Mid-West Task Force Report.

Deputy Joe Carey

I thank the Ceann Comhairle for facilitating me in raising this matter on the Adjournment tonight. Perhaps the Ceann Comhairle will inform me when I have one minute remaining.

The mid-west task force was established by Government in February of this year to consider and make recommendations in regard to the implications of the serious economic downturn on the mid-west, which was added to by the decision of Dell to end manufacturing in Limerick, and in response to calls from many Deputies on the Opposition side.

I, along with other public representatives, expressed the importance of ensuring that the task force, when established, be more than a cosmetic exercise. I was concerned that it would end up as another Government talk shop with no action on the real issues. Some four months later, following publication by the chairman, Mr. Denis Brosnan, of the task force's interim report, no action has been taken. Last week, the Tánaiste, when in Limerick, commented that the recommendations of the interim report would not be implemented. This announcement has set back the region yet again.

The task force is about to enter stage two of its work and the Government is dithering about what to do with the initial findings, which is absolutely disgraceful. It raises the questions of why the task force was established and what the Government is prepared to do in response to its findings and recommendations. The chairman of the task force has warned that the mid-west region could be faced with an unemployment rate of 20% by end 2010 if his report is not responded to by Government. This stark warning was given by Mr. Brosnan in response to a letter I wrote to him.

The mid-west is experiencing a severe economic downturn. It has gone through a poor tourism season, coupled with weekly job losses across Counties Clare, Limerick and North Tipperary. There is no justification for Government sitting on this report. If its recommendations are implemented, the economic carnage being experienced by the mid-west region will cease. The interim report gives an economic overview of the mid-west region and sets out the issues relating to cost competitiveness, how to tackle growing unemployment, the need to accelerate infrastructural projects, education and training. It also deals with enterprise and tourism in the region. The task force has met with and received presentations from 24 groups representing the major stakeholders and interest groups responsible for economic development in the region. The recommendations put forward in this report need to be implemented because they are critical.

The report makes approximately 20 recommendations which are a roadmap to address the economic situation in which we find ourselves. They relate to issues such as competitiveness and point out that Ireland has lost 32% in the international price competitive league.

While this is a national issue, the mid-west relies heavily on manufacturing, construction and tourism. In response to calls for a national competitive strategy, the report recommends employment subsidies, a reduction in employers' PRSI, and credit for corporation tax paid; it also points out the need to encourage people to stay in education or return to education for retraining and skills development. It identifies the necessity of funding the infrastructure to enable the establishment of a linked cargo facility at Shannon Airport and the urgent need for a marketing strategy for the airport. It also points out the potential of the region to develop the Shannon Estuary as an alternative renewable energy hub. There are many other recommendations, including the need to prioritise foreign direct investment in the region by the IDA.

For four months this report has been passed from Department to Department. We now need a commitment from Government that its recommendations will be implemented in a timely fashion. The implementation of all recommendations is critical for the survival of our region. Either the Government is committed to the mid-west or it is not. I call on the Government to implement all the recommendations in full and to put the necessary plans and funding in place as a matter of urgency.

Deputy John Moloney

I thank the Deputy for raising this matter on the Adjournment and apologise that the Minister for Enterprise, Trade and Employment cannot be here to answer directly.

The mid-west task force, which was, as the Deputy has pointed out, established by the Minister under the chairmanship of Mr. Denis Brosnan, completed an interim report which was presented to the Minister on 2 July last. Given the wide range of recommendations included in the report, it is currently being considered by a number of different Departments. The Minister is grateful for the work Mr. Brosnan and the other members of the task force have undertaken to date and she is in ongoing contact with the task force.

The wide range of recommendations in the task force interim report cover both local and national issues. The Government has been responding to the economic downturn generally and has taken numerous initiatives, including competitiveness and employment activation measures and use of the EU globalization fund for individual companies. All of these measures have been of particular benefit to regions affected by job losses, including the mid-west region.

Since the job losses announcement by Dell last January, all of the State development agencies, under the auspices of the Department of Enterprise, Trade and Employment, have come together and intensified their efforts and activities to support Dell and other workers being made redundant in the region. The strategy of the IDA is to reposition the mid-west as a centre for knowledge-based industry, while focusing on marketing the Limerick-Shannon gateway area as a key location for investment by building on the strengths already evident in the region. The IDA also co-operates with the existing base of employers to encourage additional investment, particularly in activities such as research and development, customer support and back-office functions. For example, eight projects with a job potential of 1,073 were announced by multinational companies in the mid-west in 2008 and the beginning of 2009.

Shannon Development has intensified its engagement with its Shannon Free Zone clients and, along with the other State development agencies, is actively promoting a range of support measures announced by the Government to assist companies that are experiencing trading difficulties at this time. Enterprise Ireland is also working collaboratively with other State agencies in providing information and support to those facing redundancy. Túsnua was set up in late 2008 to alleviate the impact of pending lay-offs announced by a number of major employers in the Shannon region which were to take effect in early 2009. Túsnua has hosted a number of information events in the region, with more than 1,500 attendees to date.

Enterprise Ireland and the Limerick County Enterprise Board have run a series of workshops in-house at Dell and are in constant contact with the company in order to respond quickly to requests for programmes or meetings with people wishing to start a business. FÁS Employment Services has also engaged on a one to one basis with 900 staff who have exited the Dell facility through redundancy since May 2009. FÁS has provided intensive on-site guidance and information services to the affected workers with the primary aim of securing other employment, training or further education.

In order to meet the substantial additional costs of the measures described above, as well as other costs, my Department has submitted an application to the European Commission under the EU globalisation fund for support in the provision of labour market services to redundant workers from Dell and downstream companies. A decision is expected on this shortly.

Hospital Accommodation.

Deputy Seymour Crawford

I thank the Ceann Comhairle for allowing me and Deputy Ó Caoláin to raise this important issue.

The outbreak of C. difficile infection at Our Lady of Lourdes Hospital in Drogheda did not come as any surprise to many of the patients and families attending that hospital. While we all appreciate the extraordinary workload that has been forced on the hospital in recent years, there were constant complaints to me — and, I am sure, to many others — about the problem of overcrowding and lack of cleanliness.

Clearly, what has happened in the north east has been the result of total mismanagement of resources. A total of €17 million was spent on the Monaghan General Hospital restructuring programme and the only way it should have been wound down was with the building of a new central hospital in Ardee. In fact, the Teamwork report, bad as it was, made it clear that only when proper structures were in place should the existing structures be removed. It is totally unacceptable for a patient to go in with a fractured bone and come out dead a short time later.

This is not a problem only at Our Lady of Lourdes Hospital; there is serious overcrowding at Cavan General Hospital as well. In the old days the matrons got their priorities right and made sure administration was at a minimum and that front line staff, nurses, trainee nurses and attendants were all in place and doing their job. I was recently told by the father of a young girl about their experience in Cavan General Hospital. She arrived at 11.45 a.m. in dreadful agony with suspected appendicitis, but she was eventually seen at approximately 6 p.m. The waiting area was full of trolleys. The girl's father was told she would be kept in that night and operated on first thing the next morning. However, the operation did not take place until 7 o'clock the following evening and she was sent home at 11 a.m. the following day. This is a personal story, just one of many of which I have been advised regarding both acute hospitals. Having said that, those who get through the system have nothing but praise for the attention and care they received.

When swine flu was deemed an epidemic I urged both Professor Drumm and the Minister for Health and Children, Deputy Harney, to ensure that the 55 beds in Monaghan were left in place as a backup, at least for the time being, but of course this was ignored. Tonight I would like to receive some indication from the Minister about whether there are any plans to ensure people can get to hospital if required without having to leave the area, which would minimise family access.

I said in the House on a previous occasion that the way the health service was being run by the Minister was in fact euthanasia by the back door. I hoped at that stage that a warning would be sufficient, but unfortunately it was not heeded.

Deputy Caoimhghín Ó Caoláin

I join with Deputy Crawford in appealing to the Minister of State to reflect our concerns to the Minister, Deputy Mary Harney, whose absence I regret given the seriousness of the issue.

We know of the report to the Louth county coroner on the deaths of four patients in the outbreak of C. difficile at Our Lady of Lourdes Hospital, Drogheda. The HSE reported that there have been approximately 21 confirmed cases and 20 symptomatic cases at the hospital. We also know there has been a further outbreak at Our Lady's Hospital in Navan and that these outbreaks have resulted in the closure of a significant number of beds at both hospitals and the cancellation of surgical procedures and all physiotherapy appointments at Navan hospital. Visiting restrictions have been put in place and all elective orthopaedic procedures and some general surgery has been cancelled until further notice at the Navan hospital site. These cutbacks have serious consequences for patients in the north-east region, where one hospital has already been closed for all acute care since 22 July. We now have two critical hospital sites, in Drogheda and Navan, working under a strict and limited regime. The closure of acute services at the Louth Hospital in Dundalk has been signalled as and from the end of the coming month. This is a very serious situation that requires an emergency response. We argue that here we have a hospital site that does not have the infection currently. Monaghan hospital deserves to be considered for the restoration of acute care as an emergency response to the current situation. We ask the Minister to recognise that while Monaghan hospital offers a temporary reprieve from the current difficulties we believe the closure of the hospital site is a direct contributor to the difficulties at other hospital sites within the region. Already hard-pressed staff and the extended throughput of patients presenting at each of these hospital sites both contribute directly to a fall in the standard of hygiene care and the ability of staff to enforce mandatory handwashing and the use of the gel provided at all ward sites.

I appeal to the Minister to respond to a situation that is currently localised in the north eastern region and that requires a similar north eastern response.

Deputy John Moloney

I apologise that the Minister, Deputy Harney, cannot be present. I shall depart from my prepared script for a moment. I absolutely resent the scurrilous allegation by Deputy Crawford. I do not believe he knows the meaning of the word "euthanasia". If he did he would not have said what he did.

Deputy Seymour Crawford

I know exactly what I said.

Deputy John Moloney

If the Deputy took some time to read recent reports on the success of the health service he would realise the age profile of people in this country has far outgrown that of many of our European colleagues. For the record, the Minister, Deputy Harney, with whom I have had the honour of working during the past year, is honest, decent and courageous. I could think of many more adjectives to describe her hard work and, most important, her caring position as Minister for Health and Children. However, I do not expect the Deputy to apologise. That would be far too much to ask.

At the outset, I wish to express my apologies to the patients and their families who have been affected by the outbreak of Clostridium difficile. I share the Deputies' concerns in relation to C. difficile and healthcare associated infections, HCAIs, generally. Since the beginning of October, there have been 22 confirmed cases of C. difficile at the hospital. There are currently ten confirmed cases. All confirmed cases were initiated on appropriate treatment for C. difficile and the majority of patients have responded to these treatments. In the same period a further 30 patients were symptomatic. Most of these patients have since improved. However, 11 patients remain symptomatic. There are currently 99 beds closed at Our Lady of Lourdes Hospital, Drogheda.

C. difficile is a well recognised HCAI. National guidelines for the surveillance, management and control of C. difficile-associated disease are implemented on an ongoing basis in Our Lady of Lourdes Hospital in order to minimise the impact of an outbreak on all patients, staff and the general public. They include guidance on the prescribing of certain antibiotics to prevent infection, case finding, risk assessment of symptomatic patients, isolation of patients who pose a potential or actual high risk of infection to others, mandatory hand hygiene and other infection control measures.

The C. difficile outbreak in Our Lady of Lourdes Hospital was reported on 28 October. I have been assured by the HSE that all appropriate infection control procedures and practices have been put in place. These include the following: an outbreak committee has been convened in accordance with the national guidelines; there has been a renewed emphasis on medication prescribing with increased restrictions on the use of certain antibiotics, laxatives and other drugs in line with expert advice available to the committee; three wards in the hospital were identified and used to implement stringent isolation and control measures; there has been targeted emphasis on mandatory hand hygiene and other infection control measures; there has been ongoing education of all grades and disciplines of staff to update on the status of the outbreak and measures that staff can take to care for the patients affected, minimise the further spread to unaffected patients and contain the outbreak.

The outbreak committee has sourced specialists to assist with deep cleaning of affected wards and hospital equipment. Specialist engineers have been drafted in to decontaminate most of the affected areas of the hospital and these measures will continue on an ongoing basis.

C. difficile is a notifiable disease which means that a doctor is legally bound to notify the coroner in all cases where a person has died who may have been exposed to or contracted a C. difficile infection. The coroner is responsible for determining if C. difficile was the cause or a contributory factor in a person’s death.

Since 6 November, in consultation with the Louth county coroner, the HSE's clinical director has agreed that all deaths occurring at the hospital during the escalation phase of the outbreak will be notified to the coroner as a matter of routine. Prior to 6 November two deaths involving C. difficile as a suspected contributory factor were notified to the coroner and since 6 November, there have been a further four deaths at the hospital which have all been notified to the coroner. The HSE expects that a number of these cases will not be attributable to C. difficile. The families of the deceased have been contacted and have been offered appointments to meet with the treating clinician.

Restrictions remain in place at the hospital and general practitioners and ambulance services have been requested to refer adult patients with medical complaints to other appropriate hospitals. Members of the public are asked to attend the emergency departments at the hospital only in the case of a genuine emergency and to contact their GP or out-of-hours service in the first instance. Visiting restrictions remain in place and where visitors are permitted they are being advised of the need for appropriate hygiene protocols including thorough hand washing.

For the moment all elective medical and surgical procedures have been cancelled. Measures have been put in place to deal with all priority 1 endoscopy procedures, namely, urgent endoscopies for diagnostic or therapeutic purposes. Arrangements have now been put in place to provide an orthopaedic and hip fractures service within the three North Dublin hospitals as a result of a C. difficile outbreak which was called in Navan on 13 November. There are two confirmed cases of C. difficile at Our Lady’s Hospital Navan.

Surgical services continue to be provided across the Louth Meath Hospital Group. Elective day case surgery continues to be provided in Our Lady's Hospital and Navan and Louth County Hospitals and is being managed on the basis of individual patient needs. Contingency arrangements are in place in Beaumont Hospital for level 2 and level 3 surgery, for example, acute surgical or urgent elective. Through proactive management of clinically discharged patients at both hospital sites, capacity has been developed to deal with requirements for patients in Louth County Hospital. As the outbreak continues all of the above are being reviewed on a daily basis and all appropriate measures will be taken to ensure timely access to quality safe services in line with patient need.

The World Health Organisation declared a global flu pandemic in June 2009. Since then my Department and the HSE have implemented plans to deal with the pandemic in Ireland. HSE national and crisis management teams are meeting regularly to co-ordinate HSE preparedness and response to issues such as the pressures being placed on the acute hospital system during the pandemic. A mass vaccination programme is underway through general practitioners and through public mass vaccination clinics which have been established all over the country.

I am satisfied that both the C. difficile and swine flu issues are being managed appropriately.

Irish Language Placenames.

Deputy Máire Hoctor

Táim an-bhuíoch as an deis a thug an Ceann Comhairle domsa labhairt anocht faoi thábhacht úsáid logainmeacha sa phost. I am very grateful to the Ceann Comhairle for giving me the opportunity to raise this important issue on the Adjournment. I thank my colleague, the Minister of State, Deputy Moloney, in anticipation of his reply.

I raise the issue on behalf of a number of people, many of whom are members of the Ormond Historical Society in Nenagh who have articulated to me their concerns regarding the forthcoming introduction of postal codes nationwide. I am not sure exactly when this is to come about but the Minister for Communications, Energy and Natural Resources, Deputy Eamon Ryan, has spoken at length about it and I understand it will be introduced in the next couple of years.

Change comes about and we know that people fear it. This is supposedly for the better, but it is important that we take into account the rich heritage stitched into the placenames of townlands and areas, many of which find their origins in the Irish language and are loaded with historical interpretations dating back many years. While anglicised, many of them hold great treasures of heritage.

The concern is that some placenames that are derived from topography and local history might be lost in the Government's attempt to introduce postal codes so as to keep up to speed with technology. However, a great heritage could be lost in serving that technology. I refer to the many townlands and cities where Irish derivations date back many years. For example, Letterkenny is derived from leitir, meaning hillside, lios meaning ring fort, dún meaning a strong fort and droichid meaning a bridge. My native place, the town of Nenagh, is Aonach Urmhumhan in Irish, which means the fair of Ormond. The fear is that people corresponding with such places may find themselves writing "Tipperary 24" and ignoring the townlands. In a quick swoop, names will be lost in serving the technology of the post offices' sorting boxes.

I take this opportunity to ask for the Minister of State's assurance that our heritage, which is a part of our townlands and areas, will be preserved for future generations and not lost through the introduction of postal codes. In Dublin city, postal codes have come to be associated with people's financial situations. For example, Dublin 4 carries a weighted, but positive, concept of the people who live therein. I hope that, in the endeavours undertaken by the Minister, Deputy Eamon Ryan, and the Government to introduce postal codes, our heritage will not be lost and our townlands' names or logainmneacha, as I call them, will be maintained and treasured forever.

Deputy John Moloney

I thank Deputy Hoctor for placing this matter on the Adjournment. As she has raised similar issues at our parliamentary party meetings, I take this opportunity to recognise her considerable interest in this matter. I apologise to her for the fact that the Minister, Deputy Eamon Ryan, cannot attend this evening, but I will respond on his behalf.

A smart economy envisages economic development based on innovation and sustainability and an economy aiming for high end performance requires that the underlying infrastructure supports enterprises based on knowledge and innovation. A key element of national infrastructure is a common spatial identifier across the economy. Postcodes provide this common identifier, which will assume greater importance as we become more embedded in the digital economy.

Ireland is the only EU country that does not have such a postal code in place, but the Government has recently approved the implementation of a postcode for Ireland as recommended by the National Postcode Project Board. Comprising representatives from Departments and public and private sector organisations, the board was established to recommend the most appropriate postcode system for Ireland and to examine the costs and benefits and the implementation of postcodes.

For any developed country, a postcode system is a key piece of national infrastructure that can deliver economic and social benefits across all sectors of the economy and consultations around this project have revealed widespread support for their introduction. The recommendation is an alphanumeric, publicly available and accessible postcode. The country would be divided into approximately 200 post towns, within each of which will be groups of approximately 40 to 50 properties. The postcode will have the structure ABC 123, with the first three characters representing the post town and the second three characters representing the group of properties in which the particular building is located. The six-character code was selected for a number of reasons, including the ability of the population to remember their codes. The inclusion of a reference to the placename would also assist in this regard.

The uptake of the code by the public is central to its success. People need not be concerned about their existing addressing customs. There is nothing in the proposal that requires individuals to change their address structures. People can be assured that they can still use local placenames or townlands in addressing mail. Postcodes will just be an additional line on their existing address structure.

Postcodes are a key enabling feature of a competitive postal market and can present significant commercial opportunities for all postal service providers, including An Post. Besides enabling more efficient deliveries, postcodes can boost mailing volumes by facilitating the development of the direct mail industry, which is and will be an increasingly important source of income for operators facing competition from electronic media and declining mail volumes generally.

Furthermore, some of the more significant benefits of having a postcode in place will materialise outside of the postal and logistics sectors. Postcodes will provide an enhanced capacity and capability to use spatial data effectively and link databases with spatial elements across Government. Using spatial data more effectively can improve public policy making and help with the more effective use of resources. It is important, now more than ever, that public finances are spent in a targeted and effective manner. Postcodes will also facilitate better location-based services and the speedier deployment of emergency services. For example, it will help to eliminate confusion about addresses with similar names and thereby save time and maybe lives.

Postcodes will bring benefits to much more than just the postal sector. They can contribute to the development of a knowledge economy and the country's overall competitiveness. As a key piece of national infrastructure, they will deliver economic and social benefits, which we will reap long into the future. At the same time, they will not impact on existing local placenames or townlands, which I hope responds to the Deputy's concerns. Postcodes will add an extra dimension to the existing address structure.

Following on from the Government approval to implement postcodes, the officials in the Minister's Department are working to address the next steps in this project, including the process of selecting a body to implement the proposed system. It is expected that postcodes will be assigned and in use in 2011.

The Dáil adjourned at 9.30 p.m. until 10.30 a.m. on Thursday, 19 November 2009.

Dáil Éireann debate - Wednesday, 18 Nov 2009