Dáil Éireann debate -
Wednesday, 13 Oct 2004

Vol. 590 No. 2

Leaders’ Questions.

Mr. Kenny

The Tánaiste will be aware of the tragic case of little Roisin Ruddle — go ndéanfaidh Dia trócaire uirthi — 15 months ago. Following that tragic case where that child was sent home from Our Lady's Hospital in Crumlin, the Minister for Health and Children set up an independent inquiry to review a report which was conducted by the health board. Neither report has been published.

We now have another circumstance where two children have been sent home, one of whom, I understand, was gowned and ready for surgery. This is appalling and God forbid that anything will happen to either of those two children or any other child in this circumstance.

I put it to the Tánaiste that the Government of which she is a part has not learned any lesson in the past 15 months. Both the internal report and the departmental report should be published forthwith. Will the Tánaiste give an assurance to the parents of children all over the country that unlike the last time when the Government said it would take steps to ensure this would never happen again, that she, as Tánaiste and Minister for Health and Children, will deal with this matter today and explain to the House why it is that a child waiting and gowned for surgery was suddenly sent home?

This is simply not good enough. It means the Government in which she is the Minister for Health and Children has not learned any lesson in the past 15 months. Will she ensure these two reports are published, explain the circumstances of what happened here and make arrangements so this will not happen again?

The Tánaiste

The report in respect of the late Roisin Ruddle has not yet been completed. I understand it is imminent and it will be published.

In regard to the two cases the Deputy mentioned, I understand they happened because of a shortage of intensive care nurses in Crumlin hospital. There is a worldwide shortage of paediatric intensive care nurses.

Mr. F. McGrath

The Tánaiste said here last night that we have enough nurses.

An Ceann Comhairle

Allow the Tánaiste to continue without interruption. The Deputy is not the leader of the Fine Gael Party.

Mr. F. McGrath

She said that we have enough nurses.

The Tánaiste

What I said yesterday was that Ireland has the highest proportion of nurses——

Mr. F. McGrath

The Tánaiste said we have enough nurses, but they are gone.

An Ceann Comhairle

I will have to ask the Deputy to leave the House if he does not cease interrupting.

Mr. F. McGrath

We do not have enough nurses or enough beds. That is the reality.

An Ceann Comhairle

I will ask the Deputy to leave if he does not stop interrupting.

Mr. F. McGrath

The Tánaiste should stop the spin.

The Tánaiste

Ireland has the highest proportion of nurses to the population in all the OECD countries. That is a fact.

Mr. F. McGrath

They are not working in Ireland.

The Tánaiste

Ireland, like many other countries, has a shortage of intensive care nurses for paediatrics. There is a global shortage. Representatives of the hospital have been overseas recruiting in the Middle East, Poland and in other places and they have to recruit nurses who can speak English. It takes six and a half years to train an ICU nurse for paediatrics-——

Mr. F. McGrath

The Tánaiste has been in power for eight years.

An Ceann Comhairle

If the Deputy interrupts once move, he will have to leave.

The Tánaiste

——four years' training plus two and a half years to qualify in intensive care. Therefore, such nurses, unfortunately, cannot be found quickly.

Ms McManus

These are here, but they have left the system.

An Ceann Comhairle

Allow the Tánaiste to continue without interruption.

The Tánaiste

I appeal to Deputies not to play politics with a very sad situation.

Deputies

Hear, hear.

Mr. G. Mitchell

To say we are playing politics with this issue is outrageous.

The Tánaiste

I will be talking to the authorities in Crumlin hospital today. That is what Deputy Kenny asked me to do and I will do that.

Mr. Kenny

Nobody on this side of the House would play politics with children's lives. I assure the Tánaiste of that. I do not want to see a situation where the Tánaiste, as Minister for Health and Children, or the Government she represents would reduce health care to the level of consumer provider. Children who need life-saving surgery are not consumers. They need healing and a Government that will do its duty.

It is not good enough to say the hospital authorities have been recruiting in Poland and the Middle East. They have, as have other hospital authorities. I am aware that the existing staff of ICU nurses in Our Lady's Hospital, Crumlin are quite prepared to do the extra shifts to ensure no child will be sent home like the two, to whom I referred, on the basis of an alleged shortage of intensive care nurses. However, the fact is that the hospital authorities will not pay the nurses because they do not have the resources to do so.

In the past eight years €44 billion has been spent on health services. When the Tánaiste speaks to the hospital authorities in Crumlin hospital today, I want her to ask them if is it clear that the intensive care nursing staff are quite prepared to do these shifts and work the extra hours to ensure no child will suffer like this, but that the hospital authorities are unable to pay them because they say they do not have the resources to do so. I ask the Tánaiste to please deal with this and I will support her on this.

The Tánaiste

What we are talking here about are patients and in this case two young children. There is no question of resources being an issue. This is not an issue of resources. As the Deputy said, we are spending over €10 billion a year and have spent more than €44 billion over the past number of years.

Ms O. Mitchell

It was spent badly and not well planned.

The Tánaiste

It is not a resource issue and I will talk to the hospital authorities today in regard to this matter.

Mr. English

It is a resource issue; it is a case of mismanagement.

Mr. McCormack

The Government is saving money for the election.

An Ceann Comhairle

I ask the Deputy to allow the Tánaiste to continue.

The Tánaiste

This is a sad and serious situation. It has arisen before. We want to ensure that it does not arise again. That is why it is important that we get the nurses we require from wherever. Hopefully, we can train them from our nursing population but I understand it takes six and half years. It takes an awful long time to train a nurse to the standard required to work in ICU paediatrics——

Ms McManus

They are here but have left the service.

The Tánaiste

There is a global shortage of such nurses all over Europe and all over the United States.

Ms McManus

They are here but have left the service because of pay and conditions.

An Ceann Comhairle

I remind the Deputy that she is not the leader of the Fine Gael Party.

The Tánaiste

Nurses are paid better in Ireland than they are almost anywhere in the world.

An Ceann Comhairle

I would prefer if the Tánaiste did not answer questions by way of interruption.

Ms McManus

Yet none of them wants to work in the service.

The Tánaiste

They are paid better here.

Mr. Rabbitte

I ask the Tánaiste what is going on in the Department of Foreign Affairs. The senior Minister seems to want to jettison the PDs and replace them with Sinn Féin and the junior Minister wants to jettison the UN target for overseas development aid even before negotiations start with the Department of Finance.

The Tánaiste will know that the Taoiseach gave a solemn commitment at the UN Summit in 2000 that the target would be met by 2007. The mid-term target was 0.45%. It was not realised and only 0.41% was reached, but consistent progress was being made at that time. When the Government reversed engines after the general election of 2002 and broke every solemn promise into which it had entered, its first cut was €32 million from the budget for ODA. In the event, it turned out to be €40 million.

Yesterday at the Committee on Foreign Affairs, on a motion tabled by my colleague, Deputy Michael Higgins, there was all-party support for the timeframe to be reinstated and alarm to be expressed at the manner in which this matter is being handled by a Minister of State, admittedly still wet behind the ears. Was the Tánaiste consulted on this and did the Cabinet agree that we were departing from the target established and policed by former Minister of State, Deputy O'Donnell? The target was let slip since. Are the poor and hungry of the developing world now to be the subject of the latest cut by this Government in spite of a solemn commitment on which the Taoiseach campaigned across the world for votes from the African states to have this country elected to the Security Council? Will the Tánaiste state whether this target will now be reinstated?

The Tánaiste

The Government has not reneged on the target and it has made no decision to that effect. It took a decision prior to the Taoiseach's announcement at the United Nations in 2000 that we were committing ourselves to reaching that target. We are seventh in the world in terms of our spending on ODA and have increased our spending more than three-fold. When the Deputy was last in office, it was €142 million, and it is now just under €0.5 billion annually. The Government remains committed to substantially increasing our overseas development aid and to the poorest countries of the world.

Mr. Howlin

A solo run again.

Mr. Rabbitte

If the Tánaiste is rededicating the Government to achieving the target by 2007, I simply welcome it.

Mr. J. O’Keeffe

She did not say that.

Mr. Rabbitte

However, she did not say that. The Minister of State responsible is present. The Tánaiste is now seeking to——

Mr. J. Breen

A friend of the Deputy's.

Mr. Rabbitte

A close friend. She is now seeking to indicate that he was on a solo run. He is the Minister of State handling this issue. Before negotiations commence with the Minister for Finance and his Department, the towel has been thrown in on what was a solemn commitment. We have gone around the world quite properly boasting of our achievement in this regard. I know where we rank among the European states in terms of our contribution and we ought to be proud of it. There are particular historical reasons this is appropriate for Ireland. Is the Government rededicating itself to the timeframe for the achievement of our goal in this regard? We have not made the mid-term target and in 2004 we are likely to slip below the 2003 figure of 0.41%.

The Government committed to a certain percentage of ODA in the programme for Government, in Sustaining Progress and in this House, and the Taoiseach made a commitment at the UN summit. Is the Tánaiste reinstating that particular commitment and timescale? I am not seeking any prevarication from her in this regard.

The Tánaiste

As the Deputy acknowledged, we have probably slipped even below 0.41%. This is because of the growth in GNP. We would clearly reach it very quickly if we saw——

Ms McManus

Give less because we have more.

Caoimhghín Ó Caoláin

Less is more.

The Tánaiste

That is actually the reality.

(Interruptions).

Mr. Howlin

The wealthier will get richer.

The Tánaiste

No, there are large sums of money involved and there are also capacity issues, as everybody has acknowledged.

Ms Burton

For six years, the capacity issue——

The Tánaiste

As I said, the Government has not reneged on the commitment we made in 2000.

(Interruptions).

An Ceann Comhairle

The Tánaiste, on Deputy Rabbitte's question.

Mr. M. Higgins

We are too rich to meet our commitment.

An Ceann Comhairle

We will move on. I call on Deputy Sargent.

Ms Burton

The Government cannot organise the hospitals and now it cannot——

The Tánaiste

We had no commitment when Deputy Michael Higgins was in power.

An Ceann Comhairle

Allow Deputy Sargent without interruption.

Mr. Sargent

We need clarity on a very important matter. From time to time we in this House claim to represent those who are disadvantaged. This is such a time when we will be asked to represent people, many millions of whom live on less than a dollar a day. It is strange that they often live in countries to which asylum seekers in this country are deported.

The Secretary General of the United Nations, Mr. Kofi Annan, will be in Ireland tomorrow. I am not sure if he has been following this debate but he will probably be thanking the Government for its commitment of 0.7% of GNP by 2007, clearly made by Cabinet decision. He will probably be thinking about the Taoiseach's speech at the UN millennium summit in New York in 2000 and his speech at the World Summit on Sustainable Development in Johannesburg in 2002, at which he clearly stated the following:

The decline in global ODA in the 1990s is shameful, indefensible and inconsistent with the commitments given at Rio. I re-iterate Ireland's absolute commitment to achieving, by 2007, the UN target of spending 0.7% of GNP on Overseas Development Assistance.

The Taoiseach is away at present handing out sweets to children in Vietnam, which is very laudable, while at home the Minister of State at the Department of Foreign Affairs, Deputy Conor Lenihan, is busy telling us that, in effect, the Taoiseach was fibbing and that the commitment was not a commitment at all but some kind of wish on his part. Deputy Conor Lenihan is also implying the Taoiseach misled the UN by appearing to give leadership regarding overseas development aid so we could secure a seat on the UN Security Council. This is a very serious matter in which the Tánaiste needs to take a leadership role.

An Ceann Comhairle

The Deputy's two minutes have concluded.

Mr. Sargent

It is important to reiterate that the Tánaiste has already stated the Progressive Democrats will not tolerate a change in Government policy. Is the lowering of our ODA target an incidence where she will not tolerate a change? Is the Progressive Democrats prepared to walk as a result?

Mr. Eamon Ryan

What are they in power for?

The Tánaiste

As I stated, the commitment was made by Cabinet decision. When the Taoiseach made the announcement at the UN millennium summit in 2000 and subsequently at the World Summit on Sustainable Development——

Mr. M. Higgins

Johannesburg.

The Tánaiste

——he was doing so on the basis of a Government commitment and decision. That decision has not been reneged on and has not been changed. We acknowledge, given our current position, that it will be difficult to reach the set target by 2007——

Ms Burton

No.

The Tánaiste

——but the Government must sign on for multi-annual funding that is clear in this particular area. That is what I want to see.

Ms Burton

It would not be difficult.

Mr. Sargent

The Government did it four years ago. It is a question of whether the Tánaiste will commit once again to a figure of 0.5% of GNP by 2005, 0.6% of GNP by 2006, and 0.7% of GNP by 2007. That is what the people want to hear if this Government policy is to have any meaning at all. We know the National Roads Authority, for example, receives multi-annual funding. Is it not the case that overseas development aid should also be subject to it? Will the Tánaiste indicate to the development agencies that they will receive funding and that we will reach our target of 0.7% of GNP by 2007? I know the former Minister of State, Deputy O'Donnell, would want an answer to this. She has said there has been no champion of ODA in the Department of Foreign Affairs since 2002. Does the Tánaiste agree with this and, if so, will she rectify the problem?

Mr. Cuffe

Deputy Conor Lenihan should stand up.

The Tánaiste

There are many champions of ODA and I would like to think I am one. There are many people in this House——

Mr. Eamon Ryan

The Tánaiste has failed for the past two years.

An Ceann Comhairle

Allow the Tánaiste to continue without interruption.

The Tánaiste

I share the Deputy's view on multi-annual budgeting. It is important, for a host of reasons, that we have clear decisions on this matter. It is not good enough that we would not. My strong view is that we cannot abandon one commitment without having an alternative commitment.

Earlier this year and certainly when we dealt with the Estimates last year, we envisaged that we would meet the target of 0.41% this year. As it happens, because the growth rate is higher than envisaged, it will probably slip below that. These targets are difficult because they are based on predicting what growth rates might be at the time the Estimates are negotiated and to a large extent are a victim of our success. If the economy was in decline we would probably have reached it quite a while ago.

There is cross-party support for a strong commitment to additional resources and multi-annual budgeting in this area. As we approach the Estimates for 2005 the Government should bear that in mind. I hope we will.