Dáil Éireann debate -
Tuesday, 14 May 2013

Vol. 803 No. 1

Leaders' Questions

Deputy Micheál Martin

Last week we learned of the tragic death of Vakaris Martinaitis, a two-year-old child, in Midleton. I offer our deepest sympathies to his parents and family. The circumstances surrounding this death have caused significant concern in the east Cork area because when a well-known neighbour rang for an ambulance, he was told there was no ambulance available to come to the scene. Indeed, no paramedic was dispatched to the scene either. I welcome the fact that the HSE has set up a review group to inquire into all the circumstances surrounding both the call and the fact that, ultimately, this child was transported to hospital in the back of the neighbour's car.

There was a similar incident in the town some weeks earlier when another young child drowned tragically. There are competing issues, but there was concern about the time it took for the ambulance to get to the scene on that occasion. Increasingly, we hear around the country that these are not isolated incidents. There are concerns across the country about the adequacy of the ambulance services and, above all, the response times of ambulances in emergency life-threatening situations in the midlands region, Galway, etc.

In Carlow some time ago it took seven hours and three ambulances to bring a minor footballer to hospital for treatment. A year earlier in Drogheda a man was left on the street for 25 minutes before being attended to. In March a garda was asked to drive an ambulance to Letterkenny General Hospital because no paramedic was available. In April 2012, it was revealed that almost half of ambulances dispatched on life-saving cardiac emergencies are failing to reach patients within the strictly set target time of eight minutes.

In February, the Minister for Health, Deputy Reilly, said he was going to abandon the national targets for the response times in dispatching ambulances in life-or-death situations. This came weeks after HIQA had increased its target for response times. The Minister has said he wanted to abandon all national targets. I do not know why he would even contemplate doing so. There are separate targets for first responders of emergency medical technicians who would be dispatched in advance of the ambulance and those targets are also not being met.

Given all of these incidents and episodes, I believe there is a fundamental need for a comprehensive review of our ambulance service. Is the Taoiseach satisfied that our national ambulance service is adequately resourced to deliver the service required? Do we have enough ambulances in place across the country? Do we have enough qualified emergency medical technicians in place? We all know about the golden hour in terms of early intervention and getting to a scene where life or death is at stake. It can be crucial in ensuring the survival of any individual caught up in such a situation. I believe there is enough evidence to suggest we all have reasons to be concerned about the adequacy of cover. We need more than just a review into a specific incident. We need reassurance from the Taoiseach that the Government is satisfied that the resources are in place to meet the requirements.

The Taoiseach

I wish to extend my sympathies and those of the Government to the parents of the young child who died as a result of this incident. I heard the radio report on the work done by Mr. Kevin Hennessy, a well-known neighbour of the child's family. These are always tragic cases and nothing we say or do here can bring back that child to his parents.

The incident has been escalated to the HSE's serious incident management team. Following preliminary inquiries into this tragic incident, the national ambulance service in line with the HSE incident review methodology, has commissioned an incident review into the fact that a 999 call was received at 14:00, 2 o'clock, on 6 May 2013 and how, in effect, that was managed. The review team has asked for a preliminary report on this as a matter of urgency to be followed by a full report. Obviously the national ambulance service's liaison officer liaised with the family.

As the Deputy is probably aware, emergency ambulances in east Cork are strategically deployed. In other words they are no longer tied to any particular station, but are employed where they are most likely to be required. In addition, county boundaries no longer apply. The nearest emergency ambulance responds regardless of its origin. There has been no loss for the national ambulance service in east Cork - in fact it has been enhanced. Previously paramedics were responding to calls after 20:00, 8 p.m., four nights a week from their homes as they were working on call. In 2012, this system successfully changed to an on-duty rota with paramedics rostered on duty 24 hours a day and seven days a week, and the on-call system was eliminated.

It is important to ascertain the true facts in so far as the handling of the emergency call was concerned. Let us get those facts accurately form the incident team.

In regard to other incidents around the country, the situation of the national ambulance service is constantly monitored and reviewed. When incidents such as this tragic one come to light, it is fundamental to ascertain what the response was and why that response was made in this particular case. I respectfully suggest to the Deputy that we should wait until we get the report from the HSE serious incident management team and - while it will not bring back the little child - we can then see how the 999 call was managed. Given the improvement in the situation with ambulance services in east Cork we need to ascertain why this particular situation followed through as it did.

Deputy Micheál Martin

We need to be very careful about using terms such as enhanced or improved services because there is no sense of that in the community affected. People are now very concerned about the next incident and what might happen because they just do not believe an adequate service is in place. Recent tragic incidents have brought them to that very sad conclusion. I have spoken to people on the ground and their concern is whether there will be an ambulance on time, if God forbid, another life-or-death situation occurs in the east Cork region.

The other incidents I outlined suggest that the Department and Minister need to ask some fundamental and hard questions about the adequacy of the service. We are hearing reports of overworked and stressed ambulance crews and that the ambulance service is at the pin of its collar to meet the demands placed on it. We may talk about the changes that occurred and so on, but clearly in many instances those changes are not working. I have instanced the research undertaken that indicated only half were reaching the targets set nationally. Those are not my figures - they are objectively ascertained figures that the Minister, himself, acknowledged more than a year ago. However, very little has happened since then to enhance or improve the situation.

The reports from Deputies in their regions indicate that the changes are not working. People do not experience an enhanced service by any stretch of the imagination. The service is not adequately resourced. We do not have enough emergency medical technicians. We do not have enough ambulances in place particularly where there have been significant demographic and population changes in recent times. We also have the issue of dispersed rural communities. In the light of what has happened, the Government should have a fundamental review of the adequacy of the service in order to be able to give genuine reassurance. People are very anxious and concerned about the adequacy of our ambulance service and whether it is fit for purpose. Does it have the resources in terms of personnel and ambulances to meet the level of demand that exists? I do not believe the people have that confidence at the moment and for good reason.

The Taoiseach

In the vast majority of cases the response of the national ambulance service is up to the standard that is expected. In this particular case a child fell from a window and died. As I have said, nothing will bring that child back. However, it is important that we ascertain the facts as to what happened after the 999 call was made at 2 p.m. It is important that we get the facts of the sequence of events that meant an ambulance was not dispatched when, I understand, an ambulance was available to deal with this particular incident.

When I said that services were enhanced in east Cork, I mean the ambulances are no longer tied to any particular ambulance centre and are enabled to travel to wherever the need is-----

Deputy Micheál Martin

That might be the problem.

The Taoiseach

Let us examine it.

Deputy Micheál Martin

That is what I am asking the Taoiseach to do.

The Taoiseach

Until 2012 paramedics were on call and answered calls after 8 p.m. from their own homes. This roster was changed and they are now on duty 24/7 which should, one would think, provide an enhanced service. I have no difficulty, when the facts of the matter come to light, with bringing it back to the House and letting everybody know.

Deputy Micheál Martin

In some cases only one ambulance is available at night, and if it is on one mission, it cannot be on a second mission.

The Taoiseach

I take the Deputy's point about the requirement for people to have confidence and trust in the national ambulance service, and from this perspective I have asked the Minister for Health to publish a general report on national response times and for a report from the high risk management team on this particularly sad case.

Deputy Gerry Adams

I wish to raise concerns that decisions by the British Government are seriously undermining the Good Friday Agreement and the work of political institutions. This agreement and subsequent agreements transformed politics on this island, gave people great hope and brought peace - although it is a, imperfect peace - and a sense of stability for the future. While it most directly impacted on the North, it had a very good and positive effect here in this part of the island and throughout the diaspora.

Once the institutions were stabilised and the big issues such as arms being put beyond use and policing were dealt with, the Government here, and I include the previous Government, took its eye off this most important issue. The British Conservative and Liberal Democrat Government has also not engaged as it should have. The agreement is 15 years old, but there are still outstanding issues such as a bill of rights, Acht na Gaeilge and an all-Ireland charter of rights. We have discussed many times the failure and refusal of the British Government to act on commitments made in Weston Park with regard to the killing of Pat Finucane and the ongoing incarceration of Marian Price and Martin Corey without trial, and the Taoiseach believes they should be released or at least face due process. The Taoiseach is aware the Orange marching season has once again begun. There is much work to do. The Government is an equal guarantor with the British Government of this agreement. This is not the British Government's agreement; it is an agreement between the two governments and the rest of the political parties.

I spent all day yesterday in Stormont. The crux of what is undermining the ongoing work is that the British Government has reneged on an £18 billion commitment agreed at St. Andrews in 2006 to develop an economic peace dividend. It has just walked away from it. It has removed £4 billion from the block grant and is now imposing £1 billion of very significant cuts in welfare. The Taoiseach understands the great difficulties we have here economically because of many issues he inherited. We have had decades of conflict, disadvantage and discrimination in the North; if ever a place needed to be sustained and had need of an economic dividend it surely is this part of the island.

Will the Taoiseach join me and others in the Dáil in getting the British Government to honour its commitments and remove what is a threat to the well-being of the political institutions in the North, the Executive and the Assembly? These are commitments it made and has now reneged upon. I am not making them up.

The Taoiseach

As Deputy Adams is aware, the Good Friday Agreement sets out a bill of rights for Northern Ireland that would include the right of recognition of the principle of mutual respect for the identity and ethos of communities and parties in Northern Ireland. We support the principle of parties in Northern Ireland setting down their views in drawing up an agreement in respect of this bill of rights. It is possible to do so with constructive discussion between the parties on what might be the substance of any such bill of rights. We continue to stress the importance of ensuring the bill of rights, if it is produced, takes into account the separate and specific context of Northern Ireland.

The Deputy is well aware from his long experience of politics in Northern Ireland that every time an issue was raised over the past 30 years, and there have been many, the political process in Northern Ireland went to Downing Street and asked for another cheque to deal with whatever crisis had arisen. I would like to think governments would honour their commitments in respect of the Good Friday Agreement. The First and Deputy First Ministers are very active in promoting Northern Ireland at home and abroad, and discussions are taking place on the possibilities which exist from changes in the taxation regime and the very active and constructive propositions being put forward by the Executive and the First and Deputy First Ministers in making Northern Ireland an attractive location for investment. This has resulted in approximately 2,200 jobs being located there, with more created from the indigenous economy.

With regard to the figures the Deputy mentioned, it has been a while and I do not have the cumulative amounts allocated by the British Government in each year since the Good Friday Agreement. I expect to meet the First and Deputy First Ministers in the not too distant future, and I would be happy to discuss the matters raised by Deputy. I expect the Executive will follow through diligently on this issue with the British Government.

Deputy Gerry Adams

The First and Deputy First Ministers are following this through diligently with the British Government. I dissent totally from the Taoiseach's suggestion that every time a crisis occurred in the North, the parties there went to Downing Street looking for a cheque. This is not the case. I am an Irish republican and I do not want any British Government involvement in our affairs. We have one of the most successful peace processes in our lifetime. I remember walking through the Turf Lodge estate with Fr. Alex Reid and he asked me how we would know whether the peace process was working. I answered it would be when the people there knew it was working. There is extreme disadvantage in mostly Nationalist, but not exclusively Nationalist, working class areas, with generational discrimination and disadvantage. The same goes for working class loyalist and Unionist communities.

What the British Government signed up to at St. Andrews was an attempt to regenerate the economy with an investment of £18 billion, but it has reneged on this and the Deputy First Minister and the First Minister have raised this issue with the British Government and the Taoiseach. The British Government also cut the block grant through which the North receives its subvention from London. There is much controversy about how much tax is lifted from the North by the British Government and how much it removes from the Six Counties. We have had a £4 billion cut on top of an £18 billion hit and now we have a very clear intent of austerity through removing £1 billion from these communities.

I welcome what the Taoiseach stated about speaking to the First and Deputy First Ministers about these matters, but they will tell him nothing different from what I have just told him. It is the Taoiseach's agreement.

It is an international agreement between the two governments, so the Irish Government cannot resile from this. People in the North - Unionists and the rest of us - look to the Government here as a co-guarantor of this agreement to ensure the British government is accountable daily in this business. Therefore, I am asking the Taoiseach again to intervene urgently. I am not one for scaring the horses or raising false concerns, but there is genuine apprehension about where this will end up if the Tory Government continues on this path.

The Taoiseach

Deputy Adams is aware that the British Government has put forward a series of proposals concerning economic incentives to develop and strengthen the economy in Northern Ireland. While this is clearly a matter for the British Government and the Northern Ireland Executive, I welcome that and would like to see it progressed. In fact, I expect that in the preparatory period for the G8 summit in Fermanagh, to which I have been invited as Ireland currently holds the EU Presidency, we will have an opportunity to discuss this matter and see what can be moved forward in the context of that particular set of proposals. I know that the British Prime Minister, Mr. Cameron, and the Northern Ireland Executive view this as an opportunity to move that package of proposals forward. That is an important element of strengthening the east-west relationship.

As regards the Deputy's question about how one knows the peace process is working, that is why the matter was raised by me directly with the US President and the Speaker of the House of Representatives, as well as with Senators and other members of the US Congress. Deputy Adams is aware of the discussions that have taken place there. He is also aware of the response from a European perspective in terms of the PEACE IV dividend.

Today, ECOFIN was able to make substantial progress on the preliminary problem of dealing with the deficit for the multi-annual financial framework, MFF, for 2012-13. The Tánaiste is engaged in the process of dealing with the approval by the European Parliament of the MFF or budget for the EU, which includes that PEACE IV dividend. I know the Deputy has welcomed it before and it will be of benefit, particularly to hard-pressed communities. I look forward to having an engagement with the First Minister, Deputy First Minister and, when possible, the British Prime Minister in respect of the proposals for economic stimulus in Northern Ireland. I have to assume that reflects, at least in part, the original decision made at St. Andrews. We will obviously have an opportunity to discuss that here again.

This matter has been raised on quite a number of occasions over the past two years. In that time, there have been at least 50 ministerial engagements in respect of the North-South Ministerial Assembly dealing with issues about Northern Ireland and cross-Border activities.

Deputy Clare Daly

We have had a weekend of determined industrial action by bus workers and midnight talks to avert disputes across the public sector. I find it interesting how people on six-figure salaries - including Government Ministers, semi-State CEOs and a couple of trade union leaders - can try to convince workers that the only show in town is one where they have to offer up their hard-won pay and conditions to make savings. Of course, they are ably assisted by a press that is owned by billionaire tax exiles. I am reminded of one of the Taoiseach's predecessors, Charlie Haughey, who in the 1980s told the rest of us that we had to tighten our belts while he unwrapped yet another Charvet shirt.

The recent disputes show a lot about the type of society that is being fostered under the Taoiseach's stewardship. Those policies are being pursued, not because there is no alternative or the Taoiseach has no choice, but because ideologically the Government supports stripping public services and driving down wages and conditions.

The Minister for Transport, Deputy Varadkar, slashes the subsidy to Bus Éireann and is then shocked that the company is somehow losing money. His personnel on the ground - although not really on the ground because some of them are based in Dubai - or his management team come up with the myth that the company's workers are to blame. According to management, these people have an absolute neck to think that they should be paid more for driving through the night, working weekends and doing 12-hour shifts. Let us be clear, bus workers earn a modest wage. They are not the worst paid workers in this country but their money is hard earned. Their wages have already been cut in recent weeks. The expectation that they would endure a cut of another €3,000 to €4,000 is absolutely scandalous.

The issue is what type of society we want to live in. Public services cost money and their value cannot be determined by break-even economics. The social benefit has to be factored in. Our transport costs are the least subsidised in Europe. Even the United States subsidises private transport more than we fund public transport.

Rather than undermining public transport, does the Taoiseach not think it would be far more sustainable, both economically and socially, to increase the subsidy to Bus Éireann and CIE, thus enabling them to slash prices and get more people out of their cars and onto buses? Is it not an obscenity that the Government continues to pay €50 million of taxpayers' money every year - that is ten times the bus cuts - to fund the West Link toll bridge? That bridge has been paid for many times over as a result of the cosy deal done by the Fianna Fáil cohort.

Does the Taoiseach not think it crazy that the taxpayer pays millions every year to public private partnerships because roads are not being used, yet he cannot use taxpayers' money to fund viable rural bus companies? When will the Taoiseach stop subsidising the private sector while at the same time driving down public sector wages and conditions?

The Taoiseach

After that long dissertation, Deputy Clare Daly understands well what we have to do: get our public finances in order, restore our country to prosperity and get our people back to work. That is why I am glad the unions have agreed to suspend the strike and go back to talks with Bus Éireann at the Labour Relations Commission. I hope that over the next 48 hours or so, the discussions will end conclusively and successfully in that the savings that have to made can be agreed, drivers will continue giving the excellent service they have always given, and passengers will have access to Bus Éireann for their journeys around the country.

The evidence of €500,000 lost in a two-day strike speaks for itself. I do not share the Deputy's view that the subsidy has been slashed by the Minister, Deputy Varadkar. In fact, last year, the subsidy to Bus Éireann was the highest ever.

Deputy Clare Daly

That is simply not true. The reality is that Bus Éireann's subsidy stood at €49 million in 2009 and has been reduced by €15 million since then. Since 2009, the wages bill has been slashed by another €15 million.

Deputy Simon Harris

That is a different company - Dublin Bus.

Deputy Clare Daly

That is €15 million out of the pockets of hard-pressed bus workers who already have had to endure cuts. The Taoiseach has chosen to avoid the fact that choices are always available. Rather than taking money from the pockets of modestly paid workers, why could the Taoiseach not have chosen instead to tax the new millionaires who have gained extra wealth under his stewardship? For example, could he not bring in a 5% hike on the new earners of more than €300,000 per annum, whose numbers have sky-rocketed under the Taoiseach's stewardship, in order to meet the deficit he wants public sector workers to shoulder?

At the behest of the Department of Transport, Tourism and Sport, Deloitte - an independent group - undertook a study on Bus Éireann and found that it was an incredibly efficient and well-run company off the backs of a good and modestly paid workforce.

The idea that the Minister expects them to make savings of €5 million while he continues to subvent the private sector is reprehensible and is a bit of a fairy tale.

The Taoiseach

I get a bit fed up with this regular comment from Deputy Daly as if she is the only one in here who values the work the public service does. We value the work of our public servants. I value it because I know them, the very many people who work long hours and late nights to see that services are provided, whether front-line or not. And yes, no more than any other sector of Irish society, there are people who do not perform to the optimum level. There are sectors in the public sector where that applies. We value the work of the public service, and Deputy Daly does not have sole ownership of respect for the public service.

I hope the discussions that are taking place with chief executive of the Labour Relations Commission and trades unions will proceed successfully, that we can have an opportunity to have a negotiated, overarching agreement regarding Croke Park II. Hopefully the discussions the unions and Bus Éireann have entered into, thankfully both with a positive attitude, can bring this matter to a conclusion and Bus Éireann drivers and workers can continue to provide an excellent, first class service for the many thousands of passengers who are glad to use their services on a daily basis for many years.