Dáil Éireann debate -
Thursday, 17 Dec 2009

Vol. 698 No. 5

Adjournment Debate.

Hospital Services.

Deputy James Bannon

I thank the Ceann Comhairle for affording me time to raise this important matter which impacts on the health of the entire midlands region and in particular, Longford-Westmeath.

Due to extreme public disquiet in the midlands, will the Minister for Health and Children give me a guarantee that services at the Midland Regional Hospital, Mullingar, County Westmeath, will be maintained, as further erosion of essential medical facilities following on the recent off-call status of the accident and emergency department at the hospital, would be untenable? There is a real fear that the Longford-Westmeath hospital is being closed by stealth. While I am not used to getting honest answers on the long-term plans of the HSE, I must stress a deliberate and cold-hearted campaign of axing services to the detriment of the health of the people of the midlands will not be tolerated and questions must be answered.

We have heard of Nero fiddling while Rome burned. What we are seeing is a health system attempting to make good the fiddling of the books while patients die. While it may not be politically correct to raise such a sensitive matter, people are dying who would be alive and with their families if they had the benefit of a competent and well-run Department of Health and Children.

Given the ongoing destruction of the health infrastructure in Longford-Westmeath and the lack of backup care given to the ill, the terminally ill, the elderly patients and those requiring emergency treatment, the people of the region are not prepared to see a further erosion of health provision. They have been totally abandoned by the Government, in particular the Government Deputies Mary O'Rourke and Peter Kelly who are supposed to represent their interests.

The Longford-Westmeath hospital is struggling to maintain its services. Unless the 41 acute beds that the HSE has axed are re-opened, this hospital will be the latest casualty of HSE mismanagement and of the scandalous disregard of this Government for the health and well-being of the midlands.

When announcing the back-on-call status of the hospital on 4 December, the HSE claimed it was giving no guarantee that Mullingar hospital will not be off-call again. This is unacceptable. During my meeting with the hospital manager and a representative of the HSE to discuss the off-call situation then, I also raised the urgent matter of the re-opening of the acute inpatient beds. I was informed that the utilisation of these beds is dependent on the employment of an extra 28 medical personnel who are urgently needed to replace the recent loss of 30 staff at the hospital.

This is very much a catch-22 situation. The Minister has removed the staff from the hospital and has, therefore, by extension removed the available beds that patients so urgently need. I am extremely angry at the cold-blooded approach of the HSE to what should be a patient-driven, patient-friendly health sector. Under the Minister's watch, patients are the last ones to matter in the system. By taking beds out of the system, patients are being put at dangerous risk. Patients are not numbers, they are real live people who bleed when cut and die when left on trolleys without treatment.

There is no excuse for the HSE's despicable failure to provide essential health care for the midlands. Following the closure of Longford hospital in 1986, the people of Longford were guaranteed 24 hour, seven day a week emergency cover. Left without a hospital of its own, County Longford was conned by the Minister for Health and Children and the promise of services at the Longford-Westmeath hospital. These cutbacks are dirty tricks which are undermining people's confidence in the level of care available at Longford-Westmeath hospital. We want guarantees that Mullingar hospital, which despite the cutbacks, is one of the top performing hospitals in the country with an excellent staff working hard on behalf of the people who attend there will be fully funded, with all outstanding works in relation to Phase 2B completed and acute beds restored. We do not want or believe spin. We want action and we want it immediately.

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

Gabhaim buíochas leis an Teachta Bannon as ucht na ceiste a árdú agus aontaím leis gur ospidéal den scoth é Mullingar. I am taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney.

The HSE accepts that there was a problem in the emergency department at Mullingar Hospital earlier this month which required the hospital to be off-call for emergencies for 24 hours. However, during this period, it was not necessary for any patient to be transferred by ambulance to the Midland Regional Hospital Tullamore in accordance with the by-pass protocol. 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. The hospital has been recognised as being one of the most efficient in the country in the context of the annual casemix adjustment. Last year, the hospital scored one of the highest in the country with a positive casemix adjustment of €1.977 million.

It should be noted that inpatient activity at Mullingar hospital to the end of October was similar to last year, while day case activity was up by 6% year on year. Up to end October this year, there were 27,436 emergency attendances, a reduction of 4.8% 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 year end.

In November, patients were transferred from old accommodation at 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.

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 has commenced a bed utilisation study with a view to establishing that all beds within the hospital are being utilised to maximum effect. The results of this study will help to identify any barriers to maximum utilisation of the inpatient beds and hospital management will act on the results of the study as soon as it is finalised.

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 the emergency 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.

Foreign Conflicts.

Deputy Michael D. Higgins

Tá áthas orm go bhfuil an tAire Stáit chun an t-ábhar seo a thógaint mar bhí suim aige uair amháin sa chás seo.

Deputy Trevor Sargent

Tá fós.

Deputy Michael D. Higgins

I have more than once raised this issue, most recently during questions to the Minister for Foreign Affairs. It is a little less than a scandal that such little progress on this matter has been made here or at European Union level. I raise this issue this evening because of the urgent position in which two human rights activists find themselves, one of whom attended a conference in Cork, of which I am sure the Minister for Foreign Affairs will be aware, and was arrested on her way home and is now ill in prison. The other, who is in prison in Lanzarote, is in the fifth week of her hunger strike. The position in terms of her health is desperate.

I became aware of the position of the Saharawi people some time after the original annexation of this territory, the old Spanish Sahara, by Morocco. On 6 November 1976, King Hassan announced the discovery of a new and empty country and marched into what was the Spanish Sahara in violation of the natural expectation of the people to independence. Since then, there have been many attempts at establishing some form of peace. The Saharawi Arab Democratic Republic, declared on 27 February 1976, is recognised by the African Union, of which Morocco is not part because of the African Union's acceptance of the SADR. They are a very interesting people. I stayed with them for some weeks and they have been visited by former Ministers for Foreign Affairs, former Deputies Andrews and Collins and many other parliamentarians.

Half of the population live in four refugee camps and are divided from their home by a long wall of 2,200 km. Scandalously, the European Union has signed an agreement through which it gives €224 million per annum to Morocco for the right, principally, of Spanish ships to fish in what are the waters of the Saharawi people. Scandalously, too, an Irish company has attempted to sell shares and to seek investment for mining rights on land the annexed occupied rights of the Saharawi people. From time to time, they come outside and attend international conferences to draw attention to the refugee camps, one of which I visited and stayed at in Tindouf on the Algerian border. I have also crossed the Sahara to the wall to which I referred earlier. I have visited the region four or five times. The United Nations agencies speak of what the women and children suffer. Now, when delegations are returning from these international conferences they are arrested and not allowed to return to Layaaoune. That is why one is on hunger strike in Lanzarote. It is also why another is in hospital.

In addition, there have been different approaches internationally to organise a UN-based referendum, but in all of the cases the Moroccan Government has insisted that it will not recognise any form of independence. For all of these reasons, in a number of prisons brought to my attention, including Casablanca, Laayoune itself and others in Marrakesh, there are civilians who will be brought before military courts, prisoners who are not allowed to be visited, prisoners being submitted to degrading and inhuman punishments, and two women I mention who have been delegates to conferences here in Ireland.

Our concern is being expressed by our ambassador to Portugal, who also is our ambassador to Morocco. However, I hope that before this weekend the ambassador will once again take up these issues and I would urge the Minister for Foreign Affairs to take it up with the Moroccan ambassador in Dublin.

Deputy Trevor Sargent

Arís, ba mhaith liom mo bhuíochas a ghabháil leis an Teachta Ó hUigín as an cheist a ardú. Bhí suim mhór agam éisteacht lena chúntas. Tá súil agam gur féidir liom roinnt de na ceisteanna a d'ardaigh sé a fhreagairt. Deanfaidh mé mo dhícheall ar son an Aire Gnóthaí Eachtracha.

The Government is aware of this case and shares the concern expressed that every effort be made to resolve it speedily and happily. Ms Aminatou Haidar, a human rights activist from Western Sahara, has been on hunger strike at Lanzarote Airport in the Canary Islands since mid-November. She landed at Laayoune Airport in the Western Sahara on 14 November, returning from a visit to Spain, and was denied access by Moroccan immigration authorities, having refused to state her nationality as Moroccan on her landing card. She was, therefore, returned to Lanzarote, from whence she had come, where she refused to leave the airport and commenced a hunger strike in protest. Although not a Spanish national, Ms Haidar has Spanish residency, but she is understandably concerned that any decision on her part to remain in Spain would prohibit her return to her family in Western Sahara.

We share the widespread concerns about Ms Haidar's health, as she has now been on hunger strike for several weeks. She is drinking sugared water, but had refused medical care from the Spanish authorities. Our latest information is that she has today been admitted to hospital in Lanzarote at her own request.

Along with our EU partners, we are closely following the case and our embassy in Lisbon, which is accredited to Morocco, is also maintaining contact with EU missions resident in Rabat. Our Spanish partners, as one would expect in the circumstances, are playing a leading role in trying to talk both to Ms Haidar and to the Moroccan authorities in order to come to a solution——

Deputy Michael D. Higgins

They are major beneficiaries of an illegal agreement on fishing.

Deputy Trevor Sargent

——which will resolve this issue and avert a tragedy. The case has also been discussed at EU level with the Moroccan Government, and the EU Presidency issued a statement concerning her situation on 10 December.

The position of the Moroccan authorities is that Ms Haidar is free to enter Morocco and that the immigration formalities required of her were the same as for other arriving passengers, and have been complied with by Ms Haidar on many previous occasions. The Government has also been in direct contact with the Moroccan ambassador in Dublin on this issue. The Minister for Foreign Affairs has written to the ambassador regarding the concern which exists about Ms Haidar's health and well-being and to encourage the Moroccan Government to take speedy steps to alleviate and resolve the situation.

Turning to the broader issue which lies behind this case, we remain very concerned about the plight of the people of Western Sahara as a whole. Ireland continues to support the right to self-determination of the people of Western Sahara, as well as the continuing engagement of the United Nations in the search for a political solution in Western Sahara based on the principle of self-determination. It is hoped that UN sponsored talks between the two sides can be continued, although it would have to be admitted that talks to date have made no progress, the last such discussions being held in March 2008. An exploratory meeting to discuss the prospects for resuming direct negotiations took place last August, but no date for a further round of direct negotiations has been set.

The Government regularly communicates its views on the situation in Western Sahara to the Moroccan authorities, including through the Moroccan ambassador here in Dublin. We also raise issues related to human rights and to the importance of safeguarding freedom of movement and of expression for human rights defenders in both Morocco and Western Sahara. These issues are also raised at EU level within the framework of the EU-Morocco dialogue. The most recent Association Council with Morocco took place last week, in the margins of the Foreign Affairs Council in Brussels. The EU used this occasion to convey its concerns over the situation of Western Sahara, as well as the need to safeguard the rights of both Moroccan and Saharawi human rights defenders.

On behalf of the Government, I repeat the call by the Minister for Foreign Affairs to the Moroccan authorities to take all possible steps to avert a tragedy in this case. I also call on Ms Haidar, who has successfully brought world attention to the cause for which she struggles, to end her hunger strike before her health is permanently damaged.

Meath-Tyrone Interconnection Project.

Deputy Damien English

I am taking this matter on behalf of myself and Deputies Crawford and McEntee who could not be here to join in the debate. I am glad to see that the Minister for Communications, Energy and Natural Resources, Deputy Eamon Ryan, is present. I appreciate that. It is important that we have a good discussion on this.

Before a Minister or Fianna Fáil colleagues try to accuse Fine Gael of being against progress or delaying important infrastructure, I want to make clear that we are not. Let us be clear, Fine Gael wants the national grid improved. We recognise and support the need for the national electricity grid to be upgraded and expanded to international best standards as speedily as possible, but we disagree with the Government's approach. We are determined to ensure that we have explored all avenues and all alternatives on how this can be done. It might be quicker to roll it out underground, if it is proven to be viable, reliable and affordable. Many other projects that went overhead are still not completed ten years later. We have a responsibility to establish if this is possible.

Fine Gael has kept an open mind on this but I am sorry to say the Minister has not, nor have his Fianna Fáil colleagues. When this debate first started, I was singing the praises of the Minister, Deputy Ryan, as an open-minded person who would consider and look at all options, but I am afraid he has not given this his full attention with an open mind.

Simply because EirGrid is a State body does not mean it is correct. Most of those involved in EirGrid, ESB International and the ESB, have a history of involvement in overhead transmission and pylons. That is their job and their expertise. I accept they have researched the other end of it lately because they were forced to, but one must not forget that their jobs and careers were based in other transmission forms. We must have an open mind and a proper discussion on this.

As local Deputies we are annoyed that this submission to An Bord Pleanála is to be made this week, before Christmas. It is the wrong time to do it and it causes doubt and fear among the people. Christmas is a time for peace and happiness at home. The prospect of overhead pylons and power transmission lines over people's homes, through their field, etc., scares people. Rightly or wrongly, they are afraid. It is unfair to start this ball rolling again on Christmas week.

I fully accept that EirGrid has stated that it has looked for more time to make up for the time lost over Christmas. There are Fianna Fáil Deputies claiming they got this done. I do not believe that because the newspapers had the advertisements weeks ago. That should be clarified as well because we cannot have Deputies messing with this serious topic.

It is the wrong time to proceed with this and it is unfair. I am disappointed that it has happened. If the Minister has any influence over EirGrid, I would ask him to ask the company to hold back until after Christmas.

It is also wrong to lodge this application before we have a full and proper debate on the subject of transmission power lines. The Minister was forced into the Ecofys report and other reports and discussions over the past year and a half since this started, but EirGrid commissioned two reports which have yet to be discussed in this House or in the relevant committee, namely, the PB Power report and the TEPCO report.

We all have managed to see the PB Power report and I question much of its contents. In my view, it contains mistruths. The report should be brought to committee and should be discussed because it is relevant to how we go forward from here. Separate to this application, it is relevant to the overall policy on overhead-underground lines.

I refer to the TEPCO, Tokyo Electric Power Company, report which EirGrid has made out to be the be-all and end-all during meetings. It maintains this is a very important report and that it proves the case made. However, it is still not published and, as of yesterday, we could not get it. These reports should be available to the House and should be debated and discussed. I trust they will be read by the Minister with an open mind. I call on the Minister to give a guarantee that regardless of when planning is applied for, the reports will be discussed here during January and that they will receive proper scrutiny and investigation. As local public representatives and on behalf of the North East Pylon Pressure, NEPP, group, we have questions we wish to put.

NEPP is an excellent group that carries out excellent research. We have questions we wish to put on behalf of the all the residents of the north east. They need to know that we are doing our job properly as politicians and acting responsibly. This is a very important matter and there will be serious consequences if we get it wrong.

Potentially, we could be making a great mistake. Other Governments are beginning to act responsibly in respect of this matter, including the Danish Government, which has set out its thinking on how to proceed, how to properly research the matter and what it intends to do. I accept the Minister did not start this process. His predecessor as Minister, Deputy Noel Dempsey, started it before the general election in 2007. However, the Minister is continuing it. He is in a very important position to influence the way in which the national grid is rolled out from here onwards. This is a big decision and the Minister has a good deal of influence. EirGrid maintains that it responds to Government policy. Basically, it does what it is told to do in respect of this matter.

This House sets the policy and the agenda. The Minister is in charge and I again call on him to give this matter some consideration. I realise he is a busy man, but I suggest he should take some time out and read the reports, including the ASKON report and, if he has time, to meet Professor Noack.

I do not believe EirGrid has given proper consideration to the proposals. I question the way in which EirGrid has done its job in many areas, including public relations and its consultation with people. In addition, the submission of an application on the week approaching Christmas was wrong. This is no way for a State body to operate, especially one with such an important job, that is, to ensure the national grid is expanded and improved quickly. I am disappointed with EirGrid. There are many questions it has not answered.

Acting Chairman (Deputy Jack Wall)

The Deputy should conclude.

Deputy Damien English

If this application proceeds, there will be many red faces because it has not been fully thought through or worked out. The reports should be before the House for proper discussion and debate. Fine Gael has acted responsibly and has not been demanding action one way or another. Simply put, we call for fair play, proper scrutiny and investigation and research.

Minister for Communications, Energy and Natural Resources (Deputy Eamon Ryan)

While I have no direct role in the operational planning and construction of transmission system infrastructure, the Government's policy objective is to ensure that energy is consistently available with minimal risk to supply disruption, to meet the needs of businesses and domestic consumers. It is EirGrid's role, as the national transmission system operator, to develop and upgrade the transmission system to meet ongoing and future electricity needs.

In October 2008, EirGrid published Grid25 which sets out its strategy for the development of the transmission grid to meet Ireland's electricity needs to 2025. The capacity of Ireland's bulk transmission system has remained largely unchanged for the past 20 years, despite a growth of 150% in electricity demand being carried by the system.

Grid25 represents a cornerstone for our economic development and will provide high quality, high voltage bulk power supply to enable the regions to attract future industry, boost existing industry and create employment in area where it would not otherwise occur. It is also an essential prerequisite for the increased integration of renewable electricity, the development of an indigenous renewable energy sector and the achievement of Ireland's 40% renewable electricity target. EirGrid predicts that parts of the grid will have reached capacity within the next five to ten years. Therefore, upgrading of the infrastructure is vital.

As part of its ongoing grid development programme and in line with the Government's energy White Paper, EirGrid is currently planning the construction and re-enforcement of a number of transmission lines. These include the proposed 138 km, 400 kV Meath Tyrone interconnection development project. The project is being undertaken in co-operation with Northern Ireland Electricity. As a result of doubling the current power transfer capacity between Ireland and Northern Ireland, it will promote better competition, facilitate renewable energy and ensure a future secure supply of electricity throughout the north east.

EirGrid has been consulting extensively on the Meath-Tyrone interconnection development project since November 2007. As part of these preplanning consultations, EirGrid was required by An Bord Pleanála to consider three potential routes for the project and to consult on these routes. Following extensive studies, route corridor options the project were developed and were presented for public consultation. In April 2009, EirGrid nominated one preferred route corridor for each 400 kV power line project for further study and commenced discussions with landowners.

EirGrid advertised its intention to submit its planning consent application to An Bord Pleanála on Wednesday, 16 December. It is currently circulating copies of the planning application for the 400 kV Meath Tyrone project to statutory consultees. The application will be lodged with An Bord Pleanála once this process is completed. The planning process provides for a consultation period of seven weeks. Recognising that the application is being submitted prior to Christmas, EirGrid has decided that the statutory consultation period will commence only in the new year. In addition, the consultation period will be extended by a further three weeks, to ten weeks.

The environmental impact statement will be available to download on-line and be on display in several venues throughout Meath, Cavan and Monaghan as soon as the planning application is made. This information will be publicised widely through local press and radio as soon as the application is lodged. By submitting the application now rather than in the New Year, EirGrid is maximising the time available to people to review and formulate views on the application.

EirGrid commissioned a report by TEPCO, Tokyo Electric Power Company, to examine technical issues associated with integrating underground high voltage cables with the Irish electricity transmission system. This work is additional to the report by PB Power which EirGrid published earlier this year, and which examined structural and cost issues associated with high voltage, long distance transmission infrastructure. I understand that the TEPCO report will be made publically available by EirGrid on its website, www.eirgrid.com, from Friday afternoon.

The Department and EirGrid have kept the relevant Oireachtas committees informed of developments on grid development generally and issues relating to the proposed Meath-Tyrone development. Several reports have already been furnished to Deputies and detailed discussions have taken place with the relevant Oireachtas committees. I confirm that EirGrid will make the TEPCO report available to Members of these committees and any other Deputies who wish to receive a copy. An Bord Pleanála is the statutory planning authority for all strategic infrastructure projects and EirGrid is submitting a full environmental impact statement, in addition to these reports to An Bord Pleanála for consideration as part of its planning consent application.

Deputy Damien English

Does the Minister accept the report should be scrutinised by the committee?

Deputy Eamon Ryan

Yes.