Dan Boyle
Question:11 Mr. Boyle asked the Minister for Health and Children the progress made to date on regulating complementary and alternative medicine; and if he will make a statement on the matter. [10815/04]
Written Answers.
The following are questions tabled by Members for written response and the ministerial replies received from the Departments [unrevised].
Questions Nos. 1 to 10 answered orally.
Medicinal Products.
As a first step towards strengthening the regulatory environment for complementary therapists, I convened a forum in June 2001 to examine and explore practical issues involved in establishing appropriate regulation. Arising from the work of the forum I asked the Institute of Public Administration to prepare a report on proposals for the way forward taking into consideration the formal views of the representative groups that participated in the forum.
The report, which was launched in November 2002, delivers on action 106 of the health strategy — quality and fairness, and makes a number of recommendations on proposals for the way forward including: the establishment of a working group to examine and consider regulatory issues in Ireland; the continuation and development of a consultation process; and support for individual therapies in developing or strengthening their systems of self-regulation. As recommended in the report, I established a national working group to advise me on future measures for the regulation of complementary therapists. The working group held its first meeting in May 2003, continues to meet regularly and is expected to report by May 2005.
A proposal for a new EU directive on traditional herbal medicinal products was agreed at European level on 11 March 2004. In order to gain the most from these types of medicinal products, it is essential that they are subject to appropriate controls to ensure that, like all other medicinal products, they are of an appropriate quality and safe for the consumer to use. The interests of public health can best be realised when there is a formal mechanism for the assessment of these products and a subsequent means of monitoring their use in order to assure their continued safety in use.
This EU proposal provides for a special legal framework for traditional herbal medicinal products, with a view to removing the differences and uncertainties about the status of these products in the member states and to further improve the protection of public health. Under the proposed directive, the quality requirements for these products are identical to those for all medicinal products. However, it is proposed that instead of conducting new tests and trials on the safety and efficacy of the product, these can be assessed on the basis of the information gathered on its traditional use over a period of at least 30 years, including 15 years in the community. Pending the implementation of this directive, the Irish Medicines Board continues to monitor the situation from a public health safety point of view.
Health Service Reform.
Liz McManus
Question:12 Ms McManus asked the Minister for Health and Children the progress to date in the work of the implementation bodies for the East Coast Area Health Board and Mid-Western Health Board area in regard to the Hanly report; if an assessment has been undertaken of the costs of implementing the Hanly recommendations in each area; and if he will make a statement on the matter. [10798/04]
I established the implementation groups relating to the Hanly Report in the east coast area and Mid Western Health Board regions on 27 February 2004. The groups include management and health professionals across all of the hospitals involved. They have been asked to develop a detailed action plan for the implementation of hospital reorganisation in the two regions, in line with the Hanly recommendations. The groups in the two regions will examine the costs as part of the implementation process.
Neither group has met to date because of industrial action taken by the Irish Hospital Consultants Association which includes non-participation in groups of this kind. While the pace of progress has been affected by the withdrawal of consultants from discussions, I am determined to advance implementation of the Hanly Report. I ask all parties to participate fully in the implementation process.
Several initiatives are under way at present to deal with accident and emergency services. These include prioritised planning for the discharge of patients by acute hospitals and increased liaison between hospital and community services; additional funds of €21.4 million to facilitate the discharge of patients from the acute system to a more appropriate setting; and additional emergency medicine consultant appointments — from 21 posts in 2000 to 51 posts approved by 1 January 2004. Subject to resolution of outstanding legal issues associated with the required regulatory changes, I intend to provide, at the earliest appropriate date, the necessary additional revenue funding to the Pre-Hospital Emergency Care Council for the roll-out of the training element of the emergency medical technician — advanced programme.
The Mid-Western Health Board has recently advertised for several emergency care physicians — fully registered doctors — to complement service delivery in emergency departments. I have also recently approved the appointment of the design team to prepare an outline development control plan for Ennis General Hospital. The plan will be prepared having regard to the development brief prepared by the project team which sets out the broad scope of the proposed future development at Ennis General and identified the priority areas for development.
Hospital Staff.
Gerard Murphy
Question:13 Mr. Murphy asked the Minister for Health and Children his plans to address the shortage of radiographers across the State; and if he will make a statement on the matter. [10869/04]
Intensive efforts have been successfully undertaken to improve staffing levels in radiography at local and national level. There had been an increase of 20% in whole time equivalent terms in the number of radiographers employed in the health service to the third quarter of 2003 compared with the end of 1999 — an increase from 757 to 908 radiographers. Recently, the number of radiography training places in the State has doubled from 30 in the 2000-01 academic year to 65 in the 2003-04 academic year.
Employment in the health services as a radiographer has been made more attractive through measures such as pay enhancements, developments in career structure and enhanced opportunities for professional development as a result of the continued implementation of the recommendations of the report of the expert group on radiography grades. In recent years, overseas recruitment by health agencies has also contributed significantly to meeting the human resource needs of the health services in radiography.
The introduction of a fast-track working visa scheme for health and social care professionals, including radiographers, and the streamlining of procedures for the validation of overseas qualifications are other initiatives that have been taken to help meet the human resource requirements for radiographers in the health service. Many radiographers with overseas qualifications have been validated as eligible to work in the Irish public health system for several years. Since the start of 2002, my Department has validated 407 radiographers as eligible to work here. Having recruited and developed many staff recently, it is a priority to retain them by offering a challenging and rewarding career path. In a human capital and skills intensive health sector, retention has been identified as a key issue in better people management. The implementation of the action plan for people management, which I launched in November 2002, is playing a crucial role in boosting the capacity of the health services to retain scarce skilled health and social care professionals, including radiographers.
Thomas P. Broughan
Question:14 Mr. Broughan asked the Minister for Health and Children the position regarding the application of the European Working Time Directive to non-consultant hospital doctors; the latest assessment of the implications for staffing levels in hospitals; and if he will make a statement on the matter. [10799/04]
Eamon Ryan
Question:64 Mr. Eamon Ryan asked the Minister for Health and Children when he hopes that Ireland will be able to comply with the European Working Time Directive for junior doctors; and if he will make a statement on the matter. [10821/04]
I propose to take Questions Nos. 14 and 64 together.
Ireland will be legally obliged to begin applying the conditions stipulated in the European Working Time Directive to doctors in training from 1 August 2004. Every effort will be made to effect these employment rights from that date. As part of the early preparation for implementing the directive, a national joint steering group on the working hours of NCHDs was established in June 1999 and reported in January 2001. In order to reduce NCHD hours, it recommended that the following measures be progressed: reduction in the number of grades of doctor on-call at any one time; introduction of cross-cover arrangements; introduction of centralised rostering and shiftwork; and changes in skill-mix and practice for other grades of hospital staff. Following this work the national task force on medical staffing also recommended the introduction of a consultant-provided service, a significant increase in the number of consultants and the adoption of a team-based approach to consultant work. In line with this and with the role proposed for non-consultant hospital doctors, the task force report outlined that there should be a significant reduction in the number of NCHDs as the number of consultants increases. The objective must be to reverse the current ratio of more than two NCHDs for every one consultant.
The reasons for this approach are, first, even if it were desirable, it would not be possible to recruit sufficient extra NCHDs to cover existing rostering arrangements under the directive. This is particularly the case in smaller hospitals where there are already problems in maintaining the current numbers of NCHDs. Second, best practice requires that doctors should be recruited to accredited training posts in order to ensure the provision of quality patient care and appropriate clinical decision-making. Medical manpower managers appointed under the NCHD 2000 agreement are overseeing the reduction in NCHD working hours and are essential to the phased implementation of the Hanly report recommendations, especially where roster management is concerned. Latest returns indicate that well in excess of 60% of NCHDs will comply with the 58 hour requirement of the directive by 1 August next. However, difficulties arise when the details contained in the directive are applied, that is, rest breaks and compensatory rest. These issues are being considered and will be continuously advanced.
Negotiations between health service management and the Irish Medical Organisation about the reduction of NCHD hours have sporadically taken place in the Labour Relations Commission over the past 18 months. Progress has been slow and several key issues have yet to be agreed. The Hanly report outlines the need to establish a working group in each hospital to implement the required measures and to monitor progress in the reduction in NCHD hours. A national implementation group is also urgently required to co-ordinate the work being undertaken at local level and to monitor progress. These groups should include appropriate hospital managers, consultants, NCHDs, nurses and other relevant health care professionals.
The urgent need to establish these groups at national and local level has been discussed with the Irish Medical Organisation at the meetings in the Labour Relations Commission but the IMO has refused to agree to their establishment. It has lobbied for many years to achieve a significant reduction in NCHD working hours. That aim could be progressed by full participation in the national and local implementation groups. Chief executive officers of health boards and voluntary hospitals, and hospital managers, together with senior officials from the Department and the Health Service Employers Agency are in regular contact about progress to reduce NCHD working hours and are identifying the various steps at national and local level required to implement the directive by 1 August. In addition, a national co-ordinator and support team have been seconded to oversee the implementation process in the health agencies, and to provide direction and guidance on specific issues. Work is also progressing on the development of IT software to record NCHD working hours.
In February 2002, the medical education and training project group of the national task force on medical staffing was established to prepare an implementation plan, for medical education and training arising from the requirements of the directive and the proposal for a consultant-provided service. The group continues this task and I expect to have interim recommendations on meeting the training requirements within the directive soon. The chief executive officer of each individual health board and each voluntary hospital has responsibility for management of the workforce, including the appropriate staffing mix and the precise grades of staff employed within that agency, in line with service plan priorities, subject to overall employment levels remaining within the authorised ceiling. Hence, the recruitment of health service staff in 2004 and beyond will take place in the context of the implementation of each agency's service plan, taking into account new policy initiatives such as those necessitated by the implementation of the directive for doctors in training.
On 27 January last, I announced the composition of a group to prepare a national plan for acute hospital services. The group is chaired by Mr. David Hanly and contains a wide range of expertise from the areas of medicine, nursing, health and social care professions and management. It also includes an expert in spatial planning and representation of the public interest. The group has been asked to prepare a plan for the interim health service executive for the reorganisation of acute hospital services, taking account of the recommendations of the national task force on medical staffing including spatial, demographic and geographic factors. Rapid progress depends on all parties commencing this urgent work and preparing the plan for acute hospital services which will further help to implement changes in the reduction of working time for doctors in training.
The existence of significant difficulties and the relatively short timeframe available do not alleviate our legal obligations arising from the directive and only serve to emphasise the urgency of making rapid progress on implementation. Excessive working hours are unsafe for the doctor and his or her patients. The need to deliver appropriate training to our doctors while maintaining necessary levels of service provision will present a range of challenges. It also presents a unique opportunity to improve training, services and the working lifestyles of all NCHDs.
National Drugs Strategy.
Pat Rabbitte
Question:15 Mr. Rabbitte asked the Minister for Health and Children the steps he is taking to provide a preventative programme to reduce the level of opiate related deaths, especially in the Dublin area where the death toll from opiates is running at the same level as from traffic accidents; and if he will make a statement on the matter. [10783/04]
The overall objective of the National Drugs Strategy 2001-2008 is to reduce the harm caused to individuals and society by the misuse of drugs through a concerted focus on supply reduction, prevention, treatment and research with the ultimate aim of leading a drug-free lifestyle. The health-related aspects of the national drugs strategy focus in particular on education and prevention and treatment and rehabilitation, including substitution treatment under the methadone protocol. The number of methadone treatment places has expanded considerably in recent years, in line with the Government's commitment under the national drugs strategy. At the end of December 2003 there were 6,883 people receiving methadone treatment, compared with just over 5,000 at the end of 2000.
In the Eastern Regional Health Authority there are 59 drug treatment locations. This compares with 12 locations in 1997. Outside the ERHA, treatment clinics have been established in the South Eastern Health Board, Mid-Western Health Board, Western Health Board and Midland Health Board. General practitioners and pharmacists also provide treatment services and their involvement has also increased over recent years. The boards aim to address substance misuse by providing effective and sustainable services working in partnership with clients and with fellow service providers. All clients entering the addiction services are assessed and appropriate treatment plans are identified based on clients' needs. Decisions concerning the appropriate treatment for patients are made in accordance with best practice guidelines.
Overdose prevention is an inherent part of the comprehensive range of services which the boards provide, including education and prevention, treatment and rehabilitation, counselling and harm reduction. International evidence supports the view that opiate users are safer in treatment, therefore, every effort is made to encourage clients to engage in treatment. Co-abuse of alcohol, cocaine and benzodiazepines is closely monitored by the clinicians treating an individual. Every effort is made to modify the clients' use of other drugs thereby minimising the risk of overdose. For opiate users outside treatment, outreach workers and needle exchange services actively engage drug users to promote safer drug using practices to address the risks involved in terms of overdose, transmission of blood-borne viruses and unsafe sex practices. Harm minimisation is at the core of the three area health boards' outreach strategy and this includes the risk of overdose.
Building on existing initiatives, one area health board designed a series of posters and leaflets, directly addressing risk factors contributing to overdose and how individuals can best provide assistance to those who may have overdosed. This initiative was piloted last month in all the addiction centres in the health board area and is due to be extended to GPs and health centres in the area in the coming months. This is taking place as part of a health promotion programme, which has been designed to promote service users taking a more active role in their own health in a range of areas. There are protocols in place for the transfer of those who are engaged in substitute treatment whilst in prison to facilitate their take-up for treatment on release and so reduce the risk of overdose among released prisoners who misuse opiates.
Drug-related deaths are recorded by the general mortality register of the CSO, based on the international classification of diseases code system. Other countries have developed dedicated systems for recording drug-related deaths and it is important, for the purposes of comparative analysis, that the Irish system is capable of generating an equivalent level of information. That is why one of the actions contained in the national drugs strategy calls for the development of an accurate mechanism for recording the number of drug-related deaths. Overall responsibility for this action rests with the Coroner's Service and the Central Statistics Office.
Health Service Reform.
Kathleen Lynch
Question:16 Ms Lynch asked the Minister for Health and Children the programme of work undertaken to date by the national steering committee to oversee the different strands of the health reform programme; and if he will make a statement on the matter. [10811/04]
The national steering committee was established to oversee, monitor and steer the health reform programme. The committee, chaired by Mr. Kevin Kelly, held its first meeting on 16 February last. This initial meeting provided an opportunity for the committee to be briefed on progress to date in the first phase of implementation of the programme; to be updated on the development of a project plan for the next phases, including the identification of key milestones in 2004; and to discuss the most appropriate focus for the committee in guiding and overseeing progress.
The four interrelated strands of activity under way are: the work of the interim health service executive leading to the establishment and the orderly transfer of functions to the HSE; aspects of the reform programme for which the Department of Health and Children has lead responsibility; the work of the acute hospitals' review group chaired by Mr. David Hanly; and the ongoing management of the health system and internal preparations for the new organisation and governance arrangements being led by the chief executive officers of health boards and the Health Boards Executive. It is anticipated that the NSC will meet again shortly.
Hospital Services.
Paul Nicholas Gogarty
Question:17 Mr. Gogarty asked the Minister for Health and Children , further to Question No. 949 of 30 September 2003, if he has received expert advice on the question of self-testing for patients on anticoagulation therapy; if he will meet with members of Anti-coagulation Europe to discuss the matter further; and if he will make a statement on the matter. [10820/04]
The treatment available to patients on anti-coagulation therapy is normally provided in a hospital setting under the supervision of a specialist, or in certain GP clinics with specialist agreement. A few patients may be opting to self-test, although this is a private matter between them and their doctors. Officials from my Department have met representatives of the self-help group known as Anti-coagulation Europe to discuss a system of self-testing for patients on anticoagulation therapy. My Department will need to consult further with relevant experts in this area to assess whether self-testing for these patients is realistic in a community setting, having regard to all the medical and other factors involved.
Fergus O'Dowd
Question:18 Mr. O’Dowd asked the Minister for Health and Children when his Department will announce the decision on the location of radiotherapy centres in Dublin; and if he will make a statement on the matter. [10844/04]
The report, The Development of Radiation Oncology Services in Ireland, that I launched in October 2003 is a most authoritative analysis of radiation oncology and provides a detailed plan for the future development of radiation oncology services nationally. The Government has accepted the recommendations of the report and the development of these services on the lines recommended is the single most important priority in cancer services in the acute setting. The report recommends two treatment centres located in the eastern region, one serving the southern part of the region and adjacent catchment areas and one serving the northern part of the region and adjacent catchment areas. I have asked the chief medical officer of my Department to advise on the optimum location of radiation treatment facilities in Dublin. A detailed request for submissions for issue to potential host hospitals is being finalised. The chief medical officer will apply the guidelines established by the group with the support of the hospital planning office of my Department and international experts. Several international organisations, expert in the field of oncology, including radiation oncology, have been asked to nominate experts. I expect the office of the chief medical officer to issue this request shortly.
Health Insurance.
Joe Costello
Question:19 Mr. Costello asked the Minister for Health and Children if he has sought or received an assessment from the VHI of the likely impact on its premiums of the decision not to proceed with the proposed risk equalisation scheme; and if he will make a statement on the matter. [10805/04]
As provided for under the Health Insurance Acts and the risk equalisation scheme, the Health Insurance Authority has notified the insurers concerned, including the Voluntary Health Insurance Board, of its proposed recommendation to me, as Minister, concerning the commencement of risk equalisation payments. The authority has advised the insurers that it proposes to recommend that risk equalisation payments ought not to be commenced. The legislation provides for the insurers to make representations to the authority on its proposed recommendation and requires it to take such representations into account before finalising its recommendation as to whether the Minister ought or ought not to commence risk equalisation payments.
As the authority has not submitted its final recommendation, and as I have no function in that process under the legislation, it would not be appropriate for me to seek an assessment of the kind referred to by the Deputy. Under VHI legislation, the VHI board has the primary responsibility to set premium rates. The legislation obliges the board to notify the Minister of proposed premium increases which it has decided before effecting them. The Minister may prevent the introduction of any proposed increase, but must give reasons for doing so. It would be inappropriate for me to engage in consideration of the matter of VHI premium increases outside that process and in the context to which the Deputy refers. I recognise the independent role and responsibilities which the authority must perform with regard to the risk equalisation scheme.
National Children’s Strategy.
Michael Ring
Question:20 Mr. Ring asked the Minister for Health and Children his plans to provide community-based early intervention services and programmes for the identification, assessment and treatment of children with emotional and behavioural problems as promised in the national children’s strategy; and if he will make a statement on the matter. [10874/04]
The further actions proposed in the national children's strategy to meet the needs of children with emotional and behavioural difficulties are being addressed, inter alia, in the context of the implementation of the Children Act 2001. The National Children’s Office is co-ordinating the cross-departmental implementation of the Children Act 2001, part 11 of which, establishing the special residential services board on a statutory footing, has been commenced. Work is also at an advanced stage to introduce soon parts 2 and 3 of the Act which provide a statutory scheme for non-offending children in need of special care or protection to be placed in special care units, on foot of a special care order made by the District Court in appropriate circumstances, as a last resort and for as short a period as possible.
Since 1997 approximately €185 million additional revenue funding has been invested through the health boards in the development of child welfare and protection services. This has provided for a wide range of developments including family support projects, preventive services and intensive community-based services.
As stated in the health strategy, Quality and Fairness: a Health System for You, child care services since the early 1990s have focused mainly on the protection and care of children at risk. This policy has recently shifted to a more preventative approach to child welfare involving support to families and individual children, with the aim of avoiding the need for further, more serious, interventions later on. I established the review of family support services in 2003 which will map out a national policy and plan for the future development of family support services by health boards in line with section 27 of the health strategy. It will report by the end of this year. The intensive community-based services which have been put in place to provide support for children who may have emotional and behavioural problems include the Springboard initiative and the Youth Advocate pilot projects. In 1998 the Cabinet Committee on Social Inclusion approved spending of €9.14 million over a three year period from the young persons services and facilities fund on several pilot projects for children at risk, working intensively with children, mainly in the seven to 12 year old age group, who are at risk of going into care or getting into trouble with their families. These were the Springboard initiative, funded and established through the health boards. Since 1998, 22 such projects have been established throughout the country. Children and families are generally referred to Springboard through social work departments, schools and other statutory agencies. Over 700 children presenting with a variety of behavioural and psychological problems attend the projects for intensive group, or individual, work. Almost 400 parents attend the projects and through individual or group work programmes they learn new patterns in parenting that improve their own self-esteem and also their children's quality of life.
Youth Advocate programmes have been established on a pilot basis since 2002 in the Northern Area Health Board and in the Western Health Board with total funding of approximately €1 million. The programme works with children and families to reduce the number of young people entering out-of-home placement, reduce the length of stay of young people in care and return children to the most appropriate family placement as quickly as possible by providing a range of intensive community-based services. The service is an internationally successful community-based alternative to special care and high support placement. The two projects cater for approximately 50 young people at any one time. Youth advocate programmes design interventions to meet the unique needs of each family with connections to other services as needed, they incorporate a crisis intervention service and attribute their success to their core principles: no eject and reject, strengths-based approaches and unconditional care. The North Eastern Health Board plans to establish a further such project this year.
Among the many programmes operating in the various health boards are neighbourhood youth projects, health advice cafés, and teen parents support projects which aim to provide direct intervention with young people experiencing risk, or at risk of experiencing personal, family, education or social problems, to enable them to grow and develop to their full potential. The Department of Health and Children, with funding by the Crisis Pregnancy Agency, will establish two further projects under the teen parents support initiative this year. The projects will be based in the North Eastern Health Board and the Northern Area Health Board. Young people identified by these services as needing further treatment are referred to other services as appropriate such as child and adolescent psychiatric services.
Internationally acknowledged best practice for the provision of child and adolescent psychiatric services is through the multi-disciplinary team. In furtherance of the recommendations of the working group on child and adolescent psychiatry, additional revenue funding of €6.061 million was allocated in 2002 to provide for the appointment of additional child and adolescent consultants, for the enhancement of existing consultant-led, multi-disciplinary teams and towards the establishment of further teams. A further €1.64 million was allocated in 2003. The working group also recommended that seven child and adolescent in-patient psychiatric units for children ranging from six to 16 years should be developed throughout the country. Project teams have been established to develop child and adolescent in-patient psychiatric units in Cork, Limerick, Galway and one in the Eastern Regional Health Authority area, at St. Vincent's Hospital, Fairview.
The second report of the working group on child and adolescent psychiatry published in June 2003, contains proposals for the development of psychiatric services for 16-18 year olds. It recommends that, in the further development of the child and adolescent psychiatric service, priority should be given to the recruitment in each health board area of a consultant child and adolescent psychiatrist with a special interest in the psychiatric disorders of later adolescence. Further implementation of the recommendations of the reports of the working group on child and adolescent psychiatry will be considered in the context of the Estimates process for 2005 and subsequent years. The expert group on mental health policy will consider the future direction and delivery of all aspects of our mental health services, including child and adolescent psychiatry and is expected to report in 2005.
National Health Strategy.
John Deasy
Question:21 Mr. Deasy asked the Minister for Health and Children the efforts he has made to ensure that persons on low incomes have better access to health care; and if he will make a statement on the matter. [10861/04]
The health strategy emphasises fairness and the objective of reducing health inequalities in our society. The Government has taken a series of initiatives which are set to improve access to the public health services and therefore have a particular impact on access for those on low income. Shorter waiting times for public patients are being prioritised, with the expansion of bed numbers and the national treatment purchase fund. In addition, there are clear commitments to targeting vulnerable and disadvantaged groups including: continued investment in services for people with disabilities and older people; initiatives to improve the health of Travellers, homeless people, drug misusers, asylum seekers and refugees, and prisoners; and implementation of the NAPS targets relating to health.
The health strategy includes a commitment that significant improvements will be made in the medical card income guidelines in order to increase the number of persons on low income who are eligible for a medical card and to give priority to families with children, particularly children with a disability. This should be viewed in the broader context of the strategy's emphasis on fairness and its stated objective of reducing health inequalities in our society. Due to the prevailing budgetary situation it is not possible to meet this commitment this year but we remain committed to the introduction of the necessary changes within the lifetime of this Government. Access to health services is more complex than medical card eligibility. The provision of improved services in the publicly funded health services is key to better access for people on low income.
Under the first phase of the acute bed capacity initiative, I have provided €118 million for an additional 709 beds, of which 584 have been commissioned to date in the first phase. Funding has been made available to health boards and authorities to commission the balance of the 709 beds this year, all of which are intended for use by public patients.
Significant progress has been achieved in reducing waiting times for adults and children. The number of adults waiting more than 12 months for in-patient treatment in the nine target surgical specialties has fallen by approximately 42% from 6,273 to 3,658 between September 2002 and September 2003. The number of children waiting more than six months for in-patient treatment in the nine target surgical specialities has decreased by 39%, from 1,201 to 734 in the same period. The national treatment purchase fund continues to target those adults and children waiting longest for treatment. The fund will facilitate, in most instances, adults waiting more than six months for an operation and children waiting more than three months. If patients are prepared to exercise choice by travelling to where there is capacity, they can be treated more quickly in many instances. By the end of March the fund had arranged treatment for approximately 12,107 patients. To give it a significant lead role in targeting waiting times for patients, I have increased the level of funding for the NTPF in 2004 bringing its overall allocation to €44 million.
Access to primary care services is of crucial concern to this Government as is evidenced by the publication of a separate strategy document, Primary Care: A New Direction. Primary care is the first port of call for most who use health services. It can meet 90-95% of all health and personal social service needs. It is a vital public service. The primary care strategy sets out a vision of the service we want to put in place building on our existing strengths, to develop a high-quality, user-friendly primary care service to meet people's needs in the future. However, change will not be effected overnight. The strategy sets out an implementation plan, which recognises the breadth of the change required to support the roll-out of the new primary care model over the next decade.
The primary care strategy acknowledged that the current health board structures are not optimised to support the development and reorganisation necessary to implement the new primary care model on a widespread basis. The new structures being developed under the health service reform programme will ensure that the system is organised and managed to support the development and implementation of the health strategy, including the primary care strategy. The targets to reduce health inequalities set out in the Government's review of the national anti-poverty strategy and which were developed in the course of an extensive consultation process have been integrated into the national health strategy. Key health targets are to reduce the gap in premature mortality and low birth weight between the highest and lowest socio-economic groups by 10% by 2007, and to reduce differences in life expectancy between Travellers and the rest of the population.
While access to health services is one of the factors that affect health status it is not the only one. The policies and activities of a wide range of areas effect health and health inequalities. This is why the first objective of national health strategy, under goal one, better health for everyone, is that "The health of the population is at the centre of public policy." To achieve this objective the Department of Health and Children is working with the Institute of Public Health to implement a programme of health impact assessment.
In the 2004 letters of determination, and in other correspondence, my Department has asked health agencies to prioritise actions to reduce health inequalities. Further, the chief executive officer of each health board was asked to prioritise its funding allocations in favour of the RAPID and CLÁR projects. The NAPS and health working group has been reconvened in a consultative capacity to monitor progress towards achievement of the targets. The social partners are represented on the working group.
Action 19 of the national health strategy is aimed at developing and expanding initiatives to eliminate barriers for disadvantaged groups to achieve healthier lifestyles. Health boards have established key partnerships with organisations in the community, both voluntary and statutory sectors, to try to eliminate such barriers and achieve healthier lifestyles. Implementation of the health promotion strategy, the Traveller health strategy, homelessness strategies and the national drugs strategy continues. Groupings targeted include low income groups, mother and toddlers groups, young lone parents, clients of mental health services, older people, people with disabilities, early school leavers and asylum seekers.
Action 52 of the national health strategy advocated community participation initiatives to enable people to have their say in health matters that concern them locally. Initiatives include: guidelines on a health service approach to community participation were produced by the Health Boards Executive in association with the Department in 2002; four boards have established regional advisory panels or consumer panels for older consumers and their carers, six boards have established consumer panels dealing with a range of service delivery issues; and the national consultative forum is convened annually to monitor progress in the implementation of the national health strategy and to comment on priorities and emerging trends. The forum is broad-based and includes patient and client groups, service providers, senior management in the health system, the voluntary sector, and organisations with an interest in the health system and relevant Departments.
Since 1997 funding for the health services has increased by 188.2% to over €10 billion in 2004 and hospital activity has increased by 28%. This, together with the actions outlined above, demonstrates my commitment to better access to publicly funded health care which particularly benefits those on low incomes.
Committee of Inquiry.
Breeda Moynihan-Cronin
Question:22 Ms B. Moynihan-Cronin asked the Minister for Health and Children the progress of the inquiry being held into the death of a person (details supplied) two weeks after undergoing an appendix operation at Cavan General Hospital and who subsequently went back to the casualty department suffering from stomach pains, but was sent home; when he expects to receive the final report; when the committee appointed to inquire into complaints made against two consultants at the hospital will report; and if he will make a statement on the matter. [10780/04]
Following the tragic death of the child concerned, the North Eastern Health Board established an expert group to undertake an urgent review of all factors involved. My Department is advised that the work of this group is ongoing and a report will issue to the North Eastern Health Board as soon as possible.
As the establishment of the committee of inquiry set up to examine matters of complaint against two consultants in Cavan General Hospital is the subject of judicial review proceedings before the High Court, the matter is sub judice. I am not, therefore, in a position to comment on the matter.
Accident and Emergency Services.
Gay Mitchell
Question:23 Mr. G. Mitchell asked the Minister for Health and Children the plans and programmes that he has in place to tackle the ongoing accident and emergency crisis in our hospitals; and if he will make a statement on the matter. [10855/04]
Bernard J. Durkan
Question:154 Mr. Durkan asked the Minister for Health and Children the reason for the continued overcrowding in hospitals with particular reference to accident and emergency congestion; his plans to resolve the issue; and if he will make a statement on the matter. [11074/04]
I propose to take Questions Nos. 23 and 154 together.
Several initiatives are under way to deal with pressures in emergency medicine departments: planning for the discharge of patients by acute hospitals and the liaison with the community services has been prioritised on an ongoing basis by the Eastern Regional Health Authority and the health boards. I have provided an additional €8.8 million to the EHRA and €3.8 million to the Southern Health Board to facilitate the discharge of patients from the acute system to a more appropriate setting thereby freeing up acute beds.
A report entitled Acute Hospital Bed Capacity — A National Review, carried out by my Department, identified a requirement for an additional 3,000 acute beds in acute hospitals by 2011 and this is reflected in the Government's health strategy, Quality and Fairness — A Health System for You. Some 584 of the 709 beds in the first phase have been commissioned to date. The ERHA continues to work closely with the major acute hospitals in Dublin with a view to reopening acute beds which were temporarily closed last year. As part of the winter initiative, an additional 20 emergency medicine consultants have been appointed from the 29 approved. Additional appointments are being progressed by the health boards and the ERHA and the number of emergency medicine consultants in the eastern region has increased from ten to 21 in the last five years. A review of the nurse staffing levels in emergency departments is also being progressed by the Health Services Employers Agency in consultation with the health service management representatives and the nursing unions. Emergency medicine departments may sometimes have to deal with injuries and conditions which are more appropriate to a primary care setting. General practitioner out-of-hours co-operatives have been established and are operating in at least part of all health board areas, with one, the North Eastern Health Board, having a region wide project. A total of €46.5 million has been allocated for the development of out-of-hours co-operatives between 1997 and 2003. I will continue to work with the various health agencies in looking for short and long-term solutions to the current difficulties.
Hospital Accommodation.
Paul Connaughton
Question:24 Mr. Connaughton asked the Minister for Health and Children the progress to date on his commitment to provide an additional 709 acute hospital beds to public patients; and if he will make a statement on the matter. [10846/04]
Liz McManus
Question:49 Ms McManus asked the Minister for Health and Children the number of new hospital beds provided to date in 2004 and the projected number that will be provided before the end of 2004; and if he will make a statement on the matter. [10797/04]
I propose to take Questions Nos. 24 and 49 together.
Under the first phase of the acute bed capacity initiative I have provided €118 million for an additional 709 beds 584 of which have been commissioned in the first phase. Funding has been made available to health boards and authorities to commission the balance of the 709 beds this year. Under the acute bed capacity initiative, I have also provided an additional €8.8 million to the Eastern Regional Health Authority and €3.8 million to the Southern Health Board to facilitate the discharge of patients from the acute system to a more appropriate setting thereby freeing up acute beds. It allows for funding, through the subvention system, of additional beds in the private nursing home sector and ongoing support in the community.
Health Board Services.
Arthur Morgan
Question:25 Mr. Morgan asked the Minister for Health and Children the funding available in each health board area in 2004 for cancer services; and if he will make a statement on the matter. [10911/04]
In 2004, the total additional accumulated funding for each health board since 1997 is:
|
Board/Authority |
2004 — Additional Accumulated Funding |
|
€m |
|
|
Eastern Regional Health Authority |
183 |
|
Midland Health Board |
27 |
|
Mid Western Health Board |
48 |
|
North Eastern Health Board |
28 |
|
North Western Health Board |
38 |
|
South Eastern Health Board |
42 |
|
Southern Health Board |
57 |
|
Western Health Board |
62 |
|
Total |
485 |
Cancer services throughout the country have benefited significantly from this investment of €485 million which far exceeds the £25 million requirement initially envisaged under the national cancer strategy. This investment has enabled the funding of 90 additional consultant posts, together with support staff in key areas such as medical oncology, radiology, palliative care, histopathology and haematology. A total of 245 additional cancer care nurse specialists, including breast care, palliative home care and oncology nurses, were appointed. The benefits of this investment are reflected in a significant increase in activity in all areas of cancer treatment. Approximately €95 million in capital funding has been allocated specifically for the development of cancer-related initiatives since 1997. These include an investment of €60 million in radiation oncology, €8.75 million in the bone marrow unit at St. James's Hospital and €11.9 million in BreastCheck.
The investment in radiotherapy will result in an increase of approximately 50% in linear accelerator capacity. It will also provide for the appointment of an additional five consultant radiation oncologists and will result in a significant increase in the number of patients receiving radiation oncology in the short term.
Medicinal Products.
Michael D. Higgins
Question:26 Mr. M. Higgins asked the Minister for Health and Children if his attention has been drawn to the results of recent research commissioned on behalf of the Irish Patients Association which shows that almost half of family doctors and two thirds of pharmacists are not informing patients of the potential side-effects of medicines; the steps he intends to take to ensure that patients are provided with full information about medicines they may be taking; and if he will make a statement on the matter. [10806/04]
As my Department has only recently received the research to which the Deputy refers, I am not yet in a position to comment on its conclusions. However, I understand that officials from my Department will be meeting representatives of the Irish Patients Association to discuss their concerns.
The relevant contractual obligations are: clause 9 of the community pharmacy contractor agreement between health boards and community pharmacists provides, in the state drug schemes, for a review by the pharmacist of a patient's medicine therapy. This review includes screening for potential drug therapy problems, therapeutic duplication, drug-drug interactions, incorrect drug dosage or duration of drug treatment, drug allergy interactions and clinical abuse or misuse, and advising patients on these and other issues, such as the importance of compliance and proper storage of medicines. Clause 11 of the general medical services contract between general practitioners and health boards requires the medical practitioner to accept clinical responsibility for, and to treat, people on his or her list who need medical treatment or, where appropriate, transfer them to appropriate consultant care and accept clinical responsibility for them on becoming aware of their discharge from consultant care. Clause 18 of the contract requires the medical practitioner to prescribe such drugs and medicines as he or she considers necessary for any person on his or her list, and to co-operate in the operation of the national drugs formulary issued by the Minister with the agreement of the Irish Medical Organisation.
Health Board Services.
Dan Neville
Question:27 Mr. Neville asked the Minister for Health and Children if his attention has been drawn to the number of cutbacks in home help services in many health boards across the country; and if he will make a statement on the matter. [10842/04]
The policy of the Department of Health and Children on services for older people is to maintain them in dignity and independence at home in accordance with their wishes, as expressed in many research studies; to restore to independence at home those older people who become ill or dependent; to encourage and support the care of older people in their own community by family, neighbours and voluntary bodies; and to provide a high quality of hospital and residential care for older people when they can no longer be maintained in dignity and independence at home. The role of the home help service is vital to this policy.
Following the publication, in 1998, of the report entitled The Future Organisation of the Home Help Service in Ireland by the National Council on Ageing and Older People, there has been a major step forward in the implementation of the home help scheme from 1999 onwards, in terms of the amount of service delivered and treatment of the home helps — the days when home helps worked for a pittance are long gone. Upwards of €50 million has been injected into the system to ensure that home helps receive a decent level of pay and other entitlements such as holidays and sick-leave. Considerable additional funding has been made available to the health boards to increase the level of home help service availability through the employment of more home helps, or by increasing the number of hours worked by existing home helps.
There are several reasons for an increased demand on the home help service, which include the demographic fact that approximately 6,000 people are coming into the over-65 bracket every year and also there is, proportionately, a bigger percentage increase in the more dependent over-80 category. These factors may necessitate some minor adjustments in the provision of the home help service. The health boards provide the home help service on the basis that the more vulnerable clients are given priority. The tables demonstrate the extent of the additional funding which has been applied to the home help service over the past three or four years and the resultant increase in the number of hours provided. While there are still gaps in the service there has been significant development in the service in recent years.
|
Health Board |
Home Help Budget |
||||
|
2000 |
2001 |
2002 |
2003 |
2004 |
|
|
€ |
€ |
€ |
€ |
€ |
|
|
ERHA |
14,854,841 |
22,304,785 |
21,673,347 |
21,650,641 |
26,846,000 |
|
NEHB |
3,943,666 |
7,940,449 |
8,788,108 |
9,290,000 |
9,301,469 |
|
NWHB |
3,297,528 |
6,883,268 |
7,987,268 |
8,347,268 |
10,654,000 |
|
MHB |
3,499,000 |
7,008,000 |
7,970,000 |
8,671,000 |
8,866,000 |
|
MWHB |
4,133,456 |
9,741,212 |
9,459,248 |
9,574,315 |
10,739,198 |
|
SEHB |
3,605,456 |
8,477,244 |
8,891,659 |
9,196,719 |
11,481,379 |
|
SHB |
12,300,000 |
27,900,000 |
28,000,000 |
31,300,000 |
32,000,000 |
|
WHB |
6,060,536 |
12,004,280 |
12,344,989 |
13,513,791 |
16,747,397 |
|
TOTAL |
51,694,483 |
102,259,238 |
€105,114,619 |
111,543,734 |
126,635,443 |
|
Health Board |
2001 |
2003 |
2004 |
|
ERHA (NAHB) |
Not available |
538,600 |
538,600 |
|
ERHA (SWAHB) |
Not available |
930,000 |
900,000 |
|
ERHA (ECAHB) |
282,642 |
313,793 |
313,793 |
|
NEHB |
783,078 |
732,183 |
815,000 |
|
NWHB |
606,300 |
676,034 |
676,034 |
|
MHB |
Not available |
516,716 |
516,716 |
|
MWHB |
610,189 |
696,935 |
696,935 |
|
SEHB |
650,555 |
878,694 |
878,694 |
|
SHB |
2,454,484 |
2,600,000 |
2,652,000 |
|
WHB |
824,409 |
945,944 |
975,611 |
|
TOTAL |
8,828,899 |
8,963,383 |
These figures show an increase in hours in 2004 as against 2003. This is in line with overall funding to this Department in 2004, on the basis of continuation of existing level of service. Since my appointment as Minister of State, I have encouraged the Eastern Regional Health Authority and the health boards to introduce personal care packages for older people as an alternative to long-stay residential care. Personal care packages are designed for the individual concerned and could possibly include the provision of a home help service, home subvention payments, arrangements for attendance at a day centre or day hospital and other services such as twilight nursing. Personal care packages allow older persons the option of remaining living in their own homes rather than going into long-stay residential care. Additional funding of €1.25 million was made available to the authority and health boards this year for the introduction of personal care packages. This is on top of the significant expenditure currently being incurred on home help and other services aimed at supporting people at home.
Hospital Accommodation.
Tom Hayes
Question:28 Mr. Hayes asked the Minister for Health and Children the progress on dealing with the problem of a shortage of long stay beds which is having a severe impact on hospital services across the State; and if he will make a statement on the matter. [10870/04]
Bernard J. Durkan
Question:150 Mr. Durkan asked the Minister for Health and Children if he will consider increasing the number of subvented or dedicated long stay beds with a view to alleviating acute bed pressure; and if he will make a statement on the matter. [11070/04]
I propose to take Questions Nos. 28 and 150 together.
There is a commitment in the national health strategy to provide 1,370 additional assessment and rehabilitation beds, plus 600 additional day hospital beds with facilities encompassing specialist areas such as falls, osteoporosis treatment, fracture prevention, Parkinson's disease, stroke prevention, heart failure and continence promotion clinics. In addition, the strategy proposed the provision of an extra 5,600 extended care and community nursing unit places over a seven year period which will include provision for people with dementia. Provision of these facilities was contingent on the provision of the necessary resources.
Public private partnerships are being piloted in the health sector. These are based on the concept that better value for money for the Exchequer may be achieved through the exploitation of private sector competencies to capture innovation and the allocation of risk to the party best able to manage it. Initially, the focus will be mainly on community nursing units for older people. It is anticipated that 17 new units will be created when the initial pilot programmes are complete, providing up to a maximum of 850 new beds in Dublin and Cork. The services offered in these units will include: assessment and rehabilitation; respite; extended care; convalescence and, if the PPP pilot demonstrates success, it is intended to use it as a means of providing additional community nursing units in other locations throughout the country.
Under the acute bed capacity initiative, I have provided additional funding of €8.8 million to the ERHA and €3.8 million to the Southern Health Board to facilitate the discharge of patients from the acute system to a more appropriate setting thereby freeing up acute beds. It allows for funding through the subvention system of additional beds in the private nursing home sector and ongoing support in the community. Already this funding has resulted in the discharge of over 240 patients from acute hospitals in the eastern region to various locations, most to private nursing homes. In the Cork area, the initiative has resulted in the discharge of 112 patients from acute hospitals to more appropriate settings. The ERHA and the Southern Health Board are monitoring the situation and working with hospitals, the area health boards and the private nursing home sector to ensure that every effort is made to minimise the number of delayed discharges in acute hospitals.
Hospital Services.
Seán Ryan
Question:29 Mr. S. Ryan asked the Minister for Health and Children when it is expected that the new five-storey facility at James Connolly Memorial Hospital, Blanchardstown, which cost more than €96 million to construct and equip, will be brought into service; the steps being taken to ensure that the facility is commissioned without further delay; and if he will make a statement on the matter. [10793/04]
Responsibility for the provision of services at James Connolly Memorial Hospital rests with the Eastern Regional Health Authority.
This major development is being jointly funded by the Northern Area Health Board, through the sale of surplus lands, and my Department. The full projected project cost is €101.4 million. This includes an amount of €5 million approved last year to facilitate refurbishment works at the hospital which are necessary as part of the transition process to the new hospital and to facilitate a land transfer in line with the project development arrangements.
My Department is advised that the first phase of the transition to the new development at James Connolly Memorial Hospital, Blanchardstown, has been completed. The coronary care and cardiac unit, the therapeutic psychiatry of old age unit, day hospital and the rheumatology service transferred to the new building in September 2003.
The further commissioning of this development is currently being examined by the ERHA and my Department.
General Medical Services Scheme.
Joe Sherlock
Question:30 Mr. Sherlock asked the Minister for Health and Children when he intends to publish the report commissioned from a company (details supplied) on the GMS, in view of the fact that it is over a year since a draft was submitted to him; if the report has been brought to Government; if it is intended to implement the recommendations of the report; and if he will make a statement on the matter. [10792/04]
The Deloitte & Touche consultancy review of governance and accountability mechanisms in the GMS schemes was received, in draft form, by my Department in February 2003. While the review was being considered by officials in my Department, both the Commission on Financial Management and Control Systems in the Health Service, Brennan, and the Audit of Structures and Functions in the Health System, Prospectus, reports were published. Since the contents and recommendations of both these reports are relevant to the subject matter of the GMS review, my Department requested Deloitte & Touche to update the draft in this light, and also having regard to the latest financial data from the general medical services, payments, board. The final draft of this review has been received by my Department. It is my intention to bring this review to Government as soon as possible, at which time its publication and implementation will be discussed.
Departmental Strategy.
Dan Boyle
Question:31 Mr. Boyle asked the Minister for Health and Children if he will consider launching an information campaign on the health effects of indoor pollution and the need for people to properly ventilate their homes; and if he will make a statement on the matter. [10816/04]
I have no plans at present to launch an information campaign on the health effects of indoor pollution and the need for people to properly ventilate their homes. Ventilation standards in houses are a matter for my colleague, the Minister for the Environment, Heritage and Local Government, who has general responsibility for the construction industry.
Health Board Services.
Róisín Shortall
Question:32 Ms Shortall asked the Minister for Health and Children if his attention has been drawn to the fact that persons attending the existing Ballymun health centre were turned away on health and safety grounds; the steps being taken to ensure that the Ballymun health centre will be brought into operation and made available to the people of the area, in view of the fact that it has remained unused, although completed, for a year at an estimated cost of €3.5 million; if he has received an application for funding to allow the centre to be fitted out; if he intends to make this money available; and if he will make a statement on the matter. [10794/04]
As outlined in my reply to a previous parliamentary question concerning this development, my Department is working with the Eastern Regional Health Authority and the Northern Area Health Board in an effort to resolve a range of issues relating to this project. The issues relate to matters such as the scope of the project, compliance with procurement procedures, securing value for money and the issue of funding for the project.
A new and revised proposal has very recently been submitted to my Department in this regard and this is currently under consideration.
Clinical Indemnity Scheme.
Mary Upton
Question:33 Dr. Upton asked the Minister for Health and Children the position regarding his discussions with the Irish Hospital Consultants’ Association regarding the proposed new system of medical insurance; and if he will make a statement on the matter. [10825/04]
Intensive efforts are continuing to resolve the issue of who should take responsibility for claims which result from events which occurred before the establishment of the clinical indemnity scheme. This issue is of the greatest concern to consultants arising from the introduction of the new indemnity arrangements. The Irish Hospital Consultants' Association and the Irish Medical Organisation are kept informed of progress on a regular basis.
Question No. 34 answered with QuestionNo. 10.
Prescribed Medication.
John Gormley
Question:35 Mr. Gormley asked the Minister for Health and Children the statistics available to his office on the amount of antidepressants prescribed to persons here by doctors; his views on whether too many antidepressants are being prescribed, as is the case in the UK; his plans to ensure that fewer antidepressants are prescribed; and if he will make a statement on the matter. [10813/04]
Prescriptions are issued by health professionals based on the symptoms of the presenting patient at the time of consultation. The level of medication prescribed, therefore, is a matter of clinical decision for the particular doctor involved. My Department has no role in the determination of appropriate medication protocols for patients with any condition.
Prescriptions for antidepressants may be issued by either general practitioners or consultants in a variety of locations, for example, general practice, community psychiatric facilities or private or public psychiatric hospitals. There is no formal national collection of data on the level, frequency or other details in connection with the prescribing of antidepressants. Accordingly, it is not possible to give the requested statistics to the Deputy.
An expert group on mental health policy was established in August 2003 to prepare a new national policy framework for the mental health services, updating the 1984 policy document, Planning for the Future. The group consists of 18 widely experienced people who are serving in their personal capacity. The membership encompasses a wide range of knowledge and a balance of views on many issues affecting the performance and delivery of care in our mental health services. All areas of mental health policy and service provision will be examined in the course of the group's work.
National Health Strategy.
Dan Neville
Question:36 Mr. Neville asked the Minister for Health and Children the progress on the primary care implementation projects; and if he will make a statement on the matter. [10841/04]
The strategy, Primary Care: A New Direction, provided for the early establishment of a number of primary care teams on the basis of the principal features of the integrated interdisciplinary model described in the strategy. One of the purposes of these projects was to allow the future more widespread implementation of the model to draw on experience gained and to be informed by the input of the relevant professional and user stakeholders to the development of the first teams. The strategy also committed to the refinement and development of the model by agreement through the joint learning that these initial implementation projects will allow for.
In October 2002 I gave approval to the establishment of ten primary care implementation projects, one in each health board area. These projects are building on the services and resources already in place in the locations involved so as to develop a primary care team in line with the interdisciplinary model described in the strategy. The spread of locations, ranging from the centre city urban areas to dispersed rural communities, has been chosen to reflect the variety of circumstances around the country in which primary care services must be delivered and to explore in a practical way how primary care teams will operate. Each location has its own intrinsic challenges and each primary care team will have to adapt to the needs of the area and community it serves.
The locations of the ten implementation projects are: Eastern Regional Health Authority; East Coast Area Health Board, Arklow, County Wicklow; Northern Area Health Board, Ballymun, Dublin city; South Western Area Health Board, Liberties, Dublin city; Midland Health Board, Portarlington, County Laois; Mid-Western Health Board, west County Limerick; North Eastern Health Board, Virginia, County Cavan; North Western Health Board; Lifford, County Donegal; South Eastern Health Board, Cashel, County Tipperary; Southern Health Board, west Kerry; and Western Health Board, Erris, County Mayo.
In 2002, initial revenue funding of €0.877 million was provided. In 2003, an additional €3.623 million in revenue funding was provided on an ongoing basis. This brought the total annual revenue funding to €4.5 million.
In 2004, I provided an additional €990,000 million to the health boards on an ongoing basis in respect of implementation of the primary care strategy and health boards may, if necessary, use this to meet any additional revenue costs associated with the primary care teams.
In 2002, I provided funding of €1 million to support information and communications technology developments for the implementation projects, and a total of €2 million to facilitate minor capital works. There has been substantial progress to date with the development of primary care teams in the chosen locations. However, it must be recognised that moving to the interdisciplinary model of service delivery poses a range of challenges for both the health professionals involved and for the health boards, who have the responsibility for leading the developments. The range of issues which must be worked through as part of the development process includes: developing the team and agreeing teamworking processes; enrolling clients with the team; managing direct patient access to team members; appointment of additional staff; ensuring that all team members are providing services to the same population; involving the community in the development process; addressing information and communications technology needs; all of these issues need to be addressed in detail and this process must involve those who will be working directly as members of the team. In several cases a number of the additional staff members required to enable the teams to deliver the full range of planned services have been appointed. Health boards must ensure that in appointing additional staff they do not exceed their authorised employment numbers and in a number of instances this has been cited as having delayed the putting in place of the full primary care team.
Projects are currently at different stages of development, with a number already providing new or enhanced primary care services to their target populations. Even at this early stage, some of the benefits which were anticipated for both service users and I understand providers are becoming evident in these cases, as new or improved primary care services are developed. Areas which are the focus of early efforts to provide new or enhanced services include physiotherapy, which has traditionally been provided as a hospital outpatient service, shared care arrangements with the general hospitals, and the development of social work services which will focus on general family support needs. I acknowledge the commitment of the front-line health professionals and the health board administrative staff involved, who have devoted considerable effort to the development of the teams to date.
The primary care strategy also indicated that a significant component of the development of primary care teams, in the short to medium term, would involve the reorientation of existing staff and resources. In 2003 my Department requested the health boards to examine how the existing primary-community care resources can best be reorganised so as to give effect to the application of the teamworking concept, as described in the strategy, on a wider basis and to map out the geographical areas to be served by primary care teams in the future. The health boards have also been asked to undertake a high-level needs assessment for primary care, which will help to inform this planning task.
The primary care strategy acknowledged that the current health board structures are not optimised to support the development and reorganisation necessary to implement the new primary care model on a widespread basis. The new structures being developed under the health service reform programme will ensure that the system is organised and managed so as to support the development and implementation of the health strategy, including the primary care strategy. The structures will be designed to achieve consistent and comprehensive implementation of national policy and to manage and drive the establishment of primary care teams and networks as the standard model of service delivery. The experience gained in the initial group of implementation projects will provide valuable learning which can inform the wider implementation which is to follow.
Health Service Reform.
Jack Wall
Question:37 Mr. Wall asked the Minister for Health and Children if his attention has been drawn to the serious concerns expressed regarding the lack of clarity from his Department in regard to roles and responsibilities of the new health service reform structures and the failure of the Government to establish a working group to consider the issue of public-private mix equity in regard to access; the steps he intends to take to deal with these concerns; and if he will make a statement on the matter. [10828/04]
The implementation of the health reform programme is currently under way. The current phase consists of four distinct but inter-related strands of activity which will take place under the reform programme during 2004. These strands are: the work of the interim health service executive, HSE, leading to the establishment and the orderly transfer of functions to the HSE; aspects of the reform programme for which the Department of Health and Children has lead responsibility; the work of the acute hospitals' review group chaired by Mr. David Hanly; and the ongoing management of the health system and internal preparations for the new organisation and governance arrangements being led by the chief executive officers of health boards and the Health Boards Executive.
A number of key bodies central to the reform programme with clearly defined roles and responsibilities are now in place. The Government has appointed a national steering committee charged with overseeing the implementation of the reform programme. Its role is to provide a co-ordinating forum for actions being led in the respective strands and will ensure overall consistency with the Government's decision. It is to report on a regular basis to the Cabinet committee on the health strategy, ensuring that the Government is kept fully informed on all important issues. The first meeting of the NSC took place on 16 February last.
I announced the establishment of the board of the interim HSE last November and the board has met on a number of occasions. The interim HSE is now established as a statutory body on foot of SI 90/04. Under the establishment order, the interim HSE has been given the task of drawing up a plan for the Minister's approval for: the establishment of a unified management structure for the proposed new Health Service Executive; the integration of the existing health board structures into the new Health Service Executive; the streamlining of other statutory bodies, identified in the Prospectus report, to be incorporated in the new structure; the establishment of regional boundaries for the delivery of primary, community and continuing care services; the establishment of procedures to develop a national service plan for the delivery of health services; the establishment of appropriate structures and procedures to ensure the proper governance and accountability arrangements for the proposed Health Service Executive; and the appointment of a chief executive officer.
The interim executive has also been given the task of making the necessary preparations to implement this plan, subject to ministerial approval, so as to ensure as smooth a transition as possible from the existing health board structure to the new Health Service Executive structure.
In the context of the national health strategy, the issue of the public-private mix and equity for public patients was given detailed consideration. The commitment to improve access to hospital services is being addressed through a series of integrated measures including: increased capacity for public patients — to date an additional 584 beds are in place; clarification in regard to the rules governing access to public beds; use of the national treatment purchase fund to reduce waiting times for public patients; and examination of the public-private issue in the context of a revised contract for consultants.
The appropriate public and private mix is a complex issue and one where my Department continues to monitor both the current mix and evaluate the relevant policy issues in this area.
Hospital Services.
Brendan Howlin
Question:38 Mr. Howlin asked the Minister for Health and Children if he will make a statement on the future role of Peamount Hospital, especially in regard to its role as the national referral centre for tuberculosis. [10809/04]
Bernard J. Durkan
Question:156 Mr. Durkan asked the Minister for Health and Children if he will defer the proposed closure of the tuberculosis unit at Peamount Hospital, Newcastle, County Dublin, with a view to providing continued service for patients as heretofore; and if he will make a statement on the matter. [11076/04]
Bernard J. Durkan
Question:157 Mr. Durkan asked the Minister for Health and Children if steps will be taken to ensure that management and the ERHA continue to provide respiratory and tuberculosis services at Peamount Hospital, Newcastle, County Dublin; and if he will make a statement on the matter. [11077/04]
Bernard J. Durkan
Question:158 Mr. Durkan asked the Minister for Health and Children the reason tuberculosis and respiratory services are being terminated at Peamount Hospital, Newcastle, County Dublin, when it is clear that the need for the services exist and that no alternative provision has been or is being made; and if he will make a statement on the matter. [11078/04]
I propose to take Question No. 38 and Questions Nos. 156 to 158, inclusive, together.
Responsibility for the provision of services at Peamount Hospital rests with the Eastern Regional Health Authority. The background to the future organisation and delivery of respiratory and tuberculosis services can be found in a report of a review carried out by Comhairle na n-Ospidéal, published in July 2000, on respiratory medicine.
This report found that, in line with major advances in medical treatment, the optimal in-patient care of patients with respiratory diseases, including tuberculosis, is more appropriate to local acute general hospitals, staffed by consultant respiratory physicians and other consultants and supported by an array of investigative facilities.
While recognising the valuable role which Peamount Hospital had played for many years in the delivery of respiratory services, Comhairle did not regard it as an appropriate location for the future treatment of TB patients, especially those requiring ventilation and specialised treatment for other symptoms, for example, heart disease, HIV etc. who may present with TB.
Comhairle subsequently appointed a committee to advise on the implementation of the 2000 report. The report of this committee endorsed the recommendations in the 2000 report and was adopted by Comhairle in April 2003. Specifically, the committee recommended that Peamount Hospital should play an active role in the provision of a range of non-acute support services, including pulmonary rehabilitation, within the South Western Area Health Board. For example, it recommends that patients who have been treated in the nearby St. James's Hospital and other major acute hospitals and who require ongoing rehabilitative care could be transferred to Peamount Hospital for completion of their care.
In addition to the Comhairle advice on this issue, the board of Peamount Hospital has developed a strategic plan for the development of services at the hospital. The hospital employed external support to assist them in this process and advise of developments in the wider health care environment. The strategy adopted by the board proposes considerable enhancement of existing services and development of new services in the areas of rehabilitation and continuing care of older people, persons with intellectual disabilities and adults with neurological or pulmonary illness. Central to the new strategy is Peamount's duty of care to patients and the hospital's commitment to providing the highest quality care to existing and future patients.
On 22 March 2004, two of the senior medical personnel at Peamount Hospital secured interim High Court orders restraining their removal from their positions. The interim injunctions were granted to the medical director and senior medical officer at the hospital. The matter arose by virtue of the termination by the hospital board of the medical director's post and revised arrangements for the senior medical officer's post arising from the new arrangements for the delivery of services at the hospital.
The hospital's admission policy in regard to admissions to its TB and non-TB respiratory units has been clarified following the granting of a further interim injunction by the High Court on 31 March 2004, which stated that admissions to Peamount Hospital require hospital management approval. I understand that a full hearing in the High Court is scheduled for 19 April 2004.
The admissions policy provides as follows: that all new referrals to the hospital must first have been assessed in an acute general hospital. The recent transfer of a patient with multi-drug resistant TB, MDRTB, to Peamount from the Mater Hospital where he had been stabilised is consistent with this approach; the transfer of patients from other hospitals to Peamount must be considered in the context of such patients being non-acute and on the basis of the transferring consultant being fully aware of the facilities and staff available at Peamount. This is in line with the recommendations of the Comhairle report in regard to the future organisation and delivery of respiratory and TB services. Peamount does not have a Comhairle-approved consultant respiratory physician on its medical staff; elective scheduled admissions will be postponed until after the 19 April 2004, the date set for the full High Court hearing, and re-scheduled after that date. Current patients with a diagnosis of malignancy will be admitted at the discretion of medical staff; and the outpatients department will continue to be maintained.
In light of this clarification of the hospital's admissions policy a consultative process has now been initiated by the ERHA with all referring hospitals and health boards to ensure that there is full awareness of Peamount Hospital's admissions policy. Within the functional area of the authority, hospitals are being asked to liaise with public health personnel regarding support requirements for patients with TB. The authority will also put in place contingency plans to manage patients locally.
Services in the hospital such as phlebotomy and X-ray will continue to be available to the local community and indeed much of the discussion to date has related to how Peamount can more effectively meet the primary care needs of the local population. After discussion with local GPs it is clear that key concerns have arisen in regard to the management of older people with chest infections and respiratory difficulties. The authority is in continuing discussion with Peamount in regard to how these services will be maintained. This approach will be supported by the appointment of a consultant geriatrician to Tallaght-Peamount hospitals, approved by Comhairle, with two sessions per week specifically committed to Peamount. A joint consultant post in rehabilitation medicine is also being established between the National Rehabilitation Hospital, NRH, and Peamount. Existing day and residential services for older people, people with intellectual and physical disabilities continue to be provided.
I am advised that the direction which Peamount is now taking will see it developing its overall role and its support for acute hospitals, general practitioners and the community of the surrounding area and is in line with its duty of care to patients and its commitment to the provision of the highest quality of care to existing and future patients.
Hospital Staff.
Bernard J. Durkan
Question:39 Mr. Durkan asked the Minister for Health and Children his plans to provide adequate staffing at all levels in hospitals and throughout the health service; and if he will make a statement on the matter. [10839/04]
Staffing requirements in the areas highlighted by the Deputy should be viewed in light of the substantial increases in employment levels achieved in the overall health service in recent years. The Deputy may wish to note that there has been an increase in the level of employment of 23,706, excluding home helps, in whole-time equivalence terms since 1999, or 32.6%. In this context, comparing employment levels at end-December 2003 to those at end-1999 shows that there were 26%, plus 1,407, more medical-dental personnel and 85%, plus 5,853, more health and social care professionals employed in the health services in whole-time equivalents, WTE, terms. In 1997 there were 25,233 whole-time equivalent nurses employed in the public health system. By the end of September 2003 this figure had reached 33,442. This is an increase of over 8,200 during the period or 32.5%. It is clear from these figures that the recruitment and retention measures I introduced are providing effective.
Developments such as pay increases, improvements in career structure and enhanced opportunities for professional and career development have all supported increased staffing levels for key health and social care professions. The implementation of the pay recommendations of the public service benchmarking body — subject to the successful ongoing completion of the performance verification process — is making a further important contribution to recruitment and improved retention. The continued implementation of the action plan for people management — a key action under the health strategy — has a crucial role in improving retention and reducing turnover of skilled staff.
The Deputy may wish to note that specific human resource initiatives in key areas will contribute significantly to meeting the workforce requirements of the health services. As far as medical personnel are concerned, the recently published report of the national task force on medical staffing details the number of consultants and non-consultant hospital doctors that will be required in the coming years to provide a high quality, consultant-provided service.
The promotional structure within nursing, including the introduction of a clinical career pathway, has been substantially improved on foot of the recommendations of the commission on nursing and the 1999 nurses' pay settlement. The National Council for the Professional Development of Nursing and Midwifery has been especially active in this area and, to date, 1,522 clinical nurse specialist and advanced nurse practitioner posts have been created.
Figures from An Bord Altranais for the same period indicate that there is a steady stream of new entrants into the profession, over and above those graduating from the Irish system, thus further increasing the potential recruitment pool. Since 1998, the total number of nurses newly registered by An Bord Altranais is 19,945. Of this number, 13,658 were overseas nurses.
According to the most recent survey of nursing vacancies by the Health Service Employers Agency, the number of nursing vacancies stood at 675 at the end of December 2003. This represents a 51% reduction in the number of vacancies reported at the end of September 2000.
The current nursing vacancy rate of 1.73% has been declining steadily in recent years, and could be considered to be a normal frictional rate, given that there will always be some level of movement due to resignations, retirements and nurses availing of opportunities to change employment and locations.
Significant progress has also been achieved in doubling the total number of professional therapy training places, that is, physiotherapy, occupational therapy and speech and language therapy, in line with the recommendations of the report, Current and Future Supply and Demand Conditions in the Labour Market for Certain Professional Therapists, commissioned by my Department from Peter Bacon and Associates and published in June 2001.
The Deputy may wish to note that responsibility for human resource planning rests with the chief executive officer, CEO, of each board. Each CEO in managing the workforce in his or her region is responsible for determining the appropriate staffing mix and the precise grades of staff to be employed in line with service plan priorities, subject to overall employment levels remaining within the approved regional employment ceiling.
Water Fluoridation.
Ciarán Cuffe
Question:40 Mr. Cuffe asked the Minister for Health and Children if the Government intends to carry out checks on fluoride levels in the blood of Irish persons; the reason this has not been done to date; and if he will make a statement on the matter. [10818/04]
As the Deputy is aware, I established the forum on fluoridation to review the fluoridation of public piped water supplies in Ireland. The forum's report was launched on 10 September 2002 and its main conclusion was that the fluoridation of public piped water supplies should continue as a public health measure.
The forum also concluded that: water fluoridation has been very effective in improving the oral health of the population, especially of children, but also of adults and the elderly; the best available and most reliable scientific evidence indicates that at the maximum permitted level of fluoride in drinking water at one part per million, human health is not adversely affected; and dental fluorosis, a form of discoloration of the tooth enamel, is a well-recognised condition and an indicator of overall fluoride absorption, whether from natural sources, fluoridated water or from the inappropriate use of fluoride toothpaste at a young age. There is evidence that the prevalence of dental fluorosis is increasing in Ireland.
In all, the report of the fluoridation forum made 33 recommendations covering a broad range of topics such as research, public awareness, and policy and technical aspects of fluoridation. The establishment of the expert body recommended by the forum is now well under way. I am pleased to announce that the chairperson of the expert body is Dr. Seamus O'Hickey, former chief dental officer with my Department. Dr. O'Hickey's mix of scientific knowledge, awareness of fluoridation issues and experience of administrative issues leave him well placed to chair the body. I understand that the intention is to have an inaugural meeting of the expert body at the end of this month.
The terms of reference of the expert body are: to oversee the implementation of the recommendations of the forum on fluoridation; to advise the Minister and evaluate ongoing research, including new emerging issues, on all aspects of fluoride and its delivery methods as an established health technology and as required; and to report to the Minister on matters of concern at his or her request or on own initiative.
The expert body is to have broad representation, including from the areas of dentistry, public health medicine, toxicology, engineering, management, environment and the public as identified within the forum on fluoridation report. Letters of invitation have been issued to prospective members of the body. I am pleased to say that the body will have a strong consumer input in terms of members of the public and representatives of consumer interests, in addition to the necessary scientific, managerial and public health inputs.
The secretariat of the body will be provided by the Dental Health Foundation, an independent charitable trust which has been very much to the fore in securing co-operation between private and public dentistry and the oral health care industry in regard to joint oral heath promotion initiatives. The foundation's stature and expertise place it in an excellent position to support the work of the forum in its initial stage. The forum's report envisages that the work of the expert body may be subsumed into the health information and quality authority, HIQA, in due course. The support of the foundation allows us to press ahead now with the establishment of the expert body in advance of the establishment of HIQA.
A research project on fluoride delivery systems, which includes an investigation into fluoride intake in the population, is currently being undertaken at the oral health services research centre, OHSRC, in University College Cork.
As part of this project, the OHSRC is developing methods to be used when measuring fluoride ingestion in the population. One of the areas of research being pursued is the development of standardised methods for measuring fluoride content of samples of saliva, urine, serum, fingernail clippings and mineralised tissues. These studies are being undertaken in close collaboration with researchers in Europe and the US in order to make sure that the methods being used conform to international standards. The final outcomes of this project, and all ongoing research related to fluoride, will be evaluated by the expert body.
Proposed Legislation.
Eamon Gilmore
Question:41 Mr. Gilmore asked the Minister for Health and Children if he has plans to introduce measures to control and regulate medical procedures offered for cosmetic purposes, such as the use of medical lasers; and if he will make a statement on the matter. [10807/04]
As the Deputy will be aware, the Medical Council is the statutory body established to provide for the registration and control of persons engaged in the practice of medicine under the Medical Practitioners Act 1978.
Section 69 (2) of the Medical Practitioners Act 1978, states: "It shall be a function of the Council to give guidance to the medical profession generally on all matters relating to ethical conduct and behaviour."
I am informed by the Medical Council of its view that doctors have been given the privilege of regulating their own professional affairs through the Medical Council and subject to the council's ongoing ethical guidance. Independent clinical decision making by doctors on behalf of their patients is a key part of how medicine operates in Ireland and the Medical Council has no wish to interfere with its effectiveness. The Medical Council's ethical guidelines are a set of ethical principles for medical practice which doctors must apply in each unique clinical situation in which they work, together with their judgement, experience, knowledge and skills. It is the statutory duty of the council to consider all complaints in the event of any alleged lapses from such standards.
Doctors practising medicine should be registered with the Medical Council. People who avail of health services, whether cosmetic or otherwise, should endeavour to seek the services of reputable institutions. In that regard, medical lasers in use in this country must comply with the EU Medical Devices Directive 1993/42 and Statutory Instrument 252 of 1994 — European Communities (Medical Devices) Regulations. Medical lasers are CE marked in accordance with the directive.
As the Deputy will be aware, my Department is currently carrying out a comprehensive review of the Medical Practitioners Act 1978. It is my intention that heads of a Bill for an amendment to the 1978 Act, which are at an advanced stage, will be put before Cabinet in the very near future. As part of this review process, consultations have been carried out with a number of bodies, including patient groups, medical representative organisations, and the key stakeholders in health service provision, regulation and post-graduate medical education and training. Some of the main issues which have been considered are greater public interest representation on the Medical Council, measures to improve the public accountability and transparency of the council, improved efficiencies in the fitness to practise procedures and measures to ensure the ongoing competence of all doctors to engage in their profession and the procedures they undertake.
Hospital Services.
Liam Twomey
Question:42 Dr. Twomey asked the Minister for Health and Children if he has had discussions on the radical reorganisation of the major acute hospitals in the Dublin region; his views on transferring tertiary services to one major site which would only do elective work; if one or more of the five major Dublin hospitals will be designated a major acute accident and emergency referral hospital which will only deal with emergencies and not deal with elective work; if there are plans to designate one or more of these five major hospitals a general hospital as defined by the Hanly report which will only do elective work; and if he will make a statement on the matter. [10699/04]
While no discussions have taken place to date regarding the matters referred to by the Deputy, these and other issues may be considered by the acute hospitals review group as part of its work. At present I have no plans to designate any hospitals as general hospitals nor to reconfigure acute hospital services so that any one of the hospitals referred to by the Deputy delivers only elective work. However, the acute hospitals review group may wish to consider these and other issues.
As the Deputy will be aware, I announced the composition of the acute hospitals review group at the end of January. The group contains a wide range of expertise from the areas of medicine, nursing, health and social care professions and management. It also includes an expert in spatial planning and representation of the public interest.
It has been asked to prepare a plan for the interim health services executive for the reorganisation of acute hospital services, taking account of the recommendations of the national task force on medical staffing including spatial, demographic and geographic factors. During its consultation process, the group will meet with hospital, health agency and health board staff as required.
To date, the acute hospitals review group has not met because of the continued industrial action on the part of the Irish Hospital Consultants' Association. I hope that all parties return to the table to progress the work of this group as soon as possible.
Pharmacy Regulations.
Brian O'Shea
Question:43 Mr. O’Shea asked the Minister for Health and Children the position regarding his consideration of the report of the pharmacy review group; and if he will make a statement on the matter. [10782/04]
Cecilia Keaveney
Question:145 Cecilia Keaveney asked the Minister for Health and Children his views on the position on the pharmacy review (details supplied); and if he will make a statement on the matter. [11050/04]
I propose to take Questions Nos. 43 and 145 together.
I established the pharmacy review group in November 2001 to examine the pharmacy issues raised in the OECD report on regulatory reform in Ireland. The group submitted its report on 31 January 2003. I am continuing to examine the complex legal and public health issues in the group's recommendations. The Deputy will appreciate that it would not be appropriate for me to comment on the report's recommendations before completion of this examination. The report is available on my Department's website, www.doh.ie, along with reports prepared for the group by Indecon International Economic Consultants.
Hospital Waiting Lists.
Pat Breen
Question:44 Mr. P. Breen asked the Minister for Health and Children the efforts he has made to reduce hospital waiting lists; and if he will make a statement on the matter. [10859/04]
Ruairí Quinn
Question:48 Mr. Quinn asked the Minister for Health and Children when he expects that the next hospital waiting list figures will be published; the steps he intends to take to reduce the numbers on the lists and the waiting periods; and if he will make a statement on the matter. [10790/04]
I propose to take Questions Nos. 44 and 48 together.
My Department collates and publishes acute hospital waiting list data which is submitted by health agencies in respect of the position as at 31 March, 30 June, 30 September and 31 December each year. Figures in respect of the position as at 31 December 2003 are being collated at present.
Significant progress has been achieved in reducing waiting times for adults and children. The number of adults waiting more than 12 months for in-patient treatment in the nine target surgical specialties has fallen by approximately 42% from 6,273 to 3,658 between September 2002 and September 2003. The number of children waiting more than six months for in-patient treatment in the nine target surgical specialties has decreased by 39%, from 1,201 to 734 in the same period.
The national treatment purchase fund, NTPF, is continuing to target those adults and children waiting longest for treatment. It is now the case that, in most instances, adults waiting more than six months for an operation and children waiting more than three months will be facilitated by the fund. In many instances, if patients are prepared to exercise choice by travelling to where there is capacity, they can be treated more quickly. To date, the fund has arranged treatment for approximately 12,000 patients.
I decided to give a significant lead role to the NTPF in targeting waiting times for patients. In this regard I provided an increase in the level of funding for the NTPF in 2004 bringing its overall allocation to €44 million.
Health Promotion.
John Gormley
Question:45 Mr. Gormley asked the Minister for Health and Children if the Government has managed to increase breastfeeding rates in the past two years; the strategy he has to increase the number of women who breastfeed; and if he will make a statement on the matter. [10814/04]
The health promotion unit of my Department published the interim report of the National Committee on Breastfeeding in May 2003. The committee, established in 2002, was charged with reviewing the 1994 national breastfeeding policy and providing recommendations on what further action is required at national, regional and local level to improve and sustain breastfeeding rates. The interim report cites that there are difficulties in accurately identifying the numbers of women who breastfeed, as currently the only national source for this data is the national perinatal reporting system, of which the most recent figures available date from 1999. The committee also identifies the need for accurate reporting of not just initiation rates but also, given the health benefits involved, duration rates. The national performance indicators project team is, at present, working towards the development of a composite set of indicators to capture this data.
The interim report was presented to me in mid-2003 and has paved the way for the development of a strategic action framework for breastfeeding. A wide range of proposals for future actions and initiatives have been put forward by the organisations and individuals who responded to the committee's call for public submissions and these will inform the development of the strategic plan. The goal for this framework is to create a truly supportive breastfeeding culture in Ireland. I do, however, recognise that for this to happen support needs to come from all sectors of Government and all areas of public life. It is envisaged that the framework for action will be completed by late 2004.
Hospital Staff.
Caoimhghín Ó Caoláin
Question:46 Caoimhghín Ó Caoláin asked the Minister for Health and Children the programme of action proposed by his Department to ensure that the target set by Comhairle na n-Ospidéal of one consultant dermatologist per 100,000 of population will be reached; when it is proposed to appoint and the places at which it is proposed to locate the additional 19 consultant dermatologists required to meet this target; and if he will make a statement on the matter. [10909/04]
The November 2003 Comhairle na n-Ospidéal report of the committee on dermatology services recommends an increase in the total number of consultant dermatologists from 19 to 38. This would represent a ratio of one consultant per 100,000 population.
The additional funding requirements arising from the Comhairle recommendations will be progressed in the context of the Estimates process and having regard to other competing needs.
Mental Health Services.
Brendan Howlin
Question:47 Mr. Howlin asked the Minister for Health and Children if his attention has been drawn to the concerns expressed by a person (details supplied) regarding the high level of compulsory committals to mental hospitals, which now amounts to more than 3,000 per year; if he has plans to review procedures for committals; and if he will make a statement on the matter. [10810/04]
I share the concern expressed by the chairperson of the Mental Health Commission, Dr. John Owens, and others about the high level of involuntary admissions in our mental health services. Ireland has a significantly higher rate of involuntary admission than other European countries. Approximately 11%, 2,723, of all admissions to psychiatric hospitals and units in 2002 were involuntary admissions. However, it is anticipated that the full implementation of the Mental Health Act 2001 with its more stringent procedures for involuntary detention, will significantly reduce the number of involuntary admissions, bringing practice in this country more into line with the rest of Europe.
The Mental Health Act 2001 was enacted in July 2001 and will significantly improve safeguards for mentally disordered persons who are involuntarily admitted for psychiatric care and treatment. The Act will bring Irish law in this area into conformity with the European Convention for the Protection of Human Rights and Fundamental Freedoms.
Part 2 of the Act provides that mental health tribunals, operating under the aegis of the Mental Health Commission, will conduct a review of each decision by a consultant psychiatrist to detain a patient on an involuntary basis or to extend the duration of such detentions. The review will be independent, automatic and must be completed within 21 days. As part of the review process the mental health tribunal will arrange, on behalf of the detained person, for an independent assessment by a consultant psychiatrist. The Mental Health Commission will also operate a scheme to provide legal aid to patients whose detention is being reviewed by a tribunal.
In its recently published strategic plan for 2004-06 the Mental Health Commission has set itself a target for the establishment of the independent review process, mental health tribunals, in 2004.
Question No. 48 answered with QuestionNo. 44.
Question No. 49 answered with QuestionNo. 24.
Consultancy Contracts.
Jan O'Sullivan
Question:50 Ms O’Sullivan asked the Minister for Health and Children if consultants have been appointed to run a public relations and information campaign in connection with the Hanly report; the company appointed; the total value of the contract; and if he will make a statement on the matter. [10787/04]
My Department has arranged for a public relations and information campaign relating to the report of the national task force on medical staffing.
In line with EU procurement guidelines, the campaign was the subject of a formal tendering process. Following evaluation of expressions of interest and tender proposals, the contract has recently been awarded to Murray Consultants. The contract price is €145,200 inclusive of all statutory charges, fees and taxes including VAT.
Cancer Care Services.
Bernard J. Durkan
Question:51 Mr. Durkan asked the Minister for Health and Children the extent to which patients suffering from various forms of cancer can obtain treatment within their own region; and if he will make a statement on the matter. [10840/04]
The Government's objective is to provide a model of cancer care which ensures that patients with cancer receive the most appropriate and best quality of care regardless of their place of residence.
Since 1997, there has been a total cumulative investment of €550 million in the development of appropriate treatment and care services for people with cancer. This includes the sum of €15 million which was provided this year to ensure that we continue to address the demands in cancer services is such areas as oncology/haematology services, oncology drug treatments, symptomatic breast disease services and to support the implementation of the report on the development of radiation oncology services in the Southern and Western Health Board regions.
Cancer services throughout the country have benefited significantly from this investment which far exceeds the £25 million requirement which was initially envisaged under the national cancer strategy. This investment has enabled the funding of 90 additional consultant posts, together with support staff in key areas such as medical oncology, radiology, palliative care, histopathology and haematology.
Since 1997, approximately €95 million in capital funding has been allocated specifically for the development of cancer related initiatives. These include an investment of €60 million in radiation oncology, €8.75 million in the bone marrow unit at St. James Hospital and €11.9 million in BreastCheck.
My plan for the development of radiotherapy services is that the supra-regional centres in Dublin, Cork and Galway will provide comprehensive radiation oncology services to patients regardless of their place of residence. Specifically, these supra-regional centres will provide significant sessional commitments to patients in the mid-west, north-west and south-east. The current developments in the southern and western regions will result in the provision of an additional five linear accelerators. This represents an increase of approximately 50% in linear accelerator capacity. We will also provide for the appointment of an additional five consultant radiation oncologists. We currently have ten consultant radiation oncologists nationally. This will result in a significant increase in the numbers of patients receiving radiation oncology in the short term. These appointments are specifically designed to offer patients in areas such as the North West, Mid-West and south-east equity of access to radiation oncology services that are in line with best international practice. As regards symptomatic breast cancer services, the report on the development of services for symptomatic breast disease, recommended the development of specialist units throughout the country. Five of these units are now operational and a further eight are at various stages of development. Last year, I also announced the extension of the national breast screening programme to counties Carlow, Kilkenny and Wexford and also the national roll-out of the programme to the southern and western counties.
Hospital Waiting Lists.
Seán Ryan
Question:52 Mr. S. Ryan asked the Minister for Health and Children if he will report on the waiting lists for public nursing home beds in view of the fact that it is alleged that in the Dublin area there is a waiting list of up to 12.5 years; if, in view of this situation, he will consider availing of the country’s vacant beds in private nursing homes; and if he will make a statement on the matter. [10829/04]
As the Deputy is aware, the administration of health services, including the placement of people into long-term care is, in the first instance, a matter for the Eastern Regional Health Authority and the health boards. I am aware that the Dublin acute teaching hospitals, DATHs, have been encountering problems with delayed discharges of patients whose acute phase of treatment has been completed and who require to be discharged to more appropriate facilities. The Deputy may be interested to know that I have been meeting on a regular basis with administrative and medical representatives of the ERHA, the area boards and the DATHs and that the most recent meeting took place yesterday at which I was advised by the authority that they have commenced a programme to re-open public extended care beds. I am, therefore, fully cognisant of the issues involved.
I understand that the ERHA has been making strenuous efforts to recruit staff in recent months and that these efforts are now starting to show results. In addition, additional funding of €8.8 million has been provided to the ERHA this year to facilitate the discharge of patients from the acute system to a more appropriate setting thereby freeing up acute beds. It allows for funding through the subvention system of additional beds in the private nursing home sector and ongoing support in the community. Already, this funding has resulted in the discharge of over 240 patients from acute hospitals in the eastern region to various locations, the vast majority to private nursing homes. The ERHA is actively monitoring the situation and working with hospitals, the area health boards and the private nursing home sector to ensure that every effort is made to minimise the number of delayed discharges in acute hospitals. I will continue to monitor the situation to ensure that, to the greatest extent possible, problems encountered by older people in the greater Dublin area in assessing services appropriate to their needs are minimised.
Thomas P. Broughan
Question:53 Mr. Broughan asked the Minister for Health and Children if, in view of the interview given by the Taoiseach on RTÉ on 7 March 2004, in which he confirmed that the commitment given on 6 May 2002 that hospital waiting lists would be cleared within two years will not be met, it is still the Government’s objective that hospital waiting lists should be cleared; if he intends to set new deadlines for such an objective; and if he will make a statement on the matter. [10800/04]
As the Deputy will be aware, there are two streams to hospital activity, emergency and elective activity. Pressures on the hospital system due to identified capacity constraints hinder its ability to provide elective activity in a planned way because of the urgent and unpredictable needs of emergency patients. Patients who require elective treatment may have to wait because beds, staff and operating theatres are being used to treat emergency cases. The balance to be achieved is to ensure that the available resources are used efficiently and that treatment can be delivered to patients in a reasonable time.
Due to the nature of any health care system not all treatments can be made available to patients immediately. Hospital facilities must be used to best effect and it is sometimes necessary to place patients for non-urgent treatments on a waiting list. Therefore, the significant issue from the patients perspective is the length of time spent waiting for treatment and as such my Department's objective is to reduce waiting times significantly in the short term with particular focus on those waiting longest for treatment.
This Government has maintained a particular focus on those waiting longest for hospital treatment. The establishment of the national treatment purchase fund has resulted in more active management of long waiting lists at a local level. To date, the fund has arranged treatment for approximately 12,000 patients and has sourced further capacity for procedures in orthopaedics, ophthalmology, ENT, gynaecology, plastic surgery and urology. It is now the case that, in most instances, adults waiting more than six months for an operation and children waiting more than three months will be facilitated by the fund. If patients are prepared to exercise choice by travelling to where there is capacity, they can be treated a lot quicker in many instances. As the NTPF has the available capacity, and the fact that patients or their GPs can contact the NTPF directly to arrange treatment, the majority of patients do not need to wait more than six months for treatment.
While the rate of progress in achieving the targets set out in the health strategy has been slower than anticipated, significant progress has been achieved to date. The overall target of no patient waiting more than three months for treatment still remains a goal to be achieved.
Health Board Services.
Jim O'Keeffe
Question:54 Mr. J. O’Keeffe asked the Minister for Health and Children the reason modern digital hearing aids are not supplied to the hard of hearing through the health service; the average length of time a person has to wait before the supply of a hearing aid; and the number on the waiting lists. [10666/04]
The provision of community audiology services is a matter for the health boards/authority in the first instance.
The Eastern Regional Health Authority, ERHA, conducted a pilot project to evaluate the appropriateness of introducing digital and digitally programmable hearing aids into the community audiology service. The project commenced in 2001 and a final report was produced last year. Staff training was provided as part of the pilot project; digital and digitally programmable hearing aids were then issued to a selected number of cases with hearing loss.
The report concluded that in order to introduce digital and digitally programmable hearing aids into the community audiology service a number of factors would need to be considered. All staff presently engaged in hearing aid fitting would need training and updating in order to use the new technology. Appropriate technology would need to be provided to staff in order to carry out the correct programming of hearing aids. In addition, if new technology is introduced the hearing aid fitting appointments would need to be made more prolonged than at present leading to longer waiting times. These issues, along with the question of costs, are currently being examined by the authority.
Finally, the management of waiting lists for community audiology services is the responsibility of the chief executive officers of the health boards/authority. As waiting list data for all health boards is collected by the ERHA, my Department has asked the regional chief executive of the authority to provide the Deputy with the information in relation to waiting lists as requested.
Caoimhghín Ó Caoláin
Question:55 Caoimhghín Ó Caoláin asked the Minister for Health and Children the way in which it is proposed to continue and to further develop Co-operation and Working Together after the end of 2004 in the context of the new health services structures including the close of co-operation between the North Eastern and North Western Health Boards and the health services in the Six Counties; and if he will make a statement on the matter. [10910/04]
The Secretary General of my Department met with officials from co-operation and working together, CAWT, regarding the health reform programme during phase I last November. In addition, the chief executive officer of the health boards' executive met with CAWT on 27 February last where it was agreed that discussions would take place at an appropriate time on how best to continue the high level of existing co-operation in the new structures.
Both sides are very keen to continue these close contacts and will be working together with my Department and the new structures to further the links developed to date.
Cancer Screening Programme.
Jack Wall
Question:56 Mr. Wall asked the Minister for Health and Children his views on the proposal lodged with his Department in June 2003 by BreastCheck to extend its services nationwide; the likely completion date for the roll out of BreastCheck. [10827/04]
The national breast screening programme commenced in March 2000 with phase one of the programme covering the Eastern Regional Health Authority, Midland Health Board and the North Eastern Health Board region. Last year, I announced the extension of the BreastCheck programme to Counties Carlow, Kilkenny and Wexford and also the national-roll out to the southern and western counties. The national roll-out of BreastCheck requires detailed planning to include essential infrastructure.
The BreastCheck clinical unit in the western area will be at University College Hospital, Galway, with two associated mobile units. The area of coverage is counties Galway, Sligo, Roscommon, Donegal, Mayo, Leitrim, Clare and Tipperary North Riding. The BreastCheck clinical unit in the southern area will be located at South Infirmary/Victoria Hospital, with three associated mobile units. Counties covered include Cork, Kerry, Limerick, Waterford and Tipperary South Riding.
Two project teams, one in each region, have been established to develop briefs for the capital infrastructure needed for the static units in the south and west. Regarding the southern region, the south infirmary considered it necessary to commission a site strategy study to ensure the integration of the breast screening service into the present and future development of the hospital. My Department made available a capital grant of €230,000 for the study to be undertaken by professional architectural, engineering and quantity surveying experts. This study is now complete and was submitted to my Department at the end of March. It is being examined at present. As regards the west, BreastCheck submitted a number of options for the construction of a static unit on the grounds of University College Hospital, Galway. This is being considered by my Department in the context of the framework for capital investment 2004-08.
An essential element of the roll out of the programme is investment in education and training of radiographers. BreastCheck employs qualified and experienced radiographers who have specialised postgraduate training and qualifications related to mammography. BreastCheck and the symptomatic breast cancer services combined have a significant ongoing recruitment and training requirement in this area. I have announced the development of a training centre for radiographers and mammography at Eccles Street. Resources are being made available to BreastCheck to support this initiative which will cost in excess of €750,000 and is expected to be completed in the second half of 2004.
Animal Welfare.
Trevor Sargent
Question:57 Mr. Sargent asked the Minister for Health and Children the extent of licences which exist for laboratories which use live animals in tests and experiments; and if he will review these licences in the context of developments in the testing of drugs and other products which no longer require the use of live animals and of reports that a company (details supplied) in Glenamoy, County Mayo, may look to expand. [9201/04]
The use of live animals in scientific research and other experimental activity is strictly controlled in accordance with the provisions of the Cruelty to Animals Act 1876 as amended by the European Communities (Amendment of Cruelty to Animals Act, 1876) Regulations 2002.
Under the Act, any establishment where animals are used for experiments must be registered with the "Authority", i.e. the Minister for Health and Children, as a "user establishment". There are currently 59 registered user establishments. The legislation provides that an experiment shall not be performed on an animal if another scientifically satisfactory method of obtaining the result sought, not entailing the use of an animal, is reasonably and practicably available.
An experiment may only be performed by a person who holds a valid licence, granted by the authority, authorising that person to perform a specified experiment on an animal of specified description. Each application for a licence must be signed by two statutory signatories, as specified in section 11 of the Act, certifying that the use of animals is essential since no alternative scientific method is reasonably and practicably available.
The European Commission established the European Centre for the Validation of Alternative Methods, ECVAM, to promote the scientific and regulatory acceptance of alternative methods which are of importance to the bio-sciences and which reduce, refine or replace the use of laboratory animals. Ireland supports the work of ECVAM and is represented on its scientific advisory committee. My Department has no information regarding reports that the company referred to by the Deputy may expand.
Health Action Plan.
Eamon Ryan
Question:58 Mr. Eamon Ryan asked the Minister for Health and Children the level of remuneration for those on the task force for obesity; the frequency with which the task force meets; when he expects its first report; and if he will make a statement on the matter. [10822/04]
The National Taskforce on Obesity was launched on 10 March 2004, the members of the taskforce do not receive any remuneration, the meetings are currently held every three weeks and an obesity strategy document is expected by December 2004.
Health Service Reform.
Jan O'Sullivan
Question:59 Ms O’Sullivan asked the Minister for Health and Children the progress made to date with regard to implementation of the Prospectus report on health structures; when he expects to introduce legislation to provide for the establishment of the four new regional health authorities; the provision there will be for democratic accountability in regard to these new authorities; when he expects that the new authorities will be operational; the plans he has for appointments to health boards in the period between the local elections in June 2004 and the establishment of the new authorities; and if he will make a statement on the matter. [10786/04]
Brian O'Shea
Question:76 Mr. O’Shea asked the Minister for Health and Children the progress made to date with regard to the implementation of the recommendations of the Brennan report; and if he will make a statement on the matter. [10784/04]
I propose to take Questions Nos. 59 and 76 together.
The implementation of the health reform programme, which includes both the Prospectus and Brennan reports, is currently under way. The current phase of implementation consists of four distinct but inter-related strands of activity which will take place during 2004. These strands are: the work of the interim health service executive, HSE, leading to the establishment and the orderly transfer of functions to the HSE; aspects of the reform programme for which the Department of Health and Children has lead responsibility, including legislation, the establishment of HIQA, governance, streamlining of agencies, HR/IR, financial management/service planning, etc.; the work of the acute hospitals' review group chaired by Mr. David Hanly; and the ongoing management of the health system and internal preparations for the new organisation and governance arrangements being led by the chief executive officers of health boards and the health boards executive.
A number of key bodies central to the reform programme are now in place. The national steering committee, NSC, charged with overseeing the implementation of the work programme of the four strands has been established. It provides a co-ordinating forum for actions being led in the respective strands and will ensure overall consistency with the Government's decision. It is to report on a regular basis to the Cabinet committee on the health strategy, ensuring that the Government is kept fully informed on all important issues. The first meeting of the NSC took place on 16 February.
I announced the establishment of the board of the interim HSE last November and the board has met on a number of occasions. The interim HSE is now established as a statutory body on foot of S.I. 90/04. Under the establishment order, the interim HSE has been given the task of drawing up a plan for the Minister's approval for: the establishment of a unified management structure for the proposed new health service executive; the integration of the existing health board structures into the new health service executive; the streamlining of other statutory bodies, identified in the Prospectus report, to be incorporated in the new structure; the establishment of regional boundaries for the delivery of primary, community and continuing care services; the establishment of procedures to develop a national service plan for the delivery of health services; the establishment of appropriate structures and procedures to ensure the proper governance and accountability arrangements for the proposed health service executive; and the appointment of a chief executive officer.
The interim executive has also been given the task of making the necessary preparations to implement this plan, subject to ministerial approval, so as to ensure as smooth a transition as possible from the existing health board structure to the new health service executive structure.
The Deputy should note that there will not in fact be four regional health boards. Instead, there will be a single unitary structure, the HSE, which will be supported by three pillars, one of which will manage the delivery of primary, community and continuing care services. This pillar will be organised through four regions for administrative purposes. I have already clarified this in the House. Regional health authorities, as referred to in the question, will not be part of the new structure.
There is a need to strengthen existing arrangements in relation to consumer panels and regional co-ordinating/advisory committees in representing the voice of service users. These structures incorporate patients, clients and other users, or their advocates. They will work to provide a bottom-up approach to understanding the needs of service users at a regional planning level. These existing models are at different stages of development and will continue to be enhanced. These mechanisms will serve to bring the patients/clients' views and inputs to bear in the decision making process.
I am conscious of the concerns to ensure that there is adequate governance of the new structures in a radically restructured health system. I have agreed to bring more detailed proposals to Government on the representation arrangements shortly. I am satisfied that the new arrangements, combined with the introduction of system-wide best practice governance and accountability systems, will ensure a stronger more effective health system and an improved health service for patients and clients.
Last week, I referred to the Health (Amendment) Bill 2004 in the House which I expect to be in a position to publish shortly. I also referred to my plans for legislation to establish the HSE to replace the Eastern Regional Health Authority and the health boards and it is my intention is to have this legislation introduced by December 2004 so as to have the HSE in place in January 2005.
Pat Rabbitte
Question:60 Mr. Rabbitte asked the Minister for Health and Children the progress made to date with regard to implementation of the recommendations of the Hanly report; and if he will make a statement on the matter. [10785/04]
The key elements of current implementation of the report of the national task force on medical staffing — the Hanly report — are as follows: negotiations with the Irish Medical Organisation in relation to the reduction of NCHD hours are continuing in the Labour Relations Commission. A number of further meetings have been scheduled over the coming weeks and every effort will be made to complete these negotiations at the earliest possible date.
In recent weeks, a national co-ordinator and support team have been seconded to oversee the implementation process in the health agencies. Medical manpower managers are also playing a central role. A working group in each hospital is needed to implement these measures and to monitor progress in relation to the reduction in NCHD hours. The urgent need to establish these groups at both national and local level has been discussed with the Irish Medical Organisation. To date, the IMO has not agreed to the establishment or operation of these groups.
In relation to the consultant contract, a number of meetings have taken place between officials from my department, health service employers and representatives of the Irish Hospital Consultants Association and the Irish Medical Organisation. I anticipate that talks will resume when the Irish Hospital Consultants Association suspends phase 1 of its program of industrial action.
I announced the establishment of implementation groups for the Hanly report in both the east coast and mid-western regions on 27 February 2004. The groups will carry out the detailed work on identifying what services should be provided in each hospital, in line with the Hanly recommendations. I announced the composition of a group to prepare a national plan for acute hospital services on 27 January 2004. The group contains a wide range of expertise from the areas of medicine, nursing, health and social care professions and management. It also includes an expert in spatial planning and representation of the public interest.
The group has been asked to prepare a plan for the interim health services executive for the reorganisation of acute hospital services, taking account of the recommendations of the national task force on medical staffing including spatial, demographic and geographic factors. Neither the local implementation groups nor the acute hospitals review group has met as a result of the consultants' continuing industrial action. I ask that all parties return to the table to progress the work of these groups.
As regards medical education and training, the sub-group of the task force which dealt with these issues has remained in place. The group has been asked to examine and report to me on the measures required to accommodate NCHD training in all postgraduate training programmes within a 48-hour working week and safeguard both training and service delivery during the transition to a 48-hour working week. The group is also working with my Department to assist it in accommodating the integrated education and training functions proposed by the task force within the structures announced by the Government in June 2003 following publication of the Brennan and Prospectus reports. It is anticipated that the group will report before the end of the year.
Regarding accident and emergency services, there are a number of initiatives under way at present. These include prioritised planning for the discharge of patients by acute hospitals and increased liaison with between hospital and community services; additional funds — €21.4 million — to facilitate the discharge of patients from the acute system to a more appropriate setting; and additional emergency medicine consultant appointments, from 21 posts in 2000 to 51 posts approved by 1 January 2004.
Subject to resolution of outstanding legal issues associated with the required regulatory changes, I recently announced my intention to provide, at the earliest appropriate date, the necessary additional revenue funding to the pre-hospital emergency care council, PHECC, for the rollout of the training element of the emergency medical technician — advanced, EMT-A, programme.
In the mid-west, the health board has recently advertised for a number of emergency care physicians, fully registered doctors, to complement service delivery in emergency departments. I have also recently approved the appointment of the design team to prepare an outline development control plan for Ennis General Hospital. The plan will be prepared having regard to the development brief prepared by the project team which sets out the broad scope of the proposed future development at Ennis General Hospital and identified the priority areas for development.
Tribunals of Inquiry.
Róisín Shortall
Question:61 Ms Shortall asked the Minister for Health and Children about his commitment to hold an inquiry into the role of multinational drug companies in the contamination of blood products. [10795/04]
I appointed Mr. Paul Gardiner, Senior Counsel, to produce a situation report on the position in Ireland and in the United States in respect of a possible investigation into the actions of the multinational pharmaceutical companies whose products are implicated in the HIV and hepatitis C infection of persons with haemophilia. He liaised with solicitors acting for the Irish Haemophilia Society as part of his investigations. Mr. Gardiner travelled to the United States and spoke to a number of relevant experts, including the lead counsel in the HIV haemophiliac litigation there. He also received legal advice from a major New York law firm on the matters relevant to his investigations.
Mr. Gardiner furnished a report to me that consisted of a 60 page opinion and a number of appendices, one of which comprised over 50 pages of legal advice from the US lawyers. The report drew attention to the fact that there is no guarantee that the US authorities would provide judicial assistance to an Irish tribunal, either to enforce the discovery of documents or compel the attendance of witnesses. I briefed my Cabinet colleagues on the content of the report and I provided the IHS with a copy of it.
Notwithstanding the difficulties that have been identified, it would be possible to mount a useful investigation that would access publicly available material and seek the assistance of persons and bodies willing to co-operate with such an investigation. The Committees of Investigation Bill may provide an appropriate mechanism for an inquiry.
Other legal avenues are also being explored in consultation with the Attorney General and the legal representatives of the IHS. I shall maintain contact with the society on this issue.
Assisted Human Reproduction.
Emmet Stagg
Question:62 Mr. Stagg asked the Minister for Health and Children the progress made to date by the Commission on Assisted Human Reproduction that was established in March 2000; when he expects to receive its report; and if it was delayed by a dispute between hospital consultants and his Department. [10824/04]
The commission was established in March 2000 with the following terms of reference:
To prepare a report on the possible approaches to the regulation of all areas of assisted human reproduction and the social, ethical and legal factors to be taken into account in determining public policy in this area.
The first commission meeting was held on 26 July 2000 and the most recent on 5 February 2004. It adopted an interdisciplinary approach to its work. Initially, each discipline — medical, legal scientific and social — prepared a report outlining its current position on assisted human reproduction. Work groups were then formed to examine specific topics and issues that needed to be addressed. They meet regularly to discuss their tasks and to progress the commission's work.
The work group structure facilitates close attention to a relatively limited range of topics by a highly specialised group. It also facilitates the detailed exploration of a range of ethical and social implications that arise from assisted human reproduction.
The commission organised a day conference in Dublin Castle in September 2001. It dealt with the social, ethical and legal factors inherent in assisted human reproduction. Experts in the various fields from Ireland, the UK, France and Germany exchanged their views.
When the commission was established I indicated that it would be required to seek submissions from the public and to consult appropriate interests. In order to inform itself on the current state of public opinion here on assisted human reproduction the commission placed an advertisement in the newspapers inviting interested members of the public, professional or voluntary organisations, and other parties who wished to do so, to make written submissions before Wednesday, 31 October 2001. Over 1,600 submissions were received and examined.
The commission has engaged in a number of information gathering exercises that include: a survey instrument was drafted with a view to establishing the extent of the provision of assisted human reproduction services in Ireland; the commission issued a survey instrument to a random sample to 50% of GPs in all health board areas and there was a high proportion of respondents; a survey instrument to obstetricians and gynaecologists to elicit information on their level of involvement in assisted human reproduction services; and a survey of public attitudes and opinions on a range of questions on assisted human reproduction.
The commission's report was not held up by the dispute between hospital consultants and my Department. Its work is nearing completion. Unfortunately, it is not possible to say when the report will be finalised given the complex ethical, social and legal implications that arise.
Galway Hospice Foundation.
Michael D. Higgins
Question:63 Mr. M. Higgins asked the Minister for Health and Children if he will make a statement on the recent report of the independent review group on the Galway hospice. [10804/04]
I have read the report of the expert review group on medication management practices of the Galway Hospice Foundation. As Minister I am concerned that patients were put at risk and I want to ensure that the errors are not repeated.
The authorities of the Galway Hospice Foundation have committed themselves to implementing the recommendations of the expert review group. Representatives from the Western Health Board and the foundation are engaged in detailed discussions aimed at agreeing conditions to recommence the admission of patients to the Galway hospice. I hope that their discussions will come to a satisfactory conclusion at an early date.
The report of the expert review group raised questions about a number of issues including governance, standards and guidelines, identification of roles, responsibilities and accountabilities, risk management and clinical audit. My Department is examining the report with a view to determining whether it would be appropriate to consider the application of these principles in a broader national context.
Question No. 64 answered with QuestionNo. 14.
National Treatment Purchase Fund.
Trevor Sargent
Question:65 Mr. Sargent asked the Minister for Health and Children the number of persons who work for the treatment purchase fund; and the amount the fund costs to manage in terms of wages, administration, publicity and so on. [10823/04]
The chief executive of the national treatment purchase fund informed my Department that it employs 16 people at present.
The provisional outturn for the fund in 2003 was €30.057 million. The figure includes €3.06 million for administration costs paid by the Department on behalf of the NTPF. It includes €0.81 million for staff costs and €1.58 million for advertising and promotional activities. The administration costs include certain start-up and set-up costs for the NTPF that were of a once-off nature in 2003.
Cancer Screening Programme.
Kathleen Lynch
Question:66 Ms Lynch asked the Minister for Health and Children when the cervical smear testing programme will be available nationwide; and the steps being taken to reduce delays in providing results. [10812/04]
Phase one of the national cervical screening programme has operated in the Mid-Western Health Board area since October 2000. Free screening is offered at five yearly intervals to approximately 74,000 women in the 25 to 60 age group.
The national health strategy includes a commitment to extend the programme to the rest of the country. The Health Boards Executive has initiated an examination of the feasibility and implications of a national programme. It is a major undertaking with significant logistical and resource implications. At present part of the programme includes an evaluation of phase one, policy development and the establishment of national governance arrangements. The work has regard to both the experiences gained from the phase one programme and other international programmes as well as current best practice.
The evaluation of phase one is a key element in informing the development of a high quality cervical screening model for Ireland. The evaluation is under way and it is anticipated that it will be completed within the next few months. Once completed, HeBE has advised that it will prepare a draft roll out plan.
I shall support boards in their efforts to reduce the waiting times for cervical smear test results. Over the past number of years my Department has allocated additional funding to support the ongoing development and enhancement of cervical cytology services, including the achievement of a reduction in waiting times for smear test results. The funding has facilitated the employment of staff, provision of training, introduction of new technologies such as liquid based cytology, investment in new equipment and upgrading of facilities. The additional funding has also enabled the contracting out of cervical smear test analysis to external laboratories to assist in clearing backlogs. Further additional funding amounting to €0.5 million was allocated in 2004 as part of a programme of continued investment in cervical cytology and colposcopy services.
Medical Cards.
Willie Penrose
Question:67 Mr. Penrose asked the Minister for Health and Children the number of persons who held medical cards in June 2002 and at the latest date for which figures are available; the proportion of the population it represents in respect of each date; when it is intended to implement the commitment to extend eligibility for medical cards to include over 200,000 extra persons; the new guidelines for eligibility for medical cards published in April 2004; and the number of additional persons he estimates will qualify as a result of these changes. [10789/04]
The details requested are as follows:
|
Date |
No. of medical cards |
No. of persons covered |
Percentage of the population |
|
% |
|||
|
June 2002 |
783,612 |
1,207,096 |
30.81 |
|
March 2004 |
762,577 |
1,152,291 |
29.42 |
The health strategy includes a commitment that significant improvements will be made in the medical card income guidelines. The aim is to increase the number of persons on low income who are eligible for a medical card and to give priority to families with children, particularly children with a disability. I regret that it is not possible to meet the commitment this year due to the prevailing budgetary position. However, the Government remains committed to the introduction of the necessary changes.
The medical card income guidelines issued by the chief executive officers of the health boards for 2004 are:
|
(Effective from 1 January 2004) |
|
|---|---|
|
€ |
|
|
Single Person Living Alone |
|
|
Aged up to 65 years |
142.50 |
|
Aged between 66 to 69 years |
156.00 |
|
Single Person Living with Family |
|
|
Aged up to 65 years |
127.00 |
|
Aged between 66 to 69 years |
134.00 |
|
Married Couple |
|
|
Aged up to 65 years |
206.50 |
|
Aged between 66 to 69 years |
231.00 |
|
Aged between 70 to 79 years |
462.00 |
|
Aged between 80 years and over |
486.00 |
|
Allowances |
|
|
For child under 16 years |
26 |
|
For dependant over 16 years with no income maintained by applicant |
27 |
|
For outgoings on house, rent and so on, in excess of |
26 |
|
Reasonable expenses necessarily incurred in travelling to work in excess of |
23 |
The medical card scheme is demand led. Medical cards may be issued by the CEOs on the basis of medical need to persons where income is above the guidelines. Therefore, it is not possible to accurately predict the numbers of persons who will qualify for a medical card in 2004.
Hospital Inquiry.
Ruairí Quinn
Question:68 Mr. Quinn asked the Minister for Health and Children when he expects to receive the report of the independent review into the circumstances of the death of a person (details supplied) on 1 July 2003 who was sent home due to a shortage of nurses in the intensive care unit at Our Lady’s Hospital for Sick Children, Crumlin. [10791/04]
On 23 July 2003 I announced that I had convened a review panel to conduct an independent review of the events surrounding the tragic death of the person concerned. The members of the panel are: Mr. David Hanly, management consultant; Ms Kay O'Sullivan, director of nursing at Cork University Hospital; Dr. Shakeel A. Qureshi, paediatric cardiologist at Guy's and Thomas's Hospital, London.
The panel's terms of reference are: to consider the report of the ERHA on the events of 30 June 2003 at Our Lady's Hospital for Sick Children, Dublin and to make further inquiries and conduct interviews as the panel considers necessary; to address the questions raised by the family; to examine protocols and procedures relevant to the incident having regard to prevailing standards of best practice and to examine their application; to report to the Minister and to make recommendations as it sees fit; and both reports will be made available following the review.
The work of the review panel is ongoing. At present I am not in a position to say when its report will become available.
Community Nursing.
Mary Upton
Question:69 Dr. Upton asked the Minister for Health and Children the number of the promised 850 community nursing units now available following his announcement in July 2002; the hospitals in which they are available; and the number in each case. [10826/04]
I announced that 850 additional beds for community nursing units would be provided under two pilot public private partnership projects. This was to take place in 17 locations throughout the Eastern Regional Health Authority and Southern Health Board areas.
The ERHA will provide nine 50-bed CNUs, three in each of the area health boards, in the following locations: Clonskeagh Hospital, Newcastle Hospital and Tivoli Road, Dún Laoighaire in the East Coast Area Health Board; St. Joseph's Hospital, Raheny, St Mary's Hospital, Phoenix Park and Swords in the Northern Area Health Board; and St. Brigid's Hospital, Crooksling, Brú Chaoimhín, Cork Street and Cherry Orchard Hospital in the South Western Area Health Board.
The SHB proposes to develop eight 50-bed CNUs in the following locations: St. Finbarr's Hospital, Farranlea Road and Ballincollig in the Cork south Lee area; St. Stephen's Hospital, Glanmire and St. Mary's Orthopaedic Hospital, Gurranbraher in the Cork north Lee area; Mount Alvernia Hospital, Mallow in the north Cork area; Bantry in the west Cork area; and Ballyard, Tralee, County Kerry.
At present these additional beds are not available. A health board or an authority must comply with the EU procurement legislation and national guidelines on PPPs in order to provide services.
The ERHA finalised a public sector benchmark project and my Department is consulting with the Department of Finance about it. The SHB is finalising its benchmark. On approval contract notices will be advertised by each of the awarding authorities in the Official Journal of the European Union. I expect that the CNUs will begin to come onstream in 2006.
Question No. 70 answered with QuestionNo. 10.
Clinical Indemnity Scheme.
Emmet Stagg
Question:71 Mr. Stagg asked the Minister for Health and Children the progress which has been made by the working group on the development of a no-fault compensation system for birth-damaged children; when he expects the group to report; if he will seek to expedite the introduction of proposals in this area, having regard to the recent awards in the High Court and the increasing difficulties facing practitioners and especially obstetricians in finding insurance cover; and if he will make a statement on the matter. [10796/04]
The advisory group examining the feasibility of introducing a no-fault compensation scheme for brain-damaged infants has met regularly since its establishment in July 2001. The group has conducted an extensive investigation of the clinical and legal issues involved in the handling of those cases. It has also examined existing levels of service provision for those affected by cerebral damage. The group has had a presentation made to it by parents of children affected by cerebral damage on the day-to-day implications of providing care for them at home. It has also examined prevention strategies and the effects of reforms introduced in the United Kingdom on the handling of claims for compensation for injuries resulting from the provision of clinical care. I hope that the group will be in a position to present its final report by mid-2004. As the group has already indicated its intention of completing its work by the middle of this year, I feel that it would not be appropriate to ask it to expedite the process.
National Cancer Strategy.
Eamon Gilmore
Question:72 Mr. Gilmore asked the Minister for Health and Children when he expects that the national cancer strategy will be published; and if he will make a statement on the matter. [10808/04]
The National Cancer Forum is currently developing a new national cancer strategy. This strategy will build on the progress that has been made during the implementation of the 1996 national cancer strategy and will set out the key priority areas to be targeted for the development of cancer services over the coming years. The strategy will have regard to developments and best practice in other jurisdictions and will make recommendations in regard to the organisation and structure of cancer services nationally.
A significant body of work has been undertaken in the development of the strategy to date. Representatives of the National Cancer Forum have met representatives of the ERHA and all health boards. The forum wrote to more than 90 professional bodies, voluntary bodies and other stakeholders to obtain their views on cancer treatment services. Members of the public have been consulted through advertisements placed in the media.
As part of the preparation of the new strategy, an evaluation of the extent to which the objectives of the 1996 strategy have been met has been carried out by Deloitte Consultants. This report was published in December 2003. The key goal of the 1996 national cancer strategy was to achieve a 15% decrease in mortality from cancer in the under 65 year age group in the ten year period from 1994. The Deloitte evaluation demonstrated that this reduction was achieved in 2001, which was three years ahead of target.
As part of the development of the strategy, sub-groups of the National Cancer Forum were established on generic screening, organisation of cancer services, evaluation and outcomes, evidence based medicine, genetics, nursing and patient issues. The work of these sub-groups is informing the development of the new strategy. It is expected that the strategy will be completed in July.
In regard to the implementation of the 1996 national cancer strategy, since 1997 there has been a cumulative additional investment of approximately €550 million in the development of cancer services. This includes an additional sum of €15 million which was allocated in 2004 for cancer services. This substantial investment has enabled the funding of 90 additional consultant posts in key areas such as medical oncology, radiology, palliative care, histopathology, haematology and radiation oncology. An additional 245 clinical nurse specialists have also been appointed in the cancer services area.
The benefit of this investment is reflected in the significant increase in activity which has occurred. For example, the number of new patients receiving radiotherapy treatment has increased from 2,402 in 1994 to 3,809 in 2000. This means that an additional 1,407 patients are accessing these services, representing an increase of 58% nationally. The number of new patients receiving chemotherapy treatment has increased from 2,693 in 1994 to 3,519 in 2000, representing an increase of 30% nationally. Breast cancer is the individual site-specific cancer which has received the most investment in recent years and in-patient breast cancer procedures have increased from 1,336 in 1997 to 1,839 in 2001. This is an increase of 37% nationally.
Ambulance Service.
Jim O'Keeffe
Question:73 Mr. J. O’Keeffe asked the Minister for Health and Children the way in which he proposes to improve and develop the ambulance service in the country; and the EU rules which affect his proposals. [10665/04]
The Eastern Regional Health Authority, ERHA, and each of the seven health boards are responsible for the provision of ambulance services in their functional areas.
The policy on the development of emergency medical services in Ireland is set out in a number of documents including: Quality and Fairness — A Health System for You; Building Healthier Hearts, the Government's cardiovascular health strategy; the strategic review of the ambulance service 2001; and the report of the national task force on medical staffing — the Hanly report.
Funding provided by my Department in recent years has facilitated significant advancements in the development of the ambulance service in line with the recommendations of these reports including: a major upgrading in training and standards; the equipping of emergency ambulances with defibrillators and the training of ambulance personnel in their use; the introduction of two person crewing; and an upgrading of the ambulance fleet and equipment and improvements in communication equipment and control operations.
The report of the strategic review of the Ambulance Service 2001, which forms the basis for the development of pre-hospital emergency medical services into the future, identifies aspects of the current emergency ambulance service which need to be addressed to bring it into line with best international practice to ensure effective and quality driven practices.
The report recommends that the service be developed at a number of levels. Principal among the proposed developments are: the elimination of on-call as a means of providing emergency cover; improved fleet reliability; and the roll-out of the emergency medical technician-advanced, EMT-A, programme.
The elimination of on-call is designed to facilitate further improvement in response times. I was pleased to be in a position to provide funding in excess of €3 million in the current year to facilitate the continuing phasing out of on-call in a number of regions. This is a programme which I hope to be in a position to extend. With regard to improved fleet reliability, my Department provided additional capital funding of €2.5 million in December 2003 to enable the boards/authority to continue with fleet and equipment replacement programmes which are essential pre-requisites for enhanced speedy and appropriate care.
In addition, I have announced policy approval for the development of the emergency medical technician-advanced, EMT-A, programme. Considerable work has been done by the Pre-Hospital Emergency Care Council in conjunction with my Department in preparing the legislation necessary to give effect to the introduction of this programme in the current year.
The EU directive which impacts directly on the development of the emergency ambulance service is the CEN, Comite European de Normalisation, Directive. The CEN directive relates to the standardisation of specifications in regard to the design, performance and equipping of road ambulances used for the transport of sick and injured persons. The Eastern Regional Health Authority and the health boards have a fleet management system in place which incorporates a formal vehicle replacement policy. My Department is advised that the design specifications laid down by the authority/health boards for replacement vehicle purchase are in full compliance with the specifications of the CEN directive.
I assure the Deputy that the Government is fully committed to the development of our emergency ambulance service and that my Department will continue to pursue a policy of improving key aspects of the emergency medical service to ensure that those calling on the service receive timely and appropriate care.
Birth Statistics.
Joan Burton
Question:74 Ms Burton asked the Minister for Health and Children the number of births in the State in 1980 and in the latest year for which figures are available; the average length of stay of mothers giving birth for the years in question; the steps he has taken to establish the nationality of mothers who give birth at the Dublin maternity hospitals; if he has received a request for additional resources for the Dublin maternity hospitals; if he has satisfied himself with the level of resources available to the Dublin maternity hospitals; and if he will make a statement on the matter. [10801/04]
Data on births are compiled by the Central Statistics Office and published in the annual and quarterly reports on vital statistics. The total number of births in 1980 was 74,064 and the provisional total for 2002 was 60,521.
Returns to my Department for 1980 from publicly funded hospitals show an average length of stay for all maternity patients of 5.9 days compared with 3.4 days in 2002.
Services at the Dublin maternity hospitals are provided under an arrangement with the Eastern Regional Health Authority. My Department has, therefore, asked the regional chief executive of the authority to investigate the matters raised by the Deputy and to reply to her directly.
Nuclear Safety.
Joan Burton
Question:75 Ms Burton asked the Minister for Health and Children the cost of the purchase and distribution to 2.1 million households of iodine tablets during 2002; if it is planned to withdraw these tablets in view of reports that they would be useless in the event of an incident at Sellafield and could even pose a health risk to some persons; and if he will make a statement on the matter. [10802/04]
The Eastern Regional Health Authority, which managed this contract, has indicated that the cost of purchase and distribution of iodine tablets to households during 2002 was approximately €2.2 million.
One packet containing six potassium iodate tablets BP 85 milligrams was to be delivered to each household; this is sufficient to provide a single dose for each member of an average sized household. Iodine tablets offer protection by saturating the thyroid gland with safe, stable iodine in order to prevent it from accumulating any radioactive iodine that may have been released into the environment arising from a nuclear incident. The persons for whom the tablets are recommended are pregnant women, women who are breast-feeding, newborn infants and infants, children and adolescents up to the age of 16 years. The benefit to other population groups is limited.
While the Calder Hall reactors based on the Sellafield site were closed in March 2003, other operational reactors in the UK and elsewhere still pose a potential risk and it is therefore not proposed to recall the iodine tablets already distributed.
In rare instances there may be an allergic response to iodine including fever, joint pain, facial swelling and breathlessness, which may require medical attention. Available evidence indicates that adverse effects associated with stable iodine are uncommon and generally minor. These may include dermatologic and sensitivity reactions. However, when potassium iodate is consumed as a prophylactic agent such adverse effects are unlikely because of its low dose and single use. The information leaflet provided with the iodine tablets contains information regarding those persons for whom the tablets are contraindicated.
Question No. 76 answered with QuestionNo. 59.
Alcohol Abuse.
Paul Nicholas Gogarty
Question:77 Mr. Gogarty asked the Minister for Health and Children his plans to curb binge drinking; if he intends to place health warnings on alcoholic beverages; and if he will make a statement on the matter. [10819/04]
I established a strategic task force on alcohol whose remit is to provide evidence-based measures to Government to prevent and reduce alcohol related harm. The task force produced an interim report and an inter-departmental group has been established to co-ordinate the responses to its recommendations. Progress has been made on a number of issues.
The issue of health warnings on alcohol products and promotional materials is currently being considered by the task force. The next report of the task force is due to be published in the near future.
Vaccination Programme.
Breeda Moynihan-Cronin
Question:78 Ms B. Moynihan-Cronin asked the Minister for Health and Children the level of take-up of the MMR vaccine in each health board area for the latest period for which figures are available; the steps being taken to promote fuller take-up; and if he will make a statement on the matter. [10781/04]
Data provided by the National Disease Surveillance Centre, NDSC, indicate that MMR uptake rates for children of 24 months of age per health board region for the third quarter of 2003 are as follows:
|
Quarter 3, 2003* |
|
|
% |
|
|
ERHA |
75 |
|
MHB |
88 |
|
MWHB |
82 |
|
NEHB |
83 |
|
NWHB |
85 |
|
SEHB |
84 |
|
SHB |
79 |
|
WHB |
77 |
|
Ireland |
80 |
*The most recent period for which uptake figures are available from the NDSC.
The MMR vaccine protects against measles, mumps and rubella and, in accordance with the recommendations of the immunisation advisory committee of the Royal College of Physicians of Ireland, can be administered to children between 12 and 15 months of age. A vaccine uptake rate of 95% is required in order to protect children from the diseases concerned and to stop the spread of the diseases in the community. Measles, in particular, is a highly infectious and serious disease; approximately one in 15 children who contract measles suffer serious complications.
I am concerned about the unsatisfactory MMR immunisation uptake rates because of the risk of unimmunised children contracting the potentially serious diseases concerned. The outbreak of measles in 2000, which resulted in approximately 2,000 cases and three deaths, is evidence of the consequences of insufficient immunisation uptake.
Based on information available from the National Disease Surveillance Centre, NDSC, there was a significant increase in 2003 in the number of reported measles cases. In 2002, 243 cases of measles were reported but provisional returns for 2003 indicate that there were 586 measles cases during that year. This underlines the importance of raising the immunisation uptake level to the optimal level of 95% against measles and the other potentially serious infectious diseases. However, I am encouraged by the most recent statistics from the NDSC which show that for the third quarter of 2003 MMR uptake for children up to 24 months of age was 80% — this uptake rate had increased from 77% in the previous quarter in 2003 and from 73% in the comparative quarter in 2002.
In 2003, CEOs in all health boards and the ERHA were asked to ensure that specific immunisation measures were prioritised in all regions in order to prevent a serious measles outbreak. A national immunisation steering committee was established to address a wide range of issues relating to the childhood and other immunisation programmes including the identification of issues that are hampering the achievement of uptake targets. I launched the report of the steering committee in April 2002 and a national implementation group was subsequently established to draw up a phased national implementation plan based on the report's recommendations.
Following consideration of proposals in regard to childhood immunisation which were submitted by the national implementation group through the Health Boards Executive, HeBE, on behalf of the health boards, €2.116 million was allocated by my Department in 2003 to fund initiatives to improve childhood immunisation uptake. A further €2.778 million has been allocated for that purpose this year.
There is concern among some parents in regard to the measles, mumps and rubella, MMR, vaccine. Negative coverage on this issue has added to the confusion of parents in deciding whether to vaccinate their children. In April 2002, I launched the MMR vaccine discussion pack — an information guide for health professionals and parents. The pack was produced by the NDSC and the department of public health, Southern Health Board and was published by HeBE on behalf of the health boards. The pack sets out the facts in regard to the most common concerns about MMR in a way that will help health professionals and parents to explore these concerns together, review the evidence in regard to MMR and provide the basis for making an informed decision. The information is presented in such a way as to allow full discussion between health professionals and parents on each issue. The pack also contains an information leaflet for parents. The pack is set out in question and answer format and addresses such issues as the alleged link between MMR and autism and Crohn's disease, the safety and side effects of the vaccine, the purpose of a second dose of vaccine, combined vaccine versus single doses and contraindications to the vaccine. The pack will enable health professionals to respond to the very real concerns of parents.
There is a sound evidence basis for the use of the MMR vaccine. Since the original publication of UK research from Dr. Andrew Wakefield about a possible causal link between MMR vaccine and autism, many researchers have investigated the proposed causal relationship and concluded that there is no link between MMR vaccine and autism or inflammatory bowel disease. My Department's submission to the Oireachtas committee contained further details on the scientific evidence in this regard. In Ireland, this issue has been examined by the immunisation advisory committee of the RCPI and the Irish Medicines Board. The conclusions are: there is no evidence to support the association between MMR vaccines and the development of autism or inflammatory bowel disease; the vaccine is safer than giving the three component vaccines separately; and the Oireachtas committee has also endorsed the safety of the MMR vaccine.
The international consensus from professional bodies and international organisations is that the MMR is a safe and effective vaccine. The institutions include the Medical Research Council expert committee and the British committee on safety of medicines in the UK, the Centres for Disease Control and Prevention, CDC, and the American Academy of Paediatrics in the USA as well as the World Health Organisation. Studies by the United States Institute of Medicine concluded that there is no link between the vaccine and autism or inflammatory bowel disease. A large Finnish study involving 1.8 million individuals demonstrated that no case of inflammatory bowel disease or autism was linked to the MMR vaccine. A recent UK study where researchers analysed 2,000 studies from 180 countries found no evidence of a causal link between MMR vaccine and autism or inflammatory bowel disease. A similar Swedish study found no increase in cases of autism in the ten years during which MMR vaccine was introduced. In late 2002, the New England Journal of Medicine published details of a study of more than 500,000 children born in Denmark between January 1991 and December 1998 which indicated that the risk of autism was the same for children regardless of whether they were vaccinated with MMR. The World Health Organisation, WHO, strongly endorses the use of MMR vaccine on the grounds of its convincing record of safety and efficacy.
Dr Simon Murch of the Centre for Paediatric Gastroenterology, Royal Free and University College Medical School, London, who had originally questioned the safety of the MMR vaccine, categorically supports use of the MMR vaccine; in the November 2003 edition of the Lancet he states that “..by any rational standards of risk/benefit calculation, it is an illogical and potentially dangerous mistake for parents to be prepared to take their children in a car on the motorway or in an aeroplane on holiday, but not to protect them with the MMR vaccine. An unprotected child is not only at personal danger, but represents a potential hazard to others, including unborn children”.
I am aware that the editor of the Lancet has said recently that the journal had learned of a “fatal conflict of interest” concerning the research carried out by Dr. Wakefield. I understand that the British General Medical Council is to examine this matter.
I understand that some health boards have undertaken measures in their regions to improve vaccine uptake which include: information sessions for professionals, for example, doctors and nurses in the area; information sessions for parents; distribution of information to the public, for example, leaflets on MMR available in public areas; advertisements taken out in local papers; advertisements on local radio stations; advice regarding immunisation, including MMR, which forms part of every public health nurse consultation with parents; information leaflets displayed prominently in all health centres; information given to schools regarding the booster MMR; follow up of parents by letter and telephone where children have not been vaccinated; follow up with GPs and nurses regarding children in their area who have not been vaccinated; and information sessions for staff. Discussions are ongoing between my Department and HeBE in regard to targeted and focused local/regional initiatives to bring about improvements in MMR uptake levels.
I take this opportunity to again urge all parents to have their children immunised against the diseases covered by the childhood immunisation programme in order to ensure that both their children and the population generally have maximum protection against the diseases concerned. This is particularly important at present in light of the increase in reported measles cases.
Bombings Investigations.
Brendan Smith
Question:79 Mr. B. Smith asked the Taoiseach when the report of Mr. Justice Barron into the Belturbet bombing will be published; and if he will make a statement on the matter. [10956/04]
I understand that Mr. Justice Barron will report next, in the coming months, on the Dublin bombings of 1972 and 1973, together with the Clones, Belturbet and Pettigo bombings of 28 December 1972 and four other bombing incidents that took place before May 1974 as well as the murder of Brid Carr in November 1971 and the murders of Oliver Boyce and Brid Porter.
Corporate Law Enforcement.
Brendan Howlin
Question:80 Mr. Howlin asked the Tánaiste and Minister for Enterprise, Trade and Employment the measures that are taken by her Department to ensure that company accounts that require a statutory audit are audited by registered auditors as defined in the Companies Acts, particularly in view of the recent related prosecutions brought by the Office of the Director of Corporate Enforcement; and if she will make a statement on the matter. [11040/04]
It is an offence under section 187 of the Companies Act 1990 for a person to act as an auditor while not qualified.
Responsibility for the enforcement of company law generally — including the enforcement of section 187 — has been vested by the Oireachtas in the Director of Corporate Enforcement. I understand that the director successfully prosecuted two cases in each of the years 2002 and 2003 for breaches of section 187. Section 12(5) of the Company Law Enforcement Act 2001 provides that the director shall be independent in the performance of his functions. As such it would be inappropriate for me to comment on the day-to-day activities of the director.
The Companies Registration Office, CRO, maintains a register of qualified auditors for inspection by the public so that companies can check to make sure that the person or firm that they have appointed as auditor to the company is properly qualified. I understand that this register will shortly be made available online on the CRO website which will facilitate public access to the register.
EU Regulations.
Brendan Howlin
Question:81 Mr. Howlin asked the Tánaiste and Minister for Enterprise, Trade and Employment if, further to Questions Nos. 40 and 63 of the 23 October 2003, she will indicate when she intends taking a decision in respect of the application of international financial reporting standards here; the outcome of the consultation process her Department was engaged in on this issue; and if she will make a statement on the matter. [11041/04]
Regulation (EC) No 1606/2002 of the European Parliament and of the Council on the application of international accounting standards provides for the mandatory application of international accounting standards adopted in accordance with the procedure contained in the regulation to the consolidated accounts of listed companies.
The regulation also contains member state options regarding the application of these standards to the annual accounts of listed companies or to the consolidated and/or annual accounts of non-listed companies. Before adopting a final decision on the options, I have sought and am awaiting the views of the Company Law Review Group, and I expect to receive these in the immediate future, after which I propose to take a final decision on this matter.
In this regard, however, I wish to repeat what I said in response to the previous questions mentioned, that, in line with my stated inclination, I expect to provide that companies will be permitted to elect to avail or not to avail of the options in question, but without making it mandatory for them to comply with these options.
Farm Retirement Scheme.
Ned O'Keeffe
Question:82 Mr. N. O’Keeffe asked the Minister for Agriculture and Food if his attention has been drawn to the fact that a deduction in respect of a spouse’s old age pension is being made from a farm retirement pension in respect of a person (details supplied) in County Cork whose spouse died in November 2003; and if the deductions will be refunded to this widow. [10957/04]
My Department has no record of being notified of the death of the husband of the person named. My officials will now contact her and make arrangements to refund the appropriate amounts.
John Perry
Question:83 Mr. Perry asked the Minister for Agriculture and Food, further to Question No. 258 of 10 June 2003, if his attention has been drawn to the circumstances outlined in the enclosed submission; the plans he has to address the issues (details supplied); and if he will make a statement on the matter. [10959/04]
The person named wrote to me in May 2003 outlining her concerns about the effects of the mid-term review proposals on some participants in the schemes of early retirement from farming. She had entered the current early retirement scheme in October 2002.
Under the detailed implementing rules for the new single payment system that have now been agreed, the person named, who was engaged in farming during the reference period, will be in a position to have entitlements established for her in 2005 under the new single payment system. These entitlements can then be leased with the land provided that a lease agreement is in place at that time whereby the entitlements can then be leased to the lessee.
Olwyn Enright
Question:84 Ms Enright asked the Minister for Agriculture and Food the reason the person (details supplied) in County Laois who entered the 1999 early retirement scheme is being refused the scheme on the basis of letting her land for a nine month period for two years; and if he will make a statement on the matter. [10960/04]
The person named lodged an application under the 1994 scheme of early retirement from farming with my Department on 10 December 1999. Following consideration, her application was rejected and she was informed of the reasons. My Department was not aware at that time that the person named had let her land for a nine month period in two of the years before her application, and this was not among the reasons for rejection of her application.
The person named subsequently sought to apply for the current early retirement 2000 scheme which was introduced in November 2000. It is a condition of the scheme that applicants must lease or transfer their land to eligible transferees after 1 January 2000 and have engaged in farming for the ten years prior to the date of the transfer or lease. Using a provision that forms part of the current scheme, she sought exemption from this condition on the grounds of ill health. That exemption was refused. My Department was already aware that she had transferred her land before January 2000, but the critical factor in my Department's view was the length of time she was out of farming. She had last farmed in 1996 and had then rented out her land. In view of the fact that she had not actively farmed since 1996, my Department concluded that it was at that point that she had ceased farming and transferred her holding. To grant an exemption from the rules in these circumstances would, in the considered opinion of my Department, have stretched the provisions of the scheme beyond reasonable limits.
Departmental Offices.
Billy Timmins
Question:85 Mr. Timmins asked the Minister for Finance the progress of the proposed district veterinary office for County Leitrim, based at Drumshambo; if it has progressed from the Chief State Solicitor’s office for legal approval; when this much anticipated proposed office will be up and running; and if he will make a statement on the matter. [10953/04]
The Commissioners of Public Works have agreed a purchase price for a site for the Department of Agriculture and Food, in Drumshanbo, County Leitrim and they hope to be in a position to sign the contract for sale in the near future. It is not possible, at this stage, to say when the office will be up and running.
Disabled Drivers.
Brian O'Shea
Question:86 Mr. O’Shea asked the Minister for Finance the position regarding the final report and recommendations of the interdepartmental group on the disabled drivers’ and disabled passengers’ (tax concessions) scheme; and if he will make a statement on the matter. [11063/04]
Bernard J. Durkan
Question:87 Mr. Durkan asked the Minister for Finance the position in regard to the interdepartmental review of the 1994 disabled drivers’ and disabled passengers’ (tax concessions) scheme; when it is expected to extend the limits of the scheme; and if he will make a statement on the matter. [11064/04]
I propose to take Questions Nos. 86 and 87 together.
As I said in a reply to a previous question, the interdepartmental report of the review group on the disabled drivers' and disabled passengers' (tax concessions) scheme is under consideration in my Department. The report is a substantive one and needs to be studied carefully. On completion of this process, I envisage that the report will be made available publicly.
Schools Building Projects.
Olwyn Enright
Question:88 Ms Enright asked the Minister for Education and Science if he will sanction the application on behalf of a school (details supplied); and if he will make a statement on the matter. [10980/04]
Olwyn Enright
Question:94 Ms Enright asked the Minister for Education and Science if he will sanction the application on behalf of a school (details supplied); and if he will make a statement on the matter. [10968/04]
I propose to take Questions Nos. 88 and 94 together.
Gaelscoil Portlaoise is currently located in temporary accommodation on the grounds of Portlaoise GAA Club. My Department grant-aids 95% of the rental costs of these premises.
The school authority has submitted a proposal to relocate the school to a site in the Kilminchy area of Portlaoise. This application is currently under consideration and a decision will issue to the school authority as soon as possible.
Teachers’ Remuneration.
Jimmy Deenihan
Question:89 Mr. Deenihan asked the Minister for Education and Science when the benchmarking award will be made to primary school secretaries employed under the 1978 scheme; and if he will make a statement on the matter. [11101/04]
The terms of Sustaining Progress provide that the final two phases of the benchmarking increase and the general round increases is dependent, in the case of each grade, sector and organisation on verification of co-operation with flexibility and change, satisfactory implementation of the agenda for modernisation, maintenance of stable industrial relations and absence of industrial action on matters covered by the agreement.
IMPACT issued an instruction to its members who are school secretaries not to make any supervision/substitution payments to teachers in respect of absences now covered by the revised supervision/substitution scheme. This instruction is related to a claim for additional payments and re-gradings for school secretaries for work associated with the scheme.
The position of my Department is that work associated with the revised scheme for supervision and substitution is within the scope of the Sustaining Progress agreement and is comprehended by clause 19.6 which precludes strikes or other forms of industrial action in respect of matters covered by the agreement. The agreement also provides for full co-operation with the introduction of new schemes and initiatives and changes to existing schemes which are a routine feature of the work of public service organisations.
The agreement further provides that implementation of initiatives in the areas of flexibility and change will not give rise to claims for increased rewards for staff in the form of promotions, re-gradings, allowances or other benefits, clause 21.2, and contemplates disputes being resolved by agreement or adjudication rather than by industrial action, clause 19.8.
In the circumstances it is considered that the union action represents a breach of the Sustaining Progress agreement and accordingly prevents payment of the associated wage increases.
This matter was the subject of discussions locally and at the Labour Relations Commission, in accordance with terms of the Sustaining Progress agreement, but remains unresolved. The matter has now been jointly referred to the Labour Court for a determination, the outcome of which will be accepted by both sides.
Schools Building Projects.
Ned O'Keeffe
Question:90 Mr. N. O’Keeffe asked the Minister for Education and Science the position regarding an application (details supplied) for funding to develop additional facilities at a secondary school. [10964/04]
The position in regard to the school to which the Deputy refers is that an application for grant-aid to develop additional facilities has been received from the management authority.
When publishing the 2004 school building programme, I outlined that my strategy going forward will be grounded in capital investment based on multi-annual allocations. My officials are reviewing all projects which were not authorised to proceed to construction as part of the 2004 school building programme, with a view to including them as part of a multi-annual school building programme from 2005 and I expect to be in a position to make further announcements on this matter in the course of the year.
The application from the school referred to will be considered in this regard.
State Examinations.
Olwyn Enright
Question:91 Ms Enright asked the Minister for Education and Science his views on the failure rate for a school (details supplied); if his attention has been drawn to the fact that the failure rate is rising; when he intends to take some action on this matter; and if he will make a statement on the matter. [10965/04]
The failure rate in the Scrúdú le hAghaidh Cáilíochta sa Ghaeilge fluctuates from year to year. I am aware that the failure rate in the examination in 2003 was somewhat higher than in recent years. My officials monitor such results and strive to detect the underlying reasons. They are clearly of the opinion that the level of readiness of candidates sitting the examination is the main factor which influences the failure rate.
The purpose of the Scrúdú le hAghaidh Cáilíochta sa Ghaeilge is to enable primary teachers who qualify outside the State to acquire accredited qualification to teach Irish or teach through Irish in primary schools in Ireland. A standard of Irish is required which is similar to that acquired by teachers who gain a pass in the Cúrsa Gairmiúil sa Ghaeilge in the Colleges of Education here. I wish to maintain that standard. The Scrúdú le hAghaidh Cáilíochta sa ghaeilge requires study and careful preparation.
I am currently studying the report of the SCG review body which has been published on the Department's website. As a result I propose to introduce some additional support systems to help candidates prepare for the examination. Education centres already use some of their annual budget to provide part-time courses for candidates. I am examining options for improving the supports for course provision for SCG candidates. I am also considering structural changes to the examination.
Schools Building Projects.
Olwyn Enright
Question:92 Ms Enright asked the Minister for Education and Science the way the multi-annual capital envelopes enabled his Department to adopt a multi-annual framework for the school building programme; the method in which the envelope operates; and if he will make a statement on the matter. [10966/04]
The Deputy will appreciate that planning and implementation of a major capital programme such as the school building programme covers all stages of the development of a project. These range from the initial forward planning stage, through site acquisition, if required, the architectural planning and design phases leading to the final construction stage. In most projects it normally takes at least more than one financial year for a project to be progressed through these stages to the final point of construction.
Arising from the budgetary announcement an agreement exists between the Department of Finance and my Department in respect of the capital investment framework 2004 to 2008. This agreement identifies the level of funding available for the years 2004 to 2008 and thus allows my Department to plan and manage more efficiently and effectively the capital investment programme. While the detailed elements of the agreement are currently being finalised between the two Departments, the certainty which the capital investment framework brings to the building programme is a most welcome and appropriate development.
Educational Provision.
Olwyn Enright
Question:93 Ms Enright asked the Minister for Education and Science the status of the McCarthy Report in the provision of education in County Laois; when he expects it will progress in relation to this matter; and if he will make a statement on the matter. [10967/04]
The Deputy will be aware that a facilitator, Dr Tom McCarthy, was appointed to assist in the development of a long-term plan for the provision of primary and post-primary infrastructure in the Portlaoise area.
Following receipt of his recommendations, it was decided that educational provision at post primary level required to be addressed as a matter of urgency. This matter has now been finalised with the decision to provide three new post-primary schools in Portlaoise — two voluntary secondary schools and a VEC school. The new VEC school is due to go to construction this year and discussions in regard to the provision of the other two schools are ongoing with the trustees.
Officials in the school planning section of my Department are now examining educational provision at primary level with a view to establishing the best way forward. The school authorities will be kept informed of developments.
Question No. 94 answered with QuestionNo. 88.
Higher Education Grants.
Olwyn Enright
Question:95 Ms Enright asked the Minister for Education and Science if funding is available for a person (details supplied) in County Meath who has been accepted on the basis of an accreditation of prior learning onto a masters degree programme; and if he will make a statement on the matter. [10969/04]
The statutory framework for the maintenance grants scheme, as set out in the Local Authorities (Higher Education Grants) Acts 1968 to 1992, provides for means-tested higher education grants to assist students to attend full-time third level education.
An approved course, for the purposes of the higher educational grant scheme is, generally speaking, a full-time undergraduate course of not less than two years duration or a full-time postgraduate course of not less than one-year duration pursued in an approved third level institution. The institutions approved under the scheme are, generally speaking, publicly funded third level colleges offering full-time courses at undergraduate and postgraduate level.
Similarly under the terms of the free fees initiative, whereby the State meets the tuition costs of eligible students, an approved course is defined as a full-time undergraduate course of a minimum duration of two years in an approved third level institution.
Part-time courses are not approved courses under the terms of the maintenance grant schemes or the free fees initiative.
Tax relief is, however, available on third level tuition fees in respect of approved part-time courses in approved colleges. Further information in this regard is available from the local tax offices.
Departmental Properties.
Jimmy Deenihan
Question:96 Mr. Deenihan asked the Minister for Education and Science if he will provide a right of way to Kerry County Council over its property at the Grove, Dingle; and if he will make a statement on the matter. [10970/04]
My Department is currently considering the issue of providing a right of way to Kerry County Council over the site at the Grove, Dingle. As soon as a decision is made on the matter the Department will be in contact with the local authority.
Child Care Services.
Jimmy Deenihan
Question:97 Mr. Deenihan asked the Minister for Education and Science if he will provide a site on their property at the Grove, Dingle for a local child care group; and if he will make a statement on the matter. [10971/04]
My Department is currently considering the question of ceding a portion of land to a local group for the purpose of building a child care centre in Dingle. As soon as a decision is made on the matter the Department will be in contact with the local authority and the child care group.
Special Educational Needs.
Jerry Cowley
Question:98 Dr. Cowley asked the Minister for Education and Science when a person (details supplied) can expect to obtain five hours weekly resource teaching, as recommended by his Department; when their sibling can expect to receive learning support; when this service is implemented that the older sibling will not lose out in order to facilitate their siblings; and if he will make a statement on the matter. [10972/04]
I can confirm that my Department has received applications for special educational resources, SER, from the school referred to by the Deputy, including an application for the first and second named child.
SER applications received between 15 February and 31 August 2003 are being considered at present. In all, more than 5,000 such applications were received. Priority was given to cases involving children starting school last September and all of these cases were responded to before or soon after the commencement of the current school year.
The balance of more than 4,000 applications has been reviewed by a dedicated team comprising members of my Department's inspectorate and the National Educational Psychological Service. These applications are being further considered in the context of the outcome of surveys of SER provision conducted over the past year or so. Account is also being taken of the data submitted by schools as part of the recent nationwide census of SER provision.
The processing of the applications is a complex and time-consuming operation. However, my Department is endeavouring to have this completed as quickly as possible and my officials will then respond to all applicant schools. Pending a response, schools are advised to refer to circular 24/03, which issued in September 2003. This circular contains practical advice on how to achieve the most effective deployment of resources already allocated for special educational needs within the school.
The arrangements for processing applications received after the 31 August 2003, including the applications for the first and second named pupils in question, will be considered in the context of the outcome of discussions on a weighted system of allocation of resource teaching support. A further communication will be sent to schools in this regard.
The school currently has the services of a shared learning support teacher. It is a matter for the school principal, together with the learning support teacher, to allocate appropriate time to pupils requiring learning support assistance.
My Department is at present reviewing existing arrangements for the allocation of special educational supports to primary schools. In that context, my officials have initiated discussions on the matter with representative interests. At this stage, it would be premature to anticipate the outcome. I can confirm, however, that the basic purpose of that review is to ensure that each school has the level of resources required to cater for its pupils with special educational needs.
Adult Literacy Service.
Seán Crowe
Question:99 Mr. Crowe asked the Minister for Education and Science the Government’s position on rectifying the over reliance on volunteers in the adult literacy service, NALA, in view of the fact that there has been no increase in funding this year. [10973/04]
The national adult literacy service is provided by the vocational education committees with funding from my Department. The VEC service is separate from the National Adult Literacy Agency, NALA, which is a voluntary organisation, concerned with national co-ordination, training and policy development in adult literacy work, rather than with direct provision of literacy tuition.
Some literacy tutors in the VEC service are professional but about 80% are volunteers. A quarter of the 28,000 learners are working with the volunteer tutors on a one to one basis. As the number of voluntary tutors is about 4,200, the cost of payment for their services would be considerable.
The Government recognises the unique and valuable contribution of volunteers in the development of the adult literacy service. It is concerned that this contribution be retained in the future and that it be validated and acknowledged. The White Paper on Adult Education, Learning for Life, published in 2000, envisages that volunteers should be provided with the opportunity to upgrade their knowledge, attitude and skills and to gain certification through flexible procedures.
Seán Crowe
Question:100 Mr. Crowe asked the Minister for Education and Science the Government’s commitment to funding the literacy service beyond 2006. [10974/04]
Adult literacy is my top priority in adult education. Since the publication of a report of an international adult literacy survey in 1997, which found that 25% of the adult population have literacy problems, the annual funding of the national adult literacy service has increased considerably and is now of the order of €19 million.
The service is delivered through the vocational education committees throughout the country, with funding from my Department. The national development plan committed €93.5 million to the service in the period 2000-2006, with a target of reaching 113,000 clients over that period. This target is likely to be exceeded.
My Department has been funding the adult literacy service since 1985. Having regard to the high priority accorded to the service, and the scope for developing it on the evidence of the 1997 report, it is envisaged that the Government will continue to make provision for adult literacy beyond 2006 to the extent that resources permit.
Home Tuition.
Fergus O'Dowd
Question:101 Mr. O’Dowd asked the Minister for Education and Science if home tuition can be arranged for a person (details supplied) in County Louth who cannot attend school due to medical problems. [10975/04]
I wish to advise the Deputy that my Department has no record of having received an application for home tuition for the pupil in question. However, should such an application be received in my Department, it will be given full consideration.
Special Educational Needs.
Paddy McHugh
Question:102 Mr. McHugh asked the Minister for Education and Science when a special needs assistant will be provided at a school in Tuam, County Galway for the benefit of a person (details supplied) in County Galway as per application submitted to his Department in December 2003; and if he will make a statement on the matter. [10976/04]
My Department allocates resource teaching support and special needs assistants support to second level schools and vocational educational committees to cater for students with special educational needs. Applications for such support are made to my Department by the relevant school authority or VEC. Each application is considered on the basis of the assessed needs of the pupil/pupils involved and the nature and level of support provided is determined on the advice of the psychological service.
My Department has allocated 1.75 whole time equivalent resource posts plus 1.47 special needs assistant posts to address the needs of students attending this school including the pupil the Deputy is referring to. It is a matter for the school to deploy this allocation and also review this deployment in line with the evolving needs of the students.
School Curriculum.
Seán Ó Fearghaíl
Question:103 Mr. Ó Fearghaíl asked the Minister for Education and Science the number of students currently participating in transition year programmes; if he has satisfied himself with the type of programme on offer throughout the country; and if he will make a statement on the matter. [11036/04]
The transition year programme is being offered in the current school year to almost 24,000 students. It is operated in accordance with guidelines issued to schools by my Department. The choice of whether to offer the transition year programme is a matter for the individual school.
A unique feature of transition year is that it does not have a prescribed national curriculum. Schools design their own individual programmes according to a recommended curriculum framework laid down by my Department. Each school should have an up-to-date transition year programme document that defines the school's curriculum for the year. Control over curriculum content enables teachers to design programmes and courses tailored to the needs and interests of students. It also enables parents, the community and local enterprise to bring new kinds of learning opportunities to the students.
I am broadly happy with how the current arrangements for the transition year programme are operating. A major evaluation of the transition year programme was carried out by the inspectorate of my Department in 146 schools offering the programme in the 1994-95 school year. This showed that most schools offering the programme used the freedom afforded in a responsible and creative manner. My Department has followed up on this evaluation report in a number of ways including ongoing evaluation of the programme in schools and support to schools in the area of assessment of pupils' work and evaluation of the programme by schools themselves.
A longitudinal study carried out for the National Council for Curriculum and Assessment, NCCA, by the Education Research Centre, Drumcondra, on 1994 junior certificate students who sat their leaving certificate examination in 1997 provides useful evidence that the transition year programme enhances students' performance at leaving certificate level by 26 points, offsets the handicap of disadvantage and makes students more ready to attempt higher level papers in their leaving certificate examinations.
Seán Ó Fearghaíl
Question:104 Mr. Ó Fearghaíl asked the Minister for Education and Science if he has satisfied himself with the number of students currently pursuing science and IT courses at second and third level; and if he will make a statement on the matter. [11037/04]
At leaving certificate level there are three main science subjects, biology, chemistry and physics. Biology remains a popular subject with 40.3% of the cohort sitting the examination in June 2003, an increase from 39.8% in 2002. The uptake of physics and chemistry has been a cause of concern for some time. The decline in uptake of these subjects started in the 1980s and continued until recently. There has been a reversal of the trend in 2002. In the leaving certificate examination in June 2002, 15.6% of the cohort took physics — up from 14.1% in 2000 — and 11.7% took chemistry — up from 11.1% in 1999. In 2003, 15.7% took physics and 11.9% took chemistry. At junior certificate level there is one science subject and the uptake of this subject has been consistently high; 85.7% of the cohort took it in 2003.
A range of actions are being taken to promote an increased uptake of science and IT. In particular, important progress is being made in regard to: curricular reform and inservice support, with new syllabi already implemented in leaving certificate biology, physics and chemistry; revised syllabi in primary science and junior certificate science beginning in schools in 2003-04; and work is under way on a new leaving certificate physical sciences syllabus to replace the physics and chemistry combined syllabus. All of these developments are being or have been supported by national inservice programmes for teachers.
Progress is being made in regard to: resourcing, with substantial grants issued to schools at primary level in 1999, 2001 and 2002; an additional per capita grant for physics and chemistry at leaving certificate; a capital grants programme for senior cycle science ICT and science equipment; and allied with the announcement in 2003 of a once-off grant scheme, likely to cost of the order of €12 million to support the implementation of the new junior certificate science syllabus. To date some 614 schools in the free education scheme have opted to provide the revised junior certificate science syllabus from 2003-04. Grants of €5.1 million were issued to these schools at the end of January 2004 and a further tranche of payments to certain schools is currently being processed. The revised junior certificate science syllabus provides for a more investigative approach to science education with some 30 experiments and investigations which have to be carried out over the period of the programme. This hands-on approach is seen as critically important to enhance the attractiveness of the subject and encourage more students to choose the physical sciences at senior cycle.
Progress is being made on ICT integration projects in teaching and learning under the schools IT initiative and the new TV Scope programme in partnership with RTE, NCCA and the National Centre for Technology in Education; on the provision of materials and publications to schools to promote the attractiveness and relevance of science for students as a subject option and career path; on reviews on mathematics, grading of subjects in the leaving certificate, gender equity issues in science, and initial reports on teacher training undertaken; on awareness measures supported by industry and third level colleges linking with schools; on the launch of the new discover science and engineering programme in October 2003 bringing together all the existing awareness activities in a unified strategy; and on the announcement by the Tánaiste in December 2003 of plans for Ireland's first interactive learning centre for children and adults, designed to give visitors a hands-on experience and understanding of science, and to be an education and outreach centre for teachers and pupils. The exploration station is due to open in 2006 and will be sited in the OPW Heuston gate development in Kilmainham, Dublin.
This work continues to be progressed and enhanced as resources permit in collaboration and consultation with the Department of Enterprise, Trade and Employment, Forfás and industry. My Department is fully committed to strengthening the quality of science teaching and learning, promoting increased scientific literacy and encouraging more students to choose science subjects at senior cycle and progress to third level options in this critical area as a vitally important part of the national strategy to support competitiveness and employment.
The CAO data show small declines in first preference applications for technology/engineering and science degree courses and somewhat larger declines in these areas for diploma/certificate courses. I am concerned at this trend, particularly given the longer term requirements for skilled graduates. In its fourth report, published last year, the expert group on future skills needs reported that the ICT industry would return to growth and that by 2006 a skills gap in ICT would re-emerge. Clearly, this points to the importance of strong enrolment on these courses.
As part of a response to this issue, the Higher Education Authority has this year, in conjunction with the ICT sector, launched an active publicity campaign to support students in considering the value of ICT when making their higher education choices through the CAO. This is in addition to measures, which have been taken in all the third level institutions, to reduce the non-completion rates on ICT courses. It is hoped that these measures will help to stimulate the supply of graduates in these areas over the medium to long term. These measures, in addition to those I have already identified at second level, will support and enhance Ireland's innovative capacity through the availability of a strong supply of technologically skilled graduates over the longer term.
Corporal Punishment.
Richard Bruton
Question:105 Mr. R. Bruton asked the Minister for Education and Science if he will indicate whetherthere were guidelines issued by the Department of Education and Science with regard to the proper use of corporal punishment in primary schools and in industrial schools during the years 1950-1970; and if he will make a statement on the matter. [11038/04]
In September 1956 my Department issued circular 17/56 to managers and teachers of national schools in regard to corporal punishment.
I am arranging for a copy of the circular to be issued to the Deputy.
School Transport.
Olwyn Enright
Question:106 Ms Enright asked the Minister for Education and Science the number of students who have used the school transport service provided by, or grant aided by, his Department for each year since 1997; and if he will make a statement on the matter. [11039/04]
The information requested by the Deputy is being collated by my Department and will be forwarded to her as soon as possible.
Schools Building Projects.
Paul Kehoe
Question:107 Mr. Kehoe asked the Minister for Education and Science the estimated cost of the proposed new extension for a school (details supplied) in County Wexford; if he will allow the school to go ahead with its own proposed builder; and if he will make a statement on the matter. [11058/04]
Paul Kehoe
Question:108 Mr. Kehoe asked the Minister for Education and Science the action he will take following correspondence from a school (details supplied) in County Wexford; and if he will make a statement on the matter. [11059/04]
Paul Kehoe
Question:109 Mr. Kehoe asked the Minister for Education and Science when a school (details supplied) in County Wexford will receive the go ahead for a new extension; and if he will make a statement on the matter. [11060/04]
I propose to take Questions Nos. 107 to 109, inclusive, together.
An application for grant-aid towards improvement works has been received from the management authority of the school referred to by the Deputy. The application is being examined in the school planning section of my Department.
As I announced in the 2004 school building programme, a key strategy going forward will be grounded on the budget day announcement of multi-annual allocations for capital investment in education projects. All projects that are not going to construction as part of the 2004 school building programme will be re-evaluated with a view to including them as part of a multi-annual building programme from 2005 onwards. The application from the school in question will be considered in this context. My Department will also, however, consider the alternative delivery method proposal from the school. This will be done in the context of my Department's obligations under public procurement procedures.
Schools Recognition.
John Bruton
Question:110 Mr. J. Bruton asked the Minister for Education and Science if a site will be allocated to the Educate Together school in Navan; and if he will make a statement on the matter. [11086/04]
Navan Educate Together national school opened with provisional recognition from my Department in September 2002. The school is currently located in temporary accommodation at Rock Lodge, Flowerhill, Navan, County Meath.
My Department has received an application for permanent recognition for the school. This is currently under consideration.
Schools with temporary recognition do not have an entitlement to capital grant aid. Accordingly, until such time as permanent recognition is granted to the school, my Department is not in a position to consider purchasing a site for a permanent location for the school. If and when permanent recognition is granted, budgetary factors will then determine the rate of progress on the acquisition of a site and on the delivery of permanent accommodation. In the meantime, it is the responsibility of the board of management to ensure that suitable temporary accommodation is available to meet the needs of the school.
Rural Housing.
Jerry Cowley
Question:111 Dr. Cowley asked the Minister for Communications, Marine and Natural Resources the definition of so-called “one off housing” as used by the ESB; and to explain how precisely the ESB distinguishes between rural one off housing and urban one off housing; and if he will make a statement on the matter. [11043/04]
The matter to which the Deputy refers is a day to day operational matter for ESB and not one in which I have a function.
Post Office Network.
Olwyn Enright
Question:112 Ms Enright asked the Minister for Communications, Marine and Natural Resources his policy in relation to post offices in rural areas; and if he has satisfied himself with agency services replacing post offices; and if he will make a statement on the matter. [10962/04]
The Government is committed to a viable and sustainable rural post office network. However, consideration must be given to the current climate in which An Post is operating, bearing in mind the serious operational losses the company has suffered and the measures which need to be implemented if the company is to reverse its current situation. All stakeholders recognise that An Post, and its network, must adapt to its customer needs within the financial constraints in which it now finds itself.
An Post has secured additional business for the network, including bill pay facilities for the ESB, phone top-ups through its PostPoint service and a contract with the AIB under which the banks' customers can access their accounts through the network.
Parallel with these developments, under an agreement between the Irish Postmasters' Union and An Post, the conversion of sub-post offices from a fixed contract to an agency basis, whereby payments are linked to transactions, is being implemented on a voluntary basis. The key requirement, that a service is provided locally, is being met by the new agency arrangement.
Fisheries Protection.
John Perry
Question:113 Mr. Perry asked the Minister for Communications, Marine and Natural Resources if the ESB plans to sell the Shannon Fisheries; his views on this speculation; and if he will make a statement on the matter. [11104/04]
I am advised by the ESB that they have no plans to sell the Shannon Fisheries.
Electricity Generation.
John Perry
Question:114 Mr. Perry asked the Minister for Communications, Marine and Natural Resources if the ESB has lowered or breached the statutory limits (details supplied) set down by the Houses of the Oireachtas since the 1930s for Lough Allen, Lough Ree and Lough Derg; and if he will make a statement on the matter. [11105/04]
John Perry
Question:115 Mr. Perry asked the Minister for Communications, Marine and Natural Resources the number of years during which the ESB has breached the statutory limits set down (details supplied) for Lough Allen; if records can be provided; if they are available for public inspection; and if he will make a statement on the matter. [11106/04]
I propose to take Questions Nos. 114 and 115 together.
I am advised by the ESB that it has always endeavoured to meet its obligations under the Electricity Supply Acts in regard to water levels in Lough Allen, Lough Ree and Lough Derg.
I am also informed, however, with regard to Lough Allen that on rare occasions in the past, due to unfavourable weather conditions and in attempting to maximise flood storage, water levels occasionally fell below the lower limit for short periods in early autumn. I am assured by the ESB that records of these occurrences are available for public inspection.
Fish Stocks.
John Perry
Question:116 Mr. Perry asked the Minister for Communications, Marine and Natural Resources if the ESB provides a licence on Lough Allen for the smolt farm; the person who operates the venture; if the ESB obtains an annual fee; and if he will make a statement on the matter. [11107/04]
John Perry
Question:117 Mr. Perry asked the Minister for Communications, Marine and Natural Resources if members of the ESB are involved in the smolt farm venture on Lough Allen; and if he will make a statement on the matter. [11108/04]
John Perry
Question:118 Mr. Perry asked the Minister for Communications, Marine and Natural Resources if the ESB intends to carry out a comprehensive survey on Lough Allen to examine the consequences of the smolt farm; and if he will make a statement on the matter. [11109/04]
John Perry
Question:119 Mr. Perry asked the Minister for Communications, Marine and Natural Resources the ESB’s views on whether the smolt farm may have caused disease in a number of native fish; his own views on the matter; and if he will make a statement on the matter. [11110/04]
John Perry
Question:121 Mr. Perry asked the Minister for Communications, Marine and Natural Resources if the ESB ever carried out a survey of fish stocks in Lough Allen; and if he will make a statement on the matter. [11112/04]
I propose to take Questions Nos. 116 to 119, inclusive, and 121 together.
The licence in force in respect of the cultivation of salmon in Lough Allen was granted by my Department to Hibernor Atlantic Salmon Ltd., Derryclare Hatchery, Recess, Connemara, County Galway. The company in question went into receivership last year and an application to assign the licence to a new company has been made to my Department recently.
I am advised by the ESB that none of its staff is involved in the smolt farm venture on Lough Allen. The advice from the ESB is that it has not carried out a survey of fish stocks in Lough Allen and has no plans to do so.
ESB Operations.
John Perry
Question:120 Mr. Perry asked the Minister for Communications, Marine and Natural Resources if he has a statutory duty with regard to the ESB; and if he will make a statement on the matter. [11111/04]
John Perry
Question:122 Mr. Perry asked the Minister for Communications, Marine and Natural Resources his views on whether the ESB is reluctant to provide operational details to his office; if he will obtain answers to previous questions; and if he will make a statement on the matter. [11113/04]
John Perry
Question:123 Mr. Perry asked the Minister for Communications, Marine and Natural Resources if the ESB fisheries division provides him, under the Electricity (Supply) (Amendment) Act 1961, with an annual financial breakdown of profits in detail and operating costs; his views on the matter; and if he will make a statement on the matter. [11114/04]
John Perry
Question:124 Mr. Perry asked the Minister for Communications, Marine and Natural Resources if the ESB fisheries division operated third party companies to reduce its accountability in relation to its statutory duties, namely fisheries protection and research; and if he will make a statement on the matter in view of the previous questions. [11115/04]
I propose to take Question No. 120 and Questions Nos. 122 to 124, inclusive, together.
I do not have any statutory powers to intervene in the day-to-day operations of the ESB. Overall corporate governance responsibilities relate in the main to appointment of the chairperson and board members; submission of annual report and accounts; approval of the board's overall capital expenditure programme; approval of the board's borrowing requirements; and approval of the establishment and acquisition of companies by the board.
Under the Shannon Fisheries Acts, the ESB has the statutory duty of managing, conducting and preserving the Shannon fisheries, subject and without prejudice to, the primary function of maintaining, working and developing the Shannon hydro-electric works. No profit accrues from the board's fisheries operations and their activities in this regard are focused on stock conservation.
Under the Electricity (Supply) (Amendment) Act 1961, the proceedings of the board regarding the fisheries and fishing rights vested in it is, without prejudice to the performance or exercise by the board of their duties, powers and functions, subject to general supervision of the Minister. The 1961 Act also provides that the board shall furnish to the Minister an annual report, statistics, returns and accounts in relation to fisheries under its management. The ESB has published its fisheries conservation annual report for the year ending December 2002 which sets out details of turnover, expenditure, payroll, operational costs and net loss figures in relation to fisheries which have been extracted from the financial statements of the ESB for the year ended 31 December 2002.
I am advised by the ESB that it has always provided protection for the fisheries of the River Shannon and that it currently employs a specialist security service for this purpose. I am further advised that the ESB also engages the services of the Shannon Regional Fisheries Board on contract to assist in the cover of peak periods and that NUIG provides its facilities and expertise to carry out any research required by the ESB. It is the view of the ESB that these contractual arrangements do not reduce or affect accountability in relation to the performance of these statutory duties and functions which are explicitly proper to the ESB under the legislation in question.
Question No. 121 answered with QuestionNo. 116.
Questions Nos. 122 to 124, inclusive, answered with Question No. 120.
Water Quality.
John Perry
Question:125 Mr. Perry asked the Minister for Communications, Marine and Natural Resources his views on the decline in water quality on the southern end of Lough Allen; if his Department proposes to carry out a survey; and if he will make a statement on the matter. [11116/04]
My colleague, the Minister for the Environment, Heritage and Local Government has primary responsibility for policy and legislation regarding water quality issues. Statutory responsibility for water management and protection rests primarily with the local authorities. Regional fisheries boards, as part of their fisheries management function, are also in a position to take prosecutions for water pollution offences. The Shannon Regional Fisheries Board advises me that it has been made aware of a deterioration in water quality in Lough Allen by Leitrim County Council. The board, in consultation with the county council, is presently monitoring water quality on the lake in order to identify the source of the problem.
Allergies Incidence.
John Gormley
Question:126 Mr. Gormley asked the Minister for Health and Children if he will consider setting up a task force on allergies and asthma with a view to initiating a strategy on these matters in order to reduce the number of persons suffering from allergies and asthma and to help those who do suffer to manage their problem; and if he will make a statement on the matter. [10917/04]
My Department is aware of a number of recent references both in the general media and in the medical literature to an increase in the prevalence of conditions which may be related to allergies. These conditions include food allergies resulting in gastrointestinal symptoms, allergies to substances in the environment which may lead to a variety of skin conditions, and the one which has been most widely researched and reported, that of an apparent increase in the prevalence of asthma in both children and adults. It is accepted that some of the factors which may influence this include environmental factors, not only smoking and workplace exposure to respiratory irritants, but a more general level of exposure to environmental substances which cause allergies to occur.
The Deputy may wish to note that the Competitiveness, Internal Market, Industry and Research, Council on 22 September 2003 approved a directive regarding the labelling of the ingredients present in foodstuffs. In particular, the new labelling rules aim to ensure that consumers suffering from food allergies, or who wish to avoid eating certain ingredients for any other reason, are informed of the ingredients present. The new directive also establishes a list of ingredients liable to cause allergies or intolerances. The new rules will also extend to alcoholic beverages if they contain an ingredient on the allergens list.
The European Commission is currently developing an action plan on environment and health which is expected to be adopted later this year. The plan is intended to reduce the disease burden caused by environmental factors in the EU with special emphasis on children, to identify and to prevent new health threats caused by environmental factors and to strengthen EU capacity for policy making in this area. Officials of my Department and of the Department of the Environment, Heritage and Local Government are involved in this issue.
An expert workshop on childhood asthma organised by the joint research centre of the European Commission will be held in Cork on 22-23 April 2004. This will examine approaches to research on childhood asthma from a genetic and environmental perspective, which is part of a major research initiative ongoing at EU level. It is hoped to agree Council conclusions on this issue at the June Employment, Social Protection, Health and Consumer Affairs Council.
At the recent meeting of EU chief medical officers, the chief medical officer of my Department placed the issues of food and asthma on the agenda in order to share experiences, information and knowledge with our EU partners on these issues. In addition, my Department has contacted the Health Research Board to discuss the issue of research into the incidence of asthma in the Irish population and the establishment of an asthma register is under discussion between professionals dealing with asthma and the ERHA. These initiatives should help to clarify some of the causative factors relating to these conditions and, more specifically, to identify contributing factors. Thus, preventative and treatment strategies can be more effectively developed and implemented.
Health Boards Funding.
Dan Neville
Question:127 Mr. Neville asked the Minister for Health and Children if his attention has drawn to the fact that a new health centre in Ballymun cannot be opened due the Northern Area Health Board’s lack of funds; if he intends to provide the NAHB with the relevant funds to ensure that the centre is fully operational; and if he will make a statement on the matter. [10921/04]
As outlined in my reply to a previous Dáil question concerning this development, my Department is working with the Eastern Regional Health Authority and the Northern Area Health Board in an effort to resolve a range of issues relating to this project. The issues relate to matters such as the scope of the project, compliance with procurement procedures, securing value for money and the issue of funding for the project. A new and revised proposal has very recently been submitted to my Department in this regard and this is currently under consideration.
Psychiatric Services.
Dan Neville
Question:128 Mr. Neville asked the Minister for Health and Children if the implementation of the recommendations of the reports of the working group on child and adolescent psychiatry was considered in the context of the Estimates process for 2004; and if he will make a statement on the matter. [10922/04]
The development of child and adolescent psychiatric services has been a priority in recent years. Since 1997, additional funding of almost €19 million has been provided to allow for the appointment of additional consultants in child and adolescent psychiatry, for the enhancement of existing consultant-led multi-disciplinary teams and towards the establishment of further teams. Further development of this much improved service, as recommended in the reports of the working group on child and adolescent psychiatry, was considered in the context of the Estimates process for 2004 and will be considered again in the context of the Estimates process for 2005 and subsequent years.
Hospital Services.
Ned O'Keeffe
Question:129 Mr. N. O’Keeffe asked the Minister for Health and Children if transportation can be made available to transfer a person (details supplied) from Dublin to a hospital in Cork. [10924/04]
Responsibility for the provision of hospital services to residents of County Cork is a matter for the Southern Health Board. My Department has, therefore, asked the chief executive officer of the board to reply to the Deputy directly in relation to the issue raised.
Ned O'Keeffe
Question:130 Mr. N. O’Keeffe asked the Minister for Health and Children the steps he intends to take to ensure that a service (details supplied) continues to be provided at Cork University Hospital. [10925/04]
Provision of the specific services referred to by the Deputy is a matter for the Southern Health Board. My Department has, therefore, asked the chief executive officer of the board to reply to the Deputy directly in relation to the issue raised.
Paul McGrath
Question:131 Mr. P. McGrath asked the Minister for Health and Children when the dialysis unit at the Midland Regional Hospital, Tullamore, was set up; the cost of setting up the unit; the training that was undertaken by staff for the unit; the number of staff appointed to run the unit and their grades; when the unit became operational; the number of persons who utilise the unit weekly; and if he will make a statement on the matter. [10926/04]
Responsibility for the provision of services at the Midland Regional Hospital at Tullamore rests with the Midland Health Board. My Department has, therefore, asked the chief executive officer of the board to examine the issues raised by the Deputy and to reply to him directly.
Paul McGrath
Question:132 Mr. P. McGrath asked the Minister for Health and Children the hospitals in which there are dialysis units; and the doctor complement in each of the units. [10927/04]
The information requested by the Deputy concerning the location of dialysis units is outlined in the following table:
|
Health Board/Authority |
Hospital |
|
Eastern Regional Health Authority |
Beaumont Hospital; Mater Hospital; St. Vincent’s University Hospital; Adelaide & Meath Hospital incorporating the National Children's Hospital at Tallaght; St. James's Hospital (acute only); Children's University Hospital, Temple Street. |
|
Mid-Western Health Board |
Limerick Regional Hospital. |
|
North Eastern Health Board |
Cavan General Hospital. |
|
North Western Health Board |
Sligo General Hospital; Letterkenny General Hospital |
|
South Eastern Health Board |
Waterford Regional Hospital. |
|
Southern Health Board |
Cork University Hospital; Tralee General Hospital. |
|
Western Health Board |
University College Hospital, Galway; Mayo General Hospital. |
In addition, the Deputy will be aware that funding has been allocated to the Midland Health Board to facilitate the commissioning of a new unit at the Midland Regional Hospital at Tullamore. My Department is advised that the unit is scheduled for commissioning in 2004.
Data in respect of the complement of doctors in each dialysis unit are not routinely collected by my Department. My Department has, therefore, requested the regional chief executive of the Eastern Regional Health Authority and the chief executive officers of the health boards to collate the information requested and to forward it directly to the Deputy.
Health Services Reports.
Paul McGrath
Question:133 Mr. P. McGrath asked the Minister for Health and Children the progress made to date on the implementation of the Hanly Report; the way in which this will impact on the Midlands area; and if he will make a statement on the matter. [10928/04]
The Hanly report makes specific recommendations for reorganising hospitals in two regions, the east coast and mid west, and sets out a series of principles for the future organisation of hospital services nationally. It also proposes measures to reduce junior doctors' average working hours and improve medical education and training. The current and future role of acute hospitals in the Midland Health Board and other regions will be examined as part of the preparation of a national hospitals plan by the acute hospitals review group which I appointed recently.
Negotiations with the Irish Medical Organisation in relation to the reduction of NCHD hours are continuing in the Labour Relations Commission. A number of further meetings have been scheduled over the coming weeks and every effort will be made to complete these negotiations at the earliest possible date.
In recent weeks, a national co-ordinator and support team have been seconded to oversee the implementation process in the health agencies. Medical manpower managers are also playing a central role. A working group in each hospital is needed to implement these measures and to monitor progress in relation to the reduction in NCHD hours. The urgent need to establish these groups at both national and local level has been discussed with the Irish Medical Organisation. To date the IMO has not agreed to the establishment or operation of these groups.
As regards the consultant contract, a number of meetings have taken place between officials of my Department, health service employers and representatives of the Irish Hospital Consultants Association and the Irish Medical Organisation. I anticipate that talks will resume when the Irish Hospital Consultants Association suspends phase one of its programme of industrial action.
I announced the establishment of implementation groups for the Hanly report in both the east coast and mid-western regions on 27 February 2004. The groups will carry out the detailed work on identifying what services should be provided in each hospital, in line with the Hanly recommendations.
I announced the composition of a group to prepare a national plan for acute hospital services on 27 January 2004. The group contains a wide range of expertise from the areas of medicine, nursing, health and social care professions and management. It also includes an expert in spatial planning and representation of the public interest. The group has been asked to prepare a plan for the interim health services executive for the reorganisation of acute hospital services, taking account of the recommendations of the national task force on medical staffing including spatial, demographic and geographic factors. Neither the local implementation groups nor the acute hospitals review group has met as a result of the consultants' continuing industrial action. I ask that all parties participate to progress the work of these groups.
As regards medical education and training, the sub-group of the task force which dealt with these issues has remained in place. The group has been asked to examine and report to me on the measures required to accommodate NCHD training in all postgraduate training programmes within a 48-hour working week and safeguard both training and service delivery during the transition to a 48-hour working week. The group is also working with my Department to assist it in accommodating the integrated education and training functions proposed by the task force within the structures announced by the Government in June 2003 following publication of the Brennan and Prospectus reports. It is anticipated that the group will report before the end of the year.
As regards accident and emergency services, there are a number of initiatives under way at present. These include prioritised planning for the discharge of patients by acute hospitals and increased liaison between hospital and community services; additional funds €21.4 million to facilitate the discharge of patients from the acute system to a more appropriate setting; and additional emergency medicine consultant appointments, rising from 21 posts in 2000 to 51 posts approved by 1 January 2004. Subject to resolution of outstanding legal issues associated with the required regulatory changes, I recently announced my intention to provide, at the earliest appropriate date, the necessary additional revenue funding to the pre-hospital emergency care council for the roll-out of the training element of the emergency medical technician-advanced programme.
In the mid-west, the health board has recently advertised for a number of emergency care physicians, fully registered doctors, to complement service delivery in emergency departments. I have also recently approved the appointment of the design team to prepare an outline development control plan for Ennis General Hospital. The plan will be prepared having regard to the development brief prepared by the project team which sets out the broad scope of the proposed future development at Ennis General Hospital and identified the priority areas for development.
Hospitals Building Programme.
Paul McGrath
Question:134 Mr. P. McGrath asked the Minister for Health and Children if he will report on progress on Phase 2B of Mullingar Hospital; and the expected date for the coming on stream of additional beds at this hospital. [10929/04]
The development control plan for phase 2B of Longford-Westmeath General Hospital is currently being examined in my Department and will be considered for progression to tender stage in the context of the Midland Health Board's capital development priorities in line with overall funding resources available for 2004 and beyond. The project is currently programmed for completion in three stages, under a single building contract, with the final stage scheduled for completion in late 2008. Almost all bed accommodation is included in stages one and two of the development which are currently programmed for completion in early 2007 and mid 2008 respectively. More accurate project construction and stage completion dates will only be available when tenders are received.
Nursing Home Subventions.
Paul McGrath
Question:135 Mr. P. McGrath asked the Minister for Health and Children the rate of nursing home subvention payable to a single person in the highest dependency category in a nursing home, who has an old age contributory pension at the maximum rate and approximately €25,000 in the bank as their only means. [10930/04]
The Nursing Home (Subvention) Regulations 1993 are administered by the health boards and the Eastern Regional Health Authority. There are currently three rates of subvention payable, namely, €114.30, €152.40 and €190.50 for the three levels of dependency which are medium, high and maximum. Included in these payments is an increase of 25% which came into effect in April 2001.
Means are assessed for this scheme to ensure that the available funding is directed at those people who have the greatest need of financial assistance. Means for the purpose of the regulations relates to any income that person might have, and includes a costing of assets derived as a weekly figure. Given the amount of information given by the Deputy, it is not possible to give a definitive answer. If the Deputy has a specific case in mind, he should contact the local area health board in the first instance.
Ambulance Service.
Brian O'Shea
Question:136 Mr. O’Shea asked the Minister for Health and Children his proposals to provide the funding sought by the South Eastern Health Board to construct a new ambulance station for Waterford (details supplied); and if he will make a statement on the matter. [10931/04]
Responsibility for the provision of ambulance services in Waterford rests with the South Eastern Health Board. The provision of a new ambulance station at Waterford is one of a number of capital development projects proposed by the board under the national development plan. The proposal will be considered by my Department in conjunction with the board in the context of its capital priorities and in line with overall funding resources available in 2004 and beyond.
Suicide Incidence.
Dan Neville
Question:137 Mr. Neville asked the Minister for Health and Children further to Parliamentary Question No. 148 of 16 November 2003, if he will give details so the report of the clinical director on the death by suicide of a person on ward 5B of the Mid-Western Regional Hospital. [10932/04]
It would not be appropriate for me to release details of the report referred to by the Deputy. My Department has therefore asked the chief executive officer of the Mid-Western Health Board to examine the request and reply directly to the Deputy in this matter.
Dan Neville
Question:138 Mr. Neville asked the Minister for Health and Children the number of suicides in each quarter of 2000, 2001, 2002 and 2003. [10933/04]
Data on mortality are compiled by the Central Statistics Office and published in the annual and quarterly reports on vital statistics. The latest period for which data are available is January to September 2003 and these figures are set out in the table below in addition to figures for years 2000 to 2002.
|
Quarter |
2000# |
2001# |
2002* |
2003* |
|
January-March |
120 |
120 |
67 |
71 |
|
April-June |
128 |
148 |
132 |
111 |
|
July-September |
130 |
128 |
114 |
116 |
|
October-December |
108 |
123 |
138 |
N/A |
|
Total |
486 |
519 |
451 |
298 |
* Provisional figures based on year of registration.
# Figures based on year of occurrence.
N/A Indicates ‘Not Available'.
Source: Central Statistics Office.
Consultant Appointments.
John Perry
Question:139 Mr. Perry asked the Minister for Health and Children his plans to appoint a nephrologist for the North Western Health Board; and if he will make a statement on the matter. [10934/04]
I am pleased to advise the Deputy that my Department recently granted approval to the North Western Health Board to proceed with the recruitment process for the appointment of a consultant nephrologist to Letterkenny and Sligo General Hospitals.
Organ Donation Scheme.
Damien English
Question:140 Mr. English asked the Minister for Health and Children if, in view of the proposals to introduce a plastic card formatted driving licence, he will consider the introduction of an organ donation scheme using these cards in an opt-out format as in an operation in many EU countries; and if he will make a statement on the matter. [10936/04]
Two systems can be used to ascertain an individual's wishes on organ donation: the opt-in system and the opt-out system. The former system, which operates in this country, requires that the specific consent to donation of each person, or their relatives, be obtained before organs or tissues are removed. The opt-out system presumes that all citizens consent to donation unless they have specifically expressed a wish to the contrary.
The practice in this country is that where a person has indicated his or her willingness to donate organs by way of carrying an organ donor card, or a driving licence marked accordingly, the consent of the next-of-kin is always sought.
Even where opt-out systems are in operation, the relatives of the deceased are approached as part of the donor screening process to seek a medical history of any high-risk behaviour. Thus, the relatives will always be aware that a donation is being considered and can register an objection to the donation.
I understand that the European Commission is considering the question of legislation in respect of organ transplantation, including the issue of consent, and proposes to conduct a thorough scientific evaluation of the situation. It will present a report to the Council of the European Union on its analysis as soon as possible.
In the meantime I propose to establish, in the near future, an expert group to examine organ donation, procurement and utilisation policy in Ireland as part of the national health strategy's commitment to develop organ transplantation services with a view to increasing donation and utilisation rates. I would be happy to have the issue raised by the Deputy considered by the group in the course of its work.
National Treatment Purchase Fund.
Tony Gregory
Question:141 Mr. Gregory asked the Minister for Health and Children if there is evidence available to his Department to indicate that certain consultants in certain health board areas are not accepting individual patients under the national treatment purchase fund; if they are delaying accepting individual patients until the NTPF provides them with additional patients; and if he will make a statement on the matter. [11045/04]
Tony Gregory
Question:142 Mr. Gregory asked the Minister for Health and Children if he will have examined the take up for the NTPF in each health board area; and the waiting lists in each health board area to establish if the NTPF is being responded to in the manner for which it was intended in each area. [11047/04]
I propose to take Questions Nos. 141 and 142 together.
The national treatment purchase fund, NTPF, was established as one of the key actions for dealing with public hospital waiting lists arising from the health strategy Quality and Fairness: A Health System for You. Significant progress has been achieved by the NTPF in targeting those patients who have been waiting longest for treatment. To date some 12,000 patients have already had treatment arranged by the NTPF. It is now the case that, in most instances, adults waiting for a procedure for six months, or three months in the case of children, are now being facilitated by the fund. If patients are prepared to travel outside of their local area, their treatment can be arranged more quickly.
The NTPF has reported that there are some difficulties with patient referrals from certain hospitals and within certain specialities, particularly in the eastern region. The NTPF is continuing to work with the individual hospitals concerned to try to ensure that patients who are waiting longest for treatment are in a position to avail of the fund. The fund has run an extensive media campaign and operates a lo-call telephone line so that patients and their general practitioners are fully aware of the services available. It is open to both patients or their general practitioners to contact the NTPF directly to inquire about treatment and to make the necessary arrangements if necessary.
I would like to assure the Deputy that the take up of the fund in each health board area continues to be kept under review by my Department in conjunction with the NTPF.
Personal Assistance Service.
Bernard J. Durkan
Question:143 Mr. Durkan asked the Minister for Health and Children when the South Western Area Health Board will provide a wheelchair for a person (details supplied) in County Kildare whose child urgently requires same; and if he will make a statement on the matter. [11048/04]
The provision of aids and appliances, including wheelchairs, is a matter for the relevant health board. Accordingly, the Deputy's question has been referred to the regional chief executive officer, Eastern Regional Health Authority with a request that he examine the matter and reply directly to the Deputy as a matter of urgency.
Community Care.
Richard Bruton
Question:144 Mr. R. Bruton asked the Minister for Health and Children his proposals for the development of community care; and if he will describe, in particular, the likely implications of these proposals for patients in the catchment of St. Ita’s, Portrane, County Dublin. [11049/04]
Responsibility for the provision of the services referred to by the Deputy rests with the Eastern Regional Health Authority. My Department has therefore asked the regional chief executive officer to investigate the matter raised by the Deputy and reply to him directly.
Question No. 145 answered with QuestionNo. 43.
Question No. 146 withdrawn.
Hospital Staff.
Bernard J. Durkan
Question:147 Mr. Durkan asked the Minister for Health and Children when and the extent to which he expects to provide sufficient staff to enable Maynooth community hospital become fully operational; and if he will make a statement on the matter. [11067/04]
As the Deputy will be aware, the provision of health services in the Kildare area is, in the first instance, the responsibility of the South Western Area Health Board acting under the aegis of the Eastern Regional Health Authority. The chief executive of the authority has informed my Department that efforts are ongoing to recruit the necessary additional staff to enable the unit to become fully operational and that interviews are currently taking place in this regard.
Hospital Funding.
Bernard J. Durkan
Question:148 Mr. Durkan asked the Minister for Health and Children when he proposes to provide the necessary funding to allow the Naas General Hospital become fully operational; and if he will make a statement on the matter. [11068/04]
Responsibility for the provision of services at Naas General Hospital rests with the Eastern Regional Health Authority. The additional revenue funding required to complete the commissioning of additional services at the hospital is the subject of consideration by my Department in conjunction with the authority.
Psychological Service.
Bernard J. Durkan
Question:149 Mr. Durkan asked the Minister for Health and Children if he has satisfied himself regarding the adequacy of numbers of psychologists available through the various health boards; if he has plans to increase the numbers in line with current demands; and if he will make a statement on the matter. [11069/04]
There has been an increase of more than 50% over the period from end-1999 to end-2003 in the number of fully qualified psychologists working in the health service. Numbers have increased by 150 from 291 to 441 in whole-time equivalent, WTE, terms. This has contributed to a significant increase in the volume of psychological services provided.
The Department, together with the directors of human resources in the health boards, is currently prioritising support for the implementation of a key recommendation of the report of the joint review group on psychological services in the health service, which was published in March 2002, relating to human resource planning through the provision of a substantial number of additional postgraduate training places in clinical psychology.
At present, 52 students are enrolled on the Psychological Society of Ireland's clinical psychologist postgraduate training diploma, 24 are enrolled on the doctoral programme in clinical psychology at TCD, 12 in second year and 12 in third year, and 21 are enrolled on the doctoral programme in clinical psychology at UCD, ten will graduate in 2004 and 11 in 2006. The National University of Ireland, Galway commenced a new postgraduate doctorate in the 2003-04 academic year with an enrolment of 12 students.
The Department remains committed to working on an ongoing basis with health agencies, educational providers and the education authorities to ensure adequate provision of training places in clinical psychology, having regard to the important recommendations on investment in training and education detailed in the action plan for people management published in November 2002.
Question No. 150 answered with QuestionNo. 28.
Primary Care Services.
Bernard J. Durkan
Question:151 Mr. Durkan asked the Minister for Health and Children if consideration will be given to the upgrading of services available through health centres thereby eliminating some of the overcrowding at accident and emergency services; and if he will make a statement on the matter. [11071/04]
Bernard J. Durkan
Question:165 Mr. Durkan asked the Minister for Health and Children if he will consider upgrading the various health centres throughout County Kildare with a view to addressing the issue of bed shortages in general hospitals; and if he will make a statement on the matter. [11085/04]
I propose to take Questions Nos. 151 and 165 together.
The primary care strategy, Primary Care: A New Direction, aims to shift the emphasis from the current over-reliance on acute hospital services to one where patients will be able to access an integrated multidisciplinary team of general practitioners, nurses, health care assistants, home helps, occupational therapists, physiotherapists and social workers in their local community.
Primary care is the first port of call for the majority of people who use health services and all but the most complex and acute health care needs of individuals, families and groups may be effectively met within the primary care setting. Appropriately structured, it can meet 90% to 95% of all health and personal social service needs.
As the new primary care model is implemented, a wider primary care network of other professionals, including speech and language therapists, community pharmacists, dieticians, dentists, chiropodists and psychologists will also provide services for the population served by each primary care team. The provision of a wide range of services in this way will allow a higher proportion of people's care requirements to be met in the community. The strategy also envisages the development of extended-hours and out-of-hours cover for defined primary care services. The management of this wide range of care within the primary care setting represents the most appropriate, effective and user-friendly approach to the organisation of service delivery.
Primary care, planned and organised on this basis, can lessen the current reliance on specialist services and the hospital system, particularly accident and emergency and out-patient services. Based on available evidence, it has the potential to reduce the requirement for specialist services, reduce hospitalisation rates, reduce lengths of stay for those who are hospitalised, promote more rational prescribing and improve efficiency.
In order to give effect to the new model, I gave approval to the establishment of ten initial primary care implementation projects — one in each health board area — in October 2002. These projects build on the services and resources already in place in the locations involved so as to develop a primary care team in line with the interdisciplinary model described in the strategy. There has been substantial progress to date with the development of primary care teams in the chosen locations and the experience gained in the initial group of implementation projects will provide valuable learning which can inform the wider implementation which is to follow.
The primary care strategy also recognises that the provision of modern, well-equipped, accessible premises will be central to the effective functioning of the primary care team. One of the Government's key objectives is to facilitate and encourage the development, where appropriate, of modern, well-equipped, user-friendly buildings in which the broad range of primary care services, including general practice, can be delivered. The strategy also emphasises the need to gain full benefit from existing buildings and to fully exploit any opportunities for public-private partnerships in implementing the development programme. I am committed to developing policy in such a way as to maximise the opportunities to attract private sector interests into the provision of facilities to support delivery of primary care service in accordance with the new interdisciplinary model.
The identification, prioritisation and provision of health centres, including the upgrading of such facilities, to meet the health and personal social service needs of local communities are matters for the health boards or the Eastern Regional Health Authority, ERHA. In the case of health centres in County Kildare, this responsibility rests with the ERHA. I have asked the regional chief executive of the ERHA to reply direct to the Deputy on this matter.
National Treatment Purchase Fund.
Bernard J. Durkan
Question:152 Mr. Durkan asked the Minister for Health and Children the costs to date of the treatment purchase scheme; the number of patients treated; the way in which this compares with the cost involved in conventional patient treatment; and if he will make a statement on the matter. [11072/04]
The cost of the national treatment purchase fund to date is as follows:
|
€m |
||
|
2002 |
5.012 |
|
|
2003 |
30.057 |
Provisional Outturn |
|
2004 |
44.00 |
Allocation |
The NTPF purchases procedures from private and public hospitals in Ireland. Where it is not possible to treat patients within a reasonable period in Ireland, either in public or private hospitals, arrangements can be made to refer the public patients for treatment abroad, having regard to quality, availability and cost. If patients are prepared to exercise choice by travelling to where there is capacity, they can be treated a lot quicker in many instances. To date the fund has arranged treatments for over 12,000 patients.
The majority of procedures funded by the NTPF to date have been carried out in private hospitals in Ireland. With regard to the cost of these procedures, the NTPF has informed my Department that it has not released individual procedure prices paid, for reasons of commercial sensitivity. However, my Department has been assured by the fund managers that the prices negotiated by the NTPF compare favourably with the comparative benchmarks available for the costs of the vast majority of procedures.
Nursing Staff.
Bernard J. Durkan
Question:153 Mr. Durkan asked the Minister for Health and Children the reasons for the increased use of agency nurses throughout the health services with consequent increased costs; and if he will make a statement on the matter. [11073/04]
The Health Services Employers Agency carries out quarterly national surveys of the nursing resource, including use of agency nurses. The numbers of agency nurses used in the public health service for the months mentioned are as follows:
|
Month |
Average Number of Agency Nurses Used per Day |
|
September 2000 |
414 |
|
January 2001 |
423 |
|
April 2001 |
499 |
|
July 2001 |
417 |
|
October 2001 |
397 |
|
January 2002 |
459 |
|
April 2002 |
384 |
|
September 2002 |
416 |
|
December 2002 |
346 |
|
March 2003 |
307 |
|
June 2003 |
294 |
|
September 2003 |
317 |
|
December 2003 |
329 |
|
Average 2001 |
434 |
|
Average 2002 |
401 |
|
Average 2003 |
312 |
While these figures demonstrate significant fluctuations, a comparison of the averages for 2001, 2002, and 2003 clearly shows a continuous and substantial downward trend. The average number of agency nurses used per day during 2003 was 122 less than the number used during 2001, and 187 less than that used during April 2001, the highest monthly number recorded since the surveys began.
As regards the use of agency nurses, the position is that they have always been a feature of the system. Use of agency nurses has been declining in recent years, but there are sound operational reasons why their use continues. These reasons include making up for unexpected absences and dealing with short-term fluctuations in workflows.
Question No. 154 answered with QuestionNo. 23.
Hospital Services.
Bernard J. Durkan
Question:155 Mr. Durkan asked the Minister for Health and Children the number of surgical beds unoccupied due to staff or other logistical reasons throughout the country; and if he will make a statement on the matter. [11075/04]
The information requested by the Deputy, on the number of surgical beds unoccupied due to staff or other logistical reasons throughout the country is not routinely collected by my Department.
My Department has, therefore, asked the chief executive officer of the Eastern Regional Health Authority and the chief executive officer of each health board to respond directly to the Deputy with regard to the information requested.
Questions Nos. 156 to 158, inclusive, answered with Question No. 38.
Hospital Waiting Lists.
Bernard J. Durkan
Question:159 Mr. Durkan asked the Minister for Health and Children the length of time a person has to wait in respect of heart surgery, hip replacement and cataract removal; and if he will make a statement on the matter. [11079/04]
Bernard J. Durkan
Question:162 Mr. Durkan asked the Minister for Health and Children the extent to which waiting lists in respect of cataract removal have increased or decreased in the past 12 months. [11082/04]
I propose to take Questions Nos. 159 and 162 together.
The total number of people reported to be on public hospital in-patient waiting lists for cardiac surgery as at 30 September 2003, the latest date for which figures are available, was 228. This includes 78 adults waiting over 12 months for cardiac surgery.
The total number of adults reported to be waiting for orthopaedic procedures, either as an in-patient or as a day case was 3,023. The total number of adults waiting more than 12 months for in-patient treatment in the specialty of orthopaedics was 794, which represents a decrease of 42% between September 2002 and September 2003.
The total number of adults reported to be waiting for ophthalmology procedures, either as an in-patient or as a day case was 3,656. The total number of adults waiting more than 12 months for in-patient treatment in the specialty of ophthalmology was 448, which represents a decrease of 16% between September 2002 and September 2003.
The national treatment purchase fund has been successful in locating additional capacity and arranging treatments for approximately 12,000 patients to date. It is now the case that, in most instances, adults waiting more than six months for an operation and children waiting more than three months will now be facilitated by the fund. The fund has reported that patients willing to be treated outside of their local area can have their treatment arranged more quickly.
Orthodontic Service.
Bernard J. Durkan
Question:160 Mr. Durkan asked the Minister for Health and Children the plans to address the increasingly serious problem of lack of services and facilities in respect of orthodontic treatment; and if he will make a statement on the matter. [11080/04]
As the Deputy is aware, the provision of orthodontic services is a matter for the health boards or health authority in the first instance.
The aim of my Department is to develop the treatment capacity of orthodontics in a sustainable way over the longer term. Given the potential level of demand for orthodontic services, the provision of those services will continue to be based on prioritisation of cases based on treatment need — as happens under the existing guidelines.
The guidelines were issued in 1985 and are intended to enable health boards to identify in a consistent way those in greatest need and to commence timely treatment for them. Patients in category A require immediate treatment and include those with congenital abnormalities of the jaws such as cleft lip and palate, and patients with major skeletal discrepancies between the sizes of the jaws. Patients in category B have less severe problems than category A patients and are placed on the orthodontic treatment waiting list. The number of cases treated is dependent on the level of resources available, in terms of qualified staff, in the area, and this is reflected in the treatment waiting list. The provision of orthodontic services is currently severely restricted in some health boards due to the limited availability of trained specialist clinical staff to assess and treat patients.
However, I am pleased to advise the Deputy that I have taken a number of measures to address the shortage of specialists and so increase the treatment capacity of the orthodontic service on a national basis.
The grade of specialist in orthodontics has been created in the health board orthodontic service. In 2003, my Department and the health boards funded 13 dentists from various health boards for specialist in orthodontics qualifications at training programmes in Ireland and at three separate universities in the United Kingdom. These 13 trainees for the public orthodontic service are additional to the six dentists who commenced their training in 2001. Thus, there is an aggregate of 19 dentists in specialist training for orthodontics. These measures will complement the other structural changes being introduced into the orthodontic service, including the creation of an auxiliary grade of orthodontic therapist to work in the orthodontic area.
Furthermore, the commitment of the Department to training development is manifested in the funding provided to both the training of specialist clinical staff and the recruitment of a professor in orthodontics for the Cork Dental School. This appointment at the school will facilitate the development of an approved training programme leading to specialist qualification in orthodontics. The chief executive officer of the Southern Health Board has reported that the professor commenced duty on 1 December 2003. In recognition of the importance of this post at Cork Dental School my Department has given approval in principle to a proposal from the school to further substantially improve the training facilities there for orthodontics. This project should see the construction of a large orthodontic unit and support facilities which will ultimately support an enhanced teaching and treatment service to the wider region under the leadership of the professor of orthodontics.
Orthodontic initiative funding of €4.698 million was provided to the health boards and authority in 2001 and this has enabled health boards to recruit additional staff, engage the services of private specialist orthodontic practitioners to treat patients and build additional orthodontic facilities.
In June 2002, my Department provided additional funding of €5 million from the treatment purchase fund to health boards, specifically for the purchase of orthodontic treatment. This funding enables boards to provide both additional sessions for existing staff and purchase treatment from private specialist orthodontic practitioners.
Finally, the chief executive officers of the health boards and authority have informed my Department that at the end of the December quarter 2003, there were 21,727 children receiving orthodontic treatment in the public orthodontic service. This means that there are over twice as many children getting orthodontic treatment as there are children waiting to be treated and 4,432 extra children are getting treatment from health boards and authority since the end of 2001.
Cancer Treatment Services.
Bernard J. Durkan
Question:161 Mr. Durkan asked the Minister for Health and Children the extent to which adequate facilities are available for the treatment of cancer patients; and if he will make a statement on the matter. [11081/04]
The Government's objective is to provide a model of cancer care which ensures that patients with cancer receive the most appropriate and best quality of care regardless of their place of residence.
Since 1997, there has been a total cumulative investment of €550 million in the development of appropriate treatment and care services for people with cancer. This includes the sum of €15 million which was provided this year to ensure that we continue to address the demands in cancer services is such areas as oncology/haematology services, oncology drug treatments, symptomatic breast disease services and to support the implementation of the report on the development of radiation oncology services in the Southern and Western Health Board regions.
Cancer services throughout the country have benefited significantly from this investment which far exceeds the £25 million requirement which was initially envisaged under the national cancer strategy. This investment has enabled the funding of 90 additional consultant posts, together with support staff in key areas such as medical oncology, radiology, palliative care, hispathology and haematology.
Since 1997, approximately €95 million in capital funding has been allocated specifically for the development of cancer related initiatives. These include an investment of €60 million in radiation oncology, €8.75 million in the bone marrow unit at St. James's Hospital and €11.9 million in BreastCheck.
My plan for the development of radiotherapy services is that the supra-regional centres in Dublin, Cork and Galway will provide comprehensive radiation oncology services to patients regardless of their place of residence. Specifically, these supra-regional centres will provide significant sessional commitments to patients in the mid-west, north-west and south-east.
The current developments in the southern and western regions will result in the provision of an additional five linear accelerators. This represents an increase of approximately 50% in linear accelerator capacity. We will also provide for the appointment of an additional five consultant radiation oncologists. We currently have ten consultant radiation oncologists nationally. This will result in a significant increase in the numbers of patients receiving radiation oncology in the short term. These appointments are specifically designed to offer patients in areas such as the north-west, mid-west and south-east equity of access to radiation oncology services that are in line with best international practice.
As regards symptomatic breast cancer services, the report on the development of services for symptomatic breast disease recommended the development of specialist units throughout the country. Five of these units are now operational and a further eight are at various stages of development. Last year, I also announced the extension of the national breast screening programme to counties Carlow, Kilkenny and Wexford and also the national roll-out of the programme to southern and western counties.
Question No. 162 answered with QuestionNo. 159.
Hospital Services.
Bernard J. Durkan
Question:163 Mr. Durkan asked the Minister for Health and Children the extent to which he expects the hospital services to be able to meet demands in respect of heart operations and hip replacements in the future; and if he will make a statement on the matter. [11083/04]
There has been a significant increase in the consultant manpower needed to deliver cardiac surgery and orthopaedic services in the past ten years. Based on figures provided by Comhairle na nOspidéal the number of cardiothoracic surgeons has increased from six to 11 between 1993 and 2003 and the number of orthopaedic surgeons has increased from 52 to 76 in the same period.
Plans and developments are in place which will increase the capacity for cardiac surgery. For example, the theatre and critical care complex, completed as part of the phase 2 development at University College Hospital Galway, includes provision for cardiac surgery facilities. Approval has also been given to the Southern Health Board to proceed with the planning and construction of a new €82 million cardiac and renal dialysis building at Cork University Hospital.
With regard to orthopaedic services, the North Eastern Health Board has reorganised its orthopaedic services in moving trauma services to Drogheda and creating additional capacity for elective services in Navan. A new orthopaedic service will be provided at Mayo General Hospital. This new service will serve the people of the western region and increase orthopaedic capacity for the region. Building and equipping of the new facility has been completed.
The single most important factor for admission to hospital is bed availability therefore increasing the bed capacity of the acute hospital system is of particular priority for my Department. The first phase of this process commenced in January 2002 where capital and revenue funding was provided for an additional 709 beds. This represents an increase of 6% on existing capacity. Some 568 of these beds have been commissioned to date.
Bernard J. Durkan
Question:164 Mr. Durkan asked the Minister for Health and Children the full bed complement at James Connolly Memorial, Blanchardstown, Dublin; the capacity of the hospital in respect of each category of patient; the extent to which adequate staff and back-up facilities and services are available; his plans to address the issue; and if he will make a statement on the matter. [11084/04]
Responsibility for the provision of services at James Connolly Memorial Hospital, Blanchardstown, rests with the Eastern Regional Health Authority. My Department has, therefore, asked the regional chief executive of the authority to investigate the matter raised by the Deputy and reply to him directly.
Question No. 165 answered with QuestionNo. 151.
Health Board Services.
Olivia Mitchell
Question:166 Ms O. Mitchell asked the Minister for Health and Children if any of the family circumstances concerning a person (details supplied) in County Meath or their child or other member of their family ever came to the attention of the social services prior to the crime which has resulted in a life sentence; and if so, the action which was taken and the support which was given to the family. [11103/04]
Responsibility in respect of the matter to which the Deputy refers rests with the North Eastern Health Board. I am aware that the person referred to previously resided in the area served by the Northern Area Health Board. Accordingly, my Department has asked the chief executive officers of the North Eastern Health Board and the Eastern Regional Health Authority to reply to the Deputy directly.
Air Services.
Eamon Ryan
Question:167 Mr. Eamon Ryan asked the Minister for Transport if his attention has been drawn to negotiations between Aer Lingus and other companies regarding potential future investment within the company or a potential working agreement with the company; when he expects the Government to decide on the future ownership structure of the company; and if an analysis has been done within his Department comparing the possible merits of the company being able to issue its own share offering as against the possible trade sale of part or all of the company. [10951/04]
I have been assured by Aer Lingus that no negotiations are ongoing between it and other companies regarding potential future investment in the company or a potential working agreement with the company. I have explained to the House on previous occasions that, in the light of the continuing turnaround in the company's finances and the continually changing environment, last July I asked the chairman of Aer Lingus to examine and report back to me on the future options for the company. The chairman furnished his report to me at a meeting on 16 September 2003 in which it was indicated that a private sector investment process should be initiated without delay.
I also commissioned an independent corporate finance consultant to examine the sale options for Aer Lingus, taking account of the Aer Lingus report. In summary, he has supported the case made by the chairman.
I recently advised my Cabinet colleagues of the current state of my deliberations concerning the future of Aer Lingus and in particular, my concerns relating to maintaining the status quo. I also advised that I will be reverting to Government on specific options for the company in the near future. My deliberations involve detailed consideration of the reports from Aer Lingus and the independent corporate finance consultant as well as a thorough examination of all options for the future of the company.
Residency Permits.
Billy Timmins
Question:168 Mr. Timmins asked the Minister for Justice, Equality and Law Reform the position regarding an American citizen who wishes to come here to stay for a number of years to be with their child; the way in which they should go about this; and if he will make a statement on the matter. [10954/04]
It is not possible, based on the information provided, to state whether the person concerned would qualify for residency in the State for a number of years. The person concerned should write to the immigration division of my Department, which is located at 13-14 Burgh Quay, Dublin 2, giving details of his or her plan to stay in Ireland to enable my officials to decide on the application.
Criminal Convictions.
Barry Andrews
Question:169 Mr. Andrews asked the Minister for Justice, Equality and Law Reform if he will consider introducing legislation on the rehabilitation of offenders who have served short custodial sentences and have not been convicted in a defined period since completing their sentence; if he will obtain the views on the Law Reform Commission; his views on the impact of such legislation on employment law, defamation law and the issuing of visas; and if he will make a statement on the matter. [11052/04]
I understand that the Deputy's question refers, in particular, to the expunging of the criminal record of an offender where that person is considered to have been rehabilitated, having served a short custodial sentence and not having been convicted of an offence again.
In general, there is no provision in Irish law allowing for the lapsing or non-disclosure of records of criminal convictions. The Employment Equality Act 1998 came into operation on 18 October 1999. The Act outlaws discrimination in relation to employment on nine grounds, namely, gender, marital status, family status, sexual orientation, religion, age, disability, race and membership of the Traveller community. A review of the Act was carried out in 2001 in accordance with section 6(4) of the Act. During the course of the review, a number of new grounds were suggested for inclusion: socio-economic status-social origin, trade union membership, criminal conviction/ex-offender/ex-prisoner and political opinion. It was decided that a detailed examination of the implications of extending the employment equality legislation to the suggested complex new grounds was necessary. The law department of UCC was awarded the contract to carry out a detailed comparative examination of international legislation in relation to the four grounds. The final report will be published shortly. The findings of the research and the information obtained through the Department's consultations in respect of the review will provide the knowledge base necessary for any future policy decisions in this area.
With the introduction of the Children Act 2001, provision was made for a limited wiping of the slate in respect of most offences committed by persons under 18, once certain conditions have been met. This provision, which came into operation on 1 May 2002, limits, as far as possible, the effects of a finding of guilt, where those conditions have been met, by treating the person for all purposes in law as a person who has not committed, been charged with, prosecuted for, found guilty or dealt with for an offence.
The second programme of the Law Reform Commission for the period 2000 to 2007 proposes, as part of an examination of the law on privacy, to consider longevity of criminal records and expunging of certain offences from the records. In addition, the Deputy may wish to note that the Law Reform Commission in its consultation paper on the court poor box, published in March this year, raised the issue of spent conviction schemes and indicated that it would welcome submissions on the issue with a view to a future publication dedicated to a full consideration of whether such a scheme should be introduced in this jurisdiction. I should caution that any proposal for a general clean slate provision would raise complex and difficult issues which would need to be addressed but I will certainly carefully consider any recommendations which the Law Reform Commission may make on the matter.
Garda Deployment.
Seán Crowe
Question:170 Mr. Crowe asked the Minister for Justice, Equality and Law Reform if he will increase the number of Garda and Garda undercover patrols in the Mount Pillear, St. Bricin’s Park and surrounding areas of Dublin. [10937/04]
I have been informed by the Garda authorities responsible for the detailed allocation of resources, including personnel, that these areas are the subject of regular foot and mobile patrols by both uniformed and plain clothes gardaí. I have been further informed that additional plain clothes gardaí have recently been assigned to the areas concerned. Local Garda management is satisfied that the current level of resources, personnel and patrols are adequate to meet the policing needs of these areas.
Visa Applications.
Pat Breen
Question:171 Mr. P. Breen asked the Minister for Justice, Equality and Law Reform, further to Question No. 515 of 23 March 2004, the grounds on which the appeal was upheld in respect of the temporary visa sought by a person (details supplied) in County Clare. [10938/04]
Following the appeal against the refusal of the application in question the visa appeals officer re-examined the application, taking into account the information supplied in the application and at appeal. The visa appeals officer was not satisfied that the concerns of the visa officer had been addressed by the appeal and upheld the decision to refuse the application for the reasons as outlined in my reply to the Deputy's Question No. 515 of 23 March 2004. It is still open to the applicant to make a fresh application with up to date supporting documentation and the matter will be considered anew.
Deportation Orders.
Donie Cassidy
Question:172 Mr. Cassidy asked the Minister for Justice, Equality and Law Reform if consideration will be given to an application made by a person (details supplied) in County Westmeath to be allowed to remain here; and when a decision will be made in this matter. [10939/04]
The person to whom the Deputy refers was initially admitted to the State on 13 September 2002 and subsequently granted permission to remain until 9 September 2003, on the basis of a work permit granted to a particular employer in County Leitrim.
The Garda national immigration bureau became aware in July 2003 that the person concerned was working for a different employer in County Kildare without a valid work permit. As a consequence of this a notice of intention to deport was issued by my Department on 25 July 2003. The Immigration Act 1999 sets out the procedures involved in deporting a person. Where the Minister proposes to deport a person he or she is given the options of making representations within 15 working days setting out the reasons he or she should not be deported, that is, be allowed to remain temporarily in the State, leave the State before the order is made or consent to the making of a deportation order. No representations for leave to remain were received from the applicant. His case will be examined shortly in the context of a consideration under section 3 of the Immigration Act 1999, as amended, and section 5 of the Refugee Act 1996 — prohibition of refoulement. When a decision has been reached it will be communicated to the applicant.
Visa Applications.
Jack Wall
Question:173 Mr. Wall asked the Minister for Justice, Equality and Law Reform the reasons a person (details supplied) in County Carlow was refused a holiday visa; and if he will make a statement on the matter. [10940/04]
The person in question made a visa application in February, 2004. The application was refused because it had not been established, on the basis of the documentation supplied to my Department, that the applicant would observe the conditions of the visa. In particular it was felt that the applicant had not displayed sufficient evidence of her obligations to return home following the proposed visit. There were also inconsistencies in the visa application. The applicant indicated that she would not be accompanied by members of their family to Ireland. It transpires, however, that the applicant's brother had also made a visa application in which he indicated he would be travelling with the applicant. It is open to the applicant to appeal against the refusal by writing to the visa appeals officer in my Department.
Prisoner Transfers.
Mary Upton
Question:174 Dr. Upton asked the Minister for Justice, Equality and Law Reform if a person (details supplied) will be facilitated in serving their sentence here; and if he will make a statement on the matter. [10955/04]
I have given my consent to this transfer. My Department has also received consent for the transfer from both the United Kingdom authorities and the person referred to by the Deputy. Our transfer legislation requires that an application be made to the High Court for a warrant authorising both the transfer into the country of a prisoner and for his or her continued detention in this jurisdiction. The State's legal officers are currently preparing an application to the High Court for the necessary warrant. On receipt of a warrant, final arrangements for the transfer will be made.
Electoral Franchise.
Aengus Ó Snodaigh
Question:175 Aengus Ó Snodaigh asked the Minister for Justice, Equality and Law Reform his views on the decision by the European Court of Human Rights that denying prisoners the opportunity to vote in elections breaches Article 3 of Protocol 1 of the European Convention on Human Rights; the steps and timetable for action his Department will implement to ensure that the Government is in full compliance with this decision. [11088/04]
The European Court of Human Rights, ECHR, in a judgment adopted on 9 March, 2004, found that a breach of Article 3 of Protocol 1 to the European Convention on Human Rights had occurred in a case taken by a prisoner in the United Kingdom. The prisoner, who is serving a sentence of life imprisonment, had complained that, as a convicted prisoner, he was subject to a blanket ban on voting in elections. This was as a result of legislation in the UK, section 3 of the Representation of the People Act 1983, which prohibits a convicted person from voting in a parliamentary or local election during the term of his or her detention in a penal institution. There is no such legislation in this country which prohibits a sentenced person from voting.
The Supreme Court, while taking cognisance of the fact that there are no statutory provisions which prohibit a convicted prisoner from voting, has held that the State is under no constitutional obligation to facilitate prisoners in the exercise of that franchise. I have, however, brought the recent ruling of the ECHR to the attention of both the Attorney General and the Minister for the Environment, Heritage and Local Government, who has primary responsibility for electoral legislation. I will consider the implications of the court's judgment in consultation with my colleagues.
Residency Permits.
Eamon Gilmore
Question:176 Mr. Gilmore asked the Minister for Justice, Equality and Law Reform the position regarding the application for residency by a person (details supplied) in County Dublin which was made to his Department in July 2003; the reason it has taken so long to process this application; if he has made a decision on the application; and if he will make a statement on the matter. [11097/04]
The person in question arrived in the State in July 2002, whereupon he made an application for permission to remain based on parentage of a child born in the State on 30 April 1999. Following the decision of the Supreme Court in the cases of L & O, the separate procedure which then existed to enable persons to apply to reside in the State on the sole basis of parentage of an Irish born child ended on 19 February 2003. The Government decided that the separate procedure would not apply to cases which were outstanding on that date. There are a large number of such cases outstanding at present, including the case to which the Deputy refers.
Since the person in question does not have an alternative legal basis for remaining in this jurisdiction the issue of permission to remain will be considered but only in the context of a ministerial proposal to make a deportation order. In that context, a notification of a proposal to make a deportation order will be issued to the person in question and he will be given an opportunity to make representations in relation to it. If, in the light of those representations and the range of factors set out in section 3(6) of the Immigration Act 1999, the Minister decides not to make a deportation order he will be given leave to remain on a humanitarian basis. Due to the large number of such cases on hand, I am unable to say at this stage when the file will be further examined.
Asylum Applications.
Eamon Gilmore
Question:177 Mr. Gilmore asked the Minister for Justice, Equality and Law Reform the position regarding the application for residency by a person (details supplied) in Dublin 1 who has been living here for the past four years; the reason it is taking so long to process this application; if he has made a decision on the application; and if he will make a statement on the matter. [11098/04]
The person in question arrived in the State in June 2000 under the work permit scheme and was granted permission to remain on that basis.
In January 2003 the person applied for permission to remain in the State based on parentage of an Irish born child. Following the decision of the Supreme Court in the cases of L & O, the separate procedure which then existed to enable persons to apply to reside in the State on the sole basis of parentage of an Irish born child ended on 19 February 2003. The Government decided that the separate procedure would not apply to cases which were outstanding on that date. There are a large number of such cases outstanding at present, including the case to which the Deputy refers. Where such persons have an alternative legal basis to remain in the State their applications are simply returned to them, as in the case of the person concerned.
I understand that the person's work permit is pending renewal by the Department of Enterprise, Trade and Employment, whereupon he may seek a further extension of his permission to remain in the State.
Question No. 178 withdrawn.
Animal Welfare.
Richard Bruton
Question:179 Mr. R. Bruton asked the Minister for the Environment, Heritage and Local Government if he intends to introduce legislation to regulate the operation of puppy farms here; his commitments to recent adverse publicity concerning the operation of this industry to date; if he has had discussions with the Kennel Club about this issue; and if he will make a statement on the matter. [10958/04]
The main focus of action by local authorities under the Control of Dogs Acts 1986 and 1992 has been on the control of stray dogs and dangerous dogs, such as guard dogs, which could present nuisance or danger to the general public or to other animals.
In light of recent concerns, my Department is currently engaged in discussions with relevant interests, including the Irish Kennel Club, regarding the proper management of kennels in relation to the provisions of the Control of Dogs Acts. These discussions are continuing and are intended to inform my Department whether, or to what extent, revised legislation or regulatory administrative measures are desirable in this area.
Election Management System.
Ned O'Keeffe
Question:180 Mr. N. O’Keeffe asked the Minister for the Environment, Heritage and Local Government if his attention has been drawn to the difficulties being placed on certain persons under a Bill (details supplied); and if he intends to make an amendment to this section. [10977/04]
The Electoral (Amendment) Act 2002 provides that a non-party candidate at a local election must have his or her nomination paper assented to by 15 persons registered in the register of electors for the area. The form is left in a local authority office for the assentors to sign and who must produce a specified photographic identification document. Details will be included in the notes to the nomination form. There are no proposals to amend the legislation.
Planning Issues.
Bernard J. Durkan
Question:181 Mr. Durkan asked the Minister for the Environment, Heritage and Local Government if he or his Department have set out guidelines appertaining to the prevention of potential pollution by applicants for planning permission; and if he will make a statement on the matter. [10978/04]
The current standard for domestic effluent treatment and disposal from single dwelling houses is set out in Recommendation SR6: 1991, which was drawn up by the National Standards Authority of Ireland and which was issued by my Department by way of circular letter to each planning authority on 8 January 1992. In another circular letter of 31 July 2003 on groundwater protection and the planning system, guidance was given on best practice in regard to development plan policies and development control and enforcement standards and practices to ensure protection of groundwater quality. I am generally satisfied that planning authorities bring these requirements substantively to the attention of prospective applicants for planning permission.
The Environmental Protection Agency has published a draft manual on treatment systems for single houses in 2000 which was designed to help planning authorities, builders and others to deal with the complexities of on-site systems, including packaged systems. I understand that the EPA is currently reviewing the draft manual in the light of comments received from interested parties. My intention is to call up the revised EPA manual, when available, in technical guidance document H — Drainage and Waste Water Disposal — on the national building regulations. I also understand that the National Standards Authority of Ireland intends, at that stage, to withdraw SR6: 1991 in favour of the revised manual.
As well as complying with the requirements of the planning code, applicants for planning permissions may, particularly in the case of larger developments, be required to comply with a range of legislation relating to the prevention of pollution, including the Water Pollution Acts 1977 and 1990, the Waste Management Acts 1996 to 2003 and the Air Pollution Act 1987. Many larger developments may also be required to comply with the integrated pollution prevention and control licensing system under the Environmental Protection Agency Acts 1992 and 2003.
Water and Sewerage Schemes.
Batt O'Keeffe
Question:182 Mr. B. O’Keeffe asked the Minister for the Environment, Heritage and Local Government when he expects to be in a position to approve, to go to planning, the application to extend and upgrade the waste water treatment plant and collection system at Clonea Power, County Waterford; and if he will make a statement on the matter. [10979/04]
The Clonea Power scheme is an element of a proposed villages sewerage scheme ranked sixth in the list of water and sewerage schemes submitted by Waterford County Council in response to my Department's request to all local authorities in 2003 to produce updated assessments of the needs for capital works in their areas and to prioritise their proposals on the basis of the assessments. The assessment will be taken into account in the framing of the next phase of my Department's water services investment programme in due course.
Planning Issues.
Jerry Cowley
Question:183 Dr. Cowley asked the Minister for the Environment, Heritage and Local Government the number of valid planning applications for so called one-off housing in relation to urban and rural areas respectively which are withdrawn by the applicant before a final discussion is made, expressed as a percentage of the total, for each year for the past five years; and if he will make a statement on the matter. [11042/04]
The information requested is not available in my Department. While planning authorities publish information on the total number of planning applications that they receive and the nature of decisions made, statistics are not provided in relation to the numbers of applications withdrawn before a decision is made by the planning authority.
Grant Payments.
Paul Kehoe
Question:184 Mr. Kehoe asked the Minister for the Environment, Heritage and Local Government if his Department has provided grant aid to a company (details supplied) in County Louth over the past year; if so, the amount of same; and if he will make a statement on the matter. [11062/04]
No grant-aid has been made available to the company in question in the past year.
The company has made an application for grant assistance under the waste management infrastructural grants scheme for private waste facilities. However, having regard to the significant levels of investment and growth in scale of the private waste industry in recent times, the process of waste industry consolidation which is in evidence and which is likely to continue, and the competing priorities for the resources available in the environment fund, I have announced earlier this week that I do not now intend to proceed with this grants scheme. Instead, I intend to divert the funding to a number of other areas including increased waste enforcement activities, which are crucial to providing the confidence that current and future investment in the legitimate waste sector will not be undermined by illegal activities competing against fully compliant operators.
Legislative Programme.
David Stanton
Question:185 Mr. Stanton asked the Minister for the Environment, Heritage and Local Government the sections of the Planning and Development Act 2000 which have yet to be implemented; the time scale for same; and if he will make a statement on the matter. [11100/04]
All sections of the Planning and Development Act 2000 have been commenced, with the exception of section 261. My Department is currently finalising detailed guidance for the assistance of planning authorities on the implementation of section 261 on the control of quarries. It is intended to commence this section of the Act following the publication of the guidance which is expected shortly.
Question No. 186 withdrawn.
Stádas na Gaeilge.
Aengus Ó Snodaigh
Question:187 D’fhiafraigh Aengus Ó Snodaigh den Aire Gnóthaí Pobail, Tuaithe agus Gaeltachta cé mhéid uair atá an coiste idir-rannach maidir le ceist stádas na Gaeilge san Aontas Eorpach tar éis bualadh le chéile ó bunaíodh é; cén uair a bhuaileadar le chéile agus cé a bhí ag an gcruinniú; cad é toradh an phlé sin; agus cén fáth nach bhfuil na heagraíochtaí agus baill thofa Thithe an Oireachtais á gcoimeád ar an eolas maidir leis an bplé sa choiste go dtí seo. [11089/04]
Aengus Ó Snodaigh
Question:188 D’fhiafraigh Aengus Ó Snodaigh den Aire Gnóthaí Pobail, Tuaithe agus Gaeltachta cé hiad na baill den choiste idir-rannach maidir le ceist stádas na Gaeilge san Aontas Eorpach; an bhfuil sé i gceist go mbeidh ionadaithe ó na heagraíochtaí deonacha nó ó Fhoras na Gaeilge mar bhaill den choiste nó fiú ag suí isteach ar na cruinnithe. [11090/04]
Aengus Ó Snodaigh
Question:189 D’fhiafraigh Aengus Ó Snodaigh den Aire Gnóthaí Pobail, Tuaithe agus Gaeltachta tuairisc a thabhairt ar cén dul chun cinn atá déanta go dtí seo ag an gcoiste idir-rannach maidir le ceist stádas na Gaeilge san Aontas Eorpach. [11091/04]
Aengus Ó Snodaigh
Question:190 D’fhiafraigh Aengus Ó Snodaigh den Aire Gnóthaí Pobail, Tuaithe agus Gaeltachta an fíor nár bhuail an coiste idir-rannach maidir le ceist stádas na Gaeilge san Aontas Eorpach le chéile ach uair amháin ó bunaíodh é seacht seachtain ó shin; agus cad iad na céimeanna a ghlacfaidh sé le fuadar a chur faoina chuid oibre. [11092/04]
Aengus Ó Snodaigh
Question:191 D’fhiafraigh Aengus Ó Snodaigh den Aire Gnóthaí Pobail, Tuaithe agus Gaeltachta an bhfuil sé i gceist miontuairiscí chruinniú an choiste idir-rannach maidir le ceist stádas na Gaeilge san Aontas Eorpach a scaipeadh ar na hurlabhraithe agus na heagraíochtaí atá ag cur na Gaeilge chun cinn. [11093/04]
Tógfaidh mé Ceisteanna Uimh. 187 go dtí 191 go huile le chéile.
Dírím aird an Teachta ar an bhfreagra a thug mé ar Cheisteanna Dála Uimh. 114, 178 & 183 ar 9 Márta 2004 maidir le stádas na Gaeilge san Aontas Eorpach.
Mar a cuireadh in iúl san fhreagra sin, agus mar a dúirt mé arís le linn na díospóireachta le déanaí sa Teach seo faoin gceist, tá grúpa oibre bunaithe ag an Rialtas chun anailís a dhéanamh ar an méid gur féidir a bhaint amach agus na féidearthachtaí atá ann chun dul chun cinn a dhéanamh. Bhí trí chruinniú ard-leibhéil ag an ngrúpa oibre seo go dtí seo agus beidh cruinniú eile ann ar 15 Aibreán 2004.
Toisc gur bunaíodh an grúpa oibre chun comhairle a ullmhú don Rialtas, níl sé i gceist go mbeidh cruinnithe an ghrúpa oscailte d'ionadaithe eile nó go bhfoilseofar miontuairiscí. É sin ráite, bhí cruinniú amháin go dtí seo idir ionadaithe ó mo Roinn féin agus ionadaithe ó Chomhdháil Náisiúnta na Gaeilge leis an gceist a phlé agus tá sé i gceist go gcasfar leo arís go luath ach cruinniú an ghrúpa oibre ar 15 Aibréan a bheith thart.
Faoi mar is eol don Teachta, is ar an Rialtas atá an fhreagracht cinneadh a dhéanamh ar an gceist seo — tar éis an taighde agus an anailís chuí a bheith déanta — agus ní ar an ngrúpa oibre. Ar an mbonn sin, agus ag cloí le nósanna imeachta an Oireachtais, ní dóigh liom gur ceart dom sonraíocht maidir le hainmneacha na n-oifigeach a lua ar thaifead an Tí.
Táim lán-sásta go bhfuil dul chun cinn fiúntach á dhéanamh ag an ngrúpa oibre agus go mbeifear in ann dul thar n-ais chuig an Rialtas le moltaí dea-bhreithnithe in am tráth. Níl sé i gceist agam, mar sin, a thuilleadh a rá faoi na torthaí a d'fhéadfadh a bheith ar an obair seo go léir go dtí go mbeidh tuairisc réitithe ag an ngrúpa oibre agus scrúdú iomlán déanta uirthi.
Social Welfare Benefits.
Bernard J. Durkan
Question:192 Mr. Durkan asked the Minister for Social and Family Affairs if a person (details supplied) in County Kildare will be reinstated to previous rent allowance payment, who is currently on a community employment scheme payment €182.20 per week; and if she will make a statement on the matter. [11054/04]
The South Western Area Health Board has advised that payment of rent supplement is being revised as a consequence of the increased level of household income arising from participation, by the person concerned, in a community employment scheme. This person who is in receipt of a one-parent family payment may retain that payment in addition to her community employment payment.
Under standard supplementary welfare allowance rules, rent supplements, which are subject to a means test, are normally calculated to ensure that a person, after the payment of rent, has an income equal to the rate of supplementary welfare allowance appropriate to his or her family circumstances, less a minimum contribution, currently €13, which recipients are required to pay from their own resources.
In addition to the minimum contribution, recipients are also required to contribute, towards their rent, any additional assessable means that they have over and above the appropriate basic supplementary welfare allowance rate. Up to €50 per week of income from part-time employment may be disregarded in this means test.
People on community employment schemes may retain a portion of their rent supplement for up to four years subject to a gross household income limit of €317.43 per week. The supplement may be retained at 75% in year one, 50% in year two and 25% in years three and four.
A participant in community employment may opt to be assessed in accordance with that tapered withdrawal system or standard supplementary welfare allowance rules and will be entitled to whichever option is more beneficial. In this case the board has advised that, as the level of household income exceeds the €317.43 limit applicable to the tapered withdrawal system, the amount of rent supplement to be put into payment has been calculated in accordance with standard supplementary welfare allowance rules. By participating in a community employment scheme the person's net income increases by €50 per week. Payment of rent supplement at the revised rate will be made shortly.