Dáil Éireann debate -
Tuesday, 25 Oct 2005

Vol. 608 No. 3

Adjournment Debate.

Hospital Services.

Mr. Morgan

I appreciate the opportunity to raise this important issue on the Adjournment. Successive Ministers have attempted to fool the people of the Dundalk area with a plethora of announcements, reports, reviews, recommendations and yet more announcements. The fact remains that there were better services at the Louth County Hospital, Dundalk, 30 years ago than there are today. Shame on the Government for presiding over such a scandalous situation.

The children's ward was the first to go, followed by the maternity ward and then the gynaecological unit. In 2001, we were told the maternity unit was to be closed temporarily yet it remains closed today. We were to get a midwife-led unit in its place. In June 2003 we were told by the then North Eastern Health Board that the building identified for future use as a midwifery-led unit would require some modification and extension and a suitable scheme was to be prepared for consideration. This work was to have been completed in 2004 subject to funding being made available. Although it will soon be 2006 there is no sign of these works.

The latest attack on the hospital came last month when a directive was issued by the HSE ordering an end to all breast surgery procedures at Louth General Hospital. We were also promised a renal dialysis unit yet there is no sign of this unit either. The kitchens at the hospital urgently require upgrading. We have had three announcements since 2002 on the approval for kitchen upgrading but it has yet to materialise.

Similarly, we were promised two modular theatres. The Minister for Foreign Affairs, Deputy Dermot Ahern, danced a merry jig on this issue, boasting about the great work he had done for the hospital. That promise has been reduced to one modular unit. I can inform the Minister for Foreign Affairs that it still has not been delivered.

The Tánaiste and Minister for Health, Deputy Harney, met a delegation from Dundalk Town Council last May. She promised the members she would consider the issue of a CT scanner for Louth General Hospital and that she would visit the site in July. More broken promises from a Minister. She still has not visited Dundalk.

The Tánaiste and Minister for Health and Children recently announced that her Department would provide matching funding for the provision of a CT scanner at Bantry General Hospital. Fair play to it. I call for similar funding for a CT scanner for Louth General Hospital. We will not be treated as second-class citizens by this or any other Minister. Our hospital cannot survive without a CT scanner. The Minister of State knows that, yet he is still dragging his feet on this important issue.

Yet another ludicrous document relating to the provision of services at Louth County Hospital has emerged recently, this time from the Royal College of Surgeons, signed by Professor Arthur Tanner. The third item in this document instructs that the consultants must have absolute discretion to transfer a patient from Dundalk to Drogheda at any time, with immediate effect. The fourth item in the document states that beds must be made available in Drogheda, without question, and on an immediate basis where such transfers are requested. How can this work in practice? If there is no bed available in Drogheda and a patient is to be transferred from Dundalk, is the sick and, perhaps, dying patient in Drogheda to be removed from a bed, placed on a trolley and pushed into the corridor to make room for the equally sick and, perhaps, dying patient from Dundalk? This document is indicative of the lack of rationale or any semblance of proper management at a senior level in the HSE.

I will give an example of what could work to resolve some of the health care crisis in the north east region. The six surgeons based at Our Lady of Lourdes Hospital, Drogheda, who have a lower throughput of procedures than the two surgeons at Dundalk, could be allocated a small number of additional "splits" with Louth General Hospital. This would have the immediate effect of bringing Dundalk back to the status of a training hospital and addressing in some way the infrastructural deficit in the north east region.

I urge the Minister of State, Deputy Tim O'Malley, to make clear in his reply whether we can expect him to address the litany of issues raised on behalf of people in the Dundalk catchment area who are currently being denied adequate health care services by the Government. They have been denied a proper and adequate health care system over the past eight and a half years when the Government has been in office. I look forward to the Minister of State's reply.

Minister of State at the Department of Health and Children (Mr. T. O’Malley)

I thank Deputy Morgan for raising this matter on the Adjournment. In raising the matter, he provides me with an opportunity to outline to the House the position on the development of services across the Louth-Meath hospital group. The Department is advised by the Health Service Executive that there are no plans to downgrade Louth County Hospital, Dundalk, and that the hospital is guaranteed an active role in the delivery of acute hospital services within the group.

This policy is reflected by recent service developments such as the establishment of a joint department of surgery between Our Lady of Lourdes Hospital, Drogheda, and Louth County Hospital, Dundalk, in January 2005. This development has resulted in increased elective activity in Louth County Hospital and a reduction in waiting lists on both sites. In April 2004 the Department approved the appointment of a design team to prepare an outline development control plan for the hospital. Design teams have been appointed to advance the provision of two modular theatres at a capital cost of €3 million and for the upgrading of the kitchens at Louth County Hospital at an estimated capital cost of €1.4 million. A cardiac rehabilitation unit opened at the hospital in 2002, an additional 14 beds were provided under the national bed capacity initiative at a full-year revenue cost of almost €1.5 million, a new consultant physician with a special interest in endocrinology was appointed in April 2004 to support these beds, and a new consultant in emergency medicine has been appointed with sessional commitments to Louth County Hospital. The Department sanctioned the purchase of almost seven acres of land at Louth County Hospital in December 2003 at a cost of €2.6 million.

Mr. Morgan

A private hospital will be built on the site.

Mr. T. O’Malley

Tóg go bog é. Is the Deputy against that also?

Mr. Morgan

The Minister of State said the purpose of——

Mr. T. O’Malley

The purpose of this purchase is to have a strategic land bank that will be of benefit to acute services.

On breast surgery services in the north-eastern region, the HSE has informed the Department that following the resignation of the lead breast surgeon for the region, breast surgery has been carried out in the Louth-Meath hospital group at Our Lady of Lourdes Hospital, Drogheda. The post of lead breast surgeon for the region, based in Our Lady of Lourdes Hospital, Drogheda, is scheduled to be advertised by the Public Appointments Service on Thursday, 13 October 2005, with a closing date of 10 November 2005.

Since 1997, approximately €37 million in cumulative additional funding has been made available to the north-eastern region for the development of appropriate treatment and care services for people with cancer, including a sum of €600,000 which was allocated this year for cancer services in the region. This investment has enabled the funding of an additional ten consultant posts and support staff in key areas of cancer care across the region. BreastCheck, the national breast screening programme, has been available to women in the 50 to 64 age group throughout the north-eastern region since 2000. Mobile units provide screening to women in the target age group approximately every two years. Follow-up treatment for those diagnosed with breast cancer under the programme is provided in the BreastCheck clinical units in Dublin.

We can only maintain progress in the fight against breast disease if the delivery of high quality care and adherence to best practice comprise our main priority. For this reason, the Tánaiste recently established a national quality assurance group, under the chairmanship of Professor Niall O'Higgins, for symptomatic breast disease services. It is an important milestone in the development of quality breast disease services. This group will develop an agreed set of interdisciplinary performance indicators for the management of symptomatic breast disease. The objective is to ensure that the same expert guidelines apply to women regardless of the hospital in which they are treated.

The arrangements I have outlined which are being put in place by the Health Service Executive are designed to enhance the overall level of hospital services across the Louth-Meath hospital group.

Sugar Industry.

Mr. Sherlock

The issue of the overhaul of the EU sugar regime is one which, if the current proposals are agreed, will signal the demise of the Irish sugar industry and with it the loss of in excess of 1,000 jobs in sugar manufacturing and associated industries. In EU terms, the Irish sugar quota is small, amounting to just over 1% of the total EU quota, but this does not give an accurate representation of the importance of the industry to Ireland. More than 3,700 farmers grow sugar beet under contract to Irish Sugar Limited and receive approximately €75 million annually for the crop. While we accept that some change to the regime is inevitable, the European Commission proposals are too radical. The price cuts proposed for sugar and sugar beet are very severe. The impact of the current reform proposals will result in the phasing out of sugar production in this country.

The European Parliament report by Mr.Fruteau states that, under the current proposals for sugar, the current support price of €631.90 per tonne is to reduce in stages to €385.50 per tonne from 2008-09. This is a cut of 39% compared with the cut of 33% proposed in the Commission communication of last year. This is unsustainable for any Irish farmer. The minimum cut in the price of sugar beet over two years is to be from €43.63 per tonne to €25.05 per tonne from 2007-08. This is a cut of 42% compared with the cut of 37% proposed in the Commission communication. This is also unsustainable. Compensation for farmers remains at 60% of the drop in the support price. This is to be paid as part of the single payment scheme. Ireland's scope is €11 million from 2006-07 and €18 million from 2007-08. For Irish growers, this works out at €7.35 per tonne of beet in 2006-07, rising to €12.03 per tonne of beet from 2007-08.

I call on the Minister to reject these proposals and, furthermore, I insist that she call for no conclusion on an agreement in advance of the November meeting of the Council of Ministers. We must await the outcome of the World Trade Organisation meeting in Hong Kong in December. The outcome of that meeting will have a direct bearing on the price at which sugar sells in the European Union. I call for prudence in this matter. The outcome of the WTO meeting will have a direct bearing for the EU-wide sugar regime. I appreciate that negotiations are difficult but if they result in the loss of a viable industry and no Irish sugar-producing facility, they will have untold consequences and leave us to the mercy of the European sugar interests. That is a vista we do not want to contemplate.

Minister of State at the Department of Agriculture and Food (Mr. B. Smith)

I thank Deputy Sherlock for raising this issue and welcome the opportunity to comment on the proposals for reform of the EU sugar regime, which were again discussed at today's Council of Agriculture Ministers meeting in Luxembourg.

It is over a year since the Commission first outlined its thinking on the future shape of the sugar regime but formal legislative proposals only emerged at the end of June 2005. The proposals have now been formally presented to the Council and the Parliament, and the UK Presidency is striving to reach political agreement before the WTO ministerial meeting in Hong Kong in December. It should also be noted that the sugar regime in its current form will expire at the end of June 2006, and therefore there is a need for a decision on future arrangements to avoid a legal vacuum from next July.

Everybody is familiar with the reasons reform of the sugar regime is high on the EU agenda. In addition to the internal EU pressures to bring the sugar industry into line with the other agricultural sectors, there are international pressures. These fall under three main headings: the everything but arms agreement, the WTO Doha round of trade negotiations, and the ruling by a WTO panel last April against aspects of the EU regime following on a complaint by Brazil, Thailand and Australia.

From the outset, Ireland pointed out the serious repercussions the proposals would have for the Irish industry. The Minister for Agriculture and Food, Deputy Coughlan, along with her colleagues from nine other EU member states, made a joint submission to the Commissioner for Agriculture and Rural Development pointing out the devastating effect the proposals would have both on producers and the industrial enterprises in the sector. While the ten Ministers acknowledged the need to modify the existing regime, they argued that the reform should aim to keep the existing pattern of sugar beet and sugar production across the entire EU territory.

The legislative proposals published last June turned out to be even more severe than anticipated and went even further than the Commission had initially envisaged, not least because of the WTO ruling in April 2005 against aspects of the EU regime. There were two key differences: the price cuts were deeper and the proposal for compulsory quota cuts along with the proposal to allow quota mobility between member states was dropped, being replaced by a voluntary restructuring scheme for factories.

The Commission's stated objective in presenting these particular proposals is to develop a sustainable future for the EU sugar industry by enhancing competitiveness and, at the same time, to attain a sustainable market balance between domestic production levels and international commitments.

The key elements of the proposals are a 39% price cut in the institutional price for sugar, a corresponding reduction in the minimum price for sugar beet and 60% compensation to farmers for the price cut. A voluntary restructuring scheme is proposed to encourage factory closures and the renunciation of quota.

From Ireland's perspective, the proposals are completely unacceptable in their present form. The price cuts proposed are so severe as to make sugar beet production in several member states, including Ireland, uneconomic. It is unprecedented for the Commission to make proposals that could lead to the demise of an entire sector in a number of member states.

The restructuring scheme as proposed is inequitable as the closure of a sugar factory would have major implications for sugar beet growers and this fact is not sufficiently appreciated. Apart from going against the expressed views of many member states, the proposals for price reductions have not found favour with the least developed countries either.

At Council in July, the Minister argued strenuously that the price cuts proposed are too severe, that the reforms should be based on a longer lead-in time for everything but arms agreement and that it would be preferable to await the outcome of the WTO meeting in Hong Kong in December before seeking to conclude an agreement on sugar reform. The Minister is in frequent contact with like-minded ministerial colleagues in other member states who also oppose the proposals. A further letter from a group of 11 member states, including Ireland, was submitted to the Commission today in advance of the formal discussion at Council setting out the objections of the group to the proposals.

The Minister also met the Agriculture Commissioner on a number of occasions to voice her strong reservations. Meanwhile, there has been ongoing contact at official level with other member states and the Commission about the reform proposals.

The Minister maintained her firm opposition to the Commission's proposals when she addressed today's meeting of the Council of Ministers in Luxembourg. Negotiations will become more intensive over the coming weeks and the proposals will be considered by the Council again next month. Given their severity, it is clear the negotiations will continue to be difficult but the Minister will be resolute in pursuing her overall objective of achieving a more balanced agreement, which will take Irish interests into account.

Third Level Education.

Ms Sexton

It is difficult in five minutes to cover adequately an issue of such importance to all second level students who make very significant sacrifices at a relatively young age to study hard to ensure they get the required points to pursue a career of their choice.

When I tabled this matter on the Adjournment I did not expect that on the same day The Irish Times would carry the moving story of Katie Murphy from Wexford. Her story, told so expressively, encapsulates in a way I could never have done the hope when she applied for a re-check, the joy when she got her additional points, the utter disbelief when no place was available to her, the subsequent disappointment of attempting to access a place and finally the resignation she experienced when she realised that her hopes and dreams were to be dashed, for this year at least. She now must watch helplessly while her friends and contemporaries start their first year in their chosen career without her. None of us can fully understand the impact such a disappointment will have on Katie and the other students whom she, perhaps unintentionally, represents.

I will confine my contribution to the faculty of medicine although it could equally apply to several disciplines. The number of re-checks of papers this year and the percentage of students upgraded were the largest ever, while the number of qualifying students refused places in the faculty of medicine was at an all-time high. I understand, however, that the Minister for Education and Science will address this soon.

Information has come into my possession which suggests that rules governing the allocation of places are not equally applied. University College Cork had four such cases and all four were offered places. Why is there not a universal and common approach between the Central Applications Office and all State universities? This would ensure that no student would feel victimised by a flawed system of allocation.

Natural justice suggests that if a wrong has been perpetrated by any Department, in this case in the correction of papers under the Department of Education and Science, that Department bears responsibility and is morally obliged to right that wrong by ensuring places are made available immediately. The decision must be made for this year and not deferred until next.

A system must be introduced from next year to ensure the results of re-checks are available in time to allow the final CAO offers to take those re-check results into consideration in the allocation of places. I appeal to the Minister to ensure the students who have been treated so unjustly by our system are accommodated this year.

The letter sent to the students concerned from University College Dublin advising that the course was fully subscribed, also stated:

Although students are not usually permitted to defer and attend another third level institution in the intervening year, in your circumstances this would be permitted. We have also been instructed that choosing this option of deferral will have no bearing on any current entitlement to ‘free fees' with respect to next year.

As a result 16 students are allowed into a course which is not of their first choice and which must be extremely costly to the State with the knock-on effect this will have in the following year. I appeal to the Minister to ask the Higher Education Authority to conclude its report immediately to allow places to be found this year for the students who so richly deserve them.

Minister of State at the Department of the Environment, Heritage and Local Government (Mr. B. O’Keeffe)

I thank the Deputy for raising this pertinent and important matter on the Adjournment. Each year leaving certificate students submit applications to the Central Applications Office for admission to courses of third level education. The principal object of the CAO is to process these applications for admission to courses.

The function of admission or rejection of applicants to institutions remains the strict preserve of the participating institutions. Neither the CAO nor the Department of Education and Science has any involvement in this process in line with the autonomy of the universities in this regard under the provisions of the Universities Act 1997.

Following the issuing of the results of the leaving certificate examination in August, students are offered places on college courses on the basis of the provisional grades achieved by them. The State Examinations Commission is responsible for the development, assessment, accreditation and certification of the second-level examinations, namely, the junior certificate and the leaving certificate. This is a non-departmental public body under the aegis of the Department of Education and Science. On 17 August 2005 the State Examinations Commission issued almost 375,000 provisional leaving certificate grades, marked by some 3,000 examiners, to in excess of 57,000 candidates.

The objective of the State Examinations Commission is to ensure the processing of results is as free from error as possible. Recognising the inevitable problems which can arise in a system of this size, a transparent, easily accessible and effective appeals process is available to all candidates unhappy with their results.

As a first step, candidates, on receipt of their results, are given the facility of viewing their marked scripts to see how the marking schemes were applied in their case. This year the viewing of marked scripts occurred on 2 and 3 September. The appeals system involves a full re-marking of papers by sometimes up to three examiners. The closing date for the receipt of appeal applications this year was 7 September. The results of the appeals issued on 12 October, some five weeks later, during which time the physical re-marking of the appeal scripts took place. During this limited timeframe, examination scripts had to be retrieved from schools, distributed to examiners, fully re-marked by appeal examiners, monitored in at least 20% of cases by appeal advisers and returned to the State Examinations Commission for results processing.

The relationship between the examinations system and entry to third level education is largely beyond the control of the State Examinations Commission. As I have said, offers of third level places are made by the CAO on the basis of the provisional results issued in August. There are good reasons for this. To delay offering places until the appeals process was completed would impact upon the start date for the academic year and as a result disadvantage the overwhelming majority of candidates whose provisional results are their final results.

The State Examinations Commission makes every effort to process the results of appeals as quickly as possible to facilitate the college entry process. This is balanced with the need to allow the appeal examiners sufficient time to carry out a thorough re-marking of candidates' work.

I understand that more than 80 students in total who applied to UCD this year received leaving certificate upgrades. More than 60 of these students have now been offered places on the basis of their upgraded results. An unprecedented number of students, 16 in total, were entitled to places in medicine at UCD this year as a consequence of leaving certificate upgrades. This has presented logistical and capacity issues for the university which cannot at this stage accommodate an additional 16 students on year one of the six-year medicine programme. In previous years it has been possible to accommodate additional students as the numbers have been much smaller, usually fewer than five.

UCD has now contacted all medicine upgrades to notify them that it is its intention that they will be offered a place in the first year of the accelerated five-year medicine programme in 2006. Most of the students are in the first year of a science related programme, so it is not envisaged that there will be any difficulty with this transition. A small number of students are not studying science related programmes and UCD is looking into mechanisms whereby their entry into the first year of the five-year programme may be facilitated.

In normal circumstances, all of these 16 students would have been entering a six-year programme this year. The alternative option of entry to the five-year programme next year ensures that they will not lose out in terms of the length of time to graduation. It is also the case that, on an exceptional basis, the eligibility of these students under the free fees scheme will not be affected as a result of the necessary transfer of programmes next year.

I thank the Deputy for providing this opportunity to clarify the position relating to the 16 upgraded applicants for medicine in UCD. It has been the normal practice of universities and institutes of technology to make every effort to accommodate students affected in this way. The Minister is satisfied that UCD has dealt sympathetically with the students involved having regard to the logistical difficulties they faced in these particular circumstances.

Water and Sewerage Schemes.

Mr. Neville

I thank the Ceann Comhairle for the opportunity to raise the issue of the provision of a sewerage scheme for Shanagolden village in County Limerick. Shanagolden is situated in the western part of the county, west of Askeaton. It is a very old town dating back to ancient Christian times and has a great heart. However, it is prevented from developing because its sewerage scheme needs updating.

Shanagolden is in an area of great population decline where the exit from farming or the transfer to part-time farming has been very pronounced. There is a great need for an injection of economic activity into the area. The construction of a new sewerage scheme would ensure this injection. People have proposed developments for Shanagolden. A year and a half ago, one person proposed a €19 million private housing development for the village but it could not proceed because of the lack of the sewerage scheme. A local person proposed 12 apartments for the village but that could not proceed because of the same lack.

Last April, during a discussion at an area committee meeting of Limerick County Council, the assistant county manager pointed out that the council owns lands in Shanagolden in excess of its needs. The council was approached by a developer who wanted to purchase some of this land to build private housing, but because the sewerage scheme was not in place, this could not proceed.

If the Government were to respond to this issue, the entrepreneurs who see potential for development in Shanagolden would come into the village, develop it and bring new people to an area in decline. Shanagolden is twinned with Foynes, where there has been flooding and many sewerage difficulties, and the provision of a new sewerage scheme for Shanagolden would also overcome the difficulties in Foynes.

The Government is obstructing the opportunity for the village to develop. That opportunity may not be around forever. It may not be around next year or in five years' time. We have no indication, other than at election time, that anything will happen with regard to the sewerage scheme. The same applies to other areas such as Askeaton, Glin, Athea, Drumcolligher, Adare, Bruff and other areas where there is an opportunity for villages and towns to develop, yet they are denied that opportunity.

All the development is around the city of Limerick. We have no problem with that but in the rural areas we want to take the opportunity, while development plans are available, to bring them to those areas. In Limerick, villages are being downgraded to rural areas. Villages accepted as such under previous country development plans are now designated as rural areas. For development purposes, they are no longer designated as villages. We are asking the Minister to give us the opportunity, by way of funding, to develop those villages. In this instance, because the opportunity of development in Shanagolden is staring us in the face, we ask that it be facilitated.

I am also concerned that many of the parliamentary questions I table get responses related to matters that need to be attended to by Limerick County Council. I have discussed this with the council and its representatives tell me that much of the information required merely involves nit-picking. It is information which could be given over the phone and followed up on very quickly. This is merely an excuse to delay answering the question in this House. We ask the Minister of State to facilitate the growth of this village.

Mr. B. O’Keeffe

I thank the Deputy for raising this issue and I am glad to have the opportunity to give an update on the scheme.

My Department's water services investment programme for 2004 to 2006 was published in May 2004 and includes funding for more than 20 water and sewerage schemes throughout County Limerick. Towns and villages including Adare, Patrickswell, Athea, Askeaton, Foynes, Glin and Kilmallock can look forward to new or upgraded sewerage schemes.

Mr. Neville

When?

Mr. B. O’Keeffe

Many areas will also benefit from improved water supplies from the major upgrade planned for the Clareville water treatment plant, improvements to the Shannon Estuary water supply scheme and extensions of the County Limerick trunk water mains. In total, almost €143 million is being invested under the water services investment programme in County Limerick.

I am glad to be able to confirm that part of this funding has been set aside for the Shanagolden sewerage scheme. The scheme is being advanced as a grouped project in conjunction with the Athea, Askeaton, and Foynes sewerage schemes and it is also proposed to now include Glin sewerage scheme in this group.

The project is a major infrastructural undertaking that envisages a combination of upgraded, extended and newly built wastewater treatment infrastructure and sewage collection networks as required in each location. It will play a major role in allowing each of these communities to develop their residential and commercial sectors. The scheme has been assigned construction status by my Department in the water services investment programme and the council will be able to prepare contract documents once it has submitted and received approval from my Department for the preliminary report for each of the locations encompassed by the project.

The position with regard to the preliminary reports is that my Department approved Limerick County Council's brief for the appointment of consultants to produce preliminary reports for Askeaton, Athea, Foynes and Shanagolden in 2002. We subsequently authorised the fees for the consultants selected by the council. That would ordinarily have cleared the way for work to start on the preliminary reports. However, later in 2003, the council submitted substantially increased fee proposals based on significantly higher scheme costs.

Approval for a further increase in the consultants' fees was sought in 2004, when it was decided to incorporate the Glin sewerage scheme into the group. It has not been possible for the Department to approve these fee increases, which result from an upward revision in the projected cost of the overall scheme from €17.5 million to €28 million.

Following correspondence and consultations between the council and the Department, further information was requested from the council last month to enable the scheme to move forward. The council has been asked to produce an economic justification for the increased costs along with details of the existing housing and projected future residential development the scheme is intended to service. These additional data are required to allow my Department to determine a preliminary budget for the scheme and to respond to the council's submission on the increased fee proposals.

I assure the Deputy that I have taken note of what he has said about the need to get this project moving and that the council's response will receive urgent consideration in my Department when it comes to hand.

The Dáil adjourned at 9.35 p.m. until 10.30 a.m. on Wednesday, 26 October 2005.