Dáil Éireann debate -
Wednesday, 24 Sep 2008

Vol. 661 No. 1

Adjournment Debate.

Hospital Services.

Deputy Seymour Crawford

I thank the Ceann Comhairle for allowing me to raise this important issue, along with my constituency colleague, Deputy Caoimhghín Ó Caoláin.

Monaghan General Hospital must be allowed remain on call and retain its accident and emergency and high care units. According to senior personnel in the HSE, it is under order to wind down the service at Monaghan General Hospital as quickly as possible and specifically to take the hospital off call, leaving only a day service available in the accident and emergency area. This is to be done in spite of the fact there is clearly no alternative available either now or in the foreseeable future. A similar order was in place for Roscommon County Hospital, but this has now been removed by the Minister, allowing the HSE to retain the services there. I beg the Minister to do the same in Monaghan and I urge my constituency colleagues in the Government party to ensure this happens. The HSE recently gave my council and town council colleagues the same message, which is that they are only doing what they are under order to do by the Government.

In the past ten days I have come across two cases of people who were sent home from Cavan General Hospital. One man, who was 90 years of age, was sent home by ambulance at 1.30 a.m. The other was a lady who was sent home and passed away a few hours later. It is absolutely clear that Cavan General Hospital is not in a position to cope with its own patients, never mind the additional load from Monaghan.

We have an excellent cardiac unit with an extremely strong independent report to state its records of success are at the highest level. Our accident and emergency unit, named by the HSE as a treatment room, is of the highest calibre and we have the most modern bed units. Nothing can justify the Minister's orders to wind down such a unit. The people of Monaghan need this service more than ever. Existing industries and potential new industries depend on such a hospital service.

There is no doubt the actions of the Minister and this Government are nothing short of an introduction of euthanasia through the backdoor. Home help and home care are not available, subvention for nursing homes has never been sorted out and now patients are being pushed by the Minister into areas where there is no service to cope.

I realise the Minister for Health and Children, Deputy Harney, has never felt the need in her heart to visit either Cavan General Hospital or Monaghan General Hospital, but if lives are to be saved she must either change the order that she and her Government have given to wind down our Monaghan General Hospital or take the only honourable alternative and step down from her position.

Deputy Caoimhghín Ó Caoláin

I note again, with some vexation, that the Minister has not seen fit to take this Adjournment debate. Perhaps it is past her bedtime, or does she continue to have little or no interest in hospital services in the north east?

The Health Service Executive confirmed in a letter to me two weeks ago its plans to remove all acute care from Monaghan General Hospital and to downgrade it, essentially, to a minor injuries unit. The HSE has confirmed the death sentence for Monaghan General Hospital and in reply to my Dáil question today the Minister also confirmed that sentence. The Minister and the HSE confirm the ongoing implementation of the so-called transformation report, which I revealed in April. The HSE is denuding Monaghan of services and working towards a deadline that, if adhered to, will mean that by Christmas 2008 Monaghan General Hospital, as we have known it for some years, will no longer be a hospital.

When read carefully the HSE letter, entitled "Developments in Cavan & Monaghan Hospital Group Services" and dated 3 September 2008, reveals a number of inconsistencies, raising huge concern about future patient care. It speaks of having specific measures "in place and bedded down prior to or in parallel with the transfer of acute care to Cavan" by the end of November. I note that those words are repeated in the Minister's reply to my parliamentary question today. What does "in parallel with" actually mean?

The HSE says it is committed to the enhancement of ambulance services, including an additional 24 hour emergency ambulance at Monaghan ambulance station, bringing the number of ambulances from two to three. Will we be faced with a situation where acute care is removed from Monaghan before the extra ambulance is provided? How long would such a gap in services be allowed to continue? We have seen in the past where the HSE commits in principle to provide new services but we wait months or years to see them delivered.

There are currently 3,000 acute medical admissions to Monaghan General Hospital per annum. By the end of November this service will have to be provided by Cavan General Hospital, which already has to cater for 5,000 acute medical admissions per annum and has 160% bed occupancy. This is to be done under this plan without a single extra bed being provided in Cavan. How can this be achieved?

The plan for the destruction of Monaghan General Hospital must be opposed in the strongest possible manner by the entire community and every elected representative. I welcome Deputy Rory O'Hanlon who is here to view the debate this evening because I believe it must include the Fianna Fáil TDs for the Cavan-Monaghan constituency. Like all Opposition Members, they too must be called to account on this matter.

Surely what is good for Roscommon is also good for Monaghan. How is it that we have not been able to prevent the loss of services at Monaghan General Hospital through the years, yet, with apparently little effort, such a situation can be put on hold, checked or reversed with regard to a hospital elsewhere in the State? We want equality of access to health services for all citizens.

Minister of State at the Department of Health and Children (Deputy Máire Hoctor)

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

The Teamwork report, prepared for the Health Service Executive, clearly indicated that the service configuration in the north-east region was unsustainable. It recommended a reconfiguration of hospital services across the existing five hospital sites to ensure the highest level of patient safety. The report also identified a significant future role for all five hospital sites in the provision of acute hospital services.

The report has helped to inform the approach being adopted by the HSE to the implementation of its transformation programme. The programme involves widespread and fundamental change and is designed to build a health system that is in line with the model of care emerging internationally. The overriding aim, which the Minister fully supports, is the improvement of safety and standards of care for patients in the region.

Deputy Seymour Crawford

It is not doing that.

Deputy Máire Hoctor

As part of the reconfiguration of acute hospital services in the north east the HSE previously indicated that it plans to transfer acute inpatient services from Monaghan to Cavan and to develop services at Monaghan. The transfer is scheduled to take place later this year. The HSE is working to ensure the necessary capacity is in place prior to or in parallel with the planned transfer date to ensure a smooth and safe transition.

Deputy Seymour Crawford

It is not doing that.

Deputy Máire Hoctor

The necessary capacity is to be generated in a number of ways. For example, a medical assessment unit is to be established at Cavan to help manage the anticipated increase in activity. Beyond that measures are needed to ensure a more efficient use of available capacity and this has been highlighted in the national bed utilisation capacity report prepared for the HSE. The average length of stay for inpatients needs to be reduced in line with best practice. The discharge planning process also needs to be improved. Alternatives to acute inpatient care are required through the provision of additional packages of care in the Cavan-Monaghan community care area.

Deputy Seymour Crawford

Where are they? They are not there.

Deputy Máire Hoctor

The capacity at Monaghan is to be increased through, for example, the development of additional respite and rehabilitation services. Enhancements in pre-hospital care in the Cavan-Monaghan area are also required.

Deputy Crawford referred to the position at Roscommon County Hospital. In the past, Roscommon County Hospital and Portiuncula Hospital, Ballinasloe, have operated independently, with two consultant general surgeons in each hospital. The difficulties faced by Roscommon and Portiuncula in maintaining surgical services independently, and the need for closer co-operation between them, were highlighted by the former Comhairle na nOspidéal in March 2006. Advances in clinical care and ever-increasing levels of specialisation mean the present model of care faces important practical difficulties, which must be addressed.

In the light of these factors, the best way of retaining and developing services in Roscommon and Portiuncula hospitals is for these hospitals to work closely together. The HSE has indicated it is proceeding with the proposal for a joint department of surgery and anaesthesia at Roscommon County Hospital and Portiuncula Hospital, Ballinasloe. The establishment of a joint department of surgery already is in place in the Cavan-Monaghan hospital group and is operating very successfully. A joint department of emergency medicine is also in place and is operating across both hospitals.

Departmental Agencies.

Deputy Róisín Shortall

I asked for this Adjournment debate because of continuing press reports that the abolition of the Combat Poverty Agency is imminent. A review steering committee has, since June 2007, been examining the workings, value and role of the agency and in recent weeks has made recommendations to the Government. Various reports suggest the agency may be merged with either the office for social inclusion or the National Economic and Social Development office or may simply be abolished altogether.

The Labour Party strongly believes that undermining the independence of the Combat Poverty Agency would be a retrograde step. It would completely destroy the objectivity of the only statutory organisation with a specific and all-encompassing role in the eradication of poverty. It would represent nothing less than the silencing of criticism of the Government, however objective and constructive that criticism may be. The Combat Poverty Agency was established in 1986 with a specific remit to help the Government to eradicate poverty. It now appears the Government is about to tell us that while poverty always will be with us, the Combat Poverty Agency may not.

Of all Government agencies, it is incredible that this is the one which the Government targets first. Poverty and social exclusion are still alive and well in Ireland. One in nine children under 14 has substandard living conditions and the number signing on the live register has increased by 93,000 since the Government took office. This week, for example, the Dublin Simon Community claimed it had been obliged to hand out three times as many sleeping bags in the first six months of this year than in the same period last year. Unless one understands such problems, one has no hope of fixing them and understanding poverty constitutes precisely the value of the Combat Poverty Agency.

The Combat Poverty Agency has played a vital role in the past 22 years. Without the agency, we would not have the facts about the chronic rate of poverty among children of low income families and the extent of poverty among lone parent households. Without the agency, increases for old age pensioners may never have been secured because the hard data on the extent of pensioner poverty would not have been available. It also was the Combat Poverty Agency that first proposed the establishment of the money advice and budgeting service, which has proved to be so successful. It promoted, secured and developed the first national anti-poverty strategy and pioneered community development programmes throughout the country.

One wonders what exactly the Government is trying to achieve. The Exchequer grant to the agency this year is €4.6 million. In a Department that will spend €17 billion this year, for the service provided, the sum of €4.6 million is relatively small. The same Department recently wrote off €82 million in overpaid benefits and last year handed back €64 million in unspent funding. Why is the Minister targeting the Combat Poverty Agency when clearly, there are savings to be made elsewhere?

It is my understanding that the review offers no figure for overall savings in costs or staff numbers, identifies no value for money issues and pinpoints very few areas in which the work of the Combat Poverty Agency is duplicated in another organisation or Department. It appears that the only saving the Government is seeking to make is the embarrassment of an independent body telling it that it has 300,000 people living in consistent poverty after ten years of bulging Government coffers. The point is that if this proposal is not being driven by savings, it must simply be by politics.

For more than 20 years, the Combat Poverty Agency has provided an important service by identifying and analysing the causes of poverty and by providing a framework in which to address such problems. It also has offered an important independent critique of the record of successive Governments. Subsuming the agency into the Department of Social and Family Affairs would completely neuter the agency and rob it of its independence. Rather than providing an independent assessment of Government policy on poverty, it simply would become another mouthpiece for the Minister. The most vulnerable in our society deserve much more than that. The Minister must reject these recommendations and give this House an assurance that the independence of the Combat Poverty Agency will be preserved. I look forward to such an assurance this evening.

Deputy Máire Hoctor

I will take this matter on behalf of my colleague, the Minister for Social and Family Affairs, Deputy Mary Hanafin.

The Government decided in June 2007 that a review of the Combat Poverty Agency should be undertaken by the Department of Social and Family Affairs in association with other relevant Departments. The review forms part of the Department's value for money and policy review initiative programme for 2006-08. The review, which commenced in December 2007, was overseen by a steering committee which was chaired by Mr. Niall Callan, former Secretary General of the Department of the Environment, Heritage and Local Government and comprised senior officials from relevant Departments and the Combat Poverty Agency.

The review's terms of reference were threefold. First, it was to examine the role of the agency in the light of the emergence since 1986 of comprehensive strategies and programmes for social inclusion and extensive new institutional developments in support of social inclusion. Second, it was to consider the operations of the agency in the context of efficiency and value for money. Third, it was to identify the extent to which newer developments or arrangements may duplicate, overlap or complement the agency's role, report on the ongoing validity of its remit, bring forward proposals as appropriate for enhancement or rationalisation, or both, and make recommendations to the Minister for Social and Family Affairs.

The review was presented to the Minister on 12 September 2008. The Minister, Deputy Hanafin, is considering its findings and recommendations and intends to bring forward proposals to the Government on the future of the agency in the near future. The Combat Poverty Agency has forwarded its views to the Minister and she will take them into account while formulating her proposals.

County Kerry Bogslide.

Deputy Jimmy Deenihan

On the evening of Friday, 22 August 2008, a number of local people, who were working in the Maghanknockane area of the Stacks Mountains, felt trembling on the bog. They found this to be highly unusual as it had never happened previously in the area. Bog movement became more visible the following morning. It gained momentum throughout the afternoon and by evening, a bogslide close to 50 m wide and 12 ft. deep simply flowed down the hillside, following a path of approximately 3 km, along the valley of the Glashareag River. It moved into an area known locally as Scanlon's Bridge. En route to Scanlon’s Bridge, the bogslide engulfed the bridge leading to the house of Denis Harris. He was cut off for a number of days and was lucky not to have been on the bridge at the time of the slide. His wife Maureen and son Padraig were unable to return home that Saturday and were obliged to stay with family and friends for a number of days. Thanks to Kerry County Council, the bridge was put back into operation after a week or so.

The Scanlon family, including Eamon Scanlon's 94 year old mother, were lucky not to be engulfed in the bogslide. Initially, they were able to remain in their home. However, following further movement of the bog, which came perilously close to their home, they subsequently were moved by Kerry County Council to a house in Tralee. Unfortunately, over the past weekend, their vacated home was burgled, which was a heinous act.

Kerry County Council's workers and engineering staff now have both bridges back in operation and the main through road through Macca is functioning at present. The county council also has constructed a dam 4 km from the source of the slide, which serves as a siltation lagoon that prevents peat silt from moving downstream.

A fish kill occurred in both the Glashoreag River and the upper Smearlagh River during this period. It is estimated that approximately 5,000 fish perished, most of which were juvenile salmon and sea trout and which constitute the next generation for the Feale and Smearlagh rivers. A fish survey is under way at present to determine the impact on the habitat and the extent of the fish kill. This report is expected shortly. It will no doubt take years for these very important and valuable spawning grounds to fully recover.

Shannon Regional Fisheries Board has worked with Kerry County Council to advise on the construction of the two settlement ponds and jointly engaged BMA consultants to assess the present status of the landslide and its possible origins. I hope this report will be completed and available shortly.

Kerry County Council is continuing to remove peat from the upper sections of the Glashoreag river. The company building a windfarm in the area has erected a dam to prevent a further large movement of peat. The company has also commissioned Carlow-based geotechnical consultants AGEC to undertake a study into the cause of the landslide. I hope both of these reports will be available in the near future as it is very important at this stage to allay the fears of the local people, make known the cause of the bogslide and take corrective action.

I ask the Minister to consider helping those people affected by the bogslide, as both the Harris and Scanlon families surely deserve some compensation for the inconvenience caused. A number of people have now been deprived of their fuel for winter because the area of bog they had turf harvested on was removed. Some bags of turf for the winter were also lost. The Minister, through Kerry County Council, should look favourably at helping these people.

I understand there has been another bogslide today in the west of Ireland. These are becoming all too prevalent. It is time we have some national action to prevent these bogslides. Whatever the reason behind them, surely it is possible to take such action. The last landslide in the Lyreacrompane area was more than 100 years ago and although I realise we had much rain this summer, there must be some reason for such a bogslide. It does not happen by accident.

I appeal to the Minister of State to give a very positive response and outline proposed actions to prevent a reoccurrence of this incident.

Deputy Máire Hoctor

I will take this matter on behalf of my colleague, the Minister for the Environment, Heritage and Local Government, Deputy John Gormley.

I sympathise very much with the people whose livelihoods have been affected by this bogslide. I understand Kerry County Council is carrying out an investigation into its cause. Unfortunately, the bogslide also resulted in serious damage to habitats and species. The investigation should address whether and to what extent the works associated with a windfarm development in the area contributed to the bogslide.

I will briefly mention the planning history of this case. The planning application, accompanied by an EIA, was lodged with Kerry County Council in December 2002; the council subsequently granted permission for the development in October 2003, subject to 15 conditions. In considering the case on appeal, I understand that An Bord Pleanála sought from the planning applicant a report from a qualified hydrogeologist or other suitable expert regarding the stability of the peat and soil cover on the site and the potential risk of landslides arising from the construction of the proposed development. The applicant submitted a report on site stability in January 2004.

I also understand that in March 2004 the board requested an additional report from the hydrogeologist assessing the impact of the potential construction works on soil stability with particular reference to construction methods and design and construction of turbine foundations. This was supplied in April 2004 and following its consideration the board granted planning permission for this development on 16 June 2004, subject to 15 conditions.

Separate bog slides on 23 August and 3 September 2008 caused damage to two designated European conservation sites — one special area of conservation and one special protection area. The special protection area was designated particularly for the hen harrier, and an area of suitable foraging habitat for this species has been lost. The special area of conservation was designated for salmon and otter habitat. Spawning beds and feeding habitat have been extensively damaged for these species.

The Feale river is recognised as one of the most important salmon rivers in the Shannon catchment. For that reason, the lower River Shannon special area of conservation was extended to include a considerable stretch of the river, including its tributary, the Smearlagh. Several kilometres of the Glashoreag river, which is a tributary of the Smearlagh, were also included in the extended special area of conservation, as they contained good stretches of salmonid spawning beds and nursery areas.

It is estimated that 4 km to 5 km of fish spawning grounds have been destroyed and now lie under a metre or more of silt. Fisheries officers have estimated that it may take ten years for the spawning grounds to recover. There are now no fish in the affected parts of these rivers, and it is feared that silt will travel downstream and cause further damage. The effects on biodiversity may also be significant, as otters in the area, which depend on fish, have lost their food source.

The otter is strictly protected under the European Communities (Natural Habitats) Regulations, 1997 to 2005, and it is an offence to damage or destroy the breeding site or resting place of this species.

The council is working closely with Shannon Regional Fisheries Board as well as the national parks and wildlife service of the Department. Any restoration plan or measure would have to be screened by NPWS in the interests of necessary compliance with the natural habitats regulations.

Farm Waste Management.

Deputy John O’Mahony

I thank the Leas-Cheann Comhairle for allowing me to raise this very important issue with the Minister for Agriculture and Food. I am disappointed the Minister is not here in person as I know thousands of farmers affected by this would have loved for him to answer this question once and for all.

I will highlight two problems relating to the farm waste management scheme introduced two years ago to much fanfare in the Department that are causing panic in the farming community around the country, including my constituency of Mayo. More than 20,000 farmers countrywide who have been approved for funding under the scheme face the impossible task of trying to complete the approved work before the expiration of the approved deadline, which has been set by the Department as 31 December 2008.

I will briefly outline some of the history of the issue. The fault for this impossible task lies firmly with the Government because it put in place a system which was clearly unable to cope with the significant demand that could have been expected in 2006. Despite asking for and receiving an extended deadline, the Government failed to speed up the application process and granting of funds for buildings under this scheme. This has greatly curtailed the time available for farmers to complete the approved works. In doing so, this has left Irish farmers at a distinct disadvantage to EU counterparts.

The progress of such works over the summer months has been confounded by certain unforeseen circumstances, most notably the inclement weather that has seen us having our wettest summer for over 70 years. The Government's misjudgment, inaction and mismanagement of the scheme in this way has seriously affected farmers, as is evidenced by the many queries received by my office and clinics in Mayo and the experience of all Deputies from rural constituencies from all sides of the House to whom I have spoken.

I have also been informed by my MEP colleague, Mr. Jim Higgins, that the Minister has informed him there are no plans to seek a further extension of the scheme. This problem has wider implications than those for the farming community. If no extension is granted to the impossible deadline, thousands more people will be laid off from building industries in January 2009. As well as supporting the farming community, will the Minister remove the risk to these construction jobs at a time when the housing crisis has already caused havoc in the sector? He can do so by going to Europe to seek a deadline extension.

The second issue relating to the farm waste management scheme is the delay in payment by the Department to farmers who have already completed their projects. I have been inundated with queries from farmers put under severe pressure by banks and lending institutions for money they rightly assumed they should get once the approved work was inspected and complete.

On contacting the relevant section in the Department, officials admitted they had been waiting for months for cheques to be signed off. We have all heard rumours to the effect that all funding for the scheme has been drawn down and no one will be paid between now and December. I call on the Minister to urgently clarify the position. Will he confirm that the farmers in question will be paid immediately?

I attended a meeting in Crossmolina, County Mayo, last night attended by 400 angry farmers who have taken many hits over the years. The issue last night was the closure of the Teagasc office in the town and its transfer to the urban setting of Ballina. The issue is on the Minister's desk. The 400 farmers who attended last night's meeting are an example of members of a rural community who have given their lives to farming and need our support now more than ever. The Minister is not paying them what they are due and he is depriving them of the opportunity to meet the deadlines for the farm waste management scheme. Now he is closing the Teagasc office in Crossmolina. I urge him, once and for all, to stand up and be counted on these major issues.

Minister of State at the Department of Agriculture, Fisheries and Food (Deputy Tony Killeen)

The Minister for Agriculture, Fisheries and Food, Deputy Brendan Smith, is unable to attend the debate because he was detained longer than he had anticipated fulfilling engagements in Kilkenny as a result of the decision by the Fine Gael Party to refuse a pair today to allow him to undertake important work at the national ploughing championships.

I am pleased to have this opportunity to clarify the current position regarding the end of 2008 deadline for completion of work under the revised farm waste management scheme. The revised scheme was introduced by the Department in March 2006 to assist farmers to meet the additional requirements of the nitrates directive. The amendments to the scheme included, in particular, an increase in the standard grant rate from the previous 40% to 60%, with 70% being available in the four zone C counties of Cavan, Donegal, Leitrim and Monaghan. In addition, the new scheme provided for an increase in the maximum eligible investment ceiling from €75,000 to €120,000 and removed any minimum income requirements from farming from the scheme in order that all small farmers could participate in the scheme.

The immense success of the farm waste management scheme is demonstrated by the 48,580 applications received from farmers by the closing date of the end of December 2006, of which more than 30,000 were received during the final month. More than 42,200 approvals to commence work have issued to date to farmers under the scheme, with the remaining applications either having been withdrawn, refused planning permission or explained by the receipt of multiple applications from a single farmer.

The financial commitment of the Government to the farm waste management scheme is substantial, particularly during these challenging economic times. This is demonstrated by the fact that to date in 2008, €181.8 million has been paid out to farmers under the scheme compared to €21 million in 2006 and €114 million in 2007. The Department is continuing to process payments under the scheme and I hardly need to confirm again that all farmers who complete investment works in accordance with the terms and conditions of the scheme will be paid their full entitlements.

There is no doubt the farm waste management scheme has dramatically transformed the Irish farming infrastructure through this major injection of capital and will leave the sector well positioned to meet the highest international environmental standards required of Irish farming, as well as changing market requirements. It will also continue to strengthen the competitiveness of Irish agriculture.

The deadline of 31 December 2008 for completion of investment works under the scheme is a condition of the EU state aid approval governing the scheme and the European Commission has recently reaffirmed that it expects Ireland to respect this deadline strictly. It should be noted that the farm waste management scheme has been in place since March 2006.

The terms and conditions of the scheme make it clear that payment of grant aid is conditional on the time limit being respected and the Department has consistently held this position since the commencement of the scheme. The Department is issuing its second written reminder to all farmers approved to commence work under the scheme to ensure all work is completed and a payment claim submitted to the Department by the end of this year. No farmer can therefore be unaware of the importance of meeting this deadline.

I thank the Deputy again for giving me an opportunity to clarify the current position on this matter.

The Dáil adjourned at 9.05 p.m. until 10.30 a.m. on Thursday, 25 September 2008.