Dáil Éireann debate -
Tuesday, 26 Jun 2012

Vol. 770 No. 1

Topical Issue Debate

Foreign Conflicts

Deputy John O’Mahony

I thank the Ceann Comhairle for selecting the topic of the ongoing crisis in Syria, which seems to be escalating out of control as each day passes. I wish to state my total support for Ireland's commitment and support for the cause of international peace. Our Defence Forces have played a key role down the years in many areas throughout the world and I hope they continue to do so.

My main reason for tabling this issue today is to establish the position of six members of the Irish Defence Forces who are part of the United Nations supervision mission in Syria. That mission was to supervise a ceasefire as part of a six-point plan devised by Kofi Annan. The ceasefire has not happened and over a week ago the United Nations announced it was pulling back from its monitoring operations. However, the mission remains in Syria. There is great concern among the family members of the Defence Force members in Syria. They are concerned about their security and safety, particularly as the mission is unarmed and is to remain in the country. According to news and other reports, UN vehicles have been shot at and hit on numerous occasions. They suffered both direct and indirect attack before they halted their monitoring patrols. Explosions have also occurred close to the UN patrols.

I understand the members of the Irish Defence Forces are in communication with their families, as are the Defence Forces here. Is there a plan in place to deal with the situation if communication with Syria or with the area in which the mission is breaks down? Is there a plan for an emergency evacuation in the event of the situation escalating further? I understand the monitoring mission has been stepped down but that it will remain in Syria until 21 July. What are the plans after the mission is complete post 21 July? I understand that initially the aim was for the mission to continue for a longer period, perhaps for years, but this appears to be under question now. I thank the Tánaiste for taking the issue and I call on him to answer the queries raised.

Tánaiste and Minister for Foreign Affairs and Trade (Deputy Eamon Gilmore)

I welcome the opportunity to update the House on the current appalling situation in Syria and I thank Deputy John O'Mahony for raising the issue. All right-thinking people are offended by the continuing violence and blatant repression of human rights which are estimated to have claimed more than 10,000 lives in the past 15 months.

The situation in Syria was extensively discussed at yesterday's meeting of the European Union Foreign Affairs Council in Luxembourg, which I attended. The Council adopted strong conclusions condemning the brutal violence and the recent massacres at Houla and Al-Qubair and urging the Syrian regime to cease killing its own civilians. The Council was united in the view that President Assad and his regime have no place in the future of Syria. The Council also discussed and strongly condemned last Friday's shooting down of a Turkish jet fighter by the Syrian forces. This incident illustrates well the serious regional ramifications of the Syrian crisis and how easily the conflict could spill over into neighbouring countries such as Turkey and Lebanon. I emphasised this point in my intervention as there is now widespread concern to ensure that the current rather fragile stability in Lebanon is not endangered by events in Syria.

In face of the repeated gross violation of human rights carried out almost on a daily basis, all Syrians are legitimately entitled to expect that those guilty of such atrocities must be held to account. These issues are being discussed at the current session of the UN Human Rights Council in Geneva, at which Ireland and its EU partners are active and which is likely to adopt a strongly worded resolution on the human rights situation in Syria in the coming days. We have also made clear that we will support any referral of Syria to the International Criminal Court by the UN Security Council.

Deputy O'Mahony referred in particular to the situation of the six brave members of the Defence Forces who are participating in the United Nations Supervision Mission in Syria, UNSMIS. At the meeting of the Foreign Affairs Council yesterday I highlighted the critical situation of the UNSMIS. The operating difficulties faced by the mission were such that the force commander, General Robert Mood, had to suspend monitoring activities on 16 June. This came about in the face of escalating violence, a rise in completely unacceptable attacks on UNSMIS patrols and the constant obstruction of its activities. I understand, however, that as of yesterday UNSMIS has been able to resume conducting patrols and that the conduct of such patrols is being reviewed on a daily basis. I welcome this development. I expect the Syrian authorities to ensure from now on the full safety and freedom of movement of UNSMIS observers. In early July, the UN Secretary General will submit proposals to the UN Security Council and troop contributors on the future of the mission after its current mandate expires on 20 July. I earnestly hope that it will be possible for the mission to continue in some form beyond next month.

Despite the significant problems it is encountering, the Annan plan is thus far the only platform available to end the violence and to initiate a long-awaited political transition in Syria. We remain fully committed to this plan and to Kofi Annan's efforts to bring about a more concerted international response to the crisis. Closer engagement with Russia remains crucial in this regard. In the meantime, pressure must be increased on the Syrian regime to abide by its international obligations. The EU has already imposed extensive sanctions against Syria and further measures were adopted yesterday. At this stage, however, UN sanctions would be most effective, in particular, a comprehensive arms embargo to prevent arms getting through to both sides. I urge early action by the UN Security Council in this regard. The prospects for further increasing the pressure on the Syrian regime as well as encouraging greater unity and co-operation among the Syrian Opposition will also be considered at the next meeting of the Friends of Syria Group in Paris on 6 July, which I will attend.

The priority must be to end the violence and initiate some form of political process leading to transition in Syria. For the moment, we must continue to lend full support to the special envoy, Kofi Annan, the UN and the Arab League in their efforts to bring this about. Ending the conflict, not escalating it, remains the goal to which the international community must direct all its efforts.

Deputy John O’Mahony

I thank the Tánaiste for his reply and for his efforts to promote and encourage a solution to this serious problem. As I noted earlier, my main concern is for the members of the Defence Forces involved. I am unsure whether the Minister can confirm that the Irish contingent does not have its own medical back-up. Can the Tánaiste throw any light on this? I have no wish to raise hysteria but I am concerned about the safety and security of the members of the Defence Forces.

Deputy Eamon Gilmore

The Government continues to attach the highest priority to the safety and security of the members of the Defences Forces participating in the mission and that of all those participating in the mission. Close contact is being maintained between my Department, the Department of Defence and the UN, through our mission in New York.

General Mood fully briefed troop contributor countries and the UN Security Council during his recent visit to New York. We have received assurances from the United Nations that ensuring the safety of personnel and the safe conduct of patrols will continue to have the highest priority as UNSMIS resumes monitoring. I hope UNSMIS can continue in some form after its current mandate expires because its presence is of great importance and reassurance to the Syrian people. I take on board Deputy O'Mahony's comments on the concerns of family members of those serving on this difficult mission and I would be happy to brief him or to have my Department brief him on the steps being taken with regard to ensuring the safety of the personnel involved.

The events in Syria represent one of the greatest challenges to international peace and stability. There is daily escalation of violence and casualties, which are horrendous. Since the conflict erupted Ireland and our EU partners have been at the forefront of international efforts to steer the Syrian authorities away from violence and repression and to persuade all parties to engage in a peaceful process of transition. The conflict in Syria is bloody and horrific and I assure the House that we are determined to contribute to its resolution. We have contributed personnel to UNSMIS which is working in difficult circumstances. We are giving the highest priority to the safety and security of the members of the Defence Forces involved in the mission.

Patient Redress Scheme

Deputy Gerald Nash

I thank the Ceann Comhairle for giving me the opportunity to raise the issue of compensation for women excluded from the redress scheme of Our Lady of Lourdes Hospital, Drogheda. All Members, including the Minister of State, Deputy Shortall, have acknowledged the appalling wrongs done to the women who suffered altogether unnecessary hysterectomies at the hands of Michael Neary. The redress scheme of Our Lady of Lourdes Hospital was rolled out in 2007. It covered most of the victims but, unfortunately, it left 35 women in the cold. These women did not fit into the bureaucratic grid designed for the scheme. The intransigence of former Minister, Mary Harney, meant that calls for the inclusion of these women were met with cold indifference for years, which compounded the injustice they had already suffered. I understand that 29 of these women were excluded on the grounds of age. Women under 40 who had unnecessary bilateral oophorectomies were barred from even applying to the scheme. In one exceptionally harsh case a woman was excluded because the procedure was delayed by one week and, as a result, took place just three days after her 40th birthday.

The voices of these women went unheard for four years until this Government committed to finding a mechanism to compensate those who were excluded from the redress scheme on age grounds alone. Other women have been excluded for reasons other than age, including some who lost children and others who suffered unnecessary gynaecological hysterectomies. These cases have already been raised by the Patient Focus organisation. Last February I was heartened by the Minister for Health when he stated to the House that he was aware of these cases and had given an undertaking to Patient Focus that he would review them. He went on to indicate that the review was already under way. However, I am concerned that five months later there is still no sign of a mechanism to acknowledge the grievous wrongs done to these women, who have already been waiting five years. What was done to these women was shameful. We must not add insult to injury by forcing them to wait any longer for the justice they deserve.

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

I thank Deputy Nash for raising this issue. I recognise that he feels strongly about it and has raised it in the House on a number of occasions previously. I am responding on behalf of the Minister for Health.

The programme for Government commits to finding a mechanism to compensate those women who were excluded on age grounds alone from the Lourdes hospital redress scheme. I am conscious of the distress that has been caused to a number of women and recognise the difficulty the issue has caused to those affected by it. The Government is committed to dealing with the matter sensitively so that, if at all possible, closure can be brought to those affected.

The Lourdes hospital redress scheme was established following the findings and recommendations contained in the report of the Lourdes hospital inquiry into peripartum hysterectomy, which was published in 2006. The inquiry was conducted by Ms Justice Maureen Harding Clark. The inquiry did not extend to a wider examination of Dr. Neary's general practice or the clinical practice of his colleagues. However, during the inquiry Ms Justice Harding Clark became aware of certain patients who underwent bilateral oophorectomy procedures, or the removal of their ovaries, which were not clinically necessary. These women lost their ability to reproduce and suffered immediate surgical menopause.

The scheme of redress approved by the Government was a non-statutory,ex-gratia scheme. Awards were determined in 2007 and 2008 by an independent redress board chaired by Ms Justice Harding Clark. The objective of the scheme was to provide compensation to the patients of Dr. Michael Neary who received unnecessary obstetric hysterectomies, that is, hysterectomies carried out in association with pregnancy, and women under 40 years of age who received unnecessary bilateral oophorectomies. The Department of Health has been engaged in a review aimed at finding a mechanism to compensate those who were excluded from the original redress scheme on age grounds alone. This review involves taking legal and other advice, including from the Office of the Attorney General, on this sensitive issue. I understand that departmental officials have engaged with the Attorney General’s office. I am also aware of the recent media reports in respect of High Court litigation where sums have been awarded to plaintiffs against the Medical Missionaries of Mary for incidents that occurred prior to the State taking over the hospital. In this context, I understand that litigation is currently before the courts in respect of two plaintiffs who were patients of Dr. Neary.

I assure the Deputy that the Minister, Deputy Reilly, is committed to finding a mechanism as soon as possible and that he intends bringing proposals to Government for its consideration at the earliest opportunity. I am aware of the sensitivities associated with this issue and understand the importance of finding a solution that will bring closure for all concerned.

Deputy Gerald Nash

I appreciate the Minister of State's response and welcome the commitment in the programme for Government regarding the women who were outside the original scheme. The removal of ovaries and the crude withdrawal of the ability to reproduce is difficult for any woman to accept but it is particularly difficult in cases where such procedures are not clinically necessary. These are challenging circumstances for the women involved, many of whom reside in my constituency. In light of the impact this process has had on the women and their families, I ask the Minister of State to bring a sense of urgency to the matter. I recognise that she understands the sensitivities involved but I do not want the Attorney General to review the issues arising in perpetuity or the views expressed by the Minister and departmental officials to disappear into a black hole in her office. That has happened too often. These women need closure and justice must be done for them and their families.

Deputy Róisín Shortall

I assure Deputy Nash that I am conscious of the sensitivities involved and the serious distress that has been caused to these women. There is no question of the issue disappearing. Departmental officials are currently holding discussions with the Attorney General and I reiterate the Minister's commitment to addressing the issue as soon as possible.

Dental Services

Deputy Michael P. Kitt

The Minister of State, Deputy Shortall, is aware of the difficulties that face homeless people. I wish to discuss the particular difficulties experienced by homeless people in accessing dental services. There are no reliable national data on the number of individuals who are homeless in this country. I have seen estimates of up to 5,000 people and concerns have also been expressed about the increase in the number of young people who are homeless.

I ask that funding be ring-fenced for dental services for the homeless in Galway and Galway city in particular. Galway Simon Community and HSE west are co-operating closely to help the homeless despite the moratorium on recruitment. Progress has also been made on funding for chiropody services for homeless people and a multi-disciplinary team has been put in place with a psychiatric nurse, a substance misuse counsellor and a designated community nurse. I pay tribute to the nurse, Ms Joan Gavin, and her team for the work they are doing. However, the homeless face major barriers to accessing dental services. They are a high risk group for oral and dental disease and dental services should form an integral part of the primary care services for these vulnerable people.

When I speak about homelessness I do not refer solely to those who are sleeping rough. Those who live in hostels, sleep on the sofas of their friends' houses or remain in hospital because they lack a home in which to recuperate are also affected by these issues. They receive limited entitlements because they are treated under the group medical card scheme but they also require dental services. Many also suffer from depression and other problems. My main request is that the Minister of State considers funding and considers ring-fencing funding for dental services for the homeless.

Deputy Róisín Shortall

I thank Deputy Kitt for raising the issue, which he has been concerned about for some time. I am pleased to address dental services for homeless people in Galway. The dental treatment services scheme, DTSS, provides access to dental treatment for adult medical card holders. The service is provided by dentists contracted by the HSE. The DTSS budget for 2012 is €63 million. A free oral examination every calendar year and free emergency dental treatment are available to all eligible patients. Patients with special needs, those who have greater clinical needs and high-risk patients, including people who are homeless, receive priority for treatment. High-risk patients are those for whom untreated dental disease or the treatment of dental disease poses significant health problems.

The National Oral Health Office of the HSE issued standard operating procedures to dental contractors in November 2011 to support equitable and priority funding and provide clearer guidance to dentists on the application of DTSS prior approval requests. The procedures confirm that high risk patients are to be prioritised for approval. They receive all DTSS services that were available prior to April 2010, when services were reduced because of budgetary constraints. This includes an examination, all fillings as required and approval for complex care including root canal treatment, gum treatment and dentures. Homeless people, because of their lifestyles, tend to have a range of attendant needs including education, training, employment and housing, as well as a range of medical issues including addiction, mental health and general health issues. Addressing this range of requirements requires interaction between the HSE, Departments and statutory and non-statutory agencies. The needs of homeless people are complex and the response must be multi-faceted and complex.

The HSE has established a number of ways to bring health services to homeless people through, for example, the establishment of outreach multi-disciplinary teams that provide sessions in a range of homeless hostels and day services. The HSE gives priority to processing of medical card applications for homeless people in order to assist them in accessing available services. Of course, access to services can be arranged locally where necessary, pending a medical card being issued. Key workers for the homeless in Galway routinely link with dental services and the use of mainstream services is directed and encouraged.

The HSE is currently funding a diploma in special care for six dentists as part of an upskilling programme. Part of their training and remit includes the provision of services for homeless people and other vulnerable groups. The expertise of the graduates will be used to advise and support decision making on dental services for homeless people. I am pleased that, once qualified later this year, one of the graduates will be assigned to the HSE west area.

Deputy Michael P. Kitt

I thank the Minister of State and I am pleased to note that the diploma is being funded by the HSE as part of an upskilling programme. One of the six dentists will be assigned to the HSE west area. Apart from the representations made by me, the Minister of State also received representations from the Galway Simon Community, which does great work, and the multidisciplinary team under Ms Joan Gavin, which lobbied strongly for funding. I hope that what the Minister of State says will be put in place. Many people feel that, even with various limited services available and the fillings and extractions allowed under the medical card, we do not meet the needs of a vulnerable group of people. Perhaps matters will improve and I give due credit to the Minister of State for the funding of chiropody and other services. Providing services for homeless people is complex. Depression and the insecurity of people living in hostels, friends' houses or in hospital and worrying about where they will go when they are discharged must also be dealt with. I hope the extra funding for the diploma will help. Everything should be done to meet the needs of a vulnerable group of people.

Deputy Róisín Shortall

I appreciate the concern of Deputy Kitt in this regard. I assure him that I will give this issue further attention in the coming months. It is a welcome development that additional dentists will be trained specifically to cater for vulnerable groups, including homeless people. The additional person in the HSE west will be a positive development. I hope I can come back to the Deputy later in the year with specific details on what is proposed. People who are homeless in the Galway area, who have medical cards, are entitled to the enhanced services currently available. I appreciate the difficulty in accessing such groups or encouraging them to avail of the services but I encourage them to take up the services available to them.

Criminal Assets Bureau

Deputy Jonathan O’Brien

I thank the Office of the Ceann Comhairle for selecting this topical issue. I have raised this matter before, as the Minister is aware. The week before last, at the meeting of the Joint Committee on Justice, Defence and Equality, we examined a European model for the Criminal Assets Bureau. The Irish system and model is held up by member states across Europe as the ideal and there are attempts to duplicate CAB across Europe, which is welcome.

At the meeting of the Joint Committee on Justice, Defence and Equality, I said it was time to examine the procedures for CAB, which are defined in legislation. It is time for a conversation on how to use the funds gathered by CAB. Under section 21 of the Act, a report must be laid before the House. The report breaks down the money confiscated under three headings - the proceeds of crime, money liable to be paid to the Revenue Commissioners and money liable to be paid to the Department of Social Protection. I asked whether we could ring-fence money coming from CAB to put into communities ravaged by drug abuse. The idea has merit and is one we should explore at the Joint Committee on Justice, Defence and Equality.

When I raised this point in the past, the Minister has told me that ring-fencing money runs contrary to the Estimates procedure. The second reason is the amounts confiscated vary each year, which will not allow for proper funding streams for community projects that need to be planned three or four years in advance. However, there are a number of one-off capital projects and promotional projects that local drugs task forces and community groups could use year after year.

There is merit in ring-fencing the portion of money under the proceeds of crime heading. Between 2006 and 2010, that sum amounts to €14 million, whereas the money to be repaid to the Revenue Commissioners amounts to €44 million and money to be repaid to the Department of Social Protection amounts to €1 million. The sum of €14 million out of that pot is a significant amount of money to put into communities dealing with drug abuse at the coalface. It only requires an amendment to the legislation to enable it to happen. I ask the Minister to consider the idea.

Minister for Justice and Equality (Deputy Alan Shatter)

I am aware that the Deputy has raised this matter on several occasions and is keen to have a full debate on the question of diverting moneys collected by the Criminal Assets Bureau into community programmes. I welcome this opportunity to outline the current position in this regard. The bureau has served the State well in tackling serious and organised crime, including drug trafficking in this jurisdiction. Its work is an important part of the overall response to serious crime. I take this opportunity to congratulate the Garda Commissioner, Mr. Callinan, and his force, together with the Revenue's Customs and Excise service, on the extraordinarily significant seizures of drugs in Dublin and Kildare today. This event demonstrates the determination and resourcefulness of An Garda Síochána and the Customs and Excise service in tackling the activities of the major players in the illicit drugs trade.

In accordance with the provisions of the Proceeds of Crime Acts 1996 and 2005, all moneys collected by the Criminal Assets Bureau are returned to the Exchequer. In 2010, the total sum forwarded to the Minister for Finance for the benefit of the Exchequer through the actions of the CAB was approximately €7 million, of which €3.1 million related to actions taken on foot of proceeds of crime legislation, some €4 million related to actions under revenue legislation and €180,000 was raised through social welfare actions. These funds are returned to the Central Fund, from which the Government draws for expenditure on all necessary public services and investment. Suggestions have been made from time to time that moneys collected through the actions of the bureau should be used to fund community programmes. I appreciate that such proposals are made out of concern for the well-being of those communities most exposed to the adverse affects of crime in our communities and which bear the burden of living with its consequences. I also appreciate the significance of such a gesture as potentially a visible and tangible expression of the right of our communities to have returned to them advantages that were taken away by criminals within those communities. It is a suggestion that has been discussed from time to time and on which my Department has previously consulted with the Department of Finance.

While it has always been accepted that there may be a symbolic value in the suggestion, it has also been acknowledged that the ring fencing of such moneys gives rise to a number of practical difficulties. We are all aware of the requirement that public moneys be spent only as Voted or approved by Dáil Éireann unless otherwise provided by statute. A policy of ring-fencing moneys obtained by the Exchequer and the reallocation of same for a specific purpose, such as the funding of community programmes, runs contrary to the normal Estimates process. While there is a small number of very specific targeted exceptions, earmarking revenues for a specific expenditure programme would, generally speaking, impose constraints on the Government in the implementation of its overall expenditure policy. It can also be argued that a significant proportion of the moneys secured by the bureau, as evidenced by the statistics I gave for 2010, are already owed to the Exchequer, being related to non-payment of taxes and social welfare fraud.

In regard to the suggestion that particular projects be funded from proceeds of crime activities, given the variable and uncertain nature of the value of the assets seized by the bureau in any given year and taking into account the delays that may arise through possible legal challenges to court disposal orders, the provision of ongoing funds to community projects would be problematic. The uncertainty surrounding the level of revenue available on a yearly basis would not facilitate the proper planning of such programmes by organisations involved in the delivery of community development services. It is also the case that additional costs would accrue in the administration of any scheme to divert funds to local programmes. There would certainly be an additional administrative burden in the management of any such programme, whether through the engagement of service providers to administer an application process or otherwise. These additional administrative costs would arise without any additional revenues being generated.

The reality, given the present economic climate, is that the Exchequer could not sustain a loss of revenue without making compensatory adjustments. If the CAB money were to be diverted to community programmes, there would inevitably be implications for any other moneys those programmes received from the Exchequer. Alternatively, other public expenditure programmes would have to sustain the loss. While there are superficial attractions in the type of proposal the Deputy is putting forward, I ask him to reflect that, given the difficulties facing the Exchequer, his proposal would not have the positive effects he wishes to see.

Deputy Jonathan O’Brien

I thank the Minister for his reply. As he acknowledged, I have been seeking a more wide-ranging debate on this matter for some time. I accept his point completely in regard to moneys owing to Revenue or to the Department of Social Protection. As I said, the figures from 2006 to 2010 show some €44 million going back to Revenue and approximately €1 million to the Department. I am not suggesting for one moment that these two pots of money should be ring-fenced for community funding purposes. I acknowledge that these are moneys that should have been gone to the State in any case. I have no issue with that. I am asking the Minister to review the other transferred money, namely, the €14 million from the proceeds of crime. He observed that such a scheme would be difficult to administer. Why could it not be done by the National Advisory Committee on Drugs or even the Health Service Executive, to give just two examples?

I do not accept the Minister's argument that such a scheme would have only superficial benefits. We are talking about communities under enormous pressure because of the economic circumstances in which we find ourselves. Most if not all community groups have been subjected to cuts in funding in recent years and are expecting more of the same in the future. I am arguing that there is an opportunity to ring-fence this particular allocation for the benefit of communities. I do not accept that this would run contrary to normal Estimates procedures. We only have to look to the introduction of the household charge to see how money can be ring-fenced if the political will exists to do so. What I have proposed could be introduced by way of a simple amendment to legislation. I understand the Minister is considering the introduction of legislation to provide enhanced powers to the CAB. That undertaking provides an opportunity at least to explore some of the proposals I have put forward. It would be a good day's work.

Deputy Alan Shatter

I acknowledge the Deputy's sincerity in raising this issue and admit that his proposal does have certain attractions. However, I am obliged to be conscious not only of what is in the current legislation but whether, on a policy basis, the introduction of such a scheme would be a good idea. The work done by CAB is paid for out of public funds, as is the work done by the Garda Síochána to bring to justice those engaged in serious criminal activities. In circumstances in which the financial position of the State is substantially constrained on a general policy basis, I cannot support an amendment to legislation the effect of which would be to ring-fence any portion of the moneys obtained by the CAB in the manner the Deputy is suggesting. It is not how we should proceed at this time because it is not defendable in the context of the fiscal difficulties confronting the country. It is important to bear in mind that some of the moneys retrieved by CAB go into the general pool of funding, out of which pool the Department of Justice and Equality receives the allocation it requires to fund a range of programmes designed to support and assist the communities to which the Deputy referred.