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Dáil Éireann debate -
Wednesday, 29 Nov 2006

Vol. 628 No. 4

Leaders’ Questions.

Today the PPARS scandal is running at €186 million and counting. This €186 million is a spectacular achievement of waste by any standard but we should not be too surprised. The Progressive Democrats, after all, is the party that gets things done. We should look at a few things it has not done. I refer to neurosurgery where the computers used to guide brain operations keep crashing and where for lack of money the equipment has not been replaced for years. It is a case of PPARS, €186 million, neurosurgery, nil. We are talking about men and women with bleeds to the brain, brain tumours, aneurysms, brain injury following accidents, severely debilitating diseases such as Parkinson's disease.

Ireland is the only country in Europe that does not provide brain stimulation for people living with Parkinson's. Seconds count in all of these conditions. General practitioners will say it is not just access to neurosurgery and neurology services that are years too late and often do not exist at all. The GP in County Wexford was promised an appointment in three weeks for a woman with epilepsy but was still waiting after three years. It is not just the patients and their families who are at breaking point; it is the state of neurosurgery itself which is now catastrophic.

Mr. Chris Pidgeon says the service is on the verge of collapse, that there is a shortage of consultants, a shortage of beds and that crucial equipment is out of date and regularly breaks down. He believes the state of neurosurgery is worse now than it was 30 years ago. In September 2005, there were 426 people waiting for surgery in Beaumont Hospital, more than half of that number had waited for a year. I remind the Tánaiste of the promise to end waiting lists in two years. I ask the Tánaiste to inform the House — on second thoughts, I ask the Tánaiste not to tell the Dáil because he treats this House with derision and contempt anyway; he should tell the camera because he loves the camera. He should, through the camera lens, tell the people waiting for neurosurgery treatment what his Government has done in the past ten years to deal with this problem.

It is obvious the Deputy got out on the wrong side of the bed this morning.

(Interruptions).

The Tánaiste without interruption.

Investment in our health services has risen to more than €12.75 billion in 2006. Ireland's public spending on health has grown at one of the highest rates in the OECD in recent years. Irish spending on health has gone from 15% below the OECD average in 1997, when the Deputies opposite were in power, to 17% above the OECD average in 2003. This is notwithstanding the fact that Ireland has a younger age structure than many other countries.

With respect to human resources, 120,000 people work full time or part-time in our public health service. Between 1997 and the end of last September, there was an increase of 33,672 staff or almost 50% in whole-time equivalent terms. Latest figures show 44.9% more medical and dental personnel in the health service, 27.6% or 7,500 more nurses in the health service, 30% or 7,727 more health and social care professionals.

They are working under great strain.

The number of approved consultant posts has increased by 720 or 56% in the period since the Deputy was in office and today.

It should be noted that this Government has provided the health service with record resources.

Record bad results.

This Government also introduced the National Treatment Purchase Fund which has been an outstanding success. People may criticise one area of the health service or another but the record shows that Ireland as a society has gone from a situation which in 1997, when Fine Gael, Labour and the Democratic Left were in office, spent 15% below the OECD average on health, to the point where we now spend considerably above it. This shows the extent of the commitment of this Government——

The Tánaiste should answer Deputy Kenny's question.

Allow the Tánaiste without interruption.

—— to improving our health system.

We have introduced the medical card for people over the age of 70 years and we have also introduced——

A Deputy

The Tánaiste was against it.

——GP visit cards and 200,000 extra GP visit cards are now available.

Nobody got them.

All the recent accident and emergency figures show conclusively that there are improvements right across the service on a daily basis. The health service is rapidly becoming one of the most effective health services in the European Union.

(Interruptions).

Allow the Tánaiste without interruption. Deputy Kenny was allowed make his contribution in silence. The Tánaiste is entitled to the same courtesy when he is making a reply.

He is not allowed ramble on.

He should be reminded of the question.

I understand a complaint was recently made to the Ceann Comhairle that I gave out about people asking questions and then trying to shout me down. It happens constantly in this House. Deputy Stagg and others are practitioners of the business of asking a question and then shouting the respondent down.

The Minister is wasting time as well as money.

The Minister is like a dumb microphone.

A Deputy

The Minister is like Brendan Grace.

I regret such tactics.

The Tánaiste is good at it himself.

It demeans the Irish Parliament. I think the Opposition is making a collective disgrace of itself and if it does not want to hear the answers I will not go any further.

The Tánaiste is a fantasist.

The Minister sounded like the Minister for Foreign Affairs on "Morning Ireland".

I give the Tánaiste two out of ten for that answer. I asked him about neurosurgery but not once did he mention the word. His answer was about as lethal as the picture of the Minister for Defence sitting on the edge of a helicopter that appeared in this morning's newspapers. It is a good job the helicopter did not take off.

The Deputy should stick to the script and not let his mind wander.

Deputy O'Dea should stick to the Sunday Independent.

The Tánaiste speaks of others as being handcuffed to mediocrity. The answer he has just given is appalling in respect of the 425 people waiting for brain surgery and treatment in Beaumont Hospital.

Those people do not matter.

The Tánaiste has not dealt through his camera with the person from Wexford who was to be given an appointment within three weeks but was not given it within three years. The Tánaiste has not referred to the five HSE reports which speak of severe deficiencies in the equipment to deal with neurosurgical treatments. He bluffed about HSE numbers and the numbers in the health system. Two years ago Professor Drumm told my parliamentary party that of the 125,000 health service employees, 3,500 did not know what their jobs or functions were yet they were to be paid for life. Yet through the camera the Tánaiste has told me that 425 people must listen to that rubbish he gave out. The HSE is bulging with well-intentioned career people who are staggering through the halls of inefficiency, bureaucracy and red tape.

The Tánaiste was so clear in his response when he took a page from a departmental file about the dismissal of Mr. Frank Connolly. He said he needed to speak to the public about an issue of public importance.

The Deputy's time has concluded. He is moving onto another question and he should only ask one topical question.

This is an issue of public importance and the Tánaiste did not refer to it once in his reply.

He does not know the answer.

The Progressive Democrats styles itself as the party that gets things done. Will the Tánaiste tell the nation what it has done about neurosurgery in the last ten years?

The Tánaiste should answer it now with one word.

The Deputy seems to be engaging in amateur theatricals. He has come into this House——

Like the Tánaiste does every Friday with a dumb microphone.

(Interruptions).

The shouting has started again. That is the end of it.

(Interruptions).

They will not let him answer. They will not let the man speak.

I take it the Tánaiste has no answer.

If Deputies do not want to afford a Member of the House when they are called by the Chair——

We want an answer.

He does not have one.

The Deputy should resume his seat when the Chair is speaking. The Chair is here to keep order.

And to make sure that questions are answered.

No. That is not a function of a Chair anywhere in the world. We are not getting into an argument on that. When called by the Chair, every Member of this House is entitled to the courtesy of being heard. That is a function of every parliamentary democracy anywhere in the world. The Chair has requested Members to show the normal courtesy and allow the Tánaiste to reply.

And the Tánaiste should reply.

The Chair has two choices——

The Tánaiste is not representing the Taoiseach. He should answer the question. He did not once mention the word "neurosurgery".

Deputy Kenny, resume your seat when the Chair is on its feet. The Chair has two choices. The Chair can suspend Members for being disorderly. The Chair does not want to take that route, but it will be left with no choice if the disruption continues.

What about Government accountability?

The Tánaiste should answer the question.

On a point of order, the Tánaiste was asked a question to which there is a reply. The House is entitled to know his reply.

That is not a point of order.

Huffing and throwing his toys out of his pram does not constitute an answer.

There cannot be a point of order on Leaders' Questions.

I wish to raise a point of order. Under the rulings of this House, I am entitled to ask a leader's question. I have asked the Tánaiste two questions. He did not mention the word "neurosurgery" once in his reply.

That is an assumption not a point of order.

My point of order is that the Tánaiste is well able to indulge himself in amateur theatrics.

I ask the Deputy to resume his seat.

The Tánaiste should answer the question. What has the Tánaiste and his Government done for neurosurgery in the past ten years? The point is the Tánaiste is not able to answer the question and does not represent the Taoiseach.

He does not have an answer.

I did not know that there was any question the Tánaiste could not answer.

We have moved on from the last question and we will hear the Deputy's question now.

The Tánaiste has a hard neck to lecture this House about decorum in Parliament when he is asked a straight question but cannot answer it and then behaves in the fashion that he has. He has now gone into a sulk.

I would like the Tánaiste to do us the honour of answering a straightforward question. I am referring to an article in The Irish Times where the Tánaiste’s single transferable speech features a couple of times a week. The Minister of State at the Department of Health and Children, Deputy Brian Lenihan, has stated that the proposed site for the new national children’s hospital must be reviewed. This apparently arose in response to the report on Crumlin Children’s Hospital published in The Irish Times yesterday. Deputy Lenihan has apparently said the Government decision on locating the new national children’s hospital must now be reviewed. Does the Tánaiste understand the concerns about this new uncertainty around the future of the national children’s hospital?

If he has not had time to study The Irish Times story, I can tell him the report from Crumlin Hospital apparently said it cannot be shoehorned into the Mater Hospital site. It points out that it is one quarter the size of the existing Crumlin site. It says there are serious problems about access, transport and parking. It says that, ideally, the hospital ought to be built on a greenfield site where the three hospitals could be merged and co-located with a maternity hospital.

The National Children's Hospital at Tallaght makes similar arguments that the reinforcement and implementation of the existing decision will lead to a serious downgrading of the tertiary teaching status of the hospital. The former Archbishop of Armagh, Dr. Robin Eames, met with the Tánaiste's predecessor and the Taoiseach and raised his concerns about the downgrading of Tallaght. He advocated a solution that seems to have merit to many people. He said there ought to be a new national children's hospital under single governance with a campus on both the north side and south side of Dublin. He makes this argument based on the circumstances that force parents with sick children to traverse this city through heavy traffic congestion. A national children's hospital should, by definition, serve the nation, and children coming from the south or west ought not to be asked to spend the additional time travelling from Newlands Cross to the Mater Hospital where there is no parking and no adequate space. It is the belief of these experts and the Minister of State, Deputy Brian Lenihan, that the decision made by Government must be reviewed. Is the Government reviewing the decision? Or does the decision to site the new hospital at the Mater Hospital stand?

As the Deputy appreciates, an extensive review of tertiary paediatric services was carried out by McKinsey and Company on behalf of the Health Service Executive. It recommended the establishment of a single — not a dual — tertiary paediatric hospital in Dublin. It also recommended that the hospital be co-located with a leading adult academic hospital. Subsequently, a joint task group was established between the Department of Health and Children and the HSE to advise on the optimum location for a single tertiary paediatric hospital, bearing in mind the recommendation that it be attached to an adult teaching hospital. That decision stands.

Based on that assessment, the task group recommended that the new national tertiary paediatric hospital be located on a site to be made available by the Mater hospital. The Deputy is well aware that a number of contending hospitals sought to have the single tertiary paediatric hospital located on their campuses. A decision was made on the merits and without political interference that it be located at the Mater hospital.

The task group's report and recommendations were then brought to, and endorsed by, the board of the HSE. They were subsequently brought to Government which mandated the HSE to move forward with the development of the new hospital and the urgent care service required to support it. A joint HSE-Department of Health and Children transition group has been established to advance the development of the new hospital.

The Crumlin report has been the subject of constructive discussions between the hospital and the group. The transition group is in the process of engaging consultants to prepare the high level framework brief for the new hospital and it has been agreed that the Crumlin report, to which the Deputy referred, will be taken into consideration in the preparation of the framework. My colleague, the Minister for Health and Children, has also had meetings with representatives from Our Lady's children's hospital in Crumlin and has assured them that she is committed to ensuring the national paediatric hospital will deliver a world-class service for the children of this country.

Based on its work to date the transition group is entirely satisfied that the Mater site has the space necessary to fully accommodate the new paediatric hospital. It is also satisfied that the future tri-location of maternity services on the site with adult and paediatric services in accordance with best international practice can be fully facilitated and represents the best way forward.

To go back to the Deputy's question, the Minister of State, Deputy Brian Lenihan, asked that the Crumlin report be taken into account, which is being done. However, the decision still stands.

I thank the Tánaiste. Given that was a considered, prepared document, I accept that is the decision of Government and that it stands. I would like to retrace the history a little in terms of the manner of presentation by the Tánaiste that McKinsey was recruited by him to report, that it recommended a single tertiary hospital, that it ought to be co-located on the same site as an adult hospital and that the subsequent decision of the group selected and of the Cabinet to nominate the Mater site was taken without political interference. I have no idea why the Tánaiste made that remark because I did not. The Government is entitled to make whatever decision it believes appropriate. I did not allege any Government interference.

However, it is interesting that he should raise that point because in September 2005, the chairman of the board of governors of the Mater Hospital, Mr. Des Lamont, thanked the Taoiseach at an event there for pledging to the hospital the national children's hospital. The significance of that is that it was three months before McKinsey reported and five months before the process, to which the Tánaiste referred, was put in place to select the site. It is very odd that the Tánaiste should refer to political interference. Those were the words of Mr. Des Lamont, chairman of the board of governors of the Mater Hospital. He did not make the information public but it became public.

I am not questioning the Government's right to make the decision but there are serious questions in the minds of parents in my constituency and in the huge catchment area covered by Tallaght Hospital, of the board of governors of Crumlin Hospital and of expert consultants about the wisdom of a single campus and a single tertiary hospital solution in the centre of a crowded city. The people on the north side ought to have access, as should people on the south side, in today's traffic conditions. One cannot attend a funeral at the Mater Hospital and get a parking place. These are the problems ordinary, hard-working parents have to endure. There is no adequate parking space there. It can be a matter of life and death whether a sick child can be transported from one side of this city to the other, and that is leaving aside the fact that it is supposed to be a national children's hospital.

The Tánaiste said that the Minister of State, Deputy Brian Lenihan, said that the Crumlin report will be taken into account. Given that the Crumlin report absolutely contests the wisdom of the decision made, I cannot see how it can be taken into account and how the Government can proceed with the decision.

Either we agree there should be a single tertiary paediatric hospital in the Dublin area or we do not. There are two schools of thought. Some people have suggested there should be more than one such institution. However, the decision of Government and the HSE, based on the McKinsey report, was that there should be only one such institution. No matter where it is located, there will be difficulties for people getting from A to B in modern circumstances. If it is difficult for people to get from Deputy Rabbitte's constituency to the Mater Hospital, it will be difficult for people who live on Eccles Street to get to Tallaght.

I did not advocate that either.

There is no magic solution to that problem.

I asked about the dual campus.

I am making a very simple point. Once we decided, based on expert advice, that there should be a single campus, which was based on the McKinsey report, it followed——

It was not.

McKinsey did not recommend a particular site.

There are seven minutes for this question and Deputy Rabbitte has already used more than seven minutes. I ask Deputy Rabbitte to allow the Tánaiste to speak.

It recommended a single tertiary paediatric hospital in Dublin co-located with a leading adult academic hospital. I believe the Deputy will agree that once one accepts that recommendation, the hospital must be located somewhere and it will not be convenient for everyone. I am quite satisfied the selection process was objective and without interference. The imputation that McKinsey and subsequently the HSE and the working group were given a political instruction to locate the hospital in one place rather than another is wrong.

McKinsey did not deal with where it should be located.

The Deputy is forgetting the answer I gave, which was that a joint HSE-Department of Health and Children task group was established and the officials on that group decided to make a recommendation. It is wrong to impugn them and to suggest they were "got at" in some way without any evidence whatsoever of that.

The Tánaiste will recall that the Irish Human Rights Commission was established under the terms of the Good Friday Agreement to enhance the human rights of everyone who lives on the island of Ireland and to assist us in meeting our international obligations to human rights.

The record will show that as Minister for Justice, Equality and Law Reform the Tánaiste has more often than not ignored the advice of the commission. Will he and the Government continue to ignore it with regard to the continued use of Shannon Airport by US military and CIA sponsored aircraft in the furtherance of their war in Iraq? Will the Government continue to facilitate the use of this facility, which clearly is in flagrant conflict with our stated position on neutrality and as being neutral on the war in Iraq?

The EU committee to investigate so-called extraordinary rendition has found that the State hosted 147 secret CIA flights, the third highest number among EU states. I emphasise, 147 secret CIA flights. Can the Tánaiste explain how that facilitation fits with our stated policy of neutrality, to be a sovereign and independent state with regard to international affairs in particular, when we continue to use Shannon Airport as a staging post for the US and British led war in Iraq?

It is a clear breach of it.

It is important to point out that this question is posed by a variety of opinions across this island and the United States and does not stem from any anti-Americanism. It is posed simply and in complement to the wishes of the clearly expressed view of the majority of citizens in the United States as recently expressed in the mid-term elections there.

Does the Tánaiste agree that the invasion of Iraq has been an unqualified disaster, has resulted in the loss of tens of thousands of lives and has plunged that country into civil war? Does he agree the war was launched on the erroneous pretext of the existence of weapons of mass destruction? Does he agree that the war policy of the Bush Administration has now been clearly rejected by a significant majority of US opinion? Why then does the Government continue in its facilitation of that US war effort by making Shannon Airport available to US military and CIA engaged aircraft? Will the Tánaiste end that policy now?

The Deputy will appreciate that the origins of the Iraq intervention by western armies occurred at a time when the Government consistently argued against military intervention and asked that more time be given to the weapons inspectors to discover whether there were weapons of mass destruction——

It did not wait to hear the result.

——and whether the issues could be dealt with differently. That was the consistent position of the Government at the time. Deputy Gormley seems to have forgotten that in the meantime a mandate from the United Nations Security Council was unanimously adopted and that it requires member states of the United Nations to facilitate and assist the UN forces in the normal way in carrying out their mandate. We are not in a position to simply tear up or reject that mandate.

With regard to military flights, Ireland, as a member of the United Nations, has an obligation to assist the Security Council in the proper implementation of a council resolution which mandates the presence of a number of countries' armed forces in Iraq. Whatever about the wisdom of the original intervention, on which the Government had a consistent position, the position is that there is a UN mandate for military flights passing through Shannon and it would be wrong for the State to say it will tear up a mandate agreed unanimously by the Security Council.

On rendition flights, the Taoiseach, the Minister for Foreign Affairs and I have personally been assured at the highest levels by US authorities——

Search the planes. If it cannot be done in one's own country, it is a disgrace.

Allow the Tánaiste to continue without interruption.

May I answer the question? Deputies may make comments afterwards. We have been assured at the highest level by the——

Some assurance.

It would be the case in Cuba.

Allow the Tánaiste without interruption.

——United States, through the Secretary of State and at diplomatic level, that there has never been a rendition flight through Irish airspace or Irish airports.

That is nonsense.

Members of the Green Party should be aware this is a Sinn Féin question. It is Deputy Ó Caoláin's question and he is entitled to hear the answer.

Experts who have examined the case have stated that in their view it would be highly improbable that the United States would ever have selected Shannon Airport as a place through which rendition flights would pass. I accept that view because, first, we have a solemn assurance they have never taken place and, second, I regard it as improbable that anyone would attempt to use Irish airspace or airports in this manner.

That is very naive.

Members of the Garda Síochána are fully entitled to search any aircraft if they have a reasonable belief that a crime is being committed on board, and it would be a crime to detain a person against his or her will on a flight, other than on foot of an extradition treaty which is not relevant to this case. As Minister for Justice, Equality and Law Reform, I have repeatedly called on any person with any credible evidence that Shannon Airport was used for allegedly unlawful purposes to share this information with the Garda. On a number of occasions information has been provided to the Garda who thoroughly investigated it and found it to be without substance.

Hear no evil, see no evil.

I remind the House that the President of the Human Rights Commission, Dr. Maurice Manning, said yesterday there was no smoking gun. Members should pay some attention to what he says rather than misquoting him and attempting to suggest that Ireland has been used for rendition flights. It has not.

This is a serious issue, but clearly we do not all share the certainty the Tánaiste's statement indicates he feels. The Irish people, if not the world community, are entitled to that reassurance and certainty. I believe that gardaí, in carrying out their function, should investigate the possibility of wrongdoing rather than wait for a crime to happen. In this instance, it is within the Tánaiste's remit as Minister to indicate, in conjunction with his colleague the Minister for Foreign Affairs, that it is in the interest of truth and right that occasional spot checks be carried out in order to give an indication that there is substance to the Tánaiste's belief.

The Tánaiste must accept that the majority of the people do not believe the assurances given by the US Administration are sufficient or adequate to address this matter and he has a responsibility to take this on board. There was no mandate for the US and British-led invasion of Iraq nor, following investigation, was any evidence presented of the presence of weapons of mass destruction. The contrary is the case. Therefore, their presence was a false pretext for the invasion and this is universally recognised. It is recognised also by citizens of the United States who are probably even more virulent in their opposition than we can represent here today. We must be mindful of this and of the importance of our relations with people in the US.

The Deputy's time has concluded.

We must not ignore them and feel that the Bush Administration is the solitary representative voice. It clearly is not. Will the Tánaiste be honest and admit that to all intents and purposes he has given a carte blanche to the US Administration with regard to its use of Shannon Airport?

I ask the Deputy to give way.

Further, does the Tánaiste recognise——

The Deputy cannot drive a coach and four through the Standing Orders of the House. I ask him to resume his seat.

——that at the very least we and everyone else deserve that occasional spot checks are carried out as a matter of course and immediately?

It is a bad, old fashioned invasion and we all know it.

There is a UN mandate for the presence of foreign contingents in Iraq. It expires at the end of this year and the Iraqi Government has applied for it to be extended.

That is some government.

There was no mandate for the invasion.

I want the Deputy to know the facts before he begins speaking. I never said there was a mandate for the invasion.

I never said the other thing either.

The Tánaiste, without interruption.

They should not lecture us about invasions. They are not so bad at invasions themselves.

The Government has consistently opposed and condemned unlawful rendition of any person by the United States. We are unequivocal on that point and my colleague, the Minister for Foreign Affairs, has made his position absolutely clear in that regard. Second, as it might be asked here, he and I are on the public record as rejecting the circumstances in which people are detained in Guantanamo. We are unequivocal in that regard also.

The Deputy suggested that somehow we are giving carte blanche for the abuse of Shannon Airport.

The military flights are authorised and above board. It is our duty as a member of the United Nations to support the mandate which the United Nations Security Council has unanimously given for the presence of those troops and, by implication, for their rotation.

We are talking about 147 secret CIA flights.

We have received categorical, unambivalent and totally clear assurances——

Does the Tánaiste believe them?

——that at no time in the past has Shannon Airport ever been used for rendition.

That is the same argument that was used for the war in Iraq.

Did the Tánaiste check the assurances?

It is the same argument.

There is no point in shouting me down. The Deputy keeps shouting me down. He is not at one of his own meetings. He should let me finish.

The Tánaiste would prefer it if he had nobody to answer to.

There is no shouting down at those meetings. It is uno duce.

When the Chair is on his feet, Deputy Ferris should stay silent.

Why is there never a leadership crisis in Sinn Féin? Why is there never a leadership battle? I often wondered that.

There are seven minutes for a Leaders' Question. Deputy Ó Caoláin used almost seven minutes on the question. No party in the House can take all the time allotted for the question and then take the time allotted to the member of Government to respond.

It happens all the time.

The Sinn Féin Deputies might listen carefully to the following. If I were to reject the solemn unequivocal word of three senior officials of the United States Administration in this regard, and disbelieve them, it would be a serious step.

A serious step——

The Deputy should let me finish. If relations between Ireland and America were at such a low ebb that we could not believe members of the American Administration on this issue, and that we were naive to believe them——

Their citizens do not believe them.

——much rethinking would have to be done. I say this to the members of the Sinn Féin Party — "You may ask this Government to regard the assurances they receive from the American Administration as false but, if you do so, do not go knocking down the door to get into the White House on St. Patrick's Day."

Their own people do not believe them.

Their people do not believe them.

They were the first to shake his hand. They made a beeline for him. It is one thing here but another over there.

The Minister is a very confused little man.

That concludes Leaders' Questions.

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