Topical Issue Debate

Community Employment Schemes

I thank the Ceann Comhairle for selecting this matter and I thank the Minister for Social Protection for attending this debate. In the budget it was announced that the training and materials grant for community employment schemes was to be reduced from €1,500 to €500. When a project is approved by FÁS, a contract is entered into for a 12-month period. Many schemes were signed up for towards the end of last year and will run until October or November 2012. In those cases, most of the money was spent or taken account of before the cuts were implemented on 1 January. In the aftermath of the budget, I welcome the Minister's decision to review the schemes. The review started in the last few days, but what good is that if the schemes are already being cut back? Contracts have been entered into. In recent months we heard of highly paid civil servants who had entered into contracts for large pensions which cannot be changed, yet people on CE schemes can have their payments cut off with a few weeks notice.

In my own constituency there are 40 projects with approximately 850 participants. These people and the projects in which they participate support local communities by offering a myriad of services, including child care, village enhancement and meals-on-wheels. I see Deputy Dara Calleary on the other side of the House. He will know of the work of CE schemes for the Moy salmon festival.

I ask the Minister to allow existing contracts to be honoured and to postpone the changes proposed in the review until the current schemes are being renewed.

Like Deputy O'Mahony, I am pleased to have the opportunity to speak on this issue. I speak on behalf of the 19 schemes, with 326 participants, in my county of Carlow. One of these schemes, the Carlow regional youth service, employs 15 people at present. Last year, five of the seven new participants in that scheme graduated to employment. One went on to retraining and only one went back to the social welfare system. The level of progression is very good.

These are not one-size-fits-all schemes. A scheme working in the disability sector would be totally different from one attached to a sports club, for example. The training issue is important. Individual training is important if people are to progress to employment. If the training element were to move to the VEC system, as is suggested, we would have one bland system which would not help the whole programme.

There has been much talk about bad schemes and schemes that have been abused. There are also many very good schemes in the system. When the review is completed, will the schemes that have passed the review with flying colours be entitled to their full grant application?

I thank the Ceann Comhairle for allowing me to raise this issue and I thank the Minister for being in attendance.

Deputies O'Mahony and Deering have spelled out our concerns. Since this measure was announced in the budget, I have met participants of many of the schemes, particularly in east Galway where there are 33 schemes and where hundreds of people will be affected. Some of these schemes have already had their funding cut. Having met them and seen the work they do it is clear that many of the people who avail of these schemes go on to further employment, having availed of the training offered. The schemes are working and are doing the job they are supposed to do.

Will schemes whose funding has been cut before the review has taken place have the money to complete their contracts, whether they end in March or continue until the summer? Will schemes that prove they are doing the job properly receive the same level of funding as last year?

I thank the Deputies who raised this issue.

I am happy to have responsibility for community employment from 1 January. These schemes play an important role in our communities, in particular by providing services which have an intrinsic social value like helping the disabled to live independently or delivering meals-on-wheels and other services to our older citizens. This is a point that tends to get lost in some of the purely economic analysis of CE schemes, which views them as not delivering sufficient progression into the labour market. While it is true that many CE schemes do need to improve the manner in which they provide labour activation services, there will always be a role for schemes that are primarily directed towards the provision of crucial social services, often for disadvantaged communities who are in dire need of services like child care, elderly care and drug treatment programmes.

The intrinsic social value of these schemes is not captured by conventional economic models but this is more a failing of conventional economics than of the schemes themselves. As Minister for Social Protection, I am determined to ensure that the contribution of such schemes is recognised in any future decisions on the future operation, funding and role of community employment.

The Department of Social Protection has agreed that an initial review of the financial resources of individual community employment schemes will commence in January 2012. The timeframe for completion of the local examination is the end of March 2012. The outcomes will inform the overall approach to be taken by the Department in implementing these reductions.

The terms of reference for the review have been circulated to regional management. To ensure consistency in approach by Department regions, a template or schedule outlining the areas for the financial review was designed and this is the basis of the review at scheme level.

The terms of reference are as follows. First, to examine the income and funding of sponsoring organisations in terms of their ability to continue the programme with reduced funding from the Department. There are community and voluntary sponsoring organisations that receive funding from a multiplicity of state agencies. Second, to quantify the expenditure on training provided and the qualifications achieved by participants. Third, alternative sources of support will be examined particularly with reference to funding from other State agencies to avoid duplication. Fourth, to establish if income is generated by scheme activity and the potential for utilisation of these funds to cover project costs.

The review process has commenced and Department staff have begun engagement with sponsors and community employment supervisors at local level. I wish to emphasise the following point to Deputies Connaughton, Deering and O'Mahony. Staff are advised that schemes which have committed expenditure to eligible costs will be reimbursed where this has been approved by Department regional staff under existing arrangements. Let me be clear. If changes in the training and material grant announced in the budget create financial difficulties for schemes, the Department of Social Protection will continue to provide funding for those schemes and funding has been made available in this context.

Separately, the former FÁS research unit, which has joined the Department of Social Protection, has been asked to complete a strategic value for money review of a number of schemes administered by the Department. Community employment will be reviewed as part of this exercise. The outcome of this review will guide future policy development and is expected to be completed by the end of March.

It is most important for schemes to be in full communication with the management with whom they dealt in FÁS and who are now officials of the Department of Social Protection. That is critical.

I thank the Minister for her reply. She said that if changes in the training and material grant announced in the budget cause financial difficulties funding will continue to be provided if schemes are in trouble. Schemes have been in trouble since 1 January, based on what their plans were. Is the Minister saying that if a programme is signed up to it will be funded until it is due for renewal? My information is that the regional staff have no discretion in this matter but that it is being implemented from 1 January.

Again, I raise the training issue. For participants to progress to employment they must have individual training, as far as possible. If training goes back into the VEC system, as was suggested, the individualisation of training will be lost and the prospect of participants progressing to employment will be lessened.

Is the Minister saying that any scheme that runs from March 2011 to March 2012 and has spent its funding will be okay, and that its shortfall will be taken care of? Could she consider other CE scheme costs, such as insurance and auditing, which eat up huge chunks of a scheme's budget before it even gets a chance to spend money on training and materials?

As the Deputies appreciate, the schemes only came under my remit on 1 January. They will make a very important contribution. The Government, in the budget, maintained the numbers and its commitments to the schemes. It is important that this message goes out.

With regard to schemes that have contracts, as described by a number of Deputies, if the scheme representatives deal on a one-to-one basis with regional social welfare employment officials, formerly FÁS officials, who are now managing them, they will note contracts which are legal commitments will be honoured to the point when they arise again. We are undertaking that no scheme will be forced to close until after the review has been completed. It is important to understand that, in the context of the troika, the criticism of activation and the budget we have been given, we have been asked to find savings. We need to find them. I accept Deputy Deering's point that there is definitely scope for saving with regard to shared insurance costs and other shared costs. I cannot, however, emphasise enough how critical it is for schemes to be in communication with former FÁS management, who are now officials in the Department of Social Protection.

Employment Rights

I had hoped the Minister for Justice and Equality would be present but I am quite sure the Minister of State at the Department of Justice and Equality, Deputy Kathleen Lynch, will deal with the matter and take it to the Minister's desk.

I will not dwell too long on the issue of forced labour as the Minister of State is very familiar with it. She understands the industries involved. There is an urgent need to criminalise forced labour. The Migrant Rights Centre Ireland, some of whose representatives are in the Visitors Gallery, has recorded 169 cases of forced labour over the past six years, but we know this is just the tip of the iceberg. Without a law against forced labour, victims will not be identified and unscrupulous employers will continue to engage in their current behaviour. Asking a victim of forced labour to pursue his rights through the existing legislation, be it health and safety legislation or employment legislation, as has been suggested, is deeply problematic. The experience of victims to date is that they do not receive protection or justice, despite these so-called protections being in place. Not one person has been prosecuted for any of the offences in forced labour cases. This reinforces the requirement for a stand-alone offence of forced labour.

The Minister for Justice and Equality, Deputy Shatter, is due to make a decision shortly regarding any legislative and administrative measures required to address deficiencies in the law in this area. We need clarification in this regard. We need to bring Ireland into line using its legal commitments at EU and international levels. The Minister of State understands what these commitments are. We ask that the Minister outline urgently the Government's plans to criminalise forced labour in Ireland and protect the most vulnerable of workers in this Republic.

It is a matter of shame that I stand to discuss this issue today because it should not have to be discussed in any civilised, democratic country. I understood the issue of slave labour was consigned to the history books but it is a sad indictment of our society that we are still dealing with it.

I recently got involved in this issue because of the case of forced labour at an Indian takeaway called Poppadom beside Newlands Cross in Clondalkin. It involved a man called Muhammad Younis, whom I am very glad to say is in the Visitors Gallery. I welcome him and the representatives of the Migrant Rights Centre Ireland. Mr. Younis's case is a classic example of forced labour. He was lucky enough to escape from the conditions he was forced to endure by his employer.

Mr. Younis, who has very little English, was brought to Ireland on a work permit but, rather than renewing that permit, his employer kept him working through threats and intimidation. This kind of practice must stop. A rights commissioner heard his case and this led to a Labour Court ruling in September 2011 that he is owed €90,000. Poppadom restaurant has yet to pay him that money. He is now unemployed, living in a hostel and cannot see his family. He has been robbed of everything, yet the restaurant keeps trading. This illustrates perfectly why action needs to be taken.

Not one person has been prosecuted in regard to any case of forced labour. For that reason, I call on the Minister of State to ensure forced labour is properly criminalised, that courts have the powers to close companies that employ forced labour and to jail offenders for significant periods, and that an inspection system is introduced that roots out those who might be using forced labour.

I thank both Deputies for raising the issue. As they rightly said, it is very serious. I am responding on behalf of the Minister for Justice and Equality, Deputy Shatter.

There are a number of measures in place to prevent exploitation and forced labour in Ireland. The International Labour Organisation's definition of forced labour comprises two basic elements: the work or service is exacted under the menace of a penalty and it is undertaken involuntarily. Forced labour cannot be equated simply with low wages or poor working conditions.

In addition to the range of employment law enacted to protect workers from exploitation generally, the Criminal Law (Human Trafficking) Act 2008, which came into effect on 7 June 2008, criminalises the trafficking of persons for the purpose of labour exploitation, including forced labour. The term "traffics" is broadly defined in the Act. For instance, an offence may be committed under the Act by providing a person with accommodation or employment in order to exploit that person for forced labour if coercion or deception is used. An offence does not require cross-border movement or illegal entry into the State. The human trafficking investigation and co-ordination unit of An Garda Síochána works closely with labour inspectors attached to the National Employment Rights Authority on cases where there are allegations of labour exploitation. Since 7 June 2008, a number of cases of alleged human trafficking for labour exploitation have been investigated by An Garda Síochána - 19 cases in 2009, 19 cases in 2010 and 12 cases in 2011. To date, no proceedings for the offence of human trafficking for labour exploitation have been commenced in this jurisdiction. Three investigation files having been submitted to the law officers. Directions for no prosecution have been received in two of these cases. Additional information has been sought and provided in respect of the third investigation file.

An Garda Síochána works closely with other police forces. For example, an intensive investigation was conducted in Ireland and evidence was transferred to Romania, where three Romanian men were sentenced to imprisonment for seven years, five years and five years, respectively, in December 2009 for the trafficking of Romanian nationals into Ireland for labour exploitation on farms in Wexford.

There is a wide range of training and awareness-raising activities ongoing with personnel in the public and private sectors likely to encounter victims of human trafficking for labour exploitation. In addition, since 2010, my Department has sanctioned over €25,000 in funding to the Migrant Rights Centre Ireland to assist it in its work in assisting migrants who may be victims of trafficking for labour exploitation or forced labour.

The Criminal Law (Human Trafficking) 2008 Act is primarily an anti-trafficking measure and was never intended to address all the exploitative phenomena outside the context of human trafficking. In some cases that have been referred to An Garda Síochána as human trafficking for labour exploitation, prospective evidence of other offences including immigration offences, employment permits offences, false imprisonment and assault has been uncovered. These matters remain under investigation. An analysis of allegations of forced labour coming to the attention of An Garda Síochána since the Criminal Law (Human Trafficking) Act 2008 came into effect is currently being examined in my Department so that any legislative and administrative measures required to address deficiencies, if any, in the protections against forced labour can be identified. In the event that a need for additional legislative measures is established, proposals will be brought to Government in the usual manner and as quickly as possible.

I remind Deputies they should not mention anybody outside the House in their address.

I will mention the Minister, Deputy Shatter, who is not present. I know the Minister of State will take our comments back to his office. What I get from the answer is a positive in that the Minister is not saying no legislative change is needed but that it may be needed and that, in due course, it may happen. However, the Minister of State can understand that, as Deputy Dowds said, we are effectively talking about slavery in this Republic currently. While the legislative process must take its course, that gives little satisfaction to those who are suffering. While we are talking about slavery, about 2012 and about a Republic, what we need to do is to ensure that any investigations into the necessity for legislation take place immediately and that legislation which we know is necessary is introduced as soon as possible. A dateline for that would be greatly appreciated.

First, although I mentioned a name, I had that person's permission and the matter has been in the public arena before this so I am not mentioning something that is not in the public arena.

The Deputy is losing his time.

What I want to be sure of at the end of this process is that if legislation is required, it will be enacted. This has been an ongoing problem for a number of years. The big case that arose was the GAMA case in 2005, which involved many workers. It particularly disturbs me that, despite this, such organisations can continue to get contracts in Ireland. It is wrong that those who are employing people in such situations are allowed to function. I urge movement on this issue.

The Migrant Rights Centre Ireland and other such organisations are not so much the first port of call for people who find themselves in difficulties but usually the only port of call. It is amazing that we have four statutory agencies charged with responsibility in this area - four different units with wide-ranging roles - namely, the Legal Aid Board, the Garda Síochána, the Department of Health and the Department of Justice and Equality.

There is a huge issue in regard to information and communication around all of this. In the event that people are granted a work permit, which is usually how they come into the country, there must be information available in their own language. As the Deputies rightly said, these people probably have very limited English, although they might have much more grasp of it than our grasp of their native language. We must ensure the information that is necessary to keep these people safe in very vulnerable positions is distributed to them.

With regard to the legislation, while the governing Act may need to be tweaked, perhaps this can be done by alteration to existing legislation and may not require the sort of over-arching legislation we assume is necessary. However, there has to be a penalty for people who exploit others in this way.

Mental Health Services

I thank the Ceann Comhairle's office for giving me the opportunity to raise this issue and the Minister of State, Deputy Kathleen Lynch, for being present. Just before Christmas, staff at the Ballina psychiatric unit at St. Joseph's District Hospital in Ballina and at Teach Aisling, a dedicated unit in Castlebar, were informed that unless they could produce what were termed "viable alternatives", these two units would be closed at the end of February and they would be transferred to the acute unit at St. Teresa's, the main mental care unit in Castlebar.

As the Minister of State can imagine, the staff at both units and across Mayo give a superb service. They are selfless in their dedication not just to their patients but to patients' families and to the communities which they serve. They are absolutely devastated by the consequences of this decision, particularly for the nurses in Ballina, who will be transferred into Castlebar, and for the patients at Teach Aisling, who are a particular kind of patient. They will not get the kind of service or attention in a central acute unit that they are getting at present. The irony in the case of Teach Aisling is that it is being used by the HSE as a prototype of how services should be delivered. In Ballina, the service has ten nurses attached and is currently serving 60 service users. It provides in-care treatment and also provides 24-hour nursing care to individuals with chronic mental illness and supports those in the community with medication and advice.

I compliment the Minister of State and everybody involved in the superb "The Frontline" programme last night. "Operation Transformation" is also on at present and I believe we are at such a stage in this country that an "Operation Transformation" should be applied to mental health as it is to obesity. The difficulty with last night's programme is that it was a one-off. I hope the Minister of State had a chance to have a discussion with Dr. Eleanor Fitzgerald Loftus, our local coroner, who would have filled her in on the difficulties we are facing in Mayo with regard to mental health.

Although the HSE management locally have told me it is not a final decision, they are informally telling everybody it is. The treatment of people in the community in what is geographically the third largest county will suffer. The range of services available within the north Mayo community, which are keeping people in north Mayo in their homes, will suffer. The acute unit in St. Teresa's, which is already under enough stress, will be put under more stress and people will suffer. There is no way around this.

I know the issue arises because of retirements and I know that the Mayo psychiatric services are suffering more retirements than normal at present. However, the level of retirements is not the same within the Ballina unit. These two units are being closed to ring-fence the acute unit at Castlebar.

I commend the Minister of State with regard to the €35 million and the 400 posts as this is probably down to her persistence and that of her predecessor, Mr. John Moloney. If we can get some of those 400 posts with a view to maintaining these services, we will go a long way towards protecting mental health services in Mayo. I heard the Minister of State talking on "The Frontline" last night of her trip around Wexford yesterday. I invite her to come to Mayo to see for herself the services on the ground provided by the HSE but also by Mayo mental health services, and to see what is at risk. I look forward to her response.

I thank Deputy Calleary for raising this issue. He is probably aware I have had an interest in this area not just since I got this job but for many years, and I have worked very closely with his colleague, the former Minister of State, Mr. John Moloney. We should never forget that what we are doing now is simply a continuum. Others have been here before and there will be others in the future. It is about ensuring that forward momentum continues.

The unit in Ballina referred to by the Deputy, which is part of the district hospital, provides inpatient and respite beds as well as a day-care centre and outreach services to patients with severe and enduring mental health conditions. The unit currently caters for four residential patients and also provides four respite beds. Teach Aisling, located in Castlebar, is a ten-bed inpatient facility for clients with severe and enduring mental illness. It is a high support hostel which also provides rehabilitative outreach services.

Mental health services across all regions are continually reviewing the provision of service to their population to maximise the balance of service access within the available resources. Mental health services in Mayo are currently reviewing their psychiatric services in the context of the recently approved HSE service plan for 2012. The process will include consultation with service users and consideration of how safe and quality services can be provided within available resources. The expenditure reductions necessary in 2012 will challenge all areas of the health system to provide continuity of services that are both appropriate and safe for patients. As in other care areas, efficiency and other savings will be required from the mental health service nationally which will necessarily involve some rationalisation and reorganisation of services at local and regional level.

In spite of this, I am glad to say that it was possible to secure an additional €35 million for mental health, in line with our programme for Government commitments. This funding will be used primarily to strengthen community mental health teams in both adult and children's mental health services. It is intended that the additional resources will be rolled out in conjunction with a scheme of appropriate clinical care programmes based on an early intervention and recovery approach. Some of the funding will also be used to advance activities in the area of suicide prevention and in response to self-harm presentations, and to initiate the provision of psychological and counselling services in primary care specifically for people with mental health problems. Some provision will also be made to facilitate the relocation of mental health service users from institutional care to more independent living arrangements in their communities, again in line with A Vision for Change.

It is important that we get best value for money from our available resources. Duplication of mental health services needs to be avoided in order to provide a more streamlined service. We need to co-ordinate our efforts and work together to develop our mental health services in line with A Vision for Change recommendations. In essence, we need to provide more with less. This has already been successfully achieved in mental health service provision in other areas, Wexford being one where I have seen this working.

I am committed to working closely with the HSE and voluntary agencies to introduce programmes and services which will deal more effectively and appropriately with the issue of mental health. The time for dealing with mental health has come. I am glad to have the opportunity at times such as this to respond, even to individual cases. I will definitely take on board the Deputy's kind invitation.

I thank the Minister of State for her reply. I assure her that in the context of the geography of County Mayo there is no duplication of service between Ballina and Castlebar. A considerable round trip is involved for those who now use the service in Ballina but who will be forced to go to Castlebar if this move proceeds. For the type of client who is being treated in Teach Ashling there is no duplication of service. They are getting a very specific treatment there which they will not get in St. Teresa's.

We all agree with the need to strengthen community mental health teams. However, if the closure of the Ballina unit goes ahead, ten nurses will be withdrawn from mental health treatment in Ballina and sent to the acute unit. That will destroy community mental health provision in north Mayo and west Sligo. People who do that job at present are unsung heroes.

I agree with many of the Minister of State's aims. However, if this decision goes ahead what may happen will fly in the face of many of those aims.

This is the second time in two months I have had to use the topical issue debate to raise the further downgrading of services at Ballina District Hospital. There seems to be a plan within the HSE, the Department of Health or somewhere, to close down that hospital. I can assure the Minister of State this will not happen on my watch. In one of the biggest towns in the country, the third biggest in Connacht, we will not stand by while our health services are being dismantled in this way. It is my job to highlight that. I look forward to welcoming the Minister of State.

There are four areas in the country where, with the co-operation of the voluntary service users and the professionals involved, we have managed to roll out what is considered the model in regard to mental health services, namely, high-support hostels, day hostels and community-based mental health teams. In the areas I have looked at where this has been done the service is extraordinary. It serves both the service user and the professionals who work within it. It has changed the view of all as to how the service is delivered; the professionals, the community and the service users. That is what we want for all areas and that is what the €35 million is about. It is about ensuring that the posts we do not have at present, those we are missing from the teams, are put in place in order that people can stay well within their own communities.

The Deputy is right. Closing down units where people are supported within their own community is not what A Vision for Change is about. That programme is about maintaining people in their own community and ensuring they stay well within that community. The last thing we want is to have ongoing admissions to acute units. In Wexford, south Kilkenny and Waterford, a vast area, the admission rate to the acute unit has been cut by 50%. People are getting an extraordinary service in the area and that is what we want everywhere. With the additional money and the plan that is in place one hopes we will also have that service in areas such as Ballina and throughout County Mayo.

Hospital Services

I thank the office of the Ceann Comhairle for accepting this issue, and the Minister of State for attending.

As we speak, and in recent weeks, the accident and emergency ward in Letterkenny General Hospital has faced another crisis situation. Staff are working in impossible conditions under severe pressure. Many of them, speaking off the record to the local media, have spoken of being at breaking point due to the pressure they have to endure.

Whenever the accident and emergency ward in Letterkenny is overcrowded patients remain on trolleys. I understand that in one case a patient had to stay on the trolley in the ambulance waiting to be admitted to a trolley in the actual ward. Privacy and dignity are denied to patients, qualities they should expect from a modern health service. Patients, many of whom are elderly and unwell, have to wait for long periods. Then there is the knock-on impact the next day when outpatient clinics are cancelled, with all the accompanying inconvenience. It is a very serious situation and happens all too often at Letterkenny General Hospital.

If that was not a big enough problem there is another. Only dozens of yards away is a state-of-the-art, brand new building with an accident and emergency ward unit and, two floors above, modern wards. However, there has been a delay of a year beyond what we expected would be its opening time because the builders, McNamara, went bust. Given the need for this building the issue should have been resolved much more quickly by the HSE in terms of the bonds and all the insurance and legalistic matters involved. It is in place now and fully completed. I urge the Minister of State and the HSE to ensure that this building is opened as soon as possible and that the necessary financial and personnel resources are provided to the management of the hospital to ensure this happens. We have already waited a year and cannot wait any longer.

I thank the Deputy for raising this important issue which I am responding to on behalf of the Minister for Health. Letterkenny General Hospital provides a full range of acute services, including a 24-hour accident and emergency department. The hospital serves a catchment population of 350,000. I am sure the Deputy is well aware of this.

During October 2011, the special delivery unit, SDU, wrote to hospitals with the highest numbers of patients waiting on trolleys, seeking proposals aimed at reducing those numbers over the critical period of November 2011 to January 2012. A range of measures was approved across 16 hospital sites and funding of €4.85 million was allocated for the purpose, with strict performance criteria laid down. In addition, the SDU put in place arrangements whereby a staff member was on duty every day over the Christmas and new year period and each of the 28 emergency departments in the country submitted an update three times per day on the numbers waiting. In other words, they did a count three times a day as opposed to doing one every morning. This allowed for close monitoring of hospitals at risk and facilitated quick decision making in regard to corrective action where it was required. This process will continue during the month of January 2012.

This reporting structure confirmed the Letterkenny Hospital emergency department in general performed very satisfactorily during this period. Today's 8 a.m. figures indicate there were no patients waiting for admission. At national level, the signs so far have been encouraging with significant reductions recorded in numbers waiting each day compared with the same time last year.

The Health Service Executive, HSE, has advised that construction on the new medical accident and emergency block, which includes the new 19-bay emergency department, an 11-bay acute assessment unit and three 24-bed wards, commenced in early October 2011. It is scheduled for completion in the near future. Equipping and commissioning will then commence.

Last Friday, the Minister for Health approved the HSE's 2012 service plan which was drawn up against the backdrop of significant funding challenges. It is designed to reflect the changed priorities of the new Government and the significant programme of reform to be undertaken. While acute hospitals face an expenditure reduction of 7.8%, the further roll-out of the clinical care programmes and other measures to improve the efficiency of clinical care delivery will limit the reduction in patient activity to an average 3% against the 2011 outturn. Hospitals will work closely with the special delivery unit to ensure, notwithstanding this reduction, nobody waits longer than nine months for an elective procedure to ensure equitable access for all.

I am shocked. Whoever wrote this reply needs to talk to the Letterkenny hospital nursing unions, local journalists and politicians rather than using some strange accounting mechanism to claim all is fine. For the life of me, I cannot understand from where the HSE is getting its figures and claiming everything is hunky dory. It must be a different hospital from the one from which I get reports. The fact remains the hospital was in crisis this winter, particularly after Christmas. This is not the first time.

A multimillion euro long-awaited hospital extension needs to be opened. The Minister of State spoke about it being equipped in the near future. She did not state the Minister and the HSE will commit the financial and personnel resources to the hospital's management to ensure the extension is opened as soon as possible. I appreciate the Minister of State visited the hospital recently and I have much respect for the work she has done in her brief. I hope she will put it to the Minister for Health, Deputy Reilly, that we need that extension opened as soon as possible. We cannot continue to expect the hospital staff to work under these conditions. More importantly, patients in the hospital deserve to have dignity, privacy and proper standards.

The extension referred to by the Deputy was due for completion by early February 2012. As he knows, however, a storm in the middle of December caused considerable damage to the block. That has been put right and it is estimated the extension will be completed in the next six weeks. With the commissioning and additional works that need to be done on internal structures, the HSE believes the extension will be ready for use by June or July 2012.