Dáil Éireann debate -
Tuesday, 15 Nov 2011

Vol. 746 No. 3

Topical Issue Debate

Sale of Booterstown Marsh

Deputy Mary Mitchell O’Connor

I raise the sale by NAMA of land known as the Ash Castle site on the border between Dún Laoghaire-Rathdown County Council and Dublin City County Council. The site is adjacent to Booterstown Marsh which is a nature reserve. I refer the Minister of State to page 8 of the properties subject to the enforcement action of NAMA on the NAMA website. However, if the Minister checks the NAMA website he will notice that the actual address given is Booterstown Marsh which is not the name of the site. As a public representative I have a major problem with this notice for sale. The NAMA website states that this site is not for sale at present but I am informed that the site has been sold subject to planning permission.

Along with many of my constituents in Booterstown-Blackrock I am very concerned that this was not an open and transparent advertisement for the sale of Ash Castle. I am not casting aspersions on the purchaser which I believe is a sporting organisation. What I am concerned about is the process used. Was this an open and transparent sale? Did NAMA, in giving a misleading address, hinder others' bids for this piece of land? Is it the case that other houses, lands and apartments for sale displayed on the NAMA website are shown with misleading addresses? Finally, and most important, is the taxpayer getting the best price for properties bought on their behalf by NAMA and now being sold by NAMA?

I understand the sensitivity of sales under NAMA but I am concerned that in giving misleading addresses or limited information on properties for sale NAMA is constraining ordinary people from knowing what is for sale and bidding on these properties. NAMA is the largest property holding company in the world and I am deeply concerned that purchasers, vendors in the know or an inner circle have the inside track and are able to bid and purchase properties the general public do not know are for sale. I am aware of at least one other example which has been reported where this is happening.

To allay the public's disquiet that deals are being made by NAMA on behalf of a small circle in the know I ask that the Minister insist that NAMA puts onto its website, first, the exact and correct address of property for sale; second, the guide price for property for sale; and, third, the sale price achieved for properties sold by NAMA. I also want to be assured that sites and properties for sale by NAMA are advertised publicly in newspapers and by estate agents in an open and transparent manner.

Minister of State at the Department of Public Expenditure and Reform (Deputy Brian Hayes)

I thank Deputy Mitchell O'Connor for raising this important matter. NAMA has a commercial remit and a statutory objective to generate a return for the taxpayer, as I am sure the Deputy is aware. However, in the context of its commercial remit and consistent with section 2 of the National Asset Management Act 2009, NAMA is at all times open to considering proposals aimed at contributing to broader social and economic objectives.

I am informed by NAMA that the property concerned is among the properties listed on the NAMA website and that the property has been offered for sale by a receiver appointed by NAMA. While the property is not owned by NAMA, I understand the receiver has an obligation to secure the maximum proceeds for the debtor to ensure that to the greatest possible extent debt outstanding against the assets can be repaid.

I am informed by NAMA that it expects the current value of the property to be determined by the receiver in line with his obligations. I also understand that the receiver has received offers from potential purchasers. Any additional expressions of interest, including from public authorities interested in making an offer on the site, can be directed towards the receiver, Mr. Declan Taite of RSM Farrell Grant Sparks. The e-mail address is [e-mail]. All offers made will be submitted by the receiver to the National Asset Management Agency for the final decision as to which of them should be accepted.

The NAMA board has confirmed its policy of giving first option to State bodies on the purchase of property which may be suitable for their purposes where these bodies have requirements such as schools, hospitals, parks and so forth. Thus, where a State body can match any alternative financial offers, NAMA would be disposed to the body in question acquiring the asset. In the context of this policy and in view of the land's proximity to the Booterstown Marsh and Nature Reserve, I expect that NAMA will consider any offers which may be submitted by the relevant public bodies before making its final decision.

In the context of contributing to wider social and economic objectives, NAMA concluded the sale of 58 social and affordable units to the Cluid housing association in July of this year. The agency has also provided a list of more than 1,000 properties to the Department of the Environment, Community and Local Government and I am informed it is in discussion with the Minister of State with responsibility for housing, his officials and the Irish Council for Social Housing with a view to identifying properties which may be suitable for social housing. I understand NAMA has also had contact with officials of other Departments and agencies, such as the Department of Education and Skills, Health Service Executive, local authorities and other public bodies. In addition, I am aware that the agency has approved the release of lands in Baldoyle to Fingal County Council for extra parklands, accommodated the sale of a 13 acre site in Hansfield West, Dublin, to the Department of Education and Skills and agreed to co-fund with Fingal County Council a link through lands that NAMA has as a security for loans in west Dublin which will link the N2-N3.

The NAMA chairman recently informed the Joint Committee on Finance and the Public Service that engagement with community groups on issues of concern to them continues to take place. He also informed the joint committee that while NAMA may not give away land or property, should a community group have an interest in a particular piece of land or property or wish to extend a sports pitch, it should speak with the agency. Any local community organisation which has a proposal that it wishes to put to NAMA should contact its portfolio management unit. The agency is engaging with the public sector and wider community in terms of social and economic objectives. I stress, however, that parties interested in purchasing the property near Booterstown Marsh should contact the receiver.

Deputy Mary Mitchell O’Connor

I thank the Minister of State for his comprehensive answer. Page 8 of the NAMA document listing properties subject to enforcement action states that Booterstown Marsh is not for sale at present. Many people in the Booterstown and Blackrock areas have been informed that the site in question has been sold subject to planning permission being secured. I am deeply concerned that the site was not placed on the market in the conventional sense, as has been the case with many other properties. As I stated previously, I am aware of a case in the South where a property is being bought by the vendor. I am concerned that taxpayers will lose out as a result of such transactions. Rather than securing the maximum price, an inner circle appears to be purchasing properties held by the National Asset Management Agency.

Deputy Brian Hayes

Having listened carefully to the Deputy's comments, it is important for the purposes of clarity that a transcript of her contribution be submitted to the National Asset Management Agency at the conclusion of business. The head of the property portfolio division of NAMA could then reply to her directly. It is a matter of law that the agency's only interest in the assets in question is to extract the highest possible price on behalf of the taxpayer. Where one has a triangular relationship between NAMA, a receiver acting on behalf of the creditors and the owner of the land or property, the objective of the receiver is to obtain the highest price through all possible means. The only legislative obligation on NAMA is to maximise the return for taxpayers.

Deputy Mitchell O'Connor has placed important information on the record. I will ensure a copy of her contribution is transmitted to the National Asset Management Agency. If there are issues the agency would like to address with her, it should do so directly.

Banking Sector Regulation

Deputy Niall Collins

I thank the Ceann Comhairle for selecting this topical issue for discussion. We are all aware of public disquiet in recent weeks and days concerning the failure of banks to pass on a reduction in the European Central Bank interest rate, although Allied Irish Bank changed tack after several days. This is an issue of major concern because members of the public appreciate that the purpose of the ECB decision to reduce the cost of its funds was to help people who find themselves in distress and stimulate growth and spending in the European economy.

Most of the debate on this issue has centred on distressed mortgage holders and others who find themselves under pressure as they try to discharge their mortgage obligations and liabilities. An important issue has, however, gone under the radar, namely, the decision by Bank of Ireland to notify business people who hold commercial mortgages and properties of a change in policy. The change gives effect to one of the terms and conditions in the small print of the original mortgage. As a result, the bank has changed the basis on which the interest rate is calculated from the EURIBOR rate to what is known as a "cost of funds" rate. The net effect of the decision has been to increase the interest rate being charged to commercial customers of Bank of Ireland by 0.7%, which is a significant amount.

Those affected are primarily business people and farmers. I have been informed by individuals working in the banking sector that many people acquired large mortgages when they purchased or extended their farms in recent years. Business people, who are under pressure as a result of problems accessing credit, declining footfall and a reduction in spending power, are being squeezed again by the decision of Bank of Ireland to enforce a clause in the small print of mortgage contracts for commercial customers. Was this matter discussed when the Economic Management Council met representatives of the banking sector last week? While I appreciate the Minister of State, Deputy Hayes, did not attend the meeting in question, I am sure he has been briefed by the four members of the Government who were present.

This issue is significant for another reason. There is a lobby to eliminate tax shelters for people who hold commercial mortgages. Many people invested and planned their businesses around the various tax shelters which were offered in the past. The Department of Finance is carrying out an impact assessment on the effects of any measures which would abruptly eliminate or phase out these tax shelters. If these shelters do not run for the lifetime envisaged for them, business people will come under more pressure as tax liabilities not foreseen in their business plans will be triggered.

What engagement, if any, has the Government had with the banks from the perspective of business people and farmers? The House has correctly had extensive debates on personal mortgages and debts. The decision by Bank of Ireland to increase the interest rate which applies to commercial customers will cost a significant amount. An example given by the bank showed that the monthly repayment on a seven year mortgage of €480,000 would increase by approximately €350, a significant amount of money that will drag on cashflow.

Deputy Brian Hayes

I thank Deputy Collins for raising this important issue and giving me the opportunity to place on record my position and that of the Department of Finance.

On the issue of lending in general, the Government has imposed lending targets on the two domestic pillar banks for the three calendar years, 2011 to 2013, inclusive. Both banks will be required to sanction lending of at least €3 billion this year, €3.5 billion next year and €4 billion in 2013 for new or increased credit facilities to small and medium sized enterprises.

Both pillar banks have provided me with their plans to ensure that the 2011 target is achieved. This is particularly relevant given the comments contained in the fifth quarterly report of the Credit Review Office, which state that "it will be a challenge for each of the banks to reach their €3 billion sanction target for new and restructured facilities in the current year."

In an effort to recoup some of its higher input funding costs, Bank of Ireland is changing the method of calculating its interest rate on its term lending facilities from the current EURIBOR derived reference rates to a reference rate based on "bank cost of funds".

The decisions financial institutions operating in Ireland make on the interest rates they charge to customers are commercial decisions for the institutions concerned. Interest rates are determined by a broad range of factors including ECB base rates, deposit rates, market funding costs, the competitive environment, and an institution's overall funding. As in the case with mortgage interest rates, the Government has no statutory function on business interest rate decisions made by individual lending institutions at any particular time.

I appreciate that this increase may be difficult for some business customers to absorb. The Deputy makes a valid point about very small businesses, especially the farming community, and the degree to which those businesses can remain viable on the basis of existing commercial mortgages. I understand the bank has written to its business customers inviting them to contact their respective relationship managers who will assist them in managing the impact of this change and look at potential solutions for their businesses.

In his report of 11 November 2011 to the Taoiseach on the issue of passing on mortgage interest rate adjustments following ECB actions, the Financial Regulator and the Deputy Governor of the Central Bank stated that the power to exercise close regulatory control over retail interest rates is not sought by the Central Bank. Similar principles apply to business interest rates. The Deputy Governor has indicated that the Central Bank will, within its existing powers and through suasion, engage with specific lenders which appear to have standard mortgage variable rates set disproportionate to their cost of funds. He has indicated that experience of such controls in the past and in other countries does not encourage the Central Bank to believe that such a regime would be advantageous in net terms as the banking system recovers its normal functioning. Binding controls tend to reduce availability of credit and channel it to the most creditworthy customers, starving smaller and less secure customers from credit. The regulator indicates that this could have a chilling effect on the entry of sound competitors into the market. By absolving banks from their responsibility to price risk accurately, binding interest rate controls would, especially during this recovery phase, impede progress towards the re-establishment of bank management practices that can ensure a healthy and free-standing banking system no longer dependent on the Government for bailouts.

In conclusion, it is vital that the banks continue to make credit available to support economic recovery. However, it is not in the interest of the banks, businesses or the economy for finance to be provided unless the business is viable and has the capacity to meet the interest payments and repay the sum borrowed.

The Deputy asks a fundamental question. Was this raised at last week's meeting? My understanding is that it was, as part of myriad other issues raised by the Taoiseach, the Tánaiste and the Ministers for Finance and Public Expenditure and Reform. The management of the three banks in questions were specifically asked to come in and outline their plans on SME funding, following the funding commitment they gave to the State once recapitalisation emerged. This was one of the issues raised and we will continue to pursue it through the regulator and the Department of Finance.

I appreciate the point made by the Deputy. Significant businesses can remain once credit lines are there. He makes a valid point. If the rules of commercial lending are changed, albeit to small businesses, it can have a profoundly negative effect on that business. I can assure the Deputy this issue was raised.

Deputy Niall Collins

I thank the Minister of State. The reality is that the Bank of Ireland is trying to recoup its losses on tracker mortgages, so the Government needs to look at this. Perhaps the Minister of State can take that message back to the Department of Finance.

I am told that the regulator and the Central Bank signed off on this change in interest calculation policy. Can the Minister of State confirm that for me? I appreciate he might not have the answer with him tonight, but perhaps he can send it to me by email or through written correspondence.

Does the Department have any engagement with the public interest directors? They are coming back into the spotlight, following the mortgage and personal debt issues that were discussed last week and this week in the Dáil. They also got a mention today during Leaders' Questions. Will the Government be engaging directly with those public interest directors? Can the Minister of State and his colleagues talk to them directly on this issue and others, especially in respect of Bank of Ireland?

Deputy Brian Hayes

The Deputy will have seen the action taken by the Government last week in respect of AIB, 98% of which is owned by the State. The same cause and effect is not as obvious when it comes to Bank of Ireland, in which the State has only a 15% holding, while Ulster Bank has no relationship with the Irish taxpayer or the ECB, because it is funded internationally. When public interest is in line with Government policy, the public interest directors will ensure the Government's view is understood by all concerned.

I thank the Deputy for his question on whether the regulator signed off on the change in interest calculation policy. I will get the answer for that. We have an independent regulatory system here. It is important that politicians understand the difference between independence on the one hand and where we have to act on the other hand. The key issue is to use common sense to make sure that we have a profitable banking sector where we can recoup the moneys we have put into these banks, but also to ensure fairness. The objective of a reduction in ECB rates is to get lending going again and to get domestic economies across the eurozone going again. It makes no sense if banks do not pass on those rate reductions, either to their commercial customers or their mortgage customers.

Northern Ireland Issues

Deputy Gerry Adams

Tá mé an-bhuíoch don Cheann Comhairle mar thug sé seans dom caint ar an ábhar tábhachtach stairiúil seo.

The families of the 11 victims of the British Parachute Regiment, who were shot and killed in the Ballymurphy area of west Belfast in the three days after the introduction of internment in 1971, are looking to the Irish Government for solidarity and active political support in their campaign for justice. Few in this Dáil can imagine the terror and the trauma that families in Nationalist areas of the North endured when internment was introduced. Thousands of homes were raided and ransacked, prisoners were tortured and working class areas were under military occupation by the British Army. Fewer still can understand the horror which 11 families in Ballymurphy suffered as they discovered that their loved ones had been shot and killed by British soldiers, or the torment, frustration and anger they experienced as the British state moved to ensure that the legal and judicial system covered up what had happened.

Of the 11 who died, ten were men, including a local priest, and the eleventh was a mother of eight. I am from Ballymurphy. These citizens were my neighbours. Fr. Hugh Mullan was my priest. These killings left 46 children without a parent. Many of these children were evacuated to this part of the island, mostly to military camps as refugees. Briege Foyle and her sister were in Waterford when an RTE television news bulletin informed them that their mother had been buried that day. Briege described it thus.

[It was] like a nightmare. We couldn't grasp it...We stayed with relatives but cried to go home. We imagined home would be like it always had been but it wasn't. It was an empty shell without our mummy. We had already been through a terrible ordeal but it didn't stop there. The paratroopers continued to torture us. They used to sing "where's your mama gone" outside our door and you couldn't walk down the street without them taunting you. We were all so terrified.

None of the dead was connected with or in any way part of any armed group. They were all unarmed citizens. The success of the British State in covering this up meant that Ballymurphy became a forgotten massacre. Now, as adults, the children and surviving siblings of those killed want the names of their loved ones cleared, and they want the Minister's help and that of the Government to do this.

The news yesterday that the North's Attorney General has ordered new inquests in ten of the 11 cases is to be welcomed. This is a landmark legal judgement that provides the families with an opportunity to get to the truth of the killing of their loved ones. The decision by the Attorney General is also evidence of the importance of having policing and justice powers transferred from London to Ireland. However, the families believe that the role of the British State and its armed forces warrants a full, thorough international investigation and an apology from the British Government which recognises their innocence. Will the Government support them and join them in demanding this investigation?

Minister of State at the Department of Foreign Affairs and Trade (Deputy Jan O’Sullivan)

I thank Deputy Adams for raising this, which is one of the darkest episodes in the history of the Troubles. It occurred on 9, 10 and 11 August 1971 in Ballymurphy, West Belfast. Eleven people were shot dead, as the Deputy has said, by British security forces over these terrible three days, and the trauma of this continues to be felt by the families of the victims. In a very real way, the people of Ballymurphy and Springfield continue to live with the legacy of those three days and struggle to this day to come to terms with such a devastating loss of life within their community — indeed, within the Deputy's own community. I would like to take this opportunity to put on record an expression of deep sympathy to the families of the victims and to their neighbours and friends who continue to grieve for their lost loved ones.

The families, friends and neighbours of the 11 victims have come together to create the Ballymurphy Massacre Campaign to co-ordinate their efforts to seek justice. In November of last year, members of the campaign travelled to London to petition MPs on behalf of the campaign. On 16 March this year another family member testified in Washington before the US Helsinki Commission, which monitors compliance with the Helsinki Final Act and other OSCE commitments, and this provided the campaign with an opportunity to highlight its quest internationally. The campaign has not been easy, and despite the 40-year anniversary of the killings this August, the families have yet to achieve the closure they justly deserve.

The Government has sought to assist the Ballymurphy Massacre Campaign in its quest for justice. Officials from the Department of Foreign Affairs and Trade maintain frequent contact with the campaign and its legal representatives, and they have met on a number of occasions this year. On 23 March 2011, shortly after assuming office, the Taoiseach made clear that he was prepared to meet with the families of the victims. A meeting between officials from the Department of the Taoiseach and the Ballymurphy Massacre Campaign was held in June to prepare for this meeting with the Taoiseach.

At present, the killings in Ballymurphy are being investigated by the historical inquiries team, HET, which was established in September 2005 by the then PSNI Chief Constable, Hugh Orde, with the aim of reviewing each of the deaths that occurred in the North during the Troubles. While I understand that the families have some misgivings about the HET process in its current format, I hope some good comes from these reports. More positive has been the announcement today that the Attorney General for Northern Ireland has ordered the reopening of ten coronial inquests into the events at Ballymurphy. I hope these reopened inquests can help to uncover more details and provide some measure of closure. The Government remains committed to assisting the Ballymurphy Massacre Campaign in its search for justice and will continue to support it.

Deputy Gerry Adams

I thank the Minister of State for her commitment to assist the campaign and continue to support the families. I know I have very little time, but I want to read this into the Dáil record. The failure to expose this massacre at the time it occurred meant that the same regiment left Ballymurphy, went to Derry and killed 14 innocent civilians there. They then came back to Belfast, killed a 14 year old boy in Lenadoon, a 17 year old in Clonard, a student teacher in Divis and two men on the Shankill Road. In 1972, six months after Derry's Bloody Sunday, they shot five people in Springhill, which is the area adjacent to Ballymurphy, including another Catholic priest. Of the four others killed, three were teenagers and the last was a father of six. In 1973 they killed five people, one a 12 year old boy, in north Belfast, while in south Armagh a 12 year old schoolgirl was shot dead.

The pattern is clear. This was the British Army doing what the British Army does and what all armies do in these situations. All of these people were innocent civilians, and their deaths were part of a planned counter-insurgency strategy by the British Government to pacify the population. These are heartland republican areas. The British soldiers had carte blanche to kill, torture and terrorise with legal and judicial impunity.

This matter cannot be ignored any longer. The Ballymurphy families want a full, thorough international investigation. They have rejected the HET process and I support them in that rejection. I will repeat what I have said before: the needs of all victims of the conflict must be dealt with. As well as victims of the British State and of Unionism, there are victims of the IRA, including victims in this part of the island. We saw this being raised during the recent presidential election. All of these victims need to have closure and be part of a healing process. Sinn Féin has proposed that the Irish and British Governments invite a reputable and independent international body to establish an independent international truth commission as part of a viable truth recovery process.

I would like, if I may, to read into the record the names of those killed in Ballymurphy: Fr. Hugh Mullan, who was 38 years old; Frank Quinn, 19, a father of two; Joan Connolly, 50, a mother of eight; Daniel Teggart, 44, a father of 13; Joseph Murphy, 41, a father of 12; Noel Phillips, who was 18; Eddie Doherty, 28, a father of four; John Laverty, who was 20; Joe Corr, 43, a father of six; John McKerr, 49, a father of two; and Paddy McCarthy, who was 44 years old. I once again implore the Government to assist and support the families' campaign and their demand for a full independent investigation.

Deputy Jan O’Sullivan

I reiterate the Government's support for the Ballymurphy families in their search for justice and truth. The officials are in constant contact with the families and their legal representatives and the Taoiseach has indicated his willingness to meet them as well. There is ongoing work, as the Deputy knows, within Northern Ireland and by the British and Irish Governments with the aim of getting at the truth of what has happened in the past. We will continue to focus on ensuring that this work is as effective as possible. I thank the Deputy again for raising this issue.

Deputy Gerry Adams

The British Government is not assisting in this process.

Stroke Services

Deputy Gerald Nash

I doubt there is a family in Ireland that has not experienced the affliction of stroke. Strokes, as the Minister of State knows, can vary from relatively mild occurrences from which people can and do make full recoveries to devastating attacks which greatly impair the quality of life of patients and their carers. Once, we viewed strokes almost as an act of God. There was nothing we could do except sit and hope that a sufferer would regain some functionality. Thankfully, we have come a long way since then.

Last year, as the Minister will be aware, the Irish Heart Foundation published ESRI research showing that 750 extra people could be saved from death or lifelong dependency each year, with a cost saving to the taxpayer of €230 million over the next decade, if stroke unit care and clot-busting thrombolysis treatment was generally available. The HSE accepted this research and, in fact, allocated an extra €4.2 million to stroke services in the 2011 service plan to fund the appointment of 45 clinical nurse specialist and therapist posts countrywide. These were in addition to a number of new consultant neurologist and geriatrician appointments that are currently being made. Two of these posts were approved for Drogheda — a clinical nurse specialist and a therapist — with the full expectation that they would be filled early this year. We are almost at the year end and, apparently, these posts are no closer to being filled. It is essential to understand that an effective, functioning stroke unit is made up of people, not simply buildings and equipment. A stroke unit requires people with the necessary expertise who altogether offer a holistic approach to patient care. As the Minister of State is aware, when done properly the results are spectacular in terms of the recovery of patients and, crucially, in terms of reducing the likelihood of further attacks and incidence. Without the required expertise there may be a "Stroke Unit" sign on the corridor but it will not meet the guidelines of what constitutes a stroke unit as envisaged by the Irish Heart Foundation and the ESRI and, therefore, the benefits and the savings will be lost.

We are all aware of the difficult situation this country is in but this is not a case of seeking additional resources; the budget for these posts has already been approved. What is more, these appointments will greatly improve the effectiveness and efficiency of our stroke care system, saving money and freeing up resources to meet other demands in the health service. This is a win-win situation and it is deeply frustrating to see such a delay in implementing a measure that will greatly improve quality of life for patients and their carers. I appeal to the Minister of State to give this her full attention and to ensure these two essential appointments are made as quickly as practicable.

Minister of State at the Department of Health (Deputy Kathleen Lynch)

I am grateful to Deputy Nash for raising this issue. The Deputy is aware that I have an interest in it through family circumstances. Following the transfer of acute services from Louth County Hospital to Our Lady of Lourdes Hospital, Drogheda, the Health Service Executive has worked to reorganise stroke services in the Louth-Meath hospital group. Stroke services in the group were prioritised by the HSE in the 2011 service plan. A dedicated consultant physician lead for stroke services is in place in the Louth-Meath hospital group. The consultant physician is progressing the planned development of the stroke service in line with the HSE's national clinical programme for stroke and is working with the programme's national clinical lead in this regard.

I am pleased to report that stroke services in the hospital group have been significantly improved this year with the designation since March of a seven-bed area for acute stroke patients in Our Lady of Lourdes Hospital, Drogheda and the introduction of thrombolysis for acute stroke patients last July. An eight-bed stroke rehabilitation unit has also been commissioned in Louth County Hospital for appropriate patients from Our Lady of Lourdes Hospital, Drogheda. Admissions to the areas are co-ordinated at weekly cross-site, multidisciplinary meetings. It is planned to increase the capacity of this unit to 11 beds once recently appointed speech and language therapists have completed a period of upskilling and induction.

A draft Louth-Meath implementation plan for the national clinical programme for stroke has been developed. Discussions are ongoing with the consultant physicians in this regard with a focus on agreeing a strategy to ensure that all stroke patients are admitted under the care of a stroke physician with a dedicated on-call rota for stroke thrombolysis. Recruitment to appoint physiotherapy and clinical nursing specialist staff to the service is being progressed by the HSE. Once this implementation plan has been agreed with the national clinical lead, the stroke service in the Louth Meath hospital group will be officially recognised by the national clinical programme. This is a welcome and important step in the development of services at Our Lady of Lourdes Hospital, Drogheda. I emphasise the importance being placed by the Department and the HSE on improving services for patients suffering strokes.

As Deputy Nash has pointed out, the Irish Heart Foundation has made some estimates of the economic burden of stroke and transient ischaemic attack, TIA, in Ireland. It has estimated the cost of stroke care at between €470 million and €1.008 billion and it has suggested that introducing changes to stroke service provision would have important implications for health outcomes and costs.

In June 2010 Changing Cardiovascular Health: National Cardiovascular Health Policy 2010 — 2019 was launched. This policy establishes a framework for the prevention, detection and treatment of cardiovascular disease, including stroke, and seeks to ensure an integrated and quality-assured approach in disease management to reduce the burden of these conditions. The policy proposes that cardiac and stroke services should be reconfigured on a network basis at hospital and emergency care level. It is planned that each network will provide specialist services by a blend of hospitals designated as local and general and regional and comprehensive centres. As part of these plans, an improved ambulance service will ensure that 80% of patients will be brought directly to the appropriate centre for initial treatment within the accepted criteria framework.

To help implement the report, specific teams have been established in the HSE. Four lead clinicians, two of whom have responsibility for stroke, have been appointed by the HSE to direct the implementation of the recommendations. The policy acknowledges the key role that primary care plays in raising awareness, in risk assessment and in the management of cardiovascular disease. A shift to community-based care is envisaged for such patients, with primary care teams providing structured, proactive care supported by specialist ambulance services. I welcome the important developments in stroke services in Ireland and especially the important role that Our Lady of Lourdes Hospital, Drogheda, will play in the future.

I accept fully that the outcomes could be improved significantly if we had a proper service in place. It seems that with the programme envisaged of nine stroke units throughout the country and with the proper expertise and the thrombolysis treatment — although not everyone is necessarily an ideal candidate for this — the outcomes could be a great deal better and the burden stroke can place on communities, the individual and the State could be reduced greatly.

Deputy Gerald Nash

I thank the Minister of State for her comprehensive reply. She has acknowledged some of the developments that have taken place not only with regard to additional resources for stroke, but also the changes in attitude towards stroke and stroke prevention and other interventions. The fact remains that an extra €4.2 million was allocated to stroke services in 2011 service plan. There was an expectation that the two positions, the clinical nurse specialist and the therapist, would be allocated to Our Lady of Lourdes Hospital, Drogheda. As I stated earlier, a stroke unit is not simply about a building or equipment it is about interventions, the type of which can be provided by the clinical nurse specialist and the therapist. I believe that the Minister of State accepts the need for such interventions and staffing arrangements. I am unsure whether the question has been satisfactorily addressed but my concern is whether we can expect these positions to be filled by the end of the year as per the plan and the resources allocated. If this is not the case, will a commitment be made that these positions will be filled early next year to deal with the clear demand in the north east and in the Louth-Meath area for interventions for stroke?

Deputy Kathleen Lynch

I cannot give the Deputy an answer to the specific question but I will relay his concerns. I will find out the answer and I will get back to the Deputy in terms of these specific areas. The Deputy is correct. If we intend to use multidisciplinary teams for other chronic diseases then we must introduce them in this case as well. The outcomes for stroke can be a great deal better if correct and speedy diagnosis and treatment is put in place and this is what the plan is about. The plan is good and the network we will put in place throughout the country will be good. It will serve the needs of those suspected of having had a stroke and those who have suffered a stroke. We must ensure the personnel required to deliver this plan are put in place. I will inquire for the Deputy about when these two appointments will be made.