Leaders' Questions

The ongoing saga of the selection of primary care centres, particularly in north County Dublin, continues unabated. The more the Minister for Health, Deputy Reilly, endeavours to explain himself, the more the number of questions that need to be answered. When one stands back to consider the situation, what emerges is the fact that a Labour Party Minister of State has resigned. The public outside Leinster House are baffled by the fact that a Minister of State who was pursuing the implementation of part of the programme for Government in an open and transparent way found it necessary to resign. People do not understand why. The general sense is that she was abandoned and isolated by the Tánaiste and her senior Labour Party colleagues.

From the outset and right up until yesterday, the answers about the site selection have kept changing. I understand that the Minister for Education and Skills, Deputy Quinn, was incensed that he took a fall because he had been given the wrong information, in that the former Minister, Ms Mary Harney, was wrongly blamed yesterday for the selection. Will the Tánaiste offer a definitive answer as to when the site was selected? To put an end to this issue, will he agree to publish all documentation and advices relating to it?

In a parliamentary reply on 16 May, the Minister for Health stated that the process represented a complete adherence to the system outlined by the then Minister of State, Deputy Shortall. There was no hint of a difference or addition. In June, the Fingal Independent reported that the Minister was signalling to people publicly that Balbriggan would be added. In July, he overrode the decision of his Minister of State. Will the Tánaiste agree to publish all of the relevant documentation and advices?

The Secretary General of the Department of Health, Mr. Ambrose McLoughlin, stated that he could not confirm whether he saw the final list. Something has become more noticeable in recent replies, particularly those last Thursday, in that the Minister has stated "I personally added", "the criteria were my criteria" or "they were decided by me". The Civil Service demarcation is clearly in evidence, in that the service was removed from what occurred subsequent to Deputy Shortall's list. This is an important issue. We could sort the situation out if all of the advices and documentation were published.

Was the Tánaiste consulted by the Minister on the added sites?

The Minister, Deputy Reilly, replied to these issues in the House yesterday. If Deputy Martin or another Deputy wishes to put questions to him, I am sure that he will happily reply. In any event, documentation is available publicly under the freedom of information system. I would have no difficulty with making documentation available.

I read newspaper reports this morning and met the Minister, his Department's Secretary General and the new CEO of the HSE. They told me that there had been no ministerial involvement of any kind in the selection of individual sites for primary care centres.

Regarding the issue of whether I was consulted, one must remember that this process occurred in the context of the production of an economic stimulus package worth €2.25 billion, which was announced by the Minister for Public Expenditure and Reform, Deputy Howlin.

A decision was taken to increase the number from 20 to 35. I was consulted about that and I agreed with the rationale for it. My primary concern was that we had a good stimulus package and it maximised the amount of input into the economy and the creation of jobs. I agreed with the increase from 20 to 35.

I find that an extraordinary response. Do not tell us we must depend on freedom of information; I am asking the Tánaiste, as deputy leader of the Government, to see to it that all the documentation will be published in the next couple of days. There is no reason it should not be. I do not want Secretaries General stating that correspondence with Ministers is confidential. On this issue, transparency demands that all the documentation be published now.

There should be no cover up.

We should not wait for two or three months for this storm to abate, with documentation then fed out with some of it redacted, as all previous experiences with freedom of information requests to the Government have shown.

No more cover ups from Labour.

There were no cover ups when Deputy McGrath supported the last Government.

I want the documentation published. Nobody stated that a Minister was involved in a selection of a site except the Minister for Education and Skills.

The Deputy was not there.

No more cover ups.

Could we have a supplementary question?

We are talking about the adding on of centres. The mention of a stimulus package is a feeble response, as the former Minister of State, Deputy Shortall, was anxious that those most in need would get the allocation, and hence the list. Dundalk was 21st on the list and Swords was 144th on it. Does the Tánaiste stand over that? There could have been another 15 on Deputy Shortall's list beyond the 20 on the basis of an internationally recognised index of deprivation. That would have satisfied any stimulus needs but this was never a stimulus project. It is a project to develop primary care in accordance with the programme for Government. Internationally agreed criteria was drawn up between the HSE, the Department of Health and the former Minister of State, Deputy Shortall, who was at the time given responsibility for primary care. The Tánaiste abandoned her, consulted with the Minister for Health and agreed to divvy up the process for whatever reasons, be it political expediency or constituency reasons. The Tánaiste cannot admit it, be honest and say why there were additions to the list made in an arbitrary and unilateral way, completely at variance with the nine-month long job of work done by Deputy Shortall, her officials and the HSE. It is a very weak response to try to cover this up under the cloak of a stimulus package.

Perhaps the Deputy could teach the Tánaiste how to cover it up.

It is about transparency.

Of all the issues he can choose to raise here, with health Deputy Martin is in no position to-----


Hear, hear.

Sorry, could the Tánaiste answer the question?

I answered the question.

People are fed up with this nonsense.

He should stop ducking and diving.

The Deputy is an architect of the HSE.

He was in the Government at a time when there was money in this country and he allowed the health system to deteriorate. He kept throwing money at it and ended up creating the HSE.

Answer the question.

We are doing-----

Are we to blame for the former Minister of State, Deputy Shortall, resigning on the Tánaiste's watch-----

We are reforming-----

-----and without his support? Am I to blame for that? Keep repeating the mantra.

-----the health system-----

The Government is reforming nothing.

-----at a time when there is less money-----

Dundalk was 21st and Swords was 144th in that list and the Tánaiste is standing over it.

Does the Deputy want the answer? He keeps bellyaching-----

I want the real answer.

-----about me not giving an answer-----

Could we have some order?

-----and every time I try to answer, he interrupts me. What the Deputy is doing-----

Which Secretary General and CEO of the HSE was involved?

He is the man who said there should be an end to politics as usual but he is continuing politics as usual.

We are reforming the health service at a time when less money is available and there are fewer staff. Our priority is to shift to primary care in our health system, and this is not just a matter of writing it down in a programme for Government or a document. We must provide-----

He is ignoring the question.

Will the Tánaiste provide the documentation?

Will the Deputy please listen to the answer? In order to deliver the reforms-----

Was it the previous Secretary General of the Department?

-----in the primary care system, we must provide the resources. That is what we were doing with the stimulus package and-----

Is it that the sites jumped the queue?

-----why the primary care centres were included in that stimulus package.

The real story here is that whereas the Deputy opposite presided over the decline in our health service-----

The Tánaiste sacrificed his own Minister of State.

He sacrificed nothing.

-----this Government is making-----

Answer the question.

He sacrificed the Minister of State.

-----reforms and driving ahead-----

She was truly reforming.

-----with the provision of primary care systems. The Deputy says he never accused the Minister, Deputy Reilly, of this or that. I am cutting to the chase on this-----

You cut Deputy Shortall.

I asked the questions of the Secretary General of the Department of Health and the CEO of the HSE.

Will the Tánaiste publish the documentation?

I have told the Deputy the answer both gave me, which was that there was no ministerial involvement in the selection of individual sites.

I accepted that. I want to know about the documentation.

What was the story yesterday?

There is the Deputy's truth.

It was different.

Will the Tánaiste publish the documentation?

I call Deputy McDonald.

The Deputy opposite was there for a decade.

I have called Deputy McDonald.

I welcome back the Tánaiste. He was missed as it was busy.

The Ceann Comhairle might deal with the little boy heckling.

Gerry was on it.

The Deputies can give it but cannot take it.


Hear, hear.

A bit like the Labour Party.

The Deputy should proceed.

There is still a picture of Deputy Finian McGrath in St. Luke's.

The Deputy should proceed, without interruption.

Yesterday's statement by the Minister for Health, Deputy Reilly, regarding the primary care centre controversy has answered none of the key questions. What we know is that the Balbriggan site belonged to a Fine Gael supporter or advocate and was selected on the Minister's watch, and not that of the previous Government, as had been suggested.

The Minister for Health and the Taoiseach have consistently told the Dáil that there had been consultation with senior Labour Cabinet Ministers in respect of the change to criteria and the additional primary health care centres. The Minister for Social Protection, Deputy Burton, and the Minister for Public Expenditure and Reform, Deputy Howlin, all denied they were consulted. At least we now know where the senior level consultation happened, as the Minister, Deputy Reilly, spoke to the Tánaiste about the issue. So the Tánaiste has said.

When did the Tánaiste first become aware of concerns about the Minister's decision to locate two of the additional primary health care centres in his constituency? Did the former Minister of State, Deputy Shortall, bring her concerns to the Tánaiste before her resignation? Was he aware of those concerns when he signed off on the additional 15 health care centres? Was he aware of those concerns at the time he voted confidence in the Minister for Health, Deputy Reilly?

The Tánaiste made a speech about openness and reform, which he is manifestly failing to deliver. I cannot understand why despite unease within his political party - two MEPs have called for the Minister, Deputy Reilly, to do the decent thing and step down - the Tánaiste is still standing by him. I will quote the Minister's statement from yesterday, if I may.

The Deputy is nearly a minute over her time.

How is this for clarity and transparency? He stated:

One and one makes two and two and two makes four but four by four makes 16 and not four and four which makes eight, and so it is with this. It is a logistical logarithmic progression.

Is he for real? It is clear as mud. The criteria were fixed, as the Tánaiste knows, and stroke politics was at the heart of the Government, as the Tánaiste knows.

The Deputy should adhere to the directions of the Chair.

Answer my questions and we can see if the Tánaiste will stand by his promises for reform.

There is no secret about the fact that there were differences between the former Minister of State, Deputy Shortall, and the Minister for Health, Deputy Reilly. At all times I supported the former Minister of State, Deputy Shortall, in what she was seeking to do in the Department of Health.

She does not believe that.

There were a variety of meetings held, including one involving the Taoiseach, me, the Minister for Health and the former Minister of State, Deputy Shortall. That took place prior to the summer and we put in place a working group representative of the Taoiseach and my office to address some of these issues and make progress on them.

The working group has been making progress since then. My priority and that of the Government, bearing in mind that we are dealing with this at a time when we have a very serious financial difficulty, is to achieve reform in our health system. At the centre of that reform is a shift to primary care. There is a very good reason we want to shift to primary care; it is because people who want to access our health system have to go to their GP, somewhere else to get a blood test and somewhere else to get another-----

We know all of that. It is waffle. Answer the question.

Allow the Tánaiste to continue without interruption.

It is not waffle to the parent of a sick child who has to go from Billy to Jack under our health system.


Hear, hear.

Our priority as a Government is to get primary care centres provided, built, staffed and up and running.

The former Minister of State, Deputy Shortall does not think it is a priority.

Members of Sinn Féin were among those who constantly asked, day in and day out, where is the stimulus package and why is there not one. We have produced a stimulus package of €2.25 million and have taken the opportunity in that package to include the provision of primary care centres in order that we can provide in local communities a centre where somebody who is ill or who has a sick child can get the range of services provided under one roof rather than the ragged, disorganised, inefficient and costly system that we have at present. That is what the programme for Government states we will do and that is what we will press ahead to do.

On the question of whether I was involved in terms of the criteria, I was no more involved in the criteria for how primary care centres were selected in the Department of Health than I was involved in the criteria that were used in the Department of Education and Skills for the selection of schools or the criteria that were used in the Department of Transport for the selection of roads.


Hear, hear.

What I was involved in, and am proud to have been involved in, was the production of a financial package, despite all the financial difficulties this country has, which provided for the building, staffing and resourcing of primary care centres and our pressing ahead with that. I recently nominated Deputy Alex White to be Minister of State to take charge of that and I am confident he will deliver on it as part of the team in the Department of Health.


Hear, hear.

The Tánaiste is well aware that he does not have to convince anyone in this House as to the value and necessity of primary health centres, so I wish that he would dispense with what amounts to waffle when straight questions are put to him.


Let us piece it together now because the Tánaiste is not volunteering information - it has to be extracted from him.

There is a time limit of one minute on this.

The Tánaiste signed off on the additional 15 primary health care centres. When he did that he was aware of Deputy Róisín Shortall's concerns. He told us that he did not know anything about the criteria. I suggest to him that as Tánaiste he should have paid more attention and, if he did not know about the criteria then I hope to God he will tell us that he has an understanding of the criteria now because none of the rest of us can make head nor tail of the incoherent bluster coming from the Minister, Deputy Reilly.

Thank you, Deputy.

There was a predetermined outcome to this and the criteria were fixed to achieve that. I think the Tánaiste knows that and that is the reason for his reluctance to spell out clearly and to answer clearly specific questions put to him. He signed off on the additional health centres; he did so knowing the difficulties and deep concerns Deputy Róisín Shortall had. He voted confidence in a Minister in whom I cannot see him having had any confidence. He hung Deputy Róisín Shortall out to dry and he makes no apology for doing that-----

That is rubbish.


-----and to top it all he will not even give a basic commitment, if he does not understand the criteria, to publish all of documentation for public scrutiny in order that the rest of us have the benefit of that information. Reform my eye.


Hear, hear.

On the criteria, I did not see the Deputy make any complaint about the selection of the additional primary care centre in Deputy Adams' constituency. There was no complaint about that. I did not hear any complaint from the Deputy.

We have raised the 15 centres.

That is one of the 15.

Yes. We are raising the criteria that-----

I did not hear any complaint from Deputy McDonald about what criteria were used to decide on the selection of Grangegorman in the Deputy's constituency to develop a new third level education facility, which we are proud to do.

That was a previous Government's policy.


The key issue is that the Government is pressing ahead with the reform of the health service, with the provision of primary care centres which is what matters to the people and to those who want to see a better health care system. We are providing the funding for that and that was done in the stimulus package.

With regard to all the allegations, implications and so on that somehow there was political interference in it, as I said, I met today with the Minister, Deputy Reilly, the Secretary General of his Department, the new CEO of the HSE and they told me directly that there was no ministerial involvement in the selection of any individual site.

There was in terms of adding certain centres. The Tánaiste is being disingenuous.

I am not being disingenuous.

Perhaps I could be allowed to make the Dáil a Deputy Reilly free zone for the next few minutes to the relief perhaps of some members of the Government. That issue has tended to overshadow an equally important issue which happened three days ago and one day ago. Three days ago AIB bondholders were paid €1 billion and one day ago AIB mortgage holders were charged another 0.5% on their mortgage if they have a standard variable rate. Those mortgage holders, the borrowers, who are affected by this do not miss the connection and they see their money and the extra payments they are making as a direct payment going to the bondholders.

The Tánaiste will be aware, because it has been well publicised, that those with a not unusual mortgage now of up to €300,000 will pay an extra €1,080 per annum as a result of this 0.5% rise. I do not know if he realises how many of these people simply will not be able to pay that rise - how many of these people he is going to be asking to pay more money and more taxes on the same properties in the forthcoming budget.

We are now reaching a situation where middle Ireland simply cannot pay what the Government is asking it to pay. I ask the Tánaiste to please not come back to me and say this is not a Government matter. I would agree with him if he were to say this has arisen because the banks, particularly AIB, have been allowed to go walkabout. There is a kind of declaration of independence by AIB at the moment where it is taking its own decisions and crucifying its mortgage holders. In the meantime the Government, which owns nearly 100% of the bank and has supposedly two public interest directors on its board, is washing its hands of a huge problem where it can exercise a serious level of control. Is it Government policy that it contributes to and helps the increasing problem of the crippling mortgage debt we are now facing by allowing this bank, which it effectively fully owns, to add to the debt by putting up mortgages for those who cannot afford it?

The issue of mortgages, mortgage arrears and the difficulties people have in meeting their mortgage commitments is very much a top priority for the Government. That is why, as the Deputy will know, we brought forward the personal insolvency legislation, Report Stage of which is due to be taken in the House shortly.

It is why we have put in place a range of measures to support people in mortgage difficulty and to ensure people do not lose their homes in this financial crisis.

This Government, unlike its predecessor, has had regular engagement with the banks about a range of issues, including their obligation to lend to business, what they are doing about new mortgages and what they are doing to deal with the problem of mortgage arrears. We inherited the banking crisis and the decisions made by the previous Government and this is why we have worked to seek agreement at EU level on the separation of bank debt from sovereign debt and why we are insisting that that agreement be implemented in full and that the huge burden placed on the back of taxpayers as a result of the banking collapse is lifted.

With regard to commercial decisions made by AIB, the Deputy would be the first to criticise the Government if it sought to engage in hands on decision-making in the banks but, as far as mortgage holders are concerned, the Government is firmly on the side of people who are having difficulty meeting their mortgage payments and that is why we have taken the steps we have taken and will continue to do so.

I thank the Tánaiste for his reply but I would like to correct him. I would be the first to say that the Government should intervene on a day-to-day basis on decisions of this sort. The Government owns it and it has two directors on the bank's board. I do not know what they are there for if they are not there to have an input into policy decisions. AIB has a disgraceful record as regards mortgages and it has brought the country to its knees. The people who were there then are still there now. Appointments of the old cronies are still being made to the board and the old people are resurfacing. The Government should ring up the bank to say: "It is not Government policy. We do not want a 0.5% increase in mortgage interests rates for these people and we forbid you to do it." This increase is obviously part of Government policy. It is rather like a tax because the Government is asking the people who are being charged an additional 0.5% to support a State asset which is losing money. It is equivalent to a tax and I suggest the Tánaiste should intervene and say there will be no more interest rate rises at this stage by giving instructions to the directors who are there at his beck and call. I do not know what they do.

What proportion of the money AIB will take in through this increase will go to the bank? Is the Tánaiste aware that a large number of the bank's mortgages have been securitised and sold off in bundles to other institutions outside this jurisdiction? Much of this money will not even go to the AIB or the Exchequer. It will go outside the country because the mortgages have been securitised. I do not expect the Tánaiste to give a specific answer to that now but I would like to know what proportion of the money will go to AIB.

I do not propose to take advice from the Deputy about how the banks should be run because I recall the advice he gave the previous Government when he said it should make Sean FitzPatrick the governor of the Bank of Ireland.

Here we go again. That is the Taoiseach's line.

That is an old one.

Deputy Ross does not have a particularly good track record on this. I will also not come into the House to defend the practices of banks, now or in the past. What the Government is doing in regard to our banking system is to ensure, first, we have a banking system that is fit for purpose for our economy. It is a work in progress and there are a number of dimensions to it, one of which is resolving the issue of the separation of the debts associated with banks and the State. This work is a priority for the Government. Second, we want to ensure our banks serve our economy and our people, and this is why we have a continuing and regular dialogue with them about that. Third, we want to ensure the homes of people who are paying their mortgage are not at risk, and that is why we are putting in place the personal insolvency legislation, the support and advice system and a range of housing supports through the Department of the Environment, Community and Local Government. The interest of mortgage holders and their needs is very much at the front of the approach the Government is taking with our banks. It is a work in progress.

Is there a Labour Party member on the bank's board?

It is difficult work but it is work in which we will succeed.

The Tánaiste is becoming more like the Taoiseach every day as he manages to avoid answering questions.

I am answering them but the Deputy does not like the answers.