Adjournment Debate.

Health Services.

Mr. Crawford

I thank the Chair for the opportunity to raise this issue. No issue has caused more problems for people in the Cavan-Monaghan region than health. I urge the Minister to intervene to ensure that all available beds in Monaghan General Hospital are put to use in light of the fact that Our Lady of Lourdes Hospital, Drogheda cannot cope with even its own day surgery requirements and patients in urgent need there now find their appointments cancelled.

I raise this issue because this morning I learnt of the case of a woman who was to have a pin removed from her ankle in a day procedure in Our Lady of Lourdes Hospital. However, the procedure was cancelled at the last minute, as was a similar procedure for her neighbour, due to the lack of beds. I understand at least three or four other procedures were also cancelled. I am advised that the lady concerned may have her operation on Friday. It is over ten weeks since she had the pin inserted and a cast put on her foot after a serious break in her ankle. She is a main carer for her 82 year old mother and handicapped sister. This delay is just a symptom of the problem in Drogheda.

I had a letter dated 6 June from a consultant stating that he could empathise completely with a person such as I wrote to him about who suffered substantial delays in treatment. He said the bed situation in Our Lady of Lourdes was very difficult due to the volume of trauma victims and that it was not unusual for no patient to be admitted on his operating list for day treatment. This was very frustrating for everybody. According to some people there is no shortage of beds, but this has proven to be untrue in the case of the Drogheda hospital.

I highlight these two cases to demonstrate the impossible situation for all concerned. I demand that the Tánaiste and Minister for Health and Children, Deputy Harney, should check the facts when she and her experts state that patients in Cavan and Monaghan are now in danger.

The Health Service Executive and its teams state they must only allow level 3 critical care patients to be dealt with in Drogheda. This means that within three months all level 3 care for patients needing ventilation and other organ failure support should be centralised at Our Lady of Lourdes Hospital. This is not viable or responsible. We know beyond question that Drogheda hospital cannot cope currently with its load, not to mind an increased load.

The only reason there may be problems in Monaghan General Hospital is that the Government removed services and staff by devious means. There is now a danger it will use the Dáil summer recess to further cut services. I warn those who allow this to happen, whether the Minister, those she employs with taxpayers' money or those who support her in the House, that they will be exposed for the lives they put at risk. It is all very well to close down a service when a proper replacement service is in place, but to force people to use an ambulance service before decent roads or services are available is unforgivable.

Last night the Taoiseach advised the House of the many billions of euro he could spend. He tried to make people believe the Government has delivered on medical cards and home help, yet it is desperately trying to advertise doctor-only cards in order to get them into the system before the next election. It hopes people will forget that at least 100,000 medical cards have been lost over the past few years.

A 94 year old woman who is on her death bed can only get five hours home help per week. This works out at less than four hours in real terms. However, the HSE sends me and others a ten-page document that makes it seem the situation is different. The facts on the ground indicate otherwise. Health in Cavan-Monaghan is in crisis. No tall stories or shouting will change that. I urge the Minister for Education and Science, who is here to represent the Minister for Health and Children, to persuade the Tánaiste to examine the situation and see what she do about it.

Minister for Education and Science (Ms Hanafin)

I will take this matter on behalf of my colleague, the Tánaiste and Minister for Health and Children, Deputy Harney.

Under the Health Act 2004, the Health Service Executive has the responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. The Department of Health and Children has been in touch with the HSE and has been advised that three hospital bed usage review groups have been established in the HSE north-east, one in the Cavan-Monaghan hospital group, one in the Louth hospital group and one in Our Lady's Hospital, Navan. I am advised that the purpose of these groups is to review, on an ongoing basis, bed usage in each hospital and to alleviate overcrowding where possible by the introduction of any initiative deemed appropriate; to develop and implement effective admission, transfer and discharge policies and procedures; to work in partnership to manage bed usage in each hospital or hospital group in a more effective manner; and to liaise with primary community continuing care colleagues regarding arrangements for clinically discharged patients. The membership of these groups includes nursing, medical and administrative representation.

In addition, an inter-hospital bed usage group has also been established to address bed usage issues in the north east and how they impact on the throughput of patients throughout the region, and to manage hospital bed usage more effectively. The membership of this group includes hospital management, directors of nursing and hospital consultants.

With particular regard to day surgery, the HSE has advised the Department that the establishment of a joint department of surgery in the Louth hospital group and the establishment of a single department of surgery in the Cavan-Monaghan hospital group has resulted in a more effective throughput of patients receiving surgery, with a result that waiting times for day procedures and surgical out-patient appointments have dropped considerably.

Following the recent publication of a review of acute hospital services in the former North Eastern Health Board area, the HSE is to establish a north east steering group to quickly address the issues that require immediate attention and at the same time develop a longer-term strategy to deliver a world class health service during the next ten years. The group will have representation from key stakeholders such as clinicians and primary care providers. There will also be widespread public engagement on the issues highlighted in the report.

The report concluded that the present system, where five local hospitals deliver acute care to relatively small populations, is exposing patients to increased risks, is not serving the community well and is not sustainable. The consultants believe there is an unprecedented opportunity over the next ten years to develop a very high quality responsive emergency and planned care service, in line with international standards, by developing local services within existing hospitals and other local centres supported by a new regional hospital.

Early School Leavers.

Ms Shortall

I thank the Minister for coming to the House at this hour of the night to respond to the debate. This is an important issue, the future of the Ballymun education support team school completion programme and specifically the school group within that SCP programme. The group was set up in 1998. It caters for six children who could be regarded as being in the group of most highly at-risk children who are out of school. They are aged between 13 and 15 years. This is a special project set up to change their thinking about school, to give them positive experiences and to enable them to acquire qualifications.

The scheme has been remarkably successful. Last year it catered for six children, all of whom had difficulties at home and who had been in contact with the Educational Welfare Service and who had been assigned to a junior liaison officer. Their school attendance rates had dropped very low before finally leaving school. The year spent in the programme has made a significant difference to them. Their attendance level has risen to 90% and they all achieved FETAC awards.

The Minister will be aware of the worth of this programme. It is referred to in the Department's publication, Guidelines Towards Best Practice for School Completion Programmes. It is the only school completion programme operating an out of school group. Various organisations in Ballymun have co-ordinated this scheme. There is general support for the scheme and an appreciation of the valuable role it plays.

It has not ever been properly funded and there was a shortfall. This service provides an essential safety net and education service for six children and costs a mere €95,000 per year. The funding available from the Minister's Department is currently only €60,000. The shortfall has been made up through various means over the years. The service was forced to close in 2002. Since then the local drugs task force has made up the shortfall of €35,000 but the task force can no longer continue this funding. This successful project may close by Christmas unless the funding is put on a proper footing. They are asking for a very small amount of €35,000 to radically change the future prospects of six children who are at risk. Two miles up the road in Finglas, young offenders are being cared for in the Finglas children's centre at a cost of more than ten times that amount for one young person, approximately €400,00 a year. The centre in Lusk, a few miles north, is costing between €300,000 and €400,000 per young person.

I appeal to the Minister to guarantee the funding of €35,000. It would be criminal if this project had to close down for the lack of such a small amount of money. This is a critical year for lots of reasons. The concern is that the funding might be committed for this year but that there could be another crisis next year. The group want a commitment on a long-term basis for full funding. The amounts of money involved are very small. The work is very worthwhile because it completely changes the future prospects for critically at-risk children. If the Government is serious about tackling the problem of educational disadvantage and early school leaving and wants to prevent young people from ending up in conflict with the law, then I urge the Minister to make that commitment.

Ms Hanafin

I thank Deputy Shortall for raising this matter and for speaking about the school completion programme, a very successful programme targeted at children and young people who are at risk of early school leaving. It is targeted at those in danger of dropping out of the education system or those who may have already dropped out. It is a broadly based programme which is cross-community and cross-sectoral. It works between the primary schools and the second level schools and involves the community to ensure the maximum participation by as many people as possible. It generally targets four to 18 year olds who are both in and out of school to ensure the best outcome for them.

The Deputy referred to multi-annual retention plans. The funding under the school completion programme is provided to projects on the basis of multi-annual retention plans drawn up and agreed between the local management committee and the Department of Education and Science.

Ms Shortall

It is not index-linked.

Ms Hanafin

The funding is not just agreed on a once-off basis but rather on a multi-annual basis. I accept that projects cannot be stop-start. A local retention plan contains strategies for the whole-school, targeted strategies for individual students and those who are already outside the formal system, as referred to by the Deputy.

As we head into the holidays, this programme offers supports during holiday time in recognition of the fact that continuous support must be given to young people at risk of early school leaving. Various holiday programmes are offered in conjunction with other agencies, such as sporting and cultural activities, literacy and numeracy development programmes, art, drama and music and youth work, sports and arts camps, English language support for students for whom English is not the mother tongue, science camps, familiarisation days and week-long transfer programmes for new entrants to second level schools to smooth their transition to the new school. An issue identified as being a particular problem for students from the most disadvantaged areas is the fear of moving into a second level school. Up to 800 children, aged between seven and 11, will in July and August attend summer literacy camps which aim to help those with literacy difficulties learn through art, dance, music and drama. The 20 summer camps have been organised and funded by the Department. Increased access will be provided to the 200 second level and 320 urban and town primary schools in SCP to a range of academic and non-academic supports based in-school, after school, out-of-school and during holiday time, based on best practices identified through the school completion programme.

There are currently 82 school completion programme sites in 21 counties, involving 108 post-primary schools and 302 primary schools, with 53 second level schools in the stay in school retention strand. That is in 17 counties, targeting approximately 23,000 young people at risk of early school leaving. In total, €24.7 million has been allocated by my Department to the school completion programme for 2006.

One might have got the impression from Deputy Shortall that the only amount of money being given for the project was in the region of €35,000. Some €402,000 was given to the school completion programme in Ballymun. That is on top of the extra supports which all those schools have by way of home school, community liaison, resource teachers etc. It is a very good school completion programme providing general support for almost 1,600 primary students and approximately 600 post-primary students. Intensive targeted supports are provided for 201 primary students and 52 post-primary students. It also caters for the six pupils particularly mentioned by the Deputy.

The school completion programme has submitted its retention plan for the coming year, which outlines all its proposed activities for the coming year, including the estimated cost of retaining the support for the six pupils who are out of school in the "school group." It is not just a case of looking for €35,000. They are looking for that on top of the €402,000.

Ms Shortall

I am referring specifically to the school group.

Ms Hanafin

That is part of the overall school completion programme. The funding allocation for next year is currently being considered and the local management committee will be notified directly on the matter. The good work being done should be borne in mind along with available resources for the rest of the programmes around the country.

Ms Shortall

Is that a "Yes" or a "No"?

An Ceann Comhairle

I call Deputy O'Connor. Deputy Crowe will speak on the same issue as Deputy O'Connor.

Ms Shortall

The Minister is surely not going to let it close. It would be criminal to do so.

An Ceann Comhairle

I remind Deputy Shortall that the Chair is speaking.

School Accommodation.

Mr. O’Connor

I thank the Ceann Comhairle for allowing me to raise this issue. I am glad to join my colleague and neighbour, Deputy Crowe, in doing so. I am particularly pleased that the Minister has been good enough to attend to the issue herself at this strange hour. That we are here discussing the issue highlights its importance.

This relates to St. Mark's schools in the Springfield estate in Tallaght, where I live. They were founded in 1974 and opened by Mr. Richard Burke, the then Fine Gael Minister for Education, on the day Erskine Childers died. These schools have a fine history and have educated young people in the parish during that period, including two of my three sons.

There are currently 440 pupils enrolled in the senior school and 550 in the junior school. The Minister will know those figures, as Deputy Crowe and I have previously raised this matter on a number of occasions. Over 400 of those young people are what we might term "newcomers" or from the international community.

This debate takes place after South Dublin County Council on Wednesday initiated discussions on the Tallaght area plan report at its Tallaght area committee. I mention this because we have often stated that Tallaght has developed tremendously over the years. Many of the schools in Tallaght have had falling numbers, as the Minister knows and may tell us. That trend is now changing.

Going around Tallaght today one may see politically-motivated posters indicating that a large number of new apartments is being built. This is adding to the burden which the schools are dealing with throughout the Tallaght region, and particularly in St. Mark's parish and its local schools. It is causing many problems. The principals, who do a tremendous job, must deal with parents on a daily basis who cannot understand why their child cannot be guaranteed a place and are being told they may have to go elsewhere. The difficulty is that parents do not wish to do so. I understand this plight as I hope the Minister does.

Many of these parents have other children in those schools. There is now much pressure on accommodation. Deputy Crowe has recently pointed out, through a Dáil question, the particular accommodation pressures being experienced by the schools. There will be more challenges for the schools next year. The physical education hall and other facilities will have to be used to cater for classes. Teachers and parents have been telling me that this will mean children will have less than 30 minutes of physical education per week. That will cause its own problems.

There has been much talk about two prefabs which are 20 years old and which are clearly not fit to be used. We are asking the Minister to consider the crisis accommodation needs of these schools. They have made it clear to us that six prefabs are required as quickly as possible. If the schools are not able to provide the additional accommodation in September, they will literally be turning children away. The schools have served the community well, with approximately 1,000 pupils. They are now packed to the door and they are under much pressure.

Particular pressures are caused because it has such a large international aspect to its population. I have heard others speak on other constituencies, but in Tallaght it is unique. That population will continue to rise.

I know the Minister has an interest in education in Tallaght and I look forward to welcoming her to Tallaght next Tuesday when she opens the VEC offices. I ask her to give special consideration to this issue and help my local schools.

Mr. Crowe

I thank the Ceann Comhairle for affording us the opportunity to speak on this issue. I will begin by describing the location of the school, which is at the edge of a RAPID area. As Deputy O'Connor has stated, its catchment covers an area which contains hundreds of apartments, and people are still moving in at the moment. The area has seen significant changes in recent years, and one in three of the houses in the area is rented.

The school is a microcosm of the community, which has itself been through significant change. Some of the changes have been positive, others have been negative. We have heard much about the new challenges facing Irish society and the education system in particular. We have heard talk of multiculturalism and a plural society, integrating people from different cultures, etc. This process needs extra resources and commitment.

I am asking for a commitment from the Minister to consider the special circumstances of this school. What happens in this school will reflect on the relationships both within the school and without. I am not trying to create a scare, but that is a factor which must be taken into account by the Department.

Approximately 50 countries are represented in the school. Six of the 24 classrooms have been divided. Deputy O'Connor spoke of the two prefabs, but these were closed down by the Health and Safety Authority — not the school — because of their condition. The authority stated that the prefabs were unsafe.

Much money has been spent on the school in recent years, but there is talk of converting the music room into a classroom, not specifically for music. There is also talk of putting a false ceiling in the school. The library has been removed, and pupils are being taught within the library space itself.

Will this case be like the school I mentioned before in Donegal, where children with special needs were being taught in an adult toilet? Will that scenario face the children in this school? Parents have asked us as local representatives to do everything in our power to stress to the Minister over the coming period, before September, that there will be no room in the school for their children.

It has been suggested that these children should go to other schools in the area. The problem for the parents is to get the children to the alternative schools. Many of the parents who have approached me have lived all their life in the area and attended the school themselves. They feel they have some rights, as taxpayers and as people who have been committed to that community all their lives. Is it too much to ask that their kids be allowed go to that school?

There is an accommodation crisis in the school and it will get more difficult as the years go by. Certainly, there is a need for extra classrooms. It will affect not only the junior school but also the senior school because there is a roll-on effect.

While this is called the Adjournment debate and no doubt the Minister probably has her answer written out in front of her, this matter needs to be looked at seriously. If at all possible, someone should speak not only to the school principal and the board of management but to the people who live in that community and have a role in the future of the school.

There is significant support for these new families. Like everyone, I am worried about the effect that this may have on community relationship in the school. That is not posing threats or anything else, but dealing with the reality of what is there at present.

Ms Hanafin

I thank Deputies O'Connor and Crowe for raising this matter on the application by St. Mark's Junior School for additional accommodation and the position in general on primary provision in the Tallaght area.

I am sure the Deputies will appreciate that in providing educational infrastructure, the Department's main responsibility is to ensure that schools in an area can, between them, cater for all eligible pupils seeking places. This may result in pupils not obtaining a place in the school of their first choice, but ensures that at all times the use of existing publicly-funded accommodation is maximised. This approach also ensures that the development and support of one school over others does not occur. Schools in an area are expected to implement enrolment polices which complements this position.

In the circumstances, when any school submits an application for capital funding, this is not considered in isolation from the circumstances prevailing in its neighbouring schools. If a school enrolls over and above what it can accommodate while there is vacant accommodation in other schools in its area, an application for capital funding cannot succeed. This is the practical application and implication of my Department's policy as outlined.

Earlier this year, St. Mark's junior school in Tallaght submitted an application for capital funding under my Department's 2006 additional accommodation scheme. At the time it sought the provision of two extra classrooms to cater for increased enrolments. This application was refused on the grounds that my Department is satisfied that there is considerable spare capacity in neighbouring schools.

The school subsequently appealed this decision and increased its application to six extra classrooms, for both it and St. Mark's senior school, but in addition, for the first time, the issue of the need to replace two old prefabs was raised. If there are problems with the standard of accommodation which might require replacement, sin scéal eile. Immediately, the Department contacted the school authority for a report which it commissioned in this matter. This will be examined when it is received as part of an assessment of the school's appeal.

As Deputy O'Connor stated, there are significant developments planned for the greater Tallaght area and my Department is aware of this. The school planning section is liaising with South Dublin County Council on future school requirements for the area in this regard.

Furthermore, the Department of Education and Science will review all existing provision to determine its long-term needs to meet the challenges presented by the proposed developments. It will do this in consultation with the local schools inspector. The Department has already asked St. Mark's to submit an application for permanent accommodation. This will kick start the process from its perspective.

While we accept that the Tallaght area is growing, there appears to be adequate provision in the area for the number of students coming forward. There are two separate issues. On the first, we have asked the school to make the application for permanent accommodation. On the second, we will take a careful look at the standard of the school's temporary accommodation as soon as it sends us its report.

The Dáil adjourned at 12.25 a.m. until10.30 a.m. on Thursday, 6 July 2006.

Dáil Éireann debate - Wednesday, 5 Jul 2006