Dáil Éireann debate -
Thursday, 3 Jun 2010

Vol. 711 No. 3

Adjournment Debate

Health Service Staff

Deputy Frank Feighan

Over two months ago, the day care services for elderly people in the Boyle area were curtailed. These services, for which they each paid €4, transformed their lives by allowing them to meet friends, eat dinner, play bingo, get their hair done and receive physiotherapy, as well as giving their families some respite. With one clinical nurse manager on sick leave, the embargo on HSE recruitment has denied day care services to these elderly people who gave so much to our country.

This problem has continued for too long. I have raised it under Standing Order 32 almost every second day in the Dáil. Three weeks ago, the Minister of State at the Department of Health and Children, Deputy Áine Brady, assured us that a clinical nurse manager was due to be appointed.

On 15 May, we were told that the services would resume and that it was merely a matter of receiving a letter from the Department of Finance. However, these services continue to be denied and I have repeatedly been in contact with the HSE and the Department of Health and Children, both of which appear to be involved in a turf war. The HSE wants a letter from the Department of Finance before it can permit the appointment of a clinical nurse manager.

I am sick and tired of this nonsense. These elderly people and their families are very angry at the way they have been treated. I seek a satisfactory answer because the buck has to stop with the Department of Health and Children. Has the Department sanctioned the appointment of a clinical nurse manager so that the people who built his country can be afforded the day care services they deserve?

Minister of State at the Departments of Education and Skills (Deputy Seán Haughey)

I am taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children. I thank the Deputy for raising this issue and giving me an opportunity to clarify the position regarding the operation of the general public sector moratorium in the health services.

The Government has made clear that a critical part of its strategy to restore the public finances is the achievement of sustainability in the cost of delivering public services relative to State revenues. To help achieve this goal, it will be necessary to restructure and reorganise the public service and to reduce public service numbers over the coming years. This requires that the moratorium on recruitment and promotion in the health service will continue to apply until numbers have fallen to the level set out in the employment control framework for the health sector. The framework for 2010-12 gives effect to the Government decision on employment policy in the public sector and provides for a net reduction in employment of 6,000 from March 2009 to the end 2012, with consequential pay roll savings.

Based on reductions already achieved in 2009, the net target reduction to the end of 2012 is 4,560 whole time equivalents. Therefore, the net target reduction in numbers in 2010 and the following two years is 1,520 wholetime equivalents.

The Government decision has been modulated to ensure key services are maintained in so far as possible in the health services, particularly in respect of children at risk, older people and persons with a disability.

Deputy Frank Feighan

On a point of order, this nonsense has to stop. The issue I raised related to the Plunkett home in Boyle. I want an answer to my questions on the issue. I am listening to nonsense from the Minister of State.

Acting Chairman (Deputy Darragh O’Brien)

I ask the Deputy to allow the Minister of State to continue. If he is not satisfied with the response, he can table a parliamentary question.

Deputy Seán Haughey

I, too, wish to raise a point of order. The issue I have been asked to address reads as follows: "The continued embargo on recruitment in the HSE which is putting people's lives at risk."

Deputy Frank Feighan

An amendment was made to include a reference to the Plunkett home in Boyle.

Deputy Seán Haughey

I am taking this matter on behalf of the Minister for Health and Children and no indication was given to me of the issues the Deputy raised. I do not know what is the problem.

Acting Chairman (Deputy Darragh O’Brien)

The Minister of State should continue with his reply.

Deputy Seán Haughey

I will do so and I will endeavour to obtain the information the Deputy seeks as there appears to be a misunderstanding, certainly as far as I am concerned.

Deputy Frank Feighan

I would appreciate if the Minister of State would provide me with the information this evening. I have tried to contact the Department on numerous occasions.

Deputy Seán Haughey

I sympathise with the sentiments expressed by the Deputy. The position is not satisfactory from my point of view either.

The framework provides for a number of grades and posts that are exempt from the moratorium on recruitment and promotion. In addition, the HSE also has the capacity under the framework to fill some exceptions from the general moratorium provided it achieves the overall target reductions. To minimise the impact on essential service delivery, the reorganisation and restructuring of work is required. The redeployment and reassignment of staff, optimal skill mix and scheduling of services will be an essential part of this process.

The draft public sector agreement reached between public sector unions and management will play an important role in this regard. The draft agreement provides for greater flexibility, an extended working day and redeployment of health sector staff. Ultimately, this will have a positive impact on the provision of health services and allow the transformation agenda to continue.

I will convey the Deputy's views to the Minister for Health and Children and endeavour to obtain the additional information he requires.

Health Services

Deputy Kieran O’Donnell

I thank the Ceann Comhairle for allowing me to raise this matter, specifically the reduction of €1.08 million in the budget of the Brothers of Charity in Bawnmore in Limerick. This 4% cut has resulted in the decision by the Brothers of Charity at the Bawnmore centre to close in ten days' time the only respite facility it has for intellectually disabled adults in Limerick city. The closure will affect 63 families, many of whom are elderly or widowed carers of sons or daughters. They have reached crisis point as they face the loss of the only respite care facility available for loved ones. The closure, which has been caused by a shortage of funding to the Brothers of Charity in Limerick, is unacceptable and an absolute disgrace.

I anticipated that the Minister for Health and Children, Deputy Harney, or the Minister of State with responsibility for disability, Deputy Moloney, would come to the House to address this issue. The Brothers of Charity in Bawnmore do fantastic work but face a shortage of funding. A cut of €1.08 million or 4% in a budget is severe. It has forced the Brothers of Charity to reorganise services in Bawnmore with the result that one respite house will be closed affecting 63 individuals and their families, another three residential units in the city have been closed and a further residential unit in Bawnmore must be reorganised. They have also had to curtail canteen facilities for more than 200 people who use them daily.

If the Minister of State provides a general response, it will be unacceptable. Deputies are being forced to submit general questions on the Adjournment when the Government is well aware that we seek responses on specific issues. I want to know whether funding of the order of €150,000 to €200,000 will be restored to ensure respite services are not discontinued on 14 June. Will the Minister of State also confirm that the funding of €1.08 million will be restored?

The Government attacks the most vulnerable, a category which includes the disabled. The parents and siblings of disabled people are so tired from caring for their disabled sons and daughters and brothers and sisters that they do not have the energy to respond to Government cuts such as these. Service providers such as the Brothers of Charity in Bawnmore are doing fantastic work but are being curtailed by a lack of funding. The moratorium on recruitment is not being applied in a consistent manner, specifically in respect of the Brothers of Charity in Limerick.

I ask the Minister of State to confirm that funding will be restored to enable the respite facility in Limerick used by 63 families and their loved ones to remain open. While the sum involved, €150,000, falls far short of a Taoiseach's salary, it impacts on 63 families. I also want the Minister of State to state the €1.08 million in funding cuts will be restored. Society is judged on how it deals with the most vulnerable, including the disabled. I do not want a general response but specific assurances that this matter will be addressed.

Deputy Seán Haughey

I am not sure I will be able to help the Deputy because the Minister for Health and Children has asked me to respond to the following motion which was raised on the Adjournment: "To call on the Minister for Health and Children to make a statement on the need to provide and maintain respite care services for families in need of respite." I have not been asked to respond on any issue related to Limerick.

Deputy Kieran O’Donnell

On a point of order, I raised the matter in that form because it was the only way I was allowed to do so. Previously, when this matter was raised in respect of the Bawnmore centre, respite was not an issue. As my case and that of my colleague, Deputy Feighan, show, Deputies are being forced to raise general statements when the Government is well aware that we are seeking specific answers. Ministers come before the Chamber and give us answers consisting of general waffle, which is not good enough.

Deputy Seán Haughey

That is not my problem. I have been asked to respond to a——

Deputy Kieran O’Donnell

With due respect to the Minister of State, the Minister for Health and Children, Deputy Mary Harney, or the Minister of State, Deputy John Moloney, should be present.

Deputy Seán Haughey

It is not my responsibility to select Adjournment matters or decide what matters may or may not be raised. I can only respond on behalf of a Minister to the Adjournment matter which has been selected.

Deputy Kieran O’Donnell

If that is the case, why is the Minister of State here?

Acting Chairman (Deputy Darragh O’Brien)

The matter raised is clear. It is printed on the document before us and is general rather than specific in nature.

Deputy Kieran O’Donnell

As is well known, the matter was specific when I submitted it.

Deputy Seán Haughey

That is not well known to me.

Acting Chairman (Deputy Darragh O’Brien)

We will allow the Minister of State to respond. He can note the specific issue raised by the Deputy and respond later.

Deputy Seán Haughey

The overarching policy of the Government is to support older people to live in dignity and independence in their own homes and communities for as long as possible. Where this is not possible, the Health Service Executive supports access to quality long-term residential care where this is appropriate. In line with this overall approach, a priority of Government in recent years has been to develop a range of community based supports such as home help, home care packages and day-respite care. Between 2006 and 2010, additional investment of more than €200 million was provided to the HSE to develop community-based services for older people. Without these initiatives, many older people would spend longer than necessary in acute hospitals, or would be admitted to residential care earlier than might be required.

The HSE service plan 2010, approved by the Minister for Health and Children last March, commits the executive to providing agreed levels of service nationally for these key community support areas. The plan includes respite care, often available through day care or home care packages, and is delivered either directly by the HSE, or in partnership with the voluntary or private sectors. Broadly speaking, the level of community supports for older people in 2010 is in line with 2009 provision. There is an increase this year in the number of home care packages available due to an additional €10 million given in the last budget for this purpose.

The key activity targets contained in this year's HSE service plan are almost 12 million home help hours to approximately 54,500 people, increased home care package provision from 8,700 recipients at any one time in 2009 to 9,600 in 2010 and a total of 21,300 day care places, which is estimated to cater for up to 80,000 people. While this target is slightly down from a comparable figure of 21,600 places last year, the respite element of day care would be generally compensated for in the overall 2010 home care service picture.

Any changes to these commitments, as part of the agreed HSE service plan, would need to be notified to the Department. Other important initiatives are also being undertaken at a strategic level to improve community-based services for older people. Arising from an evaluation of home care packages, published by the Department last December, the HSE established a taskforce to progress, this year, various improvements in home care provision. The Department accepts the need for a more standardised approach to home care generally, whether by public or private provision. This year the HSE intends to finalise and circulate standardised access and operational guidelines for delivery of home care packages, adopt and disseminate a voluntary code of quality guidelines for home care support services for older people and develop and publish a procurement framework for home care services.

The various guidelines now being prepared are intended to allow the HSE implement a more standardised approach nationally to the provision of home care services, including respite care, in the context of interlinking with the wider range of services.

The HSE has operational responsibility for the delivery of health and social services. The Deputy will appreciate that all developments in the area of home care need to be addressed in light of the current economic and budgetary pressures. The executive has been asked to make a rigorous examination of how existing funding might be reconfigured or reallocated to ensure maximum service provision is achieved. This requires a stringent ongoing review of the application of the resources available. It is, consequently, a matter for the executive to manage the services I have outlined, including respite care, at national, regional or local level, bearing in mind all relevant factors such as overall resources, local circumstances or evolving service priorities.

I have taken note of what the Deputy said about Limerick city and will convey his views to the Minister for Health and Children.

Prison Accommodation

Deputy Charles Flanagan

I thank the Ceann Comhairle for allowing me to raise this issue once again. There is a crisis in Mountjoy Prison. In recent weeks the governor of Mountjoy men's prison has announced his retirement while the governor of the women's prison has resigned. Both cited appalling conditions at the prison and the fact that they were being constantly undermined in their attempts to run effective prisons. In April Mr. John Lonergan announced his decision to retire as governor after 42 years in the Prison Service. He said his concerns about the prison had been totally ignored over the years and his autonomy as governor had been constantly reduced to the point where governors have almost no discretion regarding how prisons operate.

A week later Ms Kathleen McMahon pointed to significant overcrowding problems and the ridiculous and disgraceful practice of incarcerating women for failing to keep up with loan repayments. She noted that Dóchas prison was designed to hold 85 inmates but at the time of her statement had 130 women in the prison. In Mountjoy, a prison designed for 489 prisoners, the average number of prisoners behind bars this year is 630. Those concerns have been echoed by an outgoing member of the Mountjoy Prison visiting committee, Mr. Paul McKay, and others.

The periodic flare up of violence in Mountjoy is a reminder of the constant low level violence and threat of violence with which inmates and staff contend on a daily basis. Non-gangland prisoners are being mercilessly targeted by gang members. This is evident in published photos, circulated via mobile phones, of an "ordinary" prisoner stripped naked, beaten and tied up within the four walls of the prison. Images have also been circulated of gang members brandishing improvised weapons including "shanks" — knives made from box cutter blades. There is allegedly a constant stream of prisoners being taken to the accident and emergency unit in the Mater Hospital for treatment for injuries arising from beatings, stabbings and slashings.

The Prison Officers Association claims that staff members are barely able to cope with the levels of violence and intimidation, and are suffering from stress. A moratorium on recruitment and a reduction in overtime is making life for the prison staff in Mountjoy almost impossible. The Council of Europe Anti-Torture Committee has described conditions in Mountjoy as "inhumane and degrading". That label should be a source of shame and disgust to a government but this Government and the Minister for Justice and Law Reform are clearly without any moral compass.

A drug culture dominates and the prison chaplains have repeatedly warned that those who enter prison clean are likely to leave with a drug problem. Last month, it was reported that the Inspector of Prisons discovered 26% of the prison population, 825 prisoners, were being locked down because they or prison staff believed their lives were in danger. They are, effectively, in prisons within the prison system. This record number of inmates locked away for 23 hours a day, 365 days a year, has come about as a result of the entry into the prison system of the increasingly brutal feuding between large drug gangs on the outside.

Obviously, prison is where criminal gangsters belong, but is it the place where fine defaulters belong? Is it the place where petty criminals belong? Would minor offences not be better dealt with via the sanction of community service, thereby freeing up vital prison spaces? Kathleen McMahon claimed in her resignation statement that women were being locked up for inability to pay debts. In a reply to a parliamentary question on 13 May, I was informed that the number of committals to prison for failing to pay fines is 1,431 up to and including 31 March 2010. How can the Minister stand over this system?

The expensive fairytale of Thornton Hall solving all the problems clearly lies far into the future. I want the Minister to give me a date because the date I am hearing is not sooner than 2016. I believe it is in the constituency of the Acting Chairman, Deputy Darragh O'Brien, and he has an interest. What is to happen in the meantime? Will we see ongoing violence, drug addiction, intimidation, overcrowding and inhumane and degrading treatment? Is this situation tenable because it may someday in the distant future be improved? It is not tenable. There are steps that can be taken immediately to improve matters, foremost among them being a change in practice to ensure that petty criminals are given community sanctions rather than being incarcerated in overcrowded jails. I have raised this matter before, raise it today and will continue to raise it until matters are improved.

Deputy Seán Haughey

I am responding on behalf of the Minister for Justice and Law Reform, Deputy Dermot Ahern. At the outset I reject the accusation that the Minister is without moral compass.

Unfortunately prison overcrowding is not unique to this country. It is happening in many countries. The Minister is on record as saying before that there is no instant or quick fix solution. Rather the approach must be to focus on taking measures in the short to medium term as well as in the longer term. This is what he is doing.

The increase in committals to prison can be attributed to a range of positive developments in the provision of resources to the entire criminal justice system. For example, extra gardaí result in more successful prosecutions by the courts. There are 1,000 more criminals in our prisons now than there were there in 2006. It is accepted that the approach to tackling overcrowding must contain a range of strategies. Irish prison management has been supported by the Minister and the Government in managing the serious and consistent upward trend in the prisoner population.

Statistics for the number of new prison spaces provided since 1997 speak for themselves. In that period almost 1,800 spaces have been provided. This is a fact and is solid proof of putting resources into providing the highest standard of accommodation in prisons. The current capital building programme in the prisons will mean that almost 40% of the entire prison estate will have been replaced or refurbished.

The Minister makes no apology for this investment. He believes we needed to put in that investment when the economy allowed us to do so. In the changed economic environment we now find ourselves in, there will be continued investment in the prison system, Thornton being a firm commitment. A further 200 spaces are being provided in the short term. This will be by means of a new block that is ready to open in Wheatfield prison. The Deputy will also be aware that work is expected to start in the latter half of this year on a new 300-space block in the Midlands Prison complex in his own constituency, providing much welcomed job opportunities in the construction phase.

In the longer term, a new purpose-built campus style prison development at Thornton Hall will provide approximately 1,400 cells on a 130 acre site. This will allow for the replacement of the antiquated Mountjoy Prison campus with modern fit for purpose and regime orientated accommodation. The new facility will have operational flexibility to accommodate up to 2,200 prisoners in a range of security settings. The Thornton Hall project is progressing on a phased basis and will provide the kind of prisoner regime and staff accommodation that will stand the test of time.

On the non-custodial front, the Deputy will be aware of the provisions of the new Fines Act, which will further assist in keeping people out of prison. Other initiatives, such as community service orders and restorative justice, also have a place in the menu of disposal options available to the Judiciary. In the context of overcrowded conditions in prisons, the point is sometimes made that we are sending people to prison who should not be there. The reality is that the prison system must accept all prisoners committed into its care by the courts. The Deputy and his party must also accept that we have some very serious criminals in our prison system serving longer sentences for serious and heinous crimes and while non-custodial options do have their place, we need to maintain a balanced approach to public safety.

The mission of the Irish Prison Service is to provide safe, secure and humane custody for those placed in custody and in that regard no level of inter prisoner violence is acceptable, either to prison management or the Minister. On a daily basis every effort is made by prison staff and management to limit the scope of acts of violence. No doubt the Deputy will accept that while the prison regime is designed to limit the scope for acts of violence, it is not possible to completely eliminate the possibility of such acts in prisons holding a high proportion of violent offenders without introducing a regime that would be so restrictive as to be unacceptable. Prison management, for example, monitors the situation of prisoner interaction and where prisoners are identified as exerting undue influence or pressure over other prisoners, such offenders receive close and continued attention and targeted searching from the Irish Prison Service's operational support unit. The general experience is that attacks by prisoners on other prisoners are not usually random attacks of violence. Rather, they are related to matters on the "outside", such as drug debts or gang rivalries.

The Deputy is fully aware of the range of increased security measures introduced into the prison system in more recent times. On the Minister's behalf I do not propose to list them here. Suffice to say that the Irish Prison Service management have advised the Minister that they are satisfied that they are making a difference. The Minister and the director general of the Irish Prison Service are acutely aware of the necessity to do all in their power to maintain a safe and secure prison environment for staff and prisoners. The Minister will continue to work with the director general and his senior management team to meet this ongoing challenge.

Demonstration Library Programme

Deputy Mary Upton

I thank the Office of the Ceann Comhairle for giving me the opportunity to raise this matter on the Adjournment. The demonstration library project is one of the most important and innovative initiatives of the Department of Education and Skills and is designed to encourage and develop literacy skills of students in schools in designated disadvantaged areas. The announcement earlier this week that the project is at risk is of huge concern. The decision to abolish the project will, if it happens, affect 22 schools. It will have a negative impact not just on the schools affected, but on the students most in need of the project who will lose out on vital opportunities.

I am familiar with a number of schools in my constituency where this library support is available. It was and continues to be a real bonus to the students who might be at risk of leaving school without any formal qualifications. I have seen for myself the difference it has made, not just in terms of the literacy skills that it has helped to promote, but also by way of the social development it has engendered. It has created an environment where books of all sizes and shapes and difficulty are no longer seen as a threat to students and something that should be avoided at all costs. Instead, the availability of books in an attractive environment with ease of access has stimulated an interest in reading in students that would never have expressed any interest in literature. This is the report from their teachers and from the librarians. It is also my own experience, having seen these libraries in three schools in my constituency and observed the interest of the students in spending time in the library. The project has also generated an air of confidence in the students in tackling literacy issues that previously held no interest for them. The library project has also formed a new type of social interaction between the students themselves, their teachers and the librarians who have been so supportive of the students' needs.

In a press release in July 2008, the former Minister, Deputy Batt O'Keeffe, stated: "The project puts in place high quality, fully stocked and equipped modern libraries and provides each with a professional librarian." He went on to say: "These are not ordinary school libraries, they are creative active learning centres" and "are designed to entice and engage the most reluctant teenager". It would be truly regressive if this facility was now withdrawn. Last week, in reply to a parliamentary question raised by my colleague Deputy Róisín Shortall, Deputy Haughey stated that the demonstration library projects formed an integral part of the Government's strategy on tackling illiteracy. However, on the same day, the Minister, Deputy Coughlan, confirmed in a separate reply that the library staff were subject to the public sector moratorium on recruitment. We need clarification on this issue so that the schools can plan for the coming academic year confident that this vital support will be retained.

I am asking this evening that this project be retained, by whatever mechanism is required. If the project is lost, it will send out a singular message that literacy does not matter and that it is a right only for those who can access it with academic ease and with the financial wherewithal to do so.

Deputy Seán Haughey

I welcome the opportunity, on behalf of the Tánaiste and Minister for Education and Skills, Deputy Coughlan, to outline the up-to-date position regarding the demonstration library project that forms part of the junior certificate school programme, JCSP, literacy strategy.

The JCSP has operated in schools nationally since 1996, as an intervention at junior cycle for students who, for a variety of reasons, have experienced difficulties in school and hence are considered to be at risk of leaving school early. The programme is founded on the premise that all young people can be successful at school. It provides a curriculum framework which assists schools and individual teachers in adopting a student-centred approach to education. Students are given enhanced opportunities to engage with the curriculum and to achieve success at school through a system of profiling of achievement. The programme covers a broad range of personal and social skills, as well as academic achievements.

Since poor levels of literacy and numeracy have been widely acknowledged as factors which hinder student progress, under the programme the implementation of literacy and numeracy strategies is fundamental. The JCSP support service works with schools to employ classroom strategies to develop students' literacy and numeracy skills and to encourage them to adopt a whole-school approach to literacy and numeracy. This is facilitated by providing teachers with ongoing professional development on cross-curricular approaches to literacy and numeracy, as well as by the provision of resources annually to support the implementation of specific initiatives in both areas. At present, the JCSP is offered in 240 schools, 184 of which are DEIS schools, and provides support for 9,000 students. Over €3.07 million was spent on this programme in the past three years and €1 million has been allocated for 2010.

The demonstration library pilot project, which forms part of the JCSP literacy initiative, provides professionally staffed libraries for JCSP schools. The project was announced as a pilot in 2001, with libraries being set up in 11 JCSP schools in 2002. The Department, through the JCSP support service, provides the support necessary for schools to: establish and equip high quality school libraries; develop structured library based strategies with ICT support for JCSP students with literacy difficulties; employ professionally qualified school librarians who work with the teaching staff to develop and implement the JCSP literacy strategy and who are supported by the project librarian and the JCSP support service; and participate in an ongoing monitoring and evaluation process, which is a major part of the project.

To date, 30 schools have been included in the project. Some 25 of these are DEIS schools. The librarians in many of these schools are currently employed on fixed-term contracts and one further school has a vacancy. The remaining schools are either staffed by librarians who have been redeployed from the library service or those with contracts not falling for renewal.

The Deputy will be aware of the Government decision to implement a recruitment and promotion moratorium in the public sector so as to facilitate a permanent, structural reduction in the numbers of staff serving in the public sector in order to contribute significant and ongoing savings to the Exchequer. The terms of this moratorium require that no public service post, however arising, may be filled by recruitment, promotion nor payment of an allowance for the performance of duties at a higher grade. As the Tánaiste has previously set out, this decision also applies to temporary appointments on a fixed-term basis and to the renewal of such contracts. Exemptions from the moratorium are, in the context of the public finances, a matter for serious deliberation. The Tánaiste is, however, working together with her colleague, the Minister for Finance, in respect of those aspects of the moratorium which are having a particular impact in the education sector. The employment of librarians in the demonstration library pilot project is one such issue.

I again thank the Deputy for providing me with the opportunity to outline the up-to-date position in respect of this matter.