Topical Issue Debate

Milk Quota

Deputy Seamus Kirk

I am grateful to the Ceann Comhairle for the opportunity to raise this matter. The end of the month, 31 March, is looming for many hard working, progressive dairy farmers throughout the country. Unfortunately, a hefty milk quota super levy bill is also looking for them because of the inflexible position within the industry. As Deputies representing rural constituencies will be aware, the milk quota regime is due to be phased out between now and 2015 and while a minor transitional arrangement is in place to cater for it, it is clearly inadequate. The previous Minister, Deputy Brendan Smith, introduced the Food Harvest 2020 strategy, which set ambitious targets for the dairy industry. Dairy farmers who are in the process of expanding their operations now find that they have to tailor production to meet the strict milk quota limits. At a time when the industry is reasonably buoyant, with the potential to help our export statistics, dairy farmers find themselves seriously constrained by the prospect of a penal super-levy bill. I would have thought progress could be made by the Minister for Agriculture, Food and the Marine on a bilateral arrangement with the United Kingdom. This issue has been raised in the House from time to time, certainly in the past 12 months or so. It is quite ironic that there is probably unused super-levy quota on this island - in Northern Ireland - which should be available to dairy farmers south of the Border, but it is not. I ask the Minister to initiate a concerted effort, now that we are well into the month of March and coming to the end of the market season, to prevail on the Commission to agree, even just for this year, to a bilateral arrangement under which unused quota in the North of Ireland would be made available to help our hard-pressed farmers who are on the edge as far as production is concerned. There is no logical reason we cannot have a bilateral arrangement with the United Kingdom.

At a time when the economy could benefit from a lift in primary production such as in the dairy sector, this seems an obvious area in which to introduce an initiative. It could help the economy, dairy farmers and the industry in general. I am glad the Minister is in the House to deal with this issue because I am sure he appreciates, on a personal level, the serious difficulties being faced by farmers. I await his answer.

Minister for Agriculture, Food and the Marine (Deputy Simon Coveney)

I thank the Deputy for raising this issue which is indeed topical. During the past 12 months my Department and I have been active in raising the question of an adjustment to the milk quota regime at political, official and Commission level and have made determined efforts to secure a soft landing for all member states in the lead-up to milk quota abolition in 2015. I have discussed the matter extensively with other EU agriculture Ministers, including in bilateral meetings with my Danish, French, German, Estonian and UK counterparts. Furthermore, officials from my Department have raised the issue at every available opportunity at appropriate EU meetings in the past eight months or so and at bilateral meetings with other member states.

Among the options discussed with regard to a soft landing were the front-loading of the remaining quota increases between now and 2015, a reduction in super-levy fines, a further reduction in butterfat correction levels and a EU flexi-milk arrangement which would operate provided EU production overall was within quota. Most attention was focused on butterfat correction. In December a coalition of member states involving Ireland, Denmark, the Netherlands, Belgium and Cyprus formally put a specific proposal to the Special Committee on Agriculture for an adjustment to the butterfat correction mechanism. That would have given us flexibility of about 1.5% in our quota. Unfortunately, the Commission has consistently resisted attempts to reconsider this issue, as it has resisted attempts to revisit the outcome of the 2008 CAP health check agreement in an overall sense. This is something to which the previous Government signed up, but, unfortunately, it has not worked out.

The extent of the difficulties in terms of the potential for super-levy fines this year was confirmed today on the front of the Farming section of the Irish Independent. It was reported that Copa-Cogeca had secured agreement on a common position calling for a reduction in butterfat adjustment levels. It seems, however, that this is not the case; unfortunately, the report is not accurate, according to my information.

It is important to address the particular question the Deputy asked. This is not the first time I have addressed it, as he has spoken on this issue before. If we had been able to establish a bilateral arrangement with the United Kingdom under which we could use unused quota from Northern Ireland, we would have done it months ago. Unfortunately, however, such an arrangement cannot be made between member states. We have an agreed health check policy that was supposed to provide a soft landing for countries in advance of 2015, but it is certainly not achieving this for at least five countries within the European Union. We will have a review of that soft landing policy towards the end of the year which the Commission will be facilitating and I will have an opportunity to raise all these issues again. In the meantime, we are trying to achieve agreement on a butterfat correction which would at least allow some flexibility and help to keep us within quota, but it has not been possible to get agreement on it either, mainly because France and Germany are opposed to it.

In terms of lobbying, there is a need to put together a strong coalition in order that the concerns of countries such as Ireland, Denmark, the Netherlands, Belgium and Cyprus, with a number of others, are taken seriously. If it were as easy as simply saying, "Farmers in the UK are not using their full quota, and we need more quota, so we can just take some of theirs," we would have done this long ago. Unfortunately, it is not legally possible to do it. As much as many of us in this House would like Northern Ireland to be part of the Republic of Ireland, it is not. It is considered to be a separate jurisdiction and countries cannot transfer national quota across borders. I would like us to be able to do this, but it is not possible. I will continue to raise this issue - in fact, at my next Council meeting I intend to raise it under the heading of any other business - and we will continue to push for more flexibility.

An Leas-Cheann Comhairle

I will give the Minister a further two minutes after Deputy Kirk has spoken.

Deputy Simon Coveney

I will finish on this point. Farmers must take responsibility for themselves in the meantime. At the end of 2011 they were just under quota, but there is a significant danger that if they produce as much milk in the first three months of this year as they did last year, they will be significantly over quota and super-levy fines will be applied at 28 cent a litre. This is a significant fine for any dairy farmer who is over quota. I caution farmers to continue to do what they have been doing, that is, to act responsibly to try to remain within quota.

Deputy Seamus Kirk

The Minister is right in saying Deputies have raised this issue a number of times in the House. That it has been raised is a reflection of the fact that constituents are asking what is being done about the matter and whether progress cannot be made on it. They find it hard to comprehend unused quota down the road cannot be transferred. In the case of my constituency of Louth it may well be that there are dairy farms in the next county with unused quota. Farmers cannot comprehend the position that quota cannot be transferred, given that Ireland and the United Kingdom are within the same economic zone in the European Union.

I am looking at this issue from the point of view of the transitional arrangements between now and 2015. There is no question but that the economy could benefit from the significant exports represented by even a 5% or 10% increase in milk production in Ireland. I am sure the Minister for Finance would very much appreciate the increased revenue and also the improved balance of trade statistics. There is a demand on the world market for this product and we do need a transitional arrangement. There is no point in saying that today, in March 2012, we can have a production level of such and such, as in two years time the production level is expected to be increased.

Deputy Simon Coveney

That is exactly what the last Government signed up to.

Deputy Seamus Kirk

Given the nature of the dairy industry, it is not going to work. We need a realistic transitional arrangement. I am not expecting the European Union to just open the floodgates and allow us to produce milk ad infinitum, but we need a transitional arrangement to allow the industry to expand on an orderly, planned basis.

Deputy Simon Coveney

I do not want to take a political view, but the milk health check was signed up to by the previous Government to achieve what the Deputy would like to see, a soft landing in the transition from a quota to a non-quota system. With the benefit of hindsight, it has not worked. It does not matter at this stage whose fault that is, we must change it and I will try to do that. The Deputy has been in politics a long time; he knows we cannot just order the European Commission to do something. There must be agreement among a qualified majority of member states for a change to a health check that was voted through and agreed by everyone.

In the Commission's eyes, the Republic of Ireland availing of excess quota in Northern Ireland is no different from Luxembourg using excess Belgian quota. Unfortunately, it sees it as two different jurisdictions. I must impress on my colleagues at the Council of Ministers that the soft landing is not working and a number of countries support that position. Unfortunately there are not yet enough to have a blocking minority to force a change of policy. The Commission says if we want to raise this issue, it is up to member states to do it and we are doing that at every possible opportunity.

I would like Ireland to have the capacity to slowly increase milk production between now and 2015 in order that we do not have a situation where we are operating within the reins of a quota system that just gets released after April 2015, resulting in a 15% to 18% increase over a 12 month period in the volumes of milk produced in Ireland. Supply problems would result from that in terms of dealing with that increased quantity and there is potential for price problems as a result of that significant increase, which is not in anyone's interest across the EU. We need a transition where there is a gradual increase in the volume of milk produced across the European Union in countries that want to produce more and we should be able to facilitate that at a time when the EU quota for milk is about 5% to 7% under quota.

Five countries were fined last year for being over their quota; Ireland was just under. I hope this year we will be just under again but farmers must behave responsibly for the remaining weeks for that to happen. In the meantime, we will continue to work politically to find ways to be more flexible and change the soft landing approach between now and 2015, using the review mechanism at the end of the year to do that.

Mackerel Fisheries

Deputy Noel Harrington

The Minister will be aware of the issues involved and I support him in his efforts to have this situation in the north-east Atlantic mackerel fishery resolved as soon as possible.

The Faroe Islands and Iceland have a share of north-eastern Atlantic quota for mackerel that was agreed between the nations and the EU at 6% of the total allowable catch in the north-east Atlantic. Unfortunately, they are now harvesting a further 300,000 tonnes per annum over and above the agreement, 45% of the TAC in this fishery, or six times the agreed allowance. Putting that in context, the Irish mackerel quota is about 68,000 tones.

The mackerel fishery is worth €125 million in a €1 billion fishing industry. It is a cause of huge concern for the present industry and, if it continues, the danger exists that the sustainable mackerel stock will be wiped out in the north-east Atlantic because of overfishing by these two nations. The breach of the fisheries agreements may cost the Irish fishing industry between €10 million and €15 million in potential TAC adjustments. Abusing the quotas in this way by breaking all international agreements on mackerel quotas can be regarded only as modern day piracy.

This abuse illustrates an irresponsible and barefaced disregard for the rules set down by the European Union, Faroe Islands and Iceland. This cannot be allowed to go unchecked. If states feel there is no fall-out from breaches of this nature, what incentive is there for them to stay within the guidelines? The situation is detrimental for Irish fishermen.

Last year I called for the resolution of this matter and, in the absence of progress, the adopting of sanctions against the Faroe Islands and Iceland, beginning with trade sanctions at the least. I am now asking the Minister to consider further measures, including the possible suspension of accession talks with Iceland. Five rounds of talks have taken place in the past two years in Clonakilty, London, Brussels, Norway and Iceland but so far very little progress has been made. A sixth round of talks is scheduled for the next ten days and there should be no further trade-off on this issue. It is a smash and grab on limited fish stocks by two countries that have overfished their traditional fishing grounds by ignoring traditional conservation methods. They are taking 1,000 tonnes per day more than they should from sensitive and finely balanced and managed fish stocks. I have called for sanctions to be imposed on these countries since December and I understand the Minister will also press for immediate and hard sanctions against these countries.

An EU-sponsored fish factory is being built on the Faroe Islands capable of processing 1,000 tonnes per day. It is regrettable that negotiations conducted by the Commission are treated with scepticism by Irish fishermen because they are worried about the resolve of the Commission. We need a strong approach to this.

We are entering a new troika on 1 July in advance of Ireland's assumption of the EU Presidency on 1 January 2013. In the next 12 months we will have some power to bring these negotiations to a speedy conclusion, hopefully before we assume the Presidency.

Deputy Simon Coveney

I thank the Deputy for raising the issue. It will not come as news to him that this has caused me a great deal of concern. Mackerel is the most valuable fish stock for the Irish fishing fleet and prices for it are at an all time high, between €1,400 and €2,000 per tonne. After Scotland, Ireland has the second highest quota of mackerel to catch in the European Union in the waters referred to here. Mackerel, therefor, is the most important fish stock for our industry. The stock we rely upon is being damaged significantly by irresponsible and arguably illegal fishing by two countries, Iceland and the Faroe Islands.

I do not say that lightly. This has been going on for some time. The European Union has tried, with Norway, because there is an arrangement between the EU, Norway, the Faroe Islands and Iceland, to manage this mackerel stock in a sustainable way. This has been one of the great success stories of European fisheries because we have seen the fish stock grow and many people in Ireland have made a living out of catching it, but we are now seeing an ignoring of a sustainable management system for this stock.

It is true to say mackerel stocks in western waters have moved north into Faroese and Icelandic waters. We must negotiate a fair quota settlement with those countries. Unfortunately, however, what has happened is that there has been no sign of a willingness, particularly from the Faroe Islands but also, more recently, from Iceland, to do any sort of a reasonable deal with the European Union and Norway and, as a result, nearly half of the entire mackerel stock is being caught in Icelandic and Faroese waters, despite the fact that combined, they had less than 6% of the agreed quota until recently. Now, both of these countries catch more fish than Ireland, the second largest of the European countries in terms of this stock.

The European Union must show some teeth. Iceland is in the process of looking for EU accession. I hope it is successful in that regard. However, I believe the mackerel issue needs to be resolved to the satisfaction of all the countries concerned, including Iceland, before the fisheries chapter of that accession process opens. We have to come to a conclusion in terms of quota allocation with the Faroe Islands. It seems the view that is being taken politically is that in the absence of an agreement, fishermen should physically catch as much fish as they possibly can until such an agreement is forced on them. Both Iceland and the Faroe Islands are catching more than 150,000 tonnes of this stock, which is way above sustainable levels. Some time ago, I requested at Council of Ministers level that we introduce a mechanism whereby trade sanctions could be imposed against Iceland and the Faroe Islands in relation to fish and fish products. The European Commission and other member states agreed with me. The Commission has come up with a mechanism whereby that can be done. I will push it to use that mechanism to force a much more serious negotiation between the member states and the associated states that are doing so much damage to a valuable stock that we have all worked hard to protect.

Deputy Noel Harrington

I thank the Minister for his response. We are aware the Minister and the officials in his Department are taking this issue seriously. He has brought the matter to the European Commission with great force. The EU fisheries industry is not entirely clean in this regard, regrettably, as these breaches are being supported by vessels that departed the EU fisheries register to help the Icelandic and Faroese industries to process large amounts of fish. They do not have the capacity to process such amounts of fish without the help of individual companies within the EU. It is regrettable that they are being facilitated by EU companies. It will complicate issues when the negotiations mentioned by the Minister take place. I am very hopeful that the Commission will show its teeth when it uses this process and this instrument to propose sanctions against Iceland and the Faroe Islands. I hope the Commission will force those countries to honour the fisheries agreements into which they have entered.

It has to be noted that Iceland has form in this regard. I imagine that Irish people looked on with great glee when Iceland took on the UK in the cod wars of the 1950s and 1970s. Now that we are the victims of what is happening in Iceland, it is not as funny anymore. People in this country looked on nonchalantly and thought it was okay when Iceland took on our neighbours across the water in the UK and virtually wiped out fishing towns like Grimsby and Hull. We are now being directly affected by Iceland's efforts to uphold what it sees as its rights. As the Minister quite rightly said, Iceland agreed to total allowable catches to support and enhance sustainable fisheries for future generations. That agreement was reached not just in the interests of Iceland and the Faroe Islands, but also in the interests of Ireland, Scotland and the rest of the EU. If the agreement is not defended, our coastal communities will suffer as a direct result, unfortunately. I commend the Minister on his approach to this matter.

Deputy Simon Coveney

For the purposes of clarity, I would like to inform the House of what the proposed sanctions entail. The EU Commission has proposed a regulation of the European Parliament and of the Council which would allow for the introduction of trade sanctions against third countries that engage in irresponsible or illegal fishing activities which may lead to the depletion of EU fish stocks. The sanctions proposed would include restrictions on the importation into the EU of fish and fishery products from offending states, restrictions on the use of EU ports by vessels from offending states, prohibition on the sale and purchase of fishing vessels between EU member states and offending states and prohibition of trade agreements between nationals of an EU member state and nationals of offending states. It could be argued that we should go even further.

I am not the kind of politician who calls for trade sanctions against countries that have a lot in common with Ireland. These countries, like Ireland, are islands in the north Atlantic. I hope Iceland successfully joins the EU at some stage in the future. I hope we will be able to work with Iceland on a series of issues of mutual interest and concern. Iceland and the Faroe Islands are acting irresponsibly on this issue. They are damaging a hugely valuable stock. In my view, they are threatening the viability of our fishing industry, which has worked hard to protect and rebuild this stock. We should respond in a way that is consistent with the responsible management of a valuable stock. The EU needs to show a bit of muscle, in terms of its scale, on this issue. Unfortunately, we are currently facilitating the causing of significant damage to a valuable fish stock, which is the heartbeat of the Irish fishing industry, particularly in the north west and south west.

Hospital Services

An Leas-Cheann Comhairle

Deputies Eric Byrne, McConalogue, Kelleher and Wallace have two minutes each.

Deputy Eric Byrne

It is a bit rich to be required to say in two minutes what politicians have been speaking about for 16 years. I want to recall a debate in which I was intimately involved as a member of the board of Crumlin Children's Hospital. I recall vividly a debate about the national tertiary paediatric hospital. I am acutely aware that the board threw its weight behind the concept of moving to a single site. The refusal by An Bord Pleanála to grant permission for the proposed new hospital will have horrendous ramifications. My heart goes out to the parents and children who have been desperately waiting for a national paediatric hospital for many years. I appeal to the Minister not to panic in the face of what has happened. If we rush into a new decision to build a hospital on a lesser scale, we could end up with an incorrect development.

I remember the debate in Crumlin when we bought into the McKinsey report. The nine key criteria points were of crucial importance. I am acutely aware that the consultants and specialists in Crumlin - given that Crumlin is essentially this country's national tertiary paediatric hospital, they are the foremost specialists in the country - threw their bodies and souls behind the complex negotiations and took part in the internal planning processes that resulted in the scale of the hospital that eventually emerged. I ask the Minister to cautiously recognise that in the past, the input of the Crumlin authorities has been instrumental in facilitating this development. If my senses are right, I believe they would have severe reservations about any downscaling of the project to which they contributed in recent years.

I am calling on the Minister to carefully consider co-locating an acute general hospital, as set out in the initial criteria, with a paediatric hospital and the Coombe hospital. A potential site for such a hospital exists as a result of the failure to develop the Bailey Gibson site, the Player Wills site and the St. Teresa's Gardens area. It is exciting that we could have the tri-location of an acute adult hospital, a paediatric hospital and a maternity hospital at this site. I appeal to the Minister to consider that. Perhaps he will engage with the boards of management of St. James's Hospital and Crumlin Children's Hospital, as well as the Dublin City Council planners, on the possibility of redeveloping the Coombe site.

Deputy Charlie McConalogue

This is a two-pronged issue. We need to discuss the delays in the development of a national children's hospital and the reduction in bed capacity at the children's hospitals that are currently operating as a result of the cutbacks introduced by the Government.

A total of 25 beds in Crumlin and ten beds in Temple Street are closed due to budget cuts, forcing children to wait longer to be admitted to a ward and forcing them to stay longer than they should in emergency departments. Overall, 60% of children on inpatient waiting lists are there for more than three months, 50% of children on day case waiting lists are there for more than three months, while 2,500 children are on the waiting list for elective or day treatments. That is the situation at our children's hospitals. They are not operating to capacity because the Minister is restricting their budgets.

One year into the Minister's tenure, we are further behind than ever in respect of the national children's hospital. Today he moves on to his second review of that hospital. Only last week, in response to An Bord Pleanála's decision, I heard him talk about more grandiose elements of the children's hospital. He has been in his job for a year. If he felt that some elements of the children's hospital were grandiose, why did he not address them after he came to office? If it is the case, following the first review, that the Minister said that the Mater Hospital is the right site for the hospital, why has he said in the newspapers this week that he is not sure where he wants to place it? If it was the right site this time last year when he entered office, why is he not looking to amend the Planning and Development (Strategic Infrastructure) Act in order that he can proceed with it and ensure we do not wait any longer than we have done for a hospital that befits the health needs of our children?

Deputy Billy Kelleher

I welcome the opportunity to speak on this issue. The provision of a national paediatric hospital is the most sensitive issue facing us. We have been talking about this since 1998. We have had the McKinsey report and last year the international expert group reported to the Minister, recommending co-location on the Mater site. We now find that An Bord Pleanála has rejected that on aesthetic grounds and on the grounds of overdevelopment on the Mater site itself.

I would like to ask one or two questions in the context of the terms of reference for the group that has been established which state that it is to inform itself about planning considerations and processes affecting this project. Can the group enter discussions with An Bord Pleanála? Can the group possibly look at amending legislation to allow for the Houses for the Oireachtas to look at this particular project in the context of the Mater Hospital site? This is due in part to the McKinsey report, but more importantly due to the international expert group which stated last year that the Mater was the most suitable site.

There is much concern. Other hospitals and other interest groups will come on board again to say that one site is more suitable than the other, and we will have this debate over and over again. The Minister states that it will 56 days before the group, under the chairmanship of Mr. Frank Dolphin, reports back to him. How quickly thereafter does the Minister expect to be in a position to make a decision on this critical infrastructure in order that we can have it completed for 2016? Everyone would like to adhere to that target in order that we can pass a national children's hospital onto the next generation 100 years after the Easter Rising.

Deputy Mick Wallace

In the last 24 hours, I have spoken to Professor Michael O'Keeffe in Temple Street and Dr. Orla Franklin in Crumlin. Both are pretty horrified at the situation they are facing. Professor O'Keeffe was at pains to point out that he feels the hospital is being penalised for being too efficient and too effective, and that it had too many operations last year. He states that it will be forced to have 1,500 fewer operations this year, yet if a child is waiting 20 weeks for an operation, the hospital is liable to be fined €25,000. He is really frustrated with the bureaucracy. He states that there are too many officers and not enough soldiers, and that we need more people to roll their sleeves up and see patients.

Dr. Orla Franklin is presiding over a hospital in Crumlin that she claims is falling down. It got a brilliant intensive care unit a couple of years ago, but cardiac and cancer care are causing great problems and the hospital does not have the necessary facilities. There is no doubt that a new children's hospital will be great, but Dr. Franklin makes the point that it is for children who are not even born yet. It will be great when it is built, but what about children who are alive today? There are huge problems in Crumlin with infection. The hospital does not have an infection-free environment due to the amount of room sharing that must occur with children, along with parents sleeping on the floors. She stated that bad things are happening to Irish children due to sub-standard facilities. Surely we can do better than this.

Minister for Health (Deputy James Reilly)

I thank the Deputies opposite for their intentions in raising this. There is no doubt that this is a key facility for the well-being of our children and that it is absolutely necessary. I thank Deputy Eric Byrne for his comments and would like to reassure him that there is absolutely no panic, nor is there a need for panic, but there is a need for expediency and a sense of urgency. That certainly is the case.

I am committed to providing the best possible health service for our children and their families. I want this to be delivered through a new national children's hospital, where tertiary and acute services can be provided from one site. Immediately following the decision of An Bord Pleanála to refuse planning permission for the national children's hospital, I announced my intention to establish a group to review the implications of the decision.

The Government today agreed the terms of reference for the review group. These are to inform itself about the planning considerations and processes affecting this project; to consider the different options which now exist for progressing the construction of a national children's hospital having regard to Government policy on the delivery of health services, including accessibility and paediatric services in particular and best clinical practice considerations, the cost and value for money considerations of the different options, the likely timelines associated with the different options, and the implementation risks associated with the different options; to advise me, in the light of these considerations, on the appropriate next steps to take with a view to ensuring a national paediatric hospital can be constructed with minimal delay; and to report to me within 56 days of the first meeting of the group.

Currently the three Dublin children's hospitals work together as a unified network under the clinical leadership of Dr. Colm Costigan to ensure optimisation of resources and facilities. The hospitals are fully aware of the challenges facing their young patients and of the need to support families. Our Lady's Children's Hospital, Crumlin has been experiencing a surge in attendances to its emergency department and a corresponding increase in admissions through that department. The clinical director, Dr. Colm Costigan, is a joint appointment across all three hospitals. When individual hospitals are under pressure, he clinically reviews patients and, where necessary, redeploys patients across the hospitals to minimise impacts on elective surgery.

The regional director of operations in the HSE has met the clinical director and Ronan O'Sullivan, professor of paediatric emergency medicine. They have organised hospital site visits and are formulating an agreed approach to deal with the seasonal peak in paediatric emergency medicine. The HSE has taken steps to provide as high a level of protection as possible for the funding of the children's hospitals. The budget adjustment to both Our Lady's Children's Hospital, Crumlin and the Children's University Hospital, Temple Street was significantly less than the average in the HSE Dublin mid-Leinster service plan for 2012. The HSE management are in discussions with the Children's University Hospital, Temple Street towards agreeing a cost containment plan and will meet representatives of that hospital next week to discuss the plan further.

The HSE service plan for 2012 has set a target for children's hospitals requiring that no child should be waiting for treatment for more than 20 weeks by the end 2012. The Children's University Hospital, Temple Street is actively engaged with the HSE, the special delivery unit and the National Treatment Purchase Fund to ensure that this target is met. Discussions with the hospital have been positive and are ongoing.

I have emphasised the need to ensure that the impact of any changes to patients is minimised, and that all changes are fully communicated. All measures will be reviewed regularly by the hospital management team to ensure the least impact on patients and service users. Patient safety remains our first priority.

I reaffirm the Government's ongoing commitment to the construction of a new children's hospital. I am committed to the principle of co-location with an adult hospital, but I know that others may have a different view. I will await the completion of the work of the review group. One thing is clear: I am determined to deliver a national children's hospital for the children of this country.

An Leas-Cheann Comhairle

There is only one minute for supplementary questions. I ask Deputies to be brief.

Deputy Eric Byrne

I welcome the Minister's response, but I would like to ask him some personal and pertinent questions. Would he wish to express a view on the concept of a tri-located hospital?

We were always mystified in Crumlin because we had a great relationship with the Coombe Women's Hospital in keeping premature babies alive who required very intricate surgery very early on in their lives that a maternity hospital was not the preferred option in terms of co-location. Will the assessment criteria proposed in the McKinsey report, Children's Health First, in 2006 be used in reviewing An Bord Pleanála tragic rejection of the current site?

Deputy Charlie McConalogue

It is unacceptable that we have been waiting this long for a national children's hospital. We should have seen its construction before now. It is also unacceptable that the Minister is a year later launching his second review. He must take responsibility in that regard. If he had conducted such a review a year ago, perhaps we might be further ahead. The reality is that he made a decision to proceed with the hospital on the Mater Hospital site. If in his view it was the correct location this time last year, why is he not willing to proceed with it now on it?

The Minister has not answered my questions about - to use his own language - the more "grandiose" aspects of the project. What exactly were the grandiose aspects of it? If he Minister considered they were an unnecessary luxury, why did he not intervene before now?

Unfortunately, we are a year into the Minister's tenure and there is even more overcrowding in the children's hospital and, unfortunately, we are further behind in the delivery of a national children's hospital. I ask the Minister to address these questions.

Deputy Billy Kelleher

In the context of the Minister's commitment to adhere to best international medical and clinical advice that there be co-location with an adult teaching hospital, the terms of reference of the review group under the chairmanship of Dr. Frank Dolphin in assessing various sites do not refer to this as being sacrosanct. Clearly, if best international practice, based on the McKinsey report and the report that the Minister himself commissioned last year, is that there be co-location with an adult teaching hospital to secure the best clinical outcomes, should this not have been included in the terms of reference to ensure the review group can only look at sites where co-location is an the option, as opposed to greenfield sites? Are we limiting the potential to provide a world-class co-located facility by not even mentioning this in the group's terms of reference in the context of seeking the best clinical outcomes in the provision of paediatric care?

Deputy Mick Wallace

No matter what the Minister does, there is little doubt but that the new hospital is further down the road. Even if he was to reduce the height, the steel and concrete drawings would have to be redone. There is much work to be done to reach a stage where one can start work on the hospital. The children of today deserve a better deal in Crumlin and Temple Street. We need to spend money on these hospitals because provision of the new hospital is a while away.

Deputy James Reilly

We were advised by the expert group, the recommendation of which at the time was that it be located on the Mater Hospital site. The planners have decided otherwise. We have put together a group to report within 56 days of its first meeting on the best route forward. The main concern must be building a new facility for children in order that they can receive the best treatment in the best environment.

Deputy Mick Wallace mentioned several persons. I put it to him that even Professor Michael O'Keeffe has spoken about the fact that he gets more work done in one day in a private setting than he does in a week in the public sector. There are significant efficiencies capable of being achieved within the public sector in how we use theatres - the productive theatre initiative - and much progress has been made. I compliment Professor O'Keeffe on having one of the shortest waiting lists and doing Trojan work, but I cannot agree that children will go blind or die from brain tumours because operations will not be carried out in time. Urgent adult and children cancer cases are treated first as a matter of priority, which is the way it should be.

The Government is fully committed to developing a national paediatric hospital in order that children can receive the best care in the best environment. We will look at all the options put to us by the review group. I look forward to receiving its report within 56 days of its first meeting.

Newborn Screening Cards

Deputy Denis Naughten

Small blood spot samples are collected from all Irish children in infancy via the heel-prick test. These samples number 1.6 million since 1984. There has been controversy in the past few years because of the lack of a formal written consent process for the analysis and storage of residual samples. This has led the Data Protection Commissioner to call for the samples to be destroyed. The call for sample destruction has been prompted by the lack of consent for sample retention and concerns about protecting the privacy of the individual.

While there is little doubt that the taking and storing of samples without consent are no longer acceptable, it must be recognised that the destruction of older samples will result in the loss of a valuable national resource. The blood samples have the potential to be used to form a national DNA database, in respect of which one critically important aspect is sudden cardiac death. Up to 100 young people in Ireland die suddenly and unexpectedly each year and the cause is unidentifiable. Based on estimates of the prevalence of sudden cardiac death in Ireland and on foot of a New Zealand research study, it is estimated that up to 170 samples could provide vital information for individuals and families prone to sudden cardiac death. This would mean 170 families potentially could have access to preventive treatment to reduce the trauma faced by many on foot of an unexplained sudden death when, for example, a young person drops dead on a football pitch.

It would not only be helpful in the case of sudden cardiac deaths. It would also have the potential to help researchers to identify genetic conditions and develop treatments, even cures. This covers the full range of genetic diseases ranging from rare diseases, including cystic fibrosis, from which 17 Irish children under the age of five die every week, to more common diseases such as multiple sclerosis and cancer. Thousands of individuals and families could benefit in giving researchers access to this valuable bio-bank.

There would be non-medical benefits also. There would be massive benefits in using the bio-bank to confirm identities in the cases of missing persons, as Ireland is one of the few countries in the world which does not have a national identify card.

In September last year the New Zealand Government announced a new legislative process to protect and preserve indefinitely blood spot cards in New Zealand by way of a clear legislative framework that would include a formal written consent process, information packages for consenting parents and legal limitations on how the samples were to be used. The Data Protection Commissioner has taken the strictest possible interpretation, even when it is not benefiting society or the individuals in question. Surveys have shown that the public overwhelmingly supports medical data being used for this type of research. By all means, introduce an opt-out clause for individuals or parents who have concerns. Surely such a clause could be introduced to address the concerns raised by the Data Protection Commissioner, while, at the same time, protecting society and individuals in regard to the genetic diseases that can be identified and treated in order to save lives.

Deputy James Reilly

I thank the Deputy for raising this issue. In late 2009 the Data Protection Commissioner received a complaint from a member of the public about the retention of newborn screening cards. The basis of the complaint which was upheld by the Data Protection Commissioner was that the newborn screening cards should not be retained indefinitely without consent as this constituted a breach of the Data Protection Acts 1998 and 2003.

During 2010 a number of meetings were convened with the deputy Data Protection Commissioner and representatives of the HSE, the Department of Health and the Children's University Hospital, Temple Street. A policy was agreed in conjunction with the Data Protection Commissioner to address both the legislative and ethical requirements of the national newborn screening programme which included disposal of archived newborn screening cards older than ten years.

Following receipt of representations concerning the proposed destruction of archived newborn screening cards, I requested the HSE to conduct a review of this decision. The review examined both the legal and ethical basis for the retention of newborn screening cards and the potential use of the existing cards for research purposes. It is my understanding the review group examined the governance arrangements for the retention and use of newborn screening cards in a variety of jurisdictions, including New Zealand, Australia and the United States. As the Deputy may be aware, legal uncertainties over access to and use of newborn screening cards have led to the destruction of cards in Western Australia, Texas and the Netherlands.

The report and recommendations of the review group were submitted to my office in January. Having carefully considered the issue, I have accepted the recommendation of the review group that, in order to meet our legal and ethical responsibilities, newborn screening cards older than ten years will be destroyed. However, I fully recognise the value of this material for research purposes, as outlined by the Deputy, which was why the review group was tasked with exploring ways in which the material could be made available to the research community in a way that was compatible with our ethical and legal obligations. The international consensus clearly favours seeking explicit consent from an individual and-or his or her parent-guardian for use of previously collected biological material for research purposes. Therefore, in the interests of facilitating research, the HSE will mount an information campaign offering members of the public the opportunity to have their screening card returned to them, prior to destruction of the cards taking place. This will ensure those who wish to donate their or their child's newborn screening card to research will be afforded the opportunity to do so.

The proposed course of action seeks to ensure public trust and a continued willingness to participate in the national newborn screening programme, which is a vital public health measure for children and their families. Given the complexities of this issue and being mindful of the genuine sensitivities of those concerned, I am anxious for the findings of the review group to be published. I will arrange for my Department to liaise with the HSE to have this done as a matter of priority.

Deputy Denis Naughten

I thank the Minister for his reply which is at least moving to try to deal with the concerns I have raised. I ask that we try to find a mechanism, in so far as is possible, to clearly explain to individuals the potential uses to which this very valuable bio-bank could be put, not just for themselves but for society as a whole. This would mean that, unless someone had a real and genuine concern, such blood samples would be offered for medical research. As I said, the public very much believes such research should be facilitated.

Will the Minister ensure the report is published in full immediately? Extracts from it were published in one of the national newspapers last Saturday. It is important, therefore, that the full report is placed in the public domain as soon as possible in order that we can have a full and open public debate in advance of any option being given to the public in order that it is fully aware of the concerns raised.

Has a full assessment been carried out as part of the report of the potential uses to which such a bio-bank could be put? I note with interest that last Saturday, the day this issue was raised in the newspaper, members of the Roscommon football team were undergoing cardiac screening. It is unbelievable that, on the one hand, we are trying to screen young people and, on the other, there is a very large databank in place that could be used in ensuring every single young person in the country was screened for this and many other conditions. However, we cannot access it at this time.

Deputy James Reilly

There are plans for us to communicate with and ask people for their consent, which is only right, proper, legal, ethical and moral. It is not right to collect biological information without someone's permission and it is not right to use such information for purposes other than that for which it was collected. There will be much debate about this issue into the future as the field of genetics, including molecular genetics, continues to develop. We have the spectre of insurance companies seeking a person's DNA to decide what risk he or she presents and what are chances he or she will contract different diseases. That is not something I would particularly relish because I could foresee people being almost uninsurable due to genetic information which, no matter how good it is, is not always 100% accurate. It is certainly not 100% accurate in its current rudimentary stage.

I will endeavour to communicate the benefits, as it is very important to do so. I take the opportunity to advise that becoming involved in research and being part of clinical trials confers not alone access to the latest technology and medicines but also provides for a person tremendous supervision throughout his or her treatment that would not often be provided during normal treatment, given that the constraints during trials are so tight and the protocols so comprehensive.

We will, of course, publish the report, as the Deputy has asked. I believe he is right that we should have more debates on this issue and make a full assessment of the use of retained cards. I have no doubt that, into the future, there will be even greater possibilities arising from such sources. However, as I said, we have a legal obligation under the Data Protection Acts to ensure information, particularly biological information, is used for the purposes for which it was gathered, not for any other, unless there is express consent. The House would agree with this.

Dáil Éireann debate - Tuesday, 6 Mar 2012