Adjournment Debate.

Ambulance Service.

Mr. Healy

I thank the Ceann Comhairle for allowing me raise this important issue on the Adjournment. The issue is the urgent need for the location of an emergency ambulance service in the town of Carrick-on-Suir, County Tipperary, as the lives of heart attack and road traffic accident patients are being put at risk because the existing emergency ambulance service operating out of Clonmel and Waterford cannot meet the required normal response times for ambulance services.

This is an issue that has been going on for quite a number of years. I have raised it on many occasions in the House, as have other public representatives, both locally and nationally. It is time this nettle was grasped and a proper ambulance service was put in place for the people of Carrick-on-Suir.

Carrick-on-Suir, which is in the south-east corner of south Tipperary equidistant from Clonmel and Waterford, has no emergency ambulance. With a population of 5,000, the town is a progressive one that continues to expand with a number of large housing developments having come on stream in the town and the surrounding area in recent times. The hinterland has a population of approximately 10,000 people. There is a need, therefore, for an ambulance service in the town. It is the only major town in south Tipperary without such a service. Tipperary town, Cashel and Clonmel have ambulance services. Despite the best efforts of ambulance staff based at South Tipperary General Hospital, Clonmel, and Waterford Regional Hospital, they cannot meet standard response times for emergencies. As a result, the lives of road accident victims and those who suffer cardiac arrest have been, and are being, put in jeopardy because of the deficiency in the ambulance service. They are the first responders and they do an excellent job but they cannot be expected to do the job of an emergency team, which comprises trained emergency medical technicians and nurses and uses various equipment carried by an emergency ambulance vehicle.

The Caredoc service is available but it does not provide emergency cover and while it is a good service, it cannot meet the need for emergency services and quick responses to emergencies. I hope the Minister of State will not say a study or an appraisal will be undertaken when he replies because we have been hearing this for years.

Mr. B. Lenihan

It is on the way.

Mr. Healy

That is only a device to put the issue on the long finger again. I hope the Minister of State will acknowledge the need for an emergency ambulance service in Carrick-on-Suir and he will make a start to providing that service. St. Brigid's Hospital in the town is the ideal location for such a service while a number of health centres are located in the grounds of the hospital. HSE officials in south Tipperary know well that the current emergency ambulance service cannot meet standard response times when travelling to Carrick-on-Suir. No study or appraisal is needed because the departmental officials are also aware of that. I ask the Minister of State to make a start by agreeing this is an important issue and to provide an ambulance service in Carrick-on-Suir.

Minister of State at the Department of Health and Children (Mr. B. Lenihan)

I thank the Deputy for raising this matter, which I am taking on behalf of my colleague, the Minister for Health and Children.

Under the Health Act 2004, the Health Service Executive has responsibility for the provision of ambulance services. The HSE has advised that services for the Carrick-on-Suir area are provided from the ambulance base in Waterford with a backup service provided from the ambulance base in Clonmel. Funding has been provided in the HSE capital plan 2006 for the upgrade of the ambulance base in Waterford. The pre-hospital emergency care council, which is responsible for the development of professional and performance standards for the ambulance service, is undertaking a spatial analysis in conjunction with the HSE national ambulance office. The results of this analysis will be used to identify the optimum location for ambulance bases and deployment arrangements to meet the identified demands and minimise response times for emergency calls. The analysis commenced in the north-west region and it will be extended by the HSE to cover all regions, including south Tipperary. The HSE is reviewing ambulance demands, activity and response times, with a view to providing the best service for the people of south Tipperary and Carrick-on-Suir. Decisions on the future location on ambulance bases for the region will also be informed by the current reorganisation of acute hospital services in south Tipperary. The elimination of on-call arrangements as a means of providing emergency ambulance cover, is designed to facilitate improvements in response times. The HSE has advised that the provision of additional funding in recent years has facilitated the total elimination of on-call arrangements in a number of areas, including south Tipperary.

Housing Aid for the Elderly.

Mr. Connaughton

I thank the Ceann Comhairle for the opportunity to raise this matter, which is irritating. The Health Service Executive, western region, for some unexplained reason has not approved applications under the housing for the elderly scheme over the past two years. What is going on is an absolute disgrace. I do not know whether there is a problem at HSE level or whether the HSE is not getting sufficient money from the Government. I wish to place on record the standard letter which has been sent five times over the past two years to every constituent on behalf of whom I make representations:

I am writing to acknowledge receipt of your letter dated 28 August 2006 on behalf of [a named person]... The Special Housing Aid for the Elderly Scheme has proven to be an extremely popular service over recent years and we have been able to assist many elderly people in essential maintenance work in their homes. Consequently, there is a year round significant demand for assistance for various works to be carried out. This inevitably places periodic pressures on our capacity to respond to each application, as we would normally wish. However, we are endeavouring to respond to all applicants as early as possible and therefore, we will be contacting [a named person] again, regarding her application.

Over two years, five such letters have been sent. What is the Government doing to the elderly? I have two copies of these letters, one of which was sent to a 79 year old woman. To expect a 79 year old to wait two years for a letter of approval is similar to asking a person aged 50 to wait ten or 20 years. If the Government and the HSE would like to scrap the scheme, they should come out and say so and should not leave hundreds of vulnerable people all over Ireland waiting for a reply regarding home improvements. If this is the best we can do as a caring society given the money at our disposal throughout the economy, we might as well pack up our camp and walk away.

Is it Government and HSE policy to scrap the scheme altogether? If so, the Minister of State should come out and say that and allow some other body, such as the local authority, to do something about it. However, the Government should not try this racket with so many vulnerable people. Is the Minister of State aware that this has been a wonderful scheme for many years under all Governments? No magic is involved. A few thousand euro is invested and supplemented by a few hundred euro by the elderly people themselves to carry out essential repairs. They can then live out the rest of their days in reasonable dignity where they want to live. For every €1 million euro invested in this scheme, people are being given the opportunity to stay at home and they do not have to move to nursing homes. Could there be anything more simple or straightforward than that? The HSE and the Government have ensured elderly people have been left in the dark over the past two years.

I hope, following this debate, that a fuse will be lit and that at least a small amount of decency will be shown. Those involved will say that as they are investing money, they need to see improvements in the next couple of months or they will pull out of the scheme altogether. The Government should at least let people know where they stand. If this is a yardstick by which we determine the attitude to the elderly in this country, God help them.

Mr. B. Lenihan

I am taking the reply on behalf of the Minister for Health and Children, Deputy Harney. I thank the Deputy for raising the question as it provides the Department with an opportunity to outline the current situation with regard to the housing aid for the elderly scheme. The scheme is administered by the Health Service Executive on behalf of the Department of the Environment, Heritage and Local Government. The primary aim of the scheme is to provide financial assistance to older people who reside alone and who, from their own resources, are not in a position to carry out urgent necessary repairs to their own homes. Basically, as the Deputy is aware, aid is made available for repairs to make a dwelling suitable for the older person by providing a warm, safe, secure and healthy environment for the lifetime of the older person, thereby enabling older people to continue living in their own homes for as long as possible. The type of works envisaged in the scheme includes the replacement of windows and doors, roof repairs, provision of heating and sanitary facilities and necessary electrical works.

Applications for the scheme are assessed by HSE personnel. While the means of the applicant and spouse or partner may be considered, eligibility for this scheme is not based on means only and a number of guidelines apply. The applicant must be aged 65 years or over, live on their own or with another older person or a person with a disability, live in unfit or unsanitary conditions and have no able bodied person available to carry out essential repairs. In addition, the housing aid scheme applies to privately owned accommodation only.

Due to the nature of the group who apply, their individual circumstances and the extent of their need, considerable latitude is taken in applying the guidelines. The works that may receive grant aid may be undertaken by private contractors engaged by the applicant or by voluntary organisations working in conjunction with HSE staff.

The budget received by the HSE from the Department of the Environment, Heritage and Local Government has increased substantially year on year in recent years. In 2006 the task force on special housing aid for the elderly in the Department allocated a total of €17.02 million for the operation of the scheme by the different HSE regions. This has allowed the HSE to increase the number of grants being made available under the scheme.

Hospitals Building Programme.

Ms B. Moynihan-Cronin

I thank the Ceann Comhairle for the opportunity to raise this important matter, namely, the delay in the provision of the long-awaited 14-bed extension to Kenmare community hospital. I have raised the issue on a regular basis in the past ten years but nobody seems to listen to me or the exasperated people of Kenmare. However, I will continue to raise it until somebody listens and the funding is provided, and the people of Kenmare get the decent hospital they deserve.

The delay is unbelievable. A press release from the former Southern Health Board, dated 3 June 2000, states that at a meeting of the board members on Tuesday, 2 May 2000 the members adopted the national development plan for the Southern Health Board area for the next six years and that the plan covered capital investment for the board. The press release stated that the funding allocated was on a priority basis whereby the urgent needs of each board area was taken into account. Among the developments was the extension to Kenmare community hospital. The Southern Health Board stated the project was urgent in 2000 so what is its status now?

A group from Kenmare met the Minister, Deputy Harney, on 20 June this year. At that meeting she stated she was hopeful that Kenmare community hospital would be included in the Estimates in the autumn. It is autumn and the Minister is preparing the health Estimate. Will a commitment be made that the extension to Kenmare community hospital is included in that Estimate? The Minister also stated at the meeting that she would keep in contact with the Health Service Executive on the matter. What communication has taken place between the Minister and the HSE since 20 June in this regard? The representative group from Kenmare which met the Minister has heard nothing.

The provision of the 14-bed extension to Kenmare hospital is urgently required and was deemed urgent by the Southern Health Board in 2000. The population of Kenmare has risen by 30% since 1996 and is still increasing. Many retired and elderly people have settled in Kenmare and the surrounding areas and there is huge demand for additional beds in thehospital. The hospital services cover a very widearea, including Sneem, Castlecove, Lauragh,Tuosist, Kilgarvan, Blackwater and the BlackValley.

The Minister of State, Deputy Tim O'Malley, replied to me during an Adjournment debate on 21 February last, stating that the project would not commence in 2006 because of competing demands for capital funding but that the project would be reviewed. I understand the Minister of State, Deputy Brian Lenihan, will read a prepared script in reply in this debate — there is little he can do about it. However, while he may not be able to answer my questions tonight, he could have the decency to come back to me in the coming days or weeks to tell me whether the project is included in the health Estimate for 2006 and to explain what communication has taken place with the HSE since the meeting with the Minister on 20 June. I look forward to a positive report from the Minister that the project will be included in the Estimate for this year.

Mr. B. Lenihan

I thank the Deputy for raising the matter. I deliver this reply on behalf of the Minister for Health and Children, Deputy Harney. It is the policy of the Minister and the Department 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, 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, that is, €110 million in 2006 and a further €40 million on an annual basis for services for older people.

The prioritisation of all health capital developments is now a matter for the Health Service Executive 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 replanning 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.

The HSE has confirmed that this project was not included in its 2006 capital programme. This was due to competing demands for capital funding, including other significant capital projects in the Kerry area, of which I am sure the Deputy is aware, which require investment in 2006. However, the HSE has advised that the capital programme will be reviewed and reprioritised on a rolling annual basis. 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.

Ms B. Moynihan-Cronin

That is the same answer I received in February.

Mr. B. Lenihan

The answer is clear.

State Airports.

Mr. P. Breen

I wish to say at the outset how shocked I was recently when the Minister of State's colleague, the Minister for Transport, revealed to me by way of a parliamentary question response that he intended to proceed with the dismantling of the current bilateral agreement at next month's European Council meeting.

This is despite the failure of the EU and the US to sign an open skies agreement. The proposed 18-month bilateral transition period was negotiated by the Minister in the context of open skies being introduced at the end of that period, that is, approximately April 2008. This agreement was the only transitional arrangement in the proposed EU-US agreement and was negotiated squarely in the context of open skies. It proposes to replace the current one for one arrangement with a one-for-three Shannon to Dublin ratio.

Now we learn that the Minister proposes to go it alone with the dismantling of the bilateral, although open skies remains far away. This is an astonishing unilateral action proposed by the Minister, which I am sure is contrary to the provisions of the Treaty of Rome. The Minister will recall that the European Court of Justice decided almost four years ago that the nationality clauses in bilateral aviation agreements were inconsistent with EU member states' obligations under the Treaty of Rome. The Minister, in effect, is now proposing to renegotiate the bilateral outside the EU. I hope he will change his mind and, if not, I hope he fails.

Shannon is not afraid of open skies. We are afraid of the actions of a Minister for Transport who is intent on introducing an economic liberal agenda that takes no account of the regional economic disparities or the special place Shannon Airport has as an economic driver for the west.

The Minister will say that he negotiated the transition agreement in the context of assurances from Aer Lingus to maintain the current level of transatlantic traffic of approximately 400,000 passengers a year between Shannon and New York. On further probing, the Minister revealed that this was a verbal assurance only. As such, I believe it has little or no value.

The response from Mr. Dermot Mannion, when I repeatedly asked him for some indication of his long-term plans for the airport, was short. I pointed out that Aer Lingus, as the then national airline, operated fewer direct transatlantic services than its American competitors. I also pointed out that Aer Lingus was continually expanding its direct European services from Cork and Dublin, with no plans expected for expanding its Shannon services.

In a recent interview in Cara magazine, Mr. Mannion failed to mention Shannon Airport in the context of the development of new services. He also pointed out in that interview his intention to make Dublin a major hub for western Europe. Unfortunately, his response to me was much shorter on detail than that contained in “Cara” magazine. He stated simply:

I apologise if previous correspondence has not been responded to. Aer Lingus remains committed to our Shannon operation and, as I am sure you are aware, I am a frequent visitor to Shannon to meet with staff and discuss their concerns.

It seems then that the airport is a thorn in the side of Aer Lingus and the Government. The Minister's continued commitment to Aer Lingus, despite it now being a private company, is commendable. Aer Lingus has made no secret of its dislike of the bilateral agreement and has made it clear that its continued existence would affect shareholder value.

I am very concerned about the future of Shannon Airport in the context of the west. I question the Government's policy to make Shannon a self-sustaining airport based on an accountant's slash and burn technique. Shannon does not have to be self-sustaining. The Dukes Sorensen report indicated that Shannon Airport could lose up to half its transatlantic passengers in an open skies environment. It recommended the introduction of a public service obligation levy to buoy up Shannon.

The Minister for Transport has ignored the calls for an economic impact study to be done on the effects of open skies on Shannon. He could have negotiated a longer lead-in period in order for the infrastructure and marketing to be put in place prior to open skies. Instead he is now rushing out to Brussels to prematurely dismantle what little protection the airport enjoys. He promised an economic and tourism development plan for the airport in a blaze of publicity last summer, but we have heard nothing since.

Shannon is an international airport serving an economically marginalised part of the country. Its existence is good for international business, the west, domestic business and tourism. Expecting it to compete with the likes of Dublin on an equal footing does not make sense.

I had the pleasure of visiting Doonbeg golf club in west Clare last Sunday. An employer of over 205 people, it is a €175 million complex. Its existence is a tribute to the project backers, the locals who first mooted the idea and to Shannon Development, which first promoted it. It was put there because Shannon Airport is a stone's throw away and because it has direct airline services to the US.

I ask the Minister of State to implore his colleague, the Minister for Transport, to do us a big favour by remembering the Government's national spatial strategy, its obligations under the national development plan and its commitment to the people of the west.

Minister of State at the Department of Transport (Mr. Gallagher)

I thank Deputy Pat Breen for raising this matter on the Adjournment and thereby giving me the opportunity to outline the current situation.

Transitional arrangements for Shannon were agreed with the US authorities in November last year in the context of the impending implementation of the EU and US open skies agreement. This provided that the 1:1 Shannon stop requirement would change to 1:3 for the period November 2006 to the end of March 2008, after which the Shannon stopover requirement would end. During the transition period, Irish airlines would have access to three additional US destinations. Ireland was the only European country to secure transitional arrangements in the proposed EU and US agreement.

The transitional arrangements were intended to allow time for a smooth transition to full open skies, which would allow the Shannon Airport Authority to explore and exploit the opportunities arising from the agreement while allowing Irish airlines access to additional destinations in the US.

A number of reports — the Brattle report for the European Commission, the report of the tourism policy review group to the Minister of Arts, Sport and Tourism, and the Air Transport Users Council of the Chambers of Commerce of Ireland report into open skies — all support moving to open skies with the US, and they emphasise the significant benefits to Ireland when this happens.

In the context of the agreement on transitional arrangements, Aer Lingus confirmed that subject to market conditions and in the context of a level playing field between the airline and its competitors, it would maintain the current level of transatlantic capacity. Following the very positive approach by our European colleagues and the US authorities to providing for an orderly change to the Shannon stopover arrangements, it is very disappointing that the EU and US open skies deal still has not been finalised due to difficulties about relaxing US ownership and control restrictions for airlines. It is understood that more time is required on the US side to take account of the concerns of Congress, which can only now be properly addressed following the US mid-term elections.

The Minister has publicly stated his commitment to the view that the liberalisation of air transport services between Ireland and the US will deliver major benefits for Irish business and tourism. The conclusion of an open skies agreement would have particular benefits for Ireland compared to the 15 of 25 EU member states that already have open skies agreements with the US. These member states already enjoy an advantage in unrestricted access to route rights for the development of air services to and from the US.

In this context, the Minister informed Government last month that he proposed to continue to pursue all possible avenues through contacts with the European Commission, ministerial colleagues in other member states and the US to provide for the entry into force at the earliest possible date of the EU and US open skies agreement, including the transitional arrangements relating to Ireland already agreed between the EU and the US. He also proposed that, to the extent that agreement at the level of the European Union is not achievable within a reasonable timeframe, to seek to implement, in accordance with the applicable community law, the essential elements of the transitional arrangements by way of an amendment to the Ireland-US bilateral air services agreement. Finally, he proposed to issue a letter to Aer Lingus setting out these intentions.

The prospectus relating to the sale of shares in the company reflects this commitment. Specifically, it states:

The Minister for Transport has assured the company that he remains confident that an EU-US open skies agreement can be reached within a reasonable timeframe, and that he intends to pursue the earliest possible implementation of the transitional agreement. The Minister for Transport has confirmed to Aer Lingus that, in the event that an EU-US agreement is not achievable within a reasonable timeframe, he intends to seek to implement, in accordance with applicable Community law, the essential elements of the transitional agreement by way of an amendment to the Ireland-United States bilateral treaty.

In announcing the agreement reached with the US authorities on a transitional arrangement for Shannon Airport in the context of the proposed EU-US open skies agreement, the Minister gave an undertaking to prepare, in consultation with the Minister for Arts, Sport and Tourism and the Minister for Enterprise, Trade and Employment, a tourism and economic development plan for Shannon and the west of Ireland. The draft plan is nearing completion.

Under the aegis of the Mid-West Regional Authority, an open skies liaison group has been established to work with the Departments to ensure that Shannon Airport and the west receive adequate investment and compensatory measures when open skies is finally approved.

An official from the Department of Transport attended meetings of that open skies liaison group in an information-sharing capacity. The group recently presented its report and key recommendations.

The Dáil adjourned at 9.20 p.m. until 10.30 a.m. on Thursday, 5 October 2006.

Dáil Éireann debate - Wednesday, 4 Oct 2006