Dáil Éireann debate -
Wednesday, 13 May 2009

Vol. 682 No. 3

Adjournment Debate.

Health Service Funding.

Deputy Finian McGrath

I welcome the opportunity to speak on the urgent need to assist and develop services at Prosper Fingal. I am sharing time with Deputy Terence Flanagan whom I thank and commend for his support on this urgent matter.

I call on the Minister for Health and Children to examine the critical needs of the individuals and their carers helped at Prosper Fingal. This debate is about protecting the vulnerable, assisting those with a disability and getting our priorities right. We can go on about finance, resources and the economy but this debate is important if we are to protect the most vulnerable and their families. We must do the right thing and, if needs be, the strong and the wealthy must take the hit and provide resources for groups such as Prosper Fingal.

I have received many letters from parents on this urgent matter. One such letter sums it up. It reads:

Dear Finian,

As a parent of a young man of 23 who has Down's syndrome, I am extremely worried as to what the future holds for him. He has just completed a three year independent skills training programme with Prosper Fingal services but we are now hearing that no funding will be provided for a continued day service come 2009.

I cannot bear to think what this will mean for him having built up his self esteem and independence over the years. However, this independence is only a basic human right and does not extend itself to him being in a position to put himself on the open market for employment or making the decision to move to another country to seek employment. Therefore remaining in the service of Prosper Fingal is of the utmost importance to him.

How can we tell him come September that there is no place for him because of a lack of funding? He has built up a wonderful relationship with all members of staff and has developed a lovely network of friends. It would be heartbreaking for him and for us if this service were to be withdrawn.

I am appealing to you to plead on his behalf for adequate funding to make sure this does not happen.

The bottom line is that Prosper Fingal provides a service for 233 individuals and their carers. It is a not-for-profit organisation, a registered charity and funded by the HSE. In total, there are 35 people seeking long-term day services from Prosper Fingal in 2009. There are also eight individuals receiving residential crisis services. There has been a 3% cut in the overall budget and the group will work with the HSE in any way possible to manage demand. I urge the Minister and the HSE to fund and support Prosper Fingal.

Deputy Terence Flanagan

I thank the Ceann Comhairle for allowing me to raise this issue and thank Deputy Finian McGrath for stating the facts about Prosper Fingal. It is a not-for-profit organisation which is funded by the HSE and provides an extensive range of services for 233 adults with intellectual disabilities in north County Dublin, as well as respite, day, residential, clinical, advisory and transport services which are delivered at eight locations in Fingal — Malahide, Rush, Skerries, Piercetown, Portmarnock, Balbriggan and Swords.

The Minister has reduced the budget for the organisation by 3%, which is scandalous. Indications show that no funding will be provided for service development this year. If the service development funding is withdrawn, 24 adults who depend on the services of Proper Fingal will be devastated. They will also lose their long-term service placements and will be sentenced to spending their lives at homes with their family supports. In addition, 11 other individuals who require a long-term place will be denied a place.

The 24 people affected are young adults who have benefited enormously from the help they have received to date from Proper Fingal. They have learned new skills and have gained independence. For these young adults to progress, they need and rely on their place in Prosper Fingal. They need to continue receiving the great benefits they have received to date. Prosper Fingal not only provides essential skills but a social element for these young people. It gives them a sense of purpose, a sense of responsibility and a quality of life.

Like Deputy Finian McGrath, I have received numerous items of correspondence concerning this matter in recent weeks. Many parents are angry and extremely concerned about these cutbacks. The Minister needs to seriously reconsider this matter, having regard to all the money that was squandered here during the last ten to 15 years. The money spent on the electronic voting machines is one such example. All we are seeking is for the Minister to continue to fund Prosper Fingal. It is not expensive to do so. The average cost in respect of each person is €20,000 per annum. If funding is cut, the long-term costs of providing full-time residential places will a much more costly.

I want the Minister of State to give us positive news that he will continue to properly fund Prosper Fingal and that he will look after these people and not give up on them. Such people are forgotten about in some instances. Not enough funding is being allocated to help people with intellectual disabilities. I hope that the Minister of State will look after these people and give us a positive response.

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

I am taking this matter on behalf of the Minister for Health and Children, Deputy Harney. I am pleased also to have this opportunity to address the issues raised by Deputies Finian McGrath and Terence Flanagan.

I want to re-affirm the Government's steadfast commitment to people with disabilities in Ireland and to the national disability strategy and its long-term goals and objectives, which we will continue to pursue in the coming years in partnership with all the key stakeholders. The co-ordination and planning of services to meet the needs of people with disabilities form a central tenet of the national disability strategy. A critical element of such co-ordination and planning is the requirement to provide financial support for the developments and implementation of services.

Since 2005, the Government has provided significant additional resources for services and supports for effecting real change in the development of services for people with disabilities. The multi-annual investment programme, which was a key component of the Government's disability strategy, had, by the end of 2008, provided for the intellectual disability services 804 new residential places, 307 new respite places and 1,863 new day places. In terms of services for people with physical and sensory disabilities, 307 new residential places and 911,626 extra home care personal assistance hours have been provided. A total of 406 places in the intellectual disability residential service have been enhanced, 61 respite places have been enhanced while 43 residential places in the physical and sensory disability services have been enhanced. In addition, almost 195 day places have had their services enhanced with the provision of additional supports to allow the organisations to deal with school leavers or other adults with significant disabilities.

The HSE and voluntary disability service providers are working together to ensure that all the existing resources available for specialist disability services are used in the most effective manner possible. In the current challenging economic environment there is a responsibility on all publicly funded services to review the way in which services are delivered and to ensure resources are used to maximum effect. This also applies to disability service providers in the statutory and the non-statutory sector, including Prosper Fingal.

The overall allocation to voluntary disability service providers in the health Vote was reduced in 2009 by 1% — similar to the 1% reduction in 2008 — as part of an overall efficiency measure within the health services. In addition, in the context of the general economic situation and the financial pressure on HSE budgets, the HSE has been required to implement a further 1% budget reduction to all voluntary agencies since the start of the year.

As Deputies are aware, Prosper Fingal has developed a wide range of service options that are both centre and community-based, including day services, training, employment placement, residential and non-residential respite, residential support, clinical, community outreach and transport services. Prosper Fingal is currently supporting 220 clients with an intellectual disability and their families.

All service providers, including Prosper Fingal, have been asked by the HSE to review all non-frontline expenditure, in particular, staff travel, expenditure on conferences and seminars, and advertising to ensure maximum value from the procurement of goods and services. There is also a requirement on all providers to review the way in which services are delivered, for example, to examine opportunities for amalgamating services or back office supports and reduction or elimination of expenditure on overtime or agency staffing or both.

I further understand that the HSE has put in place a partnership process with the umbrella groups representing the voluntary sector in the context of the difficulties presenting in delivering disability services in 2009. The purpose of the group includes ensuring that the required budget reductions are implemented in a manner designed to minimise the impact on service users. The HSE has also confirmed that while there is no specific funding in 2009 for the development of new services, there will be a requirement for all stakeholders to plan to meet the needs of individuals who require services on an emergency basis.

The HSE and non-statutory providers are working together to identify how the needs of these individuals, who require services on an emergency basis in 2009, can be responded to within available resources. The aim is to agree how service providers — statutory and non-statutory — and HSE management can plan and provide for emergency requirements at local and regional level. This will involve a collaborative approach at local health office and area level in dealing with emergency situations, development of criteria for identifying emergency needs in a consistent manner across all service providers, identification of capacity to increase provision within existing resources, reviewing existing service arrangements in the context of appropriate response and service efficiency and delivering responses to meet requirements.

I take this opportunity to emphasise the Government's commitment to people with disabilities and to the strategy and its long-term goals and objectives, which we will continue to pursue in the coming years in partnership with all the key stakeholders.

World Health Assembly.

Deputy John Perry

I thank the Ceann Comhairle for selecting this matter. I also thank the Minister of State, Deputy Moloney, for his presence in the Chamber.

I very much welcome the news that the World Health Organisation has invited Taiwan to take part as an observer in the upcoming World Health Assembly this month. I also ask that the Government acknowledge that this decision is significant on many levels and, in particular, that it is a decision of practical relevance to the international efforts to fight any threatened global pandemic.

With the new flu strain posing the biggest risk of a large-scale pandemic since avian flu surfaced in 1997, I am confident that the Minister and her Department will take all necessary measures to protect our citizens. That we live in a global village is a well-worn phrase. Never has that phrase been more true than when we look to the dangers posed by this new virus.

The speed and the scope of the world's response to this new virus prove the value of preparations made because of the avian flu and SARS scares. The World Health Organisation has played an active and valuable leadership role in developing emergency response measures and in ensuring that the necessary procedures are rigorously implemented across the world.

As the WHO is the most influential multilateral forum that handles health care issues confronting the international community and as it is dedicated to the goal of good for everyone, it must have the full support of every country in the world to fight any threatened pandemic.

We should welcome Taiwan's full participation in the World Health Assembly. Admitting Taiwan will serve to improve the effectiveness of the WHO by removing a significant gap in the worldwide disease prevention system. Bringing Taiwan into the WHO will serve to remove that vulnerability and will help strengthen the worldwide disease prevention system.

Taiwan's role as a key sea and air transport hub in the Asia-Pacific region makes it vulnerable to pandemics. In 2003, an outbreak of SARS spread rapidly to over 27 countries within a few months, taking the lives of more than 800 people. According to WHO research, ease of transportation between countries was the main factor facilitating the spread.

Taiwan's inclusion as an observer in the WHA is especially important in co-ordinating global responses to pandemics. Diseases do not stop at national borders and Taiwan's absence from the WHA meant that a co-ordinated global response to a pandemic outbreak was not as effective as it will now be with Taiwan's inclusion.

Taiwan is in a position to contribute powerfully to WHO activities. It is prominent in a wide range of medical and pharmaceutical fields, and has demonstrated willingness to volunteer aid and assistance to other needy countries in the recent past. Taiwan's inclusion as an observer in the WHA is also a welcome endorsement of the health rights of the citizens of Taiwan. Their welfare has been directly threatened by its inability to establish direct access to and communication with, the WHO in the past. Neither has it been able to either acquire the latest medical updates, nor receive timely assistance when epidemics occur, such as was the case with SARS when Taiwan was left vulnerable. Taiwan's inclusion as an observer in the WHA also demonstrates the improvement of the relationship between Taiwan and China. There is now significant goodwill on both sides of the Taiwan Strait. The reopening of negotiations in 2008 marked a steep change in their relationship and it is heartening to see that progress is being achieved. Just recently, the two sides concluded a third round of talks, consolidating the real progress and achievements made to date. This is encouraging not only for the cross-strait relationship but also for regional stability and bodes well for a more enduring world peace.

I acknowledge the sterling role played by Deputy Noel O'Flynn who has been actively involved in all issues relating to Taiwan and equally with regard to the imminent announcement by the Minister on the visa waiver which will be very important for the Irish economy. Taiwan has a contribution to make to the Irish economy from the points of view of tourism, culture and education. The granting by the Minister for Justice, Equality and Law Reform of the visa waiver in the not too distant future, complemented by Taiwan's right of admission as an observer at the World Health Assembly, is a very important development for the world and will help recognise the significant role played by Taiwan globally. I am confident the Minister of State will duly recognise the role of the World Health Assembly and I await his comments on this important decision which is very good for Ireland.

Deputy John Moloney

The Government is very pleased that the World Health Organisation has invited Taiwan to take part as an observer in the upcoming World Health Assembly. We agree with Deputy Perry that this as a positive development in a worldwide disease prevention system and a welcome development in international co-operation.

In common with most member states of the UN and all EU partners, Ireland adheres to a One China policy, recognising the Government of the People's Republic of China as the sole legitimate government of China. We therefore do not support Taiwanese membership of organisations where statehood is a prerequisite for membership. We take the view that any status granted to Taiwan by the WHO must be compatible with the One China policy.

However, against the above background, and with our EU partners, Ireland for many years has been active in seeking to ensure Taiwan's meaningful participation in the activities of the WHO to the fullest extent possible, so as to ensure that there is no geographical gap in the important work of that organisation. In this context, Ireland supported the Taiwanese application for observer status at the meeting of the WHA from 18 to 27 May. We are very pleased that the Government of China also accepted the case for Taiwan's participation as an observer in the WHA, which paved the way for the director general of the WHO, who is Chinese, to issue the invitation to Taiwan.

Social Welfare Benefits.

Deputy Ciarán Lynch

As the House will be aware, with increasing unemployment figures, people who now sign on for social welfare are facing quite lengthy periods before the social welfare payments are processed and paid. In my constituency of Cork South-Central people are now waiting anything from nine to 12 weeks for a social welfare payment to come through. During that period individuals are directed to the community welfare service and the community welfare officer provides recently unemployed people with a supplementary welfare payment to tide them over the application period.

In the Ballyphehane-Togher area, the community welfare officer has gone on maternity leave and the HSE has not filled the post. As a result, people in Ballyphehane-Togher cannot therefore avail of a supplementary welfare payment because the post is vacant.

Earlier today I met with Professor Drumm and his team to talk about the reconfiguration of hospital services in the Cork and Kerry region. This is a very ambitious plan which will involve significant changes for the region. However, one would question the HSE's ability to project manage such a big project, given that it is unable to manage substitute cover for a community welfare officer in the Ballyphehane and Togher area. How, in the name of God will the HSE be able to reconfigure a whole hospital service for an area one quarter the size of Ireland?

The existing system is questionable in itself. It takes nine weeks for a person to receive a social welfare payment yet the community welfare officer can effect a payment within one week. This beggars belief because it must be the same system.

I am concerned that people who cannot get a supplementary welfare payment while waiting for a social welfare payment to come through, have no other option but to borrow that money. The banks will not lend them this money, they may be a member of a credit union and may receive bridging finance but this situation is driving people into the hands of moneylenders because the State is not fulfilling a function. I hope in his response that the Minister of State will provide a solution whereby a community welfare officer will be in place tomorrow morning or if he fails to achieve that goal, that some priority is given to social welfare applications in this area, given that people cannot be provided with a supplementary welfare allowance in that time.

Deputy John Moloney

I am replying on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. I thank the Deputy for raising this issue and for giving me this opportunity to outline what provision is being made in the Ballyphehane-Togher area of Cork. I would also like to take this opportunity to speak about the community welfare service in general.

With regard to the sudden absence of a community welfare officer in the Ballyphehane-Togher area of Cork, I am informed by the HSE that this relates to the fact that there was no clinic held in that area on Monday last, 4 May 2009. As the Deputy highlighted, this absence could not have been anticipated as the member of staff responsible for this area was suddenly taken ill. The situation was compounded by the fact that a large number of possible replacement staff were also unavailable. Obviously this was an unfortunate set of circumstances but not one that could have been foreseen. As a result, I am informed it was decided by local management that it would not be possible to hold the clinic on that day. While this unfortunately has caused inconvenience to clients who were hoping to meet with the community welfare officer, the cancellation of the clinic was unavoidable in the circumstances.

In order to address the pressures on the community welfare service in Cork, a process is under way with the staff and their trade unions to implement a revised arrangement to meet the current service need. This process has been undertaken in a partnership process and will be finalised over the coming week to ten days.

Deputy Ciarán Lynch

Just for the record, this problem did not begin on Monday; it has been going on for a number of weeks. I welcome the fact there will be a response this evening but this problem did not begin on Monday. The person went out on maternity leave, she did not become ill.

Acting Chairman (Deputy Jack Wall)

The Deputy must allow the Minister of State to continue his reply.

Deputy John Moloney

The purpose of the process is to ensure a resolution is found and I am trying to deliver on that. In the meantime, in relation to the Ballyphehane-Togher area, arrangements have been made for the assignment of a dedicated member of the relief panel of community welfare officers to take up this position immediately. The matter will be kept under ongoing review.

The Government decided in March 2006 to transfer the administration of the supplementary welfare allowance, SWA, scheme to the Department of Social and Family Affairs. The community welfare service is funded by the Department of Social and Family Affairs but the delivery of the day-to-day service is the responsibility of the HSE. I do not believe this is the best, most efficient way of delivering this service. The division of responsibility between the Department of Social and Family Affairs and the HSE is also making it more difficult to address the pressures on both the community welfare service and the Department of Social and Family Affairs in a unified, comprehensive manner.

Reform of the public service remains a priority for the Government. Citizens need and demand integrated services across public service. Public service reform also means resources must be deployed to the best effect and this requires a flexible and open attitude of staff to change and doing things differently. The transfer of the SWA is a good example of the kind of reforms which are needed. The decision to transfer the SWA was taken over three years ago. There have been lengthy discussions with the unions since then to bring it about.

Virtually all the preparatory work that can usefully be done has been completed. The Government remains firmly committed to this transfer of functions and has recently reiterated its support for accomplishing the transfer. The delays to date do not reflect well on the public service and I hope this matter can now be progressed quickly, preferably through negotiation between all the parties involved.

Road Network.

Deputy Jimmy Deenihan

On 1 February 2007, Ballinagare Bridge, Lixnaw, Co. Kerry, collapsed when a truck transporting pigs weighing 43 tonnes attempted to cross over it. The bridge had a carrying capacity of just 12 tonnes, which was clearly indicated on the approach roads. This resulted in a court conviction for the driver and an acceptance of liability by the insurance company. The quantum of liability is being decided between the insurance company and Kerry County Council. It is expected to be a substantial figure, which will reduce the overall cost of replacing the bridge for the Department.

A grant of €100,000 was allocated to Kerry County Council in 2008 for Ballinagare Bridge under the specific improvement grant scheme. This enabled Kerry County Council to design a new bridge, complete a short listing process of suitable contractors and draw up tender documents. In the 2009 regional and local roads specific improvement grants announced last February, a figure of €600,000 was allocated by the Minister for Transport for Ballinagare Bridge. The announcement was enthusiastically received and welcomed locally. However, in the revised figures for the 2009 specific improvement grants published on 14 April, the allocation for the bridge was reduced from €600,000 to €25,000, for no apparent reason. This announcement came as a major bombshell for the local community and was greeted with much dismay and anger.

The bridge was used extensively by local commuters between Lixnaw and Ballyduff and during the summer by numerous tourists visiting Ratoo round tower and Ratoo Abbey on the Ballyduff side of the River Brick and the seaside resort of Ballybunion. A number of farmers with land on both sides of the River Brick have been seriously inconvenienced since the bridge collapsed. They have to make a ten mile round trip to access their lands. In addition, a large number of people from Ballyduff who cut turf on the Lixnaw side of the River Brick in Ballinagare Bog, have to travel over ten miles to access their bogs.

On 27 April, Kerry County Council was informed by the regional and local road division of the Department of Transport that, "Unfortunately following the supplementary budget in April the Department is not in a position to fund the construction of Ballinagare Bridge at this time and the request for approval to proceed to tender is denied". I appeal to the Minister to reverse this decision and allow Kerry County Council to proceed to tender for this project. Given the downturn in the construction industry, the likelihood is that the tenders will be very competitive, as was the case with Castleisland bypass recently where the estimated cost was €16 million and the successful tender was €12 million, a €4 million reduction.

I understand a suggestion was made last Monday night at a public meeting in Ballyduff that a replacement Bailey bridge would be acceptable, similar to the original one. However, it would seem that there is just a small differential between the cost of a Bailey bridge and the one designed by Kerry County Council. The approach roads will have to be raised and realigned because of flooding and the abutments will have to be rebuilt, whether it is a Bailey bridge or the Kerry County Council design, so it seems that the latter approach is better and the officials of the council want to take it.

As most of the financial cost for this bridge will be incurred in 2010, with part funding for the scheme from the insurance settlement being available in the near future, going to tender now would seem to be a practical approach. There are moneys within the allocation by the Minister that could be used for this road, so half the funding is there. In view of the strategic importance of Ballinagar Bridge to Lixnaw-Ballyduff and the greater north Kerry community, I strongly urge the Minister to instruct the regional and local roads division in his Department to grant approval to Kerry County Council to proceed to tender immediately. If a bridge of this importance collapsed two and a half years ago in any other part of Ireland, for example in County Meath, it would have been long since replaced. I look forward to the Minister of State, Deputy Moloney's reply on behalf of the Minister and I hope it will contain a change of approach by the Department of Transport and hope for the people of Ballyduff and Lixnaw.

Deputy John Moloney

Again, I am taking this Adjournment matter, in this instance on behalf of the Minister for Transport, Deputy Dempsey. County councils and other major local authorities are responsible for managing and maintaining all roads and bridges on the regional and local road network in their area. Each year, the Department of Transport assesses the regional and local roads programmes of local authorities and makes substantial grant allocations towards them. Local authorities are also expected to commit an appropriate share of their own resources for this purpose, and the grants that the Department of Transport provide supplement these.

The bridge at Ballinagare was damaged in February 2007. That bridge was a temporary structure and had a weight restriction imposed. Subsequent to the collapse of the bridge, Kerry County Council developed proposals to provide a new replacement bridge at the location and the council sought grant aid from the Department of Transport. In 2008, a road grant of €100,000 was allocated to the council under the specific improvement grants scheme to facilitate design work for a new bridge. Kerry County Council included the bridge at Ballinagare in its application for grant aid in 2009 and, in February last, initial road grant allocations were made. At that time, a grant of €600,000 was proposed to facilitate construction work on the bridge.

The current economic climate and the difficult position of the Exchequer has, unfortunately, had an impact on the Government's ambitious plans for the development of our road network. In reviewing NDP expenditure for the rest of 2009 it was found necessary to reduce the overall level of Exchequer funds available for improvement works to regional and local roads. This impacted on all local authorities. The grants originally allocated in February 2009 were reviewed and revised road grants issued to all local authorities on 14 April 2009.

The revised road grants allocated to Kerry County Council in April amount to €17.985 million. This is a significant supplement to the expenditure proposed by Kerry County Council from its own resources at a time when public finances are under serious pressure. This grant aid was allocated under a number of grant categories and included a total of €3.1 million for ten specific improvement projects. These included the proposed new bridge at Ballinagare which was allocated €25,000.

In deciding on the revised grant allocations, the approach taken was to fund legal contractual commitments and prioritise work necessary to complete projects already under construction. Local authorities were, however, also advised that there would be flexibility as to how the grant aid may be used. It is open to Kerry County Council, if it wishes, to reprioritise the expenditure of the €3.1 million which is available for specific improvement works in 2009 and to submit an alternative programme to the Department of Transport which could allow construction work to start on the bridge. This is a matter for the council to decide in the first instance and Department of Transport officials are available to assist the council in reviewing its road programme if the council requests.

Deputy Jimmy Deenihan

I thank the Minister for that very positive response.

Deputy John Moloney

I thank Deputy Deenihan for his response.

The Dáil adjourned at 9.40 p.m. until 10.30 a.m. on Thursday, 14 May 2009.