Vol. 693 No. 2
78 Deputy James Reilly asked the Minister for Health and Children the location of the 45 Health Service Executive swine flu vaccination clinics; the persons who will man them; the opening times of the clinics; the number of patients they will see per day; the number of vaccinations they will administer per day; and if she will make a statement on the matter. [39588/09]
81 Deputy Jan O’Sullivan asked the Minister for Health and Children the number of recorded cases of H1N1 flu to date in 2009; the number of recorded deaths; when she expects the H1N1 vaccination programme to be delivered to the general population; the categories of staff who will administer the H1N1 vaccine to the general population; if they will be replaced in their regular role; and if she will make a statement on the matter. [39514/09]
I propose to take Questions Nos. 78 and 81 together. The incidence of influenza-like illnesses, ILI, reported on 25 October last is at a rate of 210.9 per 100,000 population. This is the highest ILI rate reported since sentinel influenza surveillance began in 2000. There were 2,727 laboratory confirmed cases of H1N1 on that date. It is not necessary for swabs to be taken by GPs to make a clinical diagnosis. The majority of cases are now diagnosed clinically. At 29 October, 492 cases of confirmed pandemic H1N1 2009 had been hospitalised and sadly ten deaths have occurred.
Vaccination is a key strategy being used to mitigate the effects of the pandemic. Every person in the country will be offered the vaccine. However, initially the vaccine is arriving in small quantities due to the demand for the vaccine worldwide. Ireland is not unique in the difficulties we have been experiencing in sourcing the vaccine in the quantities we would require. Obviously, therefore, vaccination will be prioritised to ensure those who require it most will be first to receive it. The national immunisation advisory committee and the pandemic influenza expert group have advised that the vaccine should be given to the population in the following order of priority: people with long term medical conditions aged between six months and 65 years and all pregnant women of more than 14 weeks gestation and for women six weeks post partum, — the “clinically at risk” groups; health care workers; children between six months and 18 years of age; adults over 65 years of age; and the rest of the population.
It is generally agreed that the preferred option for the administration of the pandemic vaccine to people under 65 in the "clinically at risk" groups is through general practice. GPs hold their medical records and are in a position to identify patients with underlying medical conditions for vaccination. It is estimated that there are approximately 410,000 people in this category. GPs have been receiving vaccine over the past two weeks and many patients have already been vaccinated. However, not all GPs are in a position to participate in the vaccination programme and the HSE has set up special vaccination clinics to vaccinate the "clinically at risk" patients of such GPs.
A full list of the locations and opening times of these clinics has been provided via the national and local media and is available on the swine flu website at www.swineflu.ie. I have arranged for a copy of this list to be circulated to Deputies. A typical HSE vaccination clinic will comprise at least one doctor, six nurses and appropriate support staff. It will have the capacity to vaccinate up to 500 people a day, but the numbers vaccinated at the clinics will clearly depend on the demand from the public for the service. Staff being assigned to the vaccination clinics will not be replaced and the vaccination programme will, therefore, mean that some other services have to be delayed or curtailed. The HSE has drawn up plans to prioritise services during the period of the vaccination programme, but the impact on particular services will only become clear as the programme is rolled out. The intention is to start vaccinating other priority groups, like health care workers and children, as soon as possible. However, depending on uptake, vaccine supplies and other factors, it could take from six to eight months to vaccinate the entire population.
The House will appreciate that this pandemic is one of the biggest public health challenges this country has faced. The logistics of undertaking such a mass vaccination programme are challenging. I am confident, however, that the extensive preparation plans which we have in place will assist in meeting this challenge.
If we extrapolate the figures from the sentinel surveillance, we see that almost 10,000 people contract the swine flu per week. However, these figures do not take into account the people who do not attend their GP and, therefore, the figure may be more like 30,000. We have a serious situation on our hands. Some GPs have opted out of the vaccination programme because they believe that even if they do not sign a contract but accept and administer it, there is an inferred contract that makes them liable in law to somebody at risk whom they failed to contact. Will the Minister comment on that and reassure GPs that will not be the case so that more people can avail of vaccination through their GPs?
Hundreds of at risk patients have had to be turned away because supplies have run out or were not delivered. One-third of the HSE vaccine clinics remain unopened and some at risk patients face up to a 250 km round trip to their nearest HSE clinic. Some practices filled out the necessary forms last month, but only received syringes and needles. Practices that received doses of vaccine expect it to run out soon and that has already happened in some cases. One GP in Edenderry received enough vaccine for only 30 patients and had to use his entire supply by lunch time yesterday. Another doctor in County Laois only received enough for 60 patients and used that allocation up yesterday. The list goes on.
The HSE has a very poor strategy in place for implementation. Will the Minister confirm how many HSE vaccine clinics remain unopened? When will all the clinics be open and what are their opening times? Will opening times be extended? Is the Minister satisfied there are sufficient vaccines available to cover at risk patients? I accept what she said about the supply issue, but what action will she take to speed up the implementation of the programme?
It is a pandemic and every country faces the same logistical challenges. Our experience is very much in keeping with our counterparts in Europe and we have had close contacts with many colleagues, particularly those in Northern Ireland and the United Kingdom.
There is no issue with regard to indemnity and this has been made clear to general practitioners, both individually and on the websites of the three insurance companies. They, Medisec, MPS and MDU have all given assurances that this is normal in general practice and that the doctors are indemnified. The producers of the vaccine have been indemnified by every country as for obvious reasons they cannot go through the normal processes. An information leaflet and documentation was sent out to all GPs last month. This is clear and easy to understand and has been translated into eight languages so that patients from countries where people do not normally speak English can easily understand the what the vaccination programme is about and the possible side effects.
We now have 615,000 doses of vaccine in the country. There is a two-week lag from the time it comes to the port to when it can be got to either a clinic or GP, because of the manner in which it arrives. It does not come like the traditional vaccine because the manufacturers are trying to get the vaccine to countries as quickly as possible and when it arrives we have to do a considerable amount of work to get it out in ten-pack vials.
There are 45 HSE clinics and 32 teams, so some teams will cover more than one clinic. We hope to have 60 teams in place in approximately two weeks. On average, each team consists of seven vaccinators, one doctor and six nurses. Some have more and some less, depending on the arrangements necessary. Some 83% of general practitioners have agreed to participate, but 17% have not. I accept there are logistical issues, but there are such issues in every country. I have spoken to many colleagues who face the same logistical challenges.
I appeal to everybody, particularly members of the medical profession, Members of the House, the regulatory body of the Medical Council, all the training bodies, the College of Obstetricians and many other bodies to follow the advice given for all health care workers, doctors and others to accept this vaccination. I am not a clinician, but I am of the same view. Significant work has been put into this programme over the summer, led by the chief medical officer and the expert group. They have done considerable work and have won public confidence. They have been involved in many public debates on the airwaves, reassuring and informing people. That will continue to be the case.
We anticipate that some 415,000 people are at risk and general practices will get approximately 415,000 vaccines to administer to their patients. I am aware some doctors have an issue with regard to identifying those patients, but the majority know who they are.
I acknowledge the work that has been done by people such as Dr. Holohan, Dr. Kelleher, Dr. Doorley and others. By and large they have done a good job. There are still some GPs who have signed up but who have not receive the vaccine, I spoke to one about half an hour ago. Can the Minister tell us when all GPs who have signed up to the programme will receive their vaccines? Those doctors who do not have it yet are getting numerous phone calls and are finding it difficult to say no to people.
What is the advice for pregnant women who want to get the mercury-free vaccine? I understand it is available in the clinics but not with the GPs.
I asked about people being replaced in their regular role when asked to work in these teams. They are taken from their regular work and that is causing problems in some areas. I was talking to a voluntary organisation that administers some of the home care packages and was told nurses are being taken from those packages. Is there a system where those people can be replaced if necessary?
The Minister said there is a two week lag for the extra supplies once the boat comes in. Can we get more information about future supplies and when we can expect all of the population to be vaccinated.
We have 615,000 vaccines at present and from their arrival at the port until we can get them to the HSE clinic or to general practice takes about two weeks. From next week it is hoped to start with infants between six months and four years, preschool children and health care workers. After that the focus will be on the over 65s and school children, with the rest of the population coming after that. It could be up to eight months before we get to everyone. It depends on the take up and the speed with which we get stocks of vaccine.
The vaccine is being delivered by United Drug Distributors cold store, which has huge experience of delivering to pharmacies. There might be issues about when people signed up. Initially the date was 9 October, extended to 14 October. Vaccines have gone to 1,500 sites, covering more than 2,000 GPs. I met the team last night and I understand some doctors will get vaccines today and tomorrow and as quickly as they can physically get out them out, they will do so.
I am not in a position to advise pregnant women because I am not a clinician. The College of Obstetrics has advised on the matter but I would advice pregnant women to consult their GPs for advice.
I wish to clarify something for the Minister. There is no issue around the medical or legal situation as regards what happens if there are side effects from the vaccine for someone. The medical, legal problem is that if I as a GP accept these vaccines and vaccinate patients, there is an inferred contract between the HSE, me and the people at risk. If I fail to contact all those at risk, which I may not be in a position to do, I could be sued by one of those individuals for failure to contact him of her if he or she gets swine flu and develops serious complications. That is the consideration and doctors wish to be reassured on that point.
There was no contact between one of the main GP organisations, the IMO, and the HSE from July until late September. That is extraordinary, given that GPs were supposed to deliver this. The Irish College of General Practitioners are acknowledged as the group to speak to about standards and quality but the IMO deals with this sort of logistical problem. Can the Minister confirm if there was an internal memo from her Department to the HSE not to engage with the IMO? Can she also confirm that an offer was made privately to the HSE that GPs would vaccinate free of charge if the HSE would organise the clinics and that this offer was not taken up?
The onus is on the individual to come forward to the general practitioner, not on the GP to find the patient. There is a good relationship between GPs and their patients, although I have heard some general practitioners say they are not in a position to identify the at-risk patients. That surprises me because we hope that under the new contract for general practice that we will be able to manage chronic illness at general practice level. The onus is on the patient to come forward.
The Department advised the HSE because, given the volume of vaccine that was coming, and the advice of the expert group in August and early September, it had not been decided whether to involve general practice at that point. That advice was from the chief medical officer and those involved in the arrangements in the Department. The advice was to engage with the ICGP because it is the standards body while the IMO is the representative organisation and, generally, in matters to do with clinical issues, training and education, the college is involved.
We are in a pandemic and the onus is on all of us to work together. This is a small country and the State has arrangements to procure the vaccine for every citizen in the State free of charge. If GPs want to administer it free of charge I would be happy to hear it. If that is also the case for other vaccines we want to introduce, I will be the first to jump on the offer. The onus is on the patient to come forward, lest there be any doubt.
I am alarmed and surprised that it could take up to eight months to vaccinate the entire population. That is a long time during a pandemic. Is there no way to do it quicker? What about replacing staff? If the same person is taken from his or her job for that length of time, assuming the HSE clinics will be consistently open, it will have an impact. In my area there was a suggestion that they would rotate staff and take people from different areas at different times so no area would be short-staffed for a long time.
Vaccination of the entire population depends on the availability of the vaccine, it is not the logistical issue. We cannot say with certainty when we will have the 7 million doses we have ordered. The other issue that is emerging is if it will be necessary to have a second dose of one of the vaccines. If that is not necessary, that will speed the process. We are in the same situation as virtually every other country in the European Union.
Staff will be rotated but when there is an emergency, there must be all hands on deck, as we all appreciate. I have asked the experts from the HSE and the CMO if they will provide a briefing for Oireachtas Members because many people are contacting me for information and I know they want a briefing session, perhaps early next week.
79 Deputy Jan O’Sullivan asked the Minister for Health and Children the planned co-located hospitals which will be progressed; the projected date for the commencement of construction in each case; when she expects them to be operational; the number of beds which will be provided in each such hospital; and if she will make a statement on the matter. [39513/09]
The co-location programme is aimed at freeing up public acute hospital capacity for use for public patients and to enhance overall acute capacity at public hospital sites.
The renewed programme for Government re-affirms the Government's commitment to the current co-location programme. This means that the procurement process which is underway will continue. Projects will be developed within the terms of those project agreements which have been signed or which may be signed. Value for money criteria remain in place and are to be met by each project.
Considerable work has been done by the HSE and the preferred bidders despite, in recent times, the effects of the banking crisis on the timing and arrangement of large scale finance for major capital projects in every sector. Preferred bidders have been selected for the Beaumont, Cork University, Limerick Regional, St. James's, Sligo and Waterford Regional Hospital projects. Project agreements for the first four projects have been signed. Planning permission has been granted in respect of three of these and a planning application has been made in the case of the other project. The necessary preparatory work for the project agreements in respect of the Waterford Regional Hospital and Sligo Hospital projects is proceeding.
The total number of in-patient and day beds proposed in these six facilities is in excess of 1,200. This is exclusive of critical care beds, which will be provided in proportion to the in-patient capacity in each hospital. I am arranging to provide the Deputy with a tabular statement setting out the details for each of the projects. Two further projects at Connolly and Tallaght Hospitals are at earlier stages of the procurement process.
The HSE estimates that, from the start of building, the overall construction and commissioning period for the projects will be approximately 28 to 36 months.
I asked the Minister when the projects will start and when the beds will be available. It is four years and four months since these were announced and the intention was to provide extra beds. Four years and four months later the Minister cannot tell me when the beds will be ready. May I have a clear answer instead of all the waffle we are getting?
My second question was to know which projects are going ahead. The Minister indicated that the four for which agreements have been signed will go ahead and Waterford, Sligo and possibly others, Tallaght in particular. I do not know if the wool has been pulled over the Green Party's eyes but the revised programme for Government states that the Minister will "Proceed with the current programme of co-location limited to already committed projects under the existing project contractual agreements." Contracts have been agreed in only four projects. Is it four, six or seven? Will the Minister be clear and have the Greens been fooled?
I presume the Deputy saw the letter from the Taoiseach to her party leader. It refers to projects that are signed or to be signed. The Deputy may recognise that there is a serious financial and banking crisis affecting large projects in Ireland and elsewhere. We are affected by that. Private investors carry the risk for all this work. They must carry the banking risk and get the funding. I am optimistic that will happen. From the time that construction begins to commissioning will be somewhere in the region of 28 to 36 months.
The Deputy has an ideological problem with this but I invite Deputies to talk to people at St. James's Hospital or any of the public hospitals involved to hear their enthusiasm for this to proceed. I can quote from a letter from St. James's for example which states that this will allow the freeing up of a significant capacity, equivalent to 21% of its annual hospital admissions. It will allow the doctors to see all their patients within six hours in the accident and emergency department and all elective admissions to happen within three months, and so on and so forth.
There is no other money available to this country to provide additional capacity in our acute hospital system. The idea is to move private activity from the public hospital so that the public hospital, funded by the taxpayer, can deal with public patients. It is intended to keep consultants on site instead of having them work in multiple sites around the city, as the letter from St. James's states. The merits of this are enormous. The banking arrangements will be put in place. I hope to see some of these projects proceed very quickly.
It is more than four years since these projects were announced as a way of fast-tracking beds. If the money had been given to the public system when it was available to build public beds we would have them by now.
Hear, hear.
The hospitals are all for this now because they want the beds but they would have expected them long before now.
Is the programme for Government not accurate in saying that it has "already committed projects under the existing project contractual agreement"? I have seen the Taoiseach's letter to my party leader and it is different from the programme for Government.
The programme for Government is exactly the same as the letter from the Taoiseach. Maybe some people misunderstand that. Some project agreements have been signed and some involved in negotiations are about to be signed. The commitments in the programme for Government cover all of those.
The issue here is to return our public hospital infrastructure as much as possible to public patients. More and more of our public hospital activity in recent years, prior to the recent consultant contract, has been private. That does not make any sense from the taxpayers' point of view or to those who are medically ill and need access to acute care. I want them to get that access. The bonus of collocation as opposed to private hospitals 5 miles down the road, which some people favour, is that the consultants, the critical medical manpower, stay on the one site.
The Minister is institutionalising the separation of public and private patients.
There are two collocated hospitals in this city, the Mater and St. Vincent's and I do not see any great objection to them.
The Minister has also fooled the Greens because that is not in the present programme for Government.
80 Deputy James Reilly asked the Minister for Health and Children if she will regulate public and private home care providers to ensure that home care services are registered and inspected by the Health Information and Quality Authority so that services reach a high standard and vulnerable people are offered the best care and protection within their home; and if she will make a statement on the matter. [39589/09]
Two priorities of the Department in recent times have been the introduction of the nursing homes support scheme, and bringing into force new regulatory standards for the long-term residential care sector.
In tandem with these initiatives in the residential care sector, the Department has been progressing initiatives on the community side and, as part of this, commissioned an independent evaluation of home care packages which will be formally submitted to the Minister shortly. The aim of the evaluation was to assess whether the objectives of the home care package initiative are being met, and this evaluation is a commitment in the Towards 2016 agreement.
In addition, two other reports on home care were recently completed. A report was undertaken by the National Economic and Social Forum, NESF, on home care packages. It acknowledges that while this was a well thought-out policy, improvements are required in several areas regarding implementation, including training and vetting of staff. A recent consultation paper by the Law Reform Commission entitled Legal Aspects of Carers considers the legal issues surrounding home care. This makes a number of provisional recommendations in the area of standards and regulations generally, including vetting, training and supervision. It also provisionally recommends giving a function to the Health Information and Quality Authority, HIQA, in professional home care. Any such changes would require primary legislation and detailed stakeholder consultations.
The Department accepts the need for a more standardised approach to the regulation of home care generally, whether by public or private provision. In the context of the independent evaluation of home care packages, and the other recent reports, the Department is, in conjunction with the HSE as appropriate, considering issues such as: finalising and agreeing standardised access and operational guidelines for delivery of home care packages; adoption and dissemination by the HSE of a voluntary code of quality guidelines for home care support services for older people; and consideration of the Law Reform Commission recommendations in the context of possible changes to legislation and regulation in the area of home care for older persons generally.
I thank the Minister of State for her reply but we are spending more than €300 million a year on home care and the report by the National Economic Social Forum has uncovered major flaws in this sector which is unregulated. It found that care workers could be sent into homes of vulnerable people with no background Garda checks, many carers were untrained despite being required to look after people with complex physical and medical needs and some private companies admitted they had never been inspected by the HSE to find out if they were meeting the terms.
The Deputy must ask a question.
Tá sé ag teacht. It is important to put this in context.
It is not in order to read from a report during Question Time.
That is fine. I can make a free speech with no problem.
It is not a question of an evaluation report. It is a question of putting in place real protection for the elderly and vulnerable in our society. We have read stories in the press of people being relieved of money to pay for petrol; being asked for loans. A whole array of things is going on. I have met some of the people delivering home care and they are also very unhappy. The HSE is providing these services but not inspecting them. The history of the HSE in residential care leaves much to be desired and requires to be inspected by an independent body such as HIQA. When will these inspections, the regulatory body and the standards be put in place so that the most vulnerable in our society are protected and the taxpayer gets value for money?
This initiative is only three years old. That is why my Department commissioned this review. We expected that it would pick up problems. The two reports that I have read, by the NESF and the Law Reform Commission, suggest that two key issues arise, the need for standardisation of access and operations across the HSE and the need for vetting and training and supervision. We have drawn up draft standards, quality guidelines for home care support. We will examine these in consultation with all private, public and voluntary providers to bring them in as policy as early as possible in the new year. Meanwhile, we are examining the recommendations of the Law Reform Commission to bring in primary legislation.
When will we have an independent inspectorate to enforce these standards?
HIQA inspections will be part of the legislation that we will draw up. First we must bring in the voluntary code which includes vetting, training and supervision.
I do not understand why we have to wait for a code. Is this legislation on the legislative clár?
No. It will be prepared. The focus has been on the residential care——
When can we expect to have an inspectorate?
The voluntary codes have been drawn up but they must be examined and we have to have consultation.
The Minister of State cannot tell us then.
On that basis it will be another ten years until we see the legislation.
Question No. 81 answered with Question No. 78
82 Deputy Alan Shatter asked the Minister for Health and Children the contacts made with the Deputy Prime Minister of Vietnam in the course of his visit to Ireland on 22 and 23 October 2009 to discuss the conclusion of a new bilateral agreement between Ireland and the Socialist Republic of Vietnam with regard to inter-country adoptions; the position and the progress made during the course of such discussions; and if it remains her intention to conclude such an agreement or to take no further action and await both Ireland and Vietnam becoming parties to the Hague Convention on inter-country adoption. [39515/09]
My office has been in negotiations with the Vietnamese Government regarding the drafting of a new bilateral inter-country adoption agreement for some time. I have indicated my intention to await the finalisation of the International Social Services, ISS, report on inter-country adoption in Vietnam before making final decisions regarding the next steps. I will be considering the report along with the report published in August by the Ministry of Labor, War Invalids and Social Affairs of the Socialist Republic of Vietnam. The ISS report should be finalised this month and I will be communicating my decision at the earliest opportunity. I am mindful of the difficult position many prospective adopters find themselves in at this point.
The Vietnamese Deputy Prime Minister, Mr. Hoàng Trung Hai recently led a trade mission to Ireland. I took this opportunity to meet again with him on 23 October — I had already met him during my July visit to Vietnam — and adoption matters were discussed. The meeting was most amicable and allowed both Governments to outline their current positions on the bilateral agreement and legislative developments in each jurisdiction, including Hague Convention ratification. Both Governments restated their desire to achieve the highest standards in inter-country adoption and they committed to ongoing dialogue to advance these goals.
Is the Minster of State aware he originally told the House that the ISS report would be published before the end of October after which some form of public debate would be held? Will he explain why he is now giving a November date? How soon will it be published?
What is the Minister of State's thinking with regard to a new bilateral agreement? He said there was an exchange between himself and the Vietnamese deputy premier. Will the Minister of State actively seek to enter into a new bilateral agreement? Alternatively, has he determined to let the matter stand until such time as the Adoption Bill 2009 is passed and the Hague Convention is ratified by both countries?
If that is the case, approximately 300 couples and individuals deemed suitable to adopt by the Adoption Board and who intended to adopt in Vietnam will find themselves in limbo. The Minister of State will be aware of 20 individuals or couples who had submitted all relevant papers to the Vietnamese to effect an adoption but no child has been allocated yet. No progress has been made in advancing these adoption applications. Is the Minister of State aware the Adoption Board and the Helping Hands organisation are waiting for some authorisation from him or his office to facilitate these 20 outstanding cases?
Yes, I did indicate initially that the ISS report would be out in October. However, in the meantime the report has much to say about many receiving countries, including Ireland, and some of those countries had much to say too which delayed the report's finalisation. I understand it has been finalised and will be signed off by the Vietnamese Government soon. This report was commissioned with the co-operation of the Vietnamese department responsible for inter-country adoption and its ministry of justice. Last week, I wrote to UNICEF to encourage the ISS to produce this report as soon as possible for the reasons mentioned by the Deputy.
Everyone involved in this issue must have a mature discussion on the report's impact. There are facts contained in it which are a cause for considerable concern for both the receiving countries and the countries of origin. These will all have to be taken into account. The paramount consideration is to ensure the best interests of the child in Vietnam and that the safest possible adoptions can be effected.
We must also reflect on the fact that inter-country adoption is a risky procedure. The writ of this country runs only as far as the jurisdiction. Going outside to other countries, we cannot know what is happening or whether procedures are being followed to the nth degree. We must also bear in mind the large number of people with declarations of eligibility and suitability for adoption. They are frustrated on the one hand by the long time it has taken for them to be assessed and, on the other, that we have had closure with Vietnam again. Earlier in the year, Ethiopia and Russia closed for different reasons beyond our control. It is extremely frustrating for parents in those circumstances.
I am making strenuous efforts to bring closure to the 20 cases to which the Deputy referred. It came to my attention during my visit to Vietnam in July that there were 20 dossiers with the department responsible for international adoptions in Hanoi but they had not received a referral. When a bilateral agreement comes to an end, it is usual practice to allow pipeline cases to be finalised. We are working to find the correct mechanism to satisfy our laws and the Vietnamese on this matter.
The Minister said facts disclosed in the ISS report, which is in draft form, are a cause for concern. In so far as those facts relate to the Vietnamese adoption process, why were none of them identified by the Irish Government long ago?
Under the bilateral agreement which concluded on 1 May 2009, joint working groups were to be established to monitor inter-country adoptions between Ireland and Vietnam. Apparently they never met to consider or identify in any detail the difficulties that will be disclosed in the ISS report.
Five reported visits were made by officials from the Department of Health and Children to Vietnam and they subsequently furnished reports to the Minister of State. Why are these reports suppressed and not published and made available to the Library?
With regard to the 20 approved cases, it was the understanding that an agreement had been reached with the Vietnamese authorities that would facilitate a child being placed with them. Will the Minister of State clarify the difficulty that has emerged in this regard?
Several individuals and couples have been deemed suitable to adopt in Ethiopia and have been in the process for three years. They are anxious to ensure the Adoption Bill contains suitable transition provisions to facilitate their completion of the process. They do not want the enactment of this legislation to put them back to the starting point in effecting their adoptions in Ethiopia. What will the Government do to address their concerns?
Five visits were made to Vietnam in the past two years during which we endeavoured to get the most amount of information possible. The withdrawal of the US and Sweden from international adoptions this time last year caused us to visit Vietnam again. We have been very solicitous in trying to ensure the highest possible standards in adoptions apply between our two countries so as to provide reassurance to those who have already adopted. They are the people for whom I have much sympathy in this case.
Why did the joint working groups not function?
Allow the Minister of State to answer the question.
The effect of all these visits was to obtain all the information possible to allow us to make an informed decision. In the case of Vietnam, the effect of these withdrawals, including our own, has caused the Vietnamese Government to put far greater resources into the issue of bringing itself not only within the provisions of the Hague Convention but also to bring in new adoption legislation. Different personnel have been brought into this area.
Deputy Shatter mentioned Ethiopia and Russia. It is still our intention to seek a bilateral agreement with both of those countries. However, as the Deputy pointed out, from the date of the enactment of the adoption Bill, which will shortly go through this House, if a bilateral agreement is not in place, it will not be possible to effect an adoption from those countries. The adoption Bill will contain a provision on transitional arrangements. I have met our officials and advisers from the Attorney General's office to discuss those transitional arrangements, how far that process can go and what point one must have reached on the adoption process before one can be allowed to continue to completion, even though there is no bilateral agreement in place and the Bill would have been enacted.
That concludes priority questions.
On a point of order, I asked the Minister of State a question about why the joint working groups did not function.
We have spent five minutes more than the time allocated on this question.
I presume the Minister of State would like to reply to that question.
We have spent double the allocated time on this question.
If the Minister of State does not reply to that question——
I call Question No. 83.
It was grossly negligent of the Government to enter into a bilateral agreement and not ensure that the joint working groups put in place to ensure no difficulties arose over a five year period——
The Deputy cannot make a Second Stage speech.
——did not function.
The Deputy will resume his seat.
The Minister of State has deliberately not addressed that issue. I have given him every opportunity to do so.
The Deputy will resume his seat.
It is outrageous that he has not done so.
I have allowed double the time allocated for this question. It is an abuse for the Deputy to disobey the Chair in the way he has just done. I ask him not to continue in that vein. I need to move on.
It was an abuse for the Minister of State not to answer that question.
As priority questions are confined to——
There is a public interest in the answer to that question.
——the Deputy who tabled the question. In the interests of other Deputies who might want to ask questions, I want to move on to ordinary questions.
