religious organisations. He should leave all that out. Are there any extant papers on which his Government based its decision? Do any papers exist, and if they do, will he hand them over to the commission which has replaced that of Ms Justice Laffoy?

The Taoiseach

Deputy Rabbitte obviously never likes my answers on this issue. He now wants me to forget all the reasons we did it. I will decide on my reply; Deputy Rabbitte can decide on his contribution.

Deputies

Hear, hear.

The Taoiseach

A few thousand cases had to be dealt with and we had to look at what process would function best in the shortest possible time. Legally, liability in each individual case could be divided into four categories and this is what faced the then Minister, Deputy Woods: the individual perpetrators of the abuse, the managers of the institutions, the religious orders who controlled the institutions and the State which put the children into care but failed to ensure that the care was of a sufficient standard. There are thousands of individual cases of abuse and the precise split of liability between the religious and the State would be different——

Ms McManus

The Taoiseach is not answering the question.

The Taoiseach

——in each case. The only way to test it would be to try every case in court.

Mr. Rabbitte

What is the simple answer to the question? Are there any papers?

An Ceann Comhairle

Deputy Rabbitte will have an opportunity for a supplementary.

Mr. D. Ahern

He should keep his arrogance for RTE.

An Ceann Comhairle

The Taoiseach without interruption, please.

The Taoiseach

That the State believed it was not 100% liable in the legal sense is reflected in the fact that the State negotiated with the religious orders and got a contribution of €128 million after long negotiations. The estimates available to the then Minister, Deputy Woods, gave rise to calculations of compensation of the order of €508 million. This works out about a 75:25 split. The only international evidence available came from Canada where the redress was of that level.

The alternative which was open to the Government was to take each of these cases through the courts and cross-examine the witnesses and the various organisations to which I referred, be they religious institutions, professional staff or whatever. I do not want to continue arguing with Deputy Rabbitte but the reason the decision was made was that we thought it would not be fair to put the victims through the trauma of court cases. We asked if it was fair to put these people through court cases. Some of them were out of the country and some were shown on the RTE television programme in Christmas week. In most cases the reason they ended up in these institutions is that the State put them there. The State did not hit them or kick them or do all the terrible things we saw in the television programmes, but by and large the State put them there. It would have taken years to bring these cases through the courts to establish 100% liability against the institutions.

Ms McManus

That was not the question.

The Taoiseach

I am not going to concede on this point. Deputy Rabbitte is wrong. I am right and I am not changing on this.

Ms Burton

It is a cover up.

The Taoiseach

We did not put the people through it. We made a political policy decision and felt that the right thing to do was to come to a settlement, make the churches pay a certain contribution and have the State indemnify the rest. Having done this, we could then process these cases. We did this with Ms Justice Laffoy and we will do it with Mr. Justice Ryan. We are right in doing this. I stand over it and will stand over it every day in this House, if necessary.

Mr. Rabbitte

If I am wrong, then Ms Justice Laffoy is wrong. Ms Justice Laffoy raised the same issue. Nobody asserted that a 100% liability should be levied on the religious institutions concerned. I did not assert this, nor did Ms Justice Laffoy. The Department of Finance suggested a 50:50 split. However, one eighth has been levied on the institutions and seven eighths on the taxpayer.

Mr. M. Smith

The Deputy does not know that.

Mr. Rabbitte

What is the answer to Ms Justice Laffoy's question? Are there papers that show why the Government reached this decision? If such papers exist, will the Taoiseach hand them over? What is difficult about this question? There either are, or are not, papers. The Taoiseach and the then Minister, Deputy Woods, without the advice of the Attorney General, and having excluded the Office of the Attorney General and its legal experts, proceeded without a memorandum to Government and went to Government on the last day it was in office——

Mr. N. Dempsey

The Deputy should tell the truth.

Mr. Rabbitte

——and made the decision on the basis of an oral presentation, in breach of Cabinet procedures. Ms Justice Laffoy, who has been forced out, now wants to know on what basis this decision was made. Are there papers and if there are, will the Taoiseach hand them over? The Government has wasted enough taxpayers' money, some €157 million has been wasted at Abbotstown and €40 million has been wasted on electronic voting. Where are the papers?

Mr. McGinley

It was done with a nod and a wink.

The Taoiseach

The answer to the Deputy's question, if he is interested in it——

Mr. Rabbitte

I am interested.

The Taoiseach

The Government decided not to take a legal view——

Mr. Stagg

Are there papers?

Mr. R. Bruton

Nothing will have been written down.

An Ceann Comhairle

Please allow the Taoiseach to continue without interruption.

The Taoiseach

They ask the questions but never listen to the answers.

Mr. McCormack

We have to listen hard to get the answers.

The Taoiseach

We thought more of the individuals. If I was to follow the legal advice or the advice of the Department of Finance, and justfollow the bureaucratic view, I would have fought each one of those cases through the courts and won or not won. There was plenty of legal advice.

Mr. Rabbitte

That is not true.

Ms McManus

The Taoiseach is misleading the House.

The Taoiseach

As far as the papers are concerned——

An Ceann Comhairle

Deputy McManus, aspiring leaders of the Labour Party are not entitled to contribute at this time. Deputy Rabbitte is entitled to hear his answer. Please allow the Taoiseach to continue without interruption.

Mr. Rabbitte

The Speaker of the House of Commons told Mr. Blair to——

A Deputy

The Deputy is in Ireland now.

The Taoiseach

Many of the institutions covered by the redress scheme were run by the State, so the State was 100% liable in those cases. What were we to do? We did not need papers, the Attorney General or legal experts. I did not need all of those. The State put these people into institutions, many of which were 100% owned by the State. Deputies are now asking why I did not put these people through the courts and cause them further suffering, and why I accepted only €128 million.

While I am not going to repeat what I said yesterday, the more I watch this argument, the more I realise what irks Deputy Rabbitte. I will not go into that.

Mr. Rabbitte

The Taoiseach should not repeat his scurrilous allegation.

The Taoiseach

What motivated me was that people were abused in institutions, many of them State institutions, and they deserve redress. We made political policy decisions and were right to do that. We did not just sit down.

Ms O'Sullivan

The Taoiseach is not answering the question.

Mr. Gormley

The Taoiseach should answer the question.

The Taoiseach

Let me make one last point. Will the Deputies listen to just one point?

An Ceann Comhairle

Deputy Gormley, you are not even in the Labour Party, let alone its leader.

Mr. Stagg

He might join us.

The Taoiseach

We set up a legal mechanism to deal with this issue quickly. I did not do this to get into a prolonged and haranguing argument about what was right or wrong. We set up asystem of redress. Ms Justice Laffoy was obviously upset by what she has seen. I am sure Mr. Justice Ryan will be equally so as he progresses his excellent work. I am sure they will see that what is at issue is the State looking after these people. I make no apology to the country for that.

Ms Burton

So the religious have no obligations.

Caoimhghín Ó Caoláin

I would like to avail of this opportunity to extend my sympathy to Brian and Rosemary Sheridan and their family on the death of little Frances, whose funeral mass is just about to begin in Cootehill.

The Government published a disabilities Bill in 2001. The Bill was totally inadequate and caused not only concern and disappointment, but real anger among people with disabilities, theirrepresentative organisations and the wider public. Such was the level of protest that the Government was forced to withdraw the Bill and establish a consultation process that included the establishment of the Disability Legislation Consultation Group. This body, comprising umbrella groups representing the different sectors within the area of disability, published its report, Equal Citizens, in February 2003. The report was a substantial contribution to the preparation of the new disability Bill. The report calls for legislation that enshrines two particular points: positive rights that are enforceable by individuals; and duties and requirements on public and private bodies providing services to the public aimed at removing barriers to full participation of people with disabilities in Irish society.

It is now 12 months later and we still do not have this legislation. It was promised for the last session. In her press release the Chief Whip has said the disability Bill is the flagship legislation for this session. It states, "Disability Bill top of legislative agenda as Chief Whip announces programme for next Dáil session". What is the position with this Bill? Is the Taoiseach aware that disability groups, organisations and the wider sector have expressed real concern that the legislation soon to be introduced, falls significantly short of the rights-based legislation required by the disability sector and demanded by wider society. Only last week the Taoiseach told the House that the further delay in the publication of this long overdue legislation was because the Disability Legislation Consultation Group had yet to make further responses. I have noted since that answer, that the group has refuted that claim by the Taoiseach.

An Ceann Comhairle

We cannot have aseparate Standing Order for the Deputy. The Standing Order allows for one minute but the Deputy has already spoken for more than two minutes.

Caoimhghín Ó Caoláin

With all due respect to the Chair, I would hope the same time would be afforded to me as to others who have asked questions of the Taoiseach. Will the Taoiseach answer the question? What is the current position of this Bill? Will the Bill measure up to the needs of the disability sector?

The Taoiseach

It is the Government's intention to put in place a framework that will ensure the most effective combination of legislation, policies, institutions and services to support and reinforce equal access for people with disabilities. A number of issues have to be dealt with, some of which Deputy Ó Caoláin has mentioned. An important Bill that has been widely welcomed is the Education for Persons with Disabilities Bill 2003 which is before the House. Intensive work is continuing in the Department of Justice, Equality and Law Reform on the preparation of the remaining parts of the framework for publication of the disability Bill as soon as possible. We hope to provide a disability Bill which will address assessment of needs, service statements, redress, access and sectoral plans across a number of areas, public service employment, genetic testing and a centre of excellence in universal design. We have had prolonged discussions with various interested parties, particularly the Disability Legislation Consultation Group, whose members have given much of their time. I have had two lengthy meetings with them and they have had several meetings with officials. We have outlined the sectoral plans for the key public service sectors.

A third Bill, the Comhairle Bill, is also part of this process. The disabilities group wants this Bill which provides for an advocacy service and sign language interpretation facilities. These were provided for in the 2001 Bill, but will now be in this separate Bill. There have been ongoing meetings since Christmas.

I want to acknowledge the work of the Disability Legislation Consultation Group. I acknowledge also the work of the officials in the Office of the Attorney General, the Department of Justice, Equality and Law Reform and other Departments who have worked four weekends in a row. There have been direct consultations with the groups as we want to try to avoid a repeat of the troubles in 2001. We want to share information and listen to what the disability groups have to say. It may not be possible, as always in legislation, to go the whole way, but we will go as far as we possibly can to satisfy their concerns. We were able to resolve the issues in the Education for Persons with Disabilities Bill 2003 and we will do our best with this Bill.

Caoimhghín Ó Caoláin

Will the Taoiseach confirm to the House — contrary to what he stated last week — that the Disability Legislation Consultation Group is not contributing to the delay in bringing this legislation forward? Will he acknowledge that the debacle on the disability Bill is coming at the end of the European Year of People with Disabilities, a year in which people with disabilities had to take to the streets to protest in support of their rights? Does he agree that at the heart of the problem regarding the disability Bill is a culture in Government that is opposed to any rights-based legislation of any kind? That malaise rests at the Cabinet table and was epitomised as never before by the national embarrassment of the legislation presented recently, the Immigration Bill, which stated that there were grounds for the refusal of entry to this country of people with disabilities. While the Government had to climb down on that issue to some extent, let us make no mistake the message was heard and noted and people recognise that the problem is at the Cabinet table, where a majority is opposed to rights-based legislation. It is time the Taoiseach weeded out those people and facilitated those who will take the decisions in the interests of people with needs.

The Taoiseach

The Education for Persons with Disabilities Bill 2003 is already on Committee Stage and is acknowledged as one of the best education disabilities Bills in the world. Additional funding of €650 million has been invested in disability services in the past number of years. This includes money that was made available last year and additional expenditure in this year's budget. Additional emergency places have been provided for services for school leavers to enhancerelated services for long-term cases and day care cases.

I did not state last week that the disability group was responsible for the delay, I said it was involved in the consultation process and that is helpful. We could bring in a Bill without consultation, but we would rather have consultation. We provided an additional 1,700 residential places for people with disabilities in recent years. We have also increased resources for those with intellectual disabilities or autism. I think Deputy Ó Caoláin's statement may have been relevant seven or eight years ago, but a great deal has been done for groups with disabilities, but there is more to be done. As I stated at the outset it is not only legislation, but capital investment and resources for services, which we are continuing to build upon after decades of neglect. I think we are doing a good job——

Caoimhghín Ó Caoláin

It should be rights based.

The Taoiseach

I will return to that issue as I do not believe the Deputy understands what he is talking about when he refers to rights-based legislation.