Dáil Éireann debate -
Wednesday, 13 Jul 2011

Vol. 738 No. 3

Adjournment Debate

School Books

Deputy Michael Healy-Rae

The cost of school books has been a sore issue for parents and students for generations. In today's harsh economic climate the high costs have never been more relevant. School book publishers have always defended their prices, quoting the high development costs of a new book and the high printing costs to name but two factors, www.educate.ie, a subsidiary of Walsh Colour Print, entered the publishing market last year and took 70% off the cost of books of past examination papers. A total of 420 schools purchased books of examination papers from www.educate.ie. Straight away, Smurfit Edco and Folens were able to reduce the prices of their past examination papers by up to 30%. They did not reduce their textbook prices because there is no real competition in the marketplace. The Minister met with the publishers and they refused to lower the cost of text books. Did he ask them why they were able to reduce the cost of past examination papers when they had to compete with educate.ie? Is the Minister aware that the publishers have plans to reduce the cost of their examination papers even further again this year to force educate.ie out of the market? I urge him to ask the Competition Authority to investigate the action of Smurfit Edco and Folens in this regard.

www.educate.ie has just published five new textbooks. Its books are now on book lists across the country. Even the highly prestigious Blackrock College has one of its books on the school's book list. A total of ten new titles will be added every year until the syllabus is covered. The entire syllabus will be covered over the life of this Dáil. All of the textbooks will cost €12 or less. I question why the Minister is talking to publishers that have ripped off the Irish public for generations but he will not talk to www.educate.ie. He refused to meet the company at the TUI conference in Tralee and he refused to meet it last month in Dublin.

Is the Minister aware that www.educate.ie textbooks would be cheaper than second-hand books in the proposed book rental scheme and that the State would have to pump in excess of €50 million into any meaningful book rental scheme? Why does the Minister not work with www.educate.ie or other such companies to save the country millions? If that were to happen pupils would be able to afford their own new books and not have to make do with ragged hand-me-downs.

Is the Minister aware that publishers add more than 1,000% onto the cost of printing a school book? Most of the printing work goes abroad. Is he also aware that publishers are one of the parties that have run the Irish printing industry into the ground? Is he further aware that €100,000 was spent on the development of www.educate.ie’s new biology book which only costs €12 compared to €36 for a textbook by established publishers? Surely meaningful competition is the only long-term answer not pumping millions into a book rental scheme.

I previously raised the issue in April. I thank Mr. Ferghal Blaney who rightly reported the matter on the front page of the Irish Daily Mail.

It is astonishing to read the headline: "[P]arents charged up to €40 for books now on sale for just €12." At a time when parents are struggling to make ends meet and to educate their children properly, surely it is of major importance to this Government and to the junior Minister who is here — I appreciate his being here — to ensure the market is opened up and that we do not have a cosy cartel, which is what we have had in the past. What has gone on in the past is wrong; it is a rip-off. Parents have been robbed. I would appreciate it greatly if the Government would do something about this. If it is to do one good thing for the parents of schoolchildren, it should be to bring down the cost of books.

I am not here to advocate on behalf of www.educate.ie just because it is a company from Castleisland, County Kerry, providing much needed jobs, which of course we appreciate. I am not just flying the flag of one company. If there are other companies in the printing business that can compete, it should be opened up; the more competition the better. However, these publishers have led the way in proving that they can produce a high-quality product at a knock-down price while providing jobs for people in our country rather than sending the printing abroad as has happened in the past. I would appreciate support from the Government in this regard.

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

I am taking this matter on behalf of my colleague, Deputy Ruairí Quinn, the Minister for Education and Skills. I thank the Deputy for raising the matter and providing an opportunity to outline the position with regard to the cost of school books.

I am aware of the concern expressed by many parents and organisations, including the Society of St. Vincent de Paul, about the high cost of school books and the frequent rate of revisions by book publishers. In response to a recent parliamentary question, the Minister stated his intention to meet with book publishers and representatives of parents to discuss this important issue in greater detail. The Minister met with representatives of parents, the Society of St. Vincent de Paul and the Irish Book Publishers' Association on 22 June. All members of the Irish Book Publishers' Association, including www.educate.ie, were invited to send a representative to the meeting with the Minister; however, no representative from that company expressed an interest in attending. The meetings provided an opportunity to obtain the views of these groups. At the meeting with publishers, the Minister urged them to minimise the number of changes in textbooks, to avoid the publication of new editions where only minor changes were involved and to consider closely the cost of the books they supply to the market. The publishers have agreed to reflect on the concerns raised by the Minister and he is currently awaiting a formal response from them.

The Minister is currently examining how best to encourage schools to establish book rental schemes, and has asked the National Parents' Council to provide him with examples of good practice they have encountered in this regard, which he intends to circulate to schools. The Department of Education and Skills has provided grants of €15 million this year to first- and second-level schools towards the cost of school books. Primary schools received a per capita grant of €11, or €21 in the case of pupils enrolled in DEIS schools, while second-level schools received a grant of €24 per pupil, or €39 in the respect of pupils enrolled in DEIS schools. Apart from a small number of prescribed texts at second-level, mainly in the case of language subjects, decisions on textbooks are taken at school level, so it may be necessary to encourage individual schools to take a more cost-conscious approach to the selection of books in their classes.

I sympathise with parents who are experiencing difficulty in paying for school books. The harsh economic reality means money is tight for many parents. It is for precisely for that reason the Minister will continue to encourage schools to establish book rental schemes as the most effective means of lowering the cost of books for all students. Many schools are already using the funding for books provided by the Department to operate successful rental schemes. I thank Deputy Healy-Rae for affording me the opportunity to respond on this matter.

Land Reclamation

Deputy Nicky McFadden

I thank the Minister, Deputy Hogan, for being here. I wish to raise the matter of land reclamation drainage works with reference to proposed new legislation requiring farmers to apply for planning permission for drainage of wetlands. Proposals under the Planning and Development (Amendment) (No. 2) Regulations 2011 will require farmers to apply for planning permission for drainage of wetlands, while the reclamation of farmland will in some instances require the approval of the Department of Agriculture, Fisheries and Food.

I understand responsibility for this matter rests with both the Department of the Environment, Heritage and Local Government and the Department of Agriculture, Fisheries and Food. To avoid EU fines of between €4,000 and €33,000 per day after 23 July, regulations are currently being prepared by the Departments. Farm bodies have expressed serious concerns over these reclamation rules, and I would like to highlight these concerns and ask that they be taken into serious consideration in advance of a final decision.

Farmer representatives were informed by officials on Friday that farmers with certain types of wetland will be required to seek full planning permission from their county councils for land drainage activities where the area exceeds 0.1 ha., or a quarter of an acre. A full-scale environmental impact assessment, EIA, will be required for drainage work on more than 2 ha — around 5 acres — of wetland. The organisations were told the new restrictions would apply to the Shannon Callows, turloughs, swamps, marshlands and river flood plains. If the screening shows that the work will have an impact on the environment, then a full EIA will be required. The removal of field boundaries such as hedges, the recontouring of land by infill, the use of uncultivated land or semi-natural areas for intensive agriculture and drainage and irrigation will all require Department clearance above a given area or threshold. Farmer representatives were also told that the new regime would apply to all lands and not just to ground that is deemed eligible under the single farm payment, SFP, scheme. However, farmers found to be in breach of the new rules could be subject to SFP fines under cross-compliance requirements.

The proposed change to the planning regulations under the Planning and Development (Amendment) (No. 2) Regulations 2011 is driven by a European Court of Justice ruling dating back to November 2008. This ruling found that Ireland's system of EIA screening for certain categories of agriculture and aquaculture-related projects was in breach of EU directives. I met representatives from the Irish Cattle and Sheep Farmers' Association in my constituency office on Monday and they expressed serious concern that land improvement projects would be shelved if the legislation as proposed went through. They would like clarification from the Minister for Agriculture, Fisheries and Food about the threshold levels and they wish to ensure the legislation will not prevent farmers from enlarging and developing their businesses. The issue should also be raised at the next EU Council of Ministers meeting so that a practical solution can be agreed between Ireland and the EU. Clarification is also needed on how much farmers will need to pay in order to apply for planning permission and to acquire EIAs.

While I recognise the importance of protecting the environment, we need to make sure there is not a bureaucracy overload that will result in farmers being unable to make improvements to their land. Worthwhile reclamation projects may be abandoned if the cost of an assessment is too high or if there is too much red tape to get through. We need land improvement measures to be made if the export targets of Food Harvest 2020 are to be reached. Any legislation introduced needs to take into account the significant contribution farming makes to the economy and the need to avoid unnecessary financial burdens on farmers.

Minister for the Environment, Community and Local Government (Deputy Phil Hogan)

I am progressing new planning regulations through both Houses which are required to deal with a judgment of the European Court of Justice in case C-66/06. The court found that in this case Ireland's system of environmental impact assessment for screening certain categories of agriculture and aquaculture related projects was over-reliant on size thresholds and did not take into account other relevant criteria such as the cumulative impacts of development and the location relative to sensitive sites. The environmental impact assessment directive requires member states to provide, in respect of projects or levels of development set out in annexe I of the directive, for an environmental impact assessment to be carried out before consent is given for a project to proceed. In respect of projects or levels of development set out in annexe II, the directive requires EU member states to determine through a case-by-case examination or the setting of national thresholds or criteria — which Ireland has done — whether the project needs to have an assessment carried out prior to a decision being made on whether consent should be given.

The activities affected by the judgment are the restructuring of rural land holdings, the use of uncultivated land or semi-natural areas for intensive agriculture and water management projects for agriculture, including irrigation and land drainage. The court decision necessitates a major reduction in the thresholds, both for the mandatory carrying out of assessments and screening of assessments of projects under the mandatory thresholds. In future certain activities, namely, the removal of field boundaries, converting semi-natural areas to engage in intensive agriculture and ordinary field drainage, will be regulated through a new consent process to be operated by the Department of Agriculture, Fisheries and Food. The drainage of wetlands will be retained to be dealt with in the planning system.

The principal purpose of the new planning and development regulations is to reduce the exempted development threshold for the drainage of wetlands from 20 ha to 0.1 ha and to reduce the threshold for a mandatory environmental impact assessment of the drainage of wetlands from 20 ha to 2 ha. The threshold of 0.1 ha in the case of planning permission will allow for minor access works and maintenance. Any more substantial development will require screening for an environmental impact assessment as part of a planning application.

The revised thresholds have not been arbitrarily chosen by the State. The European Commission has advised of numerous instances where significant damage to the environment has occurred on wetlands, even on a very small scale. For example, lands drained by a small ditch can severely impact on the local environment. The Commission concluded, following lengthy and detailed discussions with the two Departments, that the only way to fully provide for environmental impact assessment screening was to set the threshold at a level that would exempt only de minimis activities. Planning applications will be required in respect of drainage works below the planning threshold of 0.1 ha in cases where the drainage would have a significant effect on the environment. Similarly, an environmental impact statement will be required in the case of planning applications in respect of the drainage of wetlands below 2 ha in cases where it is determined that the drainage would have a significant effect on the environment. Specific guidance is being prepared by the two Departments to provide advice for planning authorities, farmers and other interested parties.

I understand the concerns of the farming community as articulated by the Deputy and the need to ensure an overly bureaucratic regime is not established. The State, however, must respond quickly and comprehensively to the judgment of the European Court of Justice. Otherwise, Ireland will be the subject of serious fines imposed by the Commission.

Hospital Services

Deputy Liam Twomey

The cardiac catheterisation laboratory, cath lab, at Waterford Regional Hospital offers patients in the south east vital cardiology services such as coronary angiography, the provision of pacemakers and stents and implanting defibrillators in patients who suffer from a range cardiac conditions. The service has only been operational for three years. Prior to this, patients in the south east had to wait weeks to have these procedures completed in either a Dublin or Cork hospital. These treatments are well advanced. For example, in Dublin a heart attack patient will have a stent inserted into his or her arteries within three hours of presenting in hospital. The cath lab in Waterford may have to return to the old-fashioned treatment of giving clot-busting drugs instead if its times are reduced from five days a week to two, which would be a regressive move. Such a move would also discriminate against patients in the south east because there are no plans to reduce similar services in any other part of the country. Will the Minister for Health stop this move to reduce the laboratory's times which will put patients at risk?

This is one reason the Minister should get rid of the Health Service Executive, HSE, and change health service delivery. Under the old health board structure, health services in the south east were under-resourced. When the HSE was established, it was to ensure patients in every part of the country would have equal access to services. This policy has failed utterly. When it comes to saving money, the HSE goes for the soft option of closing down efficient services in the south east. The cath lab in the south east can be provided at a lower cost but with the same quality of care provided in a similar laboratory in Dublin. Patients in the south east are also entitled to the same access to such a service as patients in any other part of the country. Will the Minister insist on the HSE re-examining where it is reducing health services?

If the cath lab in Waterford is closed, patients will be lying on beds in hospitals in Kilkenny, Clonmel and Wexford waiting to be transferred by ambulance to Dublin. Not only will this lead to a waste of resources in hospitals in the south east but patients will also be put at increased risk of having another cardiac event. A patient not treated in a timely manner will be left with more damage to his or her heart muscle and overall health. The attempt to reduce hours at this cath lab shows the HSE is not fit for purpose. It does not think radically about how it can improve the delivery of services or patient care. It simply closes down services that are easy to close instead of going after overall wastage in the health service.

Has the Minister received a proper reply from the HSE on why this service has been reduced? This provides an opportunity to examine how health services are run. The HSE is closing down services willy-nilly just because it suits it. Government policy is to see money following the patient. We need to pay all hospitals fixed amounts of money to provide services relative to the population size they serve. For example, 500,000 people live in the south east. The cath lab in Waterford should be expected to perform so many procedures a year relative to a population of 500,000. It should, accordingly, be allocated a budget to enable it to do this. Additional payments should be made to hospitals which are more efficient and delivering quality care and low cost services in order that they can undertake more procedures.

Under the current system, hospitals or regions are given lump sums and informed that they should spend these moneys over the course of a year. When they run short of funds, they are told to simply cut services. That represents the worst form of management. I became very annoyed when I discovered that the service to which I refer is to be cut, particularly when people spent years fighting to secure it.

Deputy Ciarán Cannon

I thank the Deputy for raising this important matter, to which I am replying on behalf of the Minister for Health, Deputy Reilly.

I assure the Deputy that the HSE has no plans to reduce cath lab services from the current level of provision. We all recognise that, in the particularly difficult circumstances the country is facing, hospitals are facing financial challenges in delivering acute services. Waterford Regional Hospital, like all other hospitals, must face these challenges in order to comply with its statutory obligations and remain within its allocated and agreed budget. That is no easy task. Waterford is pivotal to the provision of acute services in the south-east hospital network. Within a budget of almost €133 million and with a staff of over 1,700, the hospital's 2011 service plan sets out targets for the treatment of 23,000 inpatients, almost 20,000 day cases and over 149,000 outpatient attendances.

Waterford Regional Hospital has been achieving savings, through a variety of approaches to obtain better value for money. It is continuing to introduce efficiencies in how it carries out its business. For 2011, there is an increased focus on maximising income collection, a reduction in agency staffing, seasonal bed closures and the elimination of unrostered overtime. Other approaches include reductions in overtime and staff travel and subsistence, better use of generic drugs, more efficient use of locum doctors, using procurement deals negotiated nationally and implementing initiatives introduced under the public service agreement.

Significant investment continues at the hospital. The cardiac catheterisation laboratory — or cath lab — which is the subject of this Adjournment matter, was officially opened last year. Waterford Regional Hospital is now the designated regional cardiology intervention centre for a catchment area of over 460,000 people. HSE south prioritised the development of the cath lab to a five-day service in 2011 because it was recognised that the service needed expansion in order to support all the hospitals in the network. Additional funding of over €1 million has been provided to HSE south — bringing overall funding to almost €2.5 million — so that a five-day service might be provided at the lab. The Minister is pleased to confirm that the capacity of this service will be further developed as resources allow. This will assure Waterford Regional Hospital's role as a major centre for the diagnosis and treatment of cardiac disease.

As with all acute services, it is a matter for the hospital to ensure that the service is delivered in an efficient and effective manner within the agreed budget and in the context of the staff complement provided. The Minister is not aware of any intention to reduce the service from the funded five-day per week model. He welcomes the HSE's plan — details of which have been communicated to the Department of Health — to continue to run the lab on a five-day basis for the remainder of the year in line with its funding and service plan requirements.

Deputy Catherine Murphy

I thank the Ceann Comhairle for allowing me to raise this matter. There appears to be a serious problem at St. James's Hospital, which is a centre of excellence for the provision of cancer care. I was contacted by three men in the past couple of weeks who have all been diagnosed with prostate cancer and all of whom require surgery. In the middle of May, one was informed that his surgery would take place in six weeks. Now his procedure has been postponed until the end of July. However, it is not definite that it will be carried at that time. Another of the men to whom I refer was due to go for surgery this week but he has been told to ring on the day before or on the morning on which the procedure is scheduled to take place. This individual has been informed that the procedure may, in fact, be postponed.

The third man by whom I was contacted is awaiting a date but has been told that he should not worry because his cancer is of a type which is slow to develop. The difficulty is that this person has been informed by some individuals that there can be a delay of months in respect of the surgery he requires. He has been told that he should not worry but how can one not worry when one has been diagnosed with cancer and when one requires surgery? That is nonsensical.

As already stated, St. James's Hospital has been designated as a centre of excellence. Patients were diverted from St. Luke's in order to ensure that there would be such a centre and a major argument developed in respect of that matter. If better outcomes are to be achieved, adequate resources must be provided, particularly in acute situations such as that to which I refer.

What is the point in obtaining an early diagnosis if such a diagnosis is not responded to? Everyone will remember the well-publicised controversy which arose a number of years ago in respect of cancer diagnoses. My husband was diagnosed with colon cancer some years ago, a few weeks after I was first elected to the House. He is doing very well now but one of the lessons I learned from what happened to him is that once the surgery was carried out, it was possible for him to adopt a positive mental attitude because he was not focusing on his cancer but rather on his recovery. The men to whom I refer are not being allowed to focus on their recoveries.

There is something seriously wrong when we have designated a centre of excellence and when certain surgeries cannot be carried out there. I telephoned St. James's Hospital and spoke to a nurse in the admissions section of the relevant unit. I felt sorry for her. She informed me that she is on the front line and that every day she is obliged to postpone operations and deal with the people who are continually arriving — by ambulance and by other means — from different places throughout the country. She is completely frustrated. It is not, therefore, just a case of my being informed by the three men to whom I refer that a difficulty exists. A person who works on the front line at the hospital informed me that there is a serious problem there.

I request that the Minister talk to the people who run St. James's Hospital in order that he might be satisfied that the service to which I refer can be provided to those who require it. This matter does not even relate to cutting costs. The longer someone must wait for surgery, the longer he or she is out of work and the longer his or her recovery will take. It is not a question of money, there is something seriously wrong with regard to the way the service in question is being delivered.

Deputy Ciarán Cannon

I am taking this matter on behalf of my colleague, the Minister for Health, Deputy Reilly. I welcome the opportunity to address the House on the provision of cancer services, including surgery, at St. James's Hospital.

The burden of cancer continues to increase. This year, approximately 24,000 people will be diagnosed with invasive cancer. Each year an average of over 2,600 men are diagnosed with prostate cancer, making it the most common cancer in Irish men other than non-melanoma skin cancer. While approximately 500 men die from the disease each year, it is encouraging to note that estimated five-year relative survival for those diagnosed with prostate cancer in Ireland is now over 89%.

The HSE's national cancer control programme aims to address the challenge of cancer in Ireland. The programme's goals are better cancer prevention, detection and survival through a national service based on evidence and best practice. St. James's Hospital is one of the eight designated cancer centres under the programme. It provides cancer diagnosis, including a rapid-access prostate clinic which is designed to enhance access to early diagnosis and multidisciplinary decision-making, surgery and medical oncology.

Radiation oncology services are now also provided on the St. James's campus in a new unit opened in April 2011. This unit, St. Luke's Hospital and a second new unit on the site of Beaumont Hospital form the St. Luke's radiation oncology network. The development of this network means an overall increase of 50% in radiation oncology capacity over what had previously been available in the eastern region. The new centres reflect the latest advances, equipment and expertise available internationally.

In recent weeks St. James's Hospital has experienced a significant number of patients awaiting discharge to community beds. This means that fewer beds have been available for emergency or elective accommodation and this had knock-on effects in respect of scheduling of elective surgery, including treatment for prostate cancer.

With regard to prostate cancer surgery at the hospital, the national cancer control programme has advised that of the 40 elective urology surgeries booked at the hospital between 1 June and 11 July this year, seven were cancelled. In one instance, the cancellation was due to the fact that the patient did not attend. One of the seven patients affected by the cancellations has already been admitted and treated, while the other six have a date for surgery within the coming three to four weeks. I am pleased to say, on behalf of the Minister, that the hospital now anticipates an improvement in access to prostate surgery as the number of delayed discharges declines.

The latest delayed discharge report already shows a reduction in the number of delayed discharges nationally. The Minister has been advised that the HSE has approved 25 patients for transfer from St. James's Hospital under the nursing homes support scheme since early July. These transfers are now being effected, which will reduce congestion and allow elective prostate cancer surgery to proceed. It is also important to note that St. James's Hospital has confirmed that there is no issue in respect of the resourcing of necessary surgical capacity for these patients or for other cancer patients.

The Dáil adjourned at 9.30 p.m. until 10.30 a.m. on Thursday, 14 July 2011.