It is proposed to take No. 11, motion re Standing Order 99; and No. 19, the Twenty-eighth Amendment of the Constitution Bill 2008 — Second Stage (resumed). It is proposed, notwithstanding anything in Standing Orders, that No. 11 shall be decided without debate; Private Members' business, which shall be No. 34 — motion re World Trade Organisation, shall take place on the conclusion of No. 11 and shall be brought to a conclusion after three hours, if not previously concluded.
Order of Business.
Is the proposal that No. 11 be decided without debate agreed? Agreed. Is the proposed arrangement to deal with Private Members' business today agreed? Agreed.
The Dáil did not sit earlier this week on account of the death of former President, Dr. Patrick Hillery. Last week I raised a question here with the Taoiseach about the elderly in a certain hospital in Dublin. I noted the comments of the Chairman of the Joint Committee on Health and Children, Deputy John Moloney, who said in the context of that question versus stamp duty, the question of the elderly was less relevant.
I beg the indulgence of the Leas-Cheann Comhairle to permit me to say to the Tánaiste and Minister for Finance that it is a national scandal that a 76 year old woman with Alzheimer's disease who suffered a heart attack has been on a trolley in the Mater Hospital since Monday. This is an appalling situation. We are spending €15 billion on health, which is under the purse strings of the Minister for Finance. The recruitment embargo which prevents specialists being recruited and appointed will result in a disastrous situation sooner rather than later.
It is two years since the absent Minister for Health and Children said that the accident and emergency units around the country were a "national disgrace". I accept what the Tánaiste says, that he is a man who wants results and that health is his priority, but this is a national scandal. I beg the Chair's indulgence to ask the Tánaiste to apologise to the family involved on behalf of the Government and send out the Minister for Health and Children to do something about this situation this morning.
Deputies
Hear, hear.
Before I call on the Tánaiste to reply, I ask Deputies to note that there are no Leader' Questions today. I will allow for some latitude, but within that confine.
It is very important to point out that there are many improvements taking place in the health service. Obviously there are issues but if the Leader of the Opposition's tactic is to come in and talk about a particular case where there is a difficulty and suggest that the sorting out of that difficulty alone is to sort the health service is a rather simplistic and facile approach and analysis.
Clearly what we are trying to do is to bring reforms into the health service that will deal with many of the perennial problems we are facing.
Things are getting worse.
The whole purpose of the reforms we are pursuing is to achieve that.
The Government has had 11 years to sort it out.
It is not working.
(Interruptions).
The Tánaiste without interruption. I now call Deputy Eamon Gilmore.
Neither stamp duty nor the elderly counts for anything.
There is nothing facile or superficial about this issue. A 76 year old woman who had a heart attack has been lying on a trolley since last Monday. She has been feeling so bad about her condition that she has been asking her family to allow her to die. Her family have been on the national airwaves to talk about it. It is not an isolated case.
The problem of accident and emergency at the Mater Hospital has been highlighted here on many occasions by my colleague, Deputy Joe Costello. The situation in the Mater is so bad that Deputy Costello has been picketing that hospital every Saturday for the past five years. I was there with him two weeks ago. I walked through the accident and emergency ward. At 2 p.m. on a Saturday, it was overcrowded for the patients and for the staff. When I talked to some of the staff they said "You should see it on a Friday night or a Saturday night". This is scandalous and I appeal to the Tánaiste——
I am anxious that this very serious matter is dealt with in a way that is in order.
I appreciate that and I do not want to stray out of order but I would ask the Tánaiste to get——
(Interruptions).
It is funny, is it? It would not be funny if any of our mothers was lying on a trolley like that.
Deputies
Hear, hear.
This woman needs a bed in a proper ward and needs treatment. Would somebody over there go and sort it out, please?
Deputies
Hear, hear.
I wish to raise a second matter. Yesterday a High Court judge, dealing with a case involving the custody of the child of a lesbian couple and a biological father, criticised legislators for not having introduced legislation to deal with the rights of same sex couples. He said that such legislation was urgent. In March 2007, the Labour Party introduced a Bill to legislate for civil unions for same sex couples. The Government at the time used a procedural device to postpone the Second Stage. We introduced a motion in October to restore that Bill to the Order Paper and at that stage the Government told us that the heads of a Government Bill would be published by the end of March 2008. To date, we have not had the heads of that Bill, nor do we have a date for its publication. When does the Government intend to publish the heads of the Bill and when will the Bill itself be before the House?
To deal again with the first matter, the point I am making is that of course one hopes that the management and staff within the health service can accommodate any person who is an emergency case or where there is a particular issue arising. That is a responsibility for the management and staff to work out themselves. The operational responsibility is there. I am simply making the point that if our attempts to reform the health service are on the basis of trying to solve problems relating to individual cases, we will not actually reform the health service in the way we must. It will be a status quo-plus situation.
The woman has a statutory right to a minimum level of service.
She has been lying on a trolley. The oxygen ran out twice. Last week we——
Deputy Harney said she should be judged on the improvements in health.
(Interruptions).
If we are going to have order in the House——
Allow the Tánaiste to conclude his remarks without interruption.
It is not isolated. It is happening throughout the country.
The Deputy is not in order. If there is any way we can sort out those problems, of course we will seek to sort them out.
The Government has had 11 years to sort them out.
We cannot have a debate on health if Deputies are just going to keep shouting. That does not solve anybody's problems.
The situation is worse now than it ever was.
It is neither intelligent nor rational.
What has the Government been doing for the past 11 years?
I ask Deputy Bannon to allow the Tánaiste to speak.
What has been happening in the last number of years——
With respect, a Leas-Cheann Comhairle, the Tánaiste using terms like "facile" is not helpful.
The Tánaiste without interruption.
Are we going to have a debate or a shouting match?
Appoint a new Minister.
No.
(Interruptions).
The Tánaiste has the floor.
I will tell Deputies the situation. The reforms have to continue in terms of resolving these problems. On the Mater Hospital——
The Minister gets an NG. She is a failure.
(Interruptions).
Please allow the Tánaiste to speak.
With regard to the Mater Hospital, it took a considerable number of months——
Things must get worse. Is that what the Tánaiste is saying?
I am sorry, Deputy McManus, I am replying to the leader of the Labour Party, who is in order.
The Tánaiste is not in order.
I am replying to the leader of the Labour Party.
If Deputies——
If we are not going to have a debate on this, what is the point?
I ask Deputies to refer their remarks through the Chair and allow the Tánaiste to conclude his reply without interruption. This is the national Parliament.
The development of primary care teams in the north of the city, which took many months——
The Tánaiste fell asleep for three years as Minister for Health and Children.
——to negotiate with GPs is bringing a much improved primary care and out-of-hours services to the area. The situation regarding what is provided in Smithfield is another example of taking some of the pressure off the accident and emergency unit in the Mater Hospital. Those are facts and such improvements are being used by people from the north inner city as we speak. There have been continuing problems in the accident and emergency units in many of our Dublin hospitals because we have not been in a position to provide sufficient primary care cover and out-of-hours services——
A heart attack is not a primary care issue.
That is not the main issue. The system is not working.
——over weekends, particularly. In fact, there were 400,000 people——
That is not the issue at all.
——who did not have that cover in the north side of the city——
People need beds in hospital, not trolleys.
——until primary care teams were put in place. It is the intention to increase the number of primary care teams right across the city and country. Improvements are being made.
Does the Tánaiste really believe that?
With regard to the judgment that was announced yesterday, it must be examined by the relevant Departments and staff in the Attorney General's office. It has been reported that there may well be an appeal to the Supreme Court. With regard to the civil partnership Bill that the Government is seeking to sponsor, the scheme has been circulated among Departments for their observations and will be brought to Government shortly.
When, next March?
There is, unquestionably, a crisis of confidence in the Department of Health and Children and the HSE among the wider populace that is not only reflected on the Opposition benches here. What steps will the Tánaiste take to address the logjam in terms of legislation that is promised by Government under the aegis of the Minister for Health and Children? I speak specifically of the health (long-term residential care services) Bill. The fact that this Bill has not been presented to the House continues to create untold anxiety for older people and their families.
The Tánaiste to respond on the legislation.
To clarify——
There is other legislation about which I wish to ask. If the eligibility for health and personal social services Bill, about which we have asked on many occasions, is delayed any further, there might be very little left, given the way the HSE is proceeding. The nurses and midwives Bill has been promised, as has the dentists Bill and the pharmacy (No. 2) Bill. The list is endless.
The Tánaiste to respond on five Bills in the health area.
There is clearly a logjam in the Department. Is the Minister on top of her brief?
With regard to the pharmacy (No. 2) Bill, is the Tánaiste aware pharmacies throughout the country have been issuing notice to their customers that as of 1 May they may withdraw from the State-sponsored schemes of access to medication?
That is not relevant to the Order of Business.
What steps are being taken? Will the Tánaiste intervene with the Minister for Health and Children to ensure an adequate address of this fearful situation presenting? This matter has been addressed by the health committee but it has not been addressed substantively in the Chamber. Will he ask the Minister for Health and Children to come before the House and be accountable for what can only be described as her dilatoriness in regard to a serious situation presenting?
The eligibility for health and personal social services Bill and the nursing and midwives Bill will be published next year. It is not possible to say at this stage when the dentistry Bill will be published. The long-term residential care Bill is due this session and it is still with the Attorney General.
What of the eligibility Bill?
I answered that. Next year.
What of the dentistry Bill?
I answered those questions.
Does the Tánaiste agree there is an inordinate list?
The Deputy does not care what the answer is.
I care. The Tánaiste has to demonstrate he does.
I wish to raise two Bills, which have been mentioned. However, clarification is needed on the long-term home residential care Bill because there is absolute and total desperation out there. People are in dread because they do not where or how they will get the money.
The Tánaiste has answered that question.
I refer to the pharmacy (No. 2) Bill. The pharmacists dispute is absolute chaos and needs to be dealt with as a matter of urgency.
The Fines Bill 2007 has been promised for years. If implemented, it would mean gardaí could spend more time on the beat instead of collecting fines and it would make people conscious of the fact that they owe money which should be paid.
The Bill is awaiting Second Stage. The other Bill is not relevant to the issue the Deputy raises.
Earlier this week, an independent report was published with stark findings regarding the actions of six public authorities, which failed to act when information first came into the public domain about an individual who had been sentenced for serious sexual assault. In light of the recommendations in the report, does the Government have plans to put existing child care protection policy on a statutory basis? Will the House have an opportunity to debate the matter over the next few weeks?
Is legislation promised?
I am not aware of promised legislation but the Minister of State at the Department of Health and Children, Deputy Brendan Smith, has asked senior officials in his office to convene an urgent meeting with key stakeholders in child protection, including the HSE and the Garda, to ensure full awareness of child protection policies, guidelines and procedures. He has stated that the conclusions of the review referred to by the Deputy are a vindication of the existing guidelines.
The Tánaiste will have read earlier this week that Dublin City Council closed its affordable housing waiting list with 8,313 people still on it. At the current rate of affordable housing delivery, it would take 32 years to accommodate them while less than one third of the NDP commitment to affordable housing is being delivered. Does the Tánaiste accept public housing policy is in tatters? When will we see the promised social housing legislation?
The legislation is due this session. I do not accept housing policy is in tatters. We need to continue to work with local authorities and make the necessary provision to get affordable houses up and running. It is happening in many parts of the country.
Affordable housing is falling.
We have a particular problem in Dublin. Perhaps the Deputy will ask the councillors who comprise the majority on those councils, including those of his own party, to help do something about it.
It will take a generation to accommodate the people on the current waiting list.
The Tánaiste needs to get real on this issue.
In reply to the question about the lady in the Mater Hospital, the Tánaiste referred to reforms in the health service. There have been no such reforms. A young woman, Tania McCabe, died in Our Lady of Lourdes Hospital, Drogheda, in childbirth.
Unfortunately, we cannot discuss this now.
Contributory factors were overcrowding and the overworking of the staff in the hospital. In Ennis hospital, 15 people died of c.difficile as a result of overcrowding.
We cannot discuss these matters now.
Throughout the country, there is overcrowding and overworking in our health service.
That is not in order on the Order of Business.
I am sure I am in order to ask the Tánaiste whether a Supplementary Estimate relating to health services will be introduced while we wait for reform. People are dying all over the country.
Is a Supplementary Estimate promised?
None is promised.
A Supplementary Estimate is needed. I will not sit down on this issue. A debate in the House is needed because people are dying. Between 350 and 500 stroke victims are suffering because of the lack of funding, resources and reform.
The issues raised by the Deputy are important and they merit proper debate.
People are dying while the Government sits back. Can we have an urgent debate on this issue?
These matters are urgent and serious but it is not in order to raise them on the Order of the Business. No Supplementary Estimate is promised.
Can we have a promise of a debate? Can we see some indication that the Government takes these matters seriously?
Can we even see the Minister for Health and Children in the House?
Other vehicles are more appropriate to request a debate.
I have been seeking an Adjournment debate about a young woman who has tried to commit suicide seven times but I have not succeeded with my request. There are so many health issues that we cannot secure an Adjournment debate.
The Deputy should submit the request later.
I have submitted it. We need a broad debate on the appalling problems in the health service.
I refer to two areas of legislation, one of which was touched on by a colleague. A report published on Tuesday regarding Doctor A indicated a gross failure on the part of State agencies, including the Department of Justice, Equality and Law Reform, to comply with the Children First guidelines. The report contains a recommendation that these guidelines be put on a statutory basis. This is not a new recommendation as it was contained in the Ferns Report, on which the Government promised to act. The response of the Minister of State with responsibility for children to which the Tánaiste referred is grossly inadequate. Does the Government intend to introduce legislation to put these guidelines on a statutory basis?
Deputy Gilmore referred to a case in the High Court yesterday. The Government has studiously ignored the issue involved because it is paralysed by fear, which needs to be addressed. The issue is not simply about partnership legislation. A report was commissioned at substantial expense by the Department of Health and Children to kick into touch the issue of the rights that arise in regard to parents, donors and children when children are born as a result of scientific techniques such as egg or sperm donation. A report commissioned by the Government recommends the introduction of legislation in this area. The Government has abdicated its responsibility in this area because it is paralysed by fear. Is it intended to introduce legislation to deal with this important issue?
Is either of those legislative measures promised?
They are not promised but, to be helpful, the Minister of State with responsibility for children in the context of the review that arises as a result of the case will take into account everything to improve the position for the future, which may involve putting the Children First guidelines on a statutory basis. That must be determined. However, doing so could be problematic in terms of placing extensive administrative burdens on relevant bodies and organisations and slowing the notification process. Where a statutory arrangement is in place, there is anecdotal and research evidence that such problems have been encountered.
The problem is State agencies and the Department are not complying with the guidelines.
I am trying to respond. What is the point?
There are huge problems because they are not on a statutory basis.
Consideration has been given to all this in the review. I have explained that there can be some problems with putting it on a statutory basis. There is empirical evidence from other jurisdictions to confirm where the problems exist when it is put on such a basis. That is all I am saying. I am not saying it in favour or against the notion of putting it on a statutory basis — it is being considered. I am doing this to give information to the Deputy and if I can do so, he can decide what he wants to do with it.
It is true that the question of assisted reproduction techniques requires careful examination as it is a complex issue. It is being considered by a group in the Department that the Minister may have formed a couple of years ago. It is not a question of being paralysed by fear, but of treading very carefully where there are very serious ethical considerations.
The Government has been treading carefully for ten years on this. It has been treading so carefully it will drown under the weight of the issue.