Dáil Éireann debate -
Thursday, 28 Feb 2008

Vol. 648 No. 4

Adjournment Debate.

Hospital Services.

Deputy Jimmy Deenihan

I welcome the Minister of State, Deputy Jimmy Devins, to the House. He will fully appreciate the current problems with a number of services in Kerry General Hospital as he has a close relative, a prominent consultant, working in the hospital.

Some years ago, there was no public cardiologist service in Kerry. At the time, I arranged a public meeting from which it was agreed that the Bon Secours private hospital in Tralee and Kerry General Hospital would co-operate in using a cardiologist. Initially, this worked very well, with six units out of ten in the Bon Secours and four in Kerry General Hospital. However, due to a lack of resources and support, the then cardiologist left and he has been replaced by consultant cardiologist, Dr. Carey, who is not happy with the type of support services he has for the public element of his contract.

Just last week, an article in The Sunday Tribune demonstrated clearly that Irish people are three times more likely to die from heart disease than those in France, Portugal and Italy. Despite our country’s wealth, Ireland’s mortality rates from cardiovascular disease are as bad as those in less well-off eastern European countries such as Poland, Macedonia and Croatia. In Ireland, Kerry has a higher rate of heart disease than any other part of the country. More decisive action needs to be taken to come to terms with this problem.

The recent Irish Life insurance figures showed that 31% of the deaths in Kerry were attributed to cancer and 31% to heart disease. It is obvious heart disease is at an unacceptable level in Kerry. Some 250 patients are currently on the waiting list for echocardiograms and more than 100 patients are on the waiting list for coronary angiograms. Before Christmas, three patients who were on the coronary angiogram waiting list died. If the treatment service had been available these three patients might not have died. Another patient who was on the waiting list collapsed and had three stents inserted while on holiday in France.

A number of initiatives should be taken which I will outline. There is a need to upgrade and replace the current echocardiogram machine. The finished quality and storage capacity of the current machine have deteriorated significantly in recent months and it does not allow for accurate assessment of diagnosis for two reasons. First, the machine is eight years old and, second, the current model is obsolete. In addition, a portable echocardiogram machine is required as a secondary machine for inpatient echocardiograms and ICU scans as the hospital is currently carrying out approximately 1,600 scans.

There is also a need for adequate data storage. Current echocardiograms are performed and reported on with the consultant on a single machine. This restricts the number of echocardiograms that can be performed, as reporting schedules have to be scheduled at regular intervals. A PC-based system would allow for off-line reporting to allow for increased scanning times.

The quality of readings on the current stress test machine, which has been obsolete for a number of years, continues to deteriorate and needs to be replaced as a matter of urgency. Because of his knowledge of and connection with Kerry General Hospital I appeal to the Minister of State, Deputy Devins, not just to respond to the matter but to follow it up for the sake of people in Kerry where we have the highest rate of cardiovascular disease in this country. Surely this warrants some type of action and reaction.

Minister of State at the Department of Health and Children (Deputy Jimmy Devins)

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

The appointment of a full-time consultant cardiologist for Kerry General Hospital is a priority for the southern hospitals group of the Health Service Executive, HSE. The management of the hospital itself is committed to providing the best possible quality of care to all its patients and is working with the National Hospitals Office of the HSE to further enhance the cardiology service at the hospital during the coming year.

In line with the cardiovascular health strategy, Building Healthier Hearts, published in 1999, investment in the development of cardiology services has taken place across the region, in both Cork and Kerry. Kerry General Hospital received €503,778 over the first three years of the strategy to develop cardiology-related services. This resulted in approval to recruit a number of staff, including four coronary care unit nurses, an occupational therapist, two student cardiac technicians, a cardiac rehabilitation sister and cardiac rehabilitation nurse, a dietician and a physiotherapist.

In 2004, the fourth year of the strategy, €160,000 was allocated to begin the process of establishing a consultant cardiology service in Kerry with a full-year allocation of €476,000 in 2005. This funding allowed the HSE south to appoint a cardiac technician, nurse and clerical support as well as providing certain non-pay costs.

The strengthening of the infrastructure in Kerry General Hospital has so far enabled the hospital to develop a cardiac rehabilitation service, a cardiac non-invasive diagnostic service, to extend its telemetry service in the CCU, extend its resuscitation training programme and provide for ongoing staff training. It has also ensured that essential cardiac equipment was procured for the cardiology service at the hospital.

The HSE has advised my Department that currently a consultant cardiologist from the Bon Secours Hospital, Tralee, is working in a partnership arrangement with Kerry General Hospital, thus facilitating the development of specialist cardiology services. Kerry General Hospital and the HSE southern area remain committed to enhancing the cardiology service at the hospital in line with Government policy and at the rate at which resources can be allocated.

Health Services.

Deputy Jack Wall

I have raised on a number of occasions the issue on home helps in the Kildare-west Wicklow area. A total of 800 home helps do not receive travel expenses. I have tabled numerous parliamentary questions on this matter. The replies I received indicated that home helps in other areas are paid these expenses directly through the Health Service Executive and through voluntary organisations. I am delighted this is happening, but why can the same not apply to home helps in the Kildare-west Wicklow area?

I have been told by letter that an exercise is currently in progress to establish entitlements on an individual basis to travel expenses and to make arrangements for the payment of same. That has been ongoing since before Christmas but no progress has been made in resolving the matter. Although we have computers we do not seem to be able to make progress in this regard.

Parts of Kildare and west Wicklow are very rural. As a result, most home helps have to travel and they have significant costs in terms of petrol and car maintenance in order to provide their service to people in the community every day. There has been a reduction in the number of home help hours provided to people and this has resulted in more house calls being made by each home help. This puts more pressure on the vehicles of home helps and increases the cost factor.

The voluntary organisations appear to be able to pay such expenses but the HSE, in spite of PPARS and the other computer systems, is not able to pay people. The latest reply I received from Eastern Community Works, ECW, in Kildare, which acts as paymasters to process payment for salaries only to home helps, indicated that the payment system used by ECW is limited in so far as it does not have the same capacity or flexibility as the HSE computer payments system. Why are payments not transferred to the HSE computer system if it has the capacity to deal with them? Why deprive these people who provide such a service?

Given that each home help probably helps up to five or six people, up to 2,000 people could be in receipt of home help assistance in County Kildare. In spite of the great work they do, these people have not been provided with expenses in recent years. This is the case despite the fact that ordinary voluntary organisations in other areas can provide a facility to pay these expenses.

I urge the Minister of State, for the sake of common sense, not to isolate these people who provide such a valuable service. We must ensure that if the ECW is not in a position to provide the computer service that is required to calculate and ensure home helps get their money, then payments will be transferred to the main HSE computer in Millennium Park. We must ensure payments are made. It is naturally wrong that home helps in all other areas can get expenses, but not in Kildare and west Wicklow. It is not logical to deprive one group of this payment, given the service they are giving and the need for proper transport. Travel expenses would go toward ensuring the service could continue to be provided.

Deputy Jimmy Devins

I am taking this matter on behalf of the Minister for Health and Children, Deputy Harney. I thank Deputy Wall for raising this issue and giving me the opportunity to outline the situation regarding the payment of arrears due to home helps for travel expenses in the Kildare and west Wicklow area.

I am advised by the HSE that the home helps in Kildare and west Wicklow are employed by Eastern Community Works. I understand the delay in payment in this case is due to technical difficulties in processing payments. Work is ongoing to rectify these difficulties and information regarding outstanding claims is currently being gathered. Staff affected can be assured that payments will be made as soon as possible, once these difficulties have been resolved.

It is our policy that services for older people should be developed and delivered in a such a way that enables them to be maintained at home with dignity and independence for as long as possible in accordance with their wishes, as expressed in many research studies. Those older people who become ill or dependent should be restored to a level of independence at home. The role of family, neighbours and voluntary bodies in caring for older people in their own community is also to be supported and actively encouraged. The home help service is vital to the implementation of this policy. The aim of the home help service is to enable people to remain at home, where appropriate, who might otherwise need to be cared for in residential care. It is recognised that the home help service is an essential support to family and informal carers.

On the specific area of home help services, an additional €33 million was given in 2006 which funded an extra 1.75 million home help hours. This was augmented by a further €18 million in 2007 which resulted in 780,000 extra hours coming on stream. The 2008 budget includes a further €4.6 million in additional expenditure by the HSE for 200,000 extra home help hours this year. The executive expects to provide a total of around 11.98 million home help hours nationally in 2008.

As part of the HSE's ongoing transformation programme there is a move to the provision of care in the community — primary care — and this is being supported by the introduction of primary care teams throughout the country. Primary care teams should be the first access point for persons who need to access the health system. It is intended that they will facilitate people's access into, through and out of the system and ensure quality care is provided in a manner that maximises the convenience for patient and clients. Home helps will form a vital part of these teams.

In preparation for this new role the HSE, SIPTU and IMPACT established a high level group in 2006 to review the existing models of home help service with a view to establishing a standardised high quality service that would benefit both clientele and staff. A high level report was produced by this group in June 2007 and agreed by all parties. These improvements will help to ensure clients will receive the same high level of service wherever they are located in the country, as well as meaning the staff and their valuable work are given the appropriate recognition and reward.

Deputy Jack Wall

Of the eight paragraphs in that reply only one related to the matter. It is the same answer I received to a written question before Christmas.

Courts Service.

Deputy Shane McEntee

I thank the Ceann Comhairle for this opportunity to raise the issue of the Kentstown bus crash. As we all know, almost three years ago five beautiful girls from County Meath lost their lives in that crash, which had a dreadful effect on their families, the local community and the whole country. Three years later that incident is still on everybody's minds. The families would like to get on with their lives. Two days ago they had hoped the inquest into the deaths of their five girls could eventually be heard following a court case relating to this incident. This court case has been postponed until next January. The other children involved in the accident and the families would like to see this case brought forward. They would like to put a chapter of their lives in its place. Until the inquest is heard, this will not happen.

Last night I met the five families together in one room. They made it clear they want the inquest to take place and asked me to read this letter on their behalf:

We, the parents of Lisa Callan, Sinead Ledwidge, Amy McCabe, Claire McCluskey and Deirdre Scanlon who lost their lives in the Kentstown bus tragedy would like to collectively put on record our disappointment and total frustration at the deferral of a scheduled court case relating to the bus accident.

It is just not acceptable that we as parents, our extended families, along with our neighbours' children who were affected by the bus crash and the local community have to wait another year to have an inquest on our loved ones.

We have suffered almost three long, hard years of hurt and pain. We have tried to get on with our lives, especially for our other children, but until such time that the inquests take place, this will never happen.

We do not accept the fact that a country such as ours does not have the court facilities or the judges available to proceed with the court case which would help bring an end somewhat to our grief and pain.

We are asking the Government and the Court Service to bring this case forward immediately.

I am aware that the president of the Circuit Court is examining the possibility of arranging an earlier hearing for this case and if an available date is identified it will be offered to the other parties. On humanitarian grounds I ask everybody to ensure this is done.

Deputy Jimmy Devins

The Minister for Justice, Equality and Law Reform has asked me to thank the Deputy for raising this issue. He welcomes the opportunity afforded today to set out, in some detail, the developments under way in modernising and improving services to court users.

The Courts Service was established as an independent body in November 1999. The service was set up to manage the courts, support the Judiciary and provide a high quality and professional service to all users of the courts. The responsibilities of the Minister for Justice, Equality and Law Reform include ensuring adequate funding for all parts of the criminal justice system, including the courts. I am pleased to say €107 million was provided in the recent budget for the Courts Service in 2008. This represents an increase of 5% on 2007. The Deputy raises two issues, buildings and waiting times, and I will deal with them in turn.

Since its establishment, the Courts Service has been extremely successful in transforming the courts system in this State and this has been widely acknowledged. The service is continuing the major programme of work to provide modern 21st century court buildings in all parts of the country. The allocation for capital works on courthouses next year stands at nearly €30 million. This funding will ensure our courthouse stock is maintained in good condition in keeping with its role as the public expression of the administration of justice in the State. The achievements of the courts building programme are impressive. A new, state-of-the-art criminal courts complex in Dublin is being constructed in Parkgate Street and is due for completion in 2010. The building will concentrate all central Dublin criminal law business in one service location with 22 new court rooms. This will involve the transfer of courts and administrative offices from three jurisdictions — District, Circuit and Central — to the new facility. The centralisation of all criminal business in the new complex will also mean the Four Courts will be freed up for civil business. This is a public private partnership project, PPP, and the biggest undertaking in the justice sector.

Approval has been given to the Courts Service to proceed with nine other greenfield court projects by way of PPP as part of the new envelope of €50 million for such projects over the next two years. Last year courthouse building and refurbishment projects were completed in Tullamore, Bray, Fermoy, Belmullet and Dolphin House in Dublin. This year projects will be completed in Ardee, Thurles, Clones, Blanchardstown and Gorey. Work will begin in 2008 in Kilkenny, Monaghan, Mullingar, Swinford, Manorhamilton, Wexford, Kilmallock, Killaloe, Youghal and Virginia. This is an impressive list and stands as firm evidence of the ongoing efforts to improve our courthouses. This level of development and modernisation is without precedent.

I do not list these projects merely to draw attention to the substantial investment the Government has made, but to highlight the resulting vastly improved facilities for all court users. As well as the impact on waiting lists for criminal trials and civil cases, the new criminal courts complex is being planned with separate transit flows, so that victims and their families no longer have to wait in proximity with an accused person.

The Government is firmly committed to ensuring that judicial resources are adequate to the demands placed on them. Last year, the Courts and Court Officers (Amendment) Act 2007 provided for an additional 14 judges — six judges of the District Court, four judges of the Circuit Court and four judges of the High Court. The additional judges were appointed to deal with delays and generally speed up the judicial process. The waiting time between return for trial and trial in the Central Criminal Court — where the most serious cases are heard — was 18 months in 2002. Today the waiting time for the hearing of cases is six months. The strict application by the court of its own ground rules on adjournments——

Deputy Alan Shatter

What has this got to do with the matter on the Adjournment?

Deputy Jimmy Devins

——and the continuing good case management and careful scheduling of cases have all contributed to the significant reduction in waiting times and the optimum use of the judicial and other resources allocated to the court.

The situation in the Circuit Court and the District Court varies according to location. While some venues are in a position to schedule cases for the next sittings, others are experiencing delays due to a variety of factors. The president of each court has at his disposal unassigned judges who can be used to assist permanently assigned judges where pressure of work demands it. If more judges are required, they will be appointed.

The Deputy referred to a particular case. The allocation of court business is a matter for the Judiciary. The Minister for Justice, Equality and Law Reform has no function in the area. However, I can make some general comments about the tragic case in question and I assure the families involved that everything possible will be done to bring this matter to a speedy conclusion. This case was listed for hearing at Trim Circuit Court. As there were understandable difficulties in empanelling a jury locally in County Meath, the presiding judge transferred the case to Dublin for hearing. In criminal cases, priority must always be given to those cases where the defendant is in custody. The defendants in this case are not in custody. The case was listed for hearing on 26 February 2008. However, all available judges were already hearing cases and it was not possible for the case to proceed. The President of the Circuit Court is now examining the possibility of arranging an earlier hearing date. If an available date is identified, it will be offered to the parties.

The scheduling of court cases in the Circuit Court is a matter for the president of that court and the presiding judge who are, subject only to the Constitution and the law, independent in the exercise of their judicial functions.

Deputy Shane McEntee

I thank the Minister of State most sincerely.

Citizenship Applications.

Deputy Alan Shatter

I want to raise the general issue of citizenship applications and to illustrate the difficulties by referring to a specific case. It is my information that at this stage there are more than 17,000 applications for citizenship awaiting decision within the Department of Justice, Equality and Law Reform. The citizenship section of that Department is overwhelmed by the number of applications with which it must deal. It is incapable of communicating on any reasonable basis with anyone who raises specific queries, including Members of this House. It is completely unable to provide a customer friendly service. Letters from Deputies, Senators, or members of the general public seeking a citizenship application go directly to the section, but then it all disappears into a black hole.

People's lives are being kept on hold while citizenship applications are languishing undecided in the Department for two, three and four years. An example of the difficulties confronting people is illustrated by the case of Mr. Steven Phillips. He came to Ireland in 2000. He has a work permit and has worked here lawfully ever since. He is employed by a leading firm of architects. Mr. Phillips has been involved in a variety of projects of great importance. He was involved in the layout of the conferences during the last European Union Presidency in 2004 and got a Garda clearance for that work. He was a project architect manager for the renovation and refurbishment of the third floor of the premises of the Minister for Justice, Equality and Law Reform at 94 Saint Stephen's Green. He was the project manager for the new offices of the Department of Arts, Sport and Tourism in Killarney. He was involved as project manager in the refit of the offices provided for the new Minister for Communications, Energy and Natural Resources. He also was one of two people from his firm who went to Saint Fintan's Cemetery in Sutton to carry out a survey of that cemetery, in order to ensure that proper facilities would be available at the funeral of former Taoiseach Charles Haughey for the dignitaries and others who were to attend, including the media.

Having lived and worked in Ireland on a number of important projects over five years, he applied for citizenship. He applied in December 2005 and he received a response in February 2006, which informed him that his application would be examined further at some time in 2008. In November 2006, he sought a long-term residence permission so that he would not have to renew his residence permission annually. He wrote to the Minister in desperation on 3 July 2007 regarding his application for citizenship and his long-term residence application. He asked whether someone could just deal with the matters, whether someone could respond to some queries he had made, and whether there was any remote chance that his citizenship application might be processed. He received an acknowledgement from the Department on 16 July 2007, but there has been silence since then.

In one of the letters of acknowledgement he received at an early stage, he was asked not to write too often to the Department, because it might get in the way of processing applications. It is now two and a quarter years since this man applied for citizenship. Based on the backlog of cases, there is a realistic possibility that his application may not be processed until 2009 or 2010. This is gross maladministration. It is an indication of a public service incapable of providing public service. The public service is treating with contempt applications for Irish citizenship made by foreign nationals lawfully working in this country. It is particularly ironic at a time when we in this State are urging members of the US Congress to grant long-term residence and citizenship to Irish illegals who have been working there for years. This is an example of an individual lawfully working in Ireland — incidentally, he married an Irish citizen a year ago — who would like to be granted Irish citizenship so that he could get on with his life. He and his wife would like to purchase a home for themselves and possibly start their own business.

There is a blockage in all of this. It is not just in the fact that the Department has not processed his citizenship application, but in the fact that he cannot even get any information from the Department. I appreciate the tolerance of the Ceann Comhairle, but I ask that this man's citizenship application be assessed. He already has a security clearance and is obviously self-supporting. He has been involved in jobs on behalf of the Government. I ask that he be granted the citizenship he is seeking. Pending that, someone should at the very least deal with his application for long-term residence, upon which a decision should have been made six months ago.

Deputy Jimmy Devins

I speak on behalf of the Minister for Justice, Equality and Law Reform, Deputy Brian Lenihan.

The existing processing time for applications for certificates of naturalisation is approximately 30 months from the date the application is received until such time as the applicant is informed of the Minister's decision. This is primarily due to the significant increase in the volume of applications received in recent years. The number of applications received in 2007 was 8,003, an increase of almost 100% on the number received just three years previously. It appears that this upward trend is set to continue for the foreseeable future. The Minister shares the Deputy's concerns regarding processing times and I understand he has recently allocated additional resources to the citizenship section of his Department so that several categories of applicant can be dealt with more expeditiously than at present. These include refugees, spouses of Irish citizens and applications made on behalf of minors.

The Irish Nationality and Citizenship Act 1956, as amended, provides that the Minister for Justice, Equality and Law Reform may, at his absolute discretion, grant an application for a certificate of naturalisation provided certain statutory conditions are fulfilled. These conditions are that the applicant must be of full age or, by way of exception, be a minor born in the State; be of good character; have had a period of one year's continuous residency in the State immediately before the date of the application and, during the eight years immediately preceding that period, have had a total residence in the State amounting to four years; intend in good faith to continue to reside in the State after naturalisation; and have made, either before a judge of the District Court in open court or in such a manner as the Minister for special reasons allows, a declaration in the prescribed manner of fidelity to the nation and loyalty to the State.

In the context of naturalisation, certain periods of residence in the State are excluded. These include periods of residence in respect of which an applicant does not have permission to remain in the State, periods granted for the purposes of study and periods granted for the purposes of seeking recognition as a refugee within the meaning of the Refugee Act 1996.

The granting of Irish citizenship through naturalisation is an honour and applications must be processed in a manner which preserves the necessary checks and balances to ensure that it is not undervalued and is given only to persons who are suitably qualified. Upon receipt, each application is examined to determine if the statutory application is completed fully. Approximately one third of all applications for naturalisation received are not completed correctly, necessitating the forms and accompanying documentation being returned to the applicant with an explanation of the problem involved. Valid applications are examined to determine if the applicant meets the statutory residency criteria set out in the Irish Nationality and Citizenship Act 1956, as amended. Passports and other documentation are examined in detail and inquiries with the Garda National Immigration Bureau may also be necessary. Since this procedure was introduced on 1 April 2005, more than 3,500 applicants who applied since that date have been found to have insufficient residency in the State for the purposes of naturalisation. All such applicants are informed of any shortfall in their residency and will be able to re-apply when they have the required residency.

The next stage of the process involves assessing an applicant's financial status in respect of his or her ability to support himself or herself in the State. Inquiries with the Revenue Commissioners and Department of Social and Family Affairs may be necessary in this regard. At the same time, inquiries are also made with the Garda Síochána to ascertain if the applicant can be deemed to be of good character. There may also be circumstances in individual cases which require a greater level of investigation than other cases. Once all inquiries are completed, the file is referred to the Minister for Justice, Equality and Law Reform for a decision.

These procedures have been developed and refined over a number of years and the Minister is satisfied they are necessary to maintain the integrity of the naturalisation process. The Deputy will appreciate that these processes can, by their nature, take some time to complete. Consequently, having regard to the resources available, which are kept under constant review, there is a limit to the reduction in the processing time that can be achieved. The Minister has, however, instructed his officials to undertake a review of the various processes in order that these might be streamlined further where possible.

Deputy Alan Shatter

The same undertaking was made last September. Obviously, nothing has been done in the intervening period.

Deputy Jimmy Devins

Should an individual wish to make inquiries, a citizenship helpline operates in the citizenship section of the Department and this is open to public representatives and members of the public. The helpline operates each Tuesday and Thursday between 10 a.m. and 12.30 p.m. In 2007, in excess of 10,000 calls were processed on this helpline. Information can also be obtained via e-mail or alternatively by accessing the Department's website at www.justice.ie.

Deputy Alan Shatter

Ministers do not reply to e-mails.

Deputy Jimmy Devins

The Minister does not accept the Deputy's contention that the Department fails to provide a customer friendly information and response service.

An application for a certificate of naturalisation from the person referred to by the Deputy was received in the citizenship section of the Department on 5 December 2005, rather than 2004 as stated by the Deputy.

Deputy Alan Shatter

I referred to 2004.

Deputy Jimmy Devins

Officials in the citizenship section are processing applications received in mid-2005 and have approximately 1,000 applications on hand to be dealt with before that of the person concerned. These are generally dealt with in chronological order as this is deemed to be the fairest to all applicants. It is likely therefore that the individual in question might expect to receive a decision in his case in the coming months.

The Dáil adjourned at 5.25 p.m. until 2.30 p.m. on Tuesday, 4 March 2008.