Topical Issue Debate

Ambulance Service Provision

I am raising the issue of ambulance services in County Meath again. I believe the problems in the county are replicated in other parts of the country. A number of years ago, County Meath was served by four ambulances. This number had decreased to three by 2010. It was decided earlier this year that just two ambulances would be provided on two days of the week, Tuesday and Friday. I understand that just one ambulance is now available in the entire county due to significant rostering problems and a lack of overtime provision. This is happening at a time when there is significant pressure on ambulance services. Ambulances cannot always go to local hospitals because service reductions mean those hospitals usually have to be bypassed. It is significant that the call centre for ambulances in the north east is now based in Dublin, rather than being based locally.

When a woman who lives five minutes from the hospital in Navan had a serious stroke two weeks ago, it took 40 minutes for an ambulance to come from Drogheda, arrive at her house and bring her to the hospital in Navan. When an infant tragically died at the start of this year, the family had to wait an extended period of time for an ambulance to arrive. I will mention some other incidents that took place recently. An ambulance had to come from Ardee, County Louth to deal with a fatal road traffic accident in the south of County Meath. A serious non-fatal accident on the bad roads of the south west of the county was dealt with by an ambulance from Ardee. A person in the south of the county who suffered a cardiac arrest had to wait 45 minutes for an ambulance to arrive. When an eight year old girl in Navan was pinned down by an industrial-sized gate two weeks ago, it took 50 minutes for an ambulance to arrive. Ambulances are coming from towns like Mullingar and Portlaoise to serve County Meath. Ambulances occasionally have to travel from County Down into County Louth because the nearest available ambulance to deal with an incident in Dundalk is in Navan. Recently, a garda had to be asked to drive an ambulance in County Meath because just one member of the ambulance staff was available. This information has been provided to me by ambulance personnel, fire service personnel and patients. These people are living in a culture of fear and silence. They feel afraid to discuss such service breakdowns with local Deputies. In my view, every citizen should have the constitutional right to consult their Member of Parliament.

Some months ago, I tabled a parliamentary question asking the Minister to investigate these issues before any further changes were made in the region. I asked for the key performance indicators from County Meath and the rest of the north-east region to be made available. The response I received from the Minister referred me on to HIQA and the HSE. HIQA did not provide me with the key performance indicators because - believe it or not - it does not maintain key performance indicators for the ambulance service on a regional basis. Anybody who knows anything about management will understand that one cannot manage if one cannot measure. If the HSE, HIQA, the Minister or the Department of Health do not have the key performance indicators needed to measure the performance of the ambulance service in County Meath or the north east as a whole following these cuts, how is the Minister able to manage the manner in which this critical, front-line emergency service is provided to the people of the county? I sent an e-mail to the National Ambulance Service 12 days ago to look for the key performance indicators for the region and the county. When I contacted the service today because it had not acknowledged my letter, I learned that it has not started to look for the information I am seeking. Will the Minister provide the key performance indicators for the region to the House?

I thank the Deputy for raising this issue. A significant reform programme has been under way in pre-hospital emergency services in recent years. This is to ensure the best clinical care is provided for the people in each region served by the National Ambulance Service, through the provision of a clinically driven and nationally co-ordinated system that is supported by improved technology. The programme includes a performance improvement action plan and the development of the intermediate care service, the emergency aeromedical support service and the National Ambulance Service control centre reconfiguration project. Following discussions between the service and unions, changes are being implemented in rosters in a large number of ambulance stations around the country, including all stations in the former north east area, where the Deputy comes from. As a consequence of these new rostering arrangements, additional cover will be provided in a number of ambulance stations based on discussions with staff and activity and demand analysis.

The introduction of new rostering arrangements will progress a number of efficiencies arising from a Labour Court recommendation. It will address excessive overtime in rostering arrangements and will require the full co-operation of all staff.

The National Ambulance Service has completed an individual and collective consultation process with staff at each station in Louth, Meath, Cavan and Monaghan. Staff, through their trade union SIPTU have agreed to implement the new rosters. Although staff and public representatives have raised concerns over claims of reduced cover, the National Ambulance Service has advised this is not the case - in Louth, Meath, Cavan and Monaghan, the new rosters introduced earlier this year will see an increase in cover of 188 rostered hours a week, or approximately 9,800 extra rostered hours a year.

As well as the additional hours, the National Ambulance Service has introduced two rapid response vehicles in Ardee and Trim to augment services further. Also, as services are provided regionally rather than from single stations, ambulances from adjacent stations provide cover in a dynamic manner, by moving to areas as and where cover is required.

The National Ambulance Service has introduced more resources in tandem with the reorganisation of acute services in the Louth and Meath area. Extended analysis has identified that demand is in inter-hospital transfers, which have traditionally used emergency ambulances. In the former north east, this service is operating from Cavan, Castleblayney and Dundalk ambulance stations. The National Ambulance Service has also implemented additional intermediate care capacity in Louth. The ongoing introduction of intermediate care services allows the release of existing emergency ambulance resources back to emergency uses. These and other changes being implemented at local, regional and national levels will continue to move the ambulance service in the right direction - a national service, providing the best clinical care for the needs of the people in each region it serves. Emergency resources and staff are available 24 hours a day, seven days a week, ensuring the people of the north east have timely access to highly skilled paramedic and advanced paramedic staff day or night.

Ours is, to a certain extent, a disjointed conversation, Minister. There is no doubt that resource efficiencies are needed. I support efficiencies in any manner they can be procured as long as they do not have a negative effect on patients. I have requested from the Minister for Health, the Health Information and Quality Authority, HIQA, and the National Ambulance Service on previous occasions and again from the Minister today, key performance indicators to show the ambulance service's response time for life and death emergency situations in the north east. I ask again that the Minister provide those to the House as soon as possible.

It is important to note that I provide the Minister for Health with key performance indicators of patients and citizens who have come to me and shown me that the performance of the service falls outside the HIQA guidelines. The Minister mentioned there is a rapid response unit in Trim. HIQA guidelines say that treatment should be available to echo or delta patients in eight minutes but there needs to be an ambulance to transport the patients to a hospital in the 18-minute target. The ambulance service is not achieving those performance indicators in the north east.

The views of the National Ambulance Service and its staff are at polar opposites - one could not find two more divergent analyses of the situation in the region. We can talk about who said this and who said that, but the only way to cut through the issue and to enable the Minister to manage the funding of the region better is for local key performance indicators to be provided. Will the Minister provide such indicators?

I emphasise that the new rostering arrangements have resulted in increased hours of 188 hours each week, which is 9,800 hours a year. There are - as there always have been - problems in the ambulance service. According to my briefing note, the relatively high absenteeism rate rather than a lack of vehicle resources is an issue. Although the absenteeism is being addressed by the National Ambulance Service's management, unforeseen and short-notice absence presents challenges for emergency provisions, which are dealt with through regional resource utilisation, deployment and call prioritisation.

It was recently reported that a garda was driving an ambulance. That might occur for a number of reasons, including a clinical situation in which both attending crew are providing patient care. Gardaí are authorised to drive any vehicle deemed necessary in the performance of their duties. I think we all agree such collaborative arrangements are necessary when all our agencies at the scene of an incident are focused on a common goal and mission - to preserve life. Although no one wishes to hear of situations such as the ones that Deputy Tóibín has described, I assure the House that the new arrangements have increased the number of hours available to give the life-saving service. There will always be room for improvement and we shall strive to make that improvement.

I will discuss the key performance indicators with HIQA and I will get back to Deputy Tóibín in due course.

Non-Consultant Hospital Doctors Working Conditions

No one in this House or outside it likes to see people in our hospitals involved in industrial action. In making my points, I know that I will receive a historical lecture about why we are where we are. However, we are in a difficult position because commitments have been made by the Health and Safety Executive, HSE, to address the issue. The HSE's service plan 2013 highlighted that it would make efforts to address European working time directive issues. I want to know why we are at the stage that the IMO and non-consultant hospital doctors have no trust or faith in the HSE and its commitment to resolve the issue. It is required only to fulfil employment law and ensure that people work in a safe environment, are allowed periods of rest and work only in a roster in which services can be provided safely. When one looks at the history of the situation and, more important, the past couple of months with the breakdown of trust between the HSE and the IMO, many questions are raised.

The matter has been before the Labour Relations Commission - in fairness, it has huge expertise in bringing about resolutions to industrial disputes and has been doing so for many years - but the fact that it was unable to bring about a resolution raises many questions about why the HSE has not entered into meaningful dialogue in such a way that would allow non-consultant hospital doctors to believe the HSE's commitment. Given the HSE's role, and that the Minister is in charge of and politically responsible for the HSE, does he completely trust the HSE on its commitments to implement the European working time directive for non-consultant hospital doctors?

There are huge strains in the medical service. The non-consultant hospital doctors are an integral part of the medical service - they provide hugely valuable services daily. However, they are working under extreme conditions. We have seen and heard cases - today we saw people outside our hospitals who have worked more than 80 hours a week in providing healthcare. Everyone accepts that is happening. Even the Minister said previously that working arrangements are in breach of European working time directives and are completely unacceptable.

The HSE stated its position on the working time directive in its 2013 service plan, but today there are 3,000 non-consultant hospital doctors who have had to take action to encourage dialogue and a resolution to the situation.

The difficulty is that there are significant swathes of people who depend on the health system and non-consultant hospital doctors to provide the care. A total of 12,000 outpatient and 3,000 elective surgeries have been deferred. This puts significant pressure on individuals. Were 3,000 procedures deferred today because of this action? A total of 12,000 outpatient appointments were deferred as well.

Those figures are incorrect but I will clarify that.

They are the figures I have been given so I hope the Minister can correct that. Even if there were no deferrals, the point is that we still have 3,000 people who have no faith in their employers in respect of bringing about their entitlement under European law. I know the Minister will give me the historical lecture on it but we are in a position where we have a complete breakdown of trust. I urge everybody to go back to the LRC to see if this issue can be resolved but in the meantime, as political head of the HSE, the Minister must surely ask the HSE why trust has broken down and tell us whether he has faith in it in respect of how it has negotiated so far with the IMO on behalf of NCHDs.

The Deputy talks about a historical lecture because he does not want to be reminded of the true history-----

No, the Minister can remind me but he only has four minutes.

I will not focus on that but I will come to it later because it is important. What is really important is for me to say that I share people's concerns about this action, the disruption to the delivery of acute care and the unnecessary worry and anxiety caused to patients. I will correct the figures out there. I do not have absolute accuracy but no more than 7,400 patients have been affected by this. That is 7,400 more patients than should have been affected because this action will not help the situation.

I believe junior doctors have a right to reasonable working hours and that patients have a right to feel safe in their care. I do not believe it is safe to have doctors working the sort of hours they have been asked to work in the past. We all must work together towards reaching a safe solution. The point is that we have made major progress in tackling this long-standing problem, and a long-standing problem it is, as the Taoiseach said earlier. There is a report from 2001, commissioned by Fianna Fáil's leader, Deputy Martin, in January 2001 at a cost of €254,000, and here we are in 2013.

At my request, the HSE established a national group in February 2013 to bring an urgent focus to implementation of the working time directive. I have met with Commissioner Andor on a number of occasions in respect of this. This group has made progress on the number of doctors working more than 24 hours in a single shift and instances of doctors working more than 68 hours a week. The average number of hours of NCHDs is now declining. Previous surveys have shown that average working hours for NCHDs fell from 60 hours a week in 2009 - notwithstanding the fact that the initial report in 2001 wanted them under 48 - to 54 hours a week in 2012. During the first six months of this year, the number fell to 52.4. I am not saying this is enough. It must come down the rest of the way. Furthermore, the proportion of NCHDs working shifts in excess of 24 hours has fallen from 58% in March 2013 to 34% in August 2013. It is still too many and more must and will be done but we are making serious progress. In addition, I set up a group chaired by the president of DCU to carry out a strategic review of the medical training and career structure of NCHDs with a view to improving retention of graduates in the public health system. An interim report is to be provided in November.

The establishment of the hospital groups will empower hospitals to co-operate and share NCHDs when scarcities arise. This will further reduce average NCHD hours.

Compliance issues arise largely in particular specialties. Virtually all NCHDs in radiology, emergency medicine and psychiatry are fully compliant. Following discussions at the LRC over recent weeks, a joint IMO-HSE verification and implementation process has been proposed. This has already begun and will be proceeding during October. Actions to change rosters and revise work practices identified during this process will be implemented during November. Implementation and achievement of a maximum 24-hour shift would then be verified jointly by the HSE and IMO.

There is clearly going to be a reduction in planned patient attendances. It is estimated that cancellations will arise in respect of about 7,000 outpatient appointments. The patients deferred are being offered the earliest possible re-attendance dates. It is already Government policy that those waiting longest for treatment should be prioritised. The IMO has confirmed that the same level of staffing cover as is normally provided on a Sunday will be in place. It has also undertaken to provide all necessary urgent care as well as oncology, dialysis and transplantation.

We are very keen to resolve this issue and to have clear sanctions in place. The HSE has invited the IMO back to the LRC tomorrow to discuss all manner of sanctions. I have already made a statement that I want to see the sanctions aimed at those who have failed - not patients, doctors or hospitals themselves but rather the management that fails to deliver.

The report was commissioned in 2001 and it is now 2013. We have not had a junior doctors' strike in 25 years but we have one today. That is the difficulty. Regardless of whether it was thanks to the previous incumbent or not, we did not have industrial disputes of this nature. We now have a situation where over 3,000 NCHDs are outside our hospitals today and it is impacting on the delivery of health care.

We all accept that junior doctors have an integral role to play in the provision of health care in this country. They are the bulwark of our health services and do a huge amount of work. The point, as the Minister has stated, is that the working arrangements are not satisfactory. I know he has commissioned reports, including one by an individual who will report back to us with regard to what is required to attract and retain our NCHDs and the provision of clear pathways in the years ahead with regard to training and career options. I accept that all this is very positive but in the meantime, there has been a fundamental breakdown in trust and I am asking the Minister to tell me why this has happened. Is it because the HSE is dragging its feet? Is it because management in some areas of the HSE is not co-operating in terms of addressing the working time directive because it is being implemented in some hospitals? In these hospitals, rostering is being implemented to accommodate and comply with the working time directive but we do not have that in other areas.

Clearly, the HSE has a major problem in trying to deal with this and trust between the two sides has completely broken down. The key question is why this is the case. Does the Minister have full confidence in the HSE and does it have his full support in dealing with this issue because it is critically important? The NCHDs do not have faith in the HSE and have expressed that on a number of occasions. They do not believe there is a commitment to sanctions for those hospitals that fail to implement the working time directive. Does the Minister have full faith in the HSE management to address this particular issue and to get our junior doctors back to work?

The Deputy has posed many questions. One of them is why there is no trust. The reason there is no trust is that too many dawns have passed and the issue has not been addressed. In the past, money was thrown at it instead of the system being reformed. We do not have money to throw at it, as Deputy Kelleher knows for reasons well known to everyone in this country, but we are reforming the system to address the issue of giving doctors safe working practices so they can deliver safety for their patients.

Deputy Kelleher acknowledged that some hospitals are compliant and yet all hospitals are affected by this. This is an understandable expression of frustration by NCHDs about what they see as inhuman working hours, the lack of a clear career path and facing exhaustion when it is unclear what they will have to show for it. It is so difficult to ensure becoming a specialist in this country with our training times taking on average 12 years, which is far too long.

Deputy Kelleher asked me whether I had faith in the HSE and its management of this situation. I have faith in the new HSE management. I have faith in Mr. Barry O'Brien who is the new HR man and I have faith in Mr. Tony O'Brien and his new management and directors of management and I believe this can be resolved.

I appeal to the IMO NCHDs to come back to the Labour Relations Commission to resolve this issue. It will not be resolved on the picket line or by hurting those to whom they want to provide safe care. I appreciate and respect our young doctors. They are going to be the specialists and GPs of tomorrow and I ask them to come back to the table to resolve this problem in a manner that can reassures them that the ones who fail to provide will suffer not patients or doctors. They will have a bright future in medicine in this country when we clarify the career path for future specialists and GPs.

Dáil Reform

I commend the Taoiseach on fulfilling his promise to Fine Gael and the people prior to the last election that he would afford them the opportunity to express their views in a referendum on the abolition or retention of the Seanad. It is refreshing to witness a Taoiseach take a political risk in order to fulfil a promise and long may it continue. I also acknowledge the Dáil reforms this Government has introduced since it entered office, such as increasing the length of time that the Dáil sits by 50%, reducing significantly holiday periods throughout the year, reducing the Taoiseach's salary and Deputies' expenses, cutting the number of Dáil seats by eight in the next general election, reforming the committee system, introducing Topical Issue debates and introducing Friday sittings to allow backbenchers to introduce their own legislation. These are all positive steps.

I urge the Taoiseach to drive ahead with the reform agenda. I welcome that the Government has recently committed to further increasing Dáil sitting hours to allow extra time for debate and that Friday sittings will now take place every second week. Back bench and Opposition Deputies will be given greater access to Ministers in order to hold them to account and to raise issues of concern. We are moving from a system in which Bills come to the Dáil as a done deal to one where committees and the public will have a role in shaping legislation from the outset. I welcome the Taoiseach's commitment to make committees more independent.

It is vital that the Dáil is given additional time to scrutinise EU legislation. In regard to continuing reform, it is important for the democratic process that every Member of the Dáil be allowed a free vote on all moral issues. We need to find a way to allow Members to have more input into proposed legislation and introduce measures to give all Members equal access to speaking time in the Chamber.

I thank the Ceann Comhairle for selecting this topic for debate. While canvassing on the recent Seanad referendum, I heard the issue of Dáil reform raised on a considerable number of doorsteps. I acknowledge the work on reform that has been done heretofore. From my conversations with Deputies who served in previous Dáileanna, I recognise that considerable efforts have been made to streamline the way we conduct our business.

Over the past several weeks an ambitious schedule of Dáil reform was set out. I want to ensure these reforms are enacted. From the perspective of backbenchers, they will give us more time to get involved in the legislative process and have our voices heard. Some of the reforms were proposed on the basis of a unicameral system but, while I would have liked the vote to have gone differently, I accept the will of the people. Is it still possible to implement these reforms? One of the proposals was to focus on issues of major strategic and political importance, including public accounts, financial matters, the budget, EU scrutiny and social affairs. If this proposal is implemented it will allow us to play a very important role. It was also proposed to involve people from civil society in our discussion of legislation.

I understand the need for the Whip system but it might be relaxed at certain stages of the legislative process, such as Committee Stage, so that people have more opportunity to express their views.

I thank the Ceann Comhairle for selecting this issue. In recent weeks there has been considerable debate about the need for Seanad reform. I commend the Taoiseach on putting his political credibility on the line by giving the people their first opportunity in 75 years to make a decision on the Seanad. The people have now spoken and we will have to listen to what they said. However, we should not lose sight of the need for reform of the Dáil. We would not be discussing this matter if it was not for a previous reform which introduced the Topical Issue debate. Important reforms have been introduced under the programme for Government but the process of reform must go further in order to make our jobs more effective and transparent.

From the perspective of a first term backbencher who is enthusiastic about trying to get involved and making contributions, I regard the committee structure as very important. I am a member of the Joint Committee on Agriculture, Food and the Marine, which deals with matters as diverse as the restoration of the sugar industry in Ireland and fairness in the grocery sector. There is great scope for improvement in this regard because committees do not get the credit they deserve. A week should be set aside for committee business, with a report produced for the Dáil at the end of it. The crossover between Dáil and committee business has a negative impact on those who are involved in committees. They go to the Dáil Chamber to deal with parliamentary questions and other matters and then return to deal with committee business. I would like to see progress in this area.

A range of issues was raised during the debate on the Seanad. Now that debate has concluded, we need to pursue these issues with greater vigour. We can show that we are serious about reforming our system and making it more effective for the years ahead.

I thank the Taoiseach for attending this debate in person and I am grateful to the Ceann Comhairle for facilitating us. The Topical Issue debate offers an excellent avenue for Deputies to raise matters of concern.

We cannot take our eyes off Dáil reform. I commend the Taoiseach on his courage and conviction in bringing the referendum on the Seanad before the people. I am proud that the leader of my party and country is a reformer with the conviction to let the people have their say. The people had their say and we now need to act accordingly. The priority for the Government needs to be reforming this House so that the reforms are more tangible and our business can be done more easily. The people want reform. One of the reasons I think voters were reluctant to agree to the abolition of the Seanad is that they did not think this Chamber was capable of holding the Executive to account in its current form.

They want to see an expansion of the Dáil's structures to allow Members to hold the Executive further to account. We must consider every possible avenue in this regard. We could start with something small like the Order of Business, the remit of which needs to be expanded. Limiting it to promised legislation is not enough. There is no reason for our Order of Business not to include something similar to Prime Minister's questions across the water in the UK. Every Deputy should be afforded an opportunity to ask the Taoiseach or the Tánaiste about matters of importance in their constituencies or the nation. The possible reforms that were mentioned in recent weeks must be implemented.

I concur with my colleagues regarding the matters that they raised. It is important that, in the course of this debate, we not lose sight of the fact that the Dáil needs to be reformed. I hope that it can stay at the top of the agenda.

I thank the Ceann Comhairle's office for selecting this issue. I acknowledge and thank the Taoiseach and his Government for laying an important referendum on fundamental Oireachtas reform before the people. Our first action in the Chamber should be to respect the people's decision fully. We should also acknowledge that the referendum debate opened up issues other than that which was on the ballot paper, in particular questions on Dáil reform. I am pleased that this issue is being discussed in the Chamber. Obviously, the 20 minutes that have been allocated are not enough. It has been proposed that some of the new fortnightly Fridays could be set aside solely for Deputies to debate Dáil reform and to arrive at conclusions that would make the House more responsive to the needs of the State.

I welcome last week's publication of amendments to the Standing Orders, which I hope will come into effect on 5 November. Particularly welcome is the amendment on referrals from committees to Dáil sittings on fortnightly Fridays. As part of an expanded debate on how we arrange our business, one must ask whether we are going far enough. For example, how legislation is prepared and presented to the Parliament on Second Stage more or less as a fait accompli inevitably cultivates an adversarial environment, meaning that consensus is often more difficult to achieve.

The Whip system must be debated. We do not always agree with colleagues. For example, moral issues could be up for debate. However, a looser Whip system could be applied to committee decisions.

We need to take ideas from all sources. For example, best practice in other parliaments should be examined continually. I regret that we do not have more time, but I look forward to a journey in which we must all participate.

Regarding Seanad reform, a duplication of the Dáil is not required. There is a better role for a second House. For example, the Seanad could play an important role in the scrutiny of EU legislation and fulfil the greater role of national parliaments envisaged under the Lisbon treaty. In such a scenario, the existing Seanad panels could be replaced by new panels organised along the lines of the directorates of the EU, for example, agriculture, innovation, research, health, etc. Senators could be elected for terms coinciding with the European Commission, with every citizen receiving a vote. A Seanad of this type, along with the new EU affairs super Oireachtas committee included in recently announced Dáil reforms, would be an excellent way of ensuring scrutiny of EU law.

Any meaningful reform of the Seanad must have at its basis that every citizen would have a vote. Anything other would not be a real reform.

I wholeheartedly welcome the initiatives taken on Dáil reform heretofore, but we can go further. The number of Topical Issue debates should be increased to approximately eight. Routinely, 25 to 30 matters are raised every day. We also need to increase the amount of time allocated to ministerial Question Time not just for the Opposition, but for Government backbenchers also. I am lucky enough to have asked two education questions today, but that does not happen often. We could do with more time than one and a half hours per Minister.

We must ensure that the welcome plans announced for the pre-legislative and pre-enactment phases are not watered down in light of the Seanad referendum's result. This would be an excellent reform and would allow for engagement with civil society and interest groups on the preparation of legislation. I hope that there will be no alteration to this proposal.

I thank the Ceann Comhairle's office for allowing us to raise this topic. I welcome the Taoiseach to the Chamber. That this might be the first Topical Issue he has taken shows how much respect he has for this topic.

I wish to highlight two matters, the first of which is Friday sittings. As I have often stated, Friday sittings are just time-consuming efforts. We do not have a vote and we normally only debate one Bill. Proposals have been made to provide for additional Bills to be tabled on Fridays, but it is difficult for a backbencher to get a Bill on which he or she has worked onto the Order Paper. A number of the Bills on the Order Paper, particularly on Tuesdays, have been outstanding since the Dáil's first sitting in 2011. This issue must be tackled. Just as Private Members' business can be used to debate Bills, perhaps we can move backbench Bills from Friday and discuss them in a private Bills session, allowing us to vote at that time. I hope that some consideration will be given to this suggestion.

I wish the reform of the committee structure to continue. It is important that civil society be involved in the initiation of legislation. We saw the success of that process during the abortion Bill. It would give civil society every opportunity to introduce new and different ideas before Bills are published and allow consensus to be reached instead of the Houses debating Bills on Second Stage, by which time Ministers might not be willing to accept backbenchers' ideas.

I was disappointed with the result on Saturday. I share in the Taoiseach's vision of a unicameral Parliament with stronger committees and greater independence.

The people have spoken.

Like the Taoiseach, we have to respect the choice of the people. I was with family members on Saturday. They were trying to console me about the result. As one of them pointed out to me, people came out on a reform question. Whether by voting "Yes" or "No", they were taking part in that process of reform. They just had a different vision of it. Some 40% came out to do that. It is not a large number and we would have liked to have seen more, but 40% of the population are engaged and involved in the question of how we reform our Parliament to make it better. This is a positive that both sides can take away from the referendum result.

As a new Government and a new Parliament, we have a responsibility to rebuild the people's trust in their politicians, their leaders and their political institutions. We do that in deeds, not in words - by their works shall they be known. Putting the question to the people formed a part of that process. We made a commitment on which we followed through. We now have an advantage. With so many interested in reform and willing to spend time and resources in trying to shape that vision and in moving forward quickly, it would be a shame were we to delay the process of Dáil reform because we took time to reflect on Seanad reform. The processes could work side by side. For example, some of the reforms that have been mentioned in this debate - a loosening of the Whip on Committee Stage in the Dáil - would impact on the Seanad because Senators sit on those very same committees. If the ordering of the Dáil's business was returned to its Members in a non-Whipped vote in some instances, for example, the length of time for a Bill to be debated or its scheduling, it would flow down to the Seanad. Many such proposals do not need referendums or new laws and could be implemented quickly. I look forward to the reforms that will be made. We must be willing to test such reforms for a period of six months and return to this Chamber to reflect on how to progress them further.

To echo Deputy Lawlor, I thank the Taoiseach for his presence.

It is a signal of how much he respects this Chamber. It also reflects how seriously he takes his own reform proposals and his own ambition in that regard.

I thank all Deputies for the points they raised. This is always about time and the capacity for everybody to have an opportunity to say their piece in respect of Dáil reform. Over the years, I have seen situations where Ministers came in to answer questions. The Minister for Agriculture might be in possession for six months before anybody else because the questions just kept rolling through. Thus, a Minister might answer from September or October right through until March. We have made a lot of changes and there have also been some good suggestions, some of which are already under way. I want Deputies to understand that I am serious about this matter. What we introduce for this session and the next is not permanent. We would like to have a situation whereby we try things and see how they can work in the best interests of all Deputies. When we do make changes they are, of necessity, to be tried and we will continue with those that work best. That is why we have Leaders' Questions on Thursdays, which the Tánaiste takes. Topical Issues have replaced the outdated and outmoded Adjournment Debate. Friday sittings are for Deputies to introduce their own Bills, and we have never had that before, except in Private Members' time. It is a good innovation.

I am open to the question Deputy Lawlor raised about Friday sittings. Who attends and do we have real debates on Committee Stage of Bills? We could always put the votes off until Tuesday if necessary. There is always a problem with Deputies from around the country who are not able to attend the House on Fridays. It is an issue that has always been raised by them.

I assure Deputies concerning the restructuring of the Oireachtas committees that we want to continue with the pre-legislative review. The engagement with civic society is important, as was evidenced in a number of Bills recently. As regards Deputy Kyne's point, that will not be watered down. It will require the engagement of Ministers with Opposition spokespersons. Committee chairmen will ask how many hearings are needed and how long they will last. They are not dictated to by government. The chairman and other members of the committee will decide what organisations and individuals to call to provide experience whatever the case might be. Some Bills are short, comprising a few lines of amendment, so they may not require any hearings at all. By contrast, the Companies Bill had 1,800 sections and was five years in gestation. That was a very different matter. Bills, therefore, can range from being simple to complex. That system of scrutiny will not be watered down. Committee chairs will have a role in engaging with civic society.

We also want to move on so that committees can examine the stability programme update in respect of the budget. When the forthcoming budget is over, I expect the committees will engage with Ministers on departmental Votes and Estimates, as well as what their spending priorities are and how effective that expenditure will be. Hopefully, this will all be televised and streamed live so that the public is fully engaged in what is being spent on their behalf by different Departments.

I would like to think that we can arrive at a situation whereby chairmen and Opposition spokespersons can work with Ministers on Bills. Unless it is emergency legislation, it should not be rushed. I wish to allow for proper debate here but I do not want people to play games and seek extra time just for the sake of it. It must be recognised that this is the Dáil and it is the Opposition's duty to hold the Government to account. We must provide people with the facilities to do that.

We had committee weeks before and they did not work. We may look at that again. We devoted a week to particular committees in the Chamber as distinct from being in committee rooms. People said they liked it but it did not work.

Deputies have raised valid points. Some people mentioned the Whip vote but I have been in Governments where there was a minority situation, or very close to it. One cannot have instability. What might be one person's crisis of conscience is another's political crisis. I see an opportunity when the heads of a Bill are being discussed on Committee Stage whereby people could give their view irrespective of whether it is in accordance with Government philosophy or not. When one signs on for a Government Bill as Government Members, one will be expected to support that. The issue of stability is important for international investors when they look at the country. In a tight future election outcome, for example, people may ask whether the Government will be able to continue in office. Without stability, one cannot have investment.

I thank the Taoiseach for his response. If we could have given him ten minutes to show the passion he has for this subject, he would have been able to fill that without difficulty. The public are now somewhat engaged in political reform, whether it concerns the Seanad or the Dáil. The sooner we act on as many of these matters as possible, the better. The Government is facing innumerable problems and there are issues we must also face down. While the general population is engaged in the issue of political reform, now is the time to act. We must do so as soon as possible.

Likewise, I compliment the Taoiseach on his positive response. As I said earlier, committees play a valuable part in the work of Parliament. On most occasions, however, much of this work goes unnoticed. I ask the Taoiseach to consider having a separate week only for committee work, with no crossover between committee work and the work of the Dáil. It is encouraging to see the Taoiseach here to take a Topical Issue. It is probably a first. I understand the Taoiseach has many priorities at the moment and while this may not be the most pressing matter, we need to press on with reform as soon as possible in order to have credibility with the public.

I thank the Taoiseach for his response, particularly concerning the budgetary process. Unfortunately, the input of all Members in the budgetary process historically has been lacking in the Oireachtas. If we can put a better process in place, it will lead to a better country in future. I have only been here for two and a half years but there is a wealth of information, life experience and knowledge across this Chamber and also in the Seanad. Everyone needs to have an input in designing the future of our country. The annual budgetary process is a perfect opportunity for good ideas and inspirational thoughts to be implemented. We really need to focus on that area. There will be much discussion on the budget next week, but it would be wonderful if, in future, we could have a totally open discussion well in advance of the budget. In that way, when budget day comes the public would feel they were part of making it a reality.

I welcome the Taoiseach's comments and, in particular, his words about the presentation of heads of a Bill before committees. That alone would provide an invaluable opportunity to Deputies and Senators on all sides, and civic society, to be free to express their ideas on the heads of a Bill. It would ultimately lead to a more consultative, less adversarial approach to legislation. It would put down clear markers from parliament to government on issues. Equally, it would show that a government could benefit from earlier positive engagement with parliament and civic society. If that could be achieved in the short or medium term, it would be a significant improvement on our legislative process.

I thank the Taoiseach for his response. I also thank him for attending the House to take this Topical Issue. I welcome the assertion that the pre and post-enactment phases will not be watered down. While I accept the point concerning the Whip, it should be possible to consider loosening that grip for non-vital legislation. Those of us who voted on the Protection of Life During Pregnancy Bill were, in my view, as courageous and conscientious as some of those who decided not to vote for it. I welcome the Taoiseach's response on that.

I thank the Taoiseach for his response and I am heartened by what he said about committee structures and how he will empower committees in future. I would press him on Members' Bills, however.

Perhaps given the amount of work undertaken by Members in terms of bringing forth Bills the Taoiseach would give consideration to their being scheduled for debate during the week rather than on Fridays. A Bill recently introduced during a Friday sitting, the debate to which I contributed, has still not gone to committee for consideration. I would prefer if Members who make the effort to introduce Bills are given due respect for doing so and that following conclusion of Second Stage, Committee Stage would be taken as soon as possible thereafter.

With regard to the outcome of the referendum on Seanad abolition, the decision to put the matter before the people was a courageous one and was a commitment in the programme for Government. Those of us who were Fine Gael candidates in the last election stood on the Fine Gael manifesto. Even though the result was not in favour of those of us who would prefer a unicameral system, we must accept the decision of the people.

I thank the Taoiseach for his response. The Taoiseach will be aware, because we have spoken about this privately on many occasions, that I am quite passionate about Whip reform. I welcome the opportunity to have this discussion in public. It serves politics that we get to have more discussions like this in public.

I do not necessarily agree with the idea of a Whip for conscience votes. I see it more as a principle of a Parliament that is able to hold the Government to account and able to order its own affairs. I believe we should have a non-Whip vote on the Order of Business in regard to the taking of legislation and the amount of time allocated in that regard. However, I take the Taoiseach's point that stability is essential. The programme currently being implemented by Government is based on stability for the economy and stability politically for the country. People want this, particularly given the chaos that befell the country prior to the election of this Government. I believe we can maintain that stability and still loosen the Whip in respect of certain issues on Committee Stage. I believe it is possible to strike a balance between the two.

I welcome the Taoiseach's comments on the heads of a Bill and committee process. It is a good place to start. As stated by the Taoiseach, it is important we first introduce reform and then review it in the future to see how much further we can go.

Deputy Connaughton can take it that the Government proposes to continue its general population engagement. We are serious about being a reforming Government, from corporate donations to gender quotas and the perks, etc., of the past, which will ensure Parliament is seen to be more effective. This is about getting the business done here and in committee. I am serious about proving that our committee system can work far more effectively than ever before. This will be done through engagement with the public and civic society, as already proposed.

On Deputy Deering's point, we can look again at the possibility of having a committee week. I favour this but many Deputies do not for a variety of reasons. We have had committee weeks before. We could, for example, take Leaders' Questions, the Order of Business and so on in the morning and then move to the committee week. This is done to great effect in the European Parliament. The process is well controlled there. As I said, while I favour this, many others do not. I will undertake to look at it again.

On Deputy Griffin's question in relation to the budgetary process, the Government submits a stability programme update to the European Commission every April. This allows for it to be reviewed by Members of the Houses in committee prior to the budget in October. The Department of Finance and Independent Fiscal Advisory Council provides a briefing to Oireachtas Members in this regard. The budget and spending Estimates are published in October. Members of committees can then, between October and Christmas and prior to any moneys being spent, engage with Ministers in regard to their priorities in terms of spending. This is also in the public interest.

Deputy Harrington referred to the heads of Bill discussions in committee. We will ensure this happens. I see this as a fundamentally important part of the process. The Deputy will be aware that for years we have had a process whereby a Minister makes a decision to introduce a Bill, which is then prepared by the Parliamentary Counsel's office and returned to Government with nobody having any say on it until it reaches Committee Stage. If we reverse that process and have everybody involved from the beginning, we would probably save a lot of time on Committee Stage.

On the introduction of business hour sittings, many people here have families and long distances to travel, including the staff of the Houses. We must cater for everybody. I thought the introduction of earlier sittings would mean getting home earlier to family members and so on. However, for those of us who have to travel to the Dáil, it is quite a different story. We have to put the time allocated to best effect.

I take Deputy Murphy's point. However, I have been in this House on umpteen occasions when voting was tight and people because of a crisis of conscience voted against the Government, resulting in its falling. I refer the Deputy to the recent rise in interest rates when a Minister for Finance in Europe resigned. Instability is the biggest cause of mistrust by investors. They will not have sentiment, sympathy or memory. They do not react, they anticipate. A country in which there is instability loses that trust in terms of growing its economy. These are issues about which we must be, and will be, serious in the time ahead.