Topical Issue Debate

Pension Provisions

Deputy Patrick Nulty

Deputy Shortall and I have been tabling this matter for inclusion in a Topical Issue debate for the past three weeks. With all due respect to the Minister of State, Deputy Cannon, it is unacceptable that the Minister for Social Protection has not seen fit to attend the House to debate this crucial issue. It concerns not only the Waterford Crystal workers but also other workers across the economy. Plenty of notice of this matter was given, but it makes a mockery of Topical Issue Matters if the relevant Minister does not attend the House. I wish to put on record the fact that I consider it to be completely unacceptable.

I wish to explain the context of this judgment by the European Court of Justice. Some 1,700 workers in Waterford Crystal were initially impacted when the pension scheme insolvency issue arose. Ten of those brave workers took a case to the European Court of Justice, supported by their trade union, Unite. They did a great service for workers in this country. The previous Fianna Fáil-led Government and the current Government fought those workers every step of the way to stop them getting their rights under the EU insolvency directive of 2008. The State resisted that directive repeatedly.

The Pensions Ombudsman, Mr. Paul Hogan, has said that this judgment has implications for workers across the economy. The Government has known since the Robins case in 2007 that there was a need to act on this issue, but it has completely failed to legislate. The Government has left the workers in limbo, obliging them to go to Europe to vindicate their rights.

It is now clear that under EU law, the State has an absolute obligation to protect the pension entitlements of workers in the event of insolvency. It is my understanding that even since the judgment, the Government has completely failed to engage with those workers or the Unite union. They will now potentially be dragged through the High Court to vindicate their rights.

Will the Government face reality and engage with those workers to reach a settlement to which they are entitled? On a broader question, what is the Government's strategy to deal with the protection of workers' pension rights and entitlements?

Deputy Róisín Shortall

It is a matter of regret that the Government has failed to address this issue since the European Court of Justice issued its judgment last month. This is a pressing issue that has been around for a number of years. It concerns the workers from Waterford Crystal but also has implications for many other workers in this country who are members of defined benefit schemes.

The workers' legal teams are currently preparing for a return to the Commercial Court. If the matter goes ahead, the court will decide the outcome of the case. It is expected that there is likely to be a determination from the courts that will entail a capital sum as a financial settlement. Such a financial settlement will have significant implications. There has been speculation that it could be in the region of €250 million to €300 million. It would seem to make eminent sense to have an engagement between the Government and the workers in order to make provision for the workers' pension provision and secure it for the future. That could be done by way of staged payments. It is estimated by the workers' actuarial advisers that the payment could be as low as €2.5 million initially, rising to a maximum of about €80 million in 2030. This is about extending that payment period and the Government meeting its commitments by way of staged payments in order to guarantee the pension rights of those workers.

This kind of approach has a lot to recommend it because we do not know what a court ruling is likely to come up with in terms of the Government's commitment and obligations. It has potentially significant, immediate implications for the taxpayer unless the Government seeks to reach some kind of settlement which would not only give security for the workers themselves but would also initially take pressure off the taxpayer's liability. It makes common sense to take that kind of practical approach to resolving this issue. It is regrettable that no action has been taken in this regard up to now.

Minister of State at the Department of Education and Skills (Deputy Ciarán Cannon)

On 25 April, the European Court of Justice issued a ruling which contained a number of clarifications regarding the transposition of EU Directive 2008/94/EC which concerns the protection of employees in the event of the insolvency of their employer. This ruling was in response to a July 2011 referral from the High Court regarding proceedings brought by former workers at Waterford Crystal.

In taking the view that interpretation of the provisions of the Directive 2008/94 was necessary for it to give its decision in this case, the High Court had decided to stay the proceedings and to refer a number of questions to the European Court of Justice for a preliminary ruling.

Following that European Court of Justice ruling, the matter will now revert to the High Court for consideration. Given this matter remains before the courts, it would not be appropriate for the Government to comment further on any specific aspects of the case at this point in time.

Deputy Patrick Nulty

I find it astonishing that the Government now intends to drag these workers through the High Court rather than engage with them. They are ready, willing and able to come to a constructive solution which would ensure the rights of workers, as set out by the European Court of Justice, are vindicated while protecting Irish taxpayers by coming up with a practical solution to the challenge we face. The refusal of the Government to engage with the workers really beggars belief and potentially has huge costs for the taxpayer.

We do not know what the High Court will decide but we know workers in these schemes are absolutely protected in terms of their pension entitlements. Surely it would make sense to engage and negotiate with them rather than going through another prolonged and protracted legal process.

On the broader issue of pensions, it is very disappointing that although the Government has made reference many times to the gap in the social insurance fund, it has a strategy of increasing contributions to the social insurance fund for low-paid workers but cutting them for employers, who often have quite lucrative incomes due to lower employers' PRSI. I appeal to the Minister to ask the Cabinet to engage and come up with a solution. A head-in-the-sand approach will not solve the problem and certainly will not ensure the rights and entitlements of those in defined benefit schemes.

Deputy Róisín Shortall

Initially a proposal was put to the then Government to resolve this issue, which seemed to make a lot of sense at the time, but was rejected by the then Minister for Finance. It is important to point out that the European Court of Justice, ECJ, has found in favour of the workers on all fronts and on the major points that were put before it. That is the backdrop to this. It makes no sense to expose the taxpayer to further liability. On the face of it, it would seem that annual payments represent a much more efficient approach than settling for an unknown capital sum that will be decided by the courts. Annual payments avoid the need to purchase annuities to settle the matter because annuities are a very expensive way of generating pension income for people. Taking that approach would also avoid the additional legal costs involved, which are probably very significant. On behalf of the workers, and the Irish taxpayer, I urge the Minister to enter into discussions on finding a resolution to this issue and not to leave it to the High Court to decide.

Workers in other companies, both solvent and insolvent, deserve to be adequately protected. A solvent employer should be required to stand over the pension commitments it made to workers in the past. Where the employer is insolvent, a safety net is required, as has been implemented in the UK and other jurisdictions. This Government continues to be irresponsible in its failure to legislate in this area.

Deputy Ciarán Cannon

I will undertake to convey the views of both Deputies directly to the Minister, Deputy Burton, but, as I have been advised, because the matter remains before the courts it would be very inappropriate for me to comment any further on the issue.

Child Protection Services

Deputy Ann Phelan

I thank the Ceann Comhairle for the opportunity to speak on this very important topic. I support Deputies Nulty and Shortall on the pension rights of the Waterford Crystal workers.

The recent independent inspection by HIQA of the HSE’s child protection services in my home constituency of Carlow-Kilkenny has highlighted serious flaws in the assessment of children at risk and the way they are treated. As this is the first in a series of reports on child care across the country, and if one takes Carlow-Kilkenny as an example, it makes for uncomfortable reading. What is worrying is that this report is the first of its type, following a series of damning reports that have consistently highlighted failures in child protection and the general welfare of our children.

It seems we are not learning the lessons of the past. To quote Ms Jennifer Gargan, who is the head of Empowering People in Care, EPIC, a support group for young people in care, "Yet again, there are lessons from the past that have not been learned, and recommendations which have not been put in place." To combat these problems, we must embrace reports such as this regardless of their findings. The question that comes to mind is how did these failures come to pass, especially when new standards, published last year, set out clear and concise requirements for the HSE and others working in this area.

The failure to implement set guidelines has proven to have severe ramifications for our younger citizens. It can lead to alcohol and drug abuse, homelessness, social problems and a lot of other problems that manifest themselves well into adulthood. We have our own litany of tragic cases in which we failed our children, including terrible cases in Kilkenny and other parts of the south east, that have served to show what can happen to young people when the system fails them.

This report discovered evidence of children in Carlow-Kilkenny who were being placed at risk through the failure of social services to notify the Garda Síochána of cases in which abuse or neglect was suspected. The HIQA inspectors found that delays in sharing information were potentially hindering investigations carried out by the Garda. It was also found that some children who were believed to be at risk had records that were not updated and there were long waiting lists for investigations. The teams working in this area were not following the official guidelines on handling concerns about neglect and abuse. In total, none of the 27 national standards against which the services were inspected were fully met and nine of them were not met at all.

It would be remiss of me not to draw attention to the fact that the HIQA report also found that there were positives to be taken from the investigation. It was found that staff were providing a safe service and that the standards of assessments were good. Overall, the investigation found that services to children were safe and that many of the children and families who participated rated the service positively. If we can move forward with the positives and combat the negatives, we will be much closer to achieving our goal regarding children.

Deputy Ciarán Cannon

I am taking this Topical Issue debate on behalf of the Minister for Children and Youth Affairs, Deputy Fitzgerald, who is out of the country.

Deputy Fitzgerald welcomes the findings from HIQA's first inspection against the national standards for the protection and welfare of children in the Carlow-Kilkenny local health area, HSE south region. In July 2010 the Government decided to prioritise the inspection of child protection by HIQA. These inspections are undertaken against standards developed by HIQA, as provided for by the Health Act 2007, and HIQA reports its findings to the Minister for Children and Youth Affairs. The standards are designed to follow a child's journey from referral to the HSE child protection system to ensure the service the child receives is of good quality and that where necessary the child is protected. The national standards, which were a priority of the Minister, Deputy Fitzgerald, were launched last July jointly by the Taoiseach and the Minister. In addition to following Children First, they introduce new standards for management in the use of resources, risk and quality systems and information regarding services.

The Minister was glad to see that, overall, services in Carlow-Kilkenny local health area were safe and were provided to children by a generally experienced and long-standing workforce. This is borne out by figures, produced by the HSE on a monthly basis, which show that 100% of children in care in this region have an allocated social worker and a care plan. The Carlow-Kilkenny local health area has a population of approximately 130,000, with both counties experiencing high population growth and immigration in recent years. The youth demographic for Carlow is higher than the national levels. There were 1,156 referrals to the child and family services child protection team between October 2011 and October 2012. Referrals that are not appropriate for the service are referred elsewhere. Child protection concerns are given priority. At the time of inspection there were 684 children in receipt of services. Some 78 assessments were ongoing, and 42 cases, including concerns regarding welfare issues, were awaiting assessment.

The recently published HIQA report stated that the services provided to children were safe and were provided by a well-experienced and long-standing workforce. The report shows that while social work relationships with other professionals, including the Garda, were good, and the quality of child protection and welfare assessments was satisfactory overall, there were inconsistencies and poor management of aspects of the duty system in parts of the area.

The Minister noted HIQA's finding that the HSE had not referred all cases of abuse and neglect to the Garda in a timely way and has asked officials in her Department to review with the Garda and the HSE matters related to the timing of the HSE's passing information of suspected abuse and neglect to the Garda.

The Minister, Deputy Fitzgerald, would like to stress that at no time were children put at risk by delay on the part of social workers in notifying the Garda of possible criminal neglect.

Overall, HIQA inspectors found that the local health area management system did not meet the new standards, including monitoring and risk systems. The report noted that managers were unable to identify trends across the two counties. Although the standards are recent, they are welcome and will set the bar for all areas to meet in order to provide better quality services for children and their families. Most important, inspectors who spoke to children said that they had achieved good outcomes following the child protection interventions by the social workers. They saw the role of the social worker as important in their lives. Inspectors were told by one child that without the input of the social worker the child would not have been able to attend secondary school and prepare for third level education.

Arising from the report's publication, an action plan, which includes 57 actions, has been prepared to address the issues identified. The Minister is glad to note that many of these recommendations have already been implemented. She is confident that Mr. Gordon Jeyes and his team will implement the remaining actions required to improve services in this crucial area. It should be noted that this is the first inspection undertaken following the publication of the standards and, while the report shows there is considerable room for improvement in the planning and reviewing of service, the Minister is encouraged to note that inspectors noted good practice by social workers and there was no finding or evidence in the report that a child had been negatively impacted by the HSE.

Deputy Ann Phelan

I thank the Minister of State for his comprehensive response on behalf of the Minister, Deputy Fitzgerald. She has addressed issues I, too, have addressed. Although I do not wish to overdramatise the results of the report, and I welcome its publication, it is very important that nobody runs away from this. Even though the report may make uncomfortable reading, it is very important that we take on board its findings. I understand it is the first of its kind and it serves to make us aware of the mammoth task we face, as legislators, as we attempt to combat child abuse and neglect. I am also mindful of the staff who provide services in this area, whose work has been approved in the report. It is essential that they be given the full support they need in fulfilling the very difficult work they do, which requires much expertise and tact. With the help of reports such as this, from HIQA and other agencies, we can try to secure a better and brighter future for the children who have to avail of these services.

Deputy Ciarán Cannon

I have been greatly impressed by the Minister, Deputy Fitzgerald, who has been so proactive not only in ensuring that very high standards are set by this State in terms of how we care for vulnerable children when they come to us to seek support and have their issues addressed, but also that we give them every possible chance of succeeding in life. It is important, first, that we set very high standards but second, and equally if not more important, that we ensure we have a sufficient and effective inspection regime in place to ensure those high standards are being met.

If this first inspection under the new regime shows anything it shows we now have that very robust and forensic inspection regime in place and that it produces results which can be acted upon immediately. It is very encouraging to see that the weaknesses which were identified in the Carlow-Kilkenny region are now being proactively addressed. One hopes that as similar inspections roll out nationally they will be equally proactive in addressing the shortcomings in service to these most vulnerable children.

Charity Clothes Bank Thefts

Deputy Catherine Byrne

I thank the Ceann Comhairle for choosing this matter and I thank the Minister, Deputy Shatter, for attending personally. This matter was raised in the Chamber during the Order of Business but today I wish to speak about how it is affecting legitimate small businesses and charities in the community I represent.

I wish to speak specifically about Liberties Recycling, Training and Development, which is based in Bluebell. This organisation began in the inner city in 1999. It is a small, non-profit, community-based project which operates a clothing and recycling social enterprise and charity that reaches out to help people who are recovering from drug addiction. It offers them employment as well as the chance to return to education and training. At present, Liberties Recycling employs 62 people, who recycle and collect, and sort and pack grades of clothing and footwear, for reuse in markets in developing countries and for processing for use in mattress-making and insulation. Cotton material is put into bales for usage by local customers, including Dublin Bus, motor factoring companies and cleaning companies. Representatives collect clothes through their network of clothing recycle banks and schools, by door-to-door collections and through agreement with charity shops such as those run by the Irish Cancer Society.

Currently, the organisation has 145 textile banks located around the country. However, in the past 12 months more than 80 of these have been damaged by unknown individuals. As a result, since last January there has been a loss of revenue to the project of approximately €200,000. In the past two years the loss in revenue has mounted to the staggering total of more than €600,000. This money would have been invested back into the organisation to create employment and run training programmes for the individuals involved. Each year more than 100 people receive certificates in subjects as diverse as fork-lift driving, computer applications, mathematics and payroll, as well as for participation in reading and literacy projects. In recent years thousands of young people who otherwise would have been caught up in the drug culture in their communities have gained work through this project. Some of them are now well placed in long-term work throughout the city.

The recent surge in thefts from the clothing banks means there is a realistic chance that Liberties Recycling might face closure, which would be a major blow to the community I represent in the Ballyfermot-Drimnagh-Crumlin area. For those who use the centre, it is a lifeline. The recent "Prime Time" programme in April highlighted the issue of thefts and illegal profiteering from charity clothing banks. It showed organised criminal gangs were stealing clothes from these banks, often damaging them in the process. Some charities are being brutally targeted by criminals and are at their wits' end as to how to continue and counteract such attacks on their business. We urgently need to address this problem. Recycling facilities such as Liberties Recyling, which gives opportunities to young people who normally would not have them, are in need of a response.

Minister for Justice and Equality (Deputy Alan Shatter)

I thank the Deputy for raising this important issue and for praising the work undertaken by Liberties Recycling. I am very aware of the difficulties that charities can face when raising funds to support their work, especially in the current financial climate. This was highlighted in the "Prime Time" programme on this topic, which was broadcast a number of weeks ago. As I did in the Seanad, I congratulate "Prime Time" and RTE for their careful investigative work in revealing and bringing to public attention the activities of an organised gang targeting clothing banks. Burglary, theft and all types of criminal activity are, of course, to be condemned. However, there is something particularly nasty, callous and cynical in the actions of those who steal, for their own benefit, charitable donations intended to help those in need.

As to the revelations contained in the "Prime Time" broadcast, I have requested a specific report from the Garda Commissioner in regard to this type of crime and will give very careful consideration to the Commissioner's views and to any suggestions he might make in this regard. It is important that the Garda target and bring to justice those who are engaging in this despicable type of criminality.

I assure Deputy Byrne that I fully appreciate the need to protect the fund-raising ability of charities, including charities that have chosen to support their fund-raising efforts through the operation of clothing banks. I am determined to ensure that the donations of clothes and other items, so generously given by members of the public in the belief that they are supporting a charity and helping those in need, are not diverted by theft, illegal profiteering or other illegal activities.

The Criminal Justice Acts contain the necessary measures to address theft from charity clothing banks. Theft, including theft from charity clothing banks, is an offence contrary to section 4 of the Criminal Justice (Theft and Fruad Offences) Act 2001. A person convicted upon indictment of theft is liable to imprisonment for up to ten years and-or an unlimited fine.

While theft from charity clothing banks is clearly a criminal issue, the topic for this debate also concerns the wider issue of public trust and confidence in charities. The recent revelations in the "Prime Time" programme regarding the proportion of profit from charity clothing banks that actually reaches the charitable cause with which the bank is associated is also a cause for concern. Such revelations are a disincentive for people to donate and can have a negative impact on donations to charities, including donations to charities that go to great effort to ensure that the maximum proportion possible of proceeds from donations is used for charitable work.

Members of the public are entitled to know what financial benefits charities receive from such donations. Until the recent revelations by "Primetime", many donors to charity clothing banks may have been under the impression that all proceeds went to the charity. I believe there is a need for greater transparency when it comes to arrangements charities may have with commercial companies concerning the operation of clothing banks. Where a charity is lending its name to a clothing bank and by doing so is encouraging members of the public to donate, they have an obligation to indicate clearly what financial benefit they are receiving from this arrangement.

Supporting public trust and confidence in charities is the core objective of the Charities Act 2009, which was enacted to introduce a system of statutory regulation of charitable organisations. While the Act does not deal directly with the regulation of Irish clothing banks or collections, it contains measures aimed at preventing the abuse of charitable status. When brought into force, these measures will support the efforts of the relevant authorities in addressing the difficulties surrounding theft and illegal profiteering from charity clothing banks. Under section 46 of the Act, it is an offence for an organisation that is not a registered charity to describe itself or its activities in such terms as would lead members of the public to reasonably believe that it is a charity. This Act, when implemented, will help to safeguard that vital public trust in charities.

While full implementation of the Charities Act 2009 and the creation of a register of charities have been delayed for financial reasons, the Government remains committed to progressing its implementation and putting in place a dedicated regulatory framework for charities in line with the provisions of the Act. My Department recently conducted a public consultation on the implementation of key provisions of the Act on a phased and low cost basis. The submissions received are currently being reviewed and I look forward to publishing the outcome of the consultation in due course and to providing further information on the timeframe for the introduction of an operational charities regulatory authority and creation of a statutory Register of Charities as provided for under the Act.

Charitable organisations play a key role in communities throughout the country. It is in all our interests to ensure that they continue to do so. This includes protecting genuine fund-raising efforts against any who might wish to exploit the goodwill and generosity of the public. I thank Deputy Catherine Byrne for raising this topic. I appreciate the real concerns expressed by Liberties Recycling and I will draw to the attention of the Garda Commissioner the specific difficulties they are experiencing, as described by the Deputy.

Deputy Catherine Byrne

I thank the Minister for his response and welcome that he has requested a report from the Garda Commissioner on the activities of gangs. These charities are not getting their fair share of the profit. Has a timeframe been set for the completion of the report and, in the meantime, has the Garda made any suggestions on secure clothing banks? Is the Minister willing to meet representatives of these organisations to discuss their ongoing problems? I understand people are deciding against putting their clothes in banks, which leads to further problems in respect of the amount of material being made available to these projects.

Deputy Alan Shatter

I have no difficulty in meeting representatives of charities which raise funds in this way. I expect to receive a response from the Garda Commissioner in the not too distant future. I did not set a specific timeline for his response because it is important that he has an opportunity to make any inquiries he needs to make. I am conscious that a large number of charities operate clothing or textile banks around the country. There are thousands of such facilities and I recognise the particular difficulty that arises in securing them. In the early years of their existence people respected the work done by charities out of a sense of decency. The types of events we have seen over the past two to three years were not occurring but it seems they are now on the increase and that the individuals engaged in this criminality have no respect or thought for those who are genuinely in need or who give freely of their time to raise funds, or organisations doing the type of work in which Liberties Recycling is engaged.

I do not know whether these clothing banks could be constructed in a manner that better secured them. Having donated to banks, I am conscious of the size of the opening into which clothes are placed and the ease of accessing their contents. I do not know whether additional thought needs to be given to putting content in without being able to take it out. There may be some mechanical way of addressing that issue. Unfortunately, if people are intent on criminality, it seems that nothing is sacrosanct nowadays and they will engage in such conduct. This is an issue on which the Garda may have interesting or important observations and the charities themselves may also wish to consider it collectively. I would be happy to communicate further with Deputy Catherine Byrne when I receive the expected response from the Commissioner and I am more than happy to meet with any group to discuss the issue. Perhaps such groups would share with me their thoughts on how clothing banks could be better secured.

Hospital Trusts

Deputy Billy Kelleher

While nobody can object to hospitals working together in groups and sharing services, a number of issues arise from the Higgins report on the establishment of hospital groups as a transition to independent hospital trusts, which was published this week by the Minister for Health. The absence of any specific commitments in the report for a number of hospitals nationwide raises questions about their future role in the health system. The report states, for example, that Letterkenny, Wexford and Kerry hospitals should continue to provide services currently available at those hospitals, which raises questions about the retention of services at other hospitals that have not been mentioned.

While it is recommended, for example, that in the Dublin east group, Wexford General Hospital should retain its full range of emergency, medical, surgical, maternity and pediatric services because of its geographical location, no such recommendation is made for St. Luke's in Kilkenny or the Midlands Regional Hospital in Mullingar. The likely fate of these hospitals is a cause for concern. Will they continue to provide the current level of services? St. Luke's in Kilkenny has an exemplary reputation for quality and efficient patient care. It is often seen as a role model for accident and emergency services. We are merely seeking clarity and we accept the need for reform of the delivery and configuration of health services. The same questions arise in respect of the south and south west group. It is recommended that Kerry hospital should keep what it has but no such recommendation is made for Clonmel. What is the position in this regard and can we be given an assurance that no change will be made to the services provided to south Tipperary?

The report goes to great lengths to reassure the people of Waterford, on foot of a vocal local campaign launched last year to retain services in the city's hospital, that it will continue to provide renal and cardiology services for the south east area. I presume Wexford and Kilkenny hospitals, which are in the Dublin east group, will continue to refer patients to Waterford.

In light of the decision to place Waterford Regional Hospital in a different hospital group, will a guarantee be given that hospitals in Wexford and Kilkenny will continue to make referrals to Waterford? I am concerned that this decision will result in a change of referral pattern, with referrals of cardiac and renal cases gradually shifting from Waterford Regional Hospital to Dublin hospitals that are in the same group as Wexford General Hospital and St. Luke's Hospital. I ask the Minister of State to clarify the matter.

The broader issue relates to the proposed hospital reconfiguration and transition to hospital trusts. The report on hospital groups states a board will be appointed and a chief executive officer will be recruited who must report back to the board with a plan for the new hospital group within one year of taking up his or her position. The difficulty is that we do not know how hospital budgets will be reconfigured. How will the CEO, who will be the accounting officer, guarantee the services currently provided by the hospitals in each of the hospital groups? How will the Minister be able to guarantee services without a commitment to provide the capital and current funding required to provide the services outlined in the reconfiguration?

Deputy Ciarán Cannon

I am taking this debate on behalf of my colleague, the Minister for Health, Deputy James Reilly. I thank Deputy Kelleher for raising this matter and allowing me the opportunity to discuss with him the report the Minister for Health launched on Tuesday, which signals a fundamental modernisation of our health system organisation in line with best practice internationally. The traditional practice of providing as many services as possible in every hospital is neither sustainable nor safe. The formation of acute hospitals into groups, each with its own governance and management, will provide an optimum configuration for hospital services to deliver high quality, safe patient care in a cost-effective manner.

The current organisational structures have restricted the development of the management systems and leadership we require to run a world class national hospital network. In reforming these structures, the Minister wants to take the best elements of governance and autonomy found in our system to create a new governance framework that can yield the benefits of increased independence and greater control of local clinical and managerial leaders to every hospital. The introduction of groups will provide for organisational change in the first instance, giving more autonomy and better enabling the reorganisation of services in a well planned manner.

The hospital groups report is based on a comprehensive consultation process and contains almost 60 recommendations on the formation, management and governance of hospital groups. The objectives of the groups are to achieve the highest standard of quality and uniformity in hospital care across the group, deliver cost effective hospital care in a timely and sustainable manner, encourage and support clinical and managerial leaders, ensure high standards of governance both clinical and corporate and recruit and retain high quality nurses, non-consultant hospital doctors, consultants, allied health professionals and administrators in all our hospitals. The establishment of hospital groups will result in small and larger hospitals working together as teams.

Implementation of the hospital groups report will begin immediately. The Minister intends to seek and appoint chairs of each group within the next two months. Advertisements to seek other board members will be placed in parallel with the process of appointing the group chairs and the subsequent appointment of group CEOs and management teams. All appointments will be made based on the competences the individual brings to the board in line with the HIQA report on Tallaght. This will not prevent appropriate representation of the geographical areas in the group. The need to ensure primary and community care is also covered by the board membership.

Deputy Billy Kelleher

Although I accept the difficulty involved in providing assurances, clear commitments were made previously to protect services in smaller hospitals. While the report refers specifically to some hospitals, it fails to mention others. For example, it does not specifically state that all services currently provided at St. Luke's Hospital, Kilkenny, and Clonmel General Hospital will be retained. On the other hand, it is at pains to point out that Wexford, Letterkenny and Tralee hospitals will retain their current services for reasons of geographical spread. This omission is causing concern.

To follow up on our discussion in the Chamber this morning, I am not condemning the hospital groups report. My party agrees that the proposed changes are necessary. However, it would give people confidence in the process if they were given an assurance that current services will be retained. This will be very difficult to do given that the chief executive officers of the various hospital boards will be given responsibility for drawing up a business plan that is to be submitted to the relevant boards and, subsequently, passed along the new chain of command, from the director of services to the HSE board to the Secretary General of the Department and, ultimately, to the Minister. This is a circuitous route. The CEOs will be required to live within the budget in delivering services and will, therefore, dictate which services will continue to be provided in which hospitals.

Deputy Ciarán Cannon

Early on in the lifetime of this Government, our colleagues in opposition made a commitment to engage in constructive and positive opposition, which would be welcomed. I cannot understand the reason Deputy Kelleher is seeking to construct conspiracy theories about what is not in the report. Usually, one is criticised on the basis of the contents of a report. The Deputy appears to be drawing conclusions that no one else is drawing on the basis of what he describes as omissions or a lack of clarity in the report.

Each chief executive officer, in conjunction and collaboration with the chairman of the relevant hospital group, will decide how best to configure health services to serve the needs of each region. This is the autonomy about which I spoke. The needs of each region will be different, varied and unique. I am confident, however, that the new boards and their CEOs will be more than up to the challenge of deciding how best to allocate services in their respective regions. The purpose of this reform is to bring together all the expertise in the relevant region, across large and small hospitals, to provide the best possible care. Care should be provided, at least for more minor ailments and illnesses, as close to communities as possible and, where necessary, people should be transported to larger centres of excellence.

This is an excellent model, as the Deputy acknowledged, which has been broadly welcomed by everyone involved in the health service and many people in academia who recognise its value. I am sure the Deputy will agree that it deserves our support. While issues may arise during the roll-out of hospital groups, we have started on an interesting and exciting journey to provide the best possible health care for citizens.

Dáil Éireann debate - Thursday, 16 May 2013