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Dáil Éireann debate -
Tuesday, 15 Nov 2005

Vol. 610 No. 1

Adjournment Debate.

Hospitals Building Programme.

I thank the Leas-Cheann Comhairle for the opportunity to raise the important matter of the future of Kanturk community hospital and the plans of the Department of Health and Children and the Health Service Executive. I will outline the current position on the planned extension to the hospital.

This proposed extension has been on the cards for quite a long time. Kanturk community hospital, like many other community hospitals throughout the country, serves a wide area including Duhallow. It has served as a community hospital for the past number of years. The care and expertise provided are second to none. The matron and staff of the hospital are doing excellent work for the elderly of the region. As we move into the 21st century, facilities such as Kanturk community hospital are needed more. The proposed extension to the hospital has been mooted by the Department of Health and Children and the old Southern Health Board for many years. There is a great need for extra beds and facilities for the hospital and the wider community. Private nursing homes which have been opened over the past five or six years are now at full capacity. The extension to the hospital has been promised for the past four or five years but has not materialised.

The Department and the HSE southern area will say there has been a vast improvement and refurbishment of the community hospital and I am delighted to acknowledge the upgrading of the outdated facilities. However, further beds are needed in the hospital. Each community needs a vibrant hospital to cater for its needs but community hospitals did not receive priority funding in the past. The Kanturk facility needs priority funding and extra beds.

I ask the Minister of State to outline to the House the Department's policy. Many people who have recourse to this hospital and many other community hospitals throughout the region,are full of praise for them. I ask the Minister of State to outline the action that will be taken with regard to St. Patrick's community hospital in Kanturk.

I thank Deputy Michael Moynihan for raising this matter. I am making this reply on behalf of the Tánaiste and Minister for Health and Children.

Under the former Southern Health Board's strategy for older people, Aging with Confidence, which was published in 1999, a need for 18 additional beds for Kanturk hospital was identified. Funding was applied for under the NDP indicative funding for services for older people for the period 2000-06.

A draft design brief for the project was prepared by the HSE southern area, the former Southern Health Board, and was forwarded to the Department of Health and Children in September 2002. Approval was sought for the appointment of a design team for the project whose first task will be to identify the optimum location for the new accommodation and the feasibility of integrating it with the existing building.

A further request for approval to commence the process of selecting a design team with a view to progressing to stage two design was again submitted in March 2004.

The HSE is continuing to establish which projects can be progressed, taking account of existing commitments and overall funding resources available and having regard to the additional revenue funding and staffing which will be required for any development and in the light of the HSE's overall capital funding priorities.

Hospital Staffing.

I wish to share time with Deputy Moynihan-Cronin.

Yesterday I attended a protest meeting outside Kerry General Hospital at which 40 GPs took the serious step of picketing the hospital in support of the staff of the hospital as well as to show their frustration at the lack of proper services available and the lack of funding to deliver those services.

Kerry General Hospital has the same number of medical staff as 20 years ago, despite the fact it is catering for a far bigger catchment area. The hospital caters for all of County Kerry, parts of west Limerick and parts of west Cork.

Last week I saw at first hand the situation in the accident and emergency department and the strain under which the staff work. I have never seen the nurses, doctors and domestic staff with such low morale as a result of the pressure under which they work and the lack of concern at Government level to provide funding for services.

I will cite a number of recent problems at the hospital: the transfer of the medical manager; the resignation of the financial controller; the non-replacement of the third in charge in the maternity unit; the second in charge is out sick; accident and emergency consultant, Mr. Seán O'Rourke, has threatened to resign; and accident and emergency porters have not received training in the application of plaster of Paris because of lack of funds to pay for the course. Such training would alleviate pressure on the nurses in the accident and emergency department.

The hospital was criticised in the recent hygiene report. What the report failed to recognise was that the cleaning of the wards is carried out for five and a half hours per day, six days a week with a skeleton crew working on Sundays. When that cleaning is completed, there is no follow-up service and two or three hours later, the whole hospital may often need to be recleaned.

There is a proposal for contract cleaning tenders and a further cutting of the cleaning hours and an increase in the work involved. No funding has been provided for Kerry General Hospital despite criticism in the hygiene report and a lack of adequate services for the catchment area.

I have asked the Minister on numerous occasions to go to the hospital to see for herself. I ask her again to make herself available to see the situation on the ground. What is more frustrating for those of us who are elected representatives from County Kerry is that the hospital services, the entire constituency and County Kerry has a Minister at the Cabinet table yet we do not have the funding for services forthcoming from Cabinet.

I ask the Minister of State to take on board all the points I have made. This issue is raised time and again by the elected representatives but nothing seems to be happening. I hope the Minister of State will address it in his reply.

I thank Deputy Ferris for allowing me one minute of his time. I appreciate it because I want to add my voice to the concerns raised by the people in County Kerry about the victimisation we are experiencing in funding for the Kerry General Hospital.

Some 40 general practitioners left their surgeries yesterday to picket a hospital. They were not looking for anything for themselves. They were not looking for a pay rise. They were looking for fair play for patients. That is all they were looking for.

The former Minister for Health and Children, Deputy Martin, is in the House and I must put some of the blame at his door. When he was Minister for Health and Children they kept pumping money into Cork Regional Hospital and kept ignoring Kerry.

The perception, which is being stated around north Kerry and Tralee by Government supporters, is that the reason we are not getting the funding for Tralee general hospital is there is no Minister in north Kerry. This hospital covers the whole of County Kerry. There is a senior Minister in the county and I have not heard one word from him.

As I have, Deputy Ferris has invited the Tánaiste and Minister for Health and Children, Deputy Harney, to visit the hospital in Tralee. I doubt our Minister in south Kerry would even know the way there. I do not know whether he has visited the hospital in Tralee to see the position.

I met the accident and emergency consultant last year. At that stage he was outlining the difficulties he was experiencing and nobody was listening. The Opposition Deputies in the county are working as a unit on this and they have raised the matter repeatedly.

Who will take responsibility for Tralee general hospital? The position is serious. Nobody wants to take responsibility but the Government must. The Tánaiste and Minister for Health and Children, Deputy Harney, must take responsibility for the neglect. The Government representatives and the Tánaiste should be ashamed of themselves for allowing the current situation to continue in Kerry General Hospital.

I am replying on behalf of the Tánaiste and Minister for Health and Children, Deputy Harney. My colleague, the former Minister for Health and Children, Deputy Martin, initiated the first doctors' co-operative in the country in County Kerry for general practitioners, which was a marvellous development.

The GPs are looking for nothing for themselves. It is the hospital, not SouthDoc, that is the problem. SouthDoc is fine, up to a point.

However, the burden of the Deputy's complaint was that Cork was being preferred to Kerry and I am simply pointing out——

I meant the money invested in the hospital.

I am simply referring to the Minister's record in that regard.

Not for the hospital.

On taking responsibility, there is clear responsibility now on the health services in the funding for a hospital of this character. It rests with the Health Service Executive,——

He fobs it off on someone else. He was there for the past ten years and he did not give a damn.

——as Deputies are well aware. That is their responsibility. It includes responsibility for the funding and the operation of services at Kerry General Hospital. Professor Drumm, as chief executive, is heading up the Health Service Executive and he is also a medically qualified individual. No doubt he would be interested to entertain representations from the doctors in question.

I understand that recently the newly appointed hospital network manager met the executive management board of Kerry General Hospital to discuss priority issues for the hospital in 2006. The development of cardiology services at the hospital is a priority. Hospital management has prioritised the appointment of a full-time cardiologist at Kerry General Hospital and the application for the post is being considered at present by the National Hospitals Office.

Discussions are ongoing regarding the re-organisation of appropriate staffing levels in the accident and emergency department. The HSE in the southern area has also confirmed that there is no change in the status of the accident and emergency consultant in the terms of his employment at Kerry General Hospital.

The HSE and hospital management are making themselves available to discuss matters of concern raised by local general practitioners recently. It is also proposed to establish a general practitioner liaison group with the hospital which will include consultant medical staff, hospital management, general practitioners and a representative from community services in the HSE. If general practitioners are concerned, certainly the door is open at the HSE and with hospital management to discuss these concerns.

A number of developments are being planned for the hospital, including a new emergency department and ambulatory care unit. The design brief for these developments has already been finalised and a notice for the appointment of the design team was posted in the EU Journal earlier this month. The construction of the palliative care day unit has commenced on the grounds of the hospital.

The Tánaiste and Minister for Health and Children, Deputy Harney, is confident that the Health Service Executive will continue to develop the services provided at Kerry General Hospital in Tralee to ensure the delivery of high quality services to the people of County Kerry and those from the surrounding areas who depend on that hospital service.

Trade Union Representation.

I am pleased to have the opportunity of raising an outrageous abuse of a European directive and competition law for little less than the removal of the right to collective bargaining of some of the most vulnerable workers in the State. I am in a position to know about this for many reasons. I should state immediately that my wife is a member of Irish Equity. She has been for many years and remains so. I have the privilege of knowing many members of Irish Equity, members of the Musicians Union of Ireland and others who have been precluded from negotiating with the people to whom they sell their services as employees by way of collective bargaining.

The issue is simply this. The members involved — artists, musicians, singers and people who work in the film industries — are often vulnerable workers because of the nature of the work of the film and music industries and of the work of those hired to make, for example, voiceovers and advertisements. I refer the Minister to the report by the Arts Council on artists' incomes to see the income of the average actor in this State.

Last year Irish Equity was forced to sign an undertaking that the union would not negotiate fees for actors working on commercials for private companies. The result of this is that these actors have suffered serious wage cuts and are denied the right to have unions make representations on their behalf or negotiate collective agreements. The issue facing the Minister is as follows. How can an EU directive on competition be implemented in such a way that it undermines a right that Irish workers have had since 1901? I was a Minister in this area.

Many of these people are humiliated when dealing with social welfare in that when they state their occupation, the question asked is whether they are really looking for work when work is available in hotels and restaurants, even though they are actors, writers, etc. The position has not improved. Many face retirement without pensions.

The Competition Authority, which has had great successes against vulnerable and easy targets like the credit union movement and pet food for chihuahuas, regards each individual artist as a company selling his or her services. This is outrageous and must be redressed. We need a restatement of the 1990 representation Act, which redefined the rights of workers in the categories to which I refer, so that they might be properly represented. We also need to face down the Competition Authority's abuse of a reasonable principle of competition.

What does it mean practically? The National Union of Journalists cannot publish a fees guide for its freelance photographers and reporters. Except where named musicians are being engaged, the musicians' union is prohibited from telling its members what is the going rate for a performance. Irish Equity is prevented from negotiating with advertising companies, even those which want to negotiate a performance rate for the union.

Who has asked for this? Many of the people who organise concerts and events are perfectly happy to negotiate a going rate because it is more transparent and efficient. In addition, I listened to the Minister for Enterprise, Trade and Employment, Deputy Martin, on the previous matter on Private Members' business. How can this bring a benefit to the consumer when those areas, some of them heavily monopolised, are precisely those which whipped the benefits, which they had effectively taken off the most vulnerable part-time workers, into their own pockets? It is yet another outrageous extension driven ideologically against the weakest part of the labour force. Will the Minister take such action as is necessary, either under the 1990 Act or with the Competition Authority, to stop it before it spreads further? I dealt with these workers and I am aware of the efficiency and transparency of film agreements with trade unions.

The Minister spoke about the relationship between the Competition Authority and other bodies, including, for example, the Broadcasting Commission of Ireland. How can the arrangement be reasonable? The Minister has signed up to and accepted an international obligation on the fundamental freedoms and rights of workers, and the right to be represented collectively. More accurately, the Irish people have done so through the International Labour Organisation. How can an ideological shaft at the weakest workers, to whom we have never given proper recognition through social welfare, pensions or income, be permitted? Each individual actor, musician, writer and photographer is defined as a business and not a worker. This is an outrageous violation of the International Labour Organisation convention. It will be subject to an Irish and European campaign to have it redressed.

I understand this matter relates to an investigation conducted by the Competition Authority from March 2003 to June 2004 regarding possible price fixing among self-employed actors and advertising agencies. An agreement between Irish Actors Equity SIPTU, on behalf of the actors, and the Institute of Advertising Practitioners in Ireland, on behalf of advertising agencies, provided for both specific fees for services rendered and various other terms and conditions. Following the authority's investigation, Irish Actors Equity and the institute signed undertakings in which they agreed not to fix fees and to comply with the provisions of the Competition Act.

In August 2004 the Competition Authority published a decision note explaining its decision and published the acknowledgement and undertakings made to it by both Irish Actors Equity SIPTU and the Institute of Advertising Practitioners in Ireland. The authority's findings centred on the fact that section 4 of the Competition Act prohibits anti-competitive agreements, decisions and concerted practices. Section 4 applies when "undertakings" are engaged in arrangements which have as their object or effect the prevention, restriction or distortion of competition in trade in any goods or services in the State.

Section 3 of the Act defines an "undertaking" as "a person being an individual, a body corporate or an unincorporated body of persons engaged for gain in the production, supply or distribution of goods or the provision of a service". This definition has been in use in Irish competition law for some time and is supported by EU case law. To establish a breach of section 4 of the Act, the authority must demonstrate that there is an agreement, decision or concerted practice; that the parties to that agreement, decision or concerted practice are undertakings; and that the object or effect of the agreement, decision or concerted practice is to prevent, restrict or distort competition.

In this case, I understand that the parties did not dispute the existence of an agreement. The agreement was contained in a document entitled 2002 Agreement on Minimum Fees Effective from 1 October 2002. The institute did not contest that it was an association of undertakings and that its members were undertakings in their own right. The issue the authority then considered was whether actors were "undertakings" and whether Irish Actors Equity was an "association of undertakings" for the purposes of the Act.

It is not an association of undertakings. Those concerned are human beings.

Put in layperson's terms, it was a question of whether the actors in question were self-employed independent contractors, who are subject to the Act, or employees, who are generally not subject to the Act. The authority considered this issue to be particularly important in this case where the trade union has both employed persons and self-employed independent contractors as members. The authority stated in its decision that while it was perfectly legal for a trade union to represent employees in collective bargaining with their employers, its trade union mantle could not exempt its conduct when it acts as a trade association for self-employed contractors.

The authority also stated that if one were to take a wooden approach and find that all trade union members were exempt from the Act, the protections afforded to consumers by the Oireachtas in the Competition Act could easily be bypassed in that associations of independent pharmacists, publicans and barristers, to name but a few, could obtain safe haven for their members by adding "union" to their name and obtaining a negotiating licence.

That is in contravention of the convention.

On the question of whether actors are "undertakings" within the meaning of the Competition Act, I understand that, as a starting point, the Competition Authority considered whether the Revenue Commissioners treated actors as employees subject to PAYE or as independent contractors. The authority's investigation revealed that the vast majority of actors in the State are not treated as PAYE employees. It also considered other factors, such as the following——

Because they do not have continuity of employment.

Actors providing advertising services generally are not obliged to work for a single advertising agency — they may work for several at the same time. Such actors generally do not receive the benefits one usually associates with a contract of employment. For example, they generally do not receive holiday pay, health insurance, maternity leave etc.

So they can be blackguarded even further.

Such actors do not generally have employment security. They are free to accept or decline specific work as they see fit. Actors are not generally thought of as employees of a particular agency. In light of these factors, the Competition Authority took the view that actors are independent contractors and therefore are "undertakings" subject to the Competition Act. However, the authority also said there may be some actors who have genuine contracts of service and who are therefore employees, as is the case with some musicians. However, its investigation revealed that the vast majority of actors providing advertising services under the agreement that it examined were independent contractors and therefore undertakings. Having found the actors to be undertakings, it followed that Irish Actors Equity in this case was an association of undertakings and subject to the Competition Act.

The Competition Authority may enforce competition law by seeking appropriate civil remedy in the High Court or by recommending the prosecution of a criminal action by the Director of Public Prosecutions. Generally, the authority pursues a criminal prosecution only where there is clear evidence that parties are in breach of the more serious "hard-core" provisions of the Act.

Although the authority's investigation revealed an element of price-fixing, it elected, in this instance, to pursue civil relief. However, prior to the commencement of proceedings, the parties expressed their willingness to address the authority's competition concerns and signed undertakings. These undertakings are appended to the authority's decision, which is published on its website. The authority also acknowledges the right of Irish Actors Equity to represent employed actors in collective bargaining with employers.

I understand the view expressed by the authority was in respect of this particular case only as it is the courts alone that can interpret the law.

So casual workers are businesses.

The parties to the investigation do not appear to have taken issue with the authority's view——

They are doing so now.

——as they entered into undertakings with the authority in settlement of the case, thereby avoiding the need to go to court.

I emphasise that the Competition Authority is an independent statutory agency set up by this House for the enforcement of competition law.

It is an outrageous, philistine, anti-democratic decision.

In general, I do not consider that it would be appropriate, or good practice, to interfere in the performance by the authority of its statutory functions, which this House has bestowed upon it.

Road Network.

I raise this issue as it is hard to over-estimate its importance to the town of Tullamore and County Offaly in general. The issue concerns the Tullamore bypass and the fact that after the much-heralded launch of Transport 21, the bypass was not included in the list of works to commence. Of equal concern is that projects to be carried out after 2010 must be subject to NRA approval. Effectively, the Government, in its remit of deciding policy, decided that the routes out of Dublin were a priority but did not deem a bypass for Tullamore important enough to merit a mention or a commencement date.

A bypass for Tullamore was first mooted 25 years ago. In 2001 detailed plans were drawn up in this regard. I was a member of Offaly County Council in that year and noted that hard decisions were taken on route selection. A route was chosen and the matter progressed to oral hearings and confirmation. At a recent meeting, Tullamore Town Council was informed that work might not start until 2009. The announcement of Transport 21 has lead to fears that the date might be delayed even further. The NRA has since said that no decision has been taken on a starting date for the bypass. It is prioritising the national primary routes and has said it will examine the rest of the network afterwards. I can only question the Minister on the reason for this unacceptable delay.

Tullamore is in a relatively central position and is but a few kilometres from the N6. It is vital to have a proper dual carriageway connection from the new M6 to the bypass. It will link the new M6 to the M7 and M8 when they are completed and will serve as a connecting route for various national secondary roads.

Tullamore is a designated national hub under the national spatial strategy, in addition to Athlone and Mullingar. It is the capital of County Offaly and is literally choking with the traffic passing through. At 5.15 p.m. last Friday, AA Roadwatch announced that traffic was crawling in Tullamore. That is only the beginning of the supposed rush hour, yet traffic was crawling. Even larger urban areas in the country were not in such a state so early on Friday evening.

Tullamore is a vibrant town and is anxious to attract new industry, grow and prosper, but Government inaction is standing in the way. The Minister will be aware of the importance of having proper routes to a town if industry is to be attracted. A bypass is the most vital infrastructure required by Tullamore. Edenderry and Birr are also awaiting bypasses. What hope have they if the Minister does not move on this one?

Complaints about the delay are coming not only from local people who are desperately frustrated at the delays and the havoc they wreak in their daily lives, unnecessary delays also occur on the school journey, travelling into town for groceries or business and transporting and delivering goods. Complaints are also coming from people who travel through the town from other counties, which is a particular concern for the future of the hub under the national spatial strategy. It is now 25 years since the first mention of a bypass, yet we are told about topographical, geographical and archaeological surveys and the preparation of contract documents. I accept that the process must be undertaken properly but members of Tullamore Town Council have repeatedly highlighted this issue. I join them in recommending that the road, when it is built, should be upgraded to a dual carriageway.

It is a design and build project, with the design being undertaken by contractors. Surely this can begin and the entire process, including the surveys, can be undertaken by the team that will undertake the design and build. I do not know why this cannot be done. Offaly County Council claims that the bypass could begin in 2007, if there are no delays. "Could" is not good enough. The people of Tullamore and Offaly deserve better. They need a definite date and want to know when real funding, not the pittance given so far, will become available.

The Minister for Enterprise, Trade and Employment will reply on behalf of the Minister for Transport. I ask him to ask the Minister for Transport to meet Offaly County Council, Tullamore Town Council and Tullamore Chamber of Commerce. There is no more important issue facing the county at this time. The fear that Tullamore will be left behind is a genuine concern of mine as a public representative but also of the people of the town and county. If we do not move on this matter without delay, Tullamore will be left behind.

I am pleased to have the opportunity on behalf of the Minister for Transport, Deputy Cullen, to respond to Deputy Enright on this matter. The Minister for Finance keeps a watching brief on matters pertaining to Tullamore and the midlands generally.

It will take more than watchfulness.

He is very active in the context of developing the country and ensuring a central role for the midlands in that overall national development. There is no prospect of Tullamore being left behind given the presence of the Minister, Deputy Cowen, at the Cabinet table in such a pivotal position as Minister for Finance.

There are genuine concerns.

In the past 11 months the Department of Transport has developed the most detailed national transport plan ever devised in this country. Transport 21 will give Ireland a first class transport system that, on a national level, connects all regions to each other and to our main seaports and airports and, in the cities, will provide greatly enhanced public transport alternatives to the private car.

Transport 21 has been specifically developed with a view to supporting the Government's national spatial strategy 2002-20, the purpose of which is to promote more balanced regional development. In this regard the Deputy will be aware that the strategic approach of the national spatial strategy is to improve access to the wide range of attractions in the midlands so that, through the integrated network of towns, it will possess the advantages of a dynamic region containing a large city. This is being achieved by the development of Athlone, Mullingar and Tullamore as a linked gateway, using their complementary capabilities.

Athlone and Mullingar have bypasses.

With regard to roads, the midlands generally and the linked gateway of Tullamore, Athlone and Mullingar have already benefited from the major investment in the upgrade of the national roads programme in recent years. The upgrade of the N7 through the bypassing of Kildare, Monasterevin and Portlaoise has improved access to and from the midlands. Access will be further improved when the Kilcock-Kinnegad project on the N4 opens to traffic shortly and phase one of the upgrade of the Kinnegad-Athlone section of the N6 is completed in 2007.

Transport 21 also makes provision for the targeted improvement of a number of national secondary routes that are particularly important for regional development. These include the N52 from Dundalk to Nenagh via Tullamore and the N80 from Moate to Enniscorthy via Tullamore, both key cross-country routes linking corridors identified by the national spatial strategy. These improvement works will include the construction of a bypass of Tullamore. I understand from the National Roads Authority that An Bord Pleanála approved this scheme in June 2005 and that work has commenced on the preparation of contract documents. The further development of this project is a matter for the NRA having regard to the funding available for the national roads programme and other priorities on the programme.

No date is given.

With regard to rail, Tullamore has benefited from investment in the railway network under the national development plan by virtue of its location on both the Dublin-Galway and Dublin-Westport intercity rail lines. Combined with the fixed infrastructure renewal work already completed or under way, Transport 21 will provide for 120 intercity rail cars to be deployed on the mainline rail network between now and 2008. This will deliver significant benefits to Tullamore passengers in terms of an increased service frequency and a reduction in journey times on the Galway and Westport routes. Dublin-Galway services will move to an hourly frequency during peak hours and a two-hourly frequency off-peak, while the Westport route will also see frequency improvements in each direction.

Under Transport 21 Tullamore will also benefit from the improved rail connectivity with the west that will result from the development of the western rail corridor under Transport 21. Tullamore to Ennis and Limerick by rail will be possible from the end of 2008 when the Athenry to Ennis section of the western rail corridor is due to be completed under Transport 21.

Transport 21 also includes significant funding for the development of provincial bus services, including the upgrading of regional and local bus services. In addition rural areas of the country can expect to benefit from the decision to put the rural transport initiative on a permanent footing from 2007 and to increase significantly the cash funding for this successful and innovative programme.

The Dáil adjourned at 9.05 p.m. until 10.30 a.m. on Wednesday, 16 November 2005.
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