Topical Issue Debate

Hospitals Capital Programme

I welcome the opportunity to speak on this serious issue, which has highlighted the interference of the Minister for Health in the delivery of health care in the country. We all accept that a Minister should take a hands-on approach in the delivery of health care, but this was a deeply cynical political exercise. There are no two ways of explaining the issue. The fact is that the Minister for Health sacked the HSE board on taking office in April 2011. A short time afterwards, representations were made to the board on the delivery of the hospital in Wexford and St. Luke's General Hospital in Kilkenny. We all accept that people make representations on a continual basis to the Government for the delivery of health care, but on this occasion the Minister interfered with the independence of the HSE to expedite a capital project in Wexford and another capital project in Kilkenny. The HSE had an interim board appointed. The board acts independently, but it was completely unaware of the decision of the Minister to bring the hospitals in Wexford and Kilkenny to the top of the list.

I do not begrudge the people of Wexford or Kilkenny their hospital facilities. The difficulty I have is that on every other occasion when the Minister was rowing back on promises he made previously, he blamed someone else or the independence of the HSE and suggested that a given hospital had to be closed or downgraded because either the HSE or HIQA had directed it. However, on this occasion the Minister had no difficulty acting for two Cabinet colleagues and interfering in the capital projects. This is taxpayers' money. It is not a slush fund to be used by the Minister or his Cabinet colleagues in advancing themselves in their constituencies. We saw another deeply cynical exercise previously with the primary care centres. Unfortunately, the Minister has form in this regard.

The Minister for Public Expenditure and Reform had a role and has questions to answer in this case because he signed off on the original primary care list. I want to know whether there was a quid pro quo involving his scratching the back of the Minister for Health and vice versa in terms of looking after constituency needs above the Minister's responsibility to all people in the country in the provision of health care.

Let us set aside the red herrings that the Taoiseach and the Minister for Health might try to throw at us in raising these points. Everyone is delighted to see any hospitals or health care facilities upgraded for the people of Wexford, Kilkenny or anywhere else in the country. The point is that this has occurred against a background in which the Minister has closed 24-hour accident and emergency services in Roscommon, hospitals such as Loughlinstown hospital are threatened with downgrading, ambulance services are being hit in areas such as west Cork and accident and emergency services are being hit in Cork city and other parts of the country. Against that background, it is altogether unacceptable that the Minister should interfere to prioritise certain areas for the political advantage of the Government.

Given the imposition of brutal cuts of hundreds of millions of euro in health care services, there should be absolute transparency and fairness in the allocation of the inadequate resources available. This is an indication that, contrary to the Government's promises to end the era of cronyism and stroke-pulling, cute hoor politics are alive and well. We see it in this instance and we saw it in the selection of locations for primary care centres. It is clear that questions of political advantage and the need to shore up political bases for particular Deputies have taken precedence over fairness in the allocation of scarce resources for health services. It is shameful. As with the location of the primary care centres, we need to see the criteria that lead the Minister to select some sites over others and to interfere, as he has, in the allocation of scarce health resources.

As the Minister for Health was justifying the closure of their accident and emergency facility to the people of Roscommon, he was pushing through proposals for the upgrading of two further accident and emergency units in Wexford and Kilkenny. While I do not begrudge the people of Wexford and Kilkenny, the argument has now been made that the issues in Roscommon were different and that the closure was a matter of safety. The Minister articulated this case in the House in July 2011 when he stated that patients attending University Hospital Galway had a 5.8% mortality rate compared to a 21.3% mortality rate in Roscommon, which was four times greater. These allegations were immediately contested by a consultant at the hospital as well as by Senator John Crown, who had reviewed the actual figures. The mortality rate in Roscommon at the time was 4.92%. According to the Minister's own argument, Roscommon County Hospital was safer than University Hospital Galway, where patients of the former are now being treated. Subsequently, Dr. Jennifer Martin of the Department of Health informed us that those figures were based on a report compiled to examine the quality of data and not the care provided in acute hospitals. Notwithstanding the fact that the Minister's evidence was based on faulty figures and not faulty care, he has failed to correct the record in the House, apologise to the staff at Roscommon County Hospital whose professionalism was undermined or publish the report which has been imminent for the last 18 months. It raises the question: why?

Another key question is what capital projects were delayed by the decision to fast-track the upgrading of Kilkenny's and Wexford's accident and emergency departments. Reports are being circulated that the delay in delivering the new endoscopy suite at Roscommon County Hospital, the Government's replacement for the closure of the accident and emergency department, is due to the need for funding to deliver the new accident and emergency services in Kilkenny and Wexford. In July 2011, the Minister was committed to putting Roscommon's temporary endoscopy suite in place by September of that year and to instituting a permanent facility by early 2012. Some 18 months later, we are at the stage of seeking planning permission for the permanent facility and have been told the temporary endoscopy suite is too expensive.

It is clear that the upgrading of emergency departments in Wexford and Kilkenny is necessary and welcome. The issue is that they were fast-tracked ahead of other necessary projects by the Minister, Deputy James Reilly, at the behest of his Cabinet colleagues Deputy Brendan Howlin and Deputy Phil Hogan. That is the information with which we have been provided through a freedom of information request by RTE. In early June 2011, both Deputies announced the capital projects for the upgrading of Wexford General Hospital and St. Luke's General Hospital in Kilkenny. This was prior to the HSE board meeting of 9 June 2011, the minutes of which report the reaction of Mr. Brian Gilroy, which I place on the record of the House as follows:

In view of the announcements by the Minister for Public Expenditure and the Minister for the Environment in relation to capital projects in St. Luke's Hospital Kilkenny and Wexford General Hospital, revisions to the capital plan may be required. B. Gilroy will consult the Department of Health and Children and report on this matter at the next meeting.

Mr. Gilroy then had to write to the Department of Health to confirm the situation as announced by two Ministers with no connection to Deputy James Reilly's portfolio responsibilities. On 14 July 2011, the Department of Health confirmed that the Minister, Deputy James Reilly, had requested that the projects "be accelerated in the HSE's capital programme". This is not the language of Opposition Deputies; it is what the record shows. It is most regrettable because it exposes Cabinet cronyism. It is not wrong to use the phrase. Other hospital sites which are equally deserving are not getting this treatment. We must ask if the future of acute hospital care in a particular location is determined on the basis of whether a constituency representative is a Minister.

When I was in opposition, I stated that my absolute priority would be to reduce the number of patients on trolleys. When the Government came into power, I reiterated that position. Patients deserve world-class health facilities in which they are not left suffering on waiting lists or on trolleys in overcrowded hospitals. I cannot deliver the type of health system patients deserve in sub-standard accident and emergency facilities operating from converted pharmacies or where medical assessment units are operating out of reconverted laundries and portakabins. That is the situation in Kilkenny and Wexford. I cannot continue to make the progress required in health if I tolerate such poor standards. I am taking a hands-on approach, as I promised in Opposition and on taking office, and delivering results for patients, which include 20,352 fewer patients on trolleys in 2012 than in 2011, a reduction of almost 24%. By the end of December 2012, the number of adults having to wait more than nine months for inpatient and day-case surgery was down to 86 from a total of 3,706 in December 2011, a reduction of 98%. The number of children waiting more than 20 weeks for inpatient or day-case surgery was down to 89 from 1,759 in December 2011, a 95% reduction. The number of patients waiting more than 13 weeks for routine endoscopy procedures went down from 4,590 in December 2011 to 36 at the end of 2012, a 99% reduction.

For the first time in the history of the State, we have counted the true number of people waiting on outpatient lists, of whom there are in the region of 380,000, a daunting figure. Many people have been waiting for years. We have undertaken that by the end of this year, no one will wait longer than 12 months for an outpatient appointment. Some 16,000 people have been waiting longer than four years. For the first time, we will have real facts and figures which are verifiable. We do not dispute the morning trolley count with the INMO; we have a joint figure. These figures can be checked and are worth repeating. There has been a reduction of 24% in the number of people on trolleys, of 98% in the number of people waiting nine months or longer for inpatient treatment and of 95% in the number of children waiting more than 20 weeks.

I visited Wexford's emergency department, as I visited nearly every such department in the State, and I was taken aback by what I saw. There were overcrowded, cramped conditions with five cubicles and patients on full display on trolleys in the central area of what was a converted pharmacy. The new Wexford project will address these issues by providing 17 treatment bays and a separate treatment area for children. Approximately 40,000 attendances take place at that emergency department per annum. The new Kilkenny project comprises an emergency department, a medical assessment unit and a day services unit, including endoscopy, construction of which has started. This is the first medical assessment unit in the country introducing a new way to treat patients in a more civilised fashion, which also takes a great deal of pressure off the emergency department. The real point is that both projects were approved for inclusion in the HSE capital programme in 2006 and have been included in all of the HSE's multi-annual capital plans ever since.

As the House will be aware, one of the issues for many years concerns capacity issues in accident and emergency departments. Since 2006, capital funding has been made available for an accident and emergency department initiative to provide admission managers and a series of medical assessment units to relieve the pressure on accident and emergency departments. Continuing to address these capacity issues has always been a fundamental aspect of the HSE's capital plans. The 2008 capital plan contained funding to complete developments under way, deliver new accident and emergency departments and upgrade and extend existing departments. The Wexford and Kilkenny projects were part of this initiative.

The Minister's is up, but if there is a particular point he wants to make, he could make it and come back in later.

The key point is that both projects have been on the list for a long time. I was delighted to be able to receive an extra €12 million for the capital fund from the Department of Public Expenditure and Reform in order to expedite the sorely needed facility in Wexford General Hospital. I will address the issues raised by some of the Deputies, in particular the disingenuousness shown by Deputy Denis Naughten when he suggested the provision of capital funding for this project had delayed the provision of the endoscopy unit in Roscommon. It has not. The level of new services provided in that hospital and the increased footfall to which I can refer in my final response prove the point that this hospital been well capitalised, including the money spent by a previous Government on the accident and emergency department. It was well known that the service provided was not safe, as adjudicated on by HIQA. Deputies Denis Naughten and Luke 'Ming' Flanagan were at the meeting with Deputy Frank Feighan and me when Tracey Cooper of HIQA made it very clear that the service was not and could not be made safe. I gave an undertaking to support the hospital and we have done so. There is much greater footfall than before. I can go through the data later.

The Deputies have one minute in which to respond.

The Minister toured many hospitals when in opposition and has toured a few more in government. It is welcome that he is visiting accident and emergency departments in hospitals throughout the country. The point is, however, that he personally interfered in the selection process for priority capital projects. He says the hospitals concerned deserve it. Of course, they do and we do not dispute this for one moment, but the fact is that the HSE which was established independently of this House was not even aware of the decision made by the Minister on foot of representations made by two of his Cabinet colleagues. Clearly, he could ask himself whether the hospitals in Roscommon, Navan and Monaghan would receive priority if Ministers from these areas made representations, while others would lose out. That is the key question. Resources are scarce and the capital budget is always under pressure, but there was interference in the selection process on foot of representations made by the two Ministers. The Minister acceded and rode roughshod over the independence of the HSE in delivering capital projects.

None of this would be happening were it not for the fact that the Government is committed to imposing unsustainable cuts on the health service under the troika agreement. Given that this is the decision made by the Government, it is vitally important that there is fairness, complete transparency and accountability when it comes to the allocation of scarce resources. What we discovered in the primary care scandal, for that is what it was, and now in the prioritisation and acceleration of projects in Wexford and Kilkenny is not fairness and transparency but political interference in order to shore up political bases. It is the cronyism and cute hoor politics which the Minister decried during the term of office of the last Government and which was a corrosive cancer in the body politic that helped to get the country into the mess it is in. The Minister is perpetuating that kind of politics by interfering in this way instead of decisions on the allocation of scarce resources being made purely on the basis of need and fairness.

The Deputy is taking up the time of others.

That is the allegation being made which the Minister has not addressed yet again.

The Minister is correct in saying the number of trolleys has gone down, for which he is to be commended. He might, however, explain why up to 12 months ago there was no problem with trolleys in Portiuncula Hospital, while there has been a significant problem for the past 12 months because of the closure of the accident and emergency department at Roscommon.

On the accusation that I am being disingenuous, I again ask the Minister to correct the Dáil record. He has been asked to do this on numerous occasions. He said Roscommon County Hospital was four times more dangerous than Galway University Hospital. His officials have contradicted this in his presence, but he has yet to correct the Dáil record. Will he clarify that it was a faulty figure in the statistics presented about Roscommon County Hospital 18 months ago? Will he take the opportunity to once and for all correct the Dáil record? He might explain why the mortality report has not been published, even though it was said to be imminent 18 months ago. Will he tell us when it will be published?

What engagement did the Ministers for the Environment, Community and Local Government and Public Expenditure and Reform have with the Minister prior to making their announcements in early June 2011, prior to HSE board meeting on 9 June? Did the Minister indicate to them that he would ensure the projects would be fast-tracked or that he would see to it or was it just a case of "wink and say nothing"? The Minister seeks to give the impression that there is nothing irregular. The Taoiseach also attempted to give the same impression during Leaders' Questions. Perhaps it is not irregular, but the key point is that there is certainly something rotten at the core of the decision-making process. It seems to be a case of "hear no evil, see no evil, speak no evil" for the Ministers concerned. It is high time the Cabinet chimps came here and told the truth.

In response to the last contribution, it would be nice if Deputy Caoimhghín Ó Caoláin's party came in here and told the truth sometimes.

I will address the issues raised by Deputy Denis Naughten. We have made it very clear that the situation in Roscommon was unsafe, as dictated by HIQA. The Deputy was at that meeting. Since Mr. Bill Maher took over the Galway-Roscommon Hospital Group, the Galway figures have been an exemplar for what can be achieved in terms of the number of trolleys at Galway University Hospital which had the largest problem, where 40 to 50 patients were regularly on trolleys and the average figure was 27. It is now down to seven. There would have been 9,901 people waiting for nine months or longer for inpatient treatment and as day cases by the end of September before Mr. Maher took over in January 2011. That figure was nil by the end of September. He has increased footfall at Roscommon County Hospital which is busier than ever. It provides urology services, while there is plastic and reconstructive surgery and a sleep apnoea clinic that had not been available before. There has also been a radiology service upgrade. The development of the endoscopy suite continues apace and planning permission has been applied for. The existing endoscopy unit has JAG accreditation. There are new dental services and nursing initiatives centred on nurse prescribing, including X-rays, as well as nurse-led clinics. There is also a colo-rectal clinical nurse specialist. We hope it will be successful in being one of the endoscopy centres used for the screening programme.

What if one has a stroke or heart attack?

I did not interrupt the Deputy. In respect of outpatient and day cases, the figures show a major increase in the number of patients being treated, which is what people want. They want safe treatment to be provided as near to home as possible. They do not want to be misled into believing they have access to an accident and emergency department that can deal with complex fractures, bleeding and vascular problems when there is nobody available to deal with them. There cannot be because we cannot have vascular surgeons in every hospital in the country, as the Deputy knows.

We are not having a debate now. Time is up.

I saw in the media that the first issue out of Deputy Billy Kelleher's mouth was that of a slush fund for political gain. It is not surprising that he came out with this because that is exactly what Fianna Fáil did for 12 years, but that is not the case in this instance. I have in my hand Special Report No. 70 of the Comptroller and Auditor General. It states on page 42 that a new department at the Mercy Hospital was completed and opened, that a new department was completed at Drogheda and that a new extension was completed and operational at the Mater Hospital.

I ask the Minister to answer the questions put to him.

In Letterkenny a new emergency department is under construction. Construction work is ongoing at Sligo General Hospital.

Please answer the question.

The unit in Cavan is under construction. The hospital in Wexford was stuck at design stage since the previous Government was in office. Was that a political decision? When I took office as a new Minister, why would I continue to engage in Fianna Fáil's policies if I had offered something different to the people?

I ask the Minister to outline to the House the points of contact he had with the Ministers for Public Expenditure and Reform and the Environment, Community and Local Government prior to their announcements.

The Minister should conclude.

That was done for the first time, even though there was less money and fewer staff available.

Please answer the question.

Despite the Deputy's shroud waving last February, we have reduced the number who have to wait for services at all levels.

I ask the Minister to conclude as he has greatly exceeded his time.

We have not only maintained a safe service but also improved it.

It is not fair to keep other Deputies waiting.

I am determined to continue the reform agenda. In the coming weeks we will issue the new hospital groups document, the small hospitals framework document, the money follows the patient document and the universal health insurance paper. Reform continues apace and none of these distractions will deter me from the course.

The Minister will have other opportunities to make his case.

How many other hospitals have been allocated specific funding by the Minister for Public Expenditure and Reform?

Hospital Services

According to newspaper reports, a recruitment ban means epilepsy units remain closed, even though 200 patients are on waiting lists. As epilepsy can be a life threatening illness, some of these individuals' lives are at risk. The two specialised units in question are crucial to assessing the appropriateness of epilepsy patients for surgery. They were closed, in spite of the fact that they were an intrinsic part of the HSE's draft national epilepsy care programme which was published in the spring of last year. The two units are located in Cork University Hospital and Beaumont Hospital in Dublin. Among their functions is identifying patients who may be suitable for surgery, diagnosis, observation, education and counselling. I have been contacted by a number of individuals on the waiting list and know some of them personally. They suffer from a debilitating illness.

I gather that the cost of upgrading the units is in the region of €900,000. I have to agree with Brainwave, the Irish epilepsy association, that it seems entirely illogical for the HSE to sanction the redevelopment of the monitoring units and then to decline to fund the staff required to make them operational. Beaumont Hospital was also to be the national epilepsy centre under the HSE's plans, but this development cannot proceed because the emergency monitoring unit is closed. It is expected that the facility in Cork University Hospital will open at some stage this year. However, we need more than an expectation because waiting lists continue to grow. We need a definite commitment on when the units will be staffed. This morning Professor Norman Delanty from Beaumont Hospital warned that he could not look after his patients properly and would be compelled to send them abroad for treatment unless the two units needed to monitor seizures were opened. He rightly pointed out that this would have obvious cost implications for the State.

It appears that the unit in Cork has not been informed that the unit in Beaumont Hospital is closed because it continues to refer patients to Dublin. I have been contacted by numerous people with epilepsy, including the parents of young children. They were repeatedly told that new units were about to come on stream to monitor their condition. I ask the Minister the reason the HSE is not taking a more proactive approach to providing staff in the light of the money already invested in these units.

I thank the Deputy for raising this important issue. I am aware of the challenges people with epilepsy face in managing their conditions and fully acknowledge the need for the provision of a dedicated service for all epilepsy patients. The epilepsy monitoring units in Cork and Beaumont Hospital are being developed under the HSE's national epilepsy clinical programme. I understand epilepsy monitoring is only required for the most vulnerable patients who suffer the worst effects of epilepsy. The majority of patients will have their care needs met through other epilepsy services, including the newly established rapid access clinics in four centres, Cork and Beaumont Hospital among them. The epilepsy monitoring units will increase pre-surgical evaluation capacity for those patients who may benefit from complex but potentially curative surgery. This development is, therefore, a clear priority for the programme. Patients at these units will require 24-7 care. The staffing needs to enable the units to be safely opened have been identified.

It is important to point out that there is no ban on recruitment. The Government decided that the numbers employed across the public service must be reduced in order to meet its fiscal and budgetary targets. The health sector must make its contribution to that reduction, but the HSE can make staff appointments once it remains within its overall employment ceiling and has the financial resources to do so. The normal processes will apply to the HSE's decisions on the recruitment of the required staff in Cork and Beaumont Hospital.

In regard to the staffing of the epilepsy monitoring units, the HSE has advised that Beaumont Hospital and the HSE are working jointly to fill the posts necessary to support this service development. With regard to the position in Cork, the HSE has advised that the service plan for 2013 for Cork University Hospital will be finalised in the coming weeks and that the provision of additional staff for the epilepsy monitoring unit is being considered as part of that process.

Cork and Beaumont Hospital are two of the six regional centres identified by the epilepsy clinical care programme for the provision of specialist epilepsy services. It is the intention that services will be provided by a team of nurses and consultant neurologists working as a virtual national network supporting all acute and primary care locations. Rapid access clinics providing care for the broad cohort of patients with epilepsy have been developed at Beaumont Hospital, St James's Hospital, in Galway and Limerick. As 10.5 whole-time equivalent advanced nurse practitioners, ANPs, have been recruited to lead these clinics, a total of 12 ANPs are now in place across the four centres delivering services both on site and on an outreach basis. The outreach model is facilitated by the epilepsy electronic patient record system developed by the programme which allows the ANPs to access the necessary patient information at the outreach locations. For patients, the rapid access clinic model means faster access closer to home and improved continuity of care. It is delivering tangible improvements in patient access and experience. I am committed to providing the best possible health service and will continue to work with the HSE to ensure the best outcomes for these patients.

The Minister has stated the HSE is finalising its plans for the centres. I ask him to apply the same urgency to this matter as he did to the issues discussed earlier in regard to Kilkenny and Wexford hospitals. He will need to take a hands-on approach because people are suffering from epilepsy and young children are unable to access the full spectrum of services they need. I ask him to ensure the units are fully funded and operational because they are necessary for those who suffer from or have been diagnosed with epilepsy.

I respect the Deputy's interest in this area, one in which I have considerable experience as a GP. I was attached to St. Ita's Hospital where many of the patients in the intellectual disability service had this problem. I realise how much it limits people's lives and interferes with their ability to work and understand that, above all else, good control of the condition can lead to quality of life, while poor control can destroy the quality of somebody's life. I will endeavour in every way I can to expedite the provision of this important service. However, I know this has been an issue for some time. I also know that the Deputy was part of the last Government at a time of plenty and the issue was not addressed then. While I will do everything I can with the limited resources I have available, it is only right to remind Members that when Fianna Fáil was in power, the issue was not addressed.

Cost of School Textbooks

All Members will be familiar with the annual debate in May or June on the cost of school books and no doubt the coming summer it will be no different. This issue has been covered on the airwaves and in the press year after year, but there has been no resolution. Last June I received a telephone call from a parent who argued that we had the most expensive school books in Europe. I am not sure whether that is true and cannot make a judgment, as it is difficult to establish the truth.

There have been many Ministers for Education during the years, but none of them has ever dealt with this issue. However, yesterday, for the first time since the foundation of the State, the Minister for Education and Skills dealt with the fact that this was one of the few countries in Europe that did not have a school book rental scheme. He and the Department indicated that we would have the foundations for a universal school book rental scheme.

The cost of school books is a problem that does not affect people with plenty of money, but it presents a difficulty for families who do not have large incomes and parents on low or modest pay. I congratulate the Department, the Minister and the Minister of State on the introduction of this initiative yesterday. I congratulate them also on the fact that - this has gone practically unnoticed - they have managed to ring fence a sum of €15 million this year for the scheme.

With regard to the perception, true or otherwise, that we have the most expensive books, this is difficult to establish. I engaged in an exercise with the publishers and printers to establish the figures. However, it seems we have what one would call a cartel because the main publishers and printers are not limited by guarantee. Therefore, we have no access to the amount of money they make annually. The opposite is the case in our neighbouring jurisdiction and on mainland Europe. We are in a different position and companies have made significant moneys from the school book business. However, the Department has now made a start on introducing a proper universal book rental system.

I am taking this debate on behalf of my colleague, the Minister for Education and Skills, Deputy Ruairí Quinn. I am pleased to have the opportunity to discuss school book rental schemes. As the Deputy mentioned, yesterday the Minister launched the guidelines for developing textbook rental schemes in schools. The guidelines provide practical advice for primary and post-primary schools on how rental schemes can be established and operated. The aim of the guidelines is to help as many schools as possible to start such book rental programmes.

The publication of the guidelines follows a survey of schools by the Department's inspectorate last year. It had a 99% response rate at primary level and showed that 76% of primary schools operated a book rental scheme. At second level, the response rate was lower, at 44%. Of the 44% which responded, 88% of those in the VEC sector and 73% of those in the community and comprehensive sector operated a book rental scheme. These results show that we have a good foundation on which to build a scheme across the country. I hope schools not yet operating book rental schemes will be encouraged to use the guidelines introduced yesterday. If they do, this will result in substantial savings for parents. Schools which already have rental schemes can save parents up to 80% of the cost of buying new books.

A special guide for parents is also being published to inform them how the schemes operate and how they can help schools to establish and run them. The Minister has been very clear in his ongoing support for book rental schemes. All of us who are parents know how expensive textbooks can be and what a burden the cost places on already hard-pressed families at the start of every school year.

A key priority for the Minister is to continue to take steps to tackle the costs associated with school attendance. The publication of the guidelines builds on other steps taken in an attempt to reduce the burden on families such as protecting the budget for school book grants at €15 million in the past two years, despite economic pressures. The Minister has consulted widely on the guidelines, including working closely with the National Parents Council at primary and post-primary level, the Society of St. Vincent De Paul and Barnardos, to discuss ways of reducing costs for parents. These consultations resulted in a commitment from the Irish Educational Publishers Association to limit the publication of new editions and maintain editions of books in print unchanged for at least six years. The publishers also gave assurances that they would sell books for rental schemes to schools at substantial discounts.

I take the opportunity to express my admiration for the Minister of State's impressive book.

I am encouraged by the remarks made by the Minister of State on the progress being made in this area. I am in favour of the reforms being made in the education sector, particularly in this area. While the change will not affect everyone, it will benefit those on low incomes, the kind of people who elected me to this House. It is important that there is fairness and equality, particularly at primary level, and no child should be denied access to school books.

The Minister of State mentioned the Irish Educational Publishers Association. I read its statement on this issue. We have not heard much from it in the past, although it has been in existence for some time. If it had not been hauled in by the Department, it would have been quite content to continue making money from the sale of school books and keeping the status quo. Its attitude bears out the point made by the parent who telephoned me last June to say the sale of school books was a lucrative business.

It may be a lucrative business for the publishers and printers, but it is not lucrative for working-class families who cannot afford to cope with the burden of buying additional new books each year. It is good that we are making progress in that regard. Perhaps the day will come when we will have access to the sort of money that these book publishers have made during the years and figures for the volume of books printed outside the jurisdiction for Irish schools.

As the Deputy has pointed out, the school book publishers have signed up to a code of practice, in effect. They have agreed to limit substantially the number of reprints, by comparison with what happened in the past. The Minister is adamant that their performance under the voluntary code of practice will be closely monitored. I argue that there will be further consequences, in terms of the relationship between the Department and the publishers, if it transpires that the code of practice is not being honoured. It is more than coincidental that I am delivering this response with the assistance of an iPad.

I hope the Minister of State paid for it himself.

I did. There is a strange anomaly in this regard. Many schools are moving onto the digital platform. First year students at a number of schools in my area of County Galway do not have heavy satchels or bags because they have been equipped with tablets. One pays 0% VAT when one buys a school book in a local bookstore, which is more than appropriate. That is the way it should be. However, one has to pay 23% VAT when one buys an electronic copy of the same book to download it onto one of these devices. Ultimately, we should encourage young people to move onto a completely digital platform. This is an anomaly in EU taxation law. The European Union dictates that the higher tax or VAT rate that applies in each jurisdiction must be imposed on digitally-traded services. I think the application of this country's 23% VAT rate to school books on the digital platform is an unintended anomaly of that regulation. I hope to take up that matter with my colleagues in the European Parliament in Brussels to see whether it can be resolved.

School Accommodation

I am delighted to have an opportunity to raise with the Minister of State, Deputy Ciarán Cannon, the need to plan for the provision of more primary school places in the Greystones, Kilcoole and Delgany areas. The population of the town of Greystones has increased significantly in recent years. According to the CSO, the most recent census found that more than 10,000 people lived in the town. The local electoral area which encompasses Greystones, Delgany, Kilcoole and Newcastle now has a population closer to 25,000. The population of the area was approximately one fifth smaller when the previous census was taken in 2006. The locality has, therefore, seen a sizeable increase in population. Approximately 17% of the people of Greystones are aged 12 years or less, according to the census. That figure increases to approximately 20% in the case of the local electoral area. Clearly, this highlights the extent of the pressure being placed on parents and schools in the greater Greystones area.

It is regrettable that this problem has developed, given that it must have been known that a population bulge would result from the construction of a new housing area - Charlesland - just outside Greystones. Land in the Charlesland area was specifically zoned for a school. To this day, it baffles me that the school was not developed as a condition of the planning permission. It continues to be badly needed and the failure to develop it is putting huge pressure on the existing schools in the town. I have been inundated with calls and e-mails from concerned parents and teachers in the wider Greystones area who are very concerned about this difficulty. Their views were summed up by a parent who told me "the problem seems to be bigger than I can tackle and I am at a loss as to what to do." The parent in question is getting "little or no constructive advice to secure a place or a solution to this problem in Greystones." There are solutions within the existing school infrastructure and there are also longer term solutions.

I would like to ask the Minister of State two questions, the first of which relates to the short term and the second of which relates to the medium term. What are we going to do to make sure we can meet the demands of every local child of schoolgoing age in Greystones, Delgany and Kilcoole this coming September? What are we going to do in the medium and longer terms? The schools in Greystones, Kilcoole and Delgany cannot be run on a September to September basis. That would not be fair on principals, schools, boards of management or parents and their young children as they wait for school places. We have a number of options, some of which involve extensions, land acquisitions and new schools. I hope this evening we can begin the dialogue on how to address these problems.

I am responding on behalf of my colleague, the Minister for Education and Skills, Deputy Ruairí Quinn.

It is more than coincidental that Deputy Simon Harris has tabled this issue for debate once again. He has been in communication with me on the matter on a number of occasions in the past 12 months. As he will be aware, the Minister announced in June 2011 that 20 new primary and 20 new post-primary schools were to be established up to 2016 in a number of locations to cater for increased pupil numbers. Greystones and Kilcoole were not identified among the areas that required new schools in that period. However, it should be noted that two new schools - Gaelscoil na Clocha Liatha and Greystones Educate Together - opened on the same campus in Greystones in September 2008. Accommodation is being provided under my Department's rapid delivery programme for 2013. A new 16-classroom school is being provided for Greystones Educate Together. It is at the tender and planning permission stage. Subject to statutory approvals and no issues arising, the indicative date for delivery of these classrooms is September 2013. Gaelscoil na Clocha Liatha which has an eight-classroom building will take over the eight-classroom building currently occupied by Greystones Educate Together, thereby providing it with overall accommodation of 16 classrooms. The overall additionally to be provided on the campus is 15 classrooms.

The project at Kilcoole primary school represents the amalgamation of the former St. Anthony's boys school and the former St. Brigid's girls school. It is currently a 16-classroom facility. The junior classes are accommodated in the St. Brigid's building, while the senior classes are located in the St. Anthony's boys' school building. The project is included in the 2015-16 programme to proceed to tender and construction. The proposal is to extend each building by providing four additional classrooms with associated ancillary accommodation in each case. There will be an increase from eight to 12 classrooms in each building. The process of appointing a design team for the project recently commenced with invitation to tender letters being issued to the consultants in the Department of Education and Skills large schools framework.

In relation to the Greystones and Kilcoole area, officials in my Department met a delegation of principals from Greystones last month in an effort to ensure any additional needs from September 2013 would be fully catered for. The Department has sanctioned funding to provide four additional classrooms in neighbouring schools in Greystones to meet accommodation needs from September. It is continuing to liaise with patron bodies on increased provision as the need arises. In addition, the management of Kilcoole national school has applied to the Department for additional temporary accommodation. The Department will be in contact with the school in this regard shortly. The forward planning section of my Department will continue to analyse all areas of the country on an ongoing basis to establish where needs are beginning to emerge.

I thank the Minister of State for his comprehensive response which will provide a great deal of detail and clarity for many parents in the Greystones, Kilcoole and Delgany areas. I particularly welcome the progress being made with regard to the Greystones Educate Together school and the additional classroom space that will be made available to Gaelscoil na Clocha Liatha. I ask the Minister of State to take back to the officials in the Department of Education and Skills a number of options that need to be considered on a more ongoing basis. A number of well established schools in Greystones are having to turn students away each year. It is obvious that there is an element of parental choice in this regard. We need to make sure places are provided in locations that match the needs and choices of parents. The decision to sanction an extension at Kilcoole primary school is great news for the village. As it will not proceed until 2015, however, there is significant concern in Kilcoole that the waiting time is too long. I welcome the Department's decision to consider the provision of temporary accommodation at the school. I suggest the Department's forward planning section look at the project's date of delivery and consider whether there is room to move it forward. That is important. I would like the Minister of State to ask his officials to look at the catchment areas of existing schools. The boundaries of the town of Greystones have expanded significantly in recent years, but the enrolment policies of the schools of the town continue to reflect parish boundaries. The Department needs to have a conversation with the patron bodies on this matter. If we are to examine the expansion of some existing schools, the Department should initiate a conversation with them about the prospect of land acquisition, where that possibility arises into the future.

I will take on board all of the recommendations and suggestions made by the Deputy. As he is aware, it is envisaged that the number of children in the school system will increase by approximately 75,000 between now and 2017. When the Department is determining where exactly the demographic challenges will arise, it is able to avail of excellent data from the CSO and the children's allowance records of the Department of Social Protection.

Very scientific and ongoing research is taking place to ensure these demographic challenges will be met in a timely manner in the future.