Dáil Éireann debate -
Tuesday, 8 Dec 2009

Vol. 697 No. 2

Adjournment Debate.

Hospital Accommodation.

Deputy Willie Penrose

I thank the Ceann Comhairle for selecting this important matter for the Adjournment tonight. It is very important for the people of Westmeath, whom I represent. I am forced to speak here again because of the disgraceful, arrogant and dismissive actions of the HSE regarding the disproportionate cutbacks being foisted on the regional hospital in Mullingar. These caused the accident and emergency department to close for a number of days last weekend due to the unsafe levels of overcrowding which arose as patients waited to be treated. The upshot of this decision, which was reluctantly taken and motivated by the safety and well-being of patients, was that people requiring urgent treatment had to be brought to other hospitals in the region.

I raised the plight of this important and centrally-located hospital in Mullingar in the Dáil on 12 November. I pointed out that, in light of the fact that 41 acute beds — or 20% of the total acute beds complement of the hospital — were to be closed, the outcome we witnessed at the weekend was inevitable. Like all hospitals across the country, one might anticipate some reduction in acute beds because of savings being sought. Mullingar is not any different. Nevertheless, the 20% reduction of the total acute beds complement at Mullingar hospital was excessive and clearly disproportionate. It had the potential to render the hospital potentially unsafe for acute admissions over the winter.

It is reported that the number of people lying on trolleys has escalated dramatically over the past two years. At one stage last Thursday, 22 patients were waiting to be admitted, with all trolleys in use. That is normal, as 15 to 25 patients could be there at various times. The union representatives involved, who were putting the patient interests first, indicated that the accident and emergency department at Mullingar was unable to cope with the level of overcrowding; this will get worse as we progress into the depths of winter, when the number of acute admissions significantly increase.

The level of overcrowding last weekend did not arise from an unusual peak or a surge in activity. What will happen when there is a significant spike in the level of activity in admissions? The whole system will creak and break down unless immediate action is taken to reopen most of the recently closed beds at the hospital.

Lest anybody be misled, plenty of beds are available. Four wards are closed and worse still, a new ward of 26 beds in the west wing of the new part of the hospital remains closed. What sort of a system of management allows such a scandalous state of affairs to exist? It is outrageous behaviour on behalf of the HSE and the Government, along with the HSE, is treating the citizens of Longford and Westmeath as second-class citizens.

I have lost all faith in the HSE. Mullingar is one of the most efficient hospitals in the country from a case mix perspective and is in the top three of the 52 hospitals in this country on a continuous basis. What thanks does it get only to be left with an ongoing deficiency in bed numbers which seriously impacts on the emergency capacity? Furthermore, the hospital is down approximately 35 nurses over the past 12 months due to non-replacements and retirements. In whole-time equivalent terms, it is well below the average staffing levels in Irish hospitals.

The people of Longford and Westmeath, whom I represent, feel this is part of an ongoing strategy to cripple and downgrade the status of a top-performing hospital. In light of recent events, it is hard to quibble with that assessment. As I have said before, the Government has failed the people of Longford and Westmeath in the delivery of health services. There is a significant gap between the many promises made on the electoral stump and the reality which has been delivered.

I call upon HSE management, whom I understand met consultants and other personnel at Mullingar hospital this evening, to tackle this serious and pressing problem with extreme urgency. The Government and the HSE think nothing of riding roughshod over the people of Longford and Westmeath. Let me retort on their behalf — the Government and HSE will not get away with it.

On 30 November 2009, I communicated with the HSE, asking that the 26 beds in the west wing be opened and staffed so as to alleviate difficulties. It was a positive proposal to reduce the impact of the loss of these acute beds. I did not even get the courtesy of a reply, so need I say more?

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

I apologise to Deputy Penrose as the Minister for Health and Children, Deputy Mary Harney, cannot be here this evening to respond herself.

Deputy Willie Penrose

I am glad the Minister of State is here as he is decent.

Deputy John Moloney

I thank the Deputy. I will be taking this matter on the Minister's behalf. The HSE accepts that there was a problem in the emergency department at Mullingar hospital on Thursday last week. However, since then all patients in the emergency department were either admitted or discharged within the target of six hours set by the HSE this year.

The hospital's budget for 2009 is in excess of €64 million, increased from €54.8 million in 2006. As Deputy Penrose rightly points out, the hospital has been recognised as being one of the most efficient in the country in the context of the annual case mix adjustment. Last year, the hospital was the highest in the country with a positive case mix adjustment of €1.977 million. It should be noted that inpatient activity at Mullingar to the end of September was 0.2% ahead of last year, whereas day case activity was up by 6.2% year on year. There have been 24,636 emergency attendances to the end of September this year, a reduction of 5.7% on the same period last year.

Mullingar hospital, in common with all other agencies, is required to manage its services within the approved allocation and to run its services within the approved employment ceiling. It is envisaged that the hospital will break even this year and will be within its employment ceiling by end of year. There are no plans to increase the number of nurses employed in the hospital. At the end of October, there were 289.5 whole-time equivalents on the nursing staff, an increase of one whole-time equivalent on the same month last year.

In November, patients were transferred from old accommodation in Mullingar hospital to state-of-the-art accommodation in the newly upgraded wards at the hospital. The new wards are a major improvement in terms of standard of care that can be afforded to patients. Under the new arrangements, the number of inpatient beds has been reduced from 220 to 199, and the number of day beds has increased by 13 from 11 to 24. In addition, there are five extra observation beds.

These changes are very much in line with international practice, which aims to encourage a greater emphasis on the practice of day care medicine. This is a well-established part of the HSE's transformation programme and it will lead to an increase in the overall number of patients treated in the hospital in 2010. The adjustment in beds taking place will help to improve the position, thus making the hospital even more effective in providing care and treatment in the future.

The revised bed complement in place as a result of the move to the new hospital has been fully endorsed by the consultant surgeons and consultant obstetricians at the hospital. In addition, many discussions led by the clinical director have taken place with all relevant consultant staff at the hospital to increase the throughput of surgical and gynaecology work at the hospital. The provision of additional day ward beds as detailed will facilitate this increase in workload.

The hospital is arranging to carry out a bed utilisation study with a view to establishing that all beds within the hospital are being utilised to maximum effect and that all admission and discharge processes are being fully and effectively managed. It is important to note that the current usage of day beds in Mullingar hospital is still behind the international norms for such bed utilisation.

As previously noted, there has also been an increase in the number of observation unit beds from six to 11. These beds are strategically located next to the emergency department to cater for the overflow of patients from that department, which can occur from time to time. The hospital also intends to increase the throughput of patients through the medical assessment unit, which will also alleviate pressure in the emergency department. I am confident that the hospital will continue to provide the best possible quality of care for all its patients.

Water and Sewerage Schemes.

Deputy Michael P. Kitt

I thank the Ceann Comhairle for allowing me to raise the issue. As the Minister of State knows, the proposal to have Milltown sewerage scheme included for sanction by the Department of the Environment, Heritage and Local Government was originally included in a bundle of four schemes for Milltown, Claregalway, Craughwell and Carraroe. It was probably one of the saddest days ever when four schemes like this were put together because it was obviously too big a bundle and there was no possibility of the four schemes proceeding together.

I was very glad to hear that Milltown and Claregalway would proceed as two schemes, as they are most important. Claregalway is in west Galway and Deputies from there have been making the case for that village. However, I know more about Milltown because it is in north Galway in my constituency. It is located on the N17 north of Tuam and it is one of the tidiest villages in the county. It is appalling that it has taken 20 years to even get the scheme on a list for submission to the Department. If sanction cannot be obtained for a sewerage scheme in the village, it will be difficult to cater for further development there. A temporary sewerage scheme is in place on one estate in the village. Milltown is on the River Clare, which flows into the River Corrib and, therefore, pollution is a serious threat.

It is heartening, however, that sites are available for the sewerage schemes in both Claregalway and Milltown. The local GAA club has made a site available in Milltown and the Planning and Development Acts has been availed of for both schemes. There is no reason, therefore, that they should not proceed together. Many building contractors would be glad of the opportunity to proceed with the schemes while maintaining the economies of scale required. However, the lesson is there is no need to bundle schemes in large packages. It might be better to proceed with one scheme, as happened in most cases in the pasts. It is not good to bundle schemes but Galway County Council has submitted the schemes for Milltown and Claregalway as a bundle and they are on the Department's list. I hope the Minister for State will have news that they will proceed together.

Minister of State at the Department of Agriculture, Fisheries and Food (Deputy Trevor Sargent)

Ba mhaith liom mo bhuíochas a ghabháil leis an Teachta as an deis an scéal seo a shoiléiriú.

My colleague, the Minister for the Environment, Heritage and Local Government, cannot be present and he asked me to take this matter on his behalf. The Milltown and Claregalway sewerage schemes are both included for funding in the Department's Water Services Investment Programme 2007-2009. When this programme was published in 2007, it was envisaged that Milltown and Claregalway would be advanced as part of a four-scheme bundle, which would also include the Craughwell and Carraroe schemes. The preliminary reports for Claregalway and Milltown were approved by the Department in 2003 and 2004, respectively. The contract documentation for these schemes was submitted to the Department for approval in 2008. However, at that stage, the component relating to the collection networks was not accompanied by the certificate of completion of planning necessary for the examination of the contract documentation by the Department. When the contract documentation was submitted for Milltown and Claregalway, Galway County Council also submitted a proposal to unbundle these schemes from the Craughwell and Carraroe schemes. The Department is considering this proposal in the context of the examination of the contract documents.

The Department works in close co-operation with Galway County Council in the progression of all the schemes in the county. The schemes for Milltown and Claregalway are among the 50 major water and sewerage schemes included in current investment programme for County Galway. The priority to be accorded to individual schemes is a matter, in the first instance, for Galway County Council.

Last July, local authorities were asked to submit an assessment of needs for water and sewerage services in their areas to the Department by 23 October. The Department is examining these assessments, which will form a key input to the development of the 2010 to 2012 water services investment programme. In conducting their assessments, local authorities were asked to prioritise schemes and contracts for progression over the coming years based on key environmental and economic criteria. The 2010 to 2012 programme will be a three-year rolling plan for the provision of major water supply and wastewater infrastructure.

Strategic environmental and economic objectives have provided the rationale for investment in water services infrastructure since 2000. With the changed economic climate, and the completion of the first cycle of river basin management plans by local authorities in the near future, there is a greater need than ever to focus on these key priorities. The 2010 to 2012 programme will do this by prioritising projects that target public health and environmental compliance issues, support economic and employment growth, and offer best value for money. The Department expects to publish the Water Services Investment Programme 2010-2012 early next year. I assure the Deputy that the Department will work closely with Galway County Council to advance priority schemes identified in the programme.

Flood Relief.

Deputy Bernard Allen

The recent floods that hit Cork city and county were the worst I have experienced. Unlike serious flooding in the past, this was caused by a combination of heavy rainfall and, in particular, the opening of the dam at Inniscarra. Before getting to the key questions that need to be answered, I would like to pay tribute to the emergency services of all the statutory bodies who were involved in providing relief to the people of Cork. Those who at times question the effectiveness of public services should recognise the importance of the work they did immediately before and after the flooding. Cork City Council front line staff provided relief for victims in homes and businesses. The Garda, the Army and the HSE were also heavily involved. I would also like to pay tribute to the staff of the parks and roads departments. They provided relief for those whose water was cut off for more than a week, including myself.

Last night Mr. Joe Gavin, Cork city manager, presented a report to the city councillors, which revealed that three warnings issued by the ESB in the 12 hours before the city began to flood significantly underestimated the volume of water the company would release through its dam in Inniscarra. The report states the ESB delivered three warnings to the council on 19 November at 11.30 a.m., 5 p.m. and 10.10 p.m. The final warning, which was sent less than an hour before the city began to flood, said discharge levels would increase up to 450 cubic metres per second. The city then experienced what has been described by one victim as "a mini-tsunami" causing millions of euro worth of damage throughout the city and also putting lives at risk. The report also states that, at a meeting at 4 p.m. the following day, the ESB revealed that in the hours after its final warning it had been forced to increase the discharge of water through the Inniscarra dam to 535 cubic metres per second but the company, significantly, said it was fully satisfied with its role in the management of the floods and with the adequacy of warnings to the local authorities.

In raising this issue on the Adjournment, I believe that nothing short of a public inquiry into the flooding in Cork will satisfy the victims of the floods. In the time available, I cannot deal with the issues of the quay walls or the availability of relief funding for victims whose homes and businesses were destroyed but I support the speedy implementation of relief schemes. What has happened has happened with all its tragic consequences for many people but we must apply ourselves to ensure such a catastrophe never happens again.

Many questions remain about the effectiveness of the warning system and the plans to protect the city from similar events in the future. Why were businesses and homeowners not given an effective advance warning that would have allowed them to protect their property? What prompted the ESB to make the decision to release the huge volume of water from the Inniscarra dam? Did the ESB release water from the dam in the weeks and months before the flooding to minimise the effects of heavy rainfall? Was the structural integrity of the dam under threat? How much funding will be needed to reinforce the city's quay walls? Is there a need to examine how development on flood plains played a part in exacerbating the severity of the floods? What can be done in the long term to protect the city's water supply from being hit by flooding again?

A journalist in the Cork Evening Echo, Mr. Ronan Bagnall, set out these questions in a recent issue of the newspaper and he quoted an ESB spokesman who said that it would vigorously defend its management of the unprecedented flood of the River Lee in a forthcoming review. That review must be a fully transparent public inquiry into the events leading up to the flood. As this is the only format that will satisfy the victims of the flood, it must be done in a totally open manner. An internal review involving the agencies and the Department of the Environment, Heritage and Local Government will not be sufficient. The principles of transparency and accountability must be upheld. In his reply I hope the Minister of State will accede to the request for a full public inquiry and not a half-hearted review. All of the facts must come out.

Deputy Trevor Sargent

The Minister for the Environment, Heritage and Local Government, Deputy John Gormley, has asked local authorities, including Cork City Council, for reports on the effects of the recent flooding in their areas and an assessment of the measures that can be taken to reduce the risk of such flooding in the future. The Deputy will appreciate that the Minister does not have responsibility for the activities of the Electricity Supply Board and he awaits the report from Cork City Council which I am sure will cover the recent events relating to the release of water by the ESB.

Primary responsibility for flood risk management rests with the Office of Public Works, which has the lead agency role for devising and implementing measures, including flood relief schemes, to deal with flooding in Ireland. With regard to measures to be taken against future flood risks in the Cork city area, the OPW commissioned the river Lee catchment flood risk assessment and management study, in conjunction with Cork County Council and Cork City Council in 2006, as the pilot study for the national flood risk assessment management programme. The objective of the study is to identify and map existing and potential future flood risk areas in the river Lee catchment, through detailed hydrological and hydraulic modelling and flood-mapping. Once the flood risk has been quantified and mapped throughout the catchment, with particular focus on developed areas, or areas under potential development pressure, a catchment flood risk management plan is developed, which includes a prioritised set of actions, measures and works to manage the flood risk in the catchment.

In light of the recent flood events of November 2009 and the subsequent need to study the new data, the timeframe for completion has been extended to allow for a review of the risks and proposed options. Once this review is complete, the flood risk management plan and associated strategic environmental assessment will be published by the OPW, along with the flood maps, for formal public consultation early in the new year. After all relevant comments from this consultation have been addressed in the catchment flood risk management plan, the study will be complete and the recommendations will be put forward for implementation on a phased basis.

When the various reports and the above mentioned study are complete, the position will be much clearer for all the parties concerned. Separately, the national director of the National Directorate for Fire and Emergency Management has been asked to carry out a review of the operational procedures of the framework for major emergency management during the flooding event.

The Minister would like to thank the city and county council staff, together with the Garda Síochána, the Defence Forces and voluntary bodies, for all the work they undertook during the recent flooding event. Although the major emergency response procedures operated well, the Minister is, of course, very conscious of the distress and disturbance that individuals and their families continue to experience as a result of the flooding.

Deputy Bernard Allen

This is the start of a cover-up. This is totally unsatisfactory. The ESB must be held accountable and the Minister of State has stated that the Minister has no responsibility for the ESB. Somebody must have responsibility. This is a cop-out. There should be no cover-up of the facts related to this. Too many people's businesses and livelihoods are at risk. Some Minister must be able to bring the ESB to book on this.

I apologise to the Acting Chairman.

Malting Barley Industry.

Deputy Seán Fleming

I will share a moment of my time with Deputy John Browne.

I request that Dáil Éireann calls on the Minister for Agriculture, Fisheries and Food and his Government colleagues to ensure that malt and malting barley production is retained in Ireland as a condition of any proposed sale of Greencore Malt to a foreign food company. We are all concerned at reports in the media in recent weeks of the sale of Greencore Malt. A number of approaches have been received by Greencore plc. I understand a French company, Soufflet, visited Ireland more than a week ago to inspect the various facilities of Greencore Malt as part of this process.

Approximately 1,500 Irish farmers grow 130,000 tonnes of malting barley each year and this has been the case for generations with an excellent tradition in many counties, including Laois, Kildare, Carlow and Wexford. It is a valuable premium crop and I am concerned that if this does not continue those farmers would grow feed barley, leading to an excess of feed barley production in the country, with a knock-on effect on prices. There is a malting plant in Athy and depots in Stradbally and Emo in County Laois and I am concerned at reports that they may close early in the new year. I also understand there are four depots in Wexford.

Greencore Malt was formed at the beginning of 2000 with the integration of three Greencore-owned malting companies, namely, Minch Malt in Ireland, Belgomalt in Belgium, and Pauls Malt in the UK. The company has 500,000 tonnes of malting barley in the three countries and the proposed purchaser, Soufflet, already has 1.5 million tonnes of malting barley. If it succeeds in this takeover it will be the biggest malt processor in Europe and perhaps the world.

I also want to highlight the fact that there is a very strong Guinness link through the Smithwicks brand to this malting barley and Guinness trades on its Irishness. It is essential that Irish malting barley continues to supply Guinness. If this link is broken it could have a knock-on effect for the Guinness operation in Ireland. I sincerely hope this does not happen.

Here we go again with Greencore. It closed the Irish sugar industry and thousands of farmers, employees and excellent plants in Carlow and Mallow were thrown to the wind with no benefit to the Irish consumer. Greencore is nothing but an asset-stripping company. It is like a pack of vultures and it is at it here again. That is why I call on the Minister and his colleagues to refer any proposed purchase of Greencore Malt to the EU competition authorities. The purchase by Soufflet would create a new company that would have too much dominance and may abuse it in due course. It would be the biggest malting processor in Europe if it succeeds.

Will the Minister call in the chief executive of Greencore and demand guarantees on the continued growing of malting barley and the continuation of malting in Ireland if Greencore decides to sell Greencore Malt and it is approved by the EU. I am very concerned about the future of farmers in this regard.

Deputy John Browne

I support my colleague, Deputy Seán Fleming, in calling on Greencore to ensure that malting barley growing and malt production will continue in Ireland should it sell its commercial entity. Wexford, Carlow, Kilkenny and Laois have been to the forefront in growing malting barley through the generations. It is recognised that they produce the best malting barley in Europe and they have consistently done so. I am concerned that Greencore does not have a commitment to ensure that malting barley will continue to be grown here. To lose this valuable product would devastate the farming sector in the south east. There would also be a loss of jobs in the depots in County Wexford, including the Minch depot in Enniscorthy and three others.

We already lost the beet industry, which was a major loss to farmers in the south east and it would devastate them completely if we lost the malting barley industry. Despite the fact that Greencore is a commercially independent company I expect the Minister for Agriculture, Fisheries and Food and the Department to ensure that in any sale it would protect the livelihoods of our malting barley growers and ensure that malting barley growing and malt production would continue in this country for many years to come.

As Deputy Fleming indicated, Guinness and malting barley production go hand in hand in Ireland. It would be a major blow to the economy if a company from France purchases Greencore Malt and closes down production here. There is a genuine fear among farmers in the south east that this will happen. I ask the Minister of State to ensure that it does not happen and also that the livelihoods of farmers involved in growing malting barley will be protected.

Deputy Trevor Sargent

Gabhaim buíochas don Teachta as an gceist seo a ardú.

The Department of Agriculture, Fisheries and Food has a long association with the malting barley industry in Ireland which dates back to the beginning of the 1900s, with the introduction of a Guinness-initiated programme of breeding and trialling to improve the varieties of malting barley available to Irish growers. This association was formalised in 1971 when my Department and Guinness agreed to share the operating costs of the programme. The programme ceased in 2002, due mainly to Guinness withdrawing from it.

A number of other significant developments also took place in the brewing industry in Ireland at that time: first, Guinness was subsumed into a new operating company, Diageo, and decided to cease buying malting barley from growers and instead purchase finished malt from malting companies; and, second, the Greencore Malting Group was formed at the beginning of 2000 following the integration of the three Greencore-owned malting companies, namely, Pauls Malt in the UK, Minch Malt in Ireland and Belgomalt in Belgium.

These changes facilitated the introduction of a new operating relationship and cost structure programme between the Department and the malting industry whereby maltsters identified the varieties for entry into official trials and became involved in replicating the trials; and the Department continued official trialling of the varieties and submitted samples from the trials as well as issuing the appropriate results and reports. The industry paid an annual cost to the Department for this service.

While this arrangement has worked well from an operational point of view, the number of malting barley varieties being trialled has decreased significantly in the past decade. There has been an increased focus and discussion between maltsters — particularly Greencore, which is the main purchaser of malting barley in Ireland — and growers' representatives with regard to the prices being paid. The issue of prices paid for malting barley in Ireland is a matter for growers and malting companies.

I am aware of recent press coverage suggesting that Greencore may be exiting the malting industry by selling off its operation. While my Department, particularly in light of its involvement in the trialling, will be monitoring developments, the issue of the sale of the company by Greencore is a commercial matter for those involved and I cannot become involved in any formal way in that regard. However, I will discuss the matter with the Minister for Agriculture, Fisheries and Food, Deputy Brendan Smith, in order to discover what action might be taken.

The Dáil adjourned at 10.35 p.m. until 10.30 a.m. on Wednesday, 9 December 2009.