Dáil Éireann debate -
Wednesday, 23 Mar 2011

Vol. 728 No. 4

Adjournment Debate

Schools Building Projects

Deputy Éamon Ó Cuív

Tá an-díomá orm nach bhfuil an tAire féin sa Teach anocht agus go bhfuil an nós tosaithe cheana féin ag an Rialtas seo gan na hAirí sinseareacha a bheith i láthair. I am disappointed that the Minister is not present. I always considered it regrettable when senior Ministers did not attend Adjournment debates and when I was a Minister, I always tried to attend when at all possible.

In a growing community Scoil Chaitríona is situated on a potentially excellent school site. Built in 1974 when Government finances were stretched and the conservation of energy dictated the height of classroom ceilings, Scoil Chaitríona has exceeded the expected life span of such schools by 17 years. The school population has more than doubled and prefabs have become a permanent feature of the school owing to lack of space. Resource and learning support teachers are forced to use cubby holes and cordoned off sections of corridors and classrooms to teach children with special needs. These children require space, light and a stimulating environment to cope with and overcome their special needs.

The main building of Scoil Chaitríona is falling to pieces and requires constant repairs and expansion. Owing to dampness, one of the ceilings fell in onto the class floor last year and a patch-up job was done on the roof under the summer works scheme. This year the school has applied for new doors and windows to be fitted and this will prove to be an extensive and expensive project because the roof is part of the window fixture. The roof could fall down in the process. The school is also making an application for floors to be redone throughout the building owing to wear and tear and asbestos exposure. Again, it has been faced with no alternative but to patch tile by tile as the tiles became undone. This can no longer be carried out because of the asbestos under the tiles.

A new school building project would be the best option for the Department of Education and Skills and the Renmore community. Scoil Chaitríona has been described by the Department's inspectors as a special school within a school. They have put great emphasis on this in the school's evaluation. To retain and improve the services the school offers to special needs children it must accommodate them in a suitable building. This forms a big part of its building plans, even down to the details of a shared sensory room.

Scoil Chaitríona is currently enrolling children with autism for September. As there is no accommodation available for an ASD unit, the school will be making an application for a prefabricated building comprising one classroom and one sensory room. This will be an added expense on the Department's funds when such a unit is included in the plans for a new building. Scoil Chaitríona is listed as being in Band 1.2, the provision of specialist accommodation urgently required for children with special needs such as autism, speech and language impairment, intellectual impairment and so forth.

The annual cost of the summer works scheme in 2010 was €316,000, with rental of prefabs costing €70,000. In 2011 the necessary works under the summer works scheme will cost €668,000, with the rental of prefabs costing €70,000. Speaking in Galway at the Labour Party annual conference, the Minister for Education and Skills, Deputy Ruairí Quinn, said: "Many of our school buildings are a national disgrace. One hundred and sixty five schools are spending over €50,000 a year renting prefabs. This would cover the mortgage on a permanent school building. Labour will change all that with a transparent building programme and replacing temporary prefabs." I hope the Minister will now honour his commitment, given when he was in opposition, and outline a clear road map for the provision of a new school for Scoil Chaitríona in Renmore.

Minister of State at the Department of Education and Skills (Deputy Ciarán Cannon)

I am replying to this Adjournment matter on behalf of my colleague, the Minister for Education and Skills, Deputy Ruairí Quinn. I thank the Deputy for raising the matter as it provides me with the opportunity to outline to the Dáil the Government's strategy for capital investment in school building projects and also to outline the current position on the building project to provide improved accommodation at Scoil Chaitríona junior and senior schools at Renmore, Galway.

The Government, in its programme for Government, is committed to drawing up a new national development plan that reflects Ireland's changed economic circumstances, covering the seven-year period 2012-19. The plan will be based on a comprehensive study of Ireland's public investment priorities in that period. In the initial years, when resources will be most heavily constrained, the programme for Government commits to prioritising investment in a number of specific areas, including school buildings. The Government will insist that major capital projects are subjected to proper cost-benefit analysis and evaluation, improving future productivity and growth prospects, and that the value for money obtained is significantly enhanced compared to the most recent period. Modernising facilities in our existing building stock as well responding to the emerging needs in areas of rapid population growth will continue to be a significant challenge.

All applications for capital funding are assessed in the planning and building unit of the Department. The assessment process determines the extent and type of need presenting based on the demographics of an area, proposed housing developments, condition of buildings, site capacity and so forth, leading to an appropriate accommodation solution. As part of this process, a project is assigned a band rating under published prioritisation criteria for large-scale building projects. These criteria were devised following consultation with the education partners.

Projects are selected for inclusion in the schools building and modernisation programme on the basis of priority of need which is reflected in the band rating assigned to a project. In other words, a proposed building project moves through the system commensurate with the band rating assigned to it. There are four band ratings overall, of which band one is the highest and band four the lowest. Band one projects, for example, include the provision of buildings where none currently exists but there is a high demand for pupil places, while a band four project makes provision for desirable but not necessarily urgent or essential facilities, such as a library or new sports hall.

The project to provide new accommodation for Scoil Chaitríona junior and senior schools has been assigned a band rating of 1.2 under the published prioritisation criteria for large-scale building projects. The project commenced with a brief to provide an extension and refurbishment of the existing accommodation for both schools. The schools both occupy a restricted site in Renmore. A review of the initial brief took place in 2006 at which time it was decided it should be revised to provide for two new schools on the existing site.

Due to the significant expansion of the brief, it was deemed necessary to terminate the appointment of the existing design team and commence the process of appointing a new design team using the Official Journal of the European Union tender process. This tender process commenced in May 2007. However, due to competing priorities on the Department’s resources and the emerging need to concentrate on the provision of new schools in rapidly developing areas, this process was not completed. The project was not included in the school building work programme for 2011 published earlier this year by my predecessor.

The progression of all large-scale building projects, including this project, from initial design stage through to construction phase will continue to be considered in the context of the Department's multi-annual schools building and modernisation programme for 2011 and subsequent years. However, in light of competing demands on the capital budget of the Department it is not possible to give an indicative timeframe for the progression of this project to completion of tender and construction. I thank the Deputy for giving me the opportunity to outline to the Dáil the current position regarding the school building project for Scoil Chaitríona junior and senior schools in Renmore, Galway.

Foreshore Licences

Deputy Michelle Mulherin

I thank the Ceann Comhairle for allowing me to raise this matter. I welcome the Minister of State, Deputy O'Dowd, to the Chamber and wish him well. I hope he will have a long and fruitful ministerial career.

There has been a delay of several years in the issuing of a foreshore licence for the Killala sewerage scheme. This scheme is much needed and the delay arises even though there is already an outfall pipe that was used by private industry and which it is proposed will be used for the outflow from the sewerage scheme. In the meantime raw sewage is going into Killala Bay which is designated a special area of conservation as well as a natural heritage area for wild birds. As well as being a tourist attraction because of its scenic quality, the bay also attracts tourists as a place for deep sea fishing and is at the head of the River Moy, the most prolific salmon fishing river in Europe. The water quality in the Moy Estuary, which is part of Killala Bay, has been classified as moderate in the water basin management plan prepared under the water framework directive. This body of water is to be targeted for improvement under the management plan.

Why has there been a delay of many years in issuing the foreshore licence in this case? As I understand it, there are three other foreshore licences which remain to be issued in Mayo after significant delay, relating to works on slipways and another sewerage scheme. Delays in the issue of foreshore licences in general are of concern to us in Mayo where we are trying to tap into the huge wave energy off our coast as part of the county's renewable energy strategy which will also require a foreshore licence or licences in due course. The last foreshore licence issued in the county was to Shell in respect of the Corrib gasfield and it took only four months in that case. Clearly, where there is a will there is a way.

We have a new Government and a new Minister and I am hopeful there will be positive changes. In particular, I am hopeful that the bureaucracy surrounding the issue of foreshore licences can be tackled so that the delay in their issuing is no longer a stumbling block in the delivery of important infrastructure to regions, in particular the Killala sewerage scheme.

Minister of State at the Department of the Environment, Heritage and Local Government (Deputy Fergus O’Dowd)

Ba mhaith liom mo bhuíochas a ghabháil leis an Teachta Mulherin as ucht an t-ábhar seo a chur romhainn anocht. Tá sé an-thábhacht go dtiocfadh toradh maith as. I thank Deputy Mulherin for raising this matter. What is important is that we have a follow-up to this debate. I assure her I will bring her comments to the attention of Department officials tomorrow. It is vital that there is continuity and resolution if possible.

Following the enactment of the Foreshore and Dumping at Sea (Amendment) Act 2009, the Department of the Environment, Heritage and Local Government assumed responsibility in January 2010 for a range of foreshore consent functions, including outfall pipes from waste water treatment plants. The proposal by Mayo County Council to construct an outfall pipe in Killala Bay from the Killala waste water treatment plant was one of a large number of projects for which foreshore applications had been submitted and on which decisions had not been finalised or conveyed to the project promoters prior to the transfer of foreshore functions. The application for the foreshore licence was originally made to the Minister for Agriculture, Fisheries and Food in August 2007 and is in respect of the proposed use of an existing outfall pipe which was the subject of a foreshore licence granted to another licensee in 1976.

The scientific and technical advisers to the Minister for Agriculture, Fisheries and Food assessed the fresh application lodged in August 2007 and were satisfied, subject to specific conditions, to agree to the use of the existing outfall pipe as proposed by the council. However, the file did not proceed to the point where a formal submission was made to the Minister to grant the licence. Following the transfer of responsibility for the application to the Department of the Environment, Heritage and Local Government the case was identified for attention as part of a comprehensive caseload analysis of all files, including those cases on which there were lengthy periods of inactivity prior to the transfer.

The reassignment of the licence from the existing licensee has raised complex legal issues regarding title requiring legal advice before a determination of the licence application can be safely made. Advice was sought from the Chief State Solicitor's office in September 2010 and work is ongoing in that office to clarify the legal basis upon which the case can be carried forward. Accordingly, because of the nature of this case, it is not yet clear when the legal advices will be available to the Department to enable the application to be determined. I will be pleased to bring this issue to the attention of the Department tomorrow morning, together with the Deputy's comments, with a view to advancing the matter, which has been ongoing since 2007.

Departmental Funding

Deputy Gerald Nash

I thank the Ceann Comhairle for allowing me to raise this important issue for the people of the north east, an issue of which the Minister of State, Deputy O'Dowd, is well aware. It will be greatly appreciated by those who depend on the services and supports provided by the Drogheda-based Dignity 4 Patients that my colleague, the Minister of State, Deputy Shortall, is available this evening to convey the view of the Department of Health and Children and the Health Service Executive in regard to that organisation's current funding crisis.

The Garda is dealing with 120 cases of alleged sexual abuse perpetrated against patients of the struck-off medic, Michael Shine. Almost 250 cases of alleged abuse have been brought to the attention of the Dignity 4 Patients group in recent years. The House will be aware that Mr. Justice Smyth carried out a review into the handling of many of these cases and reported last year.

The organisation received funding from the State's health authorities to support those who came forward during and after the Smyth review. Since December 31, however, the funding has been stopped, at a time when the Dignity 4 Patients group and those depending on it most need it to be resourced. Dignity 4 Patients must be allowed the space and resources to do its job. I implore the Minister and the HSE to establish financial certainty for this organisation so it can be ensured those who are alleged to have suffered abuse in the public health system receive the support of the State, support to which they are entitled.

The delay in bringing cases against Michael Shine to the DPP and the frustration felt by alleged victims at the handling by the previous Government of the fallout and aftermath of the Mr. Justice Smyth review have contributed to a growing and legitimate sense of grievance and injustice. By committing to restoring State funding in line with the application the organisation has already made to the Department of Health and Children and the HSE, and committing to making available the resources required to bring closure to the torment undergone by victims, the Minister and Government would be sending out a strong message indeed.

In the absence of funding, Dignity 4 Patients has been forced to terminate staff contracts, drastically cut services and place the burden of responsibility on to the shoulders of one sole founder, who has in essence become a counsellor, a helpline operator, a campaigner and advocate, an administrator and an accountant. Given the pressure and emotional focus required to deal with cases relating to abuse of this nature, this situation is no longer sustainable. Victims are still coming forward and complaints and concerns continue to be expressed. As the Garda investigations continue, existing clients of the organisation require ongoing and consistent support and advocacy.

This organisation, those who lead it and those who work for it have acted courageously and often defiantly in shining a light into the darker recesses of a system that has failed to acknowledge the extent of the damage done to lives and, indeed, to communities by the alleged activities of the disgraced medical practitioner. I implore the Minister of State to restore a sense of hope for this organisation and for those who depend on it. I am asking the Department of Health and Children and the HSE to fund the Dignity 4 Patients group to provide the organisation and those relying on it for support with a degree of certainty for the future.

Minister of State at the Department of Health and Children (Deputy Róisín Shortall)

I apologise that written replies were not available until now. I do not know what glitch caused this but we will ensure this does not happen in future. I will be taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy James Reilly, and I thank the Deputy for raising this matter.

In 2010, a grant of almost €172,000 was approved from the Department of Health and Children's allocation of national lottery funds to Dignity 4 Patients. This was given towards the cost of providing information and support to victims of abuse wishing to attend the Drogheda review. This independent review was established by the then Minister for Health and Children to advise on whether any additional information or insights were likely to be achieved from a further full investigation. A former High Court judge, Mr. Justice T. C. Smyth, was appointed chair of this review. The report recommended that a further investigation should not be held and, to avoid prejudicing any civil or criminal cases, the report should not be published.

The Attorney General concurred with this advice but agreed that a short summary of the report could be prepared and published. Accordingly, the Department, in consultation with the Attorney General and Mr. Justice Smyth, prepared a summary which was sent for information to two patient support groups, including Dignity 4 Patients, in January 2011.

An application for funding for the current year has been received by the Department from Dignity 4 Patients. The HSE has also received an application for funding. The Minister is considering the application to his Department having regard to the services that the HSE already provides for victims of abuse. It is most important that any services supported by departmental funding are fully compatible and supportive of similar services provided by the HSE. The Minister will consider Dignity 4 Patients' request with that in mind.

It is also very important to ensure that appropriate counselling is available to all those who wish to avail of it. Both the Minister and the HSE are anxious that all former patients of the consultant are made aware of the free counselling support that is available. The HSE has arrangements in place for counselling support using the National Counselling Service, which provides individual, couple, family, group and psychosexual counselling. The NCS employs more than 70 counsellors and therapists who are highly qualified and experienced in working with developmental trauma. Clients can refer themselves directly by calling a free phone number. This service is a professional, confidential, counselling and psychotherapy service available free of charge in all regions of the HSE.

Persons affected by these issues, but who do not wish to avail of counselling, can also speak with a psychologist or counsellor in confidence. The need for additional support will be continually monitored by the HSE. The HSE has assigned co-ordinating responsibility for these matters to the regional manager for consumer affairs in the north east, who will continue to liaise as required with former patients and support groups.

The Minister will respond to the application from Dignity 4 Patients as soon as possible when he has had an opportunity to examine the matter fully. I thank Deputy Nash for raising this matter.

Hospital Services

Deputy Michael Colreavy

Ar dtús, ba mhaith liom mo bhuíochas a ghabháil le foireann iomlán Theach Laighean, na huiséirí, foireann riaracháin agus foireann na bialainne as an fháilte fhlaithiúil agus an tacaíocht a thug siad dom ar mo chéad laethanta sa Dáil. I enjoyed some latitude from the Ceann Comhairle this morning but I did not have time to thank the staff of Leinster House; the ushers, the catering staff, the one stop shop and the administrative staff who have given me a very warm welcome and have been very supportive during my initial days in Dáil Éireann. I deeply appreciate their very professional service. I also thank Deputies from other parties who have been very supportive to me as a new Deputy; I appreciate it. I also wish the Minister and the Ministers of State in the Department of Health and Children well in their posts because the public health care system has been laid waste by their predecessors and will need a lot of hard work to restore services to their proper level.

Sligo General Hospital is a special place to me and to those I represent in Sligo-Leitrim. I worked there for many years, all of my children were born there, my mother, Lord rest her, died there and my grandchildren were born there. I saw it grow from a small scale hospital with medical, surgical and maternity services to a hospital that had many specialties and top class clinical specialists. It serves the people of Sligo, Leitrim, west Cavan, south Donegal and north Roscommon. If there was a proper cross-Border health care system, it would also cover Fermanagh.

Until 2009, the hospital provided a consultant-led breast cancer service to women unfortunate enough to develop the condition. It was originally intended by the HSE in all its reports that Sligo General Hospital would be one of the centres of excellence for breast cancer services. The hospital had the required specialist staff and the necessary facilities available and was providing a service that, in measurable terms, reached a standard of excellence which matched or bettered that on offer at any other centre in the country or abroad.

However, in 2009 breast cancer services were withdrawn from Sligo General Hospital and transferred to University College Hospital Galway. Despite massive public protests in Sligo, Leitrim, Donegal and at the gates of Leinster House — at which I was in attendance — and the wealth of information and evidence which clearly underlined the quality of the services being provided at Sligo, the previous Minister for Health and Children proceeded with the transfer. She did so with the connivance of the Health Service Executive and its scapegoat, Professor Tom Keane.

The former Minister has now gone on her way and Professor Keane has returned to Canada. However, women in Sligo, Leitrim, Donegal and west Cavan who have cancer and their families continue to suffer. It is wrong that someone must spend up to six hours per day, five days per week travelling in order to obtain treatment in Galway. This should not be allowed to happen. In addition, it is scandalous that fine, hard-working staff at Sligo General Hospital are, on occasion, driven to tears as a result of the frustration they feel because they do not have time to provide patients with proper care.

It is not just cancer services which are at issue here. Some 60 orthopaedic beds have been closed at Sligo General Hospital during the past two years. The waiting lists are growing longer. That is scandalous, it is wrong and it should not happen. In the run up to the general election, the Labour Party and Fine Gael promised that cancer services would be restored to Sligo General Hospital. The Labour Party promised that this would be done within 100 days. There were no preconditions offered, the Labour Party stated that this was a red line issue when it came to its participation in Government. The target is 100 days and I am counting.

Deputy Róisín Shortall

I appreciate Deputy Colreavy's initial comments and thank him for them. I am sure the staff of the Houses also appreciate them. As everyone is aware, the staff are extremely helpful and supportive in the context of assisting new Members to settle in and I am sure that will continue to be the case.

I am taking this matter on behalf of the Minister, Deputy Reilly, and I welcome the opportunity to address the House in respect of it. In the first instance, I wish to refer briefly to some of the key changes envisaged for health services in the programme for Government. These changes will form the context for decisions on the way that health services are organised and delivered in Ireland.

This is the first Government in the history of the State to commit to developing a universal, one-tier health service. We are also committed to reforming our model of health care in order that much more care will be delivered in the community. In this way we will seek to reduce the cost of achieving the best health outcomes and, most importantly, ensure that access to medical care is based on need, not income. In all of these changes, the Minister is committed to ensuring that quality and optimal care are at the heart of our health services, including cancer services, which must be delivered in line with best practice in a safe and quality-approved setting.

In the context of cancer services, the programme for Government contains two important commitments. First, the Minister intends to oversee the introduction of a human papilloma virus, HPV, vaccination catch-up programme for girls in secondary school. The Minister has been on record for some time as having called for this vaccine to be made available to all girls attending secondary school and he now intends to ensure this happens. Second, the Minister wants to extend the BreastCheck programme to include women who are aged 65 to 69 years of age. I am aware that this is an issue of great importance to older women. Many campaigns were carried out in recent years in the context of extending the programme to those to whom I refer. The commitment in this regard is welcome. Both of these programmes are vital in terms of prevention and early detection, which are central elements of cancer control.

Many Deputies will be aware that in 2006 A Strategy for Cancer Control in Ireland was published. This strategy was developed following considerable work by a group of clinicians and other stakeholders in the national cancer forum. It set out the rationale for the restructuring of cancer services which paved the way for the establishment of the national cancer control programme. In the interim, there has been considerable change in the way cancer services in our hospitals, in particular, are organised. It is clear that services were too fragmented and that many clinicians were dealing with patient numbers that were too low to guarantee best outcomes. For this reason, the national policy has been to centralise cancer diagnosis and surgery in eight hospitals and at a satellite centre in Letterkenny, while ensuring that chemotherapy can continue to be delivered at a more local level. This is in line with international evidence which shows that the best outcomes for patients are achieved by specialist teams operating in specialist settings and with access to ongoing education, training, research and peer review.

Breast cancer diagnosis and surgery were transferred from Sligo General Hospital to University College Hospital Galway in August 2009. However, chemotherapy services have remained in place in Sligo and are linked with the necessary multidisciplinary team at Galway. The medical oncologist in Sligo participates by means of video conference in the multidisciplinary team meetings in Galway relating to both the symptomatic service and BreastCheck. A breast care nurse based in Sligo follows up locally on women with minor complications and provides ongoing support and breast care if necessary.

Other cancer services at the hospital were not affected by the change. Other than skin cancer — which usually involves minor surgery — and a limited volume of bowel and rectal cancer cases, the vast majority of other curative cancer surgeries have never been undertaken at Sligo and are routinely referred to one of the eight designated cancer centres.

Those who opposed the transfer of breast cancer surgery from Sligo point to the distances women must travel for services in Galway or Dublin. Those who support the decision argue that women only travel for initial diagnosis and surgery and that other key services including chemotherapy are provided in Sligo. They also note that women now have their surgery in a centre which has the minimum volume of new cases recommended under the national quality assurance standards for symptomatic breast disease.

Whatever one's view, this is a key decision that was not reached lightly. The Minister intends to meet Dr. Susan O'Reilly, director of the national cancer control programme, in the near future. At that meeting, he will discuss with her a range of strategic issues relating to cancer services, including the best way forward for the provision of breast cancer services at Sligo. The Minister is committed to ensuring that the quality of care and outcomes is of paramount importance in decisions relating to health policy and cancer services. This principle will underpin all of the decisions to be made, including those relating to breast cancer services at Sligo General Hospital.

The Dáil adjourned at 9.30 p.m. until 10.30 a.m. on Thursday, 24 March 2011.