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Dáil Éireann debate -
Thursday, 2 Dec 2004

Vol. 594 No. 2

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 12, inclusive, answered orally.

Hospital Services.

Richard Bruton

Question:

13 Mr. R. Bruton asked the Tánaiste and Minister for Health and Children her plans to reduce waiting lists for neurology; and if she will make a statement on the matter. [31802/04]

Fergus O'Dowd

Question:

59 Mr. O’Dowd asked the Tánaiste and Minister for Health and Children her views on the concerns of the Neurology Alliance of Ireland that almost 30% of persons with the fatal neurological diseases, multiple sclerosis or motor neurone disease, have never, or rarely ever, seen a neurologist; and if she will make a statement on the matter. [31800/04]

Billy Timmins

Question:

114 Mr. Timmins asked the Tánaiste and Minister for Health and Children her plans to increase the number of consultant neurologists, in particular, in the west of the country; and if she will make a statement on the matter. [31787/04]

In April 2003 Comhairle na nOspidéal published the report of a review of neurology and neurophysiology services. The report recommended significant enhancement of such services, including increases in consultant staffing. It also recognised that aspects of other specialties and services, such as rehabilitation medicine, geriatric medicine and old age psychiatry, are related to and overlap with neurology services. Comhairle recommended that a national multi-disciplinary review of rehabilitation services be undertaken. This would further inform the policy framework in relation to the development of neurology services.

Consistent with this recommendation, a national action plan for rehabilitation services is currently being prepared by my Department. The rehabilitation action plan, together with the Comhairle report and the work undertaken by the Neurological Alliance of Ireland through its own publications, will offer a comprehensive policy framework for the future development of neurology and neurophysiology services in this country.

The implementation of the Comhairle recommendations will be progressed with consideration to the evolving policy framework in this area, competing funding priorities and the report of the National Task Force on Medical Staffing.

Responsibility for the management and monitoring of waiting lists, including waiting lists for neurology services, rests with individual hospitals and health boards. It is a matter for each hospital to prioritise its services based on patient need and use their available resources to best effect to ensure that patient services are delivered efficiently and effectively.

Infectious Diseases.

John Gormley

Question:

14 Mr. Gormley asked the Tánaiste and Minister for Health and Children the steps she intends to take to implement the recommendations of the latest report on MRSA; the likely cost of implementing this; and if she will make a statement on the matter. [31707/04]

The response to Priority Question No. 3 refers.

Mental Health Services.

Richard Bruton

Question:

15 Mr. R. Bruton asked the Tánaiste and Minister for Health and Children the areas in which she intends spending the €15 million announced in the 2005 Estimates for mental health services; her plans for investment in the infrastructure of mental health services; and if she will make a statement on the matter. [31758/04]

An additional €15 million revenue funding will be made available for the further development of our mental health services in 2005, bringing the total spend on mental health to approximately €725 million. Priority areas for additional funding will include child and adolescent psychiatry, community-based adult mental health teams, the provision of additional community residential places and the opening of new mental health facilities. It is also my intention to provide additional funding to assist voluntary agencies in the mental health area.

In addition to the €15 million for mental health services, a further €10 million is being allocated to the Mental Health Commission to enable the mental health tribunals to commence their work in 2005.

Mary Upton

Question:

16 Dr. Upton asked the Tánaiste and Minister for Health and Children if her attention has been drawn to concerns expressed in relation to the split in responsibility for mental health that will arise in the new Health Service Executive structure; the steps she intends to take to ensure the provision and delivery of a proper integrated approach; and if she will make a statement on the matter. [31574/04]

I understand that this matter is being examined at present by the interim health service executive. My Department will be meeting with the interim health service executive shortly to discuss the issues involved. It would be essential that any new arrangements would provide for cohesive and integrated management structures for the mental health services.

Health Board Services.

Bernard J. Durkan

Question:

17 Mr. Durkan asked the Tánaiste and Minister for Health and Children the extent to which steps have or will be taken to ensure the provision of adequate medical, surgical and nursing staff to facilitate the delivery of the degree of services required by the public; and if she will make a statement on the matter. [31585/04]

As I have indicated previously, responsibility for the management of the workforce in a given region lies exclusively with the chief executive officer of relevant health board-authority. However, in order to improve recruitment and retention prospects my Department has put in place a number of important initiatives to meet the human resource needs of the health services.

Specific human resources initiatives in key areas such as pay rates, improvements in career structure and enhanced opportunities for professional and career development have and will play a part in increasing staffing levels. Overseas recruitment by health agencies has, over recent years, also contributed significantly to meeting the workforce needs of the health services, particularly in the medical, surgical and nursing professions.

The Department of Health and Children has made substantial investment in consultant numbers in recent years. In the past five years the number of consultant posts in Ireland has increased by 31% to 1,824 posts at 1 January 2004. The current number of permanent consultant posts approved by Comhairle na nOspidéal is 1,912. Between 1993 and 1 January 2004 there was a 56% increase in consultant posts. This has included significant investment in consultant staffing in regional hospitals. I expect this increase to continue.

In the nursing area, the recruitment and retention of adequate numbers of staff has been a concern of the Government. A number of substantial measures have been introduced in recent years. The number of nurse training places has been increased by 70% since 1998 to 1,640 from 2002 onwards. The promotional structure within nursing has been substantially improved. Some 1,600 clinical nurse specialist and advanced nurse practitioner posts have been created. The Department of Health and Children has also introduced a scheme of flexible working arrangements for nurses and midwives. In addition, a comprehensive range of financial supports have been introduced to support nurses in pursuing part-time degrees and specialist courses, including "back to practice" courses.

My Department gave approval in late 2003 to the rollout, on a national basis, of the health care assistant training programme. The main objective of the programme is to upskill health care assistants to enable them to take on a wider range of duties. This frees up nursing resources to concentrate on exclusively nursing tasks.

Given the large numbers of staff employed and the unique nature of the services being delivered, a coherent, strategic approach to workforce and human resource planning needs to be developed further. This should be aligned closely with strategic objectives and the service planning process. Planning for the development of new and existing services in the future must be soundly based on a robust and realistic assessment of the skill and human resource needs to deliver these services. Enhanced skills mix by matching skills to service needs benefits patients and empowers health personnel to reach their full potential. This optimises their contribution to quality care. The continued implementation of the action plan for people management has a crucial role to play in improving retention and reducing the turnover of skilled staff. The Health Service Executive will have a central role to play in the development of an integrated workforce planning strategy for the health sector.

Denis Naughten

Question:

18 Mr. Naughten asked the Tánaiste and Minister for Health and Children the action she is taking to cater for Alzheimer’s patients in the Western Health Board region; and if she will make a statement on the matter. [31836/04]

As the Deputy will be aware, the provision of health services in this case, is in the first instance, the responsibility of the Western Health Board.

The board has advised my Department that residential services are provided throughout the board's area in the community nursing units and long-stay hospitals. In addition, specialist residential facilities are available in St Brigid's Hospital, Ballinasloe, St Brendan's Hospital, Loughrea and St. Anne's Unit, Castlebar. Community based services are provided throughout the board's area through assessment and support by nursing staff and also through the provision of day care services. Respite services are provided in the board's community nursing units and long-stay units where there are approximately 47 beds allocated for the provision of respite care.

Two consultant psychiatrists of old age have been appointed, one in 2003 to Mayo Mental Health Services and one in 2004 to West Galway Mental Health Services. The board has established a project team to prepare a project brief for the development of a 12 bedded unit, within Our Lady's Unit in the Sacred Heart Hospital, Roscommon. Following completion of the project brief, the board will be seeking approval from my Department to appoint a design team for this project. The board has included the provision of a dementia unit in Merlin Park Hospital, Galway in its schedule of major capital projects submitted to my Department for funding, The West of Ireland Alzheimer Foundation, which is grant aided by the board through section 65 funding, provides the services throughout Galway, Mayo and Roscommon. Long-stay residential facilities and respite care are provided at Maryfield House, Athenry, County Galway, which caters for 21 patients. Respite care and day care facilities are provided in Marion House, Ballindine, County Mayo, which has 12 respite beds and an annual throughput of over 100 service users. The foundation also provides an in-home support service where trained staff visit the Alzheimer patients' homes on an ongoing basis to provide respite to carers. In addition, the foundation facilitates and supports carer support groups throughout the Western Health Board region. Grant aid amounting to €555,283 has been approved for the foundation in 2004. The board is currently in discussion with the West of Ireland Alzheimer Foundation for the provision of a facility in Galway city for Alzheimer patients.

The Alzheimer Society of Ireland is also supported by the board through section 65 funding and the grant approved for 2004 amounts to €206,890. Services provided by the society throughout the board's area include home care services, day care services, advice and information.

Hospital Staff.

Jimmy Deenihan

Question:

19 Mr. Deenihan asked the Tánaiste and Minister for Health and Children when a cardiologist will be appointed at Tralee General Hospital, County Kerry; and if she will make a statement on the matter. [31840/04]

Additional funding of €500,000 was allocated to the Southern Health Board under the cardiovascular health strategy in April this year. The funding has allowed the board to begin establishing a consultant-led cardiology service for patients in Kerry. I am advised by the Southern Health Board that interviews to fill a consultant cardiologist post by way of a sessional partnership between Bon Secours Hospital Tralee and Kerry General Hospital have taken place recently and it is expected that an appointment will be made shortly.

Suicide Prevention Initiatives.

Dan Neville

Question:

20 Mr. Neville asked the Tánaiste and Minister for Health and Children the funding allocated in the Estimates of 2005 for development of suicide prevention. [31719/04]

Since the publication of the Report of the National Task Force on Suicide in 1998, my Department has given special attention to the resourcing of suicide prevention initiatives. A cumulative total of more than €17.5 million has now been provided towards suicide prevention programmes and for research activity at local and national level involving various agencies, including the health boards, the National Suicide Review Group, the Irish Association of Suicidology and the National Suicide Research Foundation.

As the Deputy may be aware, an additional €15 million revenue funding will be made available for the further development of mental health services, including suicide prevention measures, in 2005. Details of the allocation are being finalised at present and it is not possible at this stage to be specific regarding the level of funding to be provided for suicide prevention.

Medical Inquiries.

Liz McManus

Question:

21 Ms McManus asked the Tánaiste and Minister for Health and Children the expected completion date of the inquiry, to be chaired by Judge Maureen Harding-Clarke into the activities of a person (details supplied); if her attention has been drawn to the call made by a number of victims for the establishment of a redress board; if she intends to act on this suggestion; and if she will make a statement on the matter. [31540/04]

John Gormley

Question:

53 Mr. Gormley asked the Tánaiste and Minister for Health and Children if she intends to set up a redress board in order to assist the victims of a person (details supplied); and if she will make a statement on the matter. [31706/04]

John Gormley

Question:

127 Mr. Gormley asked the Tánaiste and Minister for Health and Children if she intends to set up a redress board in order to assist the victims of a person (details supplied); and if she will make a statement on the matter. [32007/04]

I propose to take Questions Nos. 21, 53 and 127 together.

The inquiry referred to is expected to have completed its work by the end of March 2005. I have received proposals from the group, which represents former patients of the person referred to by the Deputy, requesting the establishment of a redress board. These proposals are being examined, and I will revert to the group as soon as possible.

Hospital Services.

Joe Costello

Question:

22 Mr. Costello asked the Tánaiste and Minister for Health and Children the timetable for the implementation of each of the planned measures in regard to the package of measures announced in the Estimates 2005 to improve accident and emergency services; and if she will make a statement on the matter. [31552/04]

Joe Costello

Question:

44 Mr. Costello asked the Tánaiste and Minister for Health and Children the progress made towards addressing the continuing severe difficulties in accident and emergency units, especially in hospitals in the greater Dublin area, which are causing such hardship for patients and staff alike; and if she will make a statement on the matter. [31553/04]

Seymour Crawford

Question:

125 Mr. Crawford asked the Tánaiste and Minister for Health and Children the dedicated cleaning services and security measures she intends to provide for accident and emergency departments as announced in the Estimates for 2005; and if she will make a statement on the matter. [31750/04]

I propose to take Questions Nos. 22, 44 and 125 together.

I have identified the delivery of accident and emergency services as a priority area for attention. Many of the difficulties and delays experienced in emergency medicine, accident and emergency departments reflect system-wide issues. It is, therefore, necessary to take a whole-system approach, involving primary care, acute care, and sub-acute and community care in tackling the problems in emergency medicine departments.

I have secured additional funding of €70 million in new current expenditure in 2005 to implement a number of initiatives to improve the delivery of emergency services. These include improvements in the following areas: patient flows through accident and emergency departments by developing and expanding minor injury units, chest pain clinics and respiratory clinics in hospitals; acute medical units for patients with urgent medical problems; GP out-of-hours services; the physical environment for patients and staff, including cleaning and security measures; direct access for GPs to diagnostic services; sourcing of capacity in the private nursing home sector for those patients who have completed their acute phase of treatment; and expanded home care packages to support older people at home.

I am confident that the measures that I have announced will have a significant impact on the delivery of accident and emergency services. Details regarding the implementation of these measures will be a matter for the incoming Health Service Executive to negotiate with the individual hospitals concerned.

Infectious Diseases.

Gerard Murphy

Question:

23 Mr. Murphy asked the Tánaiste and Minister for Health and Children her views on a report (details supplied) that MRSA is present in many hospitals and in nursing homes here; and if she will make a statement on the matter. [31811/04]

Simon Coveney

Question:

24 Mr. Coveney asked the Tánaiste and Minister for Health and Children the amount of funding she has allocated to prevent the spread of MRSA and other hospital bugs; and if she will make a statement on the matter. [31812/04]

Bernard Allen

Question:

79 Mr. Allen asked the Tánaiste and Minister for Health and Children if she will report on her efforts to combat the spread of MRSA in public hospitals and nursing homes; and if she will make a statement on the matter. [31809/04]

Liam Twomey

Question:

135 Dr. Twomey asked the Tánaiste and Minister for Health and Children her concerns on a report (details supplied) which revealed that Ireland has significantly higher levels than a number of EU countries of MRSA; and if she will make a statement on the matter. [31814/04]

Bernard J. Durkan

Question:

171 Mr. Durkan asked the Tánaiste and Minister for Health and Children the number of fatalities recorded that have occurred arising from MRSA infection; the action taken to address the issue; and if she will make a statement on the matter. [31971/04]

Bernard J. Durkan

Question:

172 Mr. Durkan asked the Tánaiste and Minister for Health and Children if in the case of the reported incidents of MRSA, action was taken to identify the cause or causes and to prevent a recurrence; and if she will make a statement on the matter. [31972/04]

Bernard J. Durkan

Question:

173 Mr. Durkan asked the Tánaiste and Minister for Health and Children to indicate the number of reported incidents of MRSA in the past five years; if such incidents occurred in the same hospital or institution more than once; the action taken to prevent a recurrence; and if she will make a statement on the matter. [31973/04]

I propose to take Questions Nos. 23, 24, 79, 135, and 171 to 173, inclusive, together.

Staphylococcus aureus is a bacteria commonly carried on the skin or in the nose of healthy people. Occasionally, "staph" can cause infections — such bacteria are one of the most common causes of skin infections. Over the past 50 years, treatment of these infections has become more difficult because bacteria have become resistant to various antibiotics — antimicrobials. MRSA, methicillin-resistant Staphylococcus aureus, is a resistant form of Staphylococcus aureus. The proportion of Staphylococcus aureus bacteraemia caused by MRSA in Ireland in 2002 was 42.7%.

The National Disease Surveillance Centre, NDSC, collects data on MRSA bacteraemia, also known as bloodstream infection or "blood poisoning", as part of the European antimicrobial resistance surveillance system, EARSS. Ireland has the highest level of participation of any country involved in EARSS and EARSS data in Ireland represent at least 95% of the population; thus the EARSS data for Ireland approximate the true total number of cases of MRSA bacteraemia in Ireland. In 2003, there were 477 cases of MRSA bacteraemia reported here. The total number of cases of MRSA bacteraemia notified for the first two quarters of 2004 is 274; it should be borne in mind that the number of laboratories notifying cases has increased in 2004.

The level of antibiotic resistance in Ireland in relation to MRSA is one of the highest in Europe. Two of the reasons for this, and the responses to date, are as follows. The first reason is that one of the common strains of MRSA in Ireland is highly contagious and it is particularly difficult to control its spread. This strain is also seen in the UK and that partially explains the reason both the UK and Ireland have such high rates.

The second reason relates to the overuse of antibiotics in hospitals. The SARI hospital antibiotic subcommittee has completed draft guidelines for hospitals on promoting prudent use of antibiotics. Many of the regional SARI committees have also appointed clinical pharmacists to individual hospitals to improve antibiotic prescribing habits. A pilot project on promoting more rational use of antibiotics has been funded by my Department, through the SARI national committee, and has commenced in the Midland Health Board region.

In 1995, my Department prepared a set of guidelines in relation to MRSA; these guidelines have been widely circulated and include an information leaflet for patients as well as guidelines for use in acute hospitals, district-community hospitals and nursing-residential homes. The infection control sub-committee of SARI has recently issued draft recommendations in relation to the control of MRSA in Irish hospitals and community health care settings for consultation; these draft recommendations update and are intended to replace the 1995 guidelines referred to above. It is assumed that the report referred to by the Deputies is in fact the new draft recommendations. The document concerned has been issued for consultation and is currently in draft format. The key recommendations cover such areas as environmental cleanliness and overcrowding, isolation facilities, hand hygiene, appropriate antibiotic use and early detection of MRSA. These draft guidelines, based on the best evidence available internationally, are a key component in the response to MRSA in Ireland.

In 1999, my Department asked the NDSC to evaluate the problem of antimicrobial resistance in Ireland and to formulate a strategy for the future. The NDSC gave detailed consideration to these issues and drew up a Strategy for the control of Antimicrobial Resistance in Ireland, SARI. This report contains a wide range of detailed recommendations to address the issue of antimicrobial resistance. The SARI recommendations can be grouped into five main categories, as follows: surveillance of antimicrobial resistance; monitoring of the supply and use of antimicrobials; development of guidance in relation to the appropriate use of antimicrobials; education of health care workers, patients and the general public; and infection control in the hospital and community setting.

SARI was launched in June 2001. Since then, approximately €16 million in funding has been made available by my Department to health boards under the strategy; and, of this amount, approximately €4.5 million has been allocated in the current year. It is at the discretion of each health board CEO, in consultation with their respective regional SARI committee, to prioritise measures to be taken in their region to implement the recommendations of the SARI report.

The strategy recommended that a national SARI committee be established to develop guidelines, protocols and strategies in relation to antimicrobial resistance. This committee was established in late 2002 and as part of its remit provides advice to the regional SARI committees in each health board area which were established as a result of the strategy's recommendations. The national SARI committee is comprised of a wide range of experts in the field.

I assume by "incidents of MRSA" the Deputies are referring to cases of MRSA infection. MRSA tends to be a recurring problem in most hospitals not just in Ireland but in most countries in Europe, North America and elsewhere; however, it is acknowledged that Ireland has a relatively high incidence of MRSA infection in international terms. Even in countries with very low levels of MRSA infection, such as Scandinavia, recurrent infections are seen over time in individual hospitals. The fact that a hospital sees multiple cases of MRSA infection over time is to be expected from international experience and may reflect the type of patient seen at that hospital, rather than implying some lapse in infection control practice. No country has ever succeeded in completely eliminating MRSA; even countries such as the Netherlands and Denmark, which have very low MRSA rates, still see MRSA infections and have to deal with MRSA outbreaks from time to time.

At national level, MRSA bacteraemia is now included — since 1 January 2004 — in the revised list of notifiable diseases of the infectious diseases regulations, so laboratories are now legally required to report cases of serious MRSA infection to health board departments of public health and to the NDSC. The reporting process for MRSA bacteraemia remains the same for now, that is, direct reporting to the NDSC via the EARSS protocol which is done on a quarterly basis, as this has proven extremely effective; as MRSA bacteraemia is a laboratory diagnosed disease, notification is done per clinical laboratory rather than on a hospital by hospital basis.

MRSA infection is generally confined to hospitals and, in particular, to vulnerable or debilitated patients — these include patients in intensive care units and on surgical or orthopaedic wards. MRSA does not generally pose a risk to hospital staff, unless they are suffering from a debilitating disease, or family members of an affected patient or their close social or work contacts. MRSA does not harm healthy people, including pregnant women, children and babies. MRSA can affect people who have certain long-term health problems. Visitors to patients with MRSA infection should be advised by the local nursing-medical staff to wash their hands thoroughly after visiting patients so as to avoid spreading MRSA.

Infection with staphylococcus aureus, including MRSA bacteria, can be prevented by practising good hygiene, that is: keeping hands clean by washing thoroughly with soap and water; keeping cuts and abrasions clean and covered with a proper dressing, namely, a bandage, until healed; and avoiding contact with other people's wounds or material contaminated by wounds.

Infection control, including hand hygiene, is a key component in the control of MRSA and the SARI infection control subcommittee has just released national guidelines for hand hygiene in health care settings; these guidelines have been widely circulated by the NDSC and are available on the NDSC's website.

Each health board-authority region has a regional SARI committee and it is the responsibility of each health board CEO, in consultation with the regional committee, to identify and prioritise the appropriate measures required to implement the SARI strategy in his or her region.

It is not possible, outside of detailed research settings, to determine the exact number of fatalities due to MRSA. This is because many, if not most, people who die with an MRSA infection die from their underlying disease rather than the MRSA infection. To routinely measure the number of deaths directly related to MRSA infection would be extremely difficult and would still only result in an estimate, given the complexities involved. For this reason few, if any, countries try to routinely measure deaths directly related to MRSA.

However, the NDSC has advised that international research shows that patients with MRSA bloodstream infection are, on average, approximately twice as likely to die as patients with bloodstream infections caused by sensitive strains of Staphylococcus aureus, that is, those that respond to antibiotics. The attributable mortality from hospital-acquired bloodstream infections, including bloodstream infections caused by MRSA, is about 20% to 30%. Thus, MRSA bloodstream infection is serious and potentially life-threatening.

One other key factor in transmission of infections in hospital is hospital bed occupancy. Basically it is difficult, if not impossible, to effectively control infection if a hospital is running at close to 100% bed occupancy. This both promotes transmission of infection and also further contributes to the bed crisis by causing beds to be blocked or closed as a result of infection. The steps taken to address the current bed crisis will also benefit the control of infection.

My Department will await the final version of the recently issued draft guidelines which will then be evaluated in conjunction with the Health Service Executive.

Hospital Waiting Lists.

Denis Naughten

Question:

25 Mr. Naughten asked the Tánaiste and Minister for Health and Children the action she is taking to address the waiting list for appointments to meet consultants prior to gaining access to the official waiting list; and if she will make a statement on the matter. [31835/04]

Tom Hayes

Question:

31 Mr. Hayes asked the Tánaiste and Minister for Health and Children the steps she has taken to reduce waiting lists for outpatients’ care in view of the extra funding for the NTPF; and if she will make a statement on the matter. [31793/04]

Paul McGrath

Question:

84 Mr. P. McGrath asked the Tánaiste and Minister for Health and Children the way in which she intends to deal with the silent waiting list, that is, patients waiting to attend outpatient services; and if she will make a statement on the matter. [31786/04]

I propose to take Questions Nos. 25, 31 and 84.

In accordance with health strategy objectives, the Government's immediate focus is on the reduction of waiting lists and waiting times for inpatients and day case treatments in acute hospitals. This is being particularly facilitated by the national treatment purchase fund, NTPF.

To date the fund has arranged treatments for some 22,000 patients. It is now the case that, in most instances, anyone waiting more than three months will be facilitated by the fund. I have increased the funding available to the NTPF to €64 million in 2005 and I expect that it will be able to provide treatment for a further 17,000 patients during the coming year.

Responsibility for the management and monitoring of outpatient waiting lists rests with individual hospitals and health boards. It is a matter for each hospital to prioritise their services based on patient need and use their available resources to best effect to ensure that patient services are delivered efficiently and effectively. However, I intend to raise with the NTPF the question of how we might begin to make progress in relation to outpatient appointments in 2005.

Cancer Screening Programme.

Gay Mitchell

Question:

26 Mr. G. Mitchell asked the Tánaiste and Minister for Health and Children the timeframe for the rollout of the cervical screening programme nationally; and if she will make a statement on the matter. [31804/04]

Enda Kenny

Question:

37 Mr. Kenny asked the Tánaiste and Minister for Health and Children her plans for a national cervical screening programme; and if she will make a statement on the matter. [31803/04]

I propose to take Questions Nos. 26 and 37 together.

A pilot cervical screening programme commenced in October 2000 and is available to eligible women resident in Limerick, Clare and Tipperary north. Under the programme, cervical screening is being offered, free of charge, to approximately 74,000 women in the 25 to 60 age group at five year intervals.

The Health Board Executive, HeBE, commissioned an international expert in cervical screening to examine the feasibility and implications of a national rollout of a cervical screening programme. The examination included an evaluation of the pilot programme, quality assurance, laboratory capacity and organisation, and the establishment of national governance arrangements. The expert's report was submitted recently to my Department for consideration. My Department is now consulting relevant professional representative and advocacy groups on the report as an essential input into its preparation of a detailed response to the recommendations. These groups are: the Irish College of General Practitioners, An Bord Altranais, the Academy of Medical Laboratory Science, the Institute of Obstetricians and Gynaecologists of the RCPI, the Faculty of Pathology of the RCPI, the Women's Health Council and the Irish Cancer Society.

Any woman, irrespective of her age or residence, who has concerns in relation to cervical cancer should contact her GP who, where appropriate, will refer her to the treatment services in her area. Appropriate treatment for women diagnosed with cervical cancer is available at major hospitals throughout the country.

Medical Education.

Michael Ring

Question:

27 Mr. Ring asked the Tánaiste and Minister for Health and Children if she has had discussions with the Department of Education and Science regarding a postgraduate medical school at the University of Limerick; and if she will make a statement on the matter. [31821/04]

Jim O'Keeffe

Question:

40 Mr. J. O’Keeffe asked the Tánaiste and Minister for Health and Children whether it is preferable to have a postgraduate medical school at the University of Limerick rather than extend the places at the established medical schools; and if she will make a statement on the matter. [31822/04]

Damien English

Question:

60 Mr. English asked the Tánaiste and Minister for Health and Children her plans for a postgraduate medical school at the University of Limerick; and if she will make a statement on the matter. [31820/04]

Fergus O'Dowd

Question:

77 Mr. O’Dowd asked the Tánaiste and Minister for Health and Children the progress which has been made on the medical school for the University of Limerick. [31819/04]

I propose to take Questions Nos. 27, 40, 60 and 77 together.

The arrangements for the provision of third level primary medical education is a matter in the first instance for my colleague, the Minister for Education and Science, Deputy Hanafin. I have, however, noted a number of media reports regarding proposals by the University of Limerick to establish a graduate school of medicine, although I have not seen any submissions or proposals in this regard to date.

As the Deputy may be aware, the Ministers for Education and Science and Health and Children jointly established, in 2003, a working group to examine and make recommendations on a range of aspects of primary medical education and training in Ireland, such as course curriculum, teaching methods, interdisciplinary work and other issues relating to the organisation and delivery of undergraduate medical education and training. In this context, the working group was asked to consider and provide advice on issues arising from a Higher Education Authority, HEA, report which recommended a move to graduate entry for medicine and other health science disciplines.

The working group is chaired by Professor Pat Fottrell and is expected to complete its report in early 2005. Both the Minister for Education and Science and I will consider the group's recommendations when its report is published.

Question No. 28 answered with Question No. 7.

Hospital Waiting Lists.

Michael D. Higgins

Question:

29 Mr. M. Higgins asked the Tánaiste and Minister for Health and Children when the next hospital waiting list figures will be published; if there is preliminary information available on the figures; the reason for the delay in view of the fact that the equivalent figures were published at the beginning of November in 2003; and if she will make a statement on the matter. [31557/04]

Michael Noonan

Question:

81 Mr. Noonan asked the Tánaiste and Minister for Health and Children when she will publish waiting lists for surgical and medical treatments at each hospital in each health board region in view of the fact that the last comprehensive waiting list is from December 2003; and if she will make a statement on the matter. [31795/04]

I propose to take Questions Nos. 29 and 81 together.

Responsibility for the collection and reporting of waiting lists and waiting times now falls within the remit of the national treatment purchase fund, NTPF. My Department understands that the NTPF is collating data for the position as at 30 June 2004. It is expected that the NTPF will report on this data as soon as it has completed its analysis.

Hospital Services.

Simon Coveney

Question:

30 Mr. Coveney asked the Tánaiste and Minister for Health and Children the steps being taken to transfer the acute psychiatric unit to Wexford General Hospital, in view of the recommendations that acute psychiatric units should be in general hospitals; and if she will make a statement on the matter. [31755/04]

A brief on the redevelopment of Wexford General Hospital, including the provision of a new acute psychiatric unit, has been submitted to the Department of Health and Children. The Department is considering this brief.

Question No. 31 answered with QuestionNo. 25.

General Practitioner Co-operatives.

Arthur Morgan

Question:

32 Mr. Morgan asked the Tánaiste and Minister for Health and Children if she will report on progress since the end of 2003 in the promised extension of general practitioner co-operatives; and if she will make a statement on the matter. [31724/04]

Pádraic McCormack

Question:

91 Mr. McCormack asked the Tánaiste and Minister for Health and Children her views on the out of hours general practitioner co-operatives; her views on the future for same; her plans to extend these co-operatives; and if she will make a statement on the matter. [31770/04]

Dinny McGinley

Question:

97 Mr. McGinley asked the Tánaiste and Minister for Health and Children the funding that she has allocated to facilitating out of hours co-operative; her plans for these co-ops; and if she will make a statement on the matter. [31796/04]

I propose to take Questions Nos. 32, 91 and 97 together.

One of the most significant developments in providing access to primary care to patients, in recent years, has been the development of out of hours general practitioner led co-operatives. These allow people easy access to appropriate care, outside of normal working hours, in the evenings, at weekends and on bank and public holidays.

The patient, both medical card holders and private patients, access the service by calling a lo-call number. Calls are received at a call centre and are handled by trained call takers. All cases are triaged by either a nurse or doctor. Advice, treatment at a specified location or domiciliary visits are provided for patients where appropriate. The service is available free of charge to medical card holders. Private patients must pay a consultation fee. In cases where a co-operative doctor decides that a domiciliary visit is clinically necessary, specially equipped vehicles, driven by experienced drivers with local knowledge, are provided to take the doctor to the patient's home. Vehicles also have radio communications so that contact can be made with the co-operative base centre. Information about patient attendance and-or treatment by the co-operative is relayed to the patient's own doctor the following day.

Independent evaluations of the out of hours services in the North Eastern Health Board and the South Eastern Health Board found them to be an enhancement of the care available to patients. They also found that the services were held in high regard by both patients and service providers.

Funding for full out of hours co-operatives commenced in 2000. Between 2000 and 2003 a total of €46.5 million was provided. All of these moneys were allocated to health boards on a once off basis. From 2003 funds for out of hours co-operatives have been allocated to health boards as base funding. In 2004 the funding allocated for co-operatives was in excess of €26 million.

All health boards have expanded their out of hours co-operatives and services since 2003. Co-operatives are now found in part of all health board areas, providing coverage in part of all of 25 of the Twenty-six Counties. Decisions in relation to the geographical areas to be covered by co-operatives and any expansions are for each health board to make, having regard to the strategic, financial and other issues involved.

In 2005 it is intended that funding will be provided to allow further expansion of the out of hours co-operatives in line with agreed policy in this area as detailed in the primary care strategy.

Clinical Indemnity Scheme.

Pat Rabbitte

Question:

33 Mr. Rabbitte asked the Tánaiste and Minister for Health and Children the position regarding her discussions with the Irish Hospital Consultants Association regarding the proposed new system of medical insurance; if she will confirm the commitment she gave to the recent IHCA conference in Kilkenny that no hospital consultant would be left without cover and no patient without redress; and if she will make a statement on the matter. [31568/04]

Discussions are continuing with the Irish Hospital Consultants Association and the Irish Medical Organisation on aspects of the coverage of claims against consultants by the clinical indemnity scheme. The major concern of both organisations is that there should be no doubt as to the position of consultants facing personal injury claims arising from events which occurred prior to the inception of the scheme. The Government's position on this matter has always been clear. The clinical indemnity scheme should not have to cover claims where insurance companies or mutual indemnity bodies had accepted premiums or subscriptions to cover these claims. This position is accepted by all of the insurers and indemnity bodies with the exception of the Medical Defence Union. The MDU has written to several of its former consultant obstetrician members in Ireland threatening to leave them without assistance in dealing with personal injury claims against them. I believe that the MDU has a moral and ethical obligation to provide assistance to these members. I also believe that these decisions may be in breach of the MDU's memorandum and articles of association. Against that background the first source of indemnity should be the body which accepted payment to cover these claims. The legal advice available to us suggests that it is not appropriate at this time for this State to grant an indemnity for past liabilities of consultants in light of our firm belief that the MDU should meet its legal responsibilities. That body should be subjected to the maximum pressure, including legal pressure, to ensure that it lives up to its obligations. In the event that it continues to refuse assistance in these cases, I believe that the plaintiffs and doctors involved cannot be left in an uncertain position while the MDU is pursued to honour its obligations.

I am as interested as the IHCA in having this matter resolved to the satisfaction of all. However, I wish to have the matter addressed as part of the overall framework which deals with a number of related issues, including the negotiation of a new contract for consultants in the context of reforming the acute hospital service and advancing the health service reform agenda,

Hospital Services.

Bernard J. Durkan

Question:

34 Mr. Durkan asked the Tánaiste and Minister for Health and Children the number of general hospital beds available in 1990; the number currently available; the extent to which it is likely that the reduction in the intervening period can be made good; and if she will make a statement on the matter. [31584/04]

The information sought by the Deputy is set out in the following table:

Publicly Funded Acute Hospitals In-Patient and Day Beds 1990, 2003 and to date in 2004.

Type of Bed

1990

2003

January to September 2004

In-Patient

11,868

12,314

12,325

Day

284

909

1,063

Total

12,152

13,223

13,388

Source: 1990 — Health Statistics Report 1990, Department of Health 2003 & 2004 — Integrated Management Returns, Department of Health and Children — provisional figures.

Abuse of the Elderly.

Pat Breen

Question:

35 Mr. P. Breen asked the Tánaiste and Minister for Health and Children the funding which has been given to each health board to appoint case officers to deal with abuse of the elderly; and if she will make a statement on the matter. [31808/04]

As the Deputy may be aware, the report of the Working Group on Elder Abuse, Protecting Our Future, was launched on 11 November 2002. This report, in starting with a definition of elder abuse and recommending the putting in place of structures to deal with suspected cases will, hopefully, give older people who feel they are the subject of abuse in any shape or form, the confidence to report their anxieties, as appropriate, to a social worker, a public health nurse, a member of the Garda Síochána or any professional or care worker.

One of the recommendations in the elder abuse report is the establishment of a national implementation group and this group was established in December 2003 and has commenced its work.

In addition, funding of €0.8 million was provided in 2003 to commence implementation of the elder abuse programme. In 2004 an additional €0.075 million was allocated to each health board for its continued implementation, including the appointment of case workers.

Childhood Obesity.

Eamon Ryan

Question:

36 Mr. Eamon Ryan asked the Tánaiste and Minister for Health and Children if she will co-operate with the Department of Transport to ensure that more school children have safe ways to walk and cycle to school in order to reduce the levels of childhood obesity; and if she will make a statement on the matter. [31714/04]

The National Task Force on Obesity established in March of this year to address the growing levels of obesity in Ireland is cognisant of the fact that a societal approach and cross sectoral working are required to identify solutions to halt the rise and reverse the prevalence of obesity in Irish society. The task force has conducted an extensive consultation process which included relevant Departments and this will be reflected in the final report. The task force is due to present a strategy document by the year end.

Question No. 37 answered with QuestionNo. 26.

Prescribed Medicines.

Dan Boyle

Question:

38 Mr. Boyle asked the Tánaiste and Minister for Health and Children the steps she is taking to reduce the use of antibiotics; and if she will make a statement on the matter. [31708/04]

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.

At my Department's request, the National Disease Surveillance Centre, NDSC, drew up a strategy for the control of antimicrobial resistance in Ireland, SARI, in 2001, including a strategy to control the inappropriate use of antibiotics. The SARI recommendations can be grouped into five main categories: surveillance of antimicrobial resistance; monitoring of the supply and use of antimicrobials; development of guidance in relation to the appropriate use of antimicrobials; education of health care workers, patients and the general public; and development of principles in relation to infection control in the hospital and community setting.

A national SARI committee was established in 2002 to develop guidelines, protocols and strategies in relation to antimicrobial resistance. It provides advice to the regional SARI committees established in each health board as part of the strategy's recommendations.

Tackling the problem of antimicrobial resistance is a multi-faceted issue which will require action on a number of fronts. The strategy is being implemented on a phased basis and will take a number of years to complete. To date, approximately €16 million has been allocated by my Department to health boards to enable them to put in place measures to control antimicrobial resistance. It is ultimately a matter for health board CEOs to determine the priorities in each region. These priorities should take account of the recommendations in the SARI report and also the recommendations put forward by each regional SARI committee. Much of the funding is designated for improving hospital infrastructure for control of infection and for appointing additional microbiologists, infection control nurses and other health care professionals involved in the control of infection.

Health Board Services.

Pádraic McCormack

Question:

39 Mr. McCormack asked the Tánaiste and Minister for Health and Children if she is satisfied that dental treatment for children and adults with special needs is adequate; and if she will make a statement on the matter. [31762/04]

Gay Mitchell

Question:

96 Mr. G. Mitchell asked the Tánaiste and Minister for Health and Children the dental services which are available to persons with disabilities; the dental work which is the State’s responsibility; if her attention has been drawn to problems in this area nationwide; and if she will make a statement on the matter. [31772/04]

I propose to take Questions Nos. 39 and 96 together.

As the Deputy is aware, the provision of dental treatment to patients with special needs is the statutory responsibility of the health boards in the first instance.

The Deputy may also be aware that the level of dental caries has declined in all socio-economic groups in Ireland. However, it is recognised that those from socially disadvantaged groups and those with disabilities suffer disproportionately from the effects of oral disease. Important steps have already been taken to focus greater attention on developing dental services for people with special needs.

There is significant research under way examining the oral health needs of persons with disabilities. This research is part of the national survey of adult and children's dental health being carried out by health boards, University College Cork and the Department of Health and Children. The outcome of this research will be used in the formulation of a new strategy for the dental services; ultimately, it will have a major impact on the evolution of dental services in the future.

In 1994, the dental health action plan was agreed which allowed for the reorientation of the dental services towards the provision of structured care for special needs patients. In this regard, health boards have restructured their dental services to give greater recognition to those involved in delivering dental services to persons with special needs.

A grade of senior dental surgeon in special needs duties has been created. The remit of the senior dental surgeon in special needs includes the identification of specific target groups in the community who may have difficulty in gaining access to or accepting oral health care or who may be at greater risk from dental disease or oral dysfunction than the majority of the population. Such target groups include the medically compromised and those with physical and intellectual disabilities. In addition, the senior dental surgeon in special needs is responsible for the prioritisation of the oral health needs of these groups and the supervising of the ongoing training needs of dental staff working with people with special needs.

My Department recognises the importance that leadership in the area of special needs dentistry can bring to the future direction and development of this area. I am pleased to advise the Deputy that the Department has funded the appointment of a professor of special care dentistry at the Dublin Dental School and Trinity College Dublin. A professor for this post has been appointed and is playing a very important role in developing education, training and research in the arena of special care dentistry.

A number of boards refer patients who are medically compromised and who need complex care to specialist dental units in Cork University Hospital and Our Lady's Hospital for Sick Children, Crumlin. In this way, the health boards ensure the welfare and safety of these patients. The Dublin Dental School and Hospital acts as a national resource for health board and general practice dentists for the referral of patients who require specialist treatments that dentists cannot provide. The school and hospital has service agreements with a range of agencies to provide specialist care services and these play an important role in specialist-consultant training programmes as well as delivering specialist care for patients. At the Cork Dental School and Hospital, senior staff, including specialists in paediatric dentistry, provide an important consultant service within their area of specialisation.

Notwithstanding the developments outlined above, my Department is committed to continuous improvement in dental services for people with special needs over the period ahead.

Question No. 40 answered with QuestionNo. 27.

Jim O'Keeffe

Question:

41 Mr. J. O’Keeffe asked the Tánaiste and Minister for Health and Children if her attention has been drawn to the huge number of children awaiting orthodontic treatment and assessment, which in some instances can involve a waiting time of up to eight years; and her proposals to deal with the situation. [31834/04]

The provision of orthodontic services is the statutory responsibility of the health boards-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. I am pleased to advise the Deputy that a number of measures have been adopted to improve orthodontic services 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 19 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 19 trainees for the public orthodontic service include six dentists who successfully completed their training in September 2004 and have taken up duties with the boards. 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. My Department has given approval in principle to a proposal to further substantially improve training facilities for orthodontics at the school, which will ultimately support an enhanced teaching and treatment service to the wider region under the leadership of the professor of orthodontics.

In June 2002, my Department provided additional funding of €5 million from the treatment purchase fund to health boards-authority specifically for the purchase of orthodontic treatment. This funding is enabling boards to provide both additional sessions for existing staff and purchase treatment from private specialist orthodontic practitioners.

The chief executive officers of the health boards-authority have informed my Department that at the end of the September 2004 quarter there were 11,041 patients awaiting orthodontic treatment with an average waiting period ranging from 12 to 48 months. The chief executive officers of the health boards-authority have also informed my Department that at the end of the September 2004 quarter, there were 22,168 patients receiving orthodontic treatment in the public orthodontic service. This means that there are over twice as many patients getting orthodontic treatment as there are waiting to be treated and more than 6,000 extra patients are getting treatment from the health boards-authority since the end of the September 2001 quarter.

Occupational Injuries Prescribed Diseases.

David Stanton

Question:

42 Mr. Stanton asked the Tánaiste and Minister for Health and Children if she will consider including chronic obstructive pulmonary disease in the list of occupational injuries prescribed diseases; the extent of COPD here; and if she will make a statement on the matter. [31839/04]

Responsibility for the list of occupational injuries prescribed diseases rests with the Health and Safety Authority and, therefore, the inclusion of a disease on that list is a matter for the authority.

Statistics on the prevalence of chronic obstructive pulmonary disease are not routinely collected by my Department.

Hospitals Building Programme.

Jimmy Deenihan

Question:

43 Mr. Deenihan asked the Tánaiste and Minister for Health and Children if approval will be given to the brief, submitted by the management at Kerry General Hospital, for a new accident and emergency unit, in view of the inadequacy of the existing infrastructure for accidents and emergencies at the hospital; and if she will make a statement on the matter. [31718/04]

The Southern Health Board proposes to provide improved infrastructure for the accident and emergency service at Kerry General Hospital. The proposed scheme consists of renovation works at, and a new extension to, the existing accident and emergency department at the hospital.

A draft brief has been prepared by the Southern Health Board. My Department has recently given approval to the board to establish a project team, which includes representatives from the board and the Department. The project team will consider and approve the brief for the works. Once the brief is formally approved, the next stage would involve the appointment of a design team to allow the detailed planning stages to be undertaken.

Question No. 44 answered with QuestionNo. 22.

Water Fluoridation.

Paul Nicholas Gogarty

Question:

45 Mr. Gogarty asked the Tánaiste and Minister for Health and Children the reason the recommendations of the fluoride forum have not been implemented; and if she will make a statement on the matter. [31713/04]

As the Deputy is aware, a forum on fluoridation was established to review the fluoridation of public piped water supplies in Ireland. The main conclusion of the forum report was that the fluoridation of public piped water supplies should continue as a public health measure.

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 and the establishment of an expert body to oversee the implementation of the recommendations.

The expert body, to be known as the Irish expert body on fluorides and health was set up earlier this year. The terms of reference 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/her request or on its own initiative.

The expert body will oversee the implementation of the wide-ranging recommendations of the forum and advise me on all aspects of fluoride going forward.

Health Board Staff.

Eamon Ryan

Question:

46 Mr. Eamon Ryan asked the Tánaiste and Minister for Health and Children the level of remuneration and expenses for those on the board of the new Health Services Executive; and if she will make a statement on the matter. [31715/04]

I am assuming that the Deputy is referring to the interim Health Service Executive, iHSE.

My Department has approved the payment of fees to eligible members of the board of the interim executive at category one level for state bodies, that is, €12,697.38 per annum. Board members are also entitled to claim travel and subsistence expenses in accordance with standard rates as approved by the Department of Finance. The remuneration of the executive chairman of the iHSE is €100,000 per annum.

Food Safety.

Mary Upton

Question:

47 Dr. Upton asked the Tánaiste and Minister for Health and Children her views on the statement from a leading food safety expert recently that food-borne hazards are a major threat to the country’s health, economy, social stability and security; and if she will make a statement on the matter. [29315/04]

I recognise the concern that food-borne hazards pose a threat to public health and to the economy of food producing countries such as Ireland. The basis of our public health control and prevention strategy is to have systems in place to prevent hazards developing into risks. A number measures have been taken in recent years to ensure that these potential food-borne hazards do not become a major risk to the health of consumers.

In 2000 the European Commission published its White Paper on Food Safety which proposed a new legal framework for the Community covering the whole of the food chain. This sought to establish a high level of consumer health protection and to clearly attribute primary responsibility for safe food production to industry, producers and suppliers. The White Paper set out a comprehensive legislative programme with more than 80 separate action points to achieve this new framework. This undertaking is now almost complete. Appropriate official controls at both national and European level have now been agreed which will provide for, among other things, product traceability through the whole food chain and will allow the Community to take rapid and effective safeguard measures in response to health emergencies.

Against a background of consumer concerns, the Food Safety Authority of Ireland was established in 1999. The authority is a statutory, independent and science-based agency with a mandate to protect consumers' health and consumers' interests by ensuring that food consumed, distributed, marketed or produced in the state meets the highest standards of safety and hygiene.

Considerable resources have been invested in recent years to ensure consumer protection and I am confident that, while we must not be complacent, our food safety controls meet the highest international standards.

Alcohol Products.

Paul Nicholas Gogarty

Question:

48 Mr. Gogarty asked the Tánaiste and Minister for Health and Children if she intends to introduce a health warning on alcoholic products; and if she will make a statement on the matter. [31712/04]

International research in the use of warning labels on alcohol products has shown increased awareness of the potential risks of alcohol use in the areas specified on the label, for example, pregnancy, driving a car or operating machinery.

The Strategic Task Force on Alcohol examined this issue and in its recently published report, recommended the use of a health warning label on alcohol products and alcohol promotional materials. Cabinet approval has been granted for the introduction of an alcohol products Bill to control alcohol advertising, sponsorship and sales promotion-marketing practices. This will allow for the introduction of regulations requiring a health warning to be placed on alcohol advertisements.

Nursing Homes.

Pat Rabbitte

Question:

49 Mr. Rabbitte asked the Tánaiste and Minister for Health and Children if she is satisfied that the powers available to the inspectors of nursing homes are adequate to guarantee the health and safety of residents, generally older persons; the type of problems that are being identified; the action that is being taken to address these problems; the number of court actions pending; and the details of the nursing homes in question. [31580/04]

The inspection of private nursing homes is the responsibility of the health boards under the Health (Nursing Homes) Act 1990 and Regulations made under this Act empower health boards to inspect private nursing homes. Having had inquiries made of the health boards-Eastern Regional Authority, I am satisfied that the nursing home regulations are being implemented properly.

A range of problems have been identified by the inspection teams which include: staffing levels and nursing policy issues; maintenance of accommodation standards; hygiene problems; lack of activities for residents; poor record keeping; insufficient or no active involvement from the local authority in fire safety; lack of equipment appropriate to clinical practice, for example, pressure mattresses; and discrepancies in the contracts of care.

In general, where problems occur, the inspection team will discuss their findings in detail with the nursing home owner-operators and this will generally ensure the matters raided will be addressed. However, reservations have been expressed that the powers of the nursing home inspection teams are limited under the legislation and this is one of the issues to be considered by the working group reviewing the nursing home subvention scheme.

There is one case pending before the courts and as the Deputy will be aware, I am not in a position to discuss the details of this case, as doing so may prejudice the outcome of the case itself.

Nursing Home Subventions.

Liam Twomey

Question:

50 Dr. Twomey asked the Tánaiste and Minister for Health and Children if she has plans to regularise the subvention payments across the new HSE; and if she will make a statement on the matter. [31752/04]

Gerard Murphy

Question:

72 Mr. Murphy asked the Tánaiste and Minister for Health and Children if she intends increasing the maximum subvention rate to local offices that will not be able to benefit from the plan to put beds in private nursing homes, as announced in the Estimates for 2005; and if she will make a statement on the matter. [31754/04]

Bernard Allen

Question:

82 Mr. Allen asked the Tánaiste and Minister for Health and Children if she plans to dramatically increase subvention payments to take the burden of care away from many families; and if she will make a statement on the matter. [31753/04]

Pat Breen

Question:

123 Mr. P. Breen asked the Tánaiste and Minister for Health and Children if the contribution made by health boards or by the HSE after 1 January 2005, in accordance with the Health (Nursing Homes) Act 1990 and the Nursing Home (Subvention) Regulations 1993 will alter in any way in the future; her plans to improve the subvention awarded to patients; and if she will make a statement on the matter. [31751/04]

I propose to take Questions Nos. 50, 72, 82 and 123 together.

The Deputy may wish to note that a working group, comprising of all stakeholders, has been established by my Department to review the Health (Nursing Homes) Act 1990 and associated regulations. This follows on from the publication of Professor Eamon O'Shea's report, Review of the Nursing Home Subvention Scheme, and the Mercer report on the Future Financing of Long-Term Care In Ireland which was commissioned by the Department of Social and Family Affairs. The review will also take into account issues arising from the interpretation of certain aspects of the 1990 Act and regulations which have arisen over the years and the Ombudsman's report on the operation of the scheme.

The objective of the review is to develop a scheme which will be transparent, offer a high standard of care for clients, provide equity within the system to include standardised dependency and means testing, be less discretionary; provide both a home and nursing home subvention depending on need; be consistent in implementation throughout the country; be financially sustainable and draw on experience of the operation of the existing scheme.

At this stage it is not proposed to make any changes to the nursing home subvention scheme pending the outcome of the review of the scheme which is currently being carried out by the working group.

Drugs Payment Scheme.

Thomas P. Broughan

Question:

51 Mr. Broughan asked the Tánaiste and Minister for Health and Children when the increase in the drugs refund threshold, the cost of an overnight stay in a hospital and the cost of a visit to an accident and emergency department will be implemented; the estimated additional revenue that will accrue from these charges; if whether these increases will be applied before the promised 30,000 additional medical cards and 200,000 general practitioner cards have been issued; and if she will make a statement on the matter. [31544/04]

Paul Kehoe

Question:

80 Mr. Kehoe asked the Tánaiste and Minister for Health and Children if patients with doctor visit medical cards are liable to the overnight hospital charge of €55 per night; if they are liable for accident and emergency charges of €55 per visit; and if she will make a statement on the matter. [31790/04]

I propose to take Questions Nos. 51 and 80 together.

The increase in the threshold for the drugs payment scheme, the statutory outpatient charge for attendance at an accident and emergency or casualty department and the statutory inpatient charge will each take effect from 1 January 2005. The estimated saving arising from the increase in the threshold of the drugs payments scheme is €7.5 million and the additional revenue that will arise from the increases in the statutory inpatient and outpatient charges is approximately €8.5 million.

The extension of the medical card scheme, aimed at enabling an additional 30,000 persons to obtain medical card eligibility will also take effect from 1 January 2005. Subject to clarifying legislative and administrative issues, the introduction of the "doctor visit" card to enable free access to GP visits to a further 200,000 people on low income will come into effect as soon as possible in 2005. The new card is an entitlement to free GP visits for those with otherwise limited category two eligibility.

All those ordinarily resident in the State have eligibility for treatment in a public hospital, subject, in the case of those with limited eligibility, to the statutory inpatient and outpatient charge. In relation to the outpatient charge for attendance at accident and emergency or casualty departments, the charge will apply except in circumstances where the person has been referred by a medical practitioner or where the person's attendance results in admission as an inpatient. There is a number of exemptions to the statutory charges, including medical card holders with full eligibility, women receiving services in respect of motherhood, children up to the age of six weeks and children referred for treatment from child health clinics and school health examinations. Also exempt from these charges, in respect of treatment for the particular condition, are children suffering from prescribed diseases, that is, mental handicap, mental illness, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, haemophilia and cerebral palsy; holders of a Health (Amendment) Act Card: Out-patient (Amendment) Regulations 2003; persons receiving services for the diagnosis or treatment of infectious diseases prescribed under Part IV of the Health Act 1947; and members of the Defence Forces personnel and their dependants. Those holding a "doctor visit" medical card will not be exempt from the statutory charges in question unless they are covered by one of the exemptions specified above. Where exemptions do not apply, the charge may still be waived if, in the opinion of the chief executive officer of the appropriate health board, payment would cause undue hardship.

Ambulance Service.

Seymour Crawford

Question:

52 Mr. Crawford asked the Tánaiste and Minister for Health and Children the number and percentage of ambulance personnel that are trained medical technicians; the plans there are to further train these EMTs to paramedical status; and if she will make a statement on the matter. [31768/04]

Michael Ring

Question:

102 Mr. Ring asked the Tánaiste and Minister for Health and Children the additional resources which the health boards or others have received to train emergency medical technicians; and the areas in which additional funding has been or will be spent. [31769/04]

I propose to take Questions Nos. 52 and 102 together.

My Department does not routinely collect information on the numbers of ambulance personnel who are trained medical technicians. My Department has, therefore, asked the health boards executive to collate the information requested and to respond to Deputy Crawford directly.

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, identified aspects of the current emergency ambulance service which need to be addressed in order to bring it into line with best international practice to ensure effective and quality driven practices.

One of the principal recommendations of the report was the rollout of the advanced paramedic training programme. A new Statutory Instrument amending the Pre-Hospital Emergency Care Council's (PHECC) Establishment Order, to facilitate the introduction of the programme, was signed in September 2004. The introduction of the advanced paramedic training programme also requires amendment of the Misuse of Drugs Regulations 1988 and the Medicinal Products (Prescription and Control) Regulations 1996. These legislative changes are being progressed as a priority by my Department.

The combined amendments will provide a statutory basis for the administration of additional medications, for example, cardiac medications, and it is intended that this expanded service will commence rollout in 2005, following the completion of training of ambulance personnel. Additional revenue funding of €500,000 was provided to the Pre-Hospital Emergency Care Council in 2004 to facilitate the commencement of the training element of the programme.

My Department is advised by the PHECC that training of the first cohort of 16 EMTs will be completed in May 2005. Groups of 16 EMTs will undergo training every three months thereafter.

I would like to 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 in order to ensure that those calling on the service receive timely and appropriate care.

Question No. 53 answered with QuestionNo. 21.

Hospital Services.

Joan Burton

Question:

54 Ms Burton asked the Tánaiste and Minister for Health and Children if her attention has been drawn to the decision of the National Maternity Hospital in Dublin to place a cap on the number of babies it is prepared to deliver during the summer months and similar concerns expressed by other maternity hospitals, including Limerick Regional Maternity Hospital regarding their capacity; the steps she intends to take to address the capacity problem in the maternity sector; and if she will make a statement on the matter. [31551/04]

Services for eligible patients at the National Maternity Hospital are provided under an arrangement with the Eastern Regional Health Authority, ERHA.

The National Maternity Hospital manages approximately 8,300 deliveries each year, an average of just under 700 per month. My Department has been advised by the ERHA that the National Maternity Hospital will continue to manage 700 deliveries per month. If demand exceeds this number, there may be a situation where a small number of women will have to attend another maternity hospital.

In July last, the then Minister, Deputy Martin, and officials of the Department met with representatives of the board and management of the National Maternity Hospital and of the authority to discuss proposals for a number of developments aimed at relieving infrastructural deficits at the National Maternity Hospital.

The then Minister, Deputy Martin, approved short-term proposals which are designed to increase capacity in delivery rooms, theatres and neo-natal intensive care units, as well as providing improved post-natal facilities for mothers and babies. Approval was given to the appointment of staff to oversee and manage the project, and the process of selection of a design team is under way. In addition, considerable work has been done in preparing plans for the longer-term redevelopment of the hospital. The project team charged with overseeing this work has completed a development plan that recommends a significant increase in the current level of accommodation at the hospital.

The Eastern Regional Health Authority has also been working with the other maternity hospitals in Dublin to address the increase in births. Approval has been given to the appointment of a design team at the Coombe Women's Hospital to allow planning to commence on a new capital development which will include an extension to the neo-natal intensive care unit; upgrading of the existing ICU; a new caesarean section theatre; a day assessment unit; an ultrasound suite; a parentcraft-admissions unit; an upgrade of mechanical and electrical services and ward upgrading. The estimated capital cost of these works will be almost €20 million.

At the Rotunda Hospital, a development which included the amalgamation of the paediatric and neo-natal intensive care units, as well as the upgrading of post-natal beds on the third floor was commissioned in 2003, at a capital cost of about €10 million.

The provision of services at Limerick Regional Maternity Hospital is a matter for the Mid-Western Health Board. The board has recently received financial clearance for a seventh consultant obstetrician-gynaecologist, and a capital development is under way to provide an additional delivery suite, theatre and an extension to the admissions-reception area at an estimated capital cost of €3.8 million. These improvements are expected to be ready in early 2005.

Work has also commenced on the development of new midwife-led maternity units at Our Lady of Lourdes Hospital, Drogheda and at Cavan General Hospital at a combined estimated capital cost of €1.5 million. This service will offer women greater choice and control within the maternity services. It is anticipated that these units will be fully commissioned early next year.

My Department has provided additional revenue funding of €1.2 million to commission the new maternity unit at Letterkenny General Hospital in early 2005, together with equipping costs in the region of €0.8 million. The new unit will provide enhanced facilities and additional midwife staffing, as well as some increase in capacity.

Construction work is continuing on a new amalgamated maternity unit at Cork University Hospital which is expected to be completed by the middle of 2005. This new maternity hospital represents an investment of €75 million and will replace the existing facilities at St. Finbarr's Hospital, Erinville Hospital and the Bons Secours Hospital, Cork. The unit is designed to cater for approximately 7,000 births annually.

I am committed to the further development of maternity services in line with available resources.

Question No. 55 answered with QuestionNo. 7.

Hospital Staff.

Michael Noonan

Question:

56 Mr. Noonan asked the Tánaiste and Minister for Health and Children if her attention has been drawn to the age profile of the existing nursing staff in psychiatry (details supplied); the steps being taken to remedy this issue; and if she will make a statement on the matter. [31766/04]

The Government recognises that the age profile of the psychiatric nursing workforce is increasing and is conscious of the need to provide for the future needs of mental health services as existing staff retire. The final report of the nursing and midwifery resource group, Towards Workforce Planning, 2002, projected that, by 2007, over 65% of psychiatric nurses would be over 45 years of age. However, this report is based on nurses on the psychiatric division of the register maintained by An Bord Altranais, ABA, rather than those actually in employment in the public health service. For instance, there are almost 9,300 nurses on the psychiatric division of the register of nurses — active — while there are just over 5,000 whole-time equivalent psychiatric nurses — over 5,400 individual psychiatric nurses — in the public health service.

Psychiatric nurses who joined the health service before 1 April 2004 are eligible to retire at age 55. My officials have estimated that around 11% — 550 psychiatric WTE nurses — of the current workforce would be eligible to retire by the end of 2007. The Government has been conscious of the need to increase the domestic supply of nurses across all disciplines, to replace staff who retire and to provide for the development of services. In 2005, over €85 million in revenue funding will be spent on undergraduate nurse training. Since 1998 the Government has increased the number student nurse places across all disciplines by 60%. There is now an annual intake of 1,640 student nurses, of which 343 are training specifically to be psychiatric nurses. It is estimated that even with an attrition rate at the higher end of the spectrum — 15% — over 2,600 psychiatric nurses will graduate over the next ten years and this resource will meet the demand for additional nurses. It is expected that limited numbers of overseas nurses will continue to seek employment in mental health services in addition to the domestic supply of nurses.

It should also be noted that there is a pilot project under way to introduce the health care assistant, HCA, grade into mental health services. The introduction of HCAs into mental health services will assist psychiatric nurses to more effectively utilise their professional skills.

Cancer Incidence.

Trevor Sargent

Question:

57 Mr. Sargent asked the Tánaiste and Minister for Health and Children the number of skin cancers here and the number of deaths resulting; if there has been an increase in the past 20 years; the steps she intends to take to deal with this problem; and if she will make a statement on the matter. [31716/04]

Statistics on the incidences of new cancers cases are collated by the National Cancer Registry. My Department has asked the director of the registry to examine the issue raised and reply directly to the Deputy.

The main cause of skin cancer is over-exposure to ultraviolet rays from the sun. The health promotion unit of my Department works in partnership with the Irish Cancer Society to develop health promotion programmes with communities and workplaces and to undertake regular public information and awareness campaigns that focus on cancer prevention, risk prevention and early detection.

Health Board Funding.

Eamon Gilmore

Question:

58 Mr. Gilmore asked the Tánaiste and Minister for Health and Children if the Eastern Regional Health Authority is facing an overrun of €25 million in 2004 and the main teaching hospitals in Dublin had a deficit of €17 million for the first eight months of 2004; the steps that are being taken to address these financial problems, especially having regard to their potential impact on services for patients; and if she will make a statement on the matter. [31554/04]

The most recent figures reported by the Eastern Regional Health Authority, ERHA, show that the authority has a cumulative variance over period budget of €9.5 million to the end of October 2004, €5 million of which is recorded in the voluntary acute sector. In his report for October, the regional chief executive is forecasting a break-even position for the region by the end of 2004. This will be achieved through the use of the remaining funds, including the authority's and individual agencies' contingency funds, and by the continued effective management of the situation by the authority and its service providers, including the Dublin academic teaching hospitals.

On the impact on services for patients, the activity figures for acute hospitals in the region show an increase of 4.9% to the end of September over the same period last year.

Question No. 59 answered with QuestionNo. 13.
Question No. 60 answered with QuestionNo. 27.

Medical Cards.

Caoimhghín Ó Caoláin

Question:

61 Caoimhghín Ó Caoláin asked the Tánaiste and Minister for Health and Children the timescale for delivery of the promised 200,000 general practitioner-only cards; the legislation that will be necessary to provide for them; the estimated cost per card in comparison with the cost per card of the full medical card; and if she will make a statement on the matter. [31583/04]

Emmet Stagg

Question:

62 Mr. Stagg asked the Tánaiste and Minister for Health and Children when she intends to honour the commitment previously given to extend eligibility in order to provide an additional 200,000 full medical cards; and if she will make a statement on the matter. [31542/04]

Dan Boyle

Question:

100 Mr. Boyle asked the Tánaiste and Minister for Health and Children when she intends to introduce the 200,000 full medical cards as promised; and if she will make a statement on the matter. [31709/04]

I propose to take Questions Nos. 61, 62 and 100 together.

The health strategy includes a commitment to making improvements in the income guidelines in order to increase the number of persons on low incomes who are eligible for the medical card and to give priority to families with children. With a view to implementing this commitment, an additional €60 million has been provided for in the 2005 Estimates for health to improve access to primary care by enabling 30,000 additional persons to become eligible for a medical card, and free access to GP visits for a further 200,000 people on low income.

The Government's policy remains as stated in the programme for Government, that is, to extend eligibility for medical cards rather than to achieve coverage of a certain percentage of the population or to issue a specific number of medical cards.

The annual cost of the new "doctor visit" card is estimated to be €250 and the annual cost of a full medical card is estimated to be €1,000. Subject to clarifying legislative and administrative issues, the new doctor visit card will be introduced as soon as possible in 2005.

My Department will be working closely with the health boards-authority over the coming weeks, and the HSE, which is due to assume responsibility for the service in 2005, to oversee the operation of the scheme and arrangements have already been agreed to put the processes required in train.

Genetic Testing.

Paudge Connolly

Question:

63 Mr. Connolly asked the Tánaiste and Minister for Health and Children the reason the national diagnostic test centre at the National University of Ireland, Galway, at which testing has been suspended, failed to contact persons who had been tested for fragile X syndrome until now when its attention had been drawn to its faulty genetic testing techniques in July 2004; the action she proposes in order to resolve the situation at the centre; and if she will make a statement on the matter. [31837/04]

The National Diagnostic Centre in Galway is not part of the public health services. It is a private service which operates under the aegis of the National University of Ireland, Galway. The centre provides testing services to hospitals and health boards on a fee-per-item basis. It is not funded either by my Department or the Western Health Board.

Cancer Screening Programme.

Jerry Cowley

Question:

64 Dr. Cowley asked the Tánaiste and Minister for Health and Children the progress she has made on the all-Ireland rollout of the BreastCheck programme; when the BreastCheck programme will be rolled out to the rest of the country; and if she will make a statement on the matter. [31857/04]

The rollout of the national screening programme to the remaining counties is a major priority in the development of cancer services. This will ensure that all women in the 50 to 64 age group in every county have access to breast screening and follow-up treatment where appropriate.

A capital investment of approximately €20 million has been approved to construct and equip two static clinical units, one in Cork and the other in Galway. This investment will also ensure that mobile units are available to screen women in the relevant age group throughout the country.

My Department and BreastCheck are fully committed to an expeditious rollout of the programme. Detailed planning for the units is progressing as a matter of priority. A design brief will be completed shortly and it is expected that a design team will be in place early next year. The design, construction and commissioning of the units will take approximately two and a half years.

Any woman, irrespective of her age or residence, who has immediate concerns or symptoms should contact her GP who, where appropriate, will refer her to the symptomatic services in her region.

Medical Cards.

Liz McManus

Question:

65 Ms McManus asked the Tánaiste and Minister for Health and Children when the legislation providing for the new free general practitioner service will be introduced; when she expects that the scheme will be operational; if she will list the services or facilities that are available to those with medical cards that will not be available to persons holding the new general practitioner card; and if she will make a statement on the matter. [31543/04]

Subject to clarifying legislative and administrative issues, the new "doctor visit" card will be introduced as soon as possible in 2005. The card will cover visits to general practitioners who hold general medical services, GMS, contracts with health boards to treat GMS patients, and to whom these patients have been, or have expressed a wish to be, assigned under the GMS medical card scheme. As I have stated previously, I wanted to use resources to benefit as many people on lower incomes as possible. Persons aged 70 years and over have a statutory entitlement to a medical card from 1 July 2001, on the grounds of age alone and persons whose sole income is a social welfare pension will not be disadvantaged by any budgetary changes which might bring their income over the income guidelines for medical card assessment.

Parents on low incomes should not have to worry about the cost of bringing their child to a doctor. People will now be able to get the advice and reassurance they need from their GP, and in many cases, no additional costs will arise. Persons who hold "doctor visit" cards will be entitled to avail of drugs and medicines under the drugs payment scheme which provides that no person or family unit must pay in excess of €78 per month —€85 from 1 January 2005 — in respect of a range of approved prescribed drugs and medicines. With the introduction of this card, the number of persons now covered for free general practitioner services will be 1.38 million.

The services in respect of the supply of medicines and a range of services provided free of charge under the GMS medical card scheme, such as pharmacy, dental, ophthalmic and aural services, will not be available to those who hold "doctor visit" cards. However, it should be pointed out that responsibility for the assessment of applications by persons for medical cards lies with the chief executive officer of the relevant health board-authority. Each case is assessed on the grounds of income and medical need. In cases where the income guidelines are exceeded, a chief executive officer may grant a medical card where, in his opinion, the circumstances of the case might cause undue financial hardship on the applicant to provide medical and other services for himself or his dependants.

Nursing Homes.

Róisín Shortall

Question:

66 Ms Shortall asked the Tánaiste and Minister for Health and Children if she is satisfied that the Health (Nursing Homes) Act 1990 in respect of inspections of private nursing homes is being implemented; if the statutory requirement of two inspections per year is being met; and if not, the reason therefor. [31579/04]

I refer the Deputy to Priority Question No. 5, which deals with the issues raised in her parliamentary question.

Medical Cards.

Jerry Cowley

Question:

67 Dr. Cowley asked the Tánaiste and Minister for Health and Children if emigrants with benefits such as the disability living allowance, incapacity benefit or the severe disablement allowance from the United Kingdom qualify for a medical card under EU regulations on their return here; and if she will make a statement on the matter. [31838/04]

The arrangements for the co-ordination of social security systems, including health care benefits, among EU member states are set out in EU Regulations 1408/71 and 574/72.

Persons covered by these regulations who are residing or staying in Ireland are entitled, free of charge, to all health care provided for by Irish legislation, where the cost of this treatment is payable by the institution of a member state other than Ireland.

In general, this means that a person residing in Ireland and in receipt of a contributory social security payment from the UK or any other member state may receive a medical card under EU regulations where he or she is not also in receipt of a contributory social welfare payment from the Department of Social and Family Affairs or employed in Ireland and subject to PRSI.

Non-contributory social security payments are not usually exportable under the regulations, that is to say, such payments cease when the recipient has transferred residence from the country making the payment. An individual who was receiving such payments and to whom these payments were no longer being paid on taking up residence in Ireland would therefore be subject to the standard means test for a medical card in these circumstances. On joining the EU, the arrangements for the co-ordination of Ireland's social security system, including health care benefits, with those of the other member states were agreed under the terms of EU Regulations No. 1408/71.

Question No. 68 answered with QuestionNo. 7.

Mental Health Services.

Ciarán Cuffe

Question:

69 Mr. Cuffe asked the Tánaiste and Minister for Health and Children her views on whether stress causes much illness; her further views on the latest Feasta review that much of this stress is due to the economic system and in particular to inequality in society here; and if she will make a statement on the matter. [31710/04]

John Perry

Question:

138 Mr. Perry asked the Tánaiste and Minister for Health and Children the measures she has in place to improve mental health and address the environmental factors which impact on mental health, ranging from poverty, poor housing and inadequate public services; if increased funding will be invested in mental health promotion measures; and if she will make a statement on the matter. [31869/04]

I propose to take Questions Nos. 69 and 138 together.

Mental health is equally as important as physical health to the overall well-being of a person and poor mental health can have a significant impact on both the quality of life of the individual as well as on their contribution to society. It is a strategic aim of the National Health Promotion Strategy 2000-2005 to promote positive mental health and contribute to a reduction in the percentage of the population experiencing poor mental health. An expert group on mental health policy was recently established to prepare a national policy framework for the further modernisation of mental health services. The group has also undertaken to examine, inter alia, measures to reduce stigma in the area of mental health. On foot of submissions made to the expert group, a subgroup on mental health promotion and the prevention of mental ill-health has been established to examine the issues around the promotion of positive mental health. It is envisaged that the subgroup will make recommendations, based on best practice and current policy, for the inclusion of mental health promotion and prevention of mental ill-health in any new national policy, as well as identifying and recommending priority areas for action. The subgroup is to report its findings to the expert group in the near future.

The health promotion unit of my Department continues to support the promotion of positive mental health nationally, as well as at regional and local levels. The unit also supports the health promotion efforts of mental health organisations such as Mental Health Ireland, Schizophrenia Ireland and GROW. All these organisations are committed to raising public awareness of mental health issues, to educating the population with regard to these issues and work to eradicate the stigma associated with mental health.

Pharmacy Regulations.

Willie Penrose

Question:

70 Mr. Penrose asked the Tánaiste and Minister for Health and Children the position regarding her consideration of the report of the pharmacy review group; and if she will make a statement on the matter. [31565/04]

The pharmacy review group was established in November 2001 to examine the pharmacy issues raised in the OECD report on regulatory reform in Ireland. I expect to take definitive decisions on the report shortly. The report is available on my Department's website, www.doh.ie, along with reports prepared for the group by Indecon International Economic Consultants.

Health Insurance.

Kathleen Lynch

Question:

71 Ms Lynch asked the Tánaiste and Minister for Health and Children the total percentage increase in VHI premiums since 1997; if her attention has been drawn to statements made by VHI representatives that the increase in the cost of private beds in public hospitals is likely to lead to a further increase of approximately 5%; if her attention has further been drawn to the severe difficulties now faced by families in meeting VHI bills; and if she will make a statement on the matter. [31560/04]

The total percentage increase in VHI premiums for its core products, since 1997 is estimated to be 96%. In calculating the income that would arise from the recently announced increase in the cost of private beds in public hospitals, my officials estimated that it would result in an increase of about 5% in health insurance premiums.

In the interests of equity, it is Government policy to gradually eliminate the effective subsidy for private stays in public hospital beds and relieve the taxpayer of the burden of carrying these costs. Even with this increase, the cost of providing services to private patients in the major hospitals will continue to exceed the income arising from the charges.

Notwithstanding this increase, and the phased implementation of moving towards economic pricing of public pay beds, the cost of community rated private health insurance remains low by international standards and continues to benefit from tax relief at the standard rate. In addition, the regulatory framework provides that premiums for children under the age of 18 and students in full-time education up to the age of 23 may not exceed 50% of the adult rate.

Question No. 72 answered with QuestionNo. 50.

Interpretation Services.

Olivia Mitchell

Question:

73 Ms O. Mitchell asked the Tánaiste and Minister for Health and Children if she plans to ensure that all non-nationals here have adequate access to interpreter services for medical and dental treatment; if there is a facility for an accurate medical and dental history to be given to non-nationals by an interpreter in order that this can be used by any doctor and dentist; and if she will make a statement on the matter. [31764/04]

Liam Twomey

Question:

132 Dr. Twomey asked the Tánaiste and Minister for Health and Children if interpreter services are available to dentists; the way in which dentists are informed on this issue; and if she will make a statement on the matter. [31763/04]

I propose to take Questions Nos. 73 and 132 together.

As the Deputy will be aware, the provision of medical and dental services to eligible persons is a matter for the health boards-authority in the first instance. The health boards-authority make necessary arrangements with regard to interpretation and translation requirements as dictated by the particular circumstances.

Officials in my Department have been working with the regional health boards and the Irish College of General Practitioners to identify areas of difficulty for general practitioners providing services for patients who are non EU nationals. In this regard, additional funding of €1 million was allocated in 2004 by my Department to assist health boards address needs in this area. Within this allocation funding was also provided to allow the Irish College of General Practitioners to support their members through the continuation of the GP and Multicultural Society project.

Mental Health Services.

Olwyn Enright

Question:

74 Ms Enright asked the Tánaiste and Minister for Health and Children the number of acute psychiatric units which are attached to psychiatric hospitals that have stand-alone facilities; the number of units which have been recommended to be transferred to an acute hospital; if she will provide a list of these hospitals; and if she will make a statement on the matter. [31756/04]

Dinny McGinley

Question:

113 Mr. McGinley asked the Tánaiste and Minister for Health and Children her views on the care of acute psychiatric patients who are treated in acute units not attached to general hospitals; and if she will make a statement on the matter. [31757/04]

I propose to take Questions Nos. 74 and 113 together.

Since the publication of Planning for the Future in 1984, it has been the policy of successive Governments to replace 19th century mental hospital accommodation with acute assessment and treatment units in general hospitals and, for less acute illness, appropriate community residential premises. The shift in the delivery of psychiatric services from isolated psychiatric hospitals to acute psychiatric units on the site of general hospitals has been extremely successful and undoubtedly the quality of care for persons with a mental illness has been enhanced by these developments.

There are now 22 operational general hospital psychiatric units. A further two such units are expected to open in 2005 and several other units are at various stages of planning. An expert group on mental health policy was established in August 2003 to prepare a national policy framework for the further modernisation of the mental health services, updating the 1984 policy document, Planning for the Future. In addition, the Deputies may note that provision has been made in the budget for funding on a multi-annual basis for the years 2006 to 2009 to further help move over 600 persons with intellectual disability or autism out of psychiatric hospitals or other inappropriate settings. The future direction and delivery of all aspects of our mental health services including the further development of community-based services will be considered in the context of the work of the group. It is expected that the expert group will report in 2005.

Contaminated Blood Products.

Róisín Shortall

Question:

75 Ms Shortall asked the Tánaiste and Minister for Health and Children the position regarding the undertaking, following the publication of the Lindsay report, to consider the possibility of initiating legal action against US drugs firms which supplied contaminated blood products to haemophiliacs here; if she has sought the legal opinion from US lawyers; and if she will make a statement on the matter. [31571/04]

In July 2003, the Government was approached unilaterally by a firm of New York lawyers with the proposal that the Government could sue certain pharmaceutical companies in the United States arising from the manufacture of blood products which caused hepatitis C and HIV infection to persons with haemophilia. Initial advices received from counsel appointed by the Attorney General raised serious concerns about the proposal. Following careful consideration of these advices, the Attorney General recommended that an independent opinion be obtained in the United States in respect of the proposed litigation. Advices are being sought on an urgent basis from a suitable US law firm. The Irish Haemophilia Society has been kept informed of developments.

Health Board Staff.

Thomas P. Broughan

Question:

76 Mr. Broughan asked the Tánaiste and Minister for Health and Children the information available to her regarding the reason a person (details supplied) decided not to take up the position as chief executive of the Health Service Executive to which he was appointed in September 2004; if she has spoken to him regarding his decision; the total cost of the recruitment process leading to his appointment; and if she will make a statement on the matter. [31545/04]

Joan Burton

Question:

86 Ms Burton asked the Tánaiste and Minister for Health and Children the procedures that will be used to replace a person (details supplied) as chief executive of the Health Service Executive; when she expects that the post will be filled; the level of salary and remuneration agreed for the acting chief executive officer; and if she will make a statement on the matter. [31550/04]

I propose to take Questions Nos. 76 and 86 together.

Professor Aidan Halligan was appointed as the chief executive officer of the interim Health Service Executive in September 2004. When appointed, he indicated that he would not be in a position to take up the post until April 2005. Following discussions between the interim Health Service Executive and Professor Halligan, he subsequently agreed to start at the end of January 2005.

During the week ending on 14 November, Professor Halligan informed the interim health service executive that he would not be taking up the post. Professor Halligan has cited personal reasons as the sole basis for his decision. The interim health service executive has reluctantly accepted his decision, and has recommended Mr. Kevin Kelly as interim chief executive officer with effect from the 1 January 2005, pending the resumption of the recruitment process.

PricewaterhouseCoopers was selected, following a competitive tendering process, to handle the recruitment of the chief executive officer. The cost of the recruitment campaign, covering fees, expenses, advertising and VAT has amounted to €103,283.80.

The board of the interim health service executive has indicated to me that it intends to continue the recruitment process for a chief executive officer with immediate effect. The board plan to re-advertise the position shortly and interviews will be held as soon as a suitable shortlist of candidates is available. The post will be filled as soon as possible, following a successful completion of the recruitment process.

Following a recommendation by the board of the interim health service executive, at its meeting on Saturday, 20 November, I appointed Mr. Kevin Kelly as the interim chief executive officer of the executive, with effect from 1 January 2005. He will step aside as chairman of the executive in order to take up this interim position. He will remain in place until the new CEO is appointed.

With the agreement of Mr. Kelly, the undertaking of the responsibilities of the interim CEO will not alter the remuneration currently payable to him, in respect of his services as executive chairman, which amounts to €100,000 per annum.

Question No. 77 answered with QuestionNo. 27.

Mental Health Services.

Olwyn Enright

Question:

78 Ms Enright asked the Tánaiste and Minister for Health and Children her views on the report of the mental health inspector on the difficulty in recruiting and retaining psychologists, social workers and occupational therapists and the fact that many of these professionals do not find careers in psychiatry attractive; the steps she has taken to deal with the issue; and if she will make a statement on the matter. [31765/04]

Substantial progress has been made in recent years in ensuring that those in need of mental health services receive the best possible care and treatment. Additional funding of approximately €90 million has been invested in mental health services since 1997. This funding has enabled real progress to be made in providing additional medical and health professional staff for expanding community mental health services, to increase child and adolescent services, to expand old age services and to provide liaison psychiatry services in general hospitals.

The Deputy may wish to note that specific human resource initiatives in the key areas of psychology, social work and occupational therapy will contribute significantly to meeting the workforce requirements of the mental health services.

In psychology, a bursary model for supporting postgraduate clinical psychology training was adopted by my Department and the health boards' directors of HR group. This is underpinning the implementation of a key recommendation of the union-management joint review group on psychological services in the health services to substantially increase the number of training places in clinical psychology from 30 to 50 and support the establishment of new courses at the National University of Ireland, Galway, and the University of Limerick. This increase in training places will help meet the long-term human resource needs of the health service for clinical psychologists and is, therefore, of very significant benefit to those who need to avail of psychological services.

In social work, a recent expansion of numbers has taken place on the masters courses in social work and coupled with the first graduates from the UCC degree course, which restarted in 1999, has almost doubled the potential output of qualified social workers in a short period of time. There is now an average intake of 200 students on social work courses each year, including 150 postgraduate places and 50 undergraduate places.

Significant progress has been achieved in expanding the numbers of professional training places in occupational therapy. Three new courses commenced in the 2003-04 academic year in UCC, NUIG and UL. In total, these courses will provide an additional 75 training places in occupational therapy. This expansion in training numbers has been identified in the Bacon report as sufficient to meet the long-term requirements for occupational therapists in Ireland. TCD has also expanded the number of students on its occupational therapy course to 40 in the last number of years.

As the Deputy may be aware, an expert group on mental health policy was appointed in August 2003 to review all areas of mental health policy and service provision. A subgroup has been set up specifically to look at manpower and training issues and this includes the issue of attracting health care professionals to work in mental health services. The group is expected to complete its work in 2005.

Question No. 79 answered with QuestionNo. 23.
Question No. 80 answered with QuestionNo. 51.
Question No. 81 answered with QuestionNo. 29.
Question No. 82 answered with QuestionNo. 50.

Hospital Services.

Breeda Moynihan-Cronin

Question:

83 Ms B. Moynihan-Cronin asked the Tánaiste and Minister for Health and Children if her attention has been drawn to concerns expressed regarding the lack of breast cancer genetic services; the steps she intends to take in regard to such genetic services; and if she will make a statement on the matter. [31575/04]

The National Centre for Medical Genetics, NCMG, is based at Our Lady's Hospital in Crumlin. Since 2002, a cumulative sum of €2.24 million has been allocated to the NCMG, of which €1.84 million was from national cancer strategy funding, including an allocation of €300,000 for the post of consultant clinical geneticist. This investment is supporting the development of breast cancer genetics services nationally.

In 1998, the NCMG was funded by the Health Research Board to carry out a collaborative study on the implementation of testing for hereditary breast cancer in Ireland. As a result of this study, the technology and expertise for screening for mutations in the BRCA1 and BRCA2 genes is now available as is the expertise to assess and counsel families with hereditary breast cancer.

A subgroup of the national cancer forum on genetics is currently examining the specific areas of inherited familial pre-disposition to cancer, cancer risk profiling of persons without inherited mutations, and molecular diagnostics and molecular therapeutics. The work of this subgroup will inform the development of the new cancer strategy, which is due to be completed shortly.

Question No. 84 answered with QuestionNo. 25.

Health Board Services.

Olivia Mitchell

Question:

85 Ms O. Mitchell asked the Tánaiste and Minister for Health and Children if she is satisfied with the dental treatment of children provided by health boards; her views on the service; her plans to extend the service by asking private providers to look after children’s dental needs; and if she will make a statement on the matter. [31759/04]

Enda Kenny

Question:

119 Mr. Kenny asked the Tánaiste and Minister for Health and Children the dental services which are available to school-going children; the dental work which is the responsibility of the State regarding school-going children; if her attention has been drawn to problems with this service nation-wide; and if she will make a statement on the matter. [31771/04]

I propose to take Questions Nos. 85 and 119 together.

Statutory responsibility for the provision of dental services to eligible persons rests with the health boards or authority in the first instance. Under section 67 of the Health Act 1970, the children eligible for health board dental services are pre-school and national school children in respect of defects noted at child health examinations. Child health examinations are provided by health boards to children attending national school in accordance with section 66 of the Health Act 1970.

All health boards have adopted a planned targeted approach to the delivery of dental services to national school children; this ensures the optimum use of dental resources, and equal access for all national school children to the same level of dental care. My Department, in conjunction with the health boards or authority, and University College Cork, is carrying out a survey of the oral health of the general population in Ireland, the national survey of adult and children's dental health. The results of this survey will inform future policy decisions with regard to dental health policy for adults and children.

Children in specific classes in national school, usually second, fourth and sixth class, are targeted for preventive measures under the school based approach; the children in these classes are screened and referred for treatment as necessary; and the programme has been specifically designed to ensure that children are dentally fit before they leave national school. The screening provided in second, fourth and sixth classes ensures that follow-up appointments for examination, treatment or orthodontic review are made, as necessary, with the dental surgeon in the clinic designated for the particular schools.

The Health (Amendment) Act 1994 amended the Health Act 1970. The regulations made under this Act — the Health (Dental Services for Children) Regulations 2000 — extended eligibility for free primary dental care to all children under 16 years of age, who have attended national school. Additional funding of over €5 million has been provided to the health boards or authority for this extension of eligibility. However, treatment is provided within the resources available to the health board or authority. This means that along with the national school screening and treatment programme provided systematically by the health boards or authority, emergency dental treatment may only be available on demand.

Primary dental care for adult medical card holders — persons aged 16 years or over — is provided under the dental treatment services scheme. This dental care is provided free of charge to medical card holders. In the main, private dental practitioners participating in the scheme under contract arrangements with health boards provide this dental care. Salaried dentists from the health boards also provide some services under the scheme.

Question No. 86 answered with QuestionNo. 76.

Community Care.

Joe Sherlock

Question:

87 Mr. Sherlock asked the Tánaiste and Minister for Health and Children if it is still intended to provide the 850 community nursing units promised in July 2002; when they are likely to be available; and if she will make a statement on the matter. [31569/04]

The provision of step-down services for people ready to be discharged from hospital is a key element in ensuring health services are matched exactly to patient needs. I recently announced that patients awaiting discharge from acute hospitals would be accommodated in private nursing home beds for a period of up to six weeks. On discharge from the private nursing home they would go to a nursing home of their choice or to their own home, with the support of a home care package. It has been estimated that up to 500 people could be accommodated in these beds over a 12 month period under this initiative.

It is a priority to increase the availability of community nursing and other units that would meet the needs of people who require care that could not be adequately provided at home. Work has been under way in the Department of Health and Children on a proposal for a public private partnership investment scheme for 850 community nursing units. There have also been discussions between my Department and the Department of Finance in the development of this scheme, as is normal and entirely appropriate with public private partnership projects.

These are complex schemes and it is important to have a clear view of the benefits that will accrue given the complexity of the public private partnership contracting structure. The work done so far has helped to clarify a number of issues. I intend to examine this project in detail very soon. The objective set by my predecessor stands, that is, putting in place a large number of nursing units that will greatly help people make the transition from an acute hospital setting to care matched to their needs.

Hospital Staff.

Arthur Morgan

Question:

88 Mr. Morgan asked the Tánaiste and Minister for Health and Children the position regarding the long overdue renegotiation of the consultants’ common contract; and if she will make a statement on the matter. [31723/04]

During 2002 and 2003, a series of meetings took place between management and the medical organisations to resolve the outstanding issues from the consultants' common contract. These negotiations resulted in the introduction of a revised grievance and dispute procedure for consultants.

In 2003, preliminary talks were held between management and the medical organisations to discuss forthcoming negotiations on the new contract. Unfortunately, the opposition of these organisations to the extension of the clinical indemnity scheme to cover claims against consultants led to a decision by the Irish Hospital Consultants Association not to participate in further negotiations with effect from 1 February 2004, which has resulted in talks on a new contract being stalled.

I am anxious to break the deadlock that has arisen, and I have continually indicated to the consultants that I am available to sit down with them to discuss a new contract in tandem with those issues that are of particular concern to them in relation to the clinical indemnity scheme. In this respect, I met again with the association last Wednesday where I sought to link the negotiations on the new consultants' contract with the resolution of the medical indemnity issues. I regret that the association indicated that it wishes to resolve the indemnity issue before it will agree to negotiate a new contract. I intend to meet again with the association soon to move beyond this impasse.

vCJD Incidence.

Brian O'Shea

Question:

89 Mr. O’Shea asked the Tánaiste and Minister for Health and Children the progress made with regard to tracing the cause of the case of vCJD for which a person is being treated in a Dublin hospital; and if she will make a statement on the matter. [31562/04]

This case relates to a 23 year old man who was admitted to a Dublin hospital about nine weeks ago and who has now been diagnosed as suffering from variant CJD. I am advised that the probability is that he contracted it before the current very strict controls on the sale of meat in Ireland were brought into force in 1996. However, given that the incubation period for variant CJD is considered to be several years, it is virtually impossible to identify the specific source of infection.

I have been advised by the chairman of the National CJD Advisory Group on any possible broader public health implications which may have arisen from this case and the advice was that there is no public health issue in this case as the patient has never received a blood transfusion; he was never a blood donor and he has not received any invasive medical treatments. The role of the CJD advisory group is to provide scientific, professional and technical advice on all aspects of CJD and the policy responses that are appropriate in the light of the evolving information and evidence on this topic.

The chairman of the advisory group has also advised me that the measures in place to protect public health, particularly for the protection of the blood supply, are in accordance with best international practice. Following preliminary discussions with the chairman of the advisory group and with the medical director of the Irish Blood Transfusion Service in regard to this case, the initial conclusion is that no other measures, apart from those already in place, need be taken. The service undertook a review of its policies following the first reported case of transfusion infection in the UK last year and again in July this year following the second reported case.

The CJD advisory group has also recently endorsed the most up-to-date infection control guidance from the National Disease Surveillance Centre in respect of the management of CJD in the health care setting and my Department is ensuring the circulation of the guidance through the health care system. The disease continues to be notifiable and the National CJD Surveillance Unit in Beaumont Hospital continues its activity in monitoring the occurrence of CJD in Ireland.

I sympathise with this young man and his family at this very difficult time.

Cancer Screening Programme.

Brian O'Shea

Question:

90 Mr. O’Shea asked the Tánaiste and Minister for Health and Children if her attention has been drawn to the recent survey undertaken by a person (details supplied) suggesting that up to 400 lives a year could be saved if bowel cancer screening were introduced here; if she intends to introduce such a screening programme; and if she will make a statement on the matter. [31561/04]

A new national cancer strategy is currently being developed by the National Cancer Forum in conjunction with my Department. As part of this work, a sub-group of the National Cancer Forum was established on generic screening. This multi-disciplinary group is reviewing all issues relating to screening and is developing criteria against which future screening programmes will be assessed. The work of the sub-group will inform the development of a new cancer strategy which is due to be completed shortly.

Question No. 91 answered with QuestionNo. 32.

Health Board Services.

John Deasy

Question:

92 Mr. Deasy asked the Tánaiste and Minister for Health and Children her views on a circular from the South Eastern Health Board that there are waiting times of up to four years for orthopaedics and up to two years for ENT; and if she will make a statement on the matter. [31791/04]

Responsibility for the management and monitoring of outpatient waiting lists, including orthopaedic and ENT outpatient waiting lists in the South Eastern Health Board, rests with individual hospitals and the health board. It is a matter for each hospital to prioritise its services based on patient need and use its available resources to best effect to ensure that patient services are delivered efficiently and effectively.

In accordance with health strategy objectives, the Government's immediate focus is on the reduction of waiting lists and waiting times for inpatients and day case treatments in acute hospitals. This is being particularly facilitated by the national treatment purchase fund. However, I intend to raise with the fund how to make progress on outpatient appointments in 2005.

Medical Cards.

Kathleen Lynch

Question:

93 Ms Lynch asked the Tánaiste and Minister for Health and Children if she will review the decision to include interest from special savings incentive accounts in determining eligibility for medical cards, especially in view of the strong efforts made by the Government to promote these accounts; if it is intended to include this money when assessing eligibility for the new general practitioner card; and if she will make a statement on the matter. [31572/04]

Entitlement to health services is primarily based on residency and means. Under the Health Act 1970, determination of eligibility for medical cards is the responsibility of the chief executive officer of the appropriate health board or authority except for persons aged 70 years and over, who are automatically eligible for a medical card. Medical cards are issued to persons who, in the opinion of the chief executive officer, are unable to provide general practitioner medical and surgical services for themselves and their dependants without undue hardship.

Health board and authority chief executive officers have discretion in issuing medical cards and a range of income sources are excluded by the health boards when assessing medical card eligibility. Someone having an income that exceeds the guidelines, may still receive a medical card if the chief executive officer considers that the person's medical needs or other circumstances would justify this. It is open to all persons to apply to the chief executive officer of the appropriate health board for health services if they are unable to provide these services for themselves or their dependants without hardship. The issue of the treatment of special savings incentive accounts proceeds in the assessment of means for a medical card is under consideration with a view to ensuring that nobody is disadvantaged under the scheme.

Mental Health Services.

Dan Neville

Question:

94 Mr. Neville asked the Tánaiste and Minister for Health and Children, further to Question No. 4 of 28 October 2004, if she will publish a report completed into the care and treatment of a person (details supplied) in the course of their admission to the acute psychiatric inpatient unit at the Mid-Western Regional Hospital in September 2002; and if she will make a statement on the matter. [31722/04]

The report referred to by the Deputy was sent to me by the Mid-Western Health Board for my information. It raises serious issues and I am keen to publish it and put these issues into the public domain. I am advised, however, that there may be legal impediments to publishing the report in full and I await the advice of the Attorney General in the matter. I have sent a copy of the same report to the Medical Council, for its attention and for any appropriate action, as it sees fit.

Phil Hogan

Question:

95 Mr. Hogan asked the Tánaiste and Minister for Health and Children the resources she intends to put into child health psychiatry; and if she will make a statement on the matter. [31725/04]

The development of child and adolescent psychiatric services has been a priority for my Department 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 multidisciplinary teams and towards the establishment of further teams.

An additional €15 million revenue funding will be made available for the further development of mental health services in 2005, bringing the total spend on mental health to approximately €725 million. A portion of this funding, the details of which are yet to be finalised, will be allocated to child and adolescent mental health services.

Question No. 96 answered with QuestionNo. 39.
Question No. 97 answered with QuestionNo. 32.

Childhood Obesity.

David Stanton

Question:

98 Mr. Stanton asked the Tánaiste and Minister for Health and Children her views on recent reports which identify obesity as a major emerging health problem here; the steps she is taking to combat obesity, especially obesity in children; and if she will make a statement on the matter. [31720/04]

The National Task Force on Obesity was established in March of this year to address the growing levels of obesity in Ireland highlighted in the survey of lifestyles, attitudes and nutrition. The terms of reference for the task force include: how best to create the social and physical environments that makes it easier for children and adults to eat more healthily and be more active on a regular basis. The task force is due to present a strategy document by the year end. To complement the ongoing work of the task force, the health promotion unit of my Department also launched a national campaign to tackle overweight and obesity in August of 2004 entitled Every Step Counts...Small Changes Make the Difference.

National Treatment Purchase Fund.

John Perry

Question:

99 Mr. Perry asked the Tánaiste and Minister for Health and Children the difference in the role of the national treatment purchase fund and the waiting list initiative for health boards; and if she will make a statement on the matter. [31794/04]

Under the waiting list initiative, which was introduced in 1993, funding was allocated to health boards and voluntary hospitals to: reduce the number of public patients awaiting elective procedures; increase the number of persons receiving elective procedures, inpatient, day cases; reduce the waiting times for elective procedures in target specialities; and improve the management of elective procedures, waiting lists and waiting times. It was a matter for individual health agencies to decide how best to use the funding provided to achieve the four objectives of the initiative. In practice, most treatments were carried out in-house in the hospitals concerned.

The national treatment purchase fund is one of the key actions for dealing with public hospital waiting lists arising from the health strategy. The fund initially concentrated on adults who have been waiting more than 12 months and children waiting more than six months for admission to hospital for surgical procedures. To date it has arranged treatments for 22,000 patients. In most instances, the fund will facilitate anyone waiting more than three months.

Most patients for whom the fund arranged procedures were treated in private hospitals in Ireland. The fund has also referred patients to public hospitals here and to private hospitals in the United Kingdom and Northern Ireland. Patients can apply to their general practitioners, medical consultants or to their local health boards to seek to have their treatment carried out. Patients can also contact the fund directly on the LoCall number 1890 720 820 to have their treatment arranged. I have increased the funding available to the fund to €64 million in 2005 and I expect that it will be able to provide treatment for a further 17,000 patients during the coming year.

Question No. 100 answered with QuestionNo. 61.

Hospital Staff.

Brendan Howlin

Question:

101 Mr. Howlin asked the Tánaiste and Minister for Health and Children the position regarding the application of the European working time directive to non-consultant hospital doctors; if the directive is being implemented in all hospitals; the impact on staffing rosters in hospitals; and if she will make a statement on the matter. [31558/04]

The provisions of the European Working Time Directive as it relates to the working hours of doctors in training came into force on 1 August 2004. The relevant provisions were transposed into Irish law by way of the European Communities (Organisation of Working Time) (Activities of Doctors in Training) Regulations 2004.

Discussions involving the Health Service Employers Agency and the Irish Medical Organisation under the aegis of the Labour Relations Commission have been taking place for some time. While some progress has been made, much remains to be resolved. The Labour Relations Commission has requested that both parties refrain from engaging in any form of unilateral action for the duration of the negotiation process. As a result, as of the 1 August, health employers have not acted unilaterally in order to achieve full compliance with the directive. In many sites around the country, the introduction of new rosters would facilitate significant progress towards compliance with the directive while maintaining safe patient care and existing levels of service provision. However, health employers, in response to the request of the Labour Relations Commission await agreement between management and the Irish Medical Organisation at national level before proceeding.

The ability of the management of the health services to effectively implement the European working time directive for the benefit of all non-consultant hospital doctors, depends on the full co-operation of the Irish Medical Organisation at national and local level. This process was delayed for some time in the absence of agreement by the Irish Medical Organisation to the establishment of a national implementation group and local implementation groups in each hospital.

In this regard, both sides have accepted a proposal from the Labour Relations Commission for the selection of nine pilot hospital sites to examine local implementation issues, and to develop plans for the full implementation of the directive. Included in these groups are representatives of consultants, local representatives of training bodies, non-consultant hospital doctors, nurses, management and other grades. The work of the groups is well under way and it is intended that they will document how measures to reduce or reorganise non-consultant hospital doctors' hours can best be implemented. Action can be taken on foot of this information when the industrial relations process is completed. It is expected that further negotiations on the outstanding areas of disagreement will take place under the auspices of the Labour Relations Commission in the new year, aided and informed by the material compiled by these pilot local hospital groups. Arrangements are also now being advanced for the establishment of a national implementation group to oversee and co-ordinate initiatives at local hospital level. I hope that early progress can be made in resolving outstanding issues, so that full implementation of the directive's requirements can proceed without further delay.

Question No. 102 answered with QuestionNo. 52.

Rights of the Child.

Emmet Stagg

Question:

103 Mr. Stagg asked the Tánaiste and Minister for Health and Children if her attention has been drawn to the recent concerns expressed by the Children’s Ombudsman that the practice of admitting children into adult psychiatric hospitals may be in breach of the UN Convention on the Rights of the Child; the steps she intends to take to provide appropriate separate treatment for such children; and if she will make a statement on the matter. [31573/04]

I am aware of the concerns expressed by the Children's Ombudsman concerning the practice of admitting children to adult psychiatric units. I accept that the placement of children with mental health problems in adult facilities is inappropriate.

The first report of the Working Group on Child and Adolescent Psychiatry recommended that a total of seven child and adolescent inpatient 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. My Department recently gave approval to tender for design teams for the units in Cork, Limerick and Galway. Inpatient services for children and adolescents are provided at Warrenstown House, Dublin and at St. Anne's in Galway.

The Working Group on Child and Adolescent Psychiatry also recommended the enhancement and expansion of the overall child and adolescent psychiatric services as the most effective means of providing the required service for children with mental illness. This has been a priority for my Department 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 multidisciplinary teams and towards the establishment of further teams. This has resulted in the funding of a further 19 child and adolescent consultant psychiatrists. Nationally, there are 52 such psychiatrists employed.

The future direction and delivery of all aspects of our mental health services, including child and adolescent psychiatry, will be considered in the context of the work of the expert group on mental health policy which is due to report in 2005.

Health Care Training Facilities.

Damien English

Question:

104 Mr. English asked the Tánaiste and Minister for Health and Children the training and education courses which exist for voluntary carers who are caring for elderly persons, persons with a long-term illness and persons with disabilities; if she has plans for this area; and if she will make a statement on the matter. [31773/04]

John Perry

Question:

108 Mr. Perry asked the Tánaiste and Minister for Health and Children the funding which is available for training and education facilities for voluntary carers who are caring for the elderly, persons with a long-term illness and persons with disabilities; and if she will make a statement on the matter. [31774/04]

I propose to take Questions Nos. 104 and 108 together.

Considerable progress has been made in recent years in improving the situation of informal family carers. My Department, in recognition of the valuable service rendered by them, has made available additional financial allocations to the health boards and the Eastern Regional Health Authority, for the purpose of supplying specific help to such carers, by way of provision of a respite grant and assistance in the home such as nurse, care attendants or home help. This funding also covers the cost of training programmes. My Department also provides separate financial assistance to the Carer's Association, Caring for Carers and the Alzheimer Society of Ireland, by way of core funding which, in 2003 amounted to €1,884,936 and in 2004 will amount to approximately €2,017,714. A proportion of this provides support to carers, including training programmes.

Ruairí Quinn

Question:

105 Mr. Quinn asked the Tánaiste and Minister for Health and Children the progress made to date with regard to implementation of the recommendations of the Hanly Report; and if she will make a statement on the matter. [31567/04]

The Government is committed to developing acute hospital services in a way that will command the confidence of people throughout the country. While implementation of some of the proposals in the report of the National Task Force on Medical Staffing has been hampered by continuing industrial action by hospital consultants, work on the other elements of the proposals is progressing. Detailed assessments have been prepared of the service and resource implications of the forthcoming reduction in non-consultant hospital doctors' working hours in each health agency. Negotiations with the Irish Medical Organisation on the reduction in non-consultant hospital doctors' hours required under the European Working Time Directive are continuing in the Labour Relations Commission. Local implementation groups have been established in eight hospitals as part of an agreed pilot process.

The medical education and training sub-group of the national task force has remained in place. I have asked the group to examine and report to me on the measures required to accommodate non-consultant hospital doctors' training in all postgraduate programmes and safeguard both training and service delivery during the transition to a 48-hour working week, which is required under the European working time directive by August 2009. The group has agreed a joint approach to training with the medical training bodies and the Medical Council, and has provided formal advice on the provision of medical education and training in a 58-hour working week.

Health Board Services.

Liam Twomey

Question:

106 Dr. Twomey asked the Tánaiste and Minister for Health and Children if she intends to advise health boards to increase preventative dental work on children’s baby teeth due to the fact that maintaining baby teeth helps to prevent future orthodontic work; and if she will make a statement on the matter. [31760/04]

Paul Connaughton

Question:

121 Mr. Connaughton asked the Tánaiste and Minister for Health and Children if she will issue guidelines to health boards or to their equivalent to ensure that their dental policies are proactive in saving children’s baby teeth, especially molars, due to the fact that baby molars help guide the permanent molars; and if she will make a statement on the matter. [31761/04]

I propose to take Questions Nos. 106 and 121 together.

As the Deputy is aware, statutory responsibility for the provision of dental services to eligible persons rests with the health boards or authority in the first instance. My Department, in conjunction with the health boards or authority and University College Cork, is currently carrying out a survey of the oral health of the general population in Ireland, the national survey of adult and children's dental health, the results of which will inform future policy decisions with regard to dental health policy. As part of this research the targeted approach to service delivery is being examined. Preliminary results indicate that current policy is very effective. The preliminary results show that the average number of primary teeth which were decayed, missing or filled due to decay among five year olds living in fluoridated areas has dropped from 5.6 in the 1960s to one in 2002. This is a very positive trend. The results of the oral health survey and research will, when completed, inform future policy decisions in this area and will have a major impact on the evolution of dental services.

Hospital Services.

Paul Connaughton

Question:

107 Mr. Connaughton asked the Tánaiste and Minister for Health and Children her views on the development of a private radiation oncology unit on the grounds of Waterford Regional Hospital, in view of the launch of the private radiation oncology development in Limerick Regional Hospital; the support she is willing to offer; and if she will make a statement on the matter. [31767/04]

The Government is committed to making the full range of cancer services available and accessible to cancer patients throughout Ireland. To this end, we will provide considerable investment in radiation oncology facilities in the coming years. The Government in its decision last year on radiotherapy services remained open to the provision of a satellite radiation oncology unit in Waterford. We are determined to deliver enhanced services for the whole population as soon as possible. There is unanimity about the urgent need for significantly enhanced services in the major population centres of Dublin, Cork and Galway. I will keep the question of networked satellite locations under active review.

The immediate developments in Cork and Galway will result in the provision of an additional five linear accelerators. Five additional consultant radiation oncologists are being recruited for this service. These developments will significantly improve access to radiotherapy for patients in the south east and throughout the country. In relation to the Dublin area, six hospitals have now submitted proposals for the development of radiation oncology services. I will be advised by the chief medical officer of my Department on the location of radiation oncology services in the eastern region and by other experts in the area. The chief medical officer will be assisted by a panel of international experts in this regard. The international panel will visit Dublin the week beginning 13 December 2004 and it is expected that it will complete its work by the end of the year.

As recommended in the report on the development of radiation oncology services, the national radiation oncology co-ordinating group has been established. The group comprises clinical, technical, managerial, academic and nursing expertise from different geographic regions. The group's remit encompasses recommending measures to facilitate improved access to existing and planned services, including transport and accommodation. The group is expected to develop proposals in these important areas. It will also advise on quality assurance protocols and guidelines for the referral of public patients to private facilities.

The national radiation oncology co-ordinating group is currently developing a national Telesynergy® network for radiation oncology services. The South-Eastern Health Board has advised the Department that a Telesynergy® system should be installed in Waterford Regional Hospital. Arrangements are now being made to install this technology at the hospital which will enable the hospital to develop improved linkages with Cork University Hospital and St. Luke's Hospital, Dublin and reduce patient and consultant travel time.

Question No. 108 answered with QuestionNo. 104.

Michael D. Higgins

Question:

109 Mr. M. Higgins asked the Tánaiste and Minister for Health and Children the expected date for the bringing into commission of each of the unopened facilities in regard to the announcement of 14 September 2004; if the health boards have been provided with the resources to recruit the appropriate staff for these units; and if she will make a statement on the matter. [31556/04]

My Department issued approval on 21 September 2004 to the chief executive officers of the health boards and the Eastern Regional Health Authority for the commissioning of a large number of new acute hospital facilities around the country. The commissioning of the new units is under way. The health boards and the Eastern Regional Health Authority have informed my Department that the units will be brought into operation on a phased basis over the remainder of 2004 and mainly in the first half of 2005.

Nursing Homes.

Seán Ryan

Question:

110 Mr. S. Ryan asked the Tánaiste and Minister for Health and Children her views on the need for an independent inspectorate of nursing homes; if so, when she proposes to establish such a body; and if she will make a statement on the matter. [31541/04]

The inspection of private nursing homes is the responsibility of the health boards under the Health (Nursing Homes) Act 1990. Regulations made under this Act empower health boards to inspect private nursing homes. My Department has established a working group comprising all stakeholders to review the operation and administration of the nursing home subvention scheme. As part of this review the working group will make recommendations on the development and implementation of quality care standards in institutional settings and examine all issues connected with the regulation of private nursing homes, including the inspection process. It is intended that the inspection of private and public long-stay facilities will fall under the remit of the social services inspectorate in due course.

Abuse of the Elderly.

Phil Hogan

Question:

111 Mr. Hogan asked the Tánaiste and Minister for Health and Children the number of health boards which have appointed a case officer to deal with elder abuse; the number of case officers that deal with elder abuse in each health board; and if she will make a statement on the matter. [31806/04]

My Department made funding of €75o,000 available to the health boards this year for the continued implementation of the report of the working group on elder abuse, including the employment of a case officer. A variety of arrangements are in place to address this need but two health boards have appointed a case officer to deal with elder abuse. Other boards have not progressed matters to the same extent for various reasons, including pressure on their employment ceilings and other competing priorities for available posts.

Organ Retention.

Joe Sherlock

Question:

112 Mr. Sherlock asked the Tánaiste and Minister for Health and Children the progress made to date by the Dunne inquiry into the retention of organs of deceased children; the date on which the report will be published; the steps being taken to address the concerns of the families affected; if it is intended to introduce legislation to regulate organ retention and transplants; and if she will make a statement on the matter. [31570/04]

The Chairman of the Post Mortem Inquiry has indicated that she will provide a report on paediatric hospitals in December 2004. There are ongoing consultations with the inquiry about the other elements of its remit, having regard to the Government decision that the inquiry should conclude by 31 March next.

The European Commission is considering a directive 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 on its analysis to the Council of the European Union as soon as possible. It is hoped that this will provide the framework for the development of legislation in this area. In the meantime, it is intended to establish an expert group to review organ donation, procurement and utilisation policy in Ireland. The work of this group will inform Ireland's contribution to the discussions on the proposed directive on organs.

Question No. 113 answered with QuestionNo. 74.
Question No. 114 answered with QuestionNo. 13.

Medicinal Products.

Ciarán Cuffe

Question:

115 Mr. Cuffe asked the Tánaiste and Minister for Health and Children the latest figures for the number of anti-depressants prescribed in the Dublin area; the reason for the increase in the amount of drugs prescribed; the steps she is taking to ensure that fewer are prescribed; and if she will make a statement on the matter. [31711/04]

Prescriptions for anti-depressants may be issued by general practitioners or consultants in a variety of locations, such as general practice, community psychiatric facilities or private or public psychiatric hospitals. 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.

Figures provided by the General Medical Services (Payments) Board for January to August 2004, the latest month for which figures are available, indicate that there were 166,386 claims for anti-depressants in the Dublin area, at a cost of €4,880,882. These figures do not include certain categories of patients in the Eastern Regional Health Authority area for whom separate arrangements are in place. I have asked the Eastern Regional Health Authority to forward the additional information directly to the Deputy as a matter of urgency. My Department does not have access to prescribing and dispensing information where monthly expenditure by an individual under the drugs payment scheme, DPS, is less than the monthly threshold.

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. The expert group has now completed an extensive public consultation process on the mental health services and is planning to publish the findings of this process shortly. It is expected to complete its work in 2005.

Question No. 116 answered with QuestionNo. 8.

Vaccination Programme.

Willie Penrose

Question:

117 Mr. Penrose asked the Tánaiste and Minister for Health and Children the current level of the take-up of the MMR vaccine in each health board area for the latest period for which figures are available; the steps that are being taken to promote fuller take-up, especially in view of reports of a significant increase in the number of cases of measles in some areas of the country; and if she will make a statement on the matter. [31566/04]

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.

In Ireland, uptake of the first dose of the measles, mumps and rubella vaccine, MMR1, is calculated on a quarterly basis among children of 24 months of age. In quarter two of 2004, the national uptake rate for this vaccine was 81%. This represents an increase of 1% in the national uptake rate when compared with the previous quarter and an increase of 4% in comparison with the same quarter in 2003. In addition, uptake rates reported by individual health boards ranged from 76% to 91% as shown in table 1.

Table 1 MMR1 Uptake rates by health board in Quarter 2 2004*.

Uptake at 24 months — Q2 2004

%

ERHA

76

MHB

91

MWHB

84

NEHB

84

NWHB

87

SEHB

86

SHB

82

WHB

76

Ireland

81

*The most recent period for which uptake figures are available from the NDSC.

The national uptake rate of MMR1 has increased from 69% in Q4 2001 to 81% in Q2 2004. This trend has been reflected in each of the health boards with all health boards having reported an increase in the uptake rate for MMR1 over this time period. Although MMR1 uptake rates have been improving over the past year and a half, they are still 14% lower than the national target rate of 95%.

I am concerned about the unsatisfactory MMR immunisation uptake rates because of the risk of un-immunised 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. However, I am encouraged by the fact that the immunisation uptake rates are steadily improving. Meanwhile, data provided by the NDSC indicate that from week one to week 46, inclusive, of 2004, that is, up to 20 November 2004, 314 cases of measles were notified which compares with 555 cases notified for the comparative period in 2003; this represents a significant reduction in the number of measles cases reported to date this year.

However, since early November 2004 there has been an increase in mumps cases occurring in teenagers and young adults, more than double that reported for the first ten months of 2004. The cases appear to be occurring mainly in individuals who were never immunised or only received one dose of MMR, the vaccine that contains mumps vaccine. In third level colleges where outbreaks are occurring, students between the ages of 16 and 25 years of age with no history of a second dose of MMR have been advised to contact student health services or their own GPs about vaccination. Outbreaks have occurred in Athlone Institute of Technology, Letterkenny Institute of Technology and NUI Maynooth. Vaccination clinics have been held in these colleges.

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. The report of the steering committee was launched 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. Funding in the region of €800,000 has been allocated to health boards via HeBE specifically for regional and localised projects focused on measures to improve immunisation uptake.

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 or not to vaccinate their children. In April 2002, the MMR Vaccine Discussion Pack, An Information Guide for Health Professionals and Parents, was launched. 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 relation 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 enables health professionals to respond to the very real concerns of parents.

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. Health boards have undertaken a range of measures in their regions in order to improve vaccine uptake in their region. These 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, 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.

Furthermore, my Department has convened a measles eradication committee to develop a national five-year action plan for the elimination of measles and rubella in line with the World Health Organisation strategic plan for 2010. This committee had its first meeting on 30 September 2004 and is due to report to me by the end of June 2005.

I would like to 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.

Nursing Homes.

Ruairí Quinn

Question:

118 Mr. Quinn asked the Tánaiste and Minister for Health and Children the number of public nursing homes and beds in the country; her views on whether there is a need for an inspectorate to be put in place on a statutory basis similar to the private sector; and if it is her intention to establish such an inspectorate. [31581/04]

As the Deputy may be aware, figures relating to the number of public nursing homes and beds are collated by my Department on an annual basis. The most recent long-stay activity statistics report was finalised in July 2004 and provides information on activity in long-stay units in 2003. The report shows that there were 12,339 long-stay beds in health board facilities, including respite beds at the 31 December, 2003. This figure represents 51.8% of the long-stay bed complement with the remaining 49.2% of long-stay beds being provided in private/voluntary nursing homes.

Currently, the inspection of private nursing homes is the responsibility of the health boards under the Health (Nursing Homes) Act 1990. Regulations made under this Act empower health boards to inspect private nursing homes.

In the context of the health reform programme, added emphasis is being placed on the setting and monitoring of standards generally. It is also planned to extend the brief of the social services inspectorate to include residential services for older people and people with a disability and to establish it on a statutory basis. Building on the existing framework for inspections, my Department is satisfied that these additional measures give grounds for added public confidence in the effectiveness of the inspections regime.

Question No. 119 answered with QuestionNo. 85.

Hospital Waiting Lists.

Seán Ryan

Question:

120 Mr. S. Ryan asked the Tánaiste and Minister for Health and Children if her attention has been drawn to the fact that there is a waiting list of up to 12 and a half years for public nursing beds in some regions of the greater Dublin area; and the way in which she proposes to deal with the problem. [31578/04]

I draw the Deputy's attention to the reply given to his parliamentary question of 22 June this year. I would also like to add, by way of additional information, that funding provided by my Department to the Eastern Regional Health Authority under the delayed discharges initiative has to date facilitated the discharge of over 600 people from the acute hospital sector to private nursing home care or back to their own homes.

Question No. 121 answered with QuestionNo. 106.

Hospital Services.

Billy Timmins

Question:

122 Mr. Timmins asked the Tánaiste and Minister for Health and Children the number of stroke units available in public hospitals; the location at which these units are available; the average number of persons who are treated in them annually; and if she will make a statement on the matter. [31779/04]

Responsibility for the provision of hospital services for stroke sufferers rests with the Eastern Regional Health Authority or the appropriate regional health board. The information requested by the Deputy is not routinely collected by my Department. My Department has, therefore, asked the regional chief executive of the authority and the chief executive officers of the health boards to investigate the position in regard to the matters raised by the Deputy and to respond to him directly.

Question No. 123 answered with QuestionNo. 50.

Medical Inquiries.

Jan O'Sullivan

Question:

124 Ms O’Sullivan asked the Tánaiste and Minister for Health and Children when she expects to receive the report of the independent review into the circumstances of the death of a person (details supplied); the reasons for the long delay in finalising this report; and if she will make a statement on the matter. [31564/04]

In July 2003, the then Minister for Health and Children, Deputy Martin, announced that he had convened a review panel to conduct an independent review of the events surrounding the tragic death of the person referred to by the Deputy.

The members of the panel are: Mr. David Hanly, Chairman; Ms Kay O'Sullivan, director of nursing at Cork University Hospital; and Dr. Shakeel A. Qureshi, paediatric cardiologist at Guy's and St. Thomas's Hospital, London.

The terms of reference of the panel are: to consider the report of the ERHA in relation to the events of 30 June 2003 at Our Lady's Hospital for Sick Children, Dublin and to make such further inquiries and conduct such interviews as the panel considers necessary; to address the questions raised by the family; to examine protocols and procedures relevant to this incident having regard to prevailing standards of best practice, and to examine their application in this case; and to report to the Minister and to make such recommendations as it sees fit.

I expect to receive the panel's report shortly. It is my intention to publish the panel's report and the earlier report by the ERHA.

Question No. 125 answered with QuestionNo. 22.

Health Board Allowances.

Bernard J. Durkan

Question:

126 Mr. Durkan asked the Tánaiste and Minister for Health and Children if and when the domiciliary care allowance in the case of a person (details supplied) in County Kildare will be started; and if she will make a statement on the matter. [31976/04]

The assessment of entitlement to and payment of the domiciliary care allowance in any individual case is a matter for the relevant health board. Accordingly, a copy of the Deputy's question has been forwarded to the regional chief executive of the Eastern Regional Health Authority with a request that he examine the case and reply directly to the Deputy as a matter of urgency.

Question No. 127 answered with QuestionNo. 21.

Services for People with Disabilities.

Dan Boyle

Question:

128 Mr. Boyle asked the Tánaiste and Minister for Health and Children the investigation that has occurred in relation to the possible introduction of a cost of disability allowance. [28173/04]

Under the Programme for Prosperity and Fairness, an interdepartmental working group, chaired by the Department of Health and Children, was established to examine the feasibility of introducing a cost of disability payment.

The National Disability Authority, on behalf of the working group, and in line with its own remit, commissioned research into the feasibility of a cost of disability payment in Ireland. The purpose of this research was to advise regarding the additional costs incurred by people with disabilities, owing specifically to the direct or indirect costs of the disability; and the appropriate mechanisms, or instruments by which to address identified additional costs.

The resultant report, Disability and the Cost of Living, was published by the NDA early in 2004. The working group in March of this year produced a position paper, which gave an overview of the work they have undertaken to date. It outlined the group's current thinking and also gave an indication of the next steps the working group intend taking.

The working group recommends that urgent steps be taken to improve the quality of data relating to disability in Ireland. This might include, for example, adjustment of existing data gathering exercises undertaken by the Central Statistics Office or other relevant bodies to include questions on the numbers per household with disabilities, the nature of the disability, severity of impairment and so on. The working group considers that it is vital that comprehensive data are available on which to base consideration of the feasibility of a cost of disability payment. Given its advisory and research remit, the working group considers that the National Disability Authority has an important role to play in addressing these data gaps along with other relevant bodies. The working group acknowledges that a number of Departments and agencies have previously carried out reviews of the various supports and payments for people with disabilities.

However, these reviews have tended to focus solely on the operation of individual schemes, without taking a broader overview of how these measures fit into the overall system of disability supports. The working group proposes to examine the scope for rationalising and streamlining the various disability supports measures, with a particular focus on mitigating the additional costs of disability for a greater number of people with disabilities, particularly in the case of those who wish to move from a position of total welfare dependence to one of greater economic independence. The working group is now proceeding to follow up on these various matters.

Mental Health Services.

Ciarán Cuffe

Question:

129 Mr. Cuffe asked the Tánaiste and Minister for Health and Children if a transparent consultation and planning process will be put in place to ensure that the redevelopment of the Central Mental Hospital will be in line with best international practice. [27279/04]

The redevelopment of the Central Mental Hospital will take account of best practice both in terms of the infrastructure and operational policies. The project will be subject to the normal planning and Government procurement processes.

Genetically Modified Organisms.

Trevor Sargent

Question:

130 Mr. Sargent asked the Tánaiste and Minister for Health and Children if her policy is to accept or reject the wish of 70.9% of EU citizens, according to a European Commission opinion poll, who do not want genetically modified food. [29374/04]

Government policy with regard to genetically modified organisms, GMOs, is set out in the report of the interdepartmental group on modern biotechnology, published in October 2000. In line with the recommendations of this report, my Department adopts a positive but precautionary approach to the issue of GM foods which reflects the priority given to consumer choice and safety.

Ireland, in common with other member states and as required by EU rules, applies EU legislation on GM foods. This legislation is in the form of EU regulations which are directly applicable to, and binding on, each member state. At present, Ireland has no additional national legislation on GM foods, however my Department is currently working on introducing provisions into national legislation which will allow for enforcement measures, including penalties, in the case of non-compliance with the recently adopted regulations.

The survey referred to by the Deputy was published in December 2001 and in the intervening period there have been significant developments. For example, during 2004 the European Union's new regulatory framework for GMOs entered into force with the consequent lifting of what was referred to as the moratorium on new GMOs. In response to consumer concerns, the EU has developed a robust safeguard system of legislation, covering the deliberate release of GMOs into the environment, regulations on GM food and feed, traceability and labelling of GMOs, trans-boundary movement of GMOs and guidance on the co-existence of GM and conventional crops.

These developments have paved the way for a high level of consumer, public health and environmental protection as they require the rigorous pre-marketing assessment of GM food and feed and include safeguard measures on labelling and traceability. The safety of GM products is independently assessed by European Food Safety Authority, EFSA, on a case by case basis and GM food is now required to be clearly labelled, thus ensuring greater consumer confidence and choice.

The Food Safety Authority of Ireland is the competent authority in Ireland for the enforcement of legislation governing GM food and carries out regular checks of the marketplace to ensure compliance with GM food legislation. The FSAI, through its GMO and novel foods sub-committee, assesses dossiers from EFSA regarding application for authorisation within the EU of GM foods and consequently feeds into the decision making process at EFSA. I am satisfied that appropriate arrangements are in place to ensure the safety of authorised GM foods, or foods containing GM ingredients, placed on the market in Ireland.

Sexually Transmitted Diseases.

David Stanton

Question:

131 Mr. Stanton asked the Tánaiste and Minister for Health and Children the situation regarding sexually transmitted diseases here, the details of the different diseases, rates of infection and trends; the actions that are being taken to address this issue; and if she will make a statement on the matter. [31721/04]

The National Disease Surveillance Centre recently published sexually transmitted infections, STIs, figures for quarter one of 2003. Some 2,664 cases of STIs were notified in Ireland during quarter one of 2003, compared to 2,541 notifications during quarter one of 2002, representing a 4.8% increase in STI notifications.

The three most commonly notified STIs in quarter one of 2003 were ano-genital warts, 929 cases; non-specific urethritis, 560 cases; andchlamydia trachomatis, 525 cases. The highest increase reported in quarter one of 2003, compared to quarter one of 2002 was for infectious hepatitis B, which was +230.0%. The most significant decreases reported during quarter one of 2003, compared to quarter one of 2002 were for gonorrhoea, -16.67%; and syphilis, -8.2%. The following Table 1 gives details of all notified STIs for quarter one of 2003 and quarter one of 2002.

Table 1: Notified sexually transmitted infections for Q1 2003 and Q1 2002.

Sexually Transmitted Infection

Q1 2003

Q1 2002

Increase/Decrease

% Increase

Ano-Genital Warts

929

1,017

-88

-8.65

Candidiasis

321

324

-3

-0.93

Chancroid

0

0

0

0.00

Chlamydia Trachomatis

525

433

92

21.25

Genital Herpes Simplex

97

84

13

15.48

Gonorrhoea

40

48

-8

-16.67

Granuloma Inguinale

0

0

0

0.00

Infectious Hepatitis B

33

10

23

230.00

Lymphogranuloma Venereum

0

0

0

0.00

Molluscum Contagiosum

42

34

8

23.53

Non-Specific Urethritis

560

470

90

19.15

Pediculosis Pubis

22

23

-1

-4.35

Syphilis

78

85

-7

-8.24

Trichomoniasis

17

13

4

30.77

Total

2,664

2,541

123

4.84

In terms of full year figures, the latest annual figures available from the NDSC show that 10,471 STIs were notified in 2002 compared with 9,703 in 2001, a 7.9% increase. The following Table 2 gives details of all notified STIs for 2002 and 2001.

Table 2: Notified sexually transmitted infections for 2002 and 2001.

Sexually Transmitted Infection

2002

2001

Increase/Decrease

% Increase

Ano-Genital Warts

3,932

3993

-61

-1.53

Candidiasis

1,351

1,150

201

17.48

Chancroid

1

1

0

0.00

Chlamydia Trachomatis

1,922

1,649

273

16.56

Genital Herpes Simplex

358

331

27

8.16

Gonorrhoea

214

349

-135

-38.68

Granuloma Inguinale

0

0

0

0.00

Infectious Hepatitis B

57

39

18

46.15

Lymphogranuloma Venereum

1

0

1

Molluscum Contagiosum

150

111

39

35.14

Non-Specific Urethritis

2,025

1,634

391

23.93

Pediculosis Pubis

84

103

-19

-18.45

Syphilis

303

279

24

8.60

Trichomoniasis

73

64

9

14.06

Total

10,471

9,703

768

7.92

The report of the National AIDS Strategy Committee, NASC, which was published in 2000, makes a range of recommendations for dealing with STIs and HIV and AIDS. My Department through the National AIDS Strategy Committee and its sub-committees on education and prevention, surveillance and care and management is working to implement these recommendations.

In regard to STIs and HIV and AIDS, our first line of defence must be education and awareness. In this regard the national health promotion strategy 2000-05 acknowledges that sexuality is an integral part of being human and healthy sexual relationships can contribute to an overall sense of well-being. A strategic aim of the health promotion strategy 2000-05 is "to promote safer sexual health and safer sexual practices among the population."

Education and prevention measures are co-ordinated by the health promotion unit, HPU, of my Department within the context of both the national health promotion strategy and the report of the National AIDS Strategy Committee 2000. In fulfilment of objectives and recommendations set out in these strategies the health promotion unit is involved in and supports a range of initiatives and interventions aimed at preventing and raising awareness of STIs and HIV and AIDS. The following are some examples of the current priorities: in the school setting, my Department is working in partnership with the Department of Education and Science and the health boards to support schools in the introduction and delivery of social, personal and health education, SPHE, at both primary and post primary level. Relationships and sexuality education is an integral part of this curriculum and remains a key priority for this work with schools.

In the out of school setting, the health promotion unit of my Department works in partnership with youth affairs section of the Department of Education and Science and the National Youth Council of Ireland to implement the national youth health programme. The aim of the programme is to provide a broad-based, flexible health promotion-education support and training service to youth organisations and to all those working with young people in the non-formal education sector. Within the context of this programme, a training initiative called Too Hot to Handle is offered to youth workers which address the issues of relationships, sexuality and sexual health with young people.

A national public awareness advertising campaign to promote sexual health which is aimed at men and women in the 18 to 35 age group to increase awareness about safe sex and STIs. The overall goal is to increase safe sex, reducing the incidence of STI transmission and unwanted pregnancies among young people in Ireland. The campaign runs in third level colleges, places of entertainments, such as pubs, clubs, discos and youth clubs. This national programme has been running for several years and a new and revised campaign is currently being implemented by the HPU, which has greatly increased the number of venues targeted.

The report of the National AIDS Strategy Committee, AIDS Strategy 2000, recommended that a national survey of sexual knowledge, attitudes and behaviours in Ireland be carried out in line with those in other European countries. Such a study would provide nationally representative information on knowledge and attitudes to sex, sexual health, sexual health services and sexual behaviour. The data will also provide a benchmark for planning future sexual health promotion services and strategies. Most importantly, it is intended that all findings will inform future policy and practice developments. This survey is being conducted by my Department in conjunction with the Crisis Pregnancy Agency. The aims of this survey include the collection of reliable nationally representative baseline information that will: build a representative and reliable national picture of sex and sexual behaviour in Ireland; measure levels of sexual knowledge among people in Ireland; reliably assess national attitudes toward important constructs related to sex, sexuality and service use; and examine patterns, similarities and differences, among different cohorts and patterns underlying these variations; examine, explore and reliably describe the interrelationships between knowledge, attitudes and behaviours in the context of theory, sexual health promotion and policy development. The HPU also produces a range of awareness raising leaflets on STIs and safe sex practices which are available through health promotion departments in each health board.

Almost €5.5 million of additional annual funding has been provided to health boards since 1997 to address the treatment of STIs and HIV and AIDS. This has resulted in a substantial increase in the facilities in place. At present there are seven consultants specialising in the treatment of STIs and HIV and AIDS; five of these are in Dublin, one of whom deals with children, one in Cork and one in Galway.

The care and management sub-committee of NASC visited hospitals and health boards involved in the provision of services to people with HIV and AIDS and STIs. The purpose of these visits was to identify gaps and make recommendations for the future direction of treatment services. The report of the sub-committee will be published in the coming months. My Department will continue to closely monitor the position in relation to sexually transmitted infections and HIV and AIDS.

Question No. 132 answered with QuestionNo. 73.

Hospital Staff.

Liam Twomey

Question:

133 Dr. Twomey asked the Tánaiste and Minister for Health and Children the number of geriatricians in public hospitals in each health board area or equivalent; and if she will make a statement on the matter. [31789/04]

My Department has contacted the health boards and the Eastern Regional Health Authority and they have advised the following information.

The Eastern Regional Health Authority confirmed there are the following number of geriatricians in public hospitals in the following agencies: Adelaide Meath National Children's Hospital — two WTE; James Connolly Memorial Hospital — one WTE; Naas Hospital — one WTE; Beaumont Hospital — one WTE; Mater Hospital — three WTE; St. James's Hospital — four WTE; and St. Vincent's University Hospital — three WTE.

Currently the North Eastern Health Board has four consultant physician/geriatricians, one each in Louth County Hospital; Our Lady's Hospital, Navan; Our Lady of Lourdes Hospital, Drogheda; and Cavan General Hospital. The number of geriatricians in the Mid-Western Health Board area is four, broken down as follows: Mid-Western Regional Hospital, Dooradoyle, Limerick — two; Mid-Western Regional Hospital, Ennis — one; and Nenagh General Hospital — one.

The Midland Health Board confirmed that it has two posts filled as consultant physician with special interests in geriatric medicine, one each in the Midland Regional Hospital at Tullamore and the Midland Regional Hospital at Mullingar. The Western Health confirmed that there are five consultant physicians with a special interest in geriatric medicine employed in the board's acute hospitals, broken down as follows: one each in University College Hospital, Merlin Park, County Hospital Roscommon, Portiuncula Hospital, Ballinasloe and Mayo General Hospital, Castlebar.

In the North Western Health Board there is one consultant geriatrician at Sligo General Hospital. The board has recently received Department of Health and Children approval for a second consultant geriatrician. This application is currently with Comhairle na nOspidéal for approval. There are two consultant geriatricians in Letterkenny General Hospital. The Southern Health Board confirmed the following: three WTEs between Cork University Hospital and St. Finbarr's Hospital; one WTE in Kerry General Hospital; one WTE in Bantry General Hospital; and one consultant physician in geriatric medicine employed in the South Infirmary-Victoria Hospital. This is a joint appointment, shared 5.5 sessions per week in the South Infirmary-Victoria Hospital and 5.5 sessions per week in the Mercy Hospital.

The South Eastern Health Board confirmed that it employs eight consultants, two in each of its four public hospitals.

Long-Term Illness Scheme.

Liam Twomey

Question:

134 Dr. Twomey asked the Tánaiste and Minister for Health and Children the action she intends to take following a recommendation from the Joint Committee on Health and Children to include persons with post polio syndrome on the long-term illness scheme; her plans for this group; and if she will make a statement on the matter. [31798/04]

Under the 1970 Health Act, a health board may arrange for the supply, without charge, of drugs, medicines and medical and surgical appliances to people with a specified condition, for the treatment of that condition under the long-term illness scheme, LTI. The conditions are: mental handicap, mental illness — for people under 16 years only, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, diabetes mellitus, diabetes insipidus, haemophilia, cerebral palsy, epilepsy, multiple sclerosis, muscular dystrophies, parkinsonism, conditions arising from thalidomide and acute leukaemia. Parkinsonism, acute leukaemia, muscular dystrophies and multiple sclerosis were added to the scheme in 1975. The LTI does not cover GP fees or hospital co-payments.

Prior to 1971, there was inadequate provision for assistance to people with large ongoing medical expenses. The purpose of the LTI scheme was to protect patients with a specified condition from excessive drug costs, by providing free drugs and medicines to treat that condition only. Following the establishment of the GMS scheme in 1971, to provide free treatment for those who cannot, without undue hardship, arrange to provide it for themselves and their dependants, various co-payment schemes have been introduced to provide assistance towards the cost of approved drugs and medicines for people with significant ongoing medical expenses, without restriction to the treatment of a particular condition.

Since 1999, non-medical card holders and people with conditions not covered under the LTI have been able to use the drugs payment scheme, DPS. Under this scheme, no individual or family unit pays more than €78 per calendar month towards the cost of approved prescribed medicines. The monthly threshold is due to increase to €85 from 1 January 2005. In light of the protection from excessive drug costs provided by the GMS and DPS schemes, there are no plans to amend the list of eligible conditions under the LTI.

The provision of health services to people with physical and sensory disabilities, including polio survivors, is a matter for the Eastern Regional Health Authority and the health boards. My Department is to provide additional ongoing funding of €300,000 in the current year to the Post Polio Support Group for the provision of aids and appliances, therapy services and other supports to people with post polio syndrome. The group's needs will be reviewed further in light of the resources available to my Department for development purposes in 2005.

In accordance with the commitment in Sustaining Progress, my Department will conduct a strategic review of existing service provision for people with disabilities. Questions of access to aids and appliances and respite care that have been raised by the Post Polio Support Group will be examined as part of that review.

Question No. 135 answered with QuestionNo. 23.

Child Abuse.

Mary Upton

Question:

136 Dr. Upton asked the Tánaiste and Minister for Health and Children if a group was established in 1994 to review the operation of guidelines for reporting child abuse with regard to children in State care; if the group’s attention has been drawn to allegations relating to residential centres under the control of the Department of Education and Science; if she will publish the report of the group; and if she will make a statement on the matter. [31863/04]

I am not aware of any group established in 1994 or any group currently in place to review the operation of guidelines for reporting child abuse with regard to children in State care.

It is assumed that the Deputy may be referring to the group established in 1994 to prepare guidelines on standards in children's residential centres in preparation for the introduction of the regulations on this issue. This group completed it work and the Child Care (Standards in Children's Residential Centres) Regulations 1996 and Guide to Good Practice in Children's Residential Centres were published in 1996. The recommendations of the report on the inquiry into the operation of Madonna House was published as part of the document. The group did not have any role relating to residential centres under the control of the Department of Education and Science.

Standards entitled "National Standards for Children's Residential Centres", developed by my Department and the social services inspectorate in conjunction with the health boards, were published in 2001 based on the relevant legislation and guidance and good practice. It is against these standards, which include standards on safeguarding and child protection, that the social services inspectorate and the registration and inspection units of the health boards inspect and form judgments about the quality of children's residential care services.

Mary Upton

Question:

137 Dr. Upton asked the Tánaiste and Minister for Health and Children if her attention has been drawn to a report which was commissioned in 1996 regarding the treatment afforded to a person (details supplied) when help was sought from the State on this person’s behalf; if she will publish the report; and if she will make a statement on the matter. [31864/04]

Responsibility for the institution concerned lies with the Department of Education and Science. Neither the Department of Education and Science nor the Department of Health and Children commissioned a report in 1996 regarding allegations concerning the institution.

Question No. 138 answered with QuestionNo. 69.

Overseas Development Aid.

Jack Wall

Question:

139 Mr. Wall asked the Tánaiste and Minister for Health and Children her views on correspondence (details supplied); and if she will make a statement regarding the way in which the correspondent’s concerns can be addressed. [31910/04]

Decisions on the level of overseas aid are a matter for the Government as a whole. It would not be appropriate for me to make any comment on the matter at this stage.

Health Board Services.

Jack Wall

Question:

140 Mr. Wall asked the Tánaiste and Minister for Health and Children when a person (details supplied) in County Kildare will receive speech therapy; and if she will make a statement on the matter. [31911/04]

The provision of health related services, including speech and language therapy, for people with physical and-or sensory disabilities is a matter for the Eastern Regional Health Authority and the health boards in the first instance. Accordingly, the Deputy's question has been referred to the regional chief executive of the Eastern Regional Health Authority with a request that he examine the matter and reply directly to the Deputy, as a matter of urgency.

Nursing Homes.

Jack Wall

Question:

141 Mr. Wall asked the Tánaiste and Minister for Health and Children the procedures and guidelines laid down by her Department and the South Western Area Health Board for the establishment and operation of a nursing home; and if she will make a statement on the matter. [31912/04]

The establishment of private nursing homes for dependent older people is governed by the Health (Nursing Homes) Act 1990, which came into operation on 1 September 1993. The following is a list of regulations made under the principal Act governing the operation and administration of private nursing homes: the Nursing Homes (Care and Welfare) Regulations 1993, S.I. No 226 of 1993; the Nursing Homes (Care and Welfare) (Amendment) Regulations 1993, S.I. No 379 of 1993; and the Nursing Homes (Care and Welfare) (Amendment) Regulations 1994, S.I. No. 147 of 1994.

Questions Nos. 142 and 143 answered with Question No. 8.

Hospital Services.

Liam Twomey

Question:

144 Dr. Twomey asked the Tánaiste and Minister for Health and Children the amount of funding which Tallaght Hospital receives for its urology department; the number of procedures carried out on inpatients and day cases; and the number of outpatients seen. [31915/04]

Services at the Adelaide and Meath Hospital, incorporating the National Children's Hospital, Tallaght, are provided under an arrangement with the Eastern Regional Health Authority. My Department has, therefore, asked the regional chief executive of the authority to examine this issue and to reply to the Deputy directly.

Liam Twomey

Question:

145 Dr. Twomey asked the Tánaiste and Minister for Health and Children the amount of funding which St. James’s Hospital receives to fund its plastic surgery and maxilofacial department; the funding which the Mater Hospital receives for the plastic surgery department; and the number of procedures carried out, and inpatients and outpatients seen by these departments. [31916/04]

Services at St. James's Hospital and the Mater Hospital 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 him directly.

Liam Twomey

Question:

146 Dr. Twomey asked the Tánaiste and Minister for Health and Children the amount of funding which the Mater Hospital receives for the cardiac transplant and cardiothoracic bypass unit; the number of procedures carried out; and the number of inpatients and outpatients treated in this unit. [31917/04]

Services at the Mater Hospital are provided under an arrangement with the Eastern Regional Health Authority and my Department has, therefore, asked the regional chief executive of the authority to examine the issue raised and to reply to the Deputy directly.

Liam Twomey

Question:

147 Dr. Twomey asked the Tánaiste and Minister for Health and Children the amount of funding which St. Vincent’s Hospital receives for the liver unit; the number of procedures carried out; and the number of inpatients and outpatients attendants. [31918/04]

Services at St. Vincent's University Hospital, Dublin, are provided under an arrangement with the Eastern Regional Health Authority. My Department has, therefore, asked the regional chief executive of the authority to examine the issue raised and to reply to the Deputy directly.

Liam Twomey

Question:

148 Dr. Twomey asked the Tánaiste and Minister for Health and Children the amount of funding that Beaumont Hospital receives for the neurosurgical unit and the neurology unit; the number of procedures carried out in the neurosurgical unit; and the number of inpatients and outpatients in both specialties. [31919/04]

Services at Beaumont Hospital are provided under an arrangement with the Eastern Regional Health Authority and my Department has, therefore, asked the regional chief executive of the authority to examine the issue raised and to reply to the Deputy directly.

Health Board Property.

Liz McManus

Question:

149 Ms McManus asked the Tánaiste and Minister for Health and Children the way in which it is intended to dispose of lands, in regard to the announcement in July 2004 regarding the sale of hundreds of acres of land from the country’s biggest psychiatric hospitals; if she will list the hospitals in question; if the hospitals in question have been consulted regarding the proposed land sale; if all such moneys will be ring-fenced for investment in the psychiatric services; and if she will make a statement on the matter. [31920/04]

Earlier this year, my Department requested health boards to provide it with detailed schedules of all proposals regarding planned disposal of property including lands attached to psychiatric hospitals. The information received from the health boards in response to this request is being examined at present. Among the matters to be considered in this context is the fulfilment of my Department's obligations in respect of the provision of lands for affordable housing. It would be inappropriate to provide further details in advance of the completion of this process. The sale of assets in the health area will be used for health purposes, with the exception of a contribution towards social and affordable housing.

Patient Compensation System.

Liz McManus

Question:

150 Ms McManus asked the Tánaiste and 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 she expects the group to report; if she 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 she will make a statement on the matter. [31921/04]

The advisory group examining the desirability of introducing a no-fault compensation scheme for infants who suffered cerebral damage at, or close to, the time of birth made substantial progress in its work programme up to the end of 2003. It had completed the bulk of its research, including an examination of no-fault schemes in other jurisdictions. It also had the benefit of presentations by legal and medical experts from Ireland and abroad. Representatives of parents of children with cerebral palsy had also made a presentation to the group. The drafting of some chapters of the group's report had been allocated to a number of sub-groups of the main group. The decision to include claims against consultants in the clinical indemnity scheme from 1 February 2004 has delayed the completion of the group's report. Consultants have withdrawn from ministerial committees and working groups. Therefore it has not been possible to complete the group's report. I hope that when the difficulties surrounding the clinical indemnity scheme are resolved this group will be able to resume its deliberations immediately and complete its task as soon as possible.

While I would like to see the group produce a report quickly I do not believe that this has any adverse impact on the affordability of indemnity cover for consultants. Consultants now have all of their practice in public hospitals, including their private practice, covered by the clinical indemnity scheme. In addition the Government has put special arrangements in place to ensure that indemnity cover for consultants in full-time private practice and for any private practice undertaken by public consultants which is not covered by the clinical indemnity scheme remains affordable. Consultant obstetricians are required to only purchase indemnity for the first €500,000 of any claim against them. There is also a protection against the cost of serial claims against any consultant in any one year. As a result a consultant in full-time private practice is paying €100,000 per annum rather than the full economic cost of €350,000 for indemnity cover. I think this is a clear demonstration of the Government's commitment to dealing with this issue.

Care of the Elderly.

Seán Ryan

Question:

151 Mr. S. Ryan asked the Tánaiste and Minister for Health and Children the way in which she can justify a reduction of approximately 300,000 home help hours in 2003 compared with 2002, the implementation of strategies increasing client contributions, a reduction in hours provided and waiting lists throughout the country; and if she proposes to reassess the needs of older persons in this area. [31922/04]

I refer to a similar question which was asked by the Deputy on 28 October. I wish to advise the Deputy that my Department is currently collating this information and I hope to be in a position to reply to the Deputy within the coming week.

Hospital Services.

Arthur Morgan

Question:

152 Mr. Morgan asked the Tánaiste and Minister for Health and Children when medical files in respect of a person (details supplied) in County Louth will be produced; the reason these files went missing following surgical procedures at the hospital in 1956; and if she will make a statement on the matter. [31947/04]

Arthur Morgan

Question:

153 Mr. Morgan asked the Tánaiste and Minister for Health and Children when medical files in respect of a person (details supplied) in County Louth will be produced; the reason these files went missing following surgical procedures at the hospital in 1973; and if she will make a statement on the matter. [31948/04]

Arthur Morgan

Question:

154 Mr. Morgan asked the Tánaiste and Minister for Health and Children when medical files in respect of a person (details supplied) in County Louth will be produced; the reason these files went missing following surgical procedures at the hospital in 1965; and if she will make a statement on the matter. [31949/04]

Arthur Morgan

Question:

155 Mr. Morgan asked the Tánaiste and Minister for Health and Children when medical files in respect of a person (details supplied) in County Louth will be produced; the reason these files went missing following surgical procedures at the hospital in 1961; and if she will make a statement on the matter. [31950/04]

Arthur Morgan

Question:

156 Mr. Morgan asked the Tánaiste and Minister for Health and Children when medical files in respect of a person (details supplied) in County Louth will be produced; the reason these files went missing following surgical procedures at the hospital; and if she will make a statement on the matter. [31951/04]

I propose to take Questions Nos. 152 to 156, inclusive, together.

Responsibility for the provision of services at Our Lady of Lourdes Hospital, Drogheda rests with the North-Eastern Health Board. My Department has, therefore, asked the chief executive officer of the board to examine the issues raised and to reply to the Deputy directly.

Accident and Emergency Services.

Enda Kenny

Question:

157 Mr. Kenny asked the Tánaiste and Minister for Health and Children the total expected income from accident and emergency charges for the years 2001 to 2005 inclusive; the amount collected; if there is an amount outstanding; and if she will make a statement on the matter. [31952/04]

The information requested by the Deputy is not routinely collected by my Department. For voluntary and statutory hospitals, I wish to advise the Deputy the information requested is monitored and is the direct responsibility of the relevant health board-authority.

The health boards and the Eastern Regional Health Authority, ERHA, are funded directly by my Department. I set out in tabular form the accident and emergency income collected for each of the years 2001 to 2003, the latest full year for which information is available. This information has been obtained from the health boards and the ERHAs annual financial statements. In accordance with my Department's accounting standards for health boards-ERHA, accident and emergency income is accounted for on a cash receipts basis rather than a bills issued basis.

My Department has referred the Deputy's question to the chief executive officers of the health boards-ERHA and has requested that they respond directly to the Deputy in relation to the accident and emergency income collected by the voluntary-statutory hospitals for 2001 to 2003, the amounts outstanding in respect of bills issued but not collected and expected incomes for the years 2004 and 2005 for their board and hospitals under their aegis.

Accident and Emergency Income Collected 2001-2003.

Health Board

2001

2002

2003

€000

€000

€000

ERHA

404

586

943

Southern Health Board

399

579

810

Western Health Board

508

609

736

Mid-Western Health Board

506

517

617

Midlands Health Board

275

365

597

South-Eastern Health Board

680

744

878

North-Eastern Health Board

601

653

787

North-Western Health Board

377

373

416

Total

3,750

4,426

5,784

Drugs Payment Scheme.

Breeda Moynihan-Cronin

Question:

158 Ms B. Moynihan-Cronin asked the Tánaiste and Minister for Health and Children the rate of the drug refund threshold at 1 June 1997 and 1 June 2002. [31958/04]

Prior to 1 July 1999, people with an ongoing condition were able to avail of the drug cost subsidisation scheme which catered for people who were certified as having a medical condition with a regular and ongoing requirement for prescribed drugs and medicines. People who qualified for inclusion in this scheme did not have to pay more than £32 in any month on prescribed medication. Under the drug refund scheme, families and individuals paid the full cost of their prescription medicines and at the end of each quarter could claim reimbursement from their health board for expenditure over £90 in that calendar quarter. The threshold for these schemes did not change between June 1997 and July 1999.

With effect from 1 July 1999, the drug payment scheme replaced the drug cost subsidisation scheme and the drug refund scheme with a monthly threshold of £42, €53.33. Under this scheme, no individual or family paid more than £42 per month for approved prescribed drugs and medicines for use in that month. The threshold for this scheme did not change between July 1999 and June 2002.

Hospital Charges.

Breeda Moynihan-Cronin

Question:

159 Ms B. Moynihan-Cronin asked the Tánaiste and Minister for Health and Children the cost of a visit to an accident and emergency department without a letter of referral from a general practitioner at 1 June 1997 and 1 June 2002. [31959/04]

The statutory charge for outpatient services in respect a visit to an accident and emergency department at 1 June 1997 was £12 —€15.24 — and at 1 June 2002 was €31.70. All those ordinarily resident in the State have eligibility for treatment in a public hospital subject, in the case of those with limited eligibility, to the statutory inpatient charge and the statutory outpatient charge in respect of attendance at accident and emergency or casualty departments. The latter charge applies except in circumstances where the person has been referred by a medical practitioner or the person's attendance results in admission as an inpatient.

There are a number of exemptions to the statutory charges, including medical card holders with full eligibility, women receiving services in respect of motherhood, children up to the age of six weeks and children referred for treatment from child health clinics and school health examinations. Also exempt from these charges, in respect of treatment for the particular condition, are: children suffering from prescribed diseases, namely, mental handicap, mental illness, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, haemophilia and cerebral palsy; holders of a Health (Amendment) Act Card: Out-patient (Amendment) Regulations 2003; persons receiving services for the diagnosis or treatment of infectious diseases prescribed under Part IV of the Health Act 1947; and members of the Defence Forces and their dependants.

Breeda Moynihan-Cronin

Question:

160 Ms B. Moynihan-Cronin asked the Tánaiste and Minister for Health and Children the cost of an overnight stay in a public hospital bed at 1 June 1997 and 1 June 2002. [31960/04]

Breeda Moynihan-Cronin

Question:

161 Ms B. Moynihan-Cronin asked the Tánaiste and Minister for Health and Children the cost of a private bed in a public hospital for a patient at 1 June 1997 and 1 June 2002. [31961/04]

I propose to take Questions Nos. 160 and 161 together.

The specialty costing system used by the Department of Health and Children as part of its national case mix programme collects costs from specific major acute hospitals nationally. Costs are aggregated and vary between hospitals. Costs relate to all inpatients, both public and private, as the cost collection system does not differentiate between the status of patients being treated.

The average inpatient cost per bed day in 1997 and 2002 were €273 and €543 respectively. These costs do not take account of complexity. Certain costs are excluded from the calculation, including day cases, outpatient services, long stay cases, psychiatry and renal dialysis, capital or depreciation.

Hospital Services.

Bernard J. Durkan

Question:

162 Mr. Durkan asked the Tánaiste and Minister for Health and Children if she intends that specialised treatment for respiratory tuberculosis patients be provided in the future; if this will require provision of new facilities or otherwise; and if she will make a statement on the matter. [31962/04]

A report published by Comhairle na nOspidéal in July 2000 found that, having regard to major advances in medical treatment, inpatient care of patients with respiratory diseases, including tuberculosis, is best provided in acute general hospitals staffed by consultant respiratory physicians and other consultants and supported by an array of investigative facilities.

The Eastern Regional Health Authority has established a working group on tuberculosis services in the eastern region and respiratory services in the South Western Area Health Board. The group is to examine the options for the future management of tuberculosis, both acute and non-acute, in the eastern region. It will also address and identify other respiratory services that might be appropriately delivered in Pea-mount Hospital, taking account of best practice. The group consists of a respiratory physician, a specialist nurse and director of nursing from Pea-mount, a management representative from Pea-mount, general practitioners, a public health specialist and an accident and emergency representative. It is envisaged that the group will report by the end of the year.

Hospital Staff.

Bernard J. Durkan

Question:

163 Mr. Durkan asked the Tánaiste and Minister for Health and Children the number of doctors and consultant surgeons currently working in the health services; the extent to which these figures need to be augmented to bring the strength up to international standards; and if she will make a statement on the matter. [31963/04]

The number of permanent consultant posts approved by Comhairle na nOspidéal as at November 2004 is 1,912. Of this figure, 360 are consultant surgeons and 1,609 posts are filled in a permanent capacity. There are 270 approved vacant permanent consultant posts. These are in the process of being filled permanently and approximately 200 of these are filled in a temporary capacity pending permanent appointees taking up duty.

The Department of Health and Children has made substantial investment in consultant numbers in recent years. In the past five years the number of consultant posts has increased by 31% to 1,824 posts at 1 January 2004. This continues increases over the past decade — between 1993 and 1 January 2004 consultant posts increased by 56%. These increases include significant investment in consultant staffing in regional hospitals. Since 1993, the number of consultant posts has increased by 82% in the North Eastern Health Board, 71% in the South Eastern Health Board and 68% in the Mid-Western Health Board.

Government policy is to substantially increase the number of consultants throughout the next decade. There are currently 4,038 NCHD training posts, the occupants of which are given the opportunity of proper skills development on the basis that many in this category will become the consultants of tomorrow. A comparison of consultant staffing ratios with those in England and France is set out below.

Ireland

England

France

Consultants/Specialists

1,824 (January 2004)

24,085 (September 2003)

39,651 (January 2003)

Population

4,043,800 (CSO 2004)

49,138,831 (2001 Census)

61,100,000 (2002)

Consultants/Specialists

No. of post per 1,000 pop

No. of post per 1,000 pop

No. of post per 1,000 pop

Total

1,824 0.45

24,085 0.49

39,651 0.65

According to the Irish College of General Practitioners there are approximately 2,600 GPs working in Ireland. According to the GMS payments board annual report of 2003, 2,181 of these hold a GMS or other public contract. My Department has been in consultation with the Irish College of General Practitioners and the health boards on the subject of addressing future manpower needs in general practice. In this regard, it was agreed that the number of trainees should increase by a total of 66 in order to conform with the recommendations of the Irish College of General Practitioners. This will be achieved on a phased basis over a three year period. This Department does not hold comparable international figures for GPs.

Bernard J. Durkan

Question:

164 Mr. Durkan asked the Tánaiste and Minister for Health and Children the number of nurses required to provide an adequate health service in view of internationally established norms; the number of extra recruitments required; and if she will make a statement on the matter. [31964/04]

There is a wide variation in the numbers of nurses employed in the health services of developed countries. Figures on a consistent basis are not readily available for cross-country comparisions. Research by the OECD published in OECD Health Data 2004, first edition, suggests that Ireland has one of the higher ratios, although I stress that countries profile their data in different ways.

The Irish health care system has traditionally been based on a large number of nurses. Other European countries tend to have systems with a greater skill mix and grade mix involved in the delivery of health care services. For this reason, their ratios of nurses to patients are lower. The Irish health service is also moving in this direction and in the coming years a higher proportion of support workers, including health care assistants, will be involved in the delivery of nursing care, freeing up nurses and midwives to concentrate more of their time on higher level duties and the development of new or expanded services.

Nurse recruitment is a priority for the Government. The HSEA recently reported that in the year ending 30 September 2004 an additional 561 nurses were employed in the health service. Since 1997 more than 6,600 additional nurses have been recruited.

Health Reform Programme.

Bernard J. Durkan

Question:

165 Mr. Durkan asked the Tánaiste and Minister for Health and Children if it is intended to implement the Hanly report in full; and if she will make a statement on the matter. [31965/04]

Bernard J. Durkan

Question:

167 Mr. Durkan asked the Tánaiste and Minister for Health and Children the status of the Hanly report; and if she will make a statement on the matter. [31967/04]

I propose to take Questions Nos. 165 and 167 together.

The Government is committed to developing acute hospital services in a way that will command the confidence of people throughout the country. The report of the national task force on medical staffing provides valuable advice in this regard. While implementation of some of the proposals in the report of the task force has been hampered by continuing industrial action by hospital consultants, work on the other elements of the proposals is progressing. Detailed assessments have been prepared of the service and resource implications of the forthcoming reduction in non-consultant hospital doctors' working hours in each health agency. Negotiations with the Irish Medical Organisation on the reduction in NCHD hours required under the European working time directive are continuing in the Labour Relations Commission. Local implementation groups have been established in eight hospitals as part of an agreed pilot process.

The medical education and training subgroup of the national task force has remained in place. I have asked the group to examine and report to me on the measures required to accommodate NCHD training in all postgraduate programmes and safeguard both training and service delivery during the transition to a 48-hour working week, which is required under the European working time directive by August 2009. The group has agreed a joint approach to training with the medical training bodies and the Medical Council, and has provided formal advice on the provision of medical education and training in a 58-hour working week.

Hospital Accommodation.

Bernard J. Durkan

Question:

166 Mr. Durkan asked the Tánaiste and Minister for Health and Children the number of extra medical, surgical and nursing beds she has identified as being available in the greater Dublin area; the location of the said beds; and if she will make a statement on the matter. [31966/04]

Bernard J. Durkan

Question:

168 Mr. Durkan asked the Tánaiste and Minister for Health and Children if she has given direction to the relevant authorities with a view to making more hospital beds available throughout the country; if she will identify the location and type of bed whether surgical, medical or nursing; and if she will make a statement on the matter. [31968/04]

I propose to take Questions Nos. 166 and 168 together.

The Government is committed to increasing acute hospital bed capacity as indicated in the health strategy. Since the publication of the strategy in December 2001, funding has been provided to hospitals to open an additional 900 beds. This includes the 700 beds announced in 2002 and 200 beds being provided as part of the commissioning of new units announced in September this year. The table below shows details of the position at October 2004 as regards additional acute hospital beds for which funding has been provided.

Hospital

Additional beds in place

Beds due to open

Beaumont/St. Joseph’s, Raheny

77

28

St. James’s

74

66

St. Vincent’s, incorporating St. Michael’s, Dún Laoghaire

42

Naas General

61

30

James Connolly Memorial

21

Tallaght

7

Temple Street

15

Midland Regional Hospital, Tullamore

6

Midland Regional Hospital, Mullingar

12

Midland Regional Hospital, Portlaoise

5

Mid-West Regional Hospital, Limerick

55

Croom Orthopaedic

17

Nenagh General

6

Louth General

14

Monaghan General

10

Our Lady’s Navan

14

Letterkenny General

8

Sligo General

30

Kilcreene Orthopaedic

28

St. Luke’s Kilkenny

14

Waterford Regional

24

Wexford General

10

Bantry General

8

Mercy University Hospital

13

South Infirmary / Victoria, Cork

35

Kerry General, Tralee

16

Mayo General

23

37

Roscommon General Hospital

9

UCHG

36

44

Portiucula

3

2

Total

600

300

Overall Total

900

In addition, extra beds will be provided in the new acute medical units which I announced as part of the accident and emergency services package on the publication of the Estimates for 2005.

Question No. 167 answered with QuestionNo. 165.
Question No. 168 answered with QuestionNo. 166

Health Board Services.

Bernard J. Durkan

Question:

169 Mr. Durkan asked the Tánaiste and Minister for Health and Children the number of persons awaiting orthodontic treatment; the length of time they have been on waiting lists; and if she will make a statement on the matter. [31969/04]

The provision of orthodontic services is the statutory responsibility of the health boards-authority in the first instance. The chief executive officers of the health boards and the ERHA have informed my Department that at the end of the September 2004 quarter there were 11,041 patients awaiting orthodontic treatment with an average waiting period ranging from 12 to 48 months.

Bernard J. Durkan

Question:

170 Mr. Durkan asked the Tánaiste and Minister for Health and Children the number of children who have been given orthodontic treatment in the past 12 months; the number still awaiting treatment; and if she will make a statement on the matter. [31970/04]

The provision of orthodontic services is a matter for the health boards in the first instance. Children in treatment in the health board orthodontic service receive between 18 to 24 appointments over the course of their treatment period of approximately two years. The chief executive officers of the health boards and the ERHA have informed my Department that at the end of the September 2004 quarter, there were 22,168 patients in receipt of orthodontic treatment and 11,041 patients awaiting orthodontic treatment. This means that there are over twice as many patients getting orthodontic treatment as there are waiting to be treated and more than 6,000 extra patients are getting treatment from the health boards and the ERHA since the end of the September 2001 quarter.

Question Nos. 171 to 173, inclusive, answered with Question No. 23.

Hospital Services.

Bernard J. Durkan

Question:

174 Mr. Durkan asked the Tánaiste and Minister for Health and Children when all the facilities at Naas Hospital will be fully commissioned and brought into daily basis; and if she will make a statement on the matter. [31974/04]

Responsibility for the provision of services at Naas General Hospital rests with the Eastern Regional Health Authority. My Department has, therefore, asked the regional chief executive of the authority to examine this issue and to reply to the Deputy directly. My Department recently approved additional revenue funding of €7.5 million to the authority for commissioning additional services at the hospital.

Hospital Waiting Lists.

Bernard J. Durkan

Question:

175 Mr. Durkan asked the Tánaiste and Minister for Health and Children the number of persons on waiting lists in respect of heart, lung, hip replacement or other surgeries; and if she will make a statement on the matter. [31975/04]

Responsibility for the collection and reporting of waiting lists and waiting times now falls within the remit of the national treatment purchase fund. My Department has asked the chief executive of the NTPF to reply to the Deputy directly with the information requested.

Child Care Services.

Róisín Shortall

Question:

176 Ms Shortall asked the Tánaiste and Minister for Health and Children if the Best Health for Children report of 1999 still forms part of the Government’s policy on child health services; if so, the reason some health boards provide a developmental check at seven to nine months by a doctor in line with this report while others, notably the Nrthern Area Health Board, do not in all cases; if it breaches the national health strategy; if she was consulted or agreed with this policy shift; her plans to allocate extra funding to deal with the shortage of area medical officers in the northern area health board; if she will provide details of the information available to her on the extent of the staffing shortages in respect of area medical officers in each of the health boards to this Deputy; and if she will make a statement on the matter. [32014/04]

The best health for children programme provides for a new core surveillance programme for all children up to the age of 12; it covers both pre-school developmental examinations as well as the school health service. Underpinning the recommendations in the report is a model that embraces a more holistic child health promotion approach and that emphasises the role of parents in achieving best health for their children. The Eastern Regional Health Authority and the health boards are responsible for the provision of health services, including child health developmental screening, within their functional areas. A child health examination service is provided by the boards and the authority to children and policy priorities within the boards and the authority account for variances between them in the provision of child health developmentalscreening. However, the commitment of my Department to the development of child health policy underlining the best health for children programme is manifested in the additional funding provided; over €2 million has been allocated to the health boards and the ERHA in order to facilitate the implementation of the recommendations set out in the report. The implementation of this programme is ongoing; the funding provided has been used to appoint key individuals at regional level to drive the implementation process at board level as well as to establish pilot projects aimed at demonstrating best practice.

The Health Boards Executive has established a programme of action for children and an interim steering group has been appointed to oversee its work and this will facilitate a co-ordinated and integrated approach to the delivery of a range of child health and child care projects. This initiative will encompass a number of child related measures, including projects associated with best health for children. The work of the programme of action for children includes: facilitating the implementation of the best health for children programme for screening and surveillance as endorsed by the national health strategy; and developing evidence based standards regarding child health screening and surveillance, in consultation with professional bodies. The programme of action for children is currently undertaking a national review of recommendations for core child health surveillance in Ireland, including child health developmental screening and working groups have been established to develop a revised national core child health surveillance and screening programme. The tasks are: to review evidence base; to develop guidelines and standards for each surveillance and screening opportunity; to agree appropriate tools and equipment; and to identify resource constraints. This systematic national review will help to assess the resources required to implement any recommendations on a revised national core child health surveillance and screening programme, including child health developmental screening. This includes implementing training programmes for doctors and nurses involved in child health surveillance and screening. One of the key recommendations in the report is the need to provide appropriate training for public health doctors and public health nurses involved in delivering the child health surveillance programme, including the school health service. Additional funding of €700,000 has been provided to health boards and the ERHA in 2003 for this purpose. The funding has been used to appoint relevant training personnel and to develop, in conjunction with TCD, a training programme for those involved in the delivery of the core surveillance programme. The training programme was launched earlier this year and it is intended that all those involved in child health surveillance will have received the necessary training by the end of 2005.

The review must also agree Irish standards of growth measurement and commission development work to support the setting of standards. The programme for action on children recently held a consensus conference on growth measurement in Ireland. The conference was attended by key experts in this area from Ireland and the United Kingdom. This conference was largely funded by my Department given our commitment to the work of the programme for action for children. The benefits of the consensus conference will be a standardised approach to growth monitoring and clear guidance to practitioners on use of growth monitoring tools and application of appropriate criteria and pathways. Ultimately, it will lead to an appropriate use of resources and an improved outcome for children.

My Department has written to the chief executive officers of the health boards and the ERHA requesting that they provide information directly to the Deputy on the staffing of area medical officers.

Tax Code.

Pat Carey

Question:

177 Mr. Carey asked the Minister for Finance if he will examine the provision in the Taxes Consolidation Act 1997 in relation to the payment of professional fees and the way in which it applies to academics who are professionally qualified as indicated in correspondence (details supplied); and if he will make a statement on the matter. [31934/04]

I am informed by the Revenue Commissioners that the Taxes Consolidation Act 1997 does not give a specific tax deduction in respect of the payment by an individual of her or his annual membership fee to a professional body. However, under the provisions of section 114 Taxes Consolidation Act 1997, an employee or office holder may claim a tax deduction in respect of expenses incurred wholly, exclusively and necessarily by her or him in the performance of the duties of her or his employment or office.

The Revenue Commissioners have informed me the payment by an individual of a fee to maintain her or his professional qualifications need not mean the expense has been incurred wholly, exclusively and necessarily in the performance of the duties of the employment or office and, therefore, deductible under section 114. Each case is examined on its merits and the facts and circumstances of such cases will determine whether or not the expense may be claimed as a deduction under section 114.

A deduction under section 114 will be due where annual membership fees of a professional body are paid by the employee and he or she must be a member of such body in order to perform the duties of his or her office or employment. For example, an accountant who must be a member of a professional body to be authorised to certify accounts would be entitled to a tax deduction in respect of the relevant membership fee.

Under the provisions of section 118-5E Taxes Consolidation Act 1997, the payment, or reimbursement, by an employer of an employee's or director's annual membership fee to a professional body does not give rise to a tax liability in the hands of the employee or director where such membership is relevant to the business of the employer. The law distinguishes these situations because the employer is bearing the cost. Membership of a professional body may be regarded as relevant to the business of the employer where it is necessary for the performance of the duties of the relevant director or employee or it facilitates the acquisition of knowledge which is necessary for or directly related to the performance of the duties of the office or employment of the director or employee.

While I have noted the points made in the correspondence referred to by the Deputy any broadening of the definition of deductible expenses would have wider implications for the treatment of employment expenses generally in the income tax system.

Overseas Development Aid.

Finian McGrath

Question:

178 Mr. F. McGrath asked the Minister for Foreign Affairs if he will reconsider the 0.7% target of GNP for overseas development aid and support the worlds poor on behalf of the people of Ireland. [31866/04]

The Book of Estimates provides for an increase of €60 million in Government spending on official development assistance in 2005. This will bring total Government aid to the developing world next year to €535 million which is an all-time record.

In addition, the Government has agreed to make increases of €65 million in each of the years 2006 and 2007. These very substantial increases mean that €1.8 billion will be spent by Ireland on development assistance over the coming three years.

This is a remarkable package of increases by any standards. It places Ireland among the world's leading aid donors.

Careful consideration was given by the Government to the area of overseas development aid before deciding on these allocations. The increases come at a time when there are many competing demands on the Exchequer and are an indication of the commitment of the Government to help the poorest people in the world. Overseas development aid has increased steadily over the past seven years and these latest increases ensure continued strong growth towards the UN target.

Company Relocation.

Billy Timmins

Question:

179 Mr. Timmins asked the Minister for Enterprise, Trade and Employment the discussions he has had with a company (details supplied) with respect to that company’s proposed move to Cherrywood, County Dublin from Bray, County Wicklow; if grant aid has been made available; and if he will make a statement on the matter. [31933/04]

I did not have any discussions with Dell regarding its intentions to relocate from Bray to Cherrywood. The decision, regarding the location of its operations, is entirely a matter for the company. Grant aid has not been made available towards the relocation costs.

The Government has approved grant aid towards the creation of additional jobs at Dell, which will see 420 additional jobs created by 2007. Dell's further investment in Ireland will result in the creation of a European, Middle East and Africa business centre and the state-of-the-art facility at Cherrywood will be the largest customer care and technology support centre in Ireland and can accommodate around 1,950 staff.

This is a significant further commitment by Dell to Ireland and involves a substantial deepening of the role that the Irish operation will fulfil in Dell's highly successful European business. It is a major testament to the quality of Ireland's workforce. As such, it further highlights Ireland's ability to support knowledge intensive, high skill business.

Employees’ Rights.

Martin Ferris

Question:

180 Mr. Ferris asked the Minister for Enterprise, Trade and Employment the steps that are taken to ensure that persons employed as domestic home helps, child minders and au pairs are protected by the relevant employment legislation including that pertaining to the minimum wage. [31944/04]

In the area of pay and conditions, it is primarily the provisions of the National Minimum Wage Act 2000 and the Organisation of Working Time Act 1997 that apply to employees who are employed as domestics or in caring roles.

The labour inspectorate of my Department is responsible for monitoring certain employment conditions for all categories of workers in Ireland. Inspectors pursue allegations of worker mistreatment and when evidence of non-compliance with the relevant employment rights legislation is found, the inspectorate seeks redress for the individuals concerned and, if appropriate, a prosecution is initiated. Employers are required to maintain records in respect of such employees and these records, together with other substantiating evidence, for example, a statement from an employee, provide the essentials of a basis for legal proceedings. Failure on behalf of the employer to maintain adequate records is an offence.

It should be noted also, that in many cases, employment rights legislation has provisions whereby workers who believe they have been denied their entitlements, or otherwise unfairly treated, can, as an alternative to dealing with the labour inspectorate, take the matter before a commissioner in the rights commissioner service of the Labour Relations Commission.

With regard to au pairs, the position is that such individuals are students, not employees, and accordingly do not come within the scope of my Department's employment rights legislation.

In this regard, I urge anyone who has evidence of the mistreatment of workers to furnish all the relevant details and any related materials to the inspectorate with a view to pursuing the matter.

Martin Ferris

Question:

181 Mr. Ferris asked the Minister for Enterprise, Trade and Employment his views on allegations made in a newspaper (details supplied) that migrant workers in domestic service are subject to exploitation by Irish employers in flagrant breach of employment legislation. [32009/04]

The labour inspectorate of my Department is responsible for monitoring certain employment conditions for all categories of workers in Ireland, including immigrant workers. The inspectorate operates without any differentiation with regard to worker nationality as statutory employment rights and protections apply to immigrant workers in exactly the same manner as they do to native Irish workers.

In the area of pay and conditions, it is primarily the provisions of the National Minimum Wage Act 2000 and the Organisation of Working Time Act 1997 that apply to employees who are employed in domestic service.

Inspectors pursue allegations of worker mistreatment and when evidence of non-compliance with the relevant employment rights legislation is found, the inspectorate seeks redress for the individuals concerned and, if appropriate, a prosecution is initiated. Employers are required to maintain records in respect of such employees and these records, together with other substantiating evidence, for example, a statement from an employee, provide the essentials of a basis for legal proceedings. Failure on behalf of the employer to maintain adequate records is an offence.

It should be noted also, that in many cases, employment rights legislation has provisions whereby workers who believe that they have been denied their entitlements, or otherwise unfairly treated, can, as an alternative to dealing with the labour inspectorate, take the matter before a commissioner in the rights commissioner service of the Labour Relations Commission.

In this regard, I urge anyone who has evidence of the mistreatment of workers to furnish all the relevant details and any related materials to the inspectorate with a view to pursuing the matter.

Where employers seek work permits in order to employ non-EEA nationals, the Department requires the statement of the main functions of the job, salary or wages, deductions, other than statutory, other benefits and hours to be worked per week. Both the proposed employer and the proposed employee must sign this statement. Work permits are not granted unless there is compliance with minimum wages legislation. Applications for renewals require confirmation that the stated wages have been paid; P60 and other sources are used. Work permits are not granted for sectors such as domestic employment where it is believed that such employment can be met from the Irish-EEA labour market and where there is a greater risk of exploitation.

Health and Safety Regulations.

Jan O'Sullivan

Question:

182 Ms O’Sullivan asked the Minister for Enterprise, Trade and Employment the position regarding inspections by the Health and Safety Authority in schools; if the HSA has the power to close a school on foot of such an inspection; the procedure from the time of a complaint and the initiation of an inspection to its completion; if a report on the inspection in a school is forwarded to his Department or to the Department of Education and Science, or both, if such a report is completed; the action which is or can be taken on foot of such an inspection or investigation; and if he will make a statement on the matter. [32010/04]

The Health and Safety Authority, HSA, has full power under the Safety, Health and Welfare at Work Act 1989 to investigate schools, the same as applies to all other workplaces. The full range of enforcement powers, including the service of improvement and prohibition notices, and if necessary in a very serious situation if that should arise the HSA may initiate an ex parte application to the High Court under the Act for closure.

The procedures for and initiation of inspections is a day-to-day matter for the HSA as an independent authority.

The HSA is not required to send reports of school inspections to my Department and it does not do so. I understand the HSA deals with school boards of management in regard to management issues concerning health, safety and welfare at the workplace. This does not include the sending of reports to the Department of Education and Science by the HSA.

The issue of taking remedial action, if required, on foot of a HSA inspectors' report, or under notices as referred to above, is I understand considered a matter for the management of each particular school in the first instance and then in consultation with whichever other organisation or body which may be appropriate.

Health Board Allowances.

Bernard J. Durkan

Question:

183 Mr. Durkan asked the Minister for Social and Family Affairs the way in which it is proposed to recover dietary allowance without causing hardship in the case of a person (details supplied) in County Kildare; and if he will make a statement on the matter. [31977/04]

Subject to certain conditions, including a means test, diet supplements are provided for under the supplementary welfare allowance scheme which is administered on my behalf by the health boards.

The South Western Area Health Board has advised that an overpayment of diet supplement occurred in this case owing to the failure of the person concerned to notify the board that he had commenced employment. The board has written to the person concerned to inform him of the amount of the overpayment and to seek his proposals for repayment of the sum due.

While the board is obliged to make all reasonable efforts to recoup the overpayment as quickly as possible it will have regard to the circumstances of the person concerned to ensure that no hardship occurs.

The board has also advised that it paid €1,270 as an exceptional needs payment to the person concerned in March 2004, to assist with outstanding funeral bills.

Pension Provisions.

Bernard J. Durkan

Question:

184 Mr. Durkan asked the Minister for Social and Family Affairs if he will increase pension entitlements to those depending on pre-1953 contributions; and if he will make a statement on the matter. [31979/04]

The pre-1953 pension, introduced in May 2000, was designed to benefit a particular group of people, with very limited social insurance records, who would not otherwise qualify for a contributory pension. The people in question have been given exemption from one of the qualifying conditions, that is the average contributions test. In considering proposals to change qualifying conditions and entitlements it is necessary to ensure that the contributory principle underlying entitlement to contributory schemes, which requires a certain level and type of social insurance, is maintained. In this regard, I am satisfied that the pre-1953 pension, as it is currently structured, affords appropriate recognition for the level of contributions which those in question have made to the social insurance system. Pre-1953 pensions are increased each year in line with budget increases paid to those on other reduced pensions.

Public Transport.

John Perry

Question:

185 Mr. Perry asked the Minister for Transport if increased funding will be allocated to Bus Éireann to allow it to expand the city centre bus service in Sligo town and to serve Carraroe, Ballisodare and Collooney (details supplied); and if he will make a statement on the matter. [31874/04]

The matters raised by the Deputy are the day to day responsibility of Bus Éireann and I have passed these on to the company for consideration.

Rural Transport Services.

Michael Lowry

Question:

186 Mr. Lowry asked the Minister for Transport if his attention has been drawn to correspondence (details supplied); if satisfactory funds will be provided for an adequate transport scheme; the funds which have been allocated to the rural transport initiatives in north Tipperary in 2003 and 2004; the funds which have been sanctioned for each RTI in north Tipperary for 2005; if he will reconsider the Estimates 2005 to find a way to significantly increase funding to such a valuable service for rural Ireland; and if he will make a statement on the matter. [31931/04]

Area Development Management Limited, ADM, administers the rural transport initiative, RTI, on behalf of my Department and makes specific allocations to individual RTI projects from funding provided under my Vote. ADM has sole responsibility in deciding on the individual RTI allocations to each of the 34 groups funded under the scheme and neither I nor my Department has any function in the matter.

By the end of this year my Department will have provided €9 million for the RTI in the three years 2002-04. A full appraisal of the initiative was completed in July this year and in line with its principal recommendation, I recently extended the scheme for a further two years to end-2006.

There is a provisional allocation of €3 million for the RTI in the 2005 Abridged Estimates Volume. Before the Estimates are finalised, I hope to be in a position to increase that provision to take account of increases in operating costs of the projects involved. This will result in an overall funding commitment of at least €12 million for the RTI to end 2005 which compares very favourably with the total of €4.4 million earmarked for the RTI in the National Development Plan 2000-2006.

It should be borne in mind that the RTI projects also benefit each year from funding provided by the Department of Social and Family Affairs arising from the application of the free travel scheme to the scheme. In addition, I know that some RTI projects are generating additional funds from the provision of transport services to health boards and from other sources.

From the outset, RTI projects have been encouraged to explore innovative ways in which their services can be partly financed from the local economy in which they operate. The degree to which prospective RTI groups put forward proposals for co-financing and the securing of additional resources from non-Exchequer sources were among the operational criteria used to assess the original applications.

In deciding on the extension of the RTI to end-2006, I was conscious that many of the pilot projects only became fully operational in 2003. I was also conscious that continuing the RTI to end 2006 will ensure that the lifespan of the initiative will dovetail with the scope of the National Development Plan 2000-2006 in which the initiative was first mooted.

The extension will facilitate a more comprehensive appraisal of the effectiveness of the RTI in addressing the transport needs of rural areas. It will enable the 34 projects to further explore best practice models of transport provision and to strategically develop approaches to planning and co-ordinating transport services in areas where it was traditionally considered difficult to do so.

Open Skies Policy.

Michael Lowry

Question:

187 Mr. Lowry asked the Minister for Transport if he will report on his recent meeting with the Mid-Western Regional Authority regarding open skies; if he has given a commitment to the authority to allow it to undertake a regional economic impact study of the open skies; if he has not approved this vital research, when he will give approval; and if he will make a statement on the matter. [31932/04]

I met a delegation from the Mid-Western Regional Authority on 25 November 2004. Each member of the delegation made a presentation to me, and those presentations covered a wide range of issues, including their regional planning guidelines, rail links, as well as issues relating to Aer Lingus and Shannon Airport. This was followed by a full discussion between us on the range of issues.

The question of a study into any of these issues was not raised by the delegation.

Local Authority Funding.

Michael Ring

Question:

188 Mr. Ring asked the Minister for Community, Rural and Gaeltacht Affairs if he will make a statement on his announcement in February 2004 that a scheme (details supplied) in County Mayo would go ahead immediately and that he was to inform the local authority immediately; and if he has informed Mayo County Council. [31981/04]

Michael Ring

Question:

189 Mr. Ring asked the Minister for Community, Rural and Gaeltacht Affairs when land on Achill in County Mayo will be secured for a project (details supplied). [31982/04]

Michael Ring

Question:

190 Mr. Ring asked the Minister for Community, Rural and Gaeltacht Affairs if he is committed to building a project (details supplied) in County Mayo. [31983/04]

Michael Ring

Question:

191 Mr. Ring asked the Minister for Community, Rural and Gaeltacht Affairs if there is islander representation on the steering committee of the proposed review of a project (details supplied) in County Mayo; and if not, the reason therefor. [31984/04]

Michael Ring

Question:

192 Mr. Ring asked the Minister for Community, Rural and Gaeltacht Affairs if the proposed review by consultants of the 1999 study by consultants for a project (details supplied) in County Mayo will take into account the social costs and benefits of the scheme or solely economic costs and benefits. [31985/04]

Michael Ring

Question:

193 Mr. Ring asked the Minister for Community, Rural and Gaeltacht Affairs the original estimated costs on completion of a project (details supplied) in County Mayo. [31986/04]

Michael Ring

Question:

194 Mr. Ring asked the Minister for Community, Rural and Gaeltacht Affairs the amount which has been or will be paid in legal fees by the State on foot of a project (details supplied) in County Mayo, whether or not it goes ahead. [31987/04]

Michael Ring

Question:

195 Mr. Ring asked the Minister for Community, Rural and Gaeltacht Affairs the amount which has been paid by the State to consultants regarding a project (details supplied) in County Mayo; and the amount which is projected to be spent by the State on further consultancy. [31988/04]

Michael Ring

Question:

196 Mr. Ring asked the Minister for Community, Rural and Gaeltacht Affairs if lands have been purchased or contracted to be purchased by Mayo County Council to date in relation to a project (details supplied) in County Mayo; and the projected costs of such purchases and ancillary works involved. [31989/04]

Michael Ring

Question:

197 Mr. Ring asked the Minister for Community, Rural and Gaeltacht Affairs the amount which has been spent and allocated to date by the State, including Mayo County Council, on a project (details supplied) in County Mayo since the early 1980s. [31990/04]

Michael Ring

Question:

199 Mr. Ring asked the Minister for Community, Rural and Gaeltacht Affairs the amount which has been earmarked for a project (details supplied) in County Mayo; when he expects this to come to a final conclusion. [32008/04]

I propose to take Questions Nos. 188 to 197, inclusive, and 199 together.

In July 2000, I approved a grant of €1.84 million to Mayo County Council in respect of the project referred to by the Deputy. This grant was based on a total estimated construction cost of €2.03 million with Mayo County Council to provide the balance of €0.19 million. It was estimated at the time that the project would require an annual subsidy from my Department of €72,375.

The construction phase was scheduled to commence in 2002 and it was envisaged that the service would be fully operational by spring 2003. However, a delay was incurred as a result of an objection lodged with An Bord Pleanála against one of the compulsory purchase orders in respect of the land required for the project. While An Bord Pleanála subsequently confirmed the said compulsory purchase orders, this decision became, in early 2003, the subject of an application for a High Court judicial review.

As a result of a settlement between Mayo County Council and the applicants, the application for a judicial review was withdrawn. Mayo County Council subsequently, in late October 2003, sought my Department's approval to proceed with the acquisition of certain lands and the appointment of consultants to prepare contract documents for the project.

Mayo County Council has a compulsory purchase order which is operative at the moment on the aforementioned land. It has until 15 April 2005 to serve a notice to treat in respect of this order, thus creating a contractual obligation on behalf of the council to purchase the land.

A contract has been entered into by Mayo County Council for the purchase of other lands, and carrying out of other ancillary works, for the project at a cost of €43,500. Amounts of €69,105.37 and €5,738.50 have been spent on consultancy and legal fees respectively associated with the project. An amount of €2,648.64 has also been paid for stenography services associated with An Bord Pleanála's oral hearing. In addition, a sum of €115,549 has been paid for the installation of three-phase electricity on the island, while in 1999 a refund of €4,334 was made to a local community group in respect of costs incurred by it in progressing the project.

I indicated earlier this year that this project would be progressed as expeditiously as possible. In view of the time that has elapsed since it was originally approved for funding, I have decided that it would be appropriate, in line with current guidelines and best practice for securing value for money for the Exchequer in respect of capital expenditure, to carry out a review of the 1999 report of the consultant engineers on the project. This review will include an analysis of social as well as economic costs and benefits.

Tenders have now been sought from qualified consultants to carry out this review, with a closing date of 10 December 2004 for receipt of tenders. A copy of the terms of reference is being forwarded to the Deputy. The steering committee to oversee this review will consist of representatives of Mayo County Council and my Department. While the island community will not be represented on the committee, it will be kept fully appraised of developments.

It is not feasible at this stage, in view of the project's current status, to forecast accurately the level of future funding that will be required. However, on completion of the review, Mayo County Council's application to proceed with the project will be considered in the context of the review's findings, the funding available to my Department for island development and the various other demands on that funding. In the meantime a scheduled ferry service has been provided from the island to Doran's Point near Ballycroy with connecting bus services.

Community Development.

Finian McGrath

Question:

198 Mr. F. McGrath asked the Minister for Community, Rural and Gaeltacht Affairs if he will urgently review the application from a centre (details supplied) in Dublin 5 and to give same the maximum support and assistance. [31991/04]

My Department has received an application from the organisation in question for a review of the decision on a proposal for grant funding received under the 2004 programme of grants for locally-based community and voluntary organisations. This application for review is under consideration.

Question No. 199 answered with QuestionNo. 188.

Genetically Modified Organisms.

Michael Lowry

Question:

200 Mr. Lowry asked the Minister for Agriculture and Food if her attention has been drawn to the fact that abroad there is a clean green image for Irish products; her views on genetically modified food; her plans to preserve Ireland’s clean green image of food production; and if she will make a statement on the matter. [31929/04]

The green image associated with Ireland, successfully promoted by Bord Bia, plays a vital role in the development and promotion of our food industry. In promoting Ireland as the "Food Island", we stake our reputation on producing high quality food, to the highest standards of food safety and traceability. This is the basis for the resounding success that has enabled our food industry to thrive and grow and for real sustainable markets for our agricultural produce.

An EU legislative framework on genetically modified production has been put in place by the European Parliament and Council of Ministers, binding on all member states. This legislation provides for a series of controls along the supply chain to ensure that only food which meets the highest possible levels of safety is produced and marketed. In regard to the growing of genetically modified crops, member states are obliged to draw up strategies and best practices on the basis of Union guidelines to provide for effective co-existence arrangements with non-genetically modified crops. An interdepartmental working group has been set up by the Department of Agriculture and Food to examine this matter.

Grant Payments.

Breeda Moynihan-Cronin

Question:

201 Ms B. Moynihan-Cronin asked the Minister for Agriculture and Food when it is proposed to allocate a headage grant to a person (details supplied) in County Kerry. [31930/04]

The person named has been contacted on a number of occasions by my Department. Originally, maps were not submitted to support his 2004 area aid application. Following submission of these maps, area difficulties were discovered and further maps have been issued to the person named to resolve these outstanding mapping problems. On receipt of his reply, the area aid unit will process his area aid application without delay.

He has also been asked to resolve some problems with the eligibility of animals for suckler cow premium. Any payments found to be due under the area based compensatory allowance, suckler cow and ewe supplementary premium schemes will be made as soon as possible after these application problems have been resolved.

Michael Ring

Question:

202 Mr. Ring asked the Minister for Agriculture and Food when persons (details supplied) in County Mayo will receive REPs payments for 2003 and 2004; and the reason for the failure to issue these payments to date. [31935/04]

The 2003 payment issued to the persons named on 30 November 2004. It was delayed by issues that emerged from an on-farm inspection and these have only recently been resolved. The participants were invited in mid-November to apply for the fourth year payment but no application has yet been received in my Department.

Environmental Protection.

Trevor Sargent

Question:

203 Mr. Sargent asked the Minister for Agriculture and Food if her attention has been drawn to the European Environmental Agency’s spatial analysis group revision of the assessment of forest creation and afforestation in Ireland (details supplied); if so, the reason for the discrepancy between this and the recent reply to a parliamentary question in which it was stated that peat and mineral soils have comprised 30% and 70%, respectively, of the area afforested since 1990. [31938/04]

Trevor Sargent

Question:

204 Mr. Sargent asked the Minister for Agriculture and Food if the Forest Service will compile the information provided in the grant application form distinguishing between peat and mineral soils in order to determine if the analysis by the European Environmental Agency which states that up to 84% of Irish afforestation between 1990 and 2000 took place on peatbogs is correct. [31939/04]

Trevor Sargent

Question:

205 Mr. Sargent asked the Minister for Agriculture and Food if the Forest Service will refuse grant applications for afforestation on peatbogs, in view of the fact that the recent European Environmental Agency report states that 98,519 hectares have been planted on them between 1990 and 2000. [31940/04]

I propose to take Questions Nos. 203 to 205, inclusive, together.

I am aware of the recent report of the European Environmental Agency on afforestation in Ireland. The figure in regard to peatbog planting quoted by the Deputy differs significantly from the information available to me. The information, captured through the grant application forms, for example, suggests a lower figure, consistent with that given in reply to Question No. 108 on 27 May 2004. My Department has requested copies of the datasets analysed in the European Environmental Agency report. The European Environmental Agency's report is based on satellite imagery and I am advised that it is difficult to classify soils accurately by using this process.

As regards controlling the afforestation of peatbogs, my Department has strict procedures in place. These procedures effectively rule out grant aid for planting on intact raised bogs of the midlands, or the impoverished oligotropic deep blanket peats of the west. In addition, areas protected, or listed for protection, under the habitats directive are not considered for grant aid without the prior agreement of the National Parks and Wildlife Service.

Freedom of Information.

Trevor Sargent

Question:

206 Mr. Sargent asked the Minister for Agriculture and Food the dates on and the means by which her Department sought third party observations in respect of FOI/04/176. [31941/04]

My Department sought informal third party observations in respect of FOI/04/176 by phone on 7 October 2004. A decision on this request issued on 19 October 2004 and the requester was given notice of his or her rights of internal review on any aspect of the decision under the relevant provisions of the Freedom of Information Acts.

Trevor Sargent

Question:

207 Mr. Sargent asked the Minister for Agriculture and Food if she has received all records from other Departments in order that forestry related appeals to the Office of the Information Commissioner can be concluded shortly; if the records have not been received, the most recent date on which they were requested; and the response to date. [31942/04]

There are five outstanding forestry-related appeals with the Office of the Information Commissioner. All of these pre-date the transfer of responsibility for forestry to my Department on 1 January 2004. My Department is awaiting receipt from the Department of Communications, Marine and Natural Resources of two sets of records. I understand that the Office of the Information Commissioner has been directly provided by that Department with copies of all records relevant to the appeals. The most recent request for the records was made by my Department on 7 October 2004. The reply on 11 October 2004 indicated that the records were missing but the search would continue.

The Office of the Information Commissioner awaits a submission from my Department on one of the appeals, which I am advised will be made in the very near future. Determination of the appeals to her office is ultimately a matter for the Information Commissioner.

Grant Payments.

Trevor Sargent

Question:

208 Mr. Sargent asked the Minister for Agriculture and Food the dates on which a person (details supplied) in County Mayo, applied for a herd number. [31943/04]

According to my Department's records, the person in question has not applied for a herd number. It was not and is not a requirement of certain schemes including forestry grants to have a herd number.

Bernard J. Durkan

Question:

209 Mr. Durkan asked the Minister for Agriculture and Food the reason for refusing the application for assistance under the heading of force majeure in the case of a person (details supplied) in County Kildare; and if she will make a statement on the matter. [31980/04]

The persons named have been notified that the circumstances outlined by them do not satisfy the criteria for force majeure or exceptional circumstance under article 40 of Council Regulation (EC) No. 1782/2003. The persons named have been advised they can appeal my Department’s decision to the independent single-payment appeals committee which will carry out a full review of the circumstances outlined.

Farm Retirement Scheme.

David Stanton

Question:

210 Mr. Stanton asked the Minister for Agriculture and Food the exemptions which are available under the scheme of early retirement from farming 2000 to 2006; the exemptions that have been considered and granted to date; and if she will make a statement on the matter. [31995/04]

The scheme for early retirement from farming includes a provision under which prospective applicants may be exempted from certain conditions of application if they cannot satisfy them for reasons outside their control. Each case is dealt with on its merits. My Department has, for example, accepted applications from farmers who had been unable to farm for the full ten-year period prior to retirement due to illness or disability. However, the provision must be used prudently and within reasonable limits. Some 65 farmers have been admitted to the scheme on the basis of its exemption provisions.

Rural Environment Protection Scheme.

Paul Connaughton

Question:

211 Mr. Connaughton asked the Minister for Agriculture and Food if she will give consideration to an appeal by a person (details supplied) in County Galway against a decision to impose a penalty on a REP scheme payment; and if she will make a statement on the matter. [31996/04]

As of now, no REPS penalties have been imposed to date on the person named. However it may be necessary to seek recovery of previous payments to him as he has informed my Department that leased lands included in his REPS application are no longer under his control. The matter is under consideration in my Department and the person named will be informed directly of the outcome. If the decision is unfavourable, he will be told of his right of appeal to the agriculture appeals office.

Registration of Title.

Michael Ring

Question:

212 Mr. Ring asked the Minister for Justice, Equality and Law Reform when a dealing application lodged in 2002 for a folio (details supplied) in County Mayo will be complete. [31865/04]

I am informed by the Registrar of Titles that the application for transmission was lodged on 2 December 2002. Dealing No. D2002SM010537H refers. I am further informed that the application was completed on 30 November, 2004.

Domestic Violence.

Eamon Gilmore

Question:

213 Mr. Gilmore asked the Minister for Justice, Equality and Law Reform if he will agree to the request from the National Domestic Violence Intervention Agency for €220,000 in funding for 2005; if he will address the shortfall in the agency’s funding for 2004; and if he will make a statement on the matter. [31868/04]

I can inform the Deputy that my Department has provided funding for the operation of a domestic violence intervention project over the last two years, on a pilot basis, in the Dún Laoghaire-Bray court areas. The project arose from research, which was funded by my Department, into the development of an intervention model and is based on similar projects operating successfully in other jurisdictions.

I can further inform the Deputy that the operation of the pilot project has recently been evaluated, along with a number of other programmes for perpetrators of domestic violence. I am sure the Deputy will appreciate that further funding for the project will be considered in the light of this evaluation report and other matters currently under discussion with the National Domestic Violence Intervention Agency.

Asylum Applications.

Jan O'Sullivan

Question:

214 Ms O’Sullivan asked the Minister for Justice, Equality and Law Reform if priority will be given to dealing with the asylum applications of parents of Irish born children who have been here for more than two years; and if he will make a statement on the matter. [31937/04]

Applications for asylum from persons who are parents of Irish born children are not prioritised unless otherwise subject to a ministerial prioritisation directive.

Ministerial prioritisation directives made under section 12 of the Refugee Act 1996 apply to applications made by nationals of Nigeria and of countries designated as safe countries of origin by the Minister under the 1996 Act. Typically, such cases are now completed by the Office of the Refugee Applications Commissioner, ORAC, within five to six weeks of an application being received, except when compelling — for example, medical — reasons prevent the case from going ahead.

In practice, as a significant proportion of all applicants are prioritised in this way, many of the cases referred to by the Deputy would be dealt with under the prioritised timescale.

Disability Legislation.

Enda Kenny

Question:

215 Mr. Kenny asked the Minister for Justice, Equality and Law Reform the details of the membership of the expert consultation team which, with the disability legislation consultation group, formed part of the consultation process prior to the drafting of the Disability Bill 2004; the number of times this group met; if the ECT produced any written advice, minutes or reports for his Department on the drafting of the Bill; if so, if he will publish the advice, minutes or reports; and if he will make a statement on the matter. [31998/04]

An expert consultation team was established by Government in April 2002 to oversee the consultation process in connection with the preparation of disability legislation. The team comprised Ms Sylda Langford, assistant secretary in the Department of Justice, Equality and Law Reform; Mr. John O' Donnell, Senior Counsel; Professor Brian Nolan, Economic and Social Research Institute; Mr. Bernard Feeney, senior consultant, Goodbody's Economic Consultants; and Mr. Brian Crowley, MEP. In addition, a group representative of people with disabilities, their families, carers and service providers — the Disability Legislation Consultation Group, DLCG — was brought together by the National Disability Authority, NDA, to facilitate dialogue at national level, both within the sector and with the consultation team.

The consultation team had 15 meetings during which it received the views of key stakeholders, including the DLCG, the social partners, the community and voluntary sector, relevant State agencies and Departments.

The consultation team helped identify key proposals for possible inclusion in future legislation in light of their consultations with stakeholders. In this way, the work of the consultation team fed into the deliberative process until the team completed its task in February 2003. From then on, the Cabinet Committee on Social Inclusion played a key role in the development of legislative proposals and in facilitating cross-departmental co-operation. It is not the practice to publish advice, minutes or reports arising from such meetings.

Adult Education.

Jan O'Sullivan

Question:

216 Ms O’Sullivan asked the Minister for Education and Science if asylum seekers who have an Irish-born child are allowed to pursue a course of study in a college of further education for which there is no charge for the course and in cases in which the college is willing to enrol such persons; and if she will make a statement on the matter. [31936/04]

Asylum seekers may not access free of charge vocational training or active labour market programmes in colleges of further education. Exceptionally, asylum seekers in possession of documentary evidence from the relevant authority that they have been granted leave to remain in the State as the parents of a child born in Ireland, could participate in further education programmes, subject to satisfying the entry requirements for the course. Applicants without documentation from the relevant authority may not be considered.

Within the constraints of the overall budget provided by my Department for the adult literacy and community education scheme, adult literacy and language tuition in further education centres may be provided by VECs free of charge for adult asylum seekers.

Sexual Abuse Allegation.

Mary Upton

Question:

217 Dr. Upton asked the Minister for Education and Science the steps that were taken to investigate an allegation in 1989 of sexual abuse in a centre (details supplied); and if she will make a statement on the matter. [31862/04]

Officials in my Department have confirmed with Trinity House School that a memo was received by the school in November 1989 from one of the authors of A Tragedy Waiting to Happen, referring to a non-specific allegation of sexual abuse of the person concerned at the school. As far as can be established, there are no records at the school indicating that the matter was investigated at the time.

Following the publication of the book, A Tragedy Waiting to Happen, which contains a detailed reference to assaults by a staff member at Trinity House School, the matter was forwarded in October 2004 to the Northern Area Health Board requesting that the allegation of sexual abuse be investigated in accordance with the child protection procedures pursuant to the appropriate guidelines. The guidelines in relation to child protection matters for the children detention schools, including Trinity House School, are documented in the Child Protection and Welfare Procedures and Guidelines for the Children Detention Schools 2002. This document incorporates the principles set out in Children First and in my Department’s child protection guidelines and procedures for primary schools, which was published in 2001.

As the Deputy may be aware, all relevant documentation held by my Department in relation to the sexual, physical and emotional abuse or neglect of children in the industrial and reformatory schools, including Trinity House School, has been forwarded to the Commission to Inquire into Child Abuse in compliance with a discovery order from the commission in June 2003.

Residential Institutions Redress Scheme.

Eamon Gilmore

Question:

218 Mr. Gilmore asked the Minister for Education and Science if she has given any further consideration to the inclusion of an institution (details supplied) within the remit of the residential institutions redress scheme; if, in relation to that institution and related matters, she has considered the contents of a newspaper article; and if she will make a statement on the matter. [31867/04]

Section 4 of the Residential Institutions Redress Act 2002 provides that in order for an institution to be placed on the Schedule of the Residential Institutions Redress Act 2002, the facility must have been subject to inspection or regulation by a public body. A total of 128 institutions are listed on the original Schedule to the Act and I recently signed an order adding a further 13 institutions to the Schedule.

In relation to the institution referred to by the Deputy, my Department is exploring with the trustees of that institution the possibility of a contribution being made by them towards the redress scheme. Any decision to include an institution will not be made on the basis of a contribution being forthcoming but this issue must be explored before a final decision is made on its inclusion. In relation to the article referred to by the Deputy, the religious ethos of an institution is irrelevant in considering whether or not it should be added to the Schedule.

Schools’ Costs.

John Perry

Question:

219 Mr. Perry asked the Minister for Education and Science if all primary schools in Counties Sligo and Leitrim will be reimbursed for water charges in view of the fact that these added charges will have to be passed on to parents of the students; the plans she has in place to increase the funding; the amount that will be granted; and if she will make a statement on the matter. [31871/04]

Primary schools' running costs are met by my Department's scheme of capitation grants. These grants are intended to contribute towards the general operating costs of national schools which would include heating, lighting, cleaning, insurance, painting, teaching aids and other miscellaneous charges. The capitation grant has been increased substantially in recent years. Since 1997, the standard rate of capitation grant has been increased from £45 —€57.14 — per pupil to €121.58 with effect from 1 January 2004, an increase of almost 113% in the period. Provision has been made for a further increase of €12 per pupil in the capitation grant bringing it to €133.58 in the current school year.

Local authority service and other charges payable to the various local authorities do not come within the remit of my Department. It would be a matter for the local authorities to decide whether schools are liable to pay such charges. Where it is decided that schools are liable for such charges, the cost would form part of the normal running costs of schools and would fall to be met from the capitation funding which schools have received from my Department.

It would not be feasible for my Department to introduce specific schemes whereby grant assistance would be provided to schools in respect of individual charges such as water charges.

Special Educational Needs.

David Stanton

Question:

220 Mr. Stanton asked the Minister for Education and Science if a person (details supplied) in Dublin 9 will be given the same level of support and assistance in school that was received up to June 2004; and if she will make a statement on the matter. [31923/04]

Every effort is made to ensure that children with special educational needs, SENs, receive an education appropriate to their needs. Decisions regarding the most appropriate model of response in each particular case are based on the professionally-assessed needs of the individual child.

The Deputy may be aware that I propose to introduce a new system of allocation of resource teacher support for pupils with SEN who, like the pupil in question, fall within the high-incidence disability categories. It would be expected that the needs of the pupil in question could be met from within the current resource-learning support teaching allocation available to the school. Currently, the school has a staffing level of two learning support and four resource teachers. However, I am conscious of difficulties that could arise in relation to the proposed new model, particularly for children in small and rural schools, if it were implemented as currently proposed. Accordingly, I will be reviewing the proposed model to ensure that it provides an automatic response for pupils with common mild learning disabilities without the need for cumbersome individual applications, while at the same time ensuring that pupils currently in receipt of service continue to receive the level of support appropriate to their needs. The review will involve consultation with educational interests and the National Council for Special Education before it is implemented next year.

Psychological Service.

Michael Lowry

Question:

221 Mr. Lowry asked the Minister for Education and Science if her attention has been drawn to the psychological assessment crisis facing north Tipperary due to the lack of psychologists in the area; her strategy to attract urgently needed educational and child psychologists to work in north Tipperary and the mid west region; her views on providing some form of master’s degree course in psychology in a third level college in the region to attract badly needed psychologists to the area; and if she will make a statement on the matter. [31924/04]

I am aware that the National Educational Psychological Service, NEPS, has had some difficulty in recruiting educational psychologists to work in the mid-western region, including north Tipperary. Meanwhile, schools that do not yet have access to the psychological service provided by NEPS are entitled to arrange for essential assessment work to be carried out under the scheme for commissioning psychological assessments, SCPA.

My Department is currently initiating the process of gaining sanction for a new recruitment competition to NEPS. Unlike previous such competitions, applicants will henceforth be asked to specify the regions for which they are applying. Those who are successful will have their names placed on the relevant regional panels. This will mean that vacancies in the regions prioritised by NEPS may be filled first. I am hopeful that this will correct the current regional imbalance that exists in NEPS.

Proposals from third level colleges to provide courses in educational psychology at master's level should be submitted to the Higher Education Authority, HEA. Any such proposals will be considered by my Department, taking into account the views of the HEA.

Michael Lowry

Question:

222 Mr. Lowry asked the Minister for Education and Science the number of educational psychologists which should be employed in the mid-west region; the number currently employed; when the empty posts will be filled; and if she will make a statement on the matter. [31925/04]

Shortly after the establishment of the National Educational Psychological Service, NEPS, in April 2000, its management committee submitted a draft development plan to the then Minister for Education and Science. According to this plan, the ultimate number of psychologists needed to provide a psychological service to all schools in the mid-west region was 16. Currently, six NEPS psychologists work in the region. During the past few months, two psychologists did not accept offers of employment from my Department on the basis that the vacancies were in the mid-west. However, a psychologist who joined NEPS on 1 November 2004 has been assigned to the region. There will be a slight expansion of the psychological service in the region after Christmas when the new psychologist has completed the induction programme and is fully operational.

My Department is initiating the process of gaining sanction for a new recruitment competition to NEPS. Subject to sanction being forthcoming and to the availability of resources, I expect that my Department will make offers of appointment to vacancies for psychologists in the mid-west during the school year 2005-06.

Schools Building Projects.

Michael Lowry

Question:

223 Mr. Lowry asked the Minister for Education and Science if her attention has been drawn to the poor state of a post primary school (details supplied) in County Tipperary; if this school will be included in the capital works programme for 2005 on the basis of serious health and safety concerns; and if she will make a statement on the matter. [31926/04]

The extension project for the school referred to by the Deputy is at an early stage of architectural planning. It has a band two rating. My Department's technical staff are currently examining the stage one documentation — site suitability and site analysis. The school authorities will be kept advised of developments. My officials are nearing completion of a review of all projects that did not proceed to construction as part of the 2004 school building programme, including the school in question. All projects are being assessed against the published prioritisation criteria, agreed earlier this year with the education partners. Each project will be assigned a band rating and the progress of all projects will be considered in the context of the school building programme from 2005 onwards.

With regard to health and safety issues, responsibility is a matter in the first instance for individual school authorities. My Department has received an application for the upgrading of the electrical installation in the school under the summer works scheme 2005. Officials in the school building unit will be in contact with the management authorities when a decision is made on their application.

Pat Breen

Question:

224 Mr. P. Breen asked the Minister for Education and Science, further to Question No. 372 of 27 April 2004, if a school (details supplied) in County Clare has been considered for a school extension; and if she will make a statement on the matter. [31927/04]

The application for an extension at the school to which the Deputy refers is being considered as part of a review of all projects which did not proceed to construction as part of the 2004 school building programme. All projects are being assessed against the published prioritisation criteria, revised earlier this year following consultation with the education partners. Each project will be assigned a band rating and the progress of all projects will be considered in the context of the school building programme from 2005 onwards. I will make further announcements on the school building programme in due course.

School Staffing.

Richard Bruton

Question:

225 Mr. R. Bruton asked the Minister for Education and Science if her attention has been drawn to a demand for a refund of money from a school secretary (details supplied); if her attention has been further drawn to the insistence by her officials that it will not continue to fund a secretary even though the school has had a secretary since 1978; and if she will make a statement on the matter. [31945/04]

I have requested my officials to investigate this matter and I will arrange for a full reply to be forwarded to the Deputy as soon as possible.

Capitation Grants.

Richard Bruton

Question:

226 Mr. R. Bruton asked the Minister for Education and Science if her attention has been drawn to the escalation in cost of insurance for schools in Dublin in recent years, which has more than doubled in the past five years; if she has developed an index of the costs of care and maintenance of second level schools; her estimation of the increase in such costs in recent years; and the current cost per pupil. [31946/04]

I am not aware of the costs of insurance in individual secondary schools, as it is a matter for the managerial authorities of the individual schools to arrange insurance cover on school property and against public liability. However, I am aware of the concerns expressed by school authorities in relation to increased insurance costs. Grant aid to voluntary secondary schools is provided by my Department by way of per capita grants and may be used towards insurance as well as care and maintenance costs.

The benefit of developing an index of the costs of care and maintenance and the associated cost per pupil is not clear. The amount expended by schools on such items is a matter for school managements and will vary depending on the priority accorded by each school in accordance with its own needs. There have been significant improvements in the level of funding for voluntary secondary schools. The standard per capita grant amounts to €274 as against the rate of €224.74 that applied in 1997. I refer to my recent announcement, in the context of the 2005 Estimates, to the further increase in this grant to €286 per pupil, with effect from January next. This increase will bring the per capita grant in the case of disadvantaged schools to €324 per pupil. In addition, under the school services support fund initiative, secondary schools have benefited from further significant increases in the support grant. This grant which was introduced in September 2000 has been increased from €25 per pupil to the current rate of €99 per pupil and it will be further increased to €103 from January next.

Funding for voluntary secondary schools has been further enhanced by the introduction of a range of equalisation measures that are designed to reduce the historical anomalies in the funding arrangements for the different school types at second level. Under the terms of recent equalisation measures, the support grant has in the case of voluntary secondary schools been significantly enhanced to €131 per pupil and from January next it will be further increased by €10 per pupil bringing the overall grant for such schools to €145 per pupil. These increases are in addition to the range of equalisation grants of up to €15,554 per school per annum that have also been approved for voluntary secondary schools.

This amounts to additional funding of up to €119,000 per annum and annual grants of €255,761 —€275,000 in the case of disadvantaged schools — towards general expenses and support services for a secondary school with 500 pupils. Schools are afforded considerable flexibility in the use of resources to cater for the needs of their pupils. This is, in general, a preferable approach to putting in place grants for specific cost items such as those referred to by the Deputy.

I was particularly pleased to announce an aggregate increase of €26 per pupil from January next for voluntary secondary schools. Schools have welcomed this increase. These significant increases in the funding of secondary schools are a clear demonstration of my commitment to prioritise available resources to address the needs of schools.

Special Educational Needs.

Róisín Shortall

Question:

227 Ms Shortall asked the Minister for Education and Science her policy in allowing a classroom assistant to move schools with a pupil to whom he or she was attending when that pupil graduates to secondary school; the salary implications of such a move for a classroom assistant; and if she will make a statement on the matter. [31999/04]

Responsibility for the recruitment and appointment of special needs assistants, SNAs, rests with the relevant school authorities. Where a pupil with special educational needs enrols in a post primary school, it is open to the school to apply to my Department for additional resources for the pupil. If approval is given for additional SNA support, it is a matter for that school to appoint a suitable person to the post. All full-time SNAs employed in primary schools and full-time SNAs in post primary schools appointed with effect from 1 September are paid on an incremental salary scale. Where a full-time SNA transfers from a primary to a post-primary school, without a break in service, payment will continue on the same point of the incremental salary scale. Part-time SNAs are paid a salary based on the hours that they actually work.

My Department has recently revised the rate of pay for all part time SNAs in primary schools. Similar arrangements are being finalised for SNAs working in post primary schools and a circular outlining the relevant details will be issued when this process is complete. Currently, all SNAs in voluntary secondary, community and comprehensive schools are paid by the school authority and the cost is recouped from my Department. With effect from 1 January 2005, these SNAs will be paid directly on my Department's payroll as is the case currently for all primary SNAs.

Willie Penrose

Question:

228 Mr. Penrose asked the Minister for Education and Science if she will take steps to approve a full-time special needs assistance for a person (details supplied) in County Westmeath; and if she will make a statement on the matter. [32000/04]

Where a pupil with special educational needs enrols in a post primary school, it is open to the school to apply to my Department for additional teaching support and-or special needs assistant support for the pupil. My Department allocates additional teaching support and special needs assistant support to second level schools and vocational educational committees to cater for pupils with special educational needs. Each application is considered on the basis of the assessed needs of the pupils involved and having regard to a range of factors including the overall resources available to the school.

The school concerned has been allocated 4.43 whole-time equivalents per week, additional teaching support and also 2.94 whole-time equivalents per week special needs assistant support for the 2004-05 school year to cater for the special educational needs of a number of pupils, including the pupil to whom the Deputy refers. A further application for additional support for the pupil in question was recently received by my Department. This application is under consideration and the school authority will be notified of the outcome as soon as possible.

Willie Penrose

Question:

229 Mr. Penrose asked the Minister for Education and Science the reason an application for additional hours for a special needs assistant for a person (details supplied) in County Longford led to a reduction of ten hours in the original application; if she will review the decision and grant the additional ten hours sought for this person; and if she will make a statement on the matter. [32001/04]

As outlined in my Department's circulars, special needs assistant, SNA, support may be approved for a pupil who has a significant medical need for such assistance, a significant impairment of physical or sensory function or where their behaviour is such that they are a danger to themselves or other pupils.

The school referred to by the Deputy applied for an increase in SNA support from 23.3 hours per week to a full-time post to meet the needs of the pupil in question. The application, together with the professional reports, was examined by my Department, which recommended 12.5 hours per week SNA support for this pupil. A letter to this effect issued to the school on 25 November 2004. In the event of additional documentation being submitted to my Department, arrangements will be made to have the matter re-examined.

A review of SNA provision, which commenced recently, will apply to approximately 2,000 primary schools with existing SNA support. The review is concerned with the level and deployment of SNA posts in mainstream classes. The intention is to ensure both the level and deployment of such posts are such as to ensure the special care needs of pupils are being appropriately met. As part of the exercise, outstanding applications for SNA support for pupils who are attending mainstream classes will be processed.

Departmental Properties.

Jack Wall

Question:

230 Mr. Wall asked the Minister for Defence when a road (details supplied) will be handed over to the local authority; and if he will make a statement on the matter. [32002/04]

Jack Wall

Question:

231 Mr. Wall asked the Minister for Defence the reason, despite previous commitments, a road under the ownership of his Department has not been handed over to the local authority; and if he will make a statement on the matter. [32004/04]

Jack Wall

Question:

232 Mr. Wall asked the Minister for Defence if his attention has been drawn to the fact that the delays in handing a road are causing financial hardship for the residents of the road; when the road will be handed over; and if he will make a statement on the matter. [32011/04]

I propose to take Questions Nos. 230 to 232, inclusive, together.

As indicated in my reply to Question No. 606 on 17 November 2004, my Department wrote to Kildare County Council on 2 June 2004 seeking to have the road in question upgraded and taken in charge by the council. My Department has again contacted Kildare County Council on the matter and its substantive response is awaited.

Radon Protection Measures.

John Perry

Question:

233 Mr. Perry asked the Minister for the Environment, Heritage and Local Government if funding will be made available to subsidise the cost of providing radon detector units in all houses in counties Sligo and Leitrim; the funding that is available at present; and if he will make a statement on the matter. [31870/04]

The Government, through the Radiological Protection Institute of Ireland, RPII, has committed significant resources to assessing the extent of the radon problem throughout the country and to increasing public awareness of radon.

During the years 1992 to 1999, the RPII carried out a national survey of radon in domestic dwellings aimed at assessing the extent of the radon problem in homes. The survey involved the measurement by the RPII of radon for a 12-month period in a random selection of homes in each ten kilometre square grid throughout the country. In all over 11,000 houses were involved in the survey carried out at no cost to the householder. Arising from that survey the RPII estimated that some 91,000 houses nationally have radon concentrations in excess of the national reference level of 200 becquerels per cubic metre. The survey also identified high radon areas. The RPII's website, www.rpii.ie, contains a comprehensive map of the high radon areas in Ireland as well as the report of its national survey of radon in homes.

The RPII has always encouraged those householders residing in high radon areas to use radon measuring kits, costing approximately €40, to establish radon levels in their homes, and where measurements are found to exceed the national reference level, to carry out radon remediation works.

In February 2002, my Department published a booklet entitled Radon in Existing Buildings — Corrective Options advising designers, builders and home owners on remediation options for reducing radon in existing houses to, or below, the national reference level.

Upgraded building regulations, introduced in June 1997, require all new houses commencing construction on or after 1 July 1998 to incorporate radon protection measures. The Department recently published an updated edition of technical guidance document C, TGD-D, on part C of the building regulations, site preparation and resistance to moisture, incorporating enhanced radon prevention measures for new buildings commencing on or after 1 April 2005.

Water Conservation Measures.

John Perry

Question:

234 Mr. Perry asked the Minister for the Environment, Heritage and Local Government the funding that will be made available to local authorities in Counties Sligo and Leitrim to install water saving devices in all local authority housing; when the funding will be put in place; the amount allocated; and if he will make a statement on the matter. [31872/04]

Low-cost water saving devices are readily available should local authorities wish to provide them in their housing and it is not considered necessary to allocate specific additional funding towards their provision. Where a local authority includes water saving devices in new local authority housing or in existing local authority housing which is being repaired under the remedial works programme the cost may be met from the capital allocation.

Budgetary Allocations.

John Perry

Question:

235 Mr. Perry asked the Minister for the Environment, Heritage and Local Government if the budgetary allocations to local authorities in County Sligo will be stabilised; and if he will make a statement on the matter. [31873/04]

I assume that the question refers to general-purpose grant allocations from the local government fund. These grants have grown to record levels over recent years with the 2004 total amounting to €751.7 million. This amount represents an increase of 14% over the corresponding allocation for 2003 and is some 121% higher than the initial allocation for 1997. These grants are in addition to other specific State grants and income from local sources.

I will shortly notify local authorities of their general purpose grant allocations for 2005, these will provide increased support to the programmes and services of all local authorities for the year ahead.

Nuclear Plants.

Brian O'Shea

Question:

236 Mr. O’Shea asked the Minister for the Environment, Heritage and Local Government his proposals to pursue the closure of the Sellafield nuclear plant (details supplied); and if he will make a statement on the matter. [31928/04]

I refer the Deputy to the reply to Questions Nos. 13, 50 and 53 of 4 November 2004.

Visitor Heritage Centres.

Michael Ring

Question:

237 Mr. Ring asked the Minister for the Environment, Heritage and Local Government the projected figures for visitors to a project (details supplied) in County Mayo. [31992/04]

It is difficult to predict visitor numbers for a green field project such as the proposed visitor centre for Ballycroy National Park, County Mayo. However, data from other heritage sites are useful as a basis to assess the potential usage of the proposed new visitor centre.

The closest equivalent attractions within my own Department to Ballycroy are the visitor centres at Connemara and Glenveagh national parks. In the case of the visitor centre in Connemara National Park, some 9,000 visitors were attracted in the first half year of operation. However, this number has risen steadily with 70,623 visitors in 2003. There were 47,651 visitors to the visitor centre at Glenveagh National Park in 2003. These figures relate to the number visiting the visitor centres: actual visitor numbers to the national parks, entry to which is free of charge, are significantly higher.

North West Mayo has two other important visitor attractions, at the Céide Fields in Ballycastle and the Museum of Country Life in Turlough Park House, Castlebar. I understand that the Céide Fields visitor centre attracted some 35,328 visitors in 2003, while the Museum of Country Life attracted some 100,000 in 2003.

The plans for the visitor centre at Ballycroy envisage an attractive and multifunctional facility which I believe will prove successful and will, I hope, attract in the region of 40,000 to 50,000 visitors a year when fully operational with the potential to significantly increase these figures over time.

Water and Sewerage Schemes.

Paul Connaughton

Question:

238 Mr. Connaughton asked the Minister for the Environment, Heritage and Local Government the position with regard to a sewerage treatment plant for Castleblakney, Ballinasloe, County Galway; and if he will make a statement on the matter. [31993/04]

Castleblakney sewerage scheme was included as a post-2006 scheme in the list of sewerage schemes submitted by Galway County Council in response to my Department's request to 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 assessments were taken into account in the framing of the water services investment programme 2004-2006 published in May 2004. Given the rating afforded to the scheme by the council, it was not included in the current programme.

Local Authority Housing.

Paul Connaughton

Question:

239 Mr. Connaughton asked the Minister for the Environment, Heritage and Local Government the reason an application for an improvements in lieu of a grant has not been approved for a person (details supplied) in County Galway; and if he will make a statement on the matter. [31994/04]

Galway County Council submitted a proposal to my Department in May 2004 seeking approval to the acceptance of a tenderfor works to be undertaken to the house in question under the improvement works in lieu of rehousing scheme. Under this scheme local authorities have delegated authority to proceed with improvement works where the cost is under €75,000. In this instance the cost is considerably in excess of this devolved limit and my Department's approval is therefore required.

Further information has recently been received from the council and a decision on the matter will be conveyed to it shortly.

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