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Dáil Éireann debate -
Tuesday, 3 Dec 2013

Vol. 823 No. 2

Topical Issue Debate

Common Agricultural Policy Negotiations

I thank the Minister of State for coming into the House. I am disappointed that his senior colleague is not here, but no doubt there is a good reason for that. I presume he is not in the country and if he is not, I fully accept that he cannot be here. However, it is a pity he is not here because we now face a huge crisis in farming. The last Pillar 2 funding for the period 2007-2013 amounted to €4.8 billion, between State funding and European funding. Pillar 2 funding has been co-funded, with 53% coming from the EU and 47% coming from the Government. Under the rules negotiated by the current Minister, the small print shows that the new Pillar 2 could be as little as €3 billion. That is a potentially huge 40% cut in funding.

This is amazingly poor negotiation by the Minister. When he was talking about the great job he was doing on the CAP, one would have thought that the Minister would have been to the forefront during these negotiations, ensuring that national governments could not get away without adequate co-funding of Pillar 2, especially since Pillar 1 is 100% European funded, and these are the big payments. Instead of that, the Minister has signed off on a deal that will cost European farmers dearly. Governments across Europe, including the Government in Ireland, can reduce their input even though the European Union input is down 11% already. On top of the 11% across the board cut in European money, we now have the potential for a huge further cut by reduced rates of co-funding. Put in simple terms, what was €4.8 billion the last time could end up being as little as €3 billion this time. It is very difficult to understand how this was negotiated without it being brought to the attention of farmers.

When the CAP was announced, the Minister said that the general rate of co-funding is 53%, that is to say, 53% from Europe and 47% from the Government. Of course he did not stress that the environmental payments can be as low as 25% and that these environmental payments - including the DAS, which is considered to be an environmental payment under European terms - amount to 90% of Pillar 2 in Ireland. When we add in the measures that can be funded as low as 20%, we are at the stage where around 94% of the payments can now be funded at a lower rate of 25%. There is huge concern now that the full enormity of the sell out of the farmers of Ireland by the Minister has become apparent.

I need an assurance from this Minister of State this afternoon that, notwithstanding the ability of this very poor agreement to allow national governments to reduce their contribution to farmers enormously, the Government will actually co-fund Pillar 2 at a rate of at least 47%, against 53% from the European Union.

I thank the Deputy for allowing me the opportunity to come in here and explain exactly where we are on this. I apologise for the absence of the Minister. The Deputy quite rightly pointed out that he was on other business. He is in Japan, where he has succeeded in opening up the trade for beef in that country, which is hugely welcome right across this country.

In June 2013, political agreement on CAP reform was achieved under the Irish Presidency. It was also hailed as a great success by all European Heads of State and the Commission. This agreement marked the first time that three main European institutions came together to agree the framework for the development of the European agriculture sector, which has enabled the sustainable development of the sector up to 2020 and beyond.

A key step in the implementation of the reformed Common Agricultural Policy will be the design and introduction of a new, rural development programme for the period 2014-2020. The development of a new rural programme under Pillar 2 will be a key support in enhancing the competitiveness of the agrifood sector, achieving more sustainable management of natural resources and ensuring a more balanced development of rural areas, which we all want and need. The new rural development programme will be based on the provisions of the draft regulation on support for rural development by the European Agricultural Fund for Rural Development. This draft regulation was originally published by the European Commission in October 2011. Discussions at Council working group level took place under the Polish, Danish, Cypriot and Irish Presidencies of the European Union prior to reaching a Common Position in June 2013.

While the draft regulation has not been formally adopted, its provisions represent the framework for the work carried out to date on the new rural development programme. It is expected that this programme will be formally adopted before the end of this year. The new programme must be based on six priority areas for rural development, as set out by the Commission. These priority areas are fostering knowledge transfer and innovation; enhancing competitiveness; promoting food chain organisation and risk management in agriculture; restoring, preserving and enhancing ecosystems; promoting resource efficiency and supporting the shift towards a low carbon and climate resilient economy; and promoting social inclusion, poverty reduction and economic development in rural areas. In addition, through addressing at least four of these six priority areas, the new rural development programme must also contribute to the cross-cutting teams of innovation, climate change and environment. The challenge in designing a new rural development programme is to take all of these considerations into account, while also ensuring that the measures chosen to form part of a new programme are clearly in line with the smart, green growth objectives of the Food Harvest 2020 strategy.

With the replies I am given sometimes, I do not know whether to cry or to laugh at the total effort to not answer a simple question. In the committee today, the Department statement highlighted that the draft rural development regulation refers to a general co-funding rate of 53%, but went on to clarify that not all measures within the rural development programme will be co-financed at that rate, as there will be a number of derogations from the general rate.

The impression given was that different rates would be applicable to perhaps 5% or 10% of measures. In fact, the derogations cover more than 90% of the spend, which means that fewer than 10% of measures will be eligible for the 53% rate. Since the Minister trumpeted his great achievements in Brussels in June, for which, we are repeatedly told, the whole world is grateful, the story was that there would be a general co-funding rate of 53%. That is bunkum. In reality, that rate applies to fewer than 10% of measures; for the other 90%, the applicable rate will be either 20% or 25%. Irish farmers are not grateful for that.

I am asking a simple question today. Can the Minister of State confirm whether it is the intention of the Government to co-fund the European money of €330 million per annum at a rate of 53%? If the Government chooses to hedge its bets the second time around, the logical conclusion must be that the intention is to avail of the very low co-funding rates, which were negotiated by the Minister in the full knowledge that his colleague, the Minister for Public Expenditure and Reform, would take advantage of them and, in so doing, take more money out of farmers' pockets. That will have a particular impact on people farming poor land, which is 75% of the land in this country, and those dependent on agri-environment schemes.

I assure the Deputy that no time or effort will be spared in negotiating for as much as can possibly be achieved in the coming months. Consultation is ongoing with all stakeholders. The Deputy should not believe everything he reads in the newspapers. To be clear, no decision has yet been made on these matters. As we speak, departmental officials are talking to colleagues in other Departments in an effort to maximise the funding we can obtain for rural development. It is important, moreover, that whatever funding we obtain we keep. The Government of which the Deputy was a member dropped the schemes it had negotiated halfway through their cycles, including the rural environment protection scheme, the young farmers' installation scheme, the early retirement scheme and the suckler cow and fallen cow schemes. We do not want to announce something that we cannot maintain. That is why we are engaged in a consultation process. Officials in every relevant Department are working with the farming organisations to ensure we have schemes that will assist people living in rural areas and ensure the agricultural industry can survive and prosper. An important element of this is the Leader programme, in which the Deputy has had a special interest for many years. The Minister is very supportive of the ongoing efforts to establish that scheme, together with the other schemes.

As I said, negotiations are ongoing and no decision has been made. I would greatly appreciate the Deputy's help in this regard. I hope he will propose ideas, which we will be happy to take into consideration. The Minister and I want to be constructive, as does the Department. We are receiving great support from many rural and farmers' organisations, including people in the Deputy's party. In fact, some of those people have advised us not to listen to what he is saying in regard to Pillars 1 and 2. Some of the Deputy's views are not going down too well with his own people and he would be well advised to check with members in constituencies such as Kilkenny and Wexford. When he brings that consultation to the table, we will be happy to listen to him.

Homelessness Strategy

I take this opportunity to express my sympathies to the family of Paul Doyle, who died of exposure in November while sleeping rough in Bray. I also convey my sympathies on the death of the man who was sleeping rough in the Phoenix Park. His death might well lead to a murder investigation.

Some 139 people were sleeping rough in Dublin on 12 November 2013, an increase of 45 in just six months. The figure does not include the hundreds in emergency accommodation, including the 265 given shelter by the Peter McVerry Trust. In fact, approximately 1,400 people are in emergency accommodation every night in Dublin, and the homelessness rate has increased by 18% in a year. Staff members at the Dublin Simon Community recently told me that they are operating at absolute capacity. It is having a damaging effect on the morale of the very good people who dedicate their time to that organisation and to the fight against homelessness. People are sleeping rough in cold and dangerous conditions, at risk of exposure and vulnerable to assault. The additional beds put in place as part of the cold weather initiative are not sufficient to meet demand, as the number of homeless people has risen since the count that took place after last winter's initiative had ended.

The incidence of homelessness and rough sleeping is increasing at an alarming rate. It is the consequence of budget after budget which went for the easy targets, cutting the most basic services and having the greatest impact on the most vulnerable. The programme for Government referred to alternative funding models for housing, such as social housing bonds. The latter have been very successful in other countries, raising billions across Europe. The Government, however, has taken no action in this regard. Instead it continually restates the promise of NAMA housing and rehashes old announcements and spin as new funding. The Minister must consider establishing semi-independent housing trusts through the local authorities, which would allow the latter to raise funds separately from the national debt. This has worked well elsewhere when capital funds were not available. I urge the Minister to consider it.

Any Government that cannot put roofs over the heads of its citizens and ensure they are not obliged to sleep on the street is not worthy of the name. For the two and a half years I have been in the Dáil, the issue I have raised most consistently is that of the housing and homelessness crisis. I have said repeatedly that the policies of the Government are leading directly to homelessness because they not only fail to address the problem but are, in fact, making it worse. The reduction in rent caps, the failure to mount a serious emergency social housing programme and the introduction of such measures as real estate investment trusts and property-based tax incentives for speculators are combining to produce the disastrous consequences we have seen this week, where the number of people sleeping on the street has doubled.

Every week people come into my clinic who are facing homelessness as a direct result of the Government's policies. Ann Heffernan, a mother of two children who worked all her life but lost her job last year as a result of the recession, will be evicted tomorrow because her rent has gone up to €1,300 while the rent cap is €1,000. She cannot find anywhere to live. Paul Verburgt will be evicted next week because he cannot find any accommodation within the rent cap. At the same time, people are waiting ten years or more on the housing list. What are these people supposed to do? Platitudes about ending homelessness and pie-in-the-sky plans will not cut it. Cathal Morgan was clear that what is needed is direct provision of social housing. Given that we will pay €9.1 billion in interest to bondholders next year, the Minister of State cannot tell me that we could not hold back a couple of billion for housing. Action must be taken to put roofs over the heads of people sleeping rough and those waiting on housing lists for ten or 12 years.

It may have escaped Deputy Boyd Barrett's notice, but a couple of days ago, I announced the provision of funding of €100 million for social housing next year. I am glad to say we are back into mainstream provision of social housing, something which was not possible up to now, not because of our policies, but because of the economic collapse of the country. I cannot comment on the specific circumstances surrounding the death of the man in the Phoenix Park as referred to in the issue raised, but I share with Deputy Ellis in offering sympathy to the family of Paul Doyle and of the man who lost his life in the Phoenix Park.

The growing number of people sleeping rough on the streets of our capital city is unacceptable. The figures released today, showing a marked increase in rough sleeping in Dublin are troubling. Those in need of an emergency night's shelter must be provided for. I have noted the expansion of bed spaces under Dublin City Council's cold weather initiative, which has provided additional bed spaces since 1 November. Cathal Morgan was mentioned, and he has said that more than 80 beds have been provided in the Dublin area since 1 November. I have been in contact with the city council to ensure more beds are made available to tackle the situation and I will provide any support needed in this immediate task.

Homelessness is an affront to the dignity of the person and a stain on our society. It is a complex problem, but rough sleeping is the most extreme manifestation of it. The figures released by Dublin City Council show that 139 people are in this category, up from 94 in the spring of this year. This situation is unacceptable, but providing secure, warm accommodation on an emergency basis for 139 people is a problem that housing authorities should be able to address in conjunction with my Department and the voluntary bodies working in this area. Almost €23 million was spent on emergency accommodation in the Dublin region in 2013. Therefore, considerable money is spent on this problem and a considerable number of beds is provided. The statement from the Dublin Region Homeless Executive today informs us that on the night of the winter count, there were 1,461 temporary beds in the Dublin region.

Emergency accommodation is not a viable long-term solution to homelessness. The Government's homelessness policy statement, which I published earlier this year, emphasises a housing-led approach to homelessness, which is about accessing permanent housing as the primary response to all forms of homelessness. My priority is to ensure homeless people have access to secure, stable, appropriate accommodation. In Dublin last year, more than 870 people moved from homeless services to permanent housing. This year we anticipate the figure will be more than 900.

The Government is committed to innovative, practical solutions to resolve long-term homelessness. These include initiatives such as the social impact initiative announced in budget 2014, which will see 136 families moved from extremely expensive long-term emergency accommodation to permanent homes supported by a voluntary body. The Housing First pilot in Dublin has placed 24 entrenched rough sleepers in permanent housing, where they are offered the necessary services to maintain their housing. Also, a rent supplement initiative, in conjunction with the Department of Social Protection, offers homeless households in Dublin an additional opportunity to avoid or to escape homelessness.

I would like to stress that some community welfare officers are assigned specifically to deal with homeless people and to address the issue raised by Deputy Boyd Barrett about the caps. We are also working very closely, with the Dublin authorities in particular where the problem is most acute, to address the issues. The issues are complex and require a mixture of responses. Deputy Ellis has made a suggestion we are open to considering. There is nothing to impede local authorities from setting up their own housing associations. We work closely with bodies like those mentioned, such as the Peter McVerry Trust and Simon. They are doing tremendous work and I commend them on the work they do in this area.

Does the Minister of State accept at this stage that the plan to end homelessness by 2016 is a fairy tale? The current rate of homelessness suggests this is the case. Does she also accept that the rental supplement and RAS policies are not working and that building and providing proper social housing is the only answer?

There are a number of reasons we are seeing this huge increase in homelessness, one of which is the lack of private rented accommodation. Also, landlords who are renting to people on rent supplement are seeking to evict tenants, through charging rents that are €50, €100 or whatever higher than the supplement. This is pushing people into homelessness as they cannot find other private accommodation covered by the rent supplement. People in the RAS are in the same boat. We were told that people in the RAS were as good as housed and would not be put out, but these people are not reporting homelessness. These are two good reasons the homelessness figures are going through the roof. This will continue unless something changes radically.

There were no answers in the Minister of State's response for the two people I mentioned, or to be honest for the huge number who are being forced into or threatened with homelessness every week. The Government does not seem to grasp how bad this problem is and how quickly it is worsening.

I spoke with Peter McVerry a couple of weeks ago and he said clearly that the rent cap reductions were a disaster. He said they were driving people into homelessness and that emergency measures were needed to provide tens of thousands, not a few hundred, council houses. At the Focus Point conference this week, it was stated that only 1.2% of all the available private, rental accommodation in Dublin is within the rent caps. The policy is a joke and cannot work. The cap is driving people into homelessness. As Cathal Morgan said, this does not affect just the traditional categories, of people with drug addiction or mental health problems. People, as a direct result of not being able to pay the rents demanded, are being driven into homelessness. What does the Minister of State propose to do about this?

I do not know whether the Deputy heard me, but I said-----

The Minister of State's €100 million is only a drop in the ocean.

Stop shouting. Take it easy please.

The Deputy will not solve the problem by shouting at me. I do not know if the Deputy heard me, but I gave him the statistics-----

Can we at least have a proper debate in the Dáil on the issue?

Will the Deputy please behave himself.

I already gave the Deputy the statistics on the number of beds that are available for emergency purposes. There are an extra 80 beds available since 1 November. I told the Deputy how many people have moved on into permanent accommodation and I told him that at the weekend I announced the provision of €100 million for the construction of social housing next year.

With regard to the rent supplement, my colleague, the Minister for Social Protection, improved the rent caps in the Dublin area earlier this year. We have a commitment in the programme for Government which we will implement next year, to transfer to a payment called HAP, housing assistance payment, which will get us away from rent supplement, except when used in the short term. All long-term rent supplement people will transfer to a system of payment whereby they will pay the same as if they were a local authority tenant. We are making progress on this and will start the transition in 2014.

I have provided the Deputy with statistics on what we are doing. We are also working closely with the voluntary sector and they are helping us provide accommodation. They particularly support the housing-led approach, which is the ultimate solution. If people continue to stay in emergency accommodation when they are ready and should move on into long-term accommodation, there are no beds available for the real emergencies that arise daily. We have a programme and an implementation plan and we are supporting people to move into homes. This is a housing-led approach, which has been shown to be the right way to go.

I am committed to reaching the goal of ending long-term homelessness by 2016. We will not do this by continuing to do things as we have always done them. This is why we are changing the way we are doing things. An oversight group will report to me in the next week with specific proposals regarding what we need to change to achieve this goal. One of the things we need to do is to move people out of emergency accommodation into homes and to provide the supports they need to deal with their addiction problems or whatever problems they have. Then, when there are emergencies, there will be spaces available in the emergency hostels.

We are working on a variety of solutions to this issue. None of us wants to see anybody sleeping rough or out in the cold weather. I pay tribute to the Dublin Region Homeless Executive which is taking strong action on this issue. It is successful in what it is doing, but there is more to do. The provision of housing is an area in which we want to see an increase now that the economy has started to turn around. We have already started on work to increase the supply of social housing.

Services for People with Disabilities

Today is international day of persons with disabilities. I thank the Ceann Comhairle for the opportunity to raise the important issue of Wi-Fi access for staff or service users, which creates a digital divide for people with disabilities.

Earlier today, I attended an eye-opening briefing from Inclusion Ireland where I heard first hand about the difficulties experienced by persons with disabilities. To quote one speaker, Mr. Adrian Noonan, people must look at their ability not their disability. The Convention on the Rights of Persons with Disabilities was signed by Ireland and is due to be ratified following the enactment of the Assisted Decision-Making (Capacity) Bill 2013. I welcome the Government's approach to ensure this key reform will be in place shortly. However, having listened to persons with disabilities today, I fear we are still not actually listening to the voices and needs of people with disabilities.

Persons with disabilities have a vote but many still do not feel equal. They want to be included not excluded. They want to have more input into decisions. To repeat what Sam O'Connor stated today, they want us to talk to them and not about them. We must ensure the Assisted Decision-Making (Capacity) Bill is written in language people can understand so they can contribute to it. Simple English should be a prerequisite for the Bill and language that is difficult to understand should not be used.

We must ensure the service we provide fits the person and not require the person to fit the service, and I will elaborate on this point. Today I heard from one particular person with a disability about attending a particular learning centre with no access to Wi-Fi This year's UN international day theme is "Break Barriers, Open Doors: for an inclusive society and development for all". I therefore ask the Minister of State how he plans to break such barriers and create an inclusive society when several service providers and users are still unable to access Wi-Fi. Does this not instead reinforce a digital divide and barrier for people with disabilities?

The Internet is an invaluable education tool, providing an enormous amount of educational information and is a great reference source for educators and students. Some staff, and the majority of service users, are unable to access Wi-Fi and beneficial interactive learning and teaching tools. Access to the Internet can provide a wealth of opportunity for persons with disabilities, opening up avenues for e-learning, independent learning, entertainment, self-expression and socialisation. With regard to self-expression, the Internet also affords an opportunity for people with disabilities to present themselves outside their disability. Another major benefit of the Internet is its ability to minimize distances and provide communication services efficiently and with very little cost. At present, service users have to travel to local libraries to access the Internet. Unlimited opportunities for training and learning are being lost. Internet use has become an integral part of daily life. Realising the full and equal participation of persons with disabilities in society should include full online inclusion at the very least.

In responding to Deputy Mitchell O'Connor's question I will outline the measures being adopted by the Department in addressing what she quite rightly describes as the digital divide. It is also important to note the very important work being done by the Minister for Communications, Energy and Natural Resources, Deputy Rabbitte, in rolling out the national digital strategy and the serious ambition on his part to provide a minimum of 30 Mb broadband connection to every community in the country. This is something I applaud and am confident will become a reality in the lifetime of the Government.

The ICT in schools programme supports the integration of ICT in teaching and learning in primary and post-primary schools. Centres for adults with intellectual or other disabilities do not fall within the immediate remit of Department of Education and Skills. Wireless networks have the potential to deliver educational benefits to support teaching and learning in a number of ways in our schools. It can help to facilitate classroom situations which are more supportive of a student-centred active learning model.

Facilitated by the 100 Mb fast broadband programme for post-primary schools, there is a significant shift in terms of ICT, where computing devices being introduced by schools for learning are increasingly mobile wireless devices and not fixed or desktop computers. At the launch of the consultation phase of the Department's digital education strategy yesterday a number of excellent examples were outlined by school principals where wireless technology is playing a major role in the provision of learning in schools throughout the country.

In October 2012 a working group on wireless ICT in post-primary schools was set up in the Department with a remit to develop a guidance document for wireless ICT systems in new schools. Its priority was to focus on post-primary schools initially arid then primary schools, to include special schools. The remit further expanded to developing a more comprehensive guidance document with enhanced guidance for all schools. The guidance document provides advice and direction regarding wireless networks in post-primary schools in Ireland, including on infrastructure, design, procurement, management, technical support and pedagogical guidance on wireless systems. The target audience includes school principals and management, ICT co-ordinating teachers, boards of management, design teams and other parties involved in the planning, provision and support of wireless in schools. The document includes non-technical and technical sections and will be published in the very near future. Work has commenced on the development of an advice document for primary schools.

At present in the case of a post-primary building project, such as a new school or an extension to an existing school, the school is given the option to have wireless installed, and the network will be provided as part of the building contract. Wireless is the preferred option of the Department of Education and Skills but ultimately the decision is made by the school itself. In the case of an existing school where no building project is being undertaken, the installation of wireless is an operational matter for the board of management of the school. Funding for the installation is provided by the schools themselves. It is of utmost importance that consultation should take place prior to the decision being made. The cost and other implications must be fully considered by the boards of management.

The assistive technology scheme provides funding to schools towards the purchase of equipment for pupils who have been assessed as having a special educational need which requires specialist equipment to access the curriculum. I have seen at first hand the power of the equipment and the software one can access. It certainly empowers students with special needs to learn in the very unique way required as a result of their needs. Grant aid is available for this specialist equipment. It is pupil-specific, as it should be, and is based on the pupil's needs as determined by an associated professional. There is no upper limit to grant aiding this assistive technology.

I welcome the response of the Minister of State and I appreciate the good work done in primary and post-primary schools. However, I was referring to learning centres for persons with disabilities over the age of 18. Given the ongoing revelations about the generous remuneration and top-up payments of senior managers, some of whom are working with services for people with disabilities, I would like to be assured that money is allocated to those who need it most in these learning centres. Finland has become the first country in the world to make broadband a legal right for every citizen. Is this something we should consider?

I agree with Deputy Mitchell O'Connor's final remark. It is something we should at least contemplate. Perhaps we should examine the significant body of experience, learning and wisdom amassed throughout our primary and post-primary school system in recent years with regard to the use of technology in education, and then use this wisdom to determine how best we serve the needs of the learners referred to by Deputy Mitchell O'Connor. I am more than open to discussing the matter with her in the future and perhaps engaging with my colleagues at the Department of Health on making it happen.

General Practitioner Services

I thank the Ceann Comhairle for allowing me to raise this matter. This is not the first occasion on which I have raised the issue of GPs charging medical card holders for service to which, I understood, they were entitled free of charge. In July 2011, I brought to the attention of the House the fact that some GPs were charging medical card holders for blood tests. At that time I received a strong commitment from the Minister of State's predecessor to the effect that the Department would ensure that any GP charging medical card holders for blood tests would be investigated. I understand the Department also wrote letters to all GPs advising them that blood tests are covered under the General Medical Services, GMS, contract. I am now seeking clarification from the Minister of State in respect of another service GPs provide to their patients which, I also understand, is covered under that contract.

I recently met one of my constituents from County Meath who has mobility issues. As a result, she is obliged to use a mobility scooter. She lives in a House that is not suited to her needs or to the use of said scooter. This makes it difficult for her to enjoy a good quality of life in her own home. The woman in question does not have the money to have her house refurbished so she has applied to Meath County Council for a house that would be more suited to her needs. The housing section of the council is helping the woman to find a new home. However, in accordance with the rules under which the latter operates, she was obliged to obtain a letter from her GP outlining her medical condition and the impact living in her current home is having on that condition. The woman concerned went to her local GP and obtained the following letter. Obviously, I will not read the names of either the woman or her GP into the record. The letter states:

To whom it may concern

This is to certify that the above mentioned is under our care. She has background history of osteoporosis and degenerative bone disease. She needs constant medical care and attention. She has recently been recommended use of a mobility scooter by the HSE's services which enables her to mobilise for longer distances. She also needs to have modifications made in her home, such as railings and ramps, to enable her to move more easily within her home environment.

I feel these adjustments would be of huge benefit to this lady with her disabling conditions. I would be grateful if you would take this into consideration on her application for housing. Many thanks for your help in this matter.

Yours sincerely

Dr. X

That is great and it is just what the council wanted. However, the woman - who is in her 70s and who has a medical card - was presented with a bill for €50 in respect of the letter, which contains only nine sentences. This is simply astonishing. It is not unusual for GPs to be asked to provide letters outlining the nature of people's illnesses to councils or other State bodies. These are very routine requests.

With respect, this is happening on the Minister of State's watch. That to which I refer is unacceptable and we need to do something about it. I ask the Minister of State to clarify whether there are circumstances in which GPs can charge medical card holders for services. If not, will he advise as to how this woman and others who have been asked to pay for the routine service to which I refer can obtain refunds? Will he also make it clear to GPs that this type of behaviour is not acceptable?

It might be useful to quote the relevant section of the GMS contract. In that regard, section 11 states:

The medical practitioner shall provide for eligible persons, on behalf of the relevant Health Board, all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess.

In the context of the issue raised by the Deputy, the section also states:

The medical practitioner shall:

...furnish to a person whom he has examined and for whom he is obliged to provide services (or, in the case of a child, to his parent) a certificate in relation, to any illness noticed during the examination which is reasonably required by him or by the parent as the case may be. Such examinations as the doctor may carry out on a patient prior to the issue to him of first and final Social Welfare certificates are comprehended by the capitation payments. Payment under this contract is not made in respect of certain other certificates required, e.g. under the Social Welfare Acts or for the purposes of insurance or assurance policies or for the issue of driving licenses.

Under paragraph 27 of the GMS contract, a medical practitioner shall not demand or accept any payment or consideration from a GMS patient for services provided by him or her which are covered by the contract. Any alleged instances of eligible patients being requested to pay for a service covered by the contract, such as the provision of a sick certificate as outlined in the quotation, is viewed as a serious matter by the HSE and the Department. The HSE's local health offices will fully investigate any reported incidents of eligible patients being charged for services covered by the GMS contract.

The Deputy may also wish to note that the Department of Social Protection pays fees to medical certifiers, who are mainly general practitioners, for the completion and issue of medical certificates for illness benefit and the completion of medical reports for various social welfare schemes. The fees are paid for the provision of medical opinion which is furnished on an official certificate or report form. Consultation fees charged by general practitioners to private patients and to GMS patients outside the terms of the GMS contract are a matter of private contract between the clinicians and the patients. While I have no role in respect of such fees, I would expect clinicians to have regard to the overall economic situation in setting them.

I thank the Minister of State for his reply, in which he set out the position very clearly. He stated that a medical practitioner shall furnish to a person services which are reasonably required by him or her. Does this revolve around what is deemed to be reasonable and what is not? I am of the view that it is very reasonable to provide to someone with osteoporosis and a degenerative bone disease - and who, under the contract, is eligible to avail of such a service free of charge - the required letter. It is clear that this is a case where the GP acted outside the terms of the contract. If I furnish the name of the GP involved, can I expect that the Department will take the necessary action?

I cannot comment specifically on an individual case. I can, however, assure the Deputy that there are certain types of letters and certificates which are comprehended by the contract and in respect of which fees should not be sought or charged. The Deputy was correct to focus on the use of the term "examination which is reasonably required" in the contract in the context of the certificate or letter to which he refers. It might be advisable to consider raising this matter with the HSE's local health office in respect of any investigation he might consider appropriate in this case. If he requires my assistance in that regard or in respect of progressing matters further, I will be more than willing to provide it.

Sitting suspended at 5.09 p.m. and resumed at 5.15 p.m.