Dáil Éireann debate -
Tuesday, 21 Feb 2006

Vol. 615 No. 1

Adjournment Debate.

Hospital Accommodation.

Ms B. Moynihan-Cronin

I thank the Leas-Cheann Comhairle for the opportunity to raise an important issue, namely, the ongoing delay in the provision of a long-promised 14-bed extension to Kenmare Community Hospital in County Kerry. Sadly this is not the first occasion on which I have had to bring this matter to the House.

The development of an extension to Kenmare Community Hospital was included in the then Southern Health Board's proposals under the National Development Plan 2001-2006. We have arrived at the year 2006 and the proposals for the speedy completion of this project are remote at best. This extension was promised by the Government under the National Development Plan 2001-2006. I have a press release from the then Southern Health Board dated 3 June 2000 hailing "major development". Included in its new programme of work the extension to Kenmare Community Hospital was costed at £2 million. The Health Service Executive submitted the draft accommodation brief for the extension to the Department of Health and Children in February 2003 and requested approval for the appointment of a design team for the project. Why has that request been gathering dust in the Department of Health and Children for three years?

The last reply I received to a parliamentary question from the Tánaiste and Minister for Health and Children, Deputy Harney, was evasive, to say the least. It seems the entire project has stalled because of the review of the national development plan and the projects under its umbrella. In her reply the Tánaiste advised me that it was not possible to say with any certainty how quickly the project would progress through the planning and construction approval stages.

This is unacceptable to me and to the people of the greater Kenmare area. Why is it not possible to say when the hospital extension will proceed? The provision of the 14-bed extension to Kenmare Community Hospital is badly needed. The population of Kenmare has risen by more than 30% since 1996. Many retired and elderly people have settled in the area and the demand for additional beds in the community hospital is growing. The hospital serves a huge area, including Sneem, Castlecove, Laragh, Tuosist, Kilgarvan, Blackwater and the Black Valley. If the Minister knew the geography of that area, he would realise the huge area it includes. The population of this area deserves and demands better than evasive and non-committal answers from the Government.

I want to know what is going on. A 14-bed extension should not require intensive planning and resourcing. As I said, in 2000 the then Southern Health Board estimated the cost at just £2 million. Now, six years on, there is no sign of the extension, only delay after delay in advancing the project. I hope the Minister of State will advise me and the people of Kenmare what the delay is and what is happening. I do not want a scripted answer. I want the Minster of State to tell me and the people of the Kenmare area when they will see the extension to their local hospital. I also want a commitment to put on the record of this House when the funding will be in place to make the extension possible and to remove any obstacles and delays. There are obstacles and delays and the people of Kenmare and I deserve to know that they are.

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

I am delighted to have the opportunity to answer this question on behalf of my colleague the Tánaiste and Minister for Health and Children. It is the Department's policy to maintain older people in dignity and independence at home in accordance with their wishes, and at the same time to provide high quality residential care for older people when living at home is no longer possible. The Government's commitment to the development of a comprehensive range of services for older people has been clearly demonstrated by the significantly increased resources made available in recent years. From 1997 to 2005, inclusive, additional spending on health care services was in excess of €302 million. In the budget package announced for 2006, additional revenue funding of €150 million in full year costs was allocated for services for older people, that is, €110 million in 2006 and a further €40 million in 2007.

The prioritisation of all health capital developments is a matter for the Health Service Executive, HSE, under the Health Act 2004. The HSE has advised that the provision of a 14-bed extension to Kenmare Community Hospital has been considered for inclusion in its multi-annual capital programme for the period 2006 to 2010. The Kenmare project involves the re-planning of the existing accommodation and the addition of new accommodation to provide an integrated 40-bed hospital to meet present day standards of care. The HSE has completed a draft accommodation brief for the enlargement of the hospital from 26 beds to 40.

The HSE has confirmed that this project will not commence in 2006. This is owing to competing demands for capital funding, including other significant capital projects in the Kerry area, which will require investment in 2006. However, the HSE has advised that the capital programme will be reviewed and reprioritised annually. Depending on available resources and the progress of other projects, proposed developments such as the extension to Kenmare Community Hospital will be reconsidered by the HSE for inclusion in its revised future capital programme.

State Property.

Mr. McGuinness

I appreciate the matter I am about to raise is at an early stage in the context of its proposal relative to the sale of land in the ownership of the HSE. I know that throughout the country a considerable amount of land is available through the former health boards and now in the ownership of the HSE. As Vice Chairman of the Committee of Public Accounts, I recognise the opportunity to raise funds from the sale of these lands to reinvest in the health services.

Yesterday I sent an open letter to the chief executive of the HSE, Professor Brendan Drumm, and to the county manager of Kilkenny County Council regarding a site in Kilkenny at St. Canice's Hospital. I have asked that the widest consultation possible be engaged in on the issue of the site and that the consultation involve all the stakeholders in Kilkenny, the HSE, the local authority and the public. The site is important to Kilkenny city and there are many demands in the city and county for services such as an Alzheimer's unit, care for the elderly, which was mentioned in the Minister of State's previous reply, and services for those with autism. There are other issues relevant to the community such as the Butler Gallery, controlled private housing and the fact that because this site, which is almost central to the city, backs on to the River Nore, there is a possibility of private investment and a controlled private housing development. There is also a possibility of a public park. A wide range of activities and development could take place on that site. It is an unprecedented opportunity for Kilkenny to develop a site of this size.

I do not want it sold to the highest bidder. I do not want developers to come in and put in blocks and rows of houses. We need a radical approach that will realise the dreams of some on the services they provide for patients in Kilkenny. The funds from the sale of various pieces of the land should be invested in providing services directly to patients. There is an issue as regards the pitch and putt club, which forms part of that land. If the whole process is allowed to go too far there will be little room for consultation or debate and we will end up with another site that has high density housing, with very little regard for the civic and public interest in Kilkenny.

This is a unique opportunity. It is not one where we should seek the last euro from the developer, thus forcing him to opt for the highest possible density so that the profit bottom line may be upheld. The HSE should give a lead in this area. It should proactively involve the local authority. With the local authority it should set up some public forum. It should devise a plan relative to the community gain and the services that are needed. Arising from that, it should enter into the controlled sale and development of that enormous site. This is about the citizens of Kilkenny demanding that space be found for services, amenities and recreation that children and senior citizens' need.

In his last reply the Minister of State mentioned care of the elderly. That is one aspect of this development in which I am keenly interested. The HSE has invested in a care for the elderly unit — I believe the Minister of State was in it some time ago. It is time to extend that to a long-stay care unit for those in the community who are elderly and need that type of care now. We have a deficit as regards beds in that area. There is a heavy demand on the beds in Thomastown and Castlecomer. There are few if any beds in Kilkenny city for care of the elderly. Now that this opportunity has been presented, we should give the lead in this area. I urge the Minister of State to take the brave step and consult the local county manager, Kilkenny County Council, Kilkenny Borough Council and the other stakeholders in this area to make this plan a reality.

Mr. T. O’Malley

I thank Deputy Mc Guinness for raising this matter and assure him that the widest possible consultation will take place. I do not disagree with the comments he made because I am very clear as regards what we intend to do in this regard.

I have been advised by the HSE that all decisions regarding the disposal of lands attached to psychiatric hospitals will be taken in the context of the recommendations contained in the report of the expert group on mental health policy. This report, A Vision for Change, recommended that a plan to bring about the closure of all mental hospitals should be drawn up and implemented. The resources released by these closures should be protected for reinvestment in the mental health service. It also stated that the full economic value of psychiatric hospital buildings and lands should be professionally assessed and realised.

A Vision for Change envisions an active, flexible and community-based mental health service where the need for hospital admission will be greatly reduced. The expert group stated in the report that mental hospitals had been the mainstay of mental health services in Ireland for many years. It stated, however, that the type of person-centred, recovery-orientated care recommended could not be provided in institutions of this size or environment. On that basis, the group recommended that steps be taken to bring about the closure of all the remaining psychiatric hospitals which are a legacy of a bygone age and to reinvest the resources released by these closures in the mental health services.

The closure of large mental hospitals and the move to modern units attached to general hospitals, together with the expansion of community services, has been Government policy since the publication of Planning for the Future in 1984. A number of large psychiatric hospitals have already been closed — Our Lady's in Cork, St. Patrick's in Castlerea, St. Columba's in Sligo, St. Mary's in Castlebar and Our Lady's in Ennis. The reorganisation of services which these closures entailed has resulted in the expansion of community facilities, new acute psychiatric units attached to general hospitals, including St. Luke's Hospital in Kilkenny, and, most importantly, an overall improvement in the delivery of services for the service users, their families and carers. Most of the remaining stand-alone psychiatric hospitals cater in the main for long-stay patients, many of whom are over 65 years of age. I understand that this is also the case at St. Canice's Hospital, Kilkenny, where the majority of patients are cared for in wards for older people.

The report recommends that a plan be drawn up for the phased closure of each of the hospitals. It is recommended that this plan consist of a four-stage process, as follows: stage 1, identify measures required to enable admissions to cease and put these measures in place; stage 2, cease admissions to the hospital and draw up plans for relocation of existing patients; stage 3, implement plans for the relocation of existing patients; and stage 4, final closure of hospital.

It is emphasised that this process should take place on a phased basis, with wards closing sequentially. It also makes clear that the process will require funding for training and upskilling of staff who will subsequently be redeployed to work within the mental health services provided in the community.

The HSE has welcomed the publication of this report and has stated that its national mental health directorate will immediately establish an implementation group to ensure that the recommendations are realised in a timely and co-ordinated manner. The HSE has also emphasised that hospitals can only close when the clinical needs of the remaining patients have been addressed in more appropriate settings.

I assure Deputy McGuinness that the Government is fully committed to the implementation of this report, which has been accepted as the basis for the future development of mental health services. The programme of investment has begun with an additional €25 million allocated to the HSE in the Estimates for 2006 for mental health services and I am confident that this level of investment will continue in the coming years. Significant capital investment will also be required to implement A Vision for Change, estimated by the expert group to be in the order of €796 million, for the provision of new and replacement facilities for the mental health services, and much of this could be realised from the value of existing hospitals and lands.

I reassure the Deputy that I should be delighted to consult him and others in Kilkenny and the other regions where hospitals will be closed. Our priority, obviously, is to ensure that the patients get suitable accommodation, either in the same location or in others. We are mindful of the fact, however, that the lands we have available are health assets and that they will be converted into mental health and other health assets as needed in the community.

Airport Development Projects.

Mr. Allen

I want to give two minutes of the time available to me to Deputy Stanton.

An Leas-Cheann Comhairle

Is that agreed? Agreed.

Mr. Allen

The former Minister for Transport, Deputy Brennan, clearly indicated that the construction costs of the new terminal at Cork Airport would not be a burden on the new Cork Airport Authority. In recent weeks, however, there is much concern that the Government is planning a U-turn on this commitment that could leave Cork Airport saddled with up to a €200 million debt, leaving the new authority with a severe financial burden. Despite these reports, no official explanation has been forthcoming from either the Minister for Transport, Deputy Cullen, or the Taoiseach. We have been informed, however, that a mediator has been appointed by the Minister to deal with this issue even though we have not been given the terms of reference to which he or she will work.

An emergency meeting of the south-west regional authority airport consultative committee was held last Friday to discuss the former Minister's commitment, given in writing in late 2003. That commitment was that Cork Airport would be fully developed and that it would be debt-free. However, the Minister of State, Deputy Batt O'Keeffe, who is in the House this evening, at that meeting claimed that the former Minister for Transport, Deputy Brennan, may have made a mistake in promising that the new airport authority would start its independent operations without debt.

Mr. B. O’Keeffe

I did not, the Deputy should not misquote me. I said there might have been a proviso.

Mr. Allen

This nonsensical defence of a promise made and reneged on is incredible, especially when the Minister of State is suggesting that the former Minister, Deputy Brennan, would have given such a commitment without checking its legal status. Any decision on the future of the debt would have been made at Cabinet level and it seems that another political promise to the people of the southern region is being broken.

Failure to honour the commitments given would seriously inhibit Cork's capacity to develop the airport to its full potential. If this matter is not sorted out, the debt burden on Cork will have the most serious consequences and implications because it is inevitable that the burden will be passed on through increased costs to the carriers and travelling public. If this happens, I fear for the future of the relationship between the airport and the carriers that use the facility. I have been told that as of now, operators are being informed of increased charges and instead of attracting new carriers, operating new routes and offering new services to the public, Cork Airport will find it impossible to hold on to its current business, as a result of which we will lose operators and routes out of Cork. What about the Government's spatial strategy where Cork is identified as one of the main gateways? All we have seen is double dealing. I demand an immediate political decision that will allow Cork Airport to proceed with the development of its business without the burden of a massive debt.

The Minister, Deputy Cullen, should clear the air once and for all on this political issue. Political decisions were made to construct a new terminal at Cork Airport which we all applauded and supported. Political promises were made to the effect that the cost of the new terminal would not have to be borne by the Cork Airport Authority. This political commitment must now be delivered on by the Government.

Mr. Stanton

I thank Deputy Allen for allowing me to share time. I support him and congratulate him on raising this issue. I wish to stress the importance of the airport, not just for the city but for the county and the wider Munster region. I, too, was at the meeting of the South West Regional Authority which was very well attended and where huge concern was expressed about the doubt regarding the debt and the burden it would place on the development and future operation of the airport. I call on the Minister to clarify the situation and to state clearly where the airport stands. It will be very difficult for the airport to format a business plan with this uncertainty hanging over it. Dublin and Shannon airports are way ahead in terms of development. Cork Airport is only catching up at this stage.

I was concerned initially when I heard about the break-up of Aer Rianta as to how future development would be financed because the airport has reached capacity. I do not know how management copes with the small terminal, which it has done up to now. Further development will be required. The area is expanding and it is important for the country as a whole that this happens because it will act as a counter-balance to Dublin. We know the problems Dublin has with traffic congestion and so on. Cork Airport is extremely important to the development of the area.

Promises were made and they should be kept. Cork Airport should be allowed to start debt-free and to move on from there. I am confident that if this were the case it would develop in a positive way in the future but I am worried that if the debt is imposed it would stifle growth and, as Deputy Allen has said, perhaps lead to the airport going into decline. We cannot allow this to happen.

I urge the Minister to clarify the situation about the future of Cork Airport in clear and unambiguous terms.

Minister for Transport (Mr. Cullen)

I thank the Deputies for raising this matter. To be helpful, if they have not done so, I invite them to read the Second Stage speech of the then Minister during the State Airports Act when this issue was set out in great detail. It would be helpful if they did so because nothing has changed since the details were set out in that speech.

The major new airport development project which is currently being completed will effectively deliver a new landside airport to Cork and represent the first major upgrading of all facilities since the airport was built in the late 1950s. The project comprises a new terminal building development and also involves the construction of new multi-storey and surface level car parks, a new fire station, new internal road systems and the upgrading or replacement of all utility services — water, gas, electricity etc.

When completed, the new Cork Airport will have a passenger capacity of 3 million people with the facility to expand to 5 million, when needed. It is important the debate about Cork Airport's future debt should not obscure this major development for the airport. Such facilities will greatly benefit the airport's users but will have to be funded. Cork Airport's future as an independent airport has to take account of a realistic assessment of what is commercially feasible, including the capacity of the airport to contribute to its capital investment programme.

In recognition of these commercial realities, the State Airports Act 2004 provides a framework for an orderly approach to the distribution of the assets of Shannon and Cork airports in conformity with the provisions of the Companies Acts. The Act also addresses business planning issues.

The boards of Cork and Shannon airports are now charged with making preparations to assume responsibility for the ownership and development of the airports. They are also empowered to undertake certain management and operational functions, on an agreed basis with the Dublin Airport Authority, during the interim period.

Under the Act, before any assets can transfer to either the Shannon or Cork airport authorities, the Ministers for Transport and Finance will have to be satisfied as to the financial and operational readiness of the airport authorities. Accordingly, each airport authority is required to prepare a comprehensive business plan and obtain the Ministers' approval for these plans before any assets can be transferred. Such plans would address the funding of capital investment and feed into decisions on determining the mechanisms for allocating airport assets among the three airports.

Cork Airport will benefit greatly from the major investment currently being made in the development of its facilities. The business planning process will provide a basis for determining the most feasible options for carrying through the restructuring. The ability of both Shannon and Cork airports to operate on a fully commercial basis will be fully assessed as part of this process and will be factored into the decisions made.

To clarify a point made by Deputy Allen, I have not appointed anybody. It is not my function to do so. I understand that both the Dublin Airport Authority and Cork Airport have agreed recently to retain an independent consultant to assist them in the finalisation of the Cork Airport business plan. I await the outcome of this work because of its importance in facilitating the development of a dynamic, independent and financially sustainable Cork Airport. The Government objective of airport restructuring must be achieved in a manner which underpins the financial sustainability of all three State airports, which fundamentally includes Cork Airport.

Water and Sewerage Schemes.

Mr. J. Higgins

I am very concerned that residents of Pallaskenry, County Limerick, are being dragged into the High Court next week by Limerick County Council in order to compel them to stop a campaign to retain the clean water they have used for 50 years from Bleach Lough in their area. Residents benefitting from this water know from experience that it is a pure and unpolluted source that provides good quality water to their homes. The residents are threatened with jail in the coming weeks unless they acquiesce to a diktat from Limerick County Council to give up their campaign.

In contrast, the neighbouring areas, including Kilcornan parish, have suffered for decades from a supply of water of dreadful quality and urgently need and want a new water supply which Limerick County Council is harnessing from the River Deel. Unfortunately, the county council is also intent on bulldozing its way into the catchment area served by Bleach Lough and forcing the Deel water on the local community, as it intends to mix the two water supplies. Local people do not want this. While it would be a big improvement for the Kilcornan area the people in Pallaskenry are happier with the more local water supply they know and trust, which they believe would need less chemical input and is not as exposed to pollution sources as the alternative sources being developed by the council.

It is regrettable in the extreme that Limerick County Council has engineered a situation where it might seem that the Bleach Lough retention campaign is denying those in the adjoining areas who urgently need a new supply. This is not the case. It is the county council, which by its inflexible diktat has held up the situation for far too long. It is possible for Limerick County Council to allow the people of Pallaskenry to retain the Bleach Lough water while expediting the extension of the River Deel scheme to those who need it.

Local democracy and subsidiarity are terms often heard from Government and its Departments and agencies. If applied in practice, in this case it would mean respecting the residents of Pallaskenry who want to hold on to the Bleach Lough water supply while, as a matter of urgency, providing a new supply for those communities which have scandalously been left with water of inferior quality for far too long.

Will the Minister for the Environment, Heritage and Local Government and his Department refrain from rubber-stamping what Limerick County Council is attempting to do and listen to the community served by Bleach Lough? While the Department should support and expedite the extension of much cleaner water to the other communities which have been denied it for decades, it should allow the community in the Bleach Lough catchment area to maintain its source and the water it enjoys, wants and has confidence in. These objectives are not mutually exclusive and it is possible to implement both of them. Rather than merely giving me a script provided by the Department, will the Minister of State genuinely examine this situation in a flexible manner, intervene and ensure the Department consults the communities involved and the county council so that the genuine democratic wishes and well-being of these communities can be served?

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

I thank the Deputy for raising this issue. I will inform him of the facts of this case. He is aware of how important the availability of a good quality water supply is for the development of all areas, including those of Pallaskenry and Kildimo. I am glad to say that my Department continues to promote investment in modern water services infrastructure to support social and economic development. Last December, we published the water services investment programme 2005-07 containing almost 900 water and sewerage schemes at different stages of development and planning.

The programme includes funding for more than 20 schemes with a value of nearly €158 million in Limerick, including the Pallaskenry-Kildimo water supply scheme, which is approved for construction. This scheme is estimated to cost approximately €1.4 million and involves an extension of the Shannon estuary water supply scheme to serve the Pallaskenry-Kildimo area. An advance section of it has already been completed in conjunction with roadworks on the N69. Approval was given to Limerick County Council's contract documents and the invitation of tenders for the remainder of the scheme in November 2004 and the works involved started last month.

As the Deputy is aware, the current water supply source for the bulk of the area to be served by the new scheme is Bleach Lough. There have been some local objections to the replacement of the Bleach Lough source by the Shannon estuary scheme extension which will instead use water from the River Deel. In this regard, I must point out to the Deputy that while my Department provides funding for a large number of public water supply schemes, actual responsibility for the planning and provision of such schemes rests with local authorities. However, as the Department was aware that there were objections in this case and to ensure that any objections were properly taken into account, the Department sought clarification from Limerick County Council.

Following a public consultation process, the council reported back to the Department in November 2002:

[A total of] 8.6% of the people who attended the public consultation and completed the questionnaires were against changing their water supply source, 34.6% had general or no comments and almost 57% required the new water supply source. In total, over 91% of people either had no comment or were in favour of being provided with a new water source because of difficulties experienced with the reliability of water quality, pressure, etc., of their existing supply.

Apart from the outcome of the consultation process, there were a range of other factors supporting the extension of the Shannon estuary scheme. These include the pressing need for additional water capacity to facilitate development in the area, the capacity limitations on the Bleach Lough supply which would affect its ability to meet future water demands fully, its vulnerability to pollution and the position of a number of group water schemes that were suffering from serious water quality problems and needed a new source. It was therefore decided in 2003 that the extension of the Shannon estuary scheme to Pallaskenry and Kildimo should go ahead as planned by Limerick County Council.

I am aware that there is a case relating to the scheme before the courts and I am anxious that I would not say anything that would impinge on that case in any way. However, I understand that the Shannon estuary water supply scheme is in existence now since the early 1980s, that it has provided a consistently good quality and reliable water supply to more than 3,000 people in the Foynes, Shanagolden and Askeaton areas and that it has adequate capacity to supply the Pallaskenry and Kildimo areas with good quality water well into the foreseeable future.

I hope that what I have outlined confirms to the Deputy that my Department's approval of the scheme was only given after serious examination and consideration of the reasons put forward by the council in particular to meet fully existing and future water supply requirements in the Kildimo and Pallaskenry areas and of the limitations of the Bleach Lough source in this regard.

The Dáil adjourned at 9.25 p.m. until 10.30 a.m. on Wednesday, 22 February 2006.