Dáil Éireann debate -
Thursday, 27 May 2004

Vol. 586 No. 4

Adjournment Debate.

Special Educational Needs.

Mr. Wall

Scoil Mhicíl Naofa is a school in Athy with special classes for children with autism as well as mainstream classes. The teaching staff and the board of management are among the best in dealing with issues and driving forward the educational agenda set out by the Minister for Education and Science.

It is with regret, therefore, that we must today seek facilities for some of the children in the school. In September 2003, the board of management of the school made an application to the Department of Education and Science to allocate resources for special needs assistance hours to the children. Despite a year having gone by, no such allocation has been made. Deputy Ó Fearghaíl and I have for some time met parents and the principal of the school to try to alleviate their concerns about this matter. Unfortunately, however, we do not seem to have made any progress in this regard with the Department of Education and Science.

One of the problems is that there is no inspector for the school. We have been waiting for some time for the appointment of an inspector for the Athy area. Therefore, the school has a problem in that no one in the system is advocating the school as making a positive contribution through its work. Misleading information is also being given by the Department of Education and Science on the numbers of teachers there and so on. This was rectified by written replies to Deputy Ó Fearghaíl and itemised by the principal to ensure that the wrong figures were not being worked from.

This school has been inspected on a number of occasions by the national executive and has been examined in regard to its work through resource hours, special needs teachers and so on. It has never been found wanting in any area. While the school has special classes for children with autism and mainstream classes, they have two separate identities. However, in determining the figures for the school, the Department seems to be rolling them together, giving the false impression that the school has enough resource hours and special needs assistance so there is no need for further hours and resources to be allocated to the school.

Some nine children have attended the school since September 2003 and we are still awaiting a decision on their application. We are approaching the second year of their education and it is of major concern to the principal, teachers and parents of these children that nothing has happened. A new school year is approaching in September but there has still been no decision. No inspector has been appointed. Even if one were appointed, however, he or she needs a training period. When the inspector is appointed, will he or she take Scoil Mhicil Naofa as one of the first schools to be investigated to ensure that the he or she can put the school's case? The school has been inspected on a number of occasions in regard to the usage of the facilities allocated through special needs assistance hours and so on.

That has been examined with a fine tooth-comb by the Department on three occasions and not one mistake has been found apart from the mistake made by the Department in dealing with figures. The Department of Education and Science should look seriously at the wonderful work being done in this school and ensure that when inspectors are appointed this is one of the first schools dealt with. I refer in particular to the nine children who have been waiting for almost a year for the facilities which will allow them to progress.

Minister of State at the Department of Education and Science (Mr. B. Lenihan)

I am pleased to clarify the position of the Department of Education and Science on Scoil Mhicíl Naofa, Stanhope Street, Athy. The Department is most anxious that all children receive an education appropriate to their needs. The school referred to by the Deputy currently has the services of two full-time resource teachers, two full-time learning support teachers, one of whom is shared with another school, three special class teachers for pupils on the autistic spectrum, two special class teachers for children with mild general learning disability, 16 full-time special needs assistants and three part-time special needs assistants.

The Department has received applications for additional special educational resources on behalf of special needs pupils at the school in question. The Department received more than 8,400 applications for special education resources since 15 February 2003 and the batch of approximately 5,000 applications received between 15 February and 31 August 2003 is being considered at present. Priority was given to cases involving children starting school last September and all these cases were responded to at or before 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 the Department's inspectorate and the national educational psychological service. These applications are being further considered in the context of the outcome of surveys of special education resource provision conducted over the past year and the data submitted by schools as part of a nationwide census of such provision.

Processing the applications is a complex and time-consuming operation. However, the Department is endeavouring to have this completed as quickly as possible and officials from the Department will then respond to all applicant schools. Pending a response, schools are advised to refer to Circular 24103, which issued in September 2003. This circular contains practical advice on how to achieve the most effective deployment of resources allocated for special educational needs within the school.

In the case of teacher resources, the outcome for each applicant school will be based on a new weighted system of allocation which the Department of Education and Science announced recently. This system, as part of which an additional 350 teaching posts will be allocated, will involve two main elements, making a staffing allocation to schools based on a predicted incidence of pupils with special educational needs and making individual allocations in the case of children with more acute lower prevalence special educational needs.

It is expected that the change to a weighted system will bring with it a number of benefits. The new system will reduce the need for individualised educational psychological assessment, reduce the volume of applications to the Department for additional resources for individual pupils and give greater flexibility to schools, which will facilitate the development and implementation of improved systems and procedures in schools to meet the needs of pupils with low achievement and pupils with special educational needs.

Transitional arrangements for the introduction of the weighted system are being developed at present in consultation with representative interests. As soon as those consultations have been completed, the detailed arrangements for processing applications for resources, including those for special needs assistants and those received after 31 August last, will be set out in a circular to be issued to schools before the end of the current school year.

The staffing for special classes for children with autism as outlined in the relevant departmental circulars is one teacher at a pupil-teacher ratio of 6:1 together with two full-time special needs assistants. The school in question has three classes for children on the autistic spectrum with a total enrolment of ten pupils in the three classes. These classes currently enjoy significant staffing resources. There are three teachers, nine special needs assistants — eight full-time and one part-time — deployed to cater for the pupils in these special classes. The staffing for special classes for children with mild general learning disability as outlined in the relevant departmental circular is one teacher at a pupil-teacher ration of 11:1. The school referred to by the Deputy currently has two classes for children with mild general learning disability with a total enrolment of 18 pupils. There are two teachers and five special needs assistants currently assigned to cater for these pupils.

The Department inspectorate reviewed this school as part of a sample survey carried out on resource teacher and special needs assistant support in 25 schools in 2002 and the national educational psychologist service is currently further reviewing the special educational needs supports required at this school.

Applications for an inclusion class and a pre-school class for children on the autistic spectrum have been submitted by the school and are also being considered. It is hoped to notify the school authorities of the outcome in the near future. An application for major capital improvement works has also been received from the management authorities of the school.

The 2004 school building programme has been published and full details of individual projects are available on the Department's website. On the basis of the funding allocation and the competing priorities for that funding, it was not possible to include the school in question. However, a key strategy for building projects 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 the multi-annual building programme from 2005 onwards. The Department expects to be in a position to make a further announcement on this matter during 2004. I thank the Deputy for giving me the opportunity to clarify the position on this school.

Drug Dealing.

Mr. Gregory

I thank the Chair for allowing me to raise this serious matter.

Some weeks ago a serious drug dealing problem in the vicinity of Our Lady of Lourdes Church in the north inner city was brought to my attention, a problem made all the more serious in that very young children were being used by drug dealers as look-outs, runners and even to exchange drugs for money. This was happening during daytime hours and while the gardaí were active, and continue to be active, against the main drug dealers involved, with a number of arrests being made, their work was made more difficult by the involvement of children as young as ten or 12, as well as a group aged between 18 and 20 years.

The anti-social behaviour associated with these groups and activities made life very difficult for local residents and in particular for senior citizens attending the Lourdes day care centre nearby. There was an atmosphere of intimidation from the groups of youths involved in this activity and it seemed to many that the area was going back to the bad old days and the open drug dealing in the early 1990s. There is a very active community policing forum in the area and its full-time co-ordinator organised a meeting of all the local projects working with young people as well as representatives of the Garda, the city council, public representatives and residents. Again, the gardaí responded very positively and their senior personnel in the area attended the meetings. The general response from those witnessing this activity was that the gardaí were doing all they could but that the same could not be said of other State agencies which clearly had a responsibility for certain aspects of the problem.

People have rightly asked why young children could be drawn into a web of drug dealing in daytime hours when they should clearly have been in school. I would like a response from the Minister outlining the measures taken by educational welfare officers, or whoever is responsible for this matter, to identify children and teenagers who are absent from school. What measures are on hand to cater for these young people so they are not drawn into this web of drug dealing?

Efforts have been made locally, with local projects creating a young people at risk process to co-ordinate all voluntary and statutory agencies working with young people at risk in the community. That process has been greatly assisted by the child care manager of the Northern Area Health Board but, regrettably, other agencies have not played their part. In particular it was felt that the Department of Education and Science, the vocational education committee and the probation and welfare service have not taken this matter seriously. They have failed to be represented at senior level in the young people at risk process or to attend meetings when invited.

I hope that by bringing this matter to the attention of the Minister he will use his good offices to ensure all relevant State agencies play their part fully, that they respond in a more positive manner in future and participate fully in the young people at risk process. If we do not respond now, not only will more young people be dragged into the drugs trade by the attraction of easy money but some will end up as the next generation of serious drug dealers.

It is ironic that the location where this problem has re-emerged was to have had facilities fast tracked and developed under the RAPID programme, if such a programme ever existed, and many of us doubt it. The national school nearby at Rutland Street was to have had a new modern school built in the adjoining Gloucester Diamond but Government cutbacks put that on the backburner. It has not happened and there is no sign of it. The Lourdes day care centre which has borne the brunt of the intimidation from the drug dealing was to have been given a brand new premises on a nearby site but again Government cutbacks have put that on the backburner. The Lourdes youth and community services were to have been provided under the RAPID programme with an ultra modern premises but that has disappeared.

These are resources that are vitally needed in this disadvantaged community. I hope the Minister will look into this matter and ensure the resources are provided and particularly that the relevant officials from the various responsible State agencies do their job and participate in the young people at risk process in order that they can respond adequately and deal with the problem.

Mr. B. Lenihan

The Education (Welfare) Act 2000 established the National Educational Welfare Board as the single national body with responsibility for school attendance. The Act provides a comprehensive framework promoting regular school attendance and tackling the problems of absenteeism and early school leaving. The general functions of the board are to ensure that each child attends a recognised school or otherwise receives a certain minimum education.

To discharge its responsibilities, the board is developing a nationwide service that is accessible to schools, parents, guardians and others concerned with the welfare of young persons. For this purpose, educational welfare officers are being appointed and deployed throughout the country to provide a welfare-focused service to support regular school attendance and discharge the board's functions locally.

The board has appointed a chief executive officer, directors of corporate services and educational welfare services and a management team of eight staff. To date, 62 educational welfare staff have been appointed.

I understand the board will shortly make a further educational welfare officer appointment which will bring the service delivery staff to its authorised complement of 63.

At this stage of its development, the aim of the board is to provide a service to the most disadvantaged areas, including areas designated under the Government's RAPID programme and most at-risk groups. Five regional teams have now been established with bases in Dublin, Cork, Limerick, Galway and Waterford and an educational welfare service is now available, for the first time, in the cities of Limerick, Galway and Kilkenny. Twelve towns with significant school going populations, 11 of which are designated under the Government's RAPID programme, also have an educational welfare officer allocated to them. These towns are Dundalk, Drogheda, Navan, Athlone, Carlow, Wexford, Bray, Clonmel, Tralee, Ennis, Sligo and Letterkenny.

In addition, the board will follow up on urgent cases nationally. Decisions relating to the assignment of staff to specific areas are a matter for the board, which is an independent statutory body. In 2004, the board will receive the first comprehensive data returns from schools and these will assist it in keeping the level of need for the new service in particular areas under review.

I understand from the board that the service delivery staff have been assigned to specific areas of the country since early December 2003 and that three such staff have been deployed to work with schools, parents, teachers and pupils in the north side of Dublin, including the Dublin 1 area. Over 400 active cases are being worked by educational welfare officers at present.

It is recognised that the difficulties experienced in disadvantaged areas cannot be solved by one agency acting alone. Education is but one of the many needs of the people living in these areas. The board is working in close co-operation with other services from the education, health and justice area so that children in need of special support are identified very early in their lives and followed up in a multidisciplinary way. I have no doubt this service will help prevent children and young people becoming involved in delinquent and anti-social behaviour in the future.

There are a range of schemes, initiatives and services dealing with educational disadvantage at both primary and post-primary level. These include the school completion programme, the visiting teacher service for Travellers and the home-school-community liaison scheme. Each of these schemes contributes in a very positive way to promoting the education of children and young persons.

As regards reports of drug dealing in the area, I am informed by my ministerial colleague, the Minister for Justice, Equality and Law Reform, that local Garda management is aware of the drug problem in the environs of Our Lady of Lourdes Church, Sean MacDermott Street. One of the main suppliers has been arrested on two occasions. I understand he has subsequently fled this jurisdiction. There have been a number of arrests this year leading to seizures and charges.

I am also informed by my ministerial colleague that the area will continue to receive ongoing attention from the Garda authorities. I also understand from the Garda authorities that the policy of the Garda Síochána on dealing with juveniles who offend is to consider the offender for inclusion in the Garda juvenile diversion programme. That programme provides that, in certain circumstances, a juvenile under 18 years of age who freely accepts responsibility for a criminal incident may be cautioned as an alternative to prosecution and the parents, guardians or persons acting in loco parentis agree to the terms of the caution. The Children Act 2001 placed this programme on a statutory footing and the relevant sections of the Act were commenced in May 2002.

The National Educational Welfare Board has indicated it has received no individual complaints about the impact of drugs on school attendance in this area. However, the board has also indicated it is prepared to meet the Deputy to hear his concerns and to see how best it can respond. I trust this clarifies the position for the Deputy.

Hospital Services.

Dr. Cowley

I am grateful for the opportunity to raise on the Adjournment. The Minister for Health and Children did not appear before the Joint Committee on Health and Children today, as arranged, to answer concerns about the Hollywood report on radiotherapy. This does not augur well for any new responsibilities the Joint Committee on Health and Children may have to fill the vacuum or democratic deficit caused by the removal of the democratically-elected members from the health boards.

This is a very important matter. There is a major problem. The Minister was in the Dáil and did not speak about the radiotherapy report or answer questions on the alternative report because he said he was going to meet the Joint Committee on Health and Children. The message was that the Minister was not available to meet us today nor would he be available next month or the following month and had other business to do in Europe. As far as I am concerned that is not acceptable. Thomas Paine who inspired the revolution in France and the US said: "A body of men holding themselves accountable to nobody, ought not to be trusted by anybody."

The Joint Committee on Health and Children is a part of the Oireachtas. Its task is to shadow the various Departments. It is composed of Senators and Deputies. The Minister has a responsibility to come before it. Under the new structure being suggested, the Joint Committee on Health and Children will be part of the accountability procedure but this does not augur well for the future.

The national cancer registry report proved once again that cancer survival depends on where one lives in Ireland. There are major deficiencies in the north-west, mid-west and the south-east. That the Hollywood report did not address the access problem is not acceptable. We have heard of various plans for private radiotherapy units in the south-east but none of these has any commitment to looking after persons with cancer who do not have money. If one has money one can have that service tomorrow, if not, one has to wait months for it. This is cancer care apartheid. Those who have money get a different service from those who do not have money.

We are entering another tier of cancer care apartheid. One will get the multidisciplinary care — the surgery, chemotherapy and radiotherapy — as recommended in the report, if one lives in Dublin, Cork or Galway but not in the south-east, mid-west or in north-west. Even when the Galway unit opens for the north-west, it will be further away than Dublin. What is proposed is not acceptable. Those in the north-west are annoyed at what is happening. They are putting up with a lifetime of pain and opting for more radical surgery and a lesser chance of cure rather than make the long journey to Dublin. Why make people travel to Dublin, where they do not wish to go, from Donegal or Waterford when the service could be provided locally at the same cost or less? Does that make sense? Ill people are not able to make the 22 journeys that are required to treat prostate cancer.

The staff costs are the same no matter where the unit is located. A unit could be provided in any area at a cost of €8 million. For example, a unit could be provided in either Waterford, Donegal and Limerick. Why does the Minister insist on spending €34 million on a unit in Dublin to where people will have to make long journeys by ambulance and arrive in a nauseous state? Is it fair that ill patients must travel such distances 22 times? A patient of mine who required radiotherapy died before he received a letter offering him it. That is a scandal. If he had money, he would have accessed that service and would have enjoyed a better life instead of dying in pain.

That is a shame and what the Minister proposes is more of the same. That is not acceptable to the people in the south-east. The people will rise up and take to the street because the Government has let them down. The people in the north-west and the mid-west have been let down as well.

Mr. B. Lenihan

The report let them down.

Dr. Cowley

The Minister let them down. The Minister refers to the survey of patients, but 44% of patients surveyed travelled fewer than ten miles, a further 16% travelled fewer than 30 miles but a number significantly less than 13% spent more than two hours travelling. While the report acknowledged that 64% had difficulty travelling to treatment, clearly when the majority of patients selected had travelled fewer than ten miles one way and the largest representation of patients came from Cork and Dublin, travelling was not an issue in the way it was for patients who travelled long distances. The patient survey was flawed. Similarly, the Hollywood report is flawed. What the Minister is doing is not acceptable and I ask him to reconsider the situation and give a commitment for radiotherapy units to the people of the south-east and the north-west.

Minister for Health and Children (Mr. Martin)

Due to unavoidable commitments, I was unable to appear before the Joint Committee on Health and Children today, although I understand there was no meeting. I am happy to reschedule a date in the future and look forward to meeting the joint committee to discuss in detail my plans for the development of radiation oncology nationally. I have discussed it already with the committee, most recently during the Estimates debate last month when the radiotherapy report was discussed. Normally such meetings are scheduled to suit both the members and the Minister in terms of being in a position to attend.

Dr. Cowley

The Minister kept putting it off.

Mr. Martin

My office indicated some weeks ago that I would not be in a position to attend the committee meeting today.

Dr. Cowley

Not from the Minister.

Mr. Martin

With respect, I would like the opportunity to speak. The Deputy interrupts me all the time. I would appreciate it if I was given the opportunity to speak. I did not interrupt the Deputy. Why was the meeting scheduled for today when my office had indicated some weeks ago that I would not be able to attend?.

The health service reform programme is based on the Government's decision of June 2003. This decision was based on the audit of structures and functions in the health system carried out by Prospectus and the report of the commission on financial management and controls in the health service. Both reports identified necessary organisational improvements to strengthen the capacity of the health system to meet the challenges of implementing the programme of development and reform set out in the health strategy document, Quality and Fairness: A Health System for You.

The health service reform programme has been brought to the attention of all members of health boards and the regional authority. The Government agreed that health boards and the Eastern Regional Health Authority would be abolished as part of the overall health reform programme. The Health (Amendment) Bill 2004 is an interim measure which provides for the abolition of the membership of the seven health boards, the Eastern Regional Health Authority and the three area health boards. It also provides for the abolition of the distinction between reserve and executive functions, with the assignment of those functions designated as reserve functions of the chief executive officers of the boards and the authority or the Minister for Health and Children, as appropriate.

The Bill's publication represents a further phase of the implementation of the reform programme for the health services and is a clear demonstration of the Government's commitment to implementing the proposals in the reform programme, which include the establishment of the Health Service Executive on a statutory basis, scheduled for January 2005.

The Government accepts that there is a need to strengthen existing arrangements for 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 aware that concerns have been expressed regarding the issue of public participation within the restructured health system. I have already indicated my intentions to bring forward proposals to provide opportunities for democratic input in the context of the new structures. I have given some consideration to the most appropriate mechanisms to support the development of appropriate interfaces at regional and local level between locally elected representatives and the Health Services Executive with a view to including provisions for these mechanisms in the legislation being drafted.

The provisions are likely to include establishment of a series of regional fora to facilitate local representatives in raising issues of concern on health services within the region with the new executive. These fora would allow local representatives to comment on and raise issues related to the development and delivery of health services locally and regionally. Membership of the fora would be based on participation of a small number of nominees in respect of each local authority in each regional forum. The number has not been determined yet. Members of the fora would also have the facility to raise particular issues with the executive.

My overall objective in putting in place such arrangements is to ensure that the voice of public representatives will continue to be heard in the development of health services. The members of the local councils will be nominated by the county councils and corporations. I am working, and have been working with the association of health boards in refining these proposals. These mechanisms would be designed to complement and reinforce the role of the Oireachtas Joint Committee on Health and Children in reflecting the views of public representatives in the ongoing oversight of the health system.

The health strategy set as one of its objectives greater community participation in decisions about the delivery of services. The Health Boards Executive in association with my Department issued guidelines to the health boards on community participation which set out the principles and framework for structures for such participation. To date, most of the health boards have set up consumer panels that deal with a wide range of issues such as development and delivery of services. Two boards have also established regional advisory panels for older consumers and their carers. It is my intention that these structures will be established on a statutory basis in a Bill which I intend to bring before the House later this year.

On the radiation oncology service in particular, I have outlined to the House and the committee on many occasions Government policy in this area. I have also outlined the significant progress that has been made in implementing the report on the development of radiation oncology services in Ireland.

Dr. Cowley

What about the north-west?

Mr. Martin

The Joint Committee on Health and Children has already heard detailed presentations from a number of clinicians on radiation oncology services. One of the participants was Professor Donal Hollywood, who chaired the expert group that produced the report on the development of radiation oncology services in Ireland. In his presentation to the committee, he set out the basis of the model for the development of radiation oncology services nationally which ensures both quality and equity. The report, which has been endorsed by Government has received significant additional endorsement from prestigious bodies such as the American Cancer Society and the National Cancer Institute in the US. The faculty of radiologists of the Royal College of Surgeons in Ireland has advised the chief medical officer of my Department that the report and its comprehensive recommendations have been endorsed by the faculty. No less a figure than the renowned oncologist expert, Deputy Cowley, disagrees with the eminent bodies who know what they are talking about when it comes to cancer care and oncology.

The implementation of the report's recommendations is my most important priority in cancer services in the acute hospital setting. I have provided additional resources this year to begin to implement the report's recommendations.

The immediate 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 have also provided for the appointment of an additional five consultant radiation oncologists. Recruitment for these posts is under way. We 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. For the first time ever, the people in the west under Fianna Fáil and the Progressive Democrats will get a radiotherapy service that they never had before and they will not have to travel to Dublin once the service is in place. That should be welcomed by Deputy Cowley and not denigrated.

We will develop a national integrated network of radiation oncology, based on equitable access regardless of location and an effective national quality assurance programme.