Adjournment Debate.

Health Services.

Ms Enright

I wish to share time with Deputy Connaughton.

I am raising this matter from a degree of frustration with the Billy to Jack service being provided by the HSE and the Department of Health and Children with specific reference to a constituent of mine but it is a matter of general concern of which Deputy Connaughton and other colleagues also have experience.

My constituent was informed he would be fitted with a digital hearing aid in October 2005. He attended his son's wedding last weekend without having been fitted with a digital hearing aid. The HSE informed me on 1 December 2006 that it would be commencing the process of supplying digital hearing aids in early 2007. It is now one third of the way through 2007 and the digital hearing aids are only being supplied to children.

I accept this was the initial plan and I have no difficulty with prioritising children but I have a difficulty with the slow pace of delivery which extends to a year and a half for this gentleman. He has endured a poor quality of life because of his poor hearing. All he is asking for is a digital hearing aid. These appliances cost in the region of €1,300. I ask for a commitment from the Minister on the timescale within which those already assessed will be supplied with their hearing aids. This is a simple request and not something one would imagine would need to be raised on the floor of Dáil Éireann. However, because of the lack of response to date I had no other choice but to do so. I ask the Minister for a firm commitment as to when the people who have applied will receive their appliances.

Mr. Connaughton

I thank Deputy Enright for allowing me the opportunity to raise the same matter concerning a number of my constituents, particularly one in south Galway. This elderly man had an analogue hearing aid which did not suit him as is the case for many people. He has a medical card and is on a very low income. He tried to better himself by acquiring an attachment for the analogue hearing aid which makes it a half-digital system. The hearing aid is relatively good but it is extremely uncomfortable and is inconvenient. I wish to make a special case for the many hundreds of people at this stage in their lives. Thankfully, I do not have a problem with my hearing. However, I imagine that it is a great drawback to have a hearing impairment. As Deputy Enright stated, quality of life is a matter of major importance to the people to whom she referred. We should at the very least provide digital hearing aids for those who are on low incomes and who are also on medical cards. I understand that the technology is so good that the units are becoming less expensive. I cannot understand why the HSE is not in a position to deliver the type of equipment which can be life changing for many people.

Minister for the Environment, Heritage and Local Government (Mr. Roche)

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

As the House will be aware, the Health Act 2004 provided for the establishment of the Health Service Executive, HSE, which duly came into being on 1 January 2005. Under the Act, the HSE has the responsibility to manage and deliver, or to arrange to be delivered on its behalf, health and personal social services. This includes the delivery of audiology services and the prioritising and resourcing of the development of national community audiology services is now a matter for the HSE. Nonetheless, I am happy to set out the position as regards this matter, as well as to convey the information provided by the HSE on the specific questions asked by the Deputies.

The national community audiology service provides free audiology services for all children, irrespective of their parents' means, and for adults who have eligibility. For an adult to be eligible, he or she must be in possession of a current medical card. The service held 4,822 clinics in 2006 and 39,432 patients were seen. A figure of €1,663,430 was spent nationally on hearing aids and accessories in 2006.

Until the end of last year, all hearing aids fitted by the national community audiology service were of the analogue type. However, since the beginning of 2007, the HSE, as part of the modernisation of the service, has started the roll-out of the provision of digital hearing aids for children up to the age of 18 years. The reason for this was the impact of hearing loss on children's education.

As Deputy Enright said, everyone would agree that if we are going to focus resources, they should be focused in this direction. At present, the HSE does not provide digital hearing aids for adults over the age of 18 years. However, it is examining the costs involved in providing digital hearing aids to adults. In addition, it hopes to establish a national review of audiology services to explore the delivery of such services in the most appropriate setting.

Meanwhile, the HSE has worked to ensure national standardisation of approaches to waiting lists and waiting times using a standardised template. Data according to this revised template is due to be reported at the end of the first quarter 2007.

A further imperative is to develop integrated working for those with hearing loss at primary care level between audiologists, general practitioners, speech and language therapists, public health nurses, etc. The HSE also envisages the development of audiology services that will be fully integrated between acute hospitals and community services and delivered in the most appropriate setting.

The Department of Health and Children is committed to the continued development of community audiology services. I will ensure that the comments of both Deputies are brought to the attention of the Minister for Health and Children, Deputy Harney.

Water Pollution.

Mr. McCormack

I welcome the Minister. Earlier today, Deputy Michael D. Higgins and I tabled motions under Standing Order 31 requesting the Adjournment of the Dáil to discuss this extremely important issue relating to the well-being and health of people in Galway. It would have been far more satisfactory if we had engaged in a debate under Standing Order 31 with the Minister and his colleague, the Minister for Health and Children, rather than dealing with the matter via this set-piece debate on the Adjournment. We had no other option but to raise the matter on the Adjournment when our motions under Standing Order 31 were refused. I have every confidence in the Minister for the Environment, Heritage and Local Government but he will read from a prepared script that will be relevant to the subject but will not provide answers in respect of some of the questions Deputy Michael D. Higgins and I intend to pose.

The Minister is aware that the waters of the Corrib are seriously polluted and, as a result, 90,000 people in Galway city, Oughterard, Killannin, Moycullen, Oranmore, Maree, Derrydonnell, Athenry, Corrandulla, Annaghdown, Headford, Tuam and elsewhere have been affected. The Minister for Community, Rural and Gaeltacht Affairs gave an interview in respect of this matter earlier this evening on national radio and he appeared to indicate that €21 million has been available since 2002 for water treatment works in Galway city and county. He more or less laid the blame at the door of local authorities for not taking up the offer of this money. Will the Minister for the Environment, Heritage and Local Government, Deputy Roche, indicate why that €21 million was not spent in Galway, where the water supplies of city and half the county are sourced from the 60,000 acre Lough Corrib, which has been seriously polluted with the cryptosporidium virus?

It is no wonder that the Corrib is polluted, particularly as a result of the Government's failure to provide sewage treatment plants and sewerage schemes in towns and villages which surround it such as Headford, Claregalway, Oughterard, Cornamona and Clonbur. The Government neglected its duty by not providing the necessary infrastructure to which I refer. We have been warning about the danger of pollution in the Corrib for many years.

There appears to be an attitude that this problem in Galway should be hushed up. It is a serious problem and well over 100 people were identified as having contracted the virus and several were hospitalised. However, several hundred more people, whose immune systems were better able to combat the infection, were also affected. The virus is extremely dangerous for the elderly, the young and people who are receiving chemotherapy. People who live in the affected area cannot touch the water, drink it, use ice cubes made from it or brush their teeth. The Government's attitude appears to be that the matter should be played down.

Deputy Paul McGrath tabled a parliamentary question earlier today in which he asked the Minister for Health and Children the number of deaths that have occurred over the past ten years from the presence of cryptosporidium in public water supplies, and the groups vulnerable to serious injury or death from this organism. The Minister replied to the question but did not provide any information about the number of deaths. From my research, I am aware that a number of deaths have resulted from people being infected with this virus in recent years.

Why is it not possible to face up to the fact that we are faced with a serious crisis? Will the Minister for the Environment, Heritage and Local Government outline the steps being taking in Galway to put in place the necessary infrastructure to facilitate the filtration and treatment of drinking water of the population of Galway city and the surrounding area? This problem will not go away by itself, particularly since it has been established that the Corrib is polluted. What steps is the Department taking to ensure the problem in the affected area, in which I live, will be remedied as soon as possible in order that proper water supplies will be restored to the people who reside there?

Mr. Roche

I thank the two Deputies who raised this matter. Deputy McCormack asked a specific question and I will cut to the details of that because he is entitled to specifics.

The presence of cryptosporidium was confirmed on 20 March, as Deputy McCormack knows. It was found to be involved at the old Terryland plant, which is part of the Galway city water supply. That was confirmed by further research the following day. I understand that there is no cryptosporidium to be found in the Galway council's second and more modern plant at Terryland.

Deputy McCormack asked me specifically to clarify the position on funding. I am pleased to confirm that the funding has been in place for a number of years but that the Galway council still has to prepare the brief to draw down that funding.

Inadequate filtration capacity at the old treatment plant in Terryland is at the centre of the problem in Galway city. Funding has been in place for some considerable time, under my Department's water services investment programme. As Deputy McCormack acknowledged, the funding is in the sum of €21.5 million. That money is intended to upgrade the plant and will minimise future risk of cryptosporidium entering the supply. I understand that Galway City Council will submit a brief for the appointment of consultants to prepare a preliminary report for this scheme to my Department as soon as possible.

As Deputy McCormack stated, the current difficulty for the people in Galway is an extremely serious matter. One of the basic and fundamental supplies which our local authorities are responsible for providing is clean water and it is astonishing that €21.5 million has been available to carry out services, with which, as Deputy McCormack suggests, it has been known in this area for some time that there were problems. I cannot understand why the brief has not been prepared and I have asked for an explanation of that. I have indicated to my Department that the brief, as soon as it is submitted, receive immediate attention and clearance in the Department.

I hope this latest incident will prompt the council in this case to show urgency in the matter and will certainly prompt local council members to show more focus and ambition on the issue. After all, that is what the people of Galway city and Galway council have elected their councillors to do. Deputy McCormack might like to inquire locally as to precisely why there has been such lethargy on the issue. My Department has spoken to the council and I am convinced that it is working hard on the issue.

I also understand from the contacts that have been made with the city council that it is putting temporary filtration facilities in place until the upgrade of the Terryland plant is complete and will produce a report on the available options later this week. As soon as that report comes to my Department it will receive attention. I wholeheartedly support the idea and my Department will assist the council in any way it can. Moreover, we will look positively on and support any proposals from the council for advance works on the €21.5 million permanent scheme.

Deputy McCormack mentioned other schemes in the area and I will advert to two of them. The Headford water supply scheme is a small stand-alone scheme using raw water from Lough Corrib with disinfection only. A €29 million extension to the Tuam regional water scheme to Headford, which is also funded by my Department, is under construction and commissioning is expected to take place in August next. In the meantime, I understand that Galway County Council has secured an alternative supply, which could be in place within a week or so, from the Caherlistrane-Kilcoona group water scheme, which itself has had a €4 million treatment plant installed last month with funding from my Department. It is simply untruthful to suggest that funding is not being provided by the Government.

Mr. McCormack

I spoke about the past.

Mr. Roche

The funding is in place now. As I stated, the council in Deputy McCormack's area has had €21.5 million available to it to do this work. I realise he is not a member of the council, but local inquiries should be made as to why that was not spent.

Mr. McCormack

I was a member.

Mr. Roche

I am sure Deputy McCormack would have been much more active in this matter than certain current councillors, who preach about the green agenda but do not practise it when they are in power in their local council. I have clarified that funding of €21.5 million has been in place for some time for the Terryland upgrade and I look forward to the council coming forward with the proposals.

Returning to the first point, I agree with Deputy McCormack — I also spoke privately to Deputy Michael D. Higgins who is not in the Chamber but who I am sure has been inadvertently detained — that it is wrong that 90,000 people should be without water. It is doubly wrong when 90,000 in an important city and surrounding area are without water when the funding is in place. Deputy McCormack and other public representatives in the area and, more importantly, the people of Galway, are entitled to an explanation for that.

I give Deputy McCormack and this House an assurance that I will do everything in my power to ensure that as soon as the brief comes up, it will not stay for a moment longer than required in my Department. I have also stated that I made clear to my Department that I want it to be helpful and to assist Galway through this great difficulty, particularly given the time of year. As Deputy McCormack stated, it is not just an inconvenience but is a threat to public health and to life itself. That is not acceptable, particularly when local councils have funding available to them. Deputy McCormack can assure his constituents, as I have assured all the other public representatives in the area, that I will encourage the council to be ambitious and will encourage my Department to co-operate fully with Galway to bring this matter to an end.

Road Network.

Ms C. Murphy

I particularly highlight the area of rural roads in north-west Kildare. Clearly, there has been tremendous pressure on many of these roads because they are being used by vehicles which are too large for them. Indeed, many gravel pits and the like have contributed to the damage. However, significant budgetary constraints are experienced by Kildare County Council as a direct result of the population growth. Although it may well have escaped notice, Kildare is the fourth most populous county, behind Dublin, Cork and Galway. It has overtaken Limerick. Kildare now has a large population, with all the related demands placed on it. Obviously, the stresses and strains are being seen in areas such as roads.

Kildare County Council carried out a dilapidation survey of roads in north-west Kildare which were west of the R402, the Enfield-Edenderry road. Subsections of the road were categorised as very poor, poor, fair, good or very good, and good was identified as a road with good visibility which was free of potholes for at least 1 km or which had no more than ten repaired potholes per 1 km. The council then carried out a costing exercise to calculate the cost of bringing the road up to a good standard. The cost per square metre was based on the historical knowledge, VAT etc. Kildare County Council concluded that bringing up to good condition the 230,000 sq m of road that need to be addressed would cost €2.83 million, but it has allocated €300,000 for this year which is significantly short of what is needed.

Over the winter some of the bus services for school children were not provided because the roads were inadequate. Some of the roads have crumbled at each side and are not even capable of taking cars in both directions simultaneously.

Kildare motorists paid €35 million in motor tax last year into the local government fund, for which it is ring-fenced, and the local authorities in Kildare received €27 million back. I, therefore, reckon that Kildare is the biggest net contributor to that fund.

Taking the local government fund and the commercial rates together, the two counties with the lowest spend per head of population were Meath and Kildare, respectively. While within those counties the widespread perception is that the money must be spent in Naas, Newbridge or elsewhere, it is the inadequacy of resources that is the problem. By not spending enough, there is a degree of wastage by repairing roads rather than doing a proper job.

Some years ago the former Minister, Pádraig Flynn, declared a war on potholes and I want the Minister, Deputy Roche, to declare a war on potholes in north-west Kildare. I have a copy of the photographs concerned to hand and if the Minister saw them, he would agree this is not acceptable in a country that is as well off as we are. With regard to transport, a state-of-the art highway was constructed not far from this part of County Kildare by a public private partnership which is not used by everyone because these people face difficulties in accessing it. They feel like the forgotten people. I would like to give the Minister a copy of the photographs and I invite him to meet these people because I am sure they would welcome him if he came to see first-hand the difficult circumstances they are experiencing, although he would be shocked by the condition of the roads. I hope he will not tell me how many millions have been allocated to County Kildare or how well-off the county is because that is a myth.

Mr. Roche

I hope not to disappoint the Deputy but I intend to outline the extraordinary resources currently available to Kildare County Council, not only from Exchequer funds but also due to the development contributions taken in by the council in recent years and the buoyancy of its rates. If any local authority should be facing difficulties in this area, it is not Kildare County Council.

I have significantly increased the allocation to non-national roads this year, with €947 million coming from the local government fund. General purpose grants from my Department have also been significantly increased to meet the gap between the cost to local authorities of providing a reasonable level of day-to-day services and the income they obtain from other sources. The amount I am providing this year represents an increase of 8% over the amount provided in 2006. In the case of Kildare County Council, I have provided €26.48 million in general purpose grants in 2007, or three times the amount received in 1997. This represents an increase of 10.8% on 2006. The Deputy will accept the allocation is ahead of the rate of inflation. If any small or medium business in County Kildare was able to guarantee an 11% increase in its bottom line revenues, it would be very happy.

The provision, maintenance and improvement of non-national roads is a matter for local authorities to fund from their own resources, supplemented by grants provided by my Department. In 2007, the grant allocation by my Department to Kildare County Council for improvement and maintenance works on non-national roads is €23.53 million, while the municipalities in the area received additional funding. This is three and a half times the funding provided in 1997 and seven and a half times the provision in 1994. Over the same period, Kildare County Council's own resources have fluctuated dramatically. One of the problems for the county may be an eccentric voting pattern by councillors with regard to funding. The figures available on my Department's website reveal some extraordinary variations. The council's resources were €4.1 million in 2001 and €1.6 million in 2002, and subsequently increased to €7.4 million and €7.6 million. I commend the council on its recent allocations, which have amounted to €10 million over the past two years. Like many other local authorities, the increased investment in non-national roads being made by Kildare County Council from its own resources is not keeping pace with the increases in those resources.

The Deputy has a lot of experience as a councillor, so she will be aware that rate income in County Kildare has doubled over a six-year period. Development contributions have increased even more spectacularly, from €6.4 million in 2000 to €27.4 million in 2005. I understand the estimate for development contribution income was over €37.3 million last year, or a 50% increase in one year alone. Any council receiving those sums has no excuse for potholes. That money is intended for a variety of purposes, including public lighting, roads and pavements, rather than being simply lodged in the bank. Development contributions are specifically designed to ensure developers play their part in upgrading local infrastructure. The Deputy is correct that there has been a significant increase in commercial and construction traffic in County Kildare, with punishing implications for roads. However, that traffic has also produced the 50% increase in development levies. I am not sure whether any other local authority achieved such an increase.

The raising of development contributions and the policy principles for expenditure are matters for local councillors but community gain should be a primary consideration. If the Deputy has concerns about how resources are being expended, she should raise them with her local councillors. I find it strange that the council has informed her it does not have the resources to carry out a comprehensive audit of roadworks for the county. I do not understand how a local authority representing a county which has experienced such a phenomenal increase in development levies could make such an excuse to a public representative.

The Exchequer is also providing significantly increased funding to local authorities towards infrastructure provision in other areas, such as national roads, housing and water services. In the past decade, the substantial level of resources provided to local authorities through central funding and the fruits of economic success resulted in a trebling of local authority expenditure. Every local authority in the country is experiencing increases in population, although these increases are higher in some areas than others. When I establish general purpose allocations, I consider non-national road grants, increased rates income and the resources now flowing into local authority coffers from development contributions.

This argument is too often made by local authorities. I believe there is insufficient ambition among elected council representatives to perform thorough audits of how funding is being spent. The Deputy may agree with me on that issue. It is the reason I have proposed establishing internal audit procedures in every local authority. Good quality external auditing experience would give elected members the ammunition to ensure more ambition, efficiency and delivery at local level. I am familiar with the potholes in County Kildare, some of which are herculean in size. However, lack of funds is not a reason for the lack of attention given to these potholes. Funding is being provided but it needs to be used properly.

The Dáil adjourned at 9.20 p.m. until 10.30 a.m. on Thursday, 29 March 2007.

Dáil Éireann debate - Wednesday, 28 Mar 2007