Dáil Éireann debate -
Tuesday, 11 Dec 2007

Vol. 643 No. 3

Adjournment Debate.

Patient Transport Service.

Deputy Michael Ring

I do not mean to show disrespect to the Minister of State at the Department of Education and Science, Deputy Seán Haughey, but it is outrageous that no representative of the Department of Health and Children has attended this adjournment debate. The health issue I am raising is very important and the Minister for Health and Children and the many Ministers of State at that Department have shown total disrespect for it. I am so angry that I am considering whether to raise it at all. When Ministers will not listen to what is happening, it is no wonder my constituents are finding that people in the health service are hanging up when they call.

I wish to raise the issue of the transportation of patients to hospital appointments. A march was held in Castlebar on this issue some weeks ago and the Health Service Executive gave a commitment that people with cancer, and others, would be taken to their hospital appointments, but this is not yet happening. Yesterday morning I met a very sick person who was waiting on a call from the Health Service Executive but did not receive it and so had to cancel a hospital appointment. The option of using a private transport operator is now being pushed. Constituents of mine must get up at 5 a.m. and 6 a.m. to be in Bangor by 6.45 a.m. and in Castlebar and Galway by 9 a.m. and 11a.m. Last week a patient with leukaemia arrived at the hospital at 9 a.m., got treatment at 10 a.m., was violently sick at 11 a.m. and had to wait until 3 p.m. for the return bus service. In the end he went home using private transport because he could not wait.

The Health Service Executive is not taking people with cancer to their hospital appointments. Yesterday a wheelchair-bound constituent of mine tried to get on a privately operated wheelchair accessible bus but could not do so and had to cancel her appointment. Shame on the Government and shame on the Health Service Executive.

There was a very good service until two years ago but Mr. Bonner, who has responsibility for the Health Service Executive in this regard, has destroyed the service because he will not help sick, weak people travel to their hospital appointments. He has attended committee meetings here in the past and he will come in again shortly. We cannot expect people with leukaemia, cancer and those on social welfare to cancel appointments. There will be a situation like that in Portlaoise and people will die, but Mr. Bonner does not care because he and his staff have a jeep for emergencies that has televisions, television cameras and radios; it cost a fortune and might never be used. People are missing their hospital appointments because of this issue.

I am disappointed that neither the Minister for Health and Children, Deputy Harney, nor one of the Ministers of State at her Department has attended this debate. I know they forwent their pay increases today but she is still on €230,000 per year and the Ministers of State are on €170,000 or €180,000. They should be here tonight to listen. The HSE will not listen but will hang up phones when people call and will not bring them to hospital appointments. I will raise this issue on the Order of Business every morning until it is sorted out because it is shameful that we cannot bring sick, old and weak people to their hospital appointments. Shame on the Government and Fianna Fáil that they have failed to ensure the provision this service.

Deputy Dinny McGinley

This is the case all over the country, including Donegal. I know an old woman with Alzheimer's disease who needs to travel 65 miles for treatment and is affected by this issue.

Minister of State at the Department of Education and Science (Deputy Seán Haughey)

I will take the adjournment debate on behalf of my colleague, the Minister for Health and Children, Deputy Harney. The Health Service Executive, HSE, provides transport to hospital appointments for patients who, because of the nature and extent of their illnesses or disabilities, are unable to use conventional modes of transport. The type of transport provided depends on whether the person requires transport by ambulance. Ambulance transport is prioritised within the categories of emergency, urgent and non-urgent. The HSE's ambulance service is complemented by the use of private ambulance services when necessary. Where there is no need for ambulance transport the HSE uses other vehicles, including taxis, to provide transport for patients. This service is also complemented by the use of private hire operators and this has been the case for a number of years.

The HSE is currently conducting a major review of the patient transport service and this will extend to the entire country. It is anticipated that the outcome of the review will inform the development of a more comprehensive national patient transport policy. Ultimately this will lead to a more equitable, integrated, needs-based service.

In general terms, the purpose of the patient transport service is to enable appropriate integrated care services to be provided. While many patients can readily avail of the standard service, it is sometimes necessary to put in place specific arrangements to meet the particular needs of individuals. In particular, the HSE recognises that some oncology patients may require specific transport arrangements and these will be considered on the basis of individual needs.

Deputy Michael Ring

I mean no disrespect to the Minister of State but his answer was rubbish and a waste of time. I will raise this matter on the Order of Business and cause such a row tomorrow that the Government will know all about this issue.

Hospital Services.

Deputy Jimmy Deenihan

I understand Deputy Ring's frustration and feel it is a disgrace that, with one Minister and four Ministers of State, no representative of the Department of Health and Children could attend this evening to listen to the matters raised on the adjournment by Deputy Ring and me. It makes a farce of the Adjournment debate, though I mean no disrespect to the Minister of State, Deputy Haughey.

Yesterday evening three consultant surgeons in Kerry General Hospital took the unprecedented measure of inviting all Oireachtas representatives of Kerry to a meeting at the hospital to discuss its future. They are concerned at the future of the provision of cancer treatment at the hospital and wonder what will happen as a result of the creation of a centre of excellence in Cork. They referred to the need for an endoscopy unit, a high dependency unit, staff for the day care ward, a maternity ward and orthopaedic services at the hospital. I am glad to have the opportunity this evening to outline the lack of orthopaedic services in Kerry General Hospital.

The outpatient waiting list at the moment for orthopaedic procedures at Kerry General Hospital consists of around 600 adults. Some 200 have been waiting more than two years and 300 more than 12 months. I do not believe there is another part of the country with such a long waiting list. The inpatient waiting list is shorter and around 46 people have been waiting more than three months. A reason is that consultants use the treatment purchase fund to send patients to other hospitals for procedures.

Many people have problems with their knees, especially the elderly, but knee replacement procedures are not done at the hospital. Operations on patients on the trauma list, that is, patients with broken bones, can only be carried out on Fridays. If one breaks a bone in one's leg or finger one must, generally, wait until Friday to be operated on. The trauma list should be dealt with every day, as in most hospitals, and a person who breaks a leg or hand should be operated on immediately.

Patients with broken bones require rapid assessment and treatment by an orthopaedic surgeon and anaesthetist. Early discharge to a comfortable environment with adequate rehabilitation facilities is also vital. Unfortunately, this level of back-up is not available and patients are generally discharged into mixed wards.

There is an urgent requirement for a daily trauma operating theatre list with adequate radiographic back-up. Only one radiographer is on call out of hours, including the weekend. There should be at least two. There is also an immediate requirement for a dedicated ward space, including a day ward facility, so that minor injuries such as finger and wrist fractures can be treated on a one-day basis.

The population of Kerry almost doubles during the summer because of the influx of tourists. Many of these tourists engage in activities such as horse riding, hill walking and rock climbing, which can result in accidents. Thus, Kerry General Hospital is under significant pressure to provide services not only for the local population but also for visitors. The resources are simply not available. I understand members of the HSE review issues that are raised in the House. I call on them to do what is necessary to make Kerry General Hospital a centre of excellence in orthopaedic services.

Deputy Seán Haughey

I am taking this matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney. In recent years, the demand for orthopaedic services in Kerry has consistently increased due to the growing population as well as significant elderly and visiting tourist populations. In response to this, the HSE has endeavoured to ensure that a comprehensive orthopaedic service is provided.

Since July 2007, the medical staffing of the orthopaedic department at Kerry General Hospital has increased by an additional registrar and now consists of three orthopaedic consultants, four senior house officers and three registrars. The department currently provides the following services: elective, or planned, and trauma, or emergency, surgery; six consultant-led outpatient clinics; on-call ward rounds; and trauma admissions. Activity in the orthopaedic department is intensive. Twelve elective orthopaedic surgery sessions are carried out each week, while trauma orthopaedic surgery has three dedicated sessions. However, some trauma cases are included in the elective sessions. Orthopaedic emergencies are managed within the general emergency theatre lists on a Saturday, Sunday and out of hours.

Within the hospital structure, there are 30 beds dedicated to orthopaedics. The complete upgrading of this ward has been flagged as a priority by management and funding in excess of €3 million has been approved for this purpose in 2008. This project will involve structural changes including the making available of high-quality facilities, including an isolation room, and will separate elective and trauma patients to reduce risk of cross-infection.

Management at Kerry General Hospital is working closely with the national treatment purchase fund towards reducing waiting times for orthopaedic patients. So far this year, 60 inpatients have been referred for surgery and a further 41 persons have been referred for outpatient consultation to the Bon Secours Hospital.

The HSE is committed to providing the best possible quality of care to all orthopaedic patients attending the hospital. The executive is undertaking a review of acute hospital services in Kerry and Cork with a view to developing acute health care that minimises risk to patients and is in line with best international practice and national policy. The review will identify the appropriate model for acute service provision in the HSE southern region and will recommend how best to configure acute hospital services in Cork and Kerry to deliver on this model.

Institutes of Technology.

Deputy Brian O’Shea

The formal application to the Department of Education and Science by Waterford Institute of Technology seeking upgrading to university status was lodged in February 2006. A spokesman for the institute stated at the time:

The expectation is that a national and international panel of respected higher educationalists will adjudicate on the merits of the institute's case and their report will be submitted to the Higher Education Authority. This expectation is absolutely in line with section 9 of the Universities Act 1997.

When I raised this matter in an Adjournment debate in October 2006, I pointed out that this panel had not been set up. That is still the position in December 2007.

In reality, the position is even worse. In her reply to a recent parliamentary question, the Minister for Education and Science failed to confirm that consideration of the report of Dr. Jim Port on the submission of Waterford Institute of Technology would be concluded in her Department by the end of 2009. It was in November 2006 that the appointment of an independent expert, Dr. Jim Port, to conduct a preliminary assessment of the Waterford Institute of Technology submission was announced. I stated at the time that this was nothing other than a political ploy to carry the Government through the upcoming general election. It gave the impression that something was happening, when the opposite was the case. Events have borne out my judgment. This is an unnecessary additional step that effectively postpones the implementation of the statutory process laid out in the Universities Act in regard to the application process for the setting up of a university of the south east.

The Minister admits she is cognisant of the strong support that has developed in the south-east region for the application from Waterford Institute of Technology for university status. However, neither the Taoiseach nor the Government has the slightest intention of approving this concept, which would allow for a hub campus in Waterford and associated centres in other counties in the region.

Figures published by the Central Statistics Office in February 2007 show that, in 2004, disposable income per person in the south-east region was 8.8% below the national average. This is the lowest in the eight regional authority areas. The 2005 report by Goodbody Economic Consultants, commissioned by Waterford Chamber of Commerce, found that the move to university status would generate €96.7 million annually for the region's economy and create 2,215 direct and indirect jobs. If Waterford Institute of Technology remains as it is, the study estimates the employment it generates will remain static and it will produce €70 million for the economy.

This illustrates the great need for a university of the south east. The benefit of such an establishment will not be confined to the region but will be nationwide. Without a university, the region will continue to under-perform particularly in regard to the knowledge economy where the potential for job creation must be urgently developed. Even if the statutory process set out in the Universities Act 1997 were set in motion today, the various stages would take considerable time to conclude.

The Government must conclude its delaying game and implement the report of Dr. Jim Port. It must cease inhibiting the vital progress of the south-east region and let the submission from Waterford Institute of Technology be assessed as the law provides. The Government cannot continue to ignore the 460,000 people in the south-east region and their vital interests in terms of development and of the prosperity of their children and grandchildren. The good effects of the establishment of a university in the region will go beyond this. This sham must come to an end without delay.

Deputy Seán Haughey

I thank the Deputy for raising this matter. In February 2006 the governing body of Waterford Institute of Technology wrote to the Department of Education and Science requesting a review of its status under section 9 of the Universities Act 1997.

The provisions of section 9 state that the Government may appoint a body, which will include international experts, to advise the Higher Education Authority on whether, having regard to the objects and functions of a university, an educational institution should be established as a university. On the advice of the body and the recommendation of the Higher Education Authority, the Government may, by order, provide that the institution shall be a university for the purposes of this Act.

To assist the Department in its assessment of Waterford IT's application, the Minister, Deputy Hanafin, appointed Dr. Jim Port in February 2007 to provide preliminary advice on the merits of the submission by WIT. In particular, he would have regard to the national strategy for the development of higher education; implications for regional development in the south east in the context of the national spatial strategy; and any likely implications for the overall structure of higher education in Ireland. Dr. Port's report was received in late July 2007 and is currently under consideration.

Aside from consideration of the nature of the statutory review process that is provided to progress an application for designation as a university, there are also significant wider issues that must be considered in the context of a decision to institute a statutory review. For example, there have been important and relevant wider policy developments in the overall higher education sector. In particular, it is important that account is taken of the very significant recent changes in the overall legislative framework governing Irish higher education, with the commencement of the new Institutes of Technology Act 2006 on 1 February 2007. There is also a wider Government policy on foot of the review of Irish higher education carried out by the OECD in 2004, the broad thrust of which was endorsed by the Government.

A central conclusion of the OECD review was to support Ireland's strategic ambition of placing our higher education system at the front rank of the OECD in the context of the wider national objective of Ireland developing as a world-leading knowledge economy and society. A key recommendation made in the OECD report to the Government was that Ireland should retain the differentiation in mission of the university and institute of technology sectors, which it identified as a key strength of our system, and that there should be no institutional transfers into the university system for the foreseeable future.

The report also recommended that the universities and institutes of technology should be brought together under the remit of a single authority for the purpose of achieving a unified higher education strategy. It further recommended the extent of external regulation of the institutes of technology should be lightened, giving them greater managerial freedom in responding to the opportunities and challenges of supporting regional and national social and economic development.

The Institutes of Technology Act 2006 addresses significant elements of these recommendations and marks a major milestone for the sector and the development of higher education in Ireland. It provides for greater autonomy for the institutes to fulfil their missions and by bringing them within the remit of the Higher Education Authority, it supports an integrated and cohesive strategic approach to the development of higher education in line with national priorities.

The Act means, in practice, that the HEA and the institutes of technology will now engage in a way that is very similar to the way the HEA and the universities engage. The new arrangements provide for a more autonomous and strategic relationship with Government, through the HEA, reflecting the dynamic and competitive nature of the environment in which the institutes are now operating.

The Minister is cognisant of the strong support built in the south-east region around the application from Waterford IT for university status. An application for designation as a university has also been received from the Dublin Institute of Technology and my Department is currently examining the submission and supporting documentation provided by DIT. The relevant wider policy developments I have outlined above are also fundamental to the Minister's consideration of the appropriate next steps in both applications.

Schools Building Projects.

Deputy Michael Creed

I thank the Ceann Comhairle for allowing me the opportunity to raise this matter. I will provide some background information on the application for funding a new school. St. Colman's boys national school has 135 pupils, 14 teachers, 12 special needs assistants, a secretary with an office in the corridor of the school, a caretaker, a part-time foreign language teacher assisting non-national students with the English language and a music teacher.

The school is currently located on the side of a national primary road, the N22, which in itself poses a traffic hazard and a major concern for parents and teachers over pupil safety. There are five prefabricated classrooms, as well as an autism unit catering for 13 pupils in three separate classroom environments. A unit in the school caters for three pupils with Down's syndrome.

I visited the school recently and, notwithstanding the cramped and almost Third World conditions under which the school is operating, it is a credit to the staff, teachers and parents in that it is an excellent school delivering excellent results for pupils. In particular there is the more recent development of the autism unit and the unit for children with mild disabilities, which is achieving tremendous results in the most appalling circumstances one can imagine.

We feel somewhat aggrieved in the constituency of Cork North-West by Government failure. In Macroom there was the closure of the GSI plant and the Molex plant in Millstreet has also closed. The closure of Delta Homes has contributed to employment loss in the area and there has also been a failure to deliver a bypass for Macroom or Charleville. Decentralisation of the Department of Agriculture, Fisheries and Food was also promised. We desperately need some indication that this Government will honour its commitments.

There is a background to the case for a new school for St. Colman's. In April 1997 the board of management applied to the Department of Education and Science to extend accommodation facilities at the school and in February 1999 a design team was appointed. In September 2000 a new school site of 2.25 acres was offered to the board of management of the school by a developer in exchange for the existing school site. In November 2001 the developer also offered to construct a temporary school on-site, trusting the Department would have a new school in place for the 2003 to 2004 school year. In January 2002 the Department's procrastination resulted in the developer withdrawing the offer to provide a temporary school and in July 2005 permission was granted by Macroom Town Council for a new development which was to include a new national school. In September 2005 the tendering process was completed and a letter of intent issued to Western Building Systems, the contractor appointed at the time. In July 2007, the developer commenced his work on the preparation of the site.

I urge the Minister of State to depart from his prepared script because I know the Department is dancing on a pinhead with regard to quantity surveyor reports and recent cost increases. A letter of intent issued to Western Building Systems in 2005 and they are now looking for accommodation for inflation in construction costs because it has not gone ahead since 2005. I appeal to the Minister of State to act immediately on the consultant architect's report on the revised sums demanded by Western Building Systems on the grounds of inflationary costs accruing since the letter of intent issued on 15 December 2005.

It is an open and shut case which has gone on for ten years since 1997. The pupils deserve better as the teaching conditions are appalling, to say the least. There is great unity of purpose evident among the board of management, staff and parents but they desperately want a signal of commitment from the Government. If they get such a signal, they could be in a new school by September of next year.

Deputy Seán Haughey

I thank the Deputy for giving me the opportunity of outlining to this House the position of the Department of Education and Science regarding the provision of new school premises for St. Colman's boys national school in County Cork. It is proposed to provide a design and build turnkey package to comprise a permanent system-built, two-storey school with ten classrooms, a double autistic unit, specialist resource rooms and ancillary accommodation. A revised report with updated costings on the project has been received in the Department and is under examination.

Under the national development plan €4.5 billion is assigned to the capital requirements of the primary and post-primary sectors. More than €540 million will be spent this year on school buildings. The level of construction alone in the primary and post-primary sectors in 2007 is such that it will deliver more than 700 classrooms to provide permanent accommodation for approximately 17,500 pupils.

The progression of all large-scale building projects from initial design stage through to construction phase is considered on an ongoing basis in the context of the Department's multi-annual school building and modernisation programme. The progression of this school project, as with all large-scale projects, will be considered in this context. The Minister intends to announce in January the first tranche of projects that will be proceeding to construction in 2008, with further announcements throughout the year as the school building programme is rolled out.

I assure the Deputy that the Department is committed to providing suitable high-quality accommodation for a national school in County Cork at the earliest possible date.

The Dáil adjourned at 10.35 p.m. until10.30 a.m. on Wednesday, 12 December 2007.