Dáil Éireann debate -
Thursday, 15 Nov 2012

Vol. 783 No. 1

Topical Issue Debate

Community Employment Schemes Eligibility

Deputy Pat Breen

I thank the Minister for coming before the House in order to clarify some issues that have arisen in respect of the eligibility criteria for existing participants on community employment schemes, which, I am informed, changed on 8 October last. I have been contacted by a number of schemes with regard to this matter and I am informed that in order to qualify for more than one year on a community employment scheme, participants over the ages of 35 and 55 are now required to have been signing on and in receipt of social welfare payments for three years or more prior to joining a scheme. These individuals could previously remain on schemes for three and six years, respectively. Perhaps the Minister will clarify the position in this regard.

Extended access to employment on these schemes for those over the age of 55 was facilitated as a result of the difficulties which those in this cohort faced in the context of trying to secure alternative employment. It has been acknowledged that during the Celtic tiger era, those over 55 years of age experienced difficulties in securing employment. Surely it should be recognised that there are even fewer employment opportunities for them at present. There are major problems with regard to isolation in rural areas and there are very few job opportunities outside of agriculture for those in this age group. Community employment schemes are filling the void by providing meaningful employment that makes a real difference within communities. It makes no sense, therefore, to pull the plug - if that is actually what is happening - on some of these schemes in the middle of a recession.

I wish to refer to two schemes in particular, namely, the Kilrush youth services scheme and the St. John the Baptist community and development scheme in Ballyea, County Clare. However, I accept that there are other schemes which have either similar or other concerns. The schemes to which I refer were renewed last year on the understanding that the status quo would be maintained. The sponsors of the Kilrush scheme are debating whether it is feasible for the scheme to continue in light of the changes. I am informed that the scheme stands to lose 15 participants this year as opposed to five. This is in an area in which very few job opportunities exist. I have a constituency office in Kilrush and I am aware that the youth services scheme provides a lifeline for people in the town. Those on the scheme support the local community hospital and work to maintain the local graveyards, the parish hall and the church grounds. In conjunction with the tidy towns committee, they also see to the upkeep of Kilrush and Kilkee. Furthermore, they provide assistance to the west Clare cancer group.

The position with the St. John the Baptist development scheme in Ballyea is similar. I met representatives from the scheme on Monday last and was informed that out of a current complement of 22 workers, only five will remain in place at the end of January 2013. The majority of the workers on this scheme are over 55 and they are making an invaluable contribution to the local community. These individuals provide support to my parish, Ballynacally, and to the community in Ballyea. They also work with local amenity projects in maintaining the abbey and the graveyard in Killone. Those on the scheme support the community in Lissycasey. They played a pivotal role in the development of the Lissycasey Cascades Loop, a 3.7 km walk through a local area.

I am informed that if the schemes in question are wound down, a number of full-time employees who have given great services to the communities in the past will be affected. These people deserve recognition for their efforts. I am aware that the Minister is a great supporter of schemes of this type.

While I understand that changes to the eligibility criteria are driven by the desire to increase the number of opportunities for people to participate in community employment schemes, I am of the view that, if they proceed, people will be obliged to return to the live register at a time when few other employment opportunities exist.

The future of these schemes is threatened as the sponsor will find it difficult to replace existing workers. Time spent on community employment schemes no longer counts as eligibility for social welfare payments. A person who decides to accept a place on a community employment scheme may not have sufficient stamps at the end of a year to qualify for social welfare payment. In my view, this would be a disincentive to working on a community employment scheme. I ask the Minister to clarify the regulations governing these schemes.

Minister for Social Protection (Deputy Joan Burton)

I thank Deputy Breen for raising this issue. The underlying eligibility criteria for entry to community employment have not changed. Eligibility for entry to community employment is based on applicants being in receipt of welfare payments for a defined length of time, notably jobseeker's allowance, jobseeker's benefit, one-parent family payment and persons in receipt of disability-related welfare payments. Persons in receipt of jobseeker's and lone-parent type payments can qualify for one year on community employment under the one-year part-time integration, PTI, option if in receipt of a payment for 12 months or more. Being in receipt of the same payments for three years or more qualifies a person for the part-time job option which can last up to three years, subject to annually renewable contracts. However, the practice of using the duration on a community employment scheme under the PTI to build up eligibility to participate in the three-year part-time job option, was amended in a recent updating of community employment operating guidelines, published on 8 October 2012 and issued to CE sponsors and departmental staff.

The reason for this amendment was to reserve the longer time duration on CE for participants who are very distant from the labour market and most in need of the longer duration part-time job option. Some minor amendments were made to the CE operating guidelines based on feedback from staff and supervisors and this document will be updated as and when required.

I wish to clarify that this amendment will apply to new entrants only. This amendment is in line with the pathways to work policy where one third of the places on community employment schemes are focused on shorter, more intensive, active labour market interventions. The effect of this change will be to increase the number of vacancies available on CE schemes. The number of people able to avail of a CE placement will increase as more vacancies become available due to a greater number of exits from the programme. This still maintains the overall number of places on community employment schemes. The number of places on employment programmes in general, including CE, rural social scheme, Tús etc., is under continual review to ensure that it is adequate for the needs of the labour market. Since 3 April 2000, all community employment scheme participation is subject to the maximum participation limit of three years overall for those under 55 years of age and six years overall for those aged 55 to 65 years. Participants who were or are in receipt of a CE-qualifying disability-linked social welfare payment can avail of one additional year on top of these maxima. Department officials are actively liaising with sponsors to facilitate recruitment and to ensure continuity of service for projects and for the local communities.

I will refer to the schemes referred to by Deputy Breen. Kilrush youth centre services has 21 participants and one CE supervisor. It is due to roll over on 28 January 2013. It has eight vacancies to be filled under the current rules. A further six would have had to finish if the amended rule were applied to all CE participants and not just to new entrants. Exit interviews for these participants will be conducted as part of the individual learner plan process, along with a referral to the employment services. St. John the Baptist Association Limited has 20 participants and rolled over on 29 October 2012.

The main objective of community employment is to enable long-term unemployed people to re-enter the labour market through the provision of training and work experience on a fixed-term basis. I thank the Deputy for raising this matter and I wish to assure him that the Department of Social Protection will continue to liaise with the sponsors to fill vacancies on community employment schemes on an ongoing basis. I value community employment schemes. I have emphasised the retention of opportunities and placements for people who are so anxious to get back to work and to contribute to their community. However, as the Deputy is aware, we have offered an additional 11,000 places in Tús and in the JobBridge scheme. I hope to be able to continue to expand opportunities for people who are anxious to participate in community-type employment in their localities.

Deputy Pat Breen

I thank the Minister for her comprehensive reply. She knows the value of the community employment schemes. She visited County Clare a few weeks ago and I am sure she was in a number of towns and villages to see the wonderful work of these community workers. My concern relates to the over 55 age group. These are people who have given a lifetime of work to their community and they are now unemployed. They do great work in the CE schemes: they often do the work that was formerly carried out by local authority workers. Their opportunities for work are very limited when they leave the CE schemes. It is difficult to find a job when one is 55 years of age, particularly in rural areas. I appreciate their work, as do most Members. I am pleased the Minister is liaising with the schemes to ensure their viability. If these schemes were discontinued it would create a significant void in rural Ireland. Without the participation of the sponsors, rural Ireland would be a very different place. I urge the Minister to continue to improve the schemes and to make it easier for people over 55 years of age to continue their work in these excellent schemes.

Deputy Joan Burton

I thank the Deputy for his remarks. I congratulate the community employment schemes in County Clare. I have had an opportunity to meet with workers on the schemes and to meet the sponsors of schemes. I can testify to the very valuable community work and the contribution of the community employment schemes. The scheme sponsors endeavour to provide opportunities for people to advance themselves in the employment market. I am pleased to say that we have retained the schemes and the supervisors. Good supervisors are fundamental to the success of the schemes. We have been in a position to develop a number of new initiatives. County Clare has been outstanding in opting to take up initiatives under the Tús scheme as well as under the community employment schemes. I can assure the Deputy that we are very anxious to support the community work carried out by CE schemes.

Family Income Supplement Applications

Deputy Aengus Ó Snodaigh

Gabhaim buíochas leis an Aire as a bheith anseo. Ní raibhamar ach ag cur ceisteanna agus freagraí ar a chéile an tseachtain seo cheana féin. The family income supplement is paid to workers whose income from employment leaves the family below the poverty line. In 2011 the numbers qualifying for family income supplement rose by 10%. I presume the same increase will occur this year. Applications have increased this year. Since this Government came to power, the number of workers classified as under-employed has increased by 120,000 to 150,000.

Under-employed workers are those who would work more hours if they were available. My statistics are taken from the quarterly national household survey. A report in May by the retail sector trade union Mandate found that 39% of its members had reported a fall in take-home pay, with an average decrease of over €105 per week. I believe the average was €109. Average retail workers' hours have declined by 4.3% in the past year alone. This represents a substantial income change.

As the unemployment grows and wages fall, the number depending on FIS to keep their heads above water will continue to increase. However, owing to a failure of the Government to resource properly the Department of Social Protection, application processing times have become inexcusably long across a range of social welfare schemes, some of which we have discussed. The delays under the FIS scheme leave families in desperate circumstances. They are forced into arrears in respect of many household bills and left at risk of energy disconnection and eviction and at the mercy of moneylenders. Some families are left hungry, as is evident from the rise in the incidence of food poverty.

The FIS scheme has been subject to a growing backlog of applicants, particularly in the past six months. The processing times are a source of embarrassment to the Government. I suspect this embarrassment, coupled with a desire to defer as many of the back payments as possible until the next budgetary cycle, or early next year, has prompted the Minister and her officials to make a cynical decision that the FIS section of the Department should process only those applications received on or after 5 November. The effect is that new applications for family income supplement will be processed before those submitted five or six months ago. The new applications may be processed immediately, while those applicants who are unfortunate enough to have submitted applications earlier this year will be left waiting. The existing applications backlog is being withdrawn from the FIS section and transferred to Letterkenny, but it is not clear what additional resources, if any, are being deployed to deal with the additional applications.

The Minister hopes to kid the public by kicking these applications to touch. She is attempting to pull a fast one at the expense of vulnerable families. I have been given to understand most of the families who applied before 5 November will not receive any payment before Christmas. Over 7,000 families, with almost 16,000 children, are affected by the delay in clearing the backlog. What are they to do for Christmas and about the growing arrears in their household bills?

Will the Minister confirm that there has been a decision to instruct the FIS section to send all applications not processed prior to 5 November to Letterkenny? Have additional resources been given to the relevant office in Letterkenny? If so, from where were those resources drawn? Will the Minister confirm whether any or all of the applications received prior to 5 November will be dealt with and subject to payment, if due, before the end of the year?

Deputy Joan Burton

If the Deputy was really concerned about resources, he would have been more cautious in his own use of them. He has been a particularly costly example of the use of resources. Perhaps if he used fewer, we would have more to spend on the families about whom he is talking.

The Department is committed to providing a quality service for all its customers. The family income supplement scheme provides income support for employees on low earnings with families and is designed to preserve the incentive to take up or remain in employment in circumstances where the employee might be only marginally better off than if he or she was claiming other social welfare payments. The average waiting time for new FIS claims at the end of October was 18 weeks and for renewal applications, 19 weeks. At the end of October, there were 7,000 new FIS applications and 7,800 renewal applications awaiting a decision. The volume of FIS claims in hand and the delays in processing are, as the Deputy acknowledged, a consequence of the continuing strong claim intake. This is also the case in the other areas to which the Deputy referred. There are substantial increases in the number applying for social welfare benefits across the board, particularly family income supplement, carer's allowance, domiciliary care allowance, etc. I am happy that, despite the current economic difficulties, we have been able to deal with the higher volume of claims, pay out more to qualifying applicants and do so in higher numbers.

I have told the Deputy before that an in-depth business process improvement project has recently been completed for the FIS scheme. This project focused on optimising output and customer service and the elimination of backlogs. Part of the project was a detailed examination of workloads and a full assessment of existing capacity within the area and what capacity was needed to process the volume of claims, both new and renewed, received on a weekly basis. A plan has now been devised and implementation commenced on 5 November. This plan sees the normal weekly new claim and renewal intake processed without delay, while the backlog has been ring-fenced. There is a focused team assigned to this work and a clear plan for the elimination of the backlog. The first step taken to eliminate permanently the build-up of backlogs of FIS claims is to have sufficient capacity and suitable structures and processes in place to deal with the weekly intake. This has been done in the case of the FIS scheme and the first week of operation has been very successful, with target output achieved.

I congratulate the staff in my Department who have transferred to new and improved business processes with a view to offering a better service to our many customers. That is not to say the backlog of claims awaiting decision is being ignored or that work has ceased thereon. On the contrary, as the Deputy has been advised, a separate team, with additional temporary resources, has been identified and is already assigned to and working on the claims in question. I am sure the Deputy welcomes this, even if he is a little down over social welfare staff working in Donegal. The work being done in Donegal is highly welcome.

Deputy Aengus Ó Snodaigh

I have no problem with the work being done in Donegal.

Deputy Joan Burton

The Letterkenny office and staff are to be highly commended. I would have expected the Deputy to congratulate them. Sinn Féin wants to be on both sides of the street. The Deputy is giving out about what is happening in Letterkenny. The staff of the Department of Social Protection in Donegal provide an excellent service.

Deputy Aengus Ó Snodaigh

I did not give out about what is happening in Letterkenny at all.

Deputy Joan Burton

The team is focused fully on the elimination of the backlog of claims in the shortest possible timeframe, concentrating, in the first instance, on those claims previously in payment but in respect of which payment has expired. The Deputy will understand the reason for this. While it is not possible to clear all claims immediately, we expect to have the backlog cleared substantially in the coming period.

Deputy Aengus Ó Snodaigh

It is a pity the Minister did not listen to what I said. I have no problem whatsoever with the civil servants involved in processing, be they in Longford or Letterkenny.

Deputy Joan Burton

I thank the Deputy.

Deputy Aengus Ó Snodaigh

I have always praised the civil servants involved. I asked whether there were additional resources available. The Minister confirmed that she had found additional resources, but she did not say from where she had got them. It is welcome that there are additional resources to deal with the backlog. The problem is that the backlog will not be dealt with before Christmas, yet applicants who apply from this week will have their claims dealt with and be in receipt of payment in many cases by the end of this month or before Christmas. Patently, this is unfair. The Minister could have cleared some of the backlog in Letterkenny, in addition to dealing with new applicants; that is the way forward. The Minister is leaving people entitled to the payment without it. In some cases, the amount concerned could be substantial. Our calculation, based on an average figure, is that many families will be owed up to €3,500 by the Department. If payment is left until after Christmas, the average sum owed will be €4,500.

Those families have forgone what they are entitled to because of a failure to address the processing problems at an earlier stage. I welcome the fact that the Minister is addressing this, but the proper way to do it is not to allow people to jump ahead of the queue. That is patently unfair. Those people who are waiting have not been informed of the situation, other than those who have been in contact with my office - who, incidentally, were informed that the Department is no longer dealing with their claims, that they have gone to Letterkenny, that there is nothing more it can do, and that they may not get any payment or decision prior to Christmas. Even though it is welcome that this is being addressed, I do not believe it is being addressed in a proper and fair fashion.

Deputy Joan Burton

I will pass on the Deputy's complaint about Letterkenny but I must say the staff in Letterkenny-----

Deputy Aengus Ó Snodaigh

I did not complain about Letterkenny.

Deputy Joan Burton

-----have provided an excellent service, particularly in areas such as child benefit.

Deputy Aengus Ó Snodaigh

I complimented it.

Deputy Joan Burton

The Deputy is lecturing about claims and costs. He would do better if he made sure his own costs in this establishment were moderated-----

Deputy Aengus Ó Snodaigh

There is no problem with my costs.

Deputy Joan Burton

-----and that money that was claimed-----

Deputy Aengus Ó Snodaigh

How many special advisers have gone up-----

Acting Chairman (Deputy Robert Troy)

The Minister, without interruption.

Deputy Joan Burton

Your usage of certain kinds of expense would put everybody else's expense claims in the shade.

Deputy Aengus Ó Snodaigh

I do not think so, Minister.

Acting Chairman (Deputy Robert Troy)

The Minister without interruption, please.

Deputy Joan Burton

You have a particular record in that regard.

Acting Chairman (Deputy Robert Troy)

The Minister should speak through the Chair.

Deputy Aengus Ó Snodaigh

The Minister is deflecting again. She will not deal with the issue in question, and she constantly twists my words.

Deputy Joan Burton

I am delighted to say that particular staff in Letterkenny have been ring-fenced to deal with the backlog. Those resources have been applied. Even Sinn Féin might acknowledge that there has been an enormous upsurge across the board in claims of certain payments such as family income supplement and carer's allowance. To cope with the increased volumes we have introduced new and improved business practices, including greater use of IT. All of that has taken place in an environment in which we must keep two systems operating side by side while we change over to the new systems. The new systems are now in place, and they will result in a better service. We also have a dedicated team working on the backlog, and whether the staff are working in Longford or in Letterkenny, they endeavour to give our important customers who rely on social welfare income the best possible service.

Hospital Waiting Lists

Deputy Liam Twomey

I highlight this issue because it is ongoing in the south east. It is appropriate to focus on it because it gives us an indication of what is wrong with our health service from a medical and financial perspective. Patients in Dublin currently wait approximately two years to see an orthopaedic surgeon but a patient in the south east can be waiting up to four years for a routine appointment to attend an orthopaedic surgeon. If a general practitioner marks a patient's case as urgent it will often be a year before that urgent case is seen by an orthopaedic consultant. This problem has been ongoing for years and it is no longer acceptable. Patients and their general practitioners have no idea how long they will be waiting to see an orthopaedic consultant. This appears to be a problem across all specialties, and part of my question to the Minister is whether he will publish data from the special delivery unit on the number of people waiting for consultant appointments in all specialties in the south east. It might help doctors referring patients if they knew how long people would have to wait because a hospital or a consultant with a shorter waiting time could be identified and the patient referred directly to that hospital or consultant.

I am also concerned about what we are hearing about the reorganisation of the service in the south east, as it will not tackle the major problem. The retention of catchment areas will continue to support the inequality and inefficiencies in our health services. That inequality sees patients in one part of the country waiting two years to see an orthopaedic consultant while patients in another part wait four years. The problem was supposed to have been ironed out with the establishment of the HSE, yet there has been no significant change to the status quo. The stated policy of our Government that money should follow the patient would help to reduce that inequality, but I would like to know whether that forms part of the remit of Professor John Higgins in reorganising the health services not just in the south east but across the country. Will we see money following the patient, and will it have an impact on waiting times? If that was the case it would at least reduce the inequality and we would see people being treated equally across the country in the future. I ask the Minister of State to address those questions.

Minister of State at the Department of the Taoiseach (Deputy Paul Kehoe)

I apologise for the non-attendance of the Minister, Deputy Reilly, and his two Ministers of State, who are detained at a press conference. They thought they would be here to take this Topical Issue matter, but I have been given that job.

I thank the Deputy for raising what I understand is a huge issue in the south east. Immediately following his appointment, the Minister for Health set about establishing the special delivery unit, SDU, whose aim is to unblock access to acute services, both emergency and elective, by improving the flow of patients through the system. The SDU's scheduled care team addressed access to elective care and initially focused on waiting times for inpatient and day case elective surgery. So far this year, overall waiting list numbers have fallen from 56,020 to 49,601, a decrease of 11%; the number of adults having to wait more than 12 months is down from 2,435 to 118, a decrease of 95%; the number of adults having to wait more than nine months is down from 5,676 to 415, a decrease of 93%; and the number of children having to wait 20 weeks is down from 1,712 to 276, a decrease of 84%.

The SDU is now beginning to focus on outpatient waiting times, building on work already undertaken by the HSE. A priority action for the HSE has been the development and implementation of standardised reporting for outpatient access through the HSE outpatient data quality programme, which has enabled reporting of outpatient waiting lists from January 2012. Waiting times have been published on www.hse.ie each month as part of the HSE performance reports. The latest HSE performance report for September 2012 shows that 25,643 patients are waiting for a consultant outpatient appointment in Waterford across all specialties, underlining the critical need to address outpatient waiting times.

Together with the National Treatment Purchase Fund, NTPF, the SDU is building on the work already done regarding outpatient waiting lists. The collation and analysis of outpatient waiting time data in a standardised format will reveal the distribution of long waiting times across all hospitals. In the first instance, this will allow the SDU and the NTPF to target their resources towards those patients who are waiting longest and ensure that they are seen and assessed.

Over the course of 2013 to 2015, the HSE, together with the SDU and the HSE clinical programmes, intends to radically reform the structure, organisation and delivery of outpatient services to ensure that the right patient is seen and assessed by the right health professional at the right time. Key elements of this large programme of reform will include ongoing validation of waiting lists, the systematic and standardised management of referrals from primary care, a reduction in unacceptably high did-not-attend rates, and discharging from outpatient services when clinically appropriate. Maximum waiting time targets of 12 months for a first-time outpatient appointment by 30 November 2013, 26 weeks by 30 November 2014 and 13 weeks by November 2015 are the goals for the HSE and the SDU.

In regard to orthopaedic outpatient waiting lists in Waterford, several initiatives are under way to address the issue. Up to 2,000 of the longest waiting patients from the south east have been transferred to Cappagh National Orthopaedic Hospital. The national musculoskeletal national clinical programme has commenced and aims to reduce the outpatient department, OPD, waiting list for both orthopaedics and rheumatology through physio-led clinics which will run alongside the consultant clinic.

Additional information not given on the floor of the House.

An arthoplasty clinical nurse specialist-led initiative relating to the care of patients after their surgery will result in an increased number of new patient slots in consultant clinics. Waiting lists are continually being validated and a programme of validating the longest waiters is currently under way. Waterford Regional Hospital continues to receive approximately 400 new referrals each month to the orthopaedic service. The initiatives I have outlined, along with the national outpatient improvement programme, are designed to ensure that those patients are seen in a timely manner and receive the care they need, when they need it.

Deputy Liam Twomey

I want to reiterate the need for us to get the information the special delivery unit is receiving about waiting times for each consultant in all hospitals in the south east. The gross figures are not much use to us when it comes to referring patients and examining the efficiency of each hospital. I know the special delivery unit and the Health Service Executive have the figures. It would be useful in channelling patients to the right consultant at which they will be seen the fastest. I also hope the initiatives outlined by the Minister of State will work, particularly in orthopaedic services because that has been stressful and unsatisfactory for patients over the past several years.

Deputy Paul Kehoe

I will ask the Minister for Health to supply the Deputy with the statistics he requested. Coming from the same county as the Deputy, I know this is a significant issue in the south east. Both of us have been approached by many patients who are in stress waiting for surgery. I will highlight to the Minister the issues raised by the Deputy.

National Maternity Hospital

Deputy Kevin Humphreys

It is a matter of urgency that the National Maternity Hospital on Holles Street, Dublin, is moved to Elm Park, Dublin 4, so that it is co-located with St. Vincent's University Hospital. The National Maternity Hospital has been located on Holles Street since 1894 and has provided 118 years of service. However, the site is unsuitable for future expansion and there has been a series of recommendations for it, the latest being the 2008 KPMG independent review of maternity and services in the greater Dublin area. It recommended the hospital should be co-located alongside adult acute services at St. Vincent’s. Holles Street is Ireland's busiest maternity hospital with nearly 10,000 babies born there in 2010. The baby boom is stretching the fabric of its outdated building to the limit.

As a former member of the board, I am aware there were concrete plans to relocate to Elm Park. Unfortunately, this was not carried out by previous Administrations when funds were available. The National Asset Management Agency, NAMA, has informed me two buildings are available in the Elm Park development with 19,230 sq. m of gross internal floor area and another with 10,869 sq. m. The building could be retrofitted to accommodate a maternity hospital which would provide the modern facilities and co-location all experts agree is required. I understand discussions took place between the Minister for Health and NAMA which have now concluded. When will the Minister seek sanction for a move from the Department of Public Expenditure and Reform for this move?

Maternity services in Dublin are at breaking point. With the recent announcement of the location of the national children's hospital, it is important we recognise the new-born and mothers are provided with a building fit for purpose and are co-located with adult services. The HSE has spent over €16 million on capital investment at Holles Street in the past ten years, over €2 million alone in 2011, to adapt a building over a century old. Tacking on space is not an answer. The announcement of the site for the national children’s hospital was very much welcomed. For well over two decades, it has been identified that the current site of the National Maternity Hospital is not fit for purpose. The building is shoehorned into a very tight space. The space and facilities for a new hospital site are just down the road beside an acute hospital, St. Vincent’s. Now is the time to make the commitment and start planning to make this move. The National Maternity Hospital services not just the greater Dublin area but the eastern region. It is important to make those decisions now to ensure the delivery of maternity services the country deserves.

Deputy Paul Kehoe

In 2008, KPMG reviewed maternity and gynaecology services in the greater Dublin area and recommended that Dublin maternity hospitals should be located alongside adult acute services. This is the optimal solution for hospital-based maternity services, as it gives access to the full range of medical and surgical specialties and clinical support services, in sufficient volume and complexity. This is particularly important for high-risk mothers and babies. In this context, it is proposed the National Maternity Hospital be relocated to St. Vincent's hospital.

There is a real opportunity for the maternity service providers to formalise their relationship with their partner adult hospital at the earliest opportunity to realise clinical and financial benefits as well as efficiencies well in advance of physical co-location. The National Maternity Hospital has been working with St. Vincent's University Hospital to progress this from a service perspective and working with the HSE in the development of the business case for relocation.

Management and delivery of health infrastructure programmes, including financing, is the responsibility of the HSE. However, as this project cannot be dealt with in isolation, it must be considered in the context of the HSE multi-annual capital programme. In prioritising capital projects within its overall capital allocation, the HSE must take into account existing capital commitment and costs to completion over the period.

Work on the draft capital plan for the next multi-annual period 2013-17 will begin shortly and will be submitted to the Department of Health in due course. The Department will then review the proposals and follow up with the HSE where further details may be required. The draft capital plan will require the Minister’s approval with the consent of the Minister for Public Expenditure and Reform.

In the interim, specific improvements can and have been made in defined areas in the existing hospital such as the recent provision of a new operating theatre and a hospital rewiring project. I accept these remedial works will only address the immediate problems of the infrastructure. The proposed relocation of the hospital to the St. Vincent's University Hospital site is still being given high priority. The Minister's concern with this issue, as with all health issues, is with patient benefit and patient outcomes. We must use within the acute system our extremely limited health resources for the maximum possible benefit and to deliver safe, modern services. Any decision on the future delivery of maternity services in Dublin, including the location of those services, will be made in this context.

Deputy Kevin Humphreys

I thank the Minister of State for the response. As he outlined, a new operating theatre was added to the hospital while a new two-storey educational and medical centre is planned for the site. It would be more cost effective to redevelop the Elm Park site for the new National Maternity Hospital, however.

I remarked earlier that there are more than 19,000 sq. m in one block alone in Elm Park. To me it would appear to be cost effective at this stage to put in the preparation and to include this plan in the capital programme of the HSE for 2011 to 2013. We should put this in motion in order that we could move the hospital as soon as possible. If we use the current buildings we could turn the site into a modern functioning national maternity hospital by 2016 for as little as €100 million.

I realise the Minister of State may not have the answer in the House now but if the Minister of Health was here he might have been able to answer it directly. An article was published in the Irish Examiner in July indicating that a memorandum was to be brought to Cabinet seeking approval for the transfer. If the volume of work reported in the Irish Examiner is correct it would suggest the work is well down the path but we need to bring it to a speedy conclusion. We should include it in the capital programme for 2013 to 2017 and it would represent a job of which we could all be proud during the term of this Government.

The maternity hospitals are in crisis. The original building was excellent. It served the city well and it is in the heart of my community. Seldom does one hear a Deputy suggest that a hospital should be removed from his constituency but we must consider the projected increase in the rate of childbirth in the city and the greater area. I call on the Minister of State to go back to the Minister for Health, Deputy Reilly, and outline the points made.

The financial package stands up by itself. This is a once-off opportunity because the vacant buildings are in the right place. This could be delivered speedily and in a cost-effective way. We could end up with a national maternity hospital co-located with a major hospital as recommended in the 2008 independent report. If we did this in the coming six months there could be a national maternity hospital in Elm Park by 2016. I urge the Minister of State to discuss this with the Minister, Deputy Reilly, in order that he could come back with some of the answers to the questions I have put today. It boils down to the fact that this is the most cost-effective solution to provide a national maternity hospital for this city and country.

Deputy Paul Kehoe

I assure Deputy Humphreys that I will take back his concerns to the Minister, Deputy Reilly. I realise he is aware of the geography of Dublin and given his experience of living here he understands what is best for the city. I will take back his ideas to the Minister, Deputy Reilly, and have him communicate with Deputy Humphreys.

Deputy Humphreys will understand that the Government has announced the location of the national children's hospital.

Deputy Kevin Humphreys

It was very welcome.

Deputy Paul Kehoe

It was very welcome. The Government now has time to reflect on the best way forward for the location of maternity services in Dublin. Deputy Humphreys is correct to note that we have a once-off opportunity now to ensure that we get the maternity services right and that once the Minister and the Government make the decision, it will in place for many years to service many families in the greater Dublin area. The Deputy can rest assured that the Government will make the decision in the most cost-effective way possible. I realise Deputy Humphreys has several ideas, including those he has outlined today. He can rest assured that I will take these back to the Minister and that the Minister will communicate directly with him.