Dáil Éireann debate -
Tuesday, 31 Mar 2009

Vol. 679 No. 1

Adjournment Debate.

Hospital Services.

Deputy Seymour Crawford

I thank the Acting Chairman for allowing me to raise this important matter on the Adjournment. Pathways, which is a high quality rehabilitation centre set up in Cavan many years ago, is now closed to all intents and purposes. Some three weeks ago I received two different calls from families in County Cavan who raised questions regarding the future of this very important unit. In both cases, they pointed out the tremendous benefit resulting from the use of the centre by the family member in question. In one case the family was very worried about what would happen to their loved one if, or when, he needed to attend Pathways again.

I subsequently contacted senior executives of the HSE and was advised that there was a short-term staffing problem, but that there was no question of the service being removed and that I would be advised of progress by the middle of the following week. Of course, this did not occur, but by Friday of last week two County Monaghan families and a further County Cavan family made contact with me. One of the County Monaghan families were near neighbours whom I have known all my life. I was alarmed at the information I received.

Again, I contacted the HSE to be advised that everything was okay, that the ward was not closed and that those patients who were not in the Pathways ward were receiving the same service as if they had been. On Saturday evening, I visited the Lisdarn unit for the elderly, adjacent to Pathways and found several of the Pathways patients and their immediate families there. I subsequently walked to the Pathways unit and found four of the long-term patients from the Lisdarn unit who were not receiving Pathways-type treatment, but had been moved into it such that it did not seem empty. This meant the HSE personnel were telling the truth and that Pathways was not closed.

I spoke to several of the families who had clients or patients in the Pathways unit before they were removed. They were very worried about their family member who had been receiving treatment. In one case, a person had been in the Pathways unit for four weeks before the service was removed and the family had seen a lack of progress or worse in the patient in the two weeks subsequent and since he was no longer receiving Pathways-type treatment. The person in question is now in the Lisdarn unit. I emphasise that these individuals have no complaints regarding any of the nurses or staff in Lisdarn, other than the fact that they simply do not have enough personnel to give the necessary care and attention that patients in need of rehabilitation require and deserve.

In the past, treatment in the Pathways ward has allowed many people to return to their own homes needing little if any help. Other younger people recovering from accidents have been given a good future. The most worrying aspect of all is the failure of the HSE to plan for the staffing and retention of such a service in Cavan while, at the same time, promising publicly to restructure a brand new 25 bed ward in Monaghan General Hospital and to create a 13 bed rehabilitation unit there. If it cannot manage a six-bed rehabilitation centre in Cavan, it is hard to see it getting started in Monaghan.

The people of Cavan and Monaghan deserve at least the truth and some honesty. Above all, we deserve a service and Pathways is one of those excellent services which has given new life to many people. Physiotherapists and speech support staff are still in place and available. However, without the proper personnel and backup for these people, Pathways, as such, is gone. I am sick, sore and tired of being advised by HSE personnel that it will all be sorted out in a week or so. This is not the case. I have been there in person and I have seen at first hand the situation, which is of great concern. I have consistently seen people admitted to the Pathways unit in recent years who were not initially able to walk and who left the unit on their own steam. I saw a young man there who had been in a bad accident and who was brought back to life again despite no hope of his admittance to the rehabilitation centre in Dún Laoghaire. Pathways is the only alternative we have to the Dún Laoghaire service. Will the Minister of State please ensure this valuable service is not taken away from us? Enough has been taken away already and we deserve better.

Minister of State at the Department of Health and Children (Deputy John Moloney)

I am taking this Adjournment matter on behalf of the Minister, Deputy Mary Harney, who cannot be here this evening. I thank Deputy Crawford for raising the matter and I am pleased to have the opportunity to outline the current position regarding the provision of rehabilitation services at the Pathways rehabilitation unit, located on the grounds of the Lisdarn unit for the elderly in Cavan. The HSE has no plans to close the Pathways rehabilitation unit service. However, the HSE has advised the Department that a staffing deficit exists at the Pathways unit arising from several recent staff retirements. While this staffing issue is being addressed, and to ensure continuity of service provision, patients from the Pathways unit are being accommodated in the Lisdarn unit for the elderly, which is located within the same building.

These patients are availing of the same levels of intensive rehabilitation therapy within the Lisdarn unit as they had received prior to their relocation from the Pathways unit.

Deputy Seymour Crawford

That is not fair comment.

Deputy John Moloney

This is the brief I have from the Department and I have to believe the brief I have been given.

Deputy Seymour Crawford

I fully understand.

Deputy John Moloney

Either way, the HSE is actively working to restore the staffing levels at the Pathways unit. In this regard a process of sourcing staff nurses is under way to address the current staffing deficit. As Deputy Crawford will be aware, the Pathways unit has been playing a key role in providing an intensive rehabilitation service to patients from Cavan and Monaghan who are recovering from an episode of acute illness such as stroke, amputation, a road traffic accident or acquired brain injury.

Pathways has operated from the outset on a multi-disciplinary team basis with input from the medical, nursing, physiotherapy, occupational therapy and speech and language therapy professions and ancillary care staff. The rehabilitation unit has evolved since it was established in 2000 and now treats patients between 18 and 95 years of age. The majority of patients have been discharged to the community following treatment. Feedback from patients has been very positive throughout the years.

The issue at the Pathways rehabilitation unit is one of a short-term staffing deficit arsing from a series of recent staff retirements. The HSE is actively engaged in a process of recruiting staff nurses with a view to restoring the service at the unit as soon as possible. I assure Deputy Crawford that the Government will continue to deliver its public health services, including rehabilitation services, in a way which delivers the best possible outcomes within the resources available.

Deputy Jan O’Sullivan

Of all the various testimonies I have heard, none has been more moving than that of Orla Tinsley who has outlined the daily struggles of people with cystic fibrosis in Ireland. She has spoken of the issues they must weigh up such as when they know they must go into hospital, but are terrified of the cross infection they may encounter in our hospital system in Ireland.

It is unbelievable and incredible that the promise that there would be a dedicated unit in St. Vincent's Hospital by 2010 has been reneged on. I realise the Minister for Health and Children, Deputy Mary Harney, is not present but she must respond to the matter.

She must find a way to build a unit, as promised, to provide for people with cystic fibrosis.

We all know that Ireland has the world's highest incidence of cystic fibrosis. It also has the worst type. However, we have the worst services among the developed world — Europe, North America and so on. This is incredible, given that it is a life and death situation. The units are necessary to give people the opportunity to be treated safely in isolation. I urge the Minister of State to ensure that the promise be kept.

When the Cystic Fibrosis Association of Ireland heard about this decision today and that there was no definite information on it, the association cited a HSE spokesperson who stated before last week's joint committee that no capital under the HSE capital plan would be made available for construction until 2011 at the earliest. Today, the HSE stated that the unit would be built in 2011. We need clarity. Will it be built in 2011 or is that in doubt? Will the Minister return to the promised date of 2010?

When this issue was highlighted in January of last year, people from the private sector offered to provide funding to build the unit, but they were refused because the Minister and the HSE had given an absolute commitment to have the unit built under the public system by 2010. That promise is being reneged on and the Minister, Deputy Harney, will ask the private sector. This is unacceptable.

Deputy Finian McGrath

Hear, hear.

Deputy Jan O’Sullivan

It is not the private sector's responsibility to provide a public health service for CF sufferers, for whom this is a matter of life and death. In the strongest manner possible, I urge that the promise be fulfilled in 2010.

Deputy Finian McGrath

I thank the Acting Chairman for the opportunity to raise the matter of the scandalous cutbacks in services for cystic fibrosis patients, particularly at St. Vincent's Hospital. I call on the Government to stop this criminal cut, a term I do not use lightly. CF patients should not need to fight, protest or appear on radio shows to get their services. Some 1,135 CF patients need to be supported and the proposed 30-room national centre at St. Vincent's Hospital forms a major part of the health strategy.

Some 300 patients use St. Vincent's Hospital, approximately 10% of whom are regularly on-site. For this reason, the 30 beds are urgently required. I demand that the project be continued as a priority and I urge the Government to listen to CF patients and their families. I feel betrayed by the Taoiseach, the Minister for Health and Children and the Minister for Finance, who promised months ago that the project would not be touched. They broke their word to me and to the CF families. They are now discussing private backers. Shame on them for this disgrace. The project, costed at €30 million, has already started and the plans are set to go. As well as saving CF patients, it would provide jobs in the construction sector, which comprises another aspect of the scandal.

I commend Dr. Charles Gallagher and the team at St. Vincent's Hospital. I thank Orla Tinsley and every other CF patient for their dignity and bravery. I urge the Government not to turn its back on such great people. Last week in the Chamber, I tabled proposals on funding and taxation in support of the unit. A few cents on a pint would sort out the problem in the morning. It is time that the Minister and the Government got real, listened to the majority of people and taxpayers and funded this necessary service.

It is time for tough decisions. Real courage means standing up for CF patients. I also urge common sense and ask people to consider the future for the patients and their families. I pledge my support to all CF families and I will continue to fight for services. I urge the Government and the Minister of State to reconsider the cut and to support the funding of a 30-bed CF unit at St. Vincent's Hospital.

Deputy John Moloney

I will be taking the Adjournment on behalf of my colleague, the Minister, Deputy Harney, who is unfortunately unable to attend to respond. She has consistently emphasised the need to improve facilities and services for persons with cystic fibrosis. Some 48 additional staff, including consultant, nursing and allied health professionals, have been appointed across the hospital system in recent years to enhance the level of services provided for persons with CF.

St. Vincent's Hospital is the national adult tertiary referral centre for patients with CF. A number of capital projects to improve the quality of accommodation have been completed at the hospital, including last year's refurbishment of accommodation to provide eight single en suite rooms for the exclusive use of people with CF. The single rooms have improved the quality of service for people with CF. It is intended that the proposed 120-bed development will include dedicated facilities for such patients. These facilities will include appropriate isolation facilities. Design work and the preparation of tender documents continue in respect of the development. This is a significant capital project in the acute hospitals area.

The HSE draft capital plan for the 2009-13 period is the subject of consideration. The Minister has confirmed that she will discuss this matter and the overall capital plan with the HSE after the forthcoming budget on 7 April. At this point, she has stated that she will encourage innovative solutions to implement high priority projects so that services, including those for patients with CF, can continue to be developed.

It is important to stress that a series of other developments that will improve the quality of service for CF patients are also in preparation. In the 2008 budget, a special allocation of €2.5 million in capital funding was provided to enable Beaumont Hospital to provide facilities for ambulatory care of people with CF. The project has now gone to tender. Patients with CF will also benefit from additional single room capacity in the new medical admissions unit at Beaumont Hospital, which is due for completion in the middle of this year.

The executive management board of Cork University Hospital has agreed in principle that new facilities for adult patients with CF are to be developed on its main campus. In the interim, plans are being advanced to provide for an interim day care facility, which will provide for dedicated day care space until the site development plan is scoped and developed.

Temple Street Children's Hospital is developing a dedicated respiratory unit, which will be a self-contained floor for the ambulant care of CF and respiratory patients. This will include a new respiratory lab, treatment room, consulting rooms and walk-in access to clinical nurse specialists. This unit is due to open later this year.

The HSE's expert advisory group on children and families produced a draft policy document on the implementation of a CF screening programme for newborns. A steering group will be established in 2009 to oversee the roll-out of the screening programme. An independent register for CF has been established. It is expected that preliminary data to inform analysis relating to median survival will be available by the third quarter 2009.

The Minister is conscious that further improvements are required, including the need to develop community outreach services to facilitate the treatment of patients outside a hospital setting where appropriate. Taken together, the planned developments represent a tangible improvement in the quality of services for people with CF.

Deputy Jan O’Sullivan

The Minister of State knows that his answer was not good enough.

Deputy Finian McGrath

The Government should finish the job. Professor Drumm seems to have an attitude about it.

Draft Net Fishing.

Deputy Michael Ring

I thank the Chairman for selecting this matter for the Adjournment debate. While this matter relates to a small number of people in the west, draft net fishing has been a way of life, reared many families and helped families to educate their children, including at third level. It was their way to supplement social welfare incomes. In recent years, people feel that they have been under attack by the Department and other agencies. The Minister of State might relay to his counterpart the fact that few fishermen are affected.

I wish to discuss the cost of getting a licence. For an eight-week period and hoping that the weather is good and that one will be able to fish, a licence costs €545. A constituent presented at my clinic recently. He has a quota of 40 tags, which means that he is allowed to catch 40 fish. If he is lucky with the weather, he will do so. If the weather is bad, he will not get the chance. Given the licence fee, each tag costs €13.62. That does not provide one with an opportunity to make a few euro on the transaction. The fishermen tell me this is the dearest licence in the entire country and that draft net licences elsewhere are cheaper than in the west of Ireland. Why does the Government charge €545 to people in the west of Ireland; why does the same rate not apply nationwide?

If the Government does not want to have draft net fishermen in Ireland, in the west of Ireland or in north County Mayo, I call on the Minister of State and on the Government to put in place a decent package. While I am open to correction in this regard, I believe that 116 people are involved in north Mayo. I assure the Minister of State that were a proper package put on the table, a significant percentage of them would take it. At present, they are being forced out of fishing by stealth. They are being forced out by the Government and by outside interests. This is unfair because fishing was a way of life in rural Ireland. Such people fought their landlords in the past to hold onto their fishing rights. At present, the new landlords, the Government, are taking away their rights and are not allowing them a living from this practice. They have been taken out by stealth through the overcharging of the licence, the shortening of the time period and by introducing quotas for them.

I ask the Government, through the Minister of State, to reduce the price of the licence. Second, the Minister should put on the table a decent package that would be of assistance. If the Government wishes such people to desist from this activity, putting such a package on the table would succeed in this regard. Third, I ask that the season be extended to provide the fishermen with an opportunity to use the quota available to them. As matters stand, draft net fishing is extremely difficult. One depends on the weather and the kind of summers one has, particularly in the west of Ireland. The last few summers have been extremely difficult with much flooding and the fishermen were unable to fish.

I hope the Minister of State will have good news for me. These fishermen believe they have no one to represent them or speak up for them. They consider this to be a way of life that is similar to cutting turf. This week, the Minister for the Environment, Heritage and Local Government, Deputy Gormley, announced he would allow turf cutting for an additional year. Everyone knows this is because of the local and European elections, as well perhaps because of a certain treaty that is coming up at the end of the year. This is the reason these fishermen do not, and did not support Europe the last time, because they consider that EU and Irish legislation, as well as Irish landlords, namely, Ministers, are trying to take away their livelihood and their business by stealth.

Deputy John Moloney

I am taking this Adjournment matter on behalf of the Minister of State at the Department of Communications, Energy and Natural Resources, Deputy Seán Power. Licence duties for commercial salmon fishing are set by statutory order made by the Minister for Communications, Energy and Natural Resources under section 68 of the Fisheries (Consolidation) Act 1959, as amended. The most recent order increasing the licence fees, the Fisheries (Commercial Fishing Licences) (Alteration of Duties and Fees) Order 2007, SI 812 of 2007, was made in 2007 and was approved by both Houses of the Oireachtas. This order prescribes the licence fees payable in respect of salmon commercial fishing licences from January 2008. The order also prescribes the licence fees payable in respect of eel and oyster commercial fishing licences and salmon, eel and molluscan shellfish dealers' licences issued or renewed for a period commencing on or after 1 January 2008.

These fees are uniform across all fisheries regions and I assure the Deputy that draft net licences are no more expensive in the west than in any other part of the country. Under the existing order, a draft net licence costs €398. It was decided not to increase the fees for any salmon fishing licences for 2009 and, accordingly, licence fees have remained static.

Certain waters around the country are designated as special tidal waters and draft net users are required to obtain a special draft net licence to fish these waters. I am advised that in the west under the Rivers Owenmore and Owenduff (Tidal Waters) Order 1967, SI 33 of 1967, the tidal waters of Owenmore and Owenduff are so designated and therefore attract the licence fees applicable to special draft net licences. Section 74 of the Fisheries (Consolidation) Act 1959 provides that the licence duty to be fixed in respect of special local licences shall not be less than the licence duty payable in respect of ordinary licences. The licence fees payable in respect of special local licences are prescribed by the Special Tidal Waters (Special Local Licences) (Alteration of Duties) Order 2007, SI 795 of 2007. At present, a special draft net licence for the Owenduff and Owenmore costs €545.

The proceeds from the sale of licences contribute to the revenues of the central and regional fisheries boards, which are currently statutorily responsible for the conservation, management and development of inland fisheries in the State, including the fisheries to which licences apply. In 2007 the management of the wild salmon fishery was aligned with the scientific advice and fundamental changes were introduced regarding conservation and protection of the national wild salmon resource. As part of a suite of measures agreed by the Government, in line with the recommendations of the independent group on salmon, a salmon conservation component was applied to all salmon rod licences and commercial salmon fisheries licences from 2007. The salmon conservation component represents 50% of the licence fee. The revenue generated from the salmon conservation component is reinvested in salmon stock rehabilitation and habitat improvement and is ring-fenced and designated for the purpose of prioritised investment in such initiatives.

To ensure that the revenue generated by the salmon conservation component is used for its intended purpose, a ministerial direction, in accordance with section 18A of the Fisheries Act 1980, issued to the central and regional fisheries boards instructing that the Central Fisheries Board co-ordinate the preparation and implementation of a programme for the rehabilitation of salmon stocks, which will be funded by the proceeds of the salmon conservation component. The boards also were instructed to identify in each of their annual accounts the income generated as part of the salmon conservation component of the licence fee.

The fund is being managed by a committee comprising of scientists from the Central Fisheries Board and representatives from the regional fisheries boards, which receive project applications from the central and regional fisheries boards. Each project is assessed and scored based on the river's conservation limit status, its special area of conservation status, its water quality and the maximum potential benefits to the river.

School Accommodation.

Deputy David Stanton

I thank the Ceann Comhairle's office for choosing this matter this evening, thereby allowing me to raise it. I thank the Minister of State for taking this debate. Unfortunately, his ministerial colleagues in the Department of Education and Science, which has one Minister and two Ministers of State, could not be present. However, the Minister of State who is present is most competent to take this issue.

I raise the issue of the gaelscoil in Midleton again, more than 12 months after doing so previously. Gaelscoil Mhainistir na Corann now is well established and is attended by 305 pupils at present. Attendance will increase to 340 and 370 pupils next year and the year after, respectively. The school is growing at an alarming rate and needs one new classroom every year. It operates out of a community centre, which ironically has developed through taking out loans on the strength of getting rent from the Department, which it has used to build permanent rooms onto the community centre.

However, the community centre is not a suitable site and the town has lost its community centre as a result of the gaelscoil taking over the building. It has no playground as such, parking is inadequate and the school is spread out upstairs, downstairs and all over the place. Moreover, the school is set to grow even further. It is very popular and successful and, increasingly, parents are choosing this school, as is their right. More than 50 children are seeking to enrol in 2010 with a waiting list of 30.

Ironically, had the Department decided a number of years ago to build and fund a new school, the amount it has expended on rent over that period would have funded such a development and its pupils now would have a new school. This cockeyed policy of spending millions upon millions on rental accommodation does not make sense to me because sooner or later, the Department will be obliged to build a new school anyway. The community centre management is delighted because the centre now has many new rooms that ultimately will benefit the community. In the short term, however, the students are being short-changed. The Minister of State should revert to the Department of Education and Science to reconsider this school. The school itself considers itself to be abandoned and has little contact with the Department. It has a band rating that I contend is not suitable to its needs.

The population in the area is growing at a significant rate and this is an urgent need. Building a new school would provide much needed employment in the area, particularly to the construction industry. That should be part of policies across the House. Instead of allocating money to renting prefabs, let us build new, solid schools for the education of our children. I hope the Minister of State has positive news for me, not a cut and paste version of what I got 12 months ago or a cut and paste version of answers to parliamentary questions I tabled during the year. This seems to happen more and more. I hope the Minister of State will take the message back to the Department that we must start planning for a new gaelscoil in Mainistir na Corann as soon as possible.

Deputy John Moloney

I apologise that the senior Minister, Deputy Batt O'Keeffe, cannot be present to respond.

Deputy David Stanton

Nor his deputies.

Deputy John Moloney

I am a Minister of State at the Department of Education and Science, with responsibility for special education. I thank the Deputy for raising this matter as it provides me with the opportunity to outline the strategy for capital investment in education projects and also to outline the current position of Gaelscoil Mhainistir na Corann.

Modernising facilities in the existing building stock, as well as the need to respond to emerging needs in areas of rapid population growth, is a significant challenge and is one of the priorities of the Minister for Education and Science. The allocation of funding for school buildings in 2009 is €653 million. This represents a significant investment in the schools building and modernisation programme. This level of funding, at a time of great pressure on public finances, is a sign of the Government's commitment to investing in school infrastructure and will permit the continuation of progress in the overall improvement of school accommodation.

All applications for capital funding are assessed in the planning and building unit of the Department of Education and Science. The assessment process determines the extent and type of need based on the demographics of an area, the proposed housing developments, the condition of buildings and site capacity etc., leading ultimately to an appropriate accommodation solution.

Gaelscoil Mhainistir na Corann currently has 305 pupils and staffing of a principal plus ten mainstream teachers, one developing post, two full-time learning support teachers and one shared learning support teacher. The school has submitted an application for permanent accommodation and this project has been given a band rating of 1.1 for a new school in a developing area which is the highest priority that can be assigned.

In 2007, a developer proposed transferring a site to the Department. Departmental officials carried out a technical examination of the site and subsequently wrote to the developer requesting contract documents. The Department is continuing to liaise with the developer on the proposed site transfer and has recently requested an update from the developer as to the status of the original offer. In the interim, the Department has sanctioned the rental of temporary premises and accommodation in Midleton Community Centre in order for the school to operate.

Regarding the school's immediate accommodation needs for September 2009, the Department has recently written directly to the school approving funding, in principle, for additional accommodation. However, the Department has requested clarification of certain terms and conditions in the school's proposal. The Department will continue to work with the school on this.

Progression of a project to provide permanent accommodation for this school will be considered in the context of overall primary level provision in the Midleton area and in the context of the multi-annual school building programme. However, it is not possible to progress all projects at the same time. In light of current demands on the capital budget of the Department, it is not possible to give an indicative timeframe for the progression of the project. I thank Deputy Stanton for giving me the opportunity to outline to the House the current position of Gaelscoil Mhainistir na Corann.

The Dáil adjourned at 9.05 p.m. until 10.30 a.m. on Wednesday, 1 April 2009.