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Dáil Éireann debate -
Tuesday, 3 Jul 2007

Vol. 637 No. 5

Adjournment Debate.

Hospital Services.

I thank the Leas-Cheann Comhairle for the opportunity to raise this matter.

Two months ago my Sinn Féin elected colleagues in the north-east region and I presented the media with copies of a document we had received, which spells out in detail the Health Service Executive plans for acute hospital services in the north east, including costings, staff reductions and timeframes. The HSE and the Government did not want this document to enter the public arena before the general election. They sought to conceal the full facts regarding their plans for the future of services at Monaghan and Cavan general hospitals, the Louth Hospital in Dundalk, Our Lady's Hospital, Navan, and Our Lady of Lourdes Hospital in Drogheda but we fully exposed them. The plans include the following: the further loss of services at Monaghan General Hospital; the reduction in treatment room services to an 8 a.m. to 8 p.m., seven-day service by 2008; the transfer of acute medicine from Monaghan General Hospital to Cavan General Hospital by July 2008, with the loss of 5.5 whole-time equivalent posts; the transfer of all Monaghan critical care patients to Our Lady of Lourdes Hospital, Drogheda; closure of the Monaghan high or critical care unit; all in-patient activity to be non-acute and nurse-led; Monaghan General Hospital to become an ambulatory care facility providing diagnostics, rehabilitation and related services, with a target date of July 2008; increases in ambulance staff and vehicles to accommodate increased movement of patients within and to services beyond the region; one bed increase in ITU capacity at Our Lady of Lourdes Hospital, Drogheda, to accommodate the transfer of critically-ill patients from Monaghan; the establishment of a single department of anaesthesia within the Cavan-Monaghan hospitals group with a target date of February 2008; key pathology posts to be Cavan and Drogheda-based, with a reduction in overall staffing of 15 by July 2009; and psychiatric services priority 1 — as it is described — acute psychiatric services to be located on a new regional hospital site, with all this entails for the St. Davnet's hospital facility in Monaghan.

The Monaghan high dependence care unit was to close by Sunday last, 1 July, but this has not yet happened, thank God. We need to know if and when it will happen, or whether public pressure has caused the HSE to relent on this latest cut, which I hope has happened. Following the initial further transfer of services and workload from Monaghan to Cavan, and from Dundalk and Navan to Drogheda, and with a projected staff reduction of 48 by July 2009, the Teamwork implementation project sets 2012 as the target date for the establishment of a new regional hospital that will incorporate all acute and planned inpatient activity for the region upon which, it states, all existing hospitals in the region, including Cavan General Hospital, will become ambulatory centres. The document which we revealed refers to the proposed changes as presenting "major opportunities for savings, efficiencies and staff redeployment". It also refers to front-line staff reductions and the savings that will result as a consequence. Savings of €2.2 million in 2007 and €5 million in 2008 are projected.

This was a damning exposure of the real intent and purpose of the Teamwork recommendations. Improved services and patient safety get scant mention in the text of this implementation document. The real intent of the HSE and the Government towards hospital services in the north east has been shown as never before. I call on the Government to state categorically to the people of Cavan, Monaghan, Meath and Louth that it has at last seen the folly of its approach to acute hospital services and health care in general in the north east and will withdraw their support for the Hanley-Teamwork proposals, and instead commit their long-awaited support for the network of hospitals across this region and throughout the State. I call on the Green Party in particular to honour the signed pledge it gave to the people of County Monaghan in the course of the recent general election.

What is needed is a radical change in the direction of health care policy in both the Department of Health and Children and the Health Service Executive. Democratic accountability must return to the office of the Minister and services must return to our local hospitals. The Sinn Féin vision of health care is one that truly places the patient first and is geared to meeting the needs of communities. Sinn Féin will remain committed to the pledge it gave in support of Monaghan General Hospital and the retention and development of the network of smaller hospitals across this State. For us, our pledge is our word.

I take this matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. I am sure the House will join with me in extending our sympathies to the Minister on the death of her mother.

I thank Deputy Ó Caoláin for raising the matter. The Teamwork Management Services Limited report, Improving Safety and Achieving Better Standards, provides a detailed assessment of hospital services and recommends an action plan for health services in the north east. The report finds that the present system, whereby five local hospitals deliver acute care to a relatively small population, has exposed patients to increased risks. The report recommends a three strand action plan as follows: the development of local services, with the existing five hospitals and primary and community care providers playing central roles; the development of a new regional acute hospital; and the development of a series of clinical networks which bind these local and regional services and are centred around the needs of patients, including networks for emergency care, surgery and critical care.

The Teamwork report includes a number of recommendations to improve patient care in the region. It particularly highlights the need to develop a high quality, responsive emergency and planned service in line with international standards. It recommends that there be one major regional hospital in the north east, supported by the five existing local hospitals. The new hospital is to provide emergency and trauma services on a 24-hour basis and also provide planned specialist procedures that are complex and require the facilities of a large regional hospital.

The hospital reconfiguration process is being overseen by the HSE steering group which is leading the project. A sub-committee of the steering group was established to progress the issue of site selection. Following a tendering process, the HSE appointed consultants to carry out an independent site location study. The study, which the HSE expects to be finalised in August, will take account of various criteria including demographics, access, planning and development considerations and interdependencies.

The first step in the development of a fully integrated regional health service is to ensure the people of the north east have local access to both routine planned care and immediate life saving emergency care. Over the next few years, in preparation for all acute emergency inpatient care and complex planned care being provided at a regional centre, services at the existing five hospitals will continue to be improved. The Department of Health and Children has been advised that the existing hospitals will continue to provide services which meet the majority of health needs of the community.

The HSE advises that the implementation plan will involve some level of redeployment of existing staff but that the plan will result in an increase in the overall number of staff in the region. The HSE has given an assurance that, in progressing the implementation of the Teamwork report, there will be no discontinuation of existing services until suitable alternative arrangements have been put in place.

It has not done that at any time in the past.

Foster Care.

I congratulate the Ceann Comhairle and Leas-Cheann Comhairle on their appointment. I thank the Ceann Comhairle for allowing me to raise this issue, which is dear to my heart.

In 2005 a young woman died tragically, leaving two young children, aged six months and 18 months at the time. To compound this tragedy, her husband suffered a severe stroke six weeks later, was incapacitated and could not look after his children. The children's aunt, who is from south Kerry, took in the children the day after the man had the stroke, which was in September 2005. Following many efforts to secure a foster care grant from the State to look after the two children, they have not received a cent from the State almost two years on.

The foster care allowance is paid in respect of children who are placed in foster care or relative care under the Child Care (Placement of Children in Foster Care) Regulations 1995 or the Child Care (Placement of Children with Relatives) Regulations 1995. The issue of relative care was dealt with in detail in the 2001 report of the working group entitled, Foster Care — A Child Centred Partnership, a title I will bear in mind. The report sets out a number of basic principles that should guide placements with relatives. These are as follows: that the best interests of the child are paramount; that the child should be placed only in an appropriate, safe, healthy and stable environment; that the standard of care must be equivalent to that provided in a traditional foster care arrangement; that the relative placements should only be made where a secure attachment exists or has the potential to develop between the child and the relative concerned; and that a partnership approach should be used to develop skills and support for relatives providing foster care.

I can vouch for these people under each of these headings. The problem, however, is that they have received no foster care or help from the State. The woman who has taken in these children should have received a medal as well as monetary assistance for providing all the care set out under the principles for placements with relatives. The best interests of the children are being cared for and the children are placed in "an appropriate, safe, healthy and stable environment". These people are precluded from receiving the foster care allowance because under the Child Care Act 1991 the children in respect of whom the allowances are paid must be in the care of the Health Service Executive on either a voluntary basis or by court order.

This lady took these children in the day after their father had a severe stroke, which was little more than six weeks after their mother died. Their father was incapacitated and could not look after them. I cannot understand why this woman has not been helped in giving these children love, attention and support. She has given them a ready made family. She has since had a child of her own and the children are in a secure environment but because they were not taken into the care of the HSE they are precluded from the foster care grant. I urge the Minister of State to do all in his power to help these two children who are in a safe, healthy environment.

I add my congratulations to those of Deputy Sheahan on Deputy Howlin's appointment as Leas-Cheann Comhairle. It was remiss of me not to do so earlier. I also congratulate Deputy Sheahan on his election to the Dáil and I wish him well here.

I am replying to this Adjournment matter on behalf of the Minister for Health and Children, Deputy Harney. Deputy Sheahan will appreciate that it would not be appropriate for me to comment in detail on an individual case. I will, however, outline the current legislation and policy which underpin the foster care system.

The Health Service Executive is required under the Child Care Act 1991 to promote the welfare of children who are not receiving adequate care and protection. Where a child requires care or protection that he or she is unlikely to receive unless he or she is taken into care, the HSE must take the child into its care and provide the most appropriate form of alternative care for that child.

The foster care allowance can only be paid in respect of children who are taken into the care of the HSE under the provisions of the Child Care Act 1991 and placed in foster care or relative care in accordance with the Child Care Regulations 1995. In 1998 the then Minister of State in the Department of Health and Children set up a working group on foster care. The task of the working group was to make recommendations on all aspects of foster care. The issue of relative care was dealt with in detail in the 2001 report of the working group entitled Foster Care — A Child Centred Partnership. The report sets out a number of basic principles that should guide placements with relatives. These are as follows: the best interests of the child are paramount; the child should be placed only in an appropriate, safe, healthy and stable environment; the standard of care must be equivalent to that provided in a traditional foster care arrangement; relative placements should only be made where a secure attachment exists or has the potential to develop between the child and the relative concerned; a partnership approach should be used in developing skills and supports for relatives providing foster care; and placements should not be made as a means to provide income support.

While it is not relevant to the case raised by the Deputy, the working group considered the possibility that some children are placed in the care of the HSE in order to provide income support for the family in respect of the child. The group was strongly of the view that such a practice would be highly inappropriate. Income support is a matter for the Department of Social and Family Affairs and people in need of such support should contact that Department.

The working group stated that children should be brought into the care of the HSE if they meet the criteria regarding the need for care and protection set out in the Child Care Act. In addition, the choice of placement of any child in the care system should be based on the particular child's individual best interests.

Under the legislation, the HSE must assess the needs of a child placed in care and the suitability of the prospective foster or relative carers, and draw up a child care plan. The implementation of the child care plan places significant responsibilities and duties on foster carers, whether relatives or non-relatives. The foster care allowance is paid in recognition of these additional responsibilities and the additional costs of looking after foster children.

I understand from the HSE that in this case the children in question are not in the statutory care of the executive and as such the foster care allowance is not payable. The family concerned may, however, wish to apply for a guardian's payment in respect of the children. The payment of this allowance is a matter for the Department of Social and Family Affairs.

These payments are made directly by the Department of Social and Family Affairs, normally to the child's guardian, and are intended to provide income maintenance in respect of children satisfying certain qualifying criteria. The circumstances in which these payments are made and the level of payment are determined by that Department.

Youth Services.

This may appear to be a small issue but it is important. The Cabra West youth service has been operating for two decades in a school in an area with which the Minister of State is probably familiar as it is just across the border from Finglas. The Taoiseach gave out prizes in the school last Thursday morning. The next day the board of management told the Cabra West youth service that it could no longer expect to use part of the premises as an office.

The service has had the resource of the primary school as its headquarters from which it has operated a community employment scheme employing 19 people locally and most important, has provided a service for the young people in the area. Cabra presents many difficulties for the social services, and for young people growing up in the area, as the Minister of State knows. There is significant drug abuse in Cabra. The youth service has provided sporting and recreational clubs, and homework facilities, all of which help to keep young people on the straight and narrow.

In many parts of the north inner city and further afield, primary schools do not close their doors at 3 p.m. but provide greater resources to the community by allowing various CE schemes, youth services and senior citizens' groups to operate on their premises. It seems that this resource is being closed down. The only information the youth service has received is that it must leave the premises and seek alternative accommodation, perhaps across the road in a senior citizens' complex under development. That is not a suitable location for a youth service. Besides, there is no provision in the local authority's plans for a senior citizens' development to include facilities for a youth service.

The youth service is high and dry at the start of the summer and does not know how it will operate. It is extremely disappointing that a service that was provided on those premises for over two decades should now be turfed out at short notice and told not to return during the summer or in the autumn when the school re-opens. I want to highlight the situation whereby a service will be lost and local jobs are at risk. There will be a serious impact on the local community. I know the Minister of State is not directly responsible for the board but, in the context of the broader educational and resource requirements, is there any possibility the Department of Education and Science can make it known that it is anxious to ensure the service is retained, ideally on the premises from which it operates at present? Can it make it known to the board that it looks very kindly on the provision of services of this nature for young people?

I thank Deputy Costello for raising this matter, which I am taking on behalf of the Minister for Education and Science. As the Deputy said, I am well aware of this project as both he and I were both members of the City of Dublin VEC and the City of Dublin Youth Service Board, which were instrumental in helping the project progress.

The issue provides me with the opportunity to explain to the House the position of the Department of Education and Science on the ownership of school properties in the State. It is not commonly understood that the vast majority of our school buildings, both primary and post-primary, are privately owned and managed institutions and that the ultimate responsibility for their usage outside of their principal purpose rests with the trustees or the board of management.

One of the issues regularly raised with the Department by local and community interests is the use of spare school facilities or the use of school facilities outside of school time for community education and recreation purposes. These requests have come from a variety of bodies including county development boards, community groups and the National Children's Office. The Department issued a circular letter to schools in 2005 urging trustees and boards of management to give serious consideration to such requests where possible. In urging school authorities to respond sensitively to this need, the Department fully appreciates that, as already stated, the decision ultimately lies with the relevant board or trustees and that the first priority at all times should be the interest of the school, its teachers and pupils.

Many schools already make their premises available to the local community outside of school hours and schools benefit from the improved relationship with the wider community. Good relations between the school and the community can be beneficial when it comes to seeking placements for work experience, outlets for community service or when schools seek to access local services and expertise. Being linked in effectively with the local community can help the school to provide a wider curriculum and range of co-curricular activities. It is for this reason that the Department publication "Looking at our Schools: an aid to self-evaluation for primary and post-primary schools", suggests that the relationship between the school and the wider community should form one of the self-evaluation criteria for schools.

The Department also acknowledges the need for trustees and boards to prioritise the interests of the principal school users and to protect their own interests. The Department has given advice to schools in key areas in this regard including the need to have a proper licensing agreement in place. With regard to St. Finbar's national school, again the Department does not own the site or the building in which the Cabra West Youth Services, CWYS, is accommodated and the Department is not privy to the school's arrangement with this group.

It is the Department's understanding that the CWYS is funded primarily by the City of Dublin Youth Service Board. The board has indicated to the Department that it is aware of the accommodation issues in question and that negotiations are ongoing with the school authority to resolve them. Given that what is in question here is a private arrangement, this is the correct procedure to address this matter and the Department of Education and Science has no role to play in it.

I thank the Deputy once again for raising this matter. I hope I have explained that, while the Department fully supports and encourages the use of school properties not in its ownership by community and other groups, the decision in these matters rests with school authorities and it is a matter for them to safeguard their own positions where such arrangements are made and to resolve any difficulties arising therefrom.

I give an undertaking to Deputy Costello to raise the matter with the Minister of State with responsibility for lifelong learning, youth work and school transport, Deputy Haughey, and with other related agencies.

I thank the Minister of State.

Drug Seizures.

I wish to share time with Deputy P.J. Sheehan. It is important to let Deputy Sheehan have his say on this incident as it took place a couple of hundred yards from his home.

Last night and today people have being following the extraordinary story of attempted drug smuggling off the west Cork coast, near Goleen. Garda sources now say that up to 1.5 tonnes of baled cocaine have been recovered from the sea next to an upturned inflatable boat. This, the largest drugs haul in the history of the State, happened by chance and because of the weather and the incompetence of the gang of men involved. The street value of the enormous haul of drugs is estimated to be as high as €300 million. Make no mistake, this should be given the priority of a major international drug smuggling incident. We need to learn lessons from what happened and put measures in place to reduce the likelihood of it happening again.

It is not the first time we have seen seizures of drugs off the south-west coast. In July 1991, cannabis worth €9 million was seized in Courtmacsherry; in July 1993 cannabis worth €25 million was found off the Clare coast; in September 1996 cocaine worth €125 million was found on a trawler in Cork harbour; in September 1998 cocaine worth €61 million was found on a catamaran yacht in Kinsale harbour; and in November 1999 cannabis worth €18 million was discovered off the south-west coast by the Naval Service. Now, cocaine worth between €200 million and €300 million has been found in Goleen. It is not surprising, therefore, that senior customs officers state Ireland is perceived as a soft touch for criminal gangs for their drug trafficking activities in the EU.

The Taoiseach's response today in the Dáil was nothing short of pathetic. Apart from saying that we were talking to our EU partners about how best to counteract drug smuggling and announcing the setting up of a monitoring centre in Lisbon, he had little or nothing to say about Ireland's state of preparedness to combat drug smuggling. Yes, we do need to work with other countries which face similar challenges, but we can certainly do something more ourselves within Irish waters in the meantime.

The truth is that we are, indeed, a soft touch for drug smugglers in having an open, largely unpatrolled coastline. We have a competent but small Naval Service, an under-resourced coastguard and an inadequate customs structure in terms of policing and monitoring activity along our coastline. If this incident, which happened purely by accident, does not jolt us into a frank and honest debate about how we invest in the fight against drug trafficking then what will?

I thank Deputy Coveney for allowing me two minutes of his time. The find of a massive cocaine haul off the coast of south-west Cork in Dunlough Bay, near Mizen Head, yesterday, 2 July 2007, was valued at more than €300 million, making it the biggest drugs find in the history of the State. Priority must be given to policing our coastline, involving investment in our coastal defences, gardaí in coastal areas, the coastguard services, the Naval Service and the Customs and Excise.

Did a CASA patrol aeroplane monitor this area in the 48 hours prior to this event? A CASA patrol aeroplane monitors every Irish fishing trawler that leaves our ports and the Irish Naval Service intercepts them in Irish territorial waters and investigates them. How was this international yacht free to enter Irish waters with her deadly haul of cocaine worth €300 million and to put it aboard RIB inflated crafts to bring ashore in Dunlough Bay in my constituency, five miles from where I live?

The Taoiseach, in his reply today, said there would be an international monitoring conference in Lisbon and that he had been in communication with the relevant people. The State did not hear about this incident until the Goleen inshore rescue service was called out on humanitarian grounds to rescue three people clinging onto the raft in Dunlough Bay, after one had swum ashore to raise the alarm at 7 a.m., which alerted the authorities. The Goleen inshore rescue service was the only service that was called to the area. This is not proper management of our coastal area and I urge the Government to take immediate steps to arrest a practice that has been going on for years. The Minister and the Government have been warned about this over the years.

The time is ripe for action and not pious words. Actions speak louder than words. The Government will have to act before it is too late and I appeal to the Minister of State to do so.

I make this reply on behalf of the Minister for Justice, Equality and Law Reform. I thank Deputies Coveney and Sheehan for raising this important matter in the House.

All Members share a sense of relief that the attempt to import a massive amount of cocaine into west Cork on Sunday night and Monday morning failed. I commend the efforts of the Garda Síochána, the customs service, the Naval Service and the coast guard on the operation which has been taking place there over the past couple of days. I acknowledge the great amount of support and assistance they received in their efforts from members of the local community.

The House will appreciate that this matter is the subject of an ongoing investigation from which criminal charges would be expected to ensue so there are some constraints on what I can say. I understand that the Minister met with the Garda Commissioner and the Deputy Commissioner for operations earlier this evening about a range of matters and has been fully briefed on the incident. I also understand that he has been assured by the Commissioner of the Garda's determination to bring its investigation into this matter to a successful conclusion and that no resources will be spared.

The basic facts are by now fairly well known. At 8 a.m. yesterday, Bantry Garda station was alerted to a situation at Dunlough Bay, Mizen Head, where a type of vessel known as a RIB had reportedly ran aground on rocks in heavy seas. One of the occupants of the RIB swam ashore and called to a local residence where the emergency services were alerted. This person was taken by ambulance to Bantry General Hospital. A second person was rescued from the sea and also taken to the hospital. The submerged RIB was 100 yd. off the shoreline in rough seas, together with a large number of floating parcels. Sixty bales, each containing 25 kg. of what is believed to be cocaine, were recovered and removed to Bantry Garda station where an incident room has been established. Three vehicles which are believed to have been linked to the attempted importation have been seized and are being technically examined at Bantry Garda station. The two people removed to the hospital are obviously central to the Garda investigation, but others suspected to have been involved in the attempted importation are also being sought as part of an intensive Garda operation. A full search of the coastline was resumed at first light this morning.

This incident is a stark reminder of the difficulties faced by all of the agencies involved in trying to prevent drugs being imported into the country, either for use in Ireland, or as is likely to be the case here, for onward transmission to other countries. Nobody should underestimate the difficulties posed by the nature and extent — some 3,000 miles — of our coastline. Under the national drugs strategy, the customs service has primary responsibility for the prevention, detection, interception and seizure of controlled drugs at importation. However, the strategy recognises the vital importance of co-operation between the customs service and the Garda Síochána — for which Deputy Brian Lenihan is the accountable Minister — as well as the Naval Service.

While a certain amount may be achieved by random patrols of our waters, the priority must be intelligence-based targeted activities by all the agencies involved. In terms of intelligence gathering and sharing of information, the agencies here co-operate fully not only among themselves but with their counterparts in organisations such as Europol, the World Customs Organisation, the United Nations Drug Control Programme and the Serious and Organised Crime Agency in the UK. On the role of the Garda Síochána, for example, Garda liaison officers are based at London, Paris, The Hague, Madrid and Europol. The work of the customs service in monitoring our rugged and indented coastline is based on risk analysis and intelligence-led enforcement. Mobile anti-smuggling teams operate from key strategic locations. These officers are engaged in intelligence gathering and in operational interventions. This type of enforcement strategy is in keeping with best international practice. The customs service drugs watch programme is also in place to encourage the coastal and maritime communities to assist in confidentially reporting suspicious activity and a dedicated freephone is in operation on a 24-7 basis.

In order to enhance the State's capability to protect the community from drug trafficking by sea, the Revenue Commissioners deployed the customs cutter, Suirbhéir, in 2004. This vessel is currently engaged in the search operation. The Revenue Commissioners constantly monitor the adequacy of the controls that are in place in response to emerging trends and risks as identified both nationally and internationally. Co-operation with other customs services and law enforcement agencies abroad is also an important aspect of this work and such co-operation and intelligence exchange is well established and effective.

In light of recent events I am glad, on behalf of the Minister, to be able to inform the House of a very significant initiative which is under way, namely, the establishment in Lisbon of a new maritime analysis and operational centre. The centre is intended to focus on targeting the sea cocaine routes from Central and South America into the European Union. It will collect and analyse operational information, enhance intelligence through better information exchange, and ascertain the availability of assets to facilitate interdictions in accordance with the national laws of the participants involved. The UK, Spain, Portugal, Italy, Ireland, France and the Netherlands will participate in the work of the centre. I have made clear my full support for this initiative in which the Garda Síochána, the customs service and the Naval Service will be involved. Officials from the Department of Justice, Equality and Law Reform are to travel to Lisbon next week when I expect that the text of an agreement on Ireland's participation will be finalised.

I mentioned earlier the support which has been forthcoming from the local community in west Cork. It is important to stress that, as well as international intelligence, there is obviously a key role for people in coastal areas to report any unusual activities. If people notice unusual objects at sea, underwater or ashore, ships being met by small craft, or vessels operating at night without lights, then they should pass this information on to the appropriate authorities. Both the customs service and the Garda operate coastal alert schemes to encourage this practice.

The subject of this Adjournment matter specifically relates to the interdiction of drugs at sea but we should not overlook the fact that when drugs find their way into the country considerable efforts are made by the Garda to track them down and seize them. For example, between 2004 and 2006 over €40 million worth of cocaine was seized.

That is nothing compared with what was seized yesterday.

It is inevitable that an incident of this kind leads to speculation about what attempts there may have been to import drugs in this way which may have been successful and about which the authorities know nothing. Of its nature, that is speculation for which no hard evidence exists, but in 2005 the United Nations Office on Drugs and Crime estimated that global seizures of cocaine amounted to 44% of cocaine production.

I have listened carefully to the helpful contribution which Deputies Coveney and Sheehan made during this debate. The events of the past couple of days have underlined the fact that the efforts of all the agencies involved to combat this deadly trade must be relentless. For its part, the Government will continue to provide all the resources that are necessary.

The Dáil adjourned at 9.10 p.m. until 10.30 a.m. on Wednesday, 4 July 2007.
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