Topical Issue Debate

Flood Relief Schemes Funding

I thank the Ceann Comhairle for allowing me to raise this very important topic. With all due respect to the rules of the House, I do not believe two minutes is adequate to properly deal with the devastation and disaster visited on the city of Limerick over the weekend, or with the destitution, misery, hopelessness and despair which followed in its wake. My constituents in Kings Island in Limerick city awoke on Saturday morning to their own particular version of Dante's Inferno and but for the dedication and professionalism of the emergency services, whom I thank and congratulate, there is no doubt lives would have been lost.

In the very short time available to me I wish to ask the Minister of State practical questions and I would appreciate direct answers because I am asking them on behalf of my constituents who are asking me the same questions. What will be the position on people whose houses have been destroyed and rendered uninhabitable? These houses fall into two categories, namely, those owned and rented by the local authority and those privately owned. Will the local authority effect repairs to these houses? Is it possible to repair them? Does the local authority intend to rehouse people, and if so when will something happen in this regard? Is it possible to have a timetable for this? The Minister of State will be aware from his visit to Limerick yesterday, which I welcome, that many of these people have been put into facilities for the homeless and others have gone to live with relatives. This situation cannot continue indefinitely. What is the position with regard to those who own their houses, particularly those who do not have insurance because they are specifically excluded from having flood insurance?

The Minister of State is aware the way of life of many people has been grievously disrupted by the events of the weekend. Some people have lost boilers and have no way of heating their houses and others have lost fridges or freezers and have no way of keeping food. Some have lost their cars. With regard to emergency provision for these people, how many social welfare officers have been allocated? What is the total amount of specific funding that has been allocated to deal with these issues? What is the timescale between application and payment? What is the Government's intention on general compensation? The Minister of State is aware that when 20 houses were flooded 15 years ago we received general compensation of £500,000.

The flooding in Limerick is unprecedented. I have visited the areas affected and the spirit shown by the people living there is nothing short of phenomenal. They rallied and worked with the services. Outside of Saint Mary's Park and Lee Estate, areas such as Athlunkard Street, Corbally Road, the Mill Road in Corbally and areas in Thomondgate were badly affected. People should never have to go through this again. Will the Minister of State advise us on the defences and procedures to be put in place to ensure this never happens again?

I welcome the fact €15 million has been set aside, but this must operate in a very efficient manner. Ballynanty Health Centre has been established as the location for the community welfare office but services for those who cannot physically visit the centre must be ensured.

The issue of insurance has been raised. Many of those living in the affected areas do not have insurance because they could not obtain it. How is this being considered in discussions with the insurance industry and in dealing with the loss of possession and homes, which Deputy O'Dea also raised?

Sean Hogan, the head of the National Directorate for Fire and Emergency Management, was in Limerick on Sunday and the Minister of State was there yesterday. The Government appreciates the overwhelming impact this has had on people's lives. Will the Minister of State ensure the €15 million of humanitarian aid is fast-tracked for people living in the areas? Will he also deal with the issues of insurance and the defences being put in place? This is a real-life story for people living in the areas.

That is why I felt it important that the Minister, and Sean Hogan also, would visit the area to get an appreciation of what occurred. We now need to see timelines in terms of these measures being put in place for the people I represent in Limerick.

I remind the House that the other two Deputies have a separate Topical Issue in regard to the insurance matter. They will be dealt with separately.

I thank both Deputies for raising this matter and I welcome the opportunity to address the House on the subject of the flooding in Limerick city. As the House will be aware, I visited Limerick city yesterday to see the situation for myself and to meet with people whose homes had been flooded, and it was heartbreaking to see the devastation that was caused. The Minister, Deputy Noonan, the Minister of State, Deputy O'Sullivan, and I, who were joined on that occasion by Deputy O'Donnell, assured the flood victims that support will be made available to them. I very much welcome the announcement earlier by the Taoiseach that an additional amount of €15 million in humanitarian aid is being made available by the Government to assist those affected. This will go some way towards dealing with the immediate financial needs of the people whose homes have been damaged.

I want to pay tribute to the tremendous efforts of the emergency response team, as both my colleagues have done, who put themselves in the front line in sometimes very dangerous conditions and whose dedication and skill helped to mitigate the very worst effects of the flooding event that occurred on Saturday morning. I would like to take this opportunity of thanking them personally for their work since this cycle of storms and flooding started. In addition, I would like to say that the community spirit, which came to the fore in Limerick city at the weekend, was heartening, with neighbours helping each other to deal with a situation that was very difficult. One of my abiding memories will be meeting a group of young men and women, a Civil Defence team, all under 18 years of age, who had been out over the weekend helping their fellow citizens. It was a fantastic sight to see the work of those young people.

The flooding levels reached in Limerick city at the weekend were the highest since the Office of Public Works, OPW, hydrometric section began recording data in the 1950s. Substantial flooding occurred at King's Island and at St. Mary's Park.

With the Minister and the Minister of State, Deputies Noonan and O'Sullivan, I visited the local co­ordination centre yesterday to assess the current situation and to offer appropriate help and assistance to the affected areas. It was agreed that works will commence straight away on the installation of a temporary barrier to adequately protect the island area from future flooding. I spoke this afternoon with the county manager and we have agreed that Limerick County Council will immediately begin putting in place this temporary measure, assisted and funded by the OPW. We want to see the work start immediately and both the manager and I agree that it will be started as soon as possible, funded by and with assistance from the OPW.

It was agreed also that the regeneration project for this area will proceed and that a permanent solution for flood protection of the island will be incorporated into the overall regeneration of the island. Limerick City and County Council will take the lead role and will be advised and funded by the OPW in regard to the flood relief elements of the works.

Some works have already been carried out to enhance flood defences in Limerick city. They date back to recent years and I will not go into them at this stage as I do not want to waste time.

The House will be aware that the interim report of the severe weather group was presented to Government on 13 January, which provided a preliminary estimate of the financial impact of the storm. A second report comprising updated and more detailed costings from affected local authorities on the storm damage and recent floods is being prepared, and the Government will respond accordingly when it examines that report. The Deputies should be aware that we have asked all the local authorities to submit reports by today. A memorandum will go to Government next week, 11 February, and as we have information from Limerick, Limerick's situation will be included in terms of the longer-term structural cost to homes, which I will deal with in a moment.

Obviously, what is needed in Limerick city, as in other parts of the Shannon, is to proceed with the catchment flood risk assessment and management, CFRAM, programme and that plan is already under way. We have established the Shannon CFRAM study. Jacobs have been the consultants. They were appointed in January 2011.

Much has been done and much progress has been made in tackling flooding problems throughout the country. In the past ten years we have spent approximately €370 million but it is fair to say much more needs to be done. Can I have some indulgence, Sir, in answering the questions the Deputies asked because I think it only fair?

The Minister can do that when he comes back in. The Minister's time has expired. If the Deputies wish to-----

I have some brief questions for the Minister of State. First, is it the Government's intention to introduce legislation along the lines of what has been done in the United Kingdom to make it compulsory for insurance companies to insure against flooding for reasonable cost? Second, can the Minister give me an assurance that funds will not be diverted from the regeneration project in Limerick, and that this will be separate funding? Third, I welcome the provision of €15 million but does he consider it will be enough? In my opinion it will not be enough. Is it the Government's intention to increase provision if this is deemed to be insufficient? Fourth, has any application been made to the European Union for funding? My understanding from a contribution in the Seanad last week by the Minister of State, Deputy Costello, was that we would not be eligible under the EU funding scheme. The Taoiseach, on the other hand, stated today that he was examining the possibility of applying to the EU. Bizarrely, he mentioned the time the Rhine flooded. I am not too concerned about people living on the banks of the old River Rhine; I am concerned about people living on the banks of the Shannon, in Limerick. What is the position about applying to the EU for funding?

There is an enormous sense of urgency in terms of Limerick because many people are out of their homes. Up to 300 homes are affected. The questions are simple. On an immediate issue, first, when does the Minister anticipate the Government will be in a position to do an overall assessment of the level of humanitarian aid that is needed in Limerick? Second, insurance is an enormously urgent issue in Limerick because as many of the people were living on a flood plain they do not have insurance, and we are talking about their homes. I ask the Minister to give us the timeframe in terms of when he will be in a position to provide conclusions and certainty to the people living in these areas in Limerick in respect of their homes.

On the question of EU funding, the Government is reviewing this issue. We have over 100 days before an application can be made from when the initial storm damage was done in the first week of January. Limerick can be included in that.

As to the potential of funding, no one knows until we see the full scale of the damage. We have an initial amount of €65 million for the western counties from the first week of January, but more information is coming to hand. We have an open view about that. If we can obtain funding from it, we certainly will do so.

The Deputy asked me about my views on the €15 million immediate humanitarian aid. This is an immediate fund that we are putting in place. If more needs to be done, more will be provided. It is important, as Deputy O'Donnell stated, that people would start applying for the funds and that they can be turned around very quickly. I am aware some already have done that. The Minister, Deputy Burton, who is responsible in this area, has set up a separate section dealing with this issue in the Ballynanty Health Centre area. I understand they are staying open late. Equally, they have people on the ground to make sure we can turn around those applications as soon as possible.

If we need a separate fund for Limerick because of the scale of the structural damage, that will only become known once the full assessment is in by the local authority. In fairness to the local authority, and the Deputy will appreciate this, it is dealing with this since the weekend. It is dealing with it on a day to day basis at the moment.

There are three categories. There are local authority homes, which are ultimately the responsibility of the landlord, in this case Limerick City Council, and it will have to make applications to us as to what it wants to do with those particular homes. There is no question that the regeneration funds will in some way be supplementing the funds for flood defences but we must have regeneration and flood defence schemes operating hand in hand. As I walked around St. Mary's Park yesterday I discovered that some of the houses were due for demolition anyway because of the regeneration project. We have got to work at that on the same basis.

I met people yesterday who had insurance, and obviously their assessors are in place. We want the insurance companies to pay up in that circumstance.

For people who have major structural problems with their home but who do not have insurance, I would have thought that will require capital funding from the State. It is too early to say whether that can be obtained in the original €15 million allocation but, ultimately, a great deal of damage has been done. Structural damage has been done. Tens of thousands of euro worth of damage has been done to each individual home and if someone does not have insurance, we will have to work out with them exactly what can be obtained in each case as a means of making that house habitable again for that family or individual. I have done my best to answer all the questions.

This will be an issue in the coming weeks and I presume we will return to it.

Last Sunday was the 12th anniversary of the flooding of more than 400 homes in Ringsend and Irishtown. The issue of flood insurance has been on the agenda for those 12 years. Hundreds of my constituents can see the Aviva stadium on the horizon when they leave their homes every morning but they cannot get flood insurance from Aviva or any other company. Geocoding has been a disaster for Dublin and across the country because people can no longer get insurance for their properties. Action is urgently needed. In March 2013, the Joint Committee on the Environment, Community and the Gaeltacht heard that more than 50,000 homes were no longer able to get flood insurance. I would estimate the current figure to be closer to 100,000 hard-pressed homeowners, who are being discriminated against by the insurance industry. I am concerned that a cartel is forming to the effect that local households and business owners who have been geozoned cannot get flood insurance. In my constituency, the OPW has spent €15 million on flood defences and it is due to spend a further €10 million on the stretch from Ballsbridge to Clonskeagh. Even when this work is finished, however, the residents in the area will not be able to get flood insurance. In the UK there is an agreement with insurance companies whereby in return for the UK State's investment in flood defences, companies will continue to offer cover to homes at risk. Every pound invested in flood defences in the UK saves the insurance industry £7. We are investing the money but we are not getting the return. The Minister of State suggested on "Prime Time" last night that the State may consider becoming insurer of last resort. I ask him to update the House on that suggestion.

I thank the Minister of State for coming to the House to take this issue. I ask him the status of the memorandum of understanding between the OPW and the insurance industry on ensuring that insurance is offered to households and businesses where flood remediation work has been carried out. This evening, people in Cork are bracing themselves for a flood that is expected to arrive at 8.30 p.m.

We have seen in Limerick that the trauma created for households and businesses is almost immeasurable. However, those businesses and households will face another trauma once they recover from the flooding because they will not be able to get insurance. They will have been geozoned, that is, the industry will have decided that it can no longer offer flood cover to their area. I do not suggest that areas of high risk should have normalised insurance but the current practice is that everybody is locked out from insurance cover once an area is geozoned. This has serious consequences for house values because the banks' engineers will not permit future purchasers to get mortgages on them. Businesses will be unable to trade into the future because they cannot get insurance on their stock.

When millions of euro are spent by the OPW and local authorities on remedial works, people should be able to change their geozoned status in order to get insurance. When is it expected that the memorandum of understanding will be put in place and what powers will it contain to ensure that insurance companies comply with it?

I thank the Deputies for raising this important issue, which Deputy Ciarán Lynch previously raised in committee last week. I am aware of the impact of flooding on businesses and households across the country. In regard to the issue of renewing existing flood cover, this is a commercial matter for insurance companies and must be based on a proper assessment of the risks they are accepting. These risks are often considered on a case-by-case basis and neither the Government nor the Central Bank has any influence in this regard. The Central Bank's consumer protection code does not include any provision to compel an insurance company to accept a particular insurance risk. Flood insurance is sometimes not economically viable for insurance companies and, in the interest of keeping premiums affordable for policy holders in general, insurers decline new or renewed flood cover for certain risks. These are commercial decisions that insurers make in the circumstances they face.

The fact, however, that at least 2% of households cannot obtain flood insurance is a cause of concern for the Government. The OPW has actively engaged with the insurance industry for some time on this matter. In January 2013 a working group, comprising representatives from the OPW, Insurance Ireland and the main household insurance companies in the Irish market, was established to consider the matter. It is important that the group's specific purpose and the role of the OPW in relation to it are clearly understood. The OPW has no role or function in regard to the oversight or regulation of the insurance industry. The discussions between the OPW, Insurance Ireland and the companies concerned are focused solely on agreeing a basis on which information can be provided to the insurance industry on flood relief schemes completed or funded by the OPW, and the standard of protection offered by these schemes. The discussions have been complex and technical in nature because it is important that all elements are addressed in a way that provides a robust and reliable system of data exchange.

The working group has made good progress and agreement has been reached on a data sharing platform which will facilitate the transfer of detailed information on completed OPW flood relief schemes on an ongoing basis. This will allow the insurance industry to take account of the levels of capital investment in flood protection measures over several decades by the OPW when assessing flood risk in the relevant localities. The initial focus of the group's work is the provision of information on schemes which provide protection for one in 100 year flooding events. The OPW provided an initial batch of information to the insurance companies and the latter are currently integrating the information into their respective operating systems.

A memorandum of understanding to guide current and future interaction between the industry and the OPW in regard to communications regarding completed flood defence works effectively has been agreed. I expect to be in a position to make an announcement in this regard as soon as the outstanding technical difficulties are resolved by the insurance companies. While the agreement on the memorandum of understanding is to be welcomed, ultimately it is for the insurance companies themselves to decide how they will use the information provided on completed flood defence works. They have committed to take into account the information in their own risk assessments and it is hoped this will facilitate the provision of flood cover in all areas protected by completed schemes.

I assure the Deputies of my intention to progress the matter with the industry and remind them of the avenue that is available to those with difficulties, complaints or queries in regard to insurance cover through Insurance Ireland's free insurance information service. In addition, the Financial Services Ombudsman deals independently with unresolved complaints from consumers about their dealings with financial service providers.

I am very disappointed with the working group. It has been meeting since January 2013 but we still do not have a solution. I find the Minister of State's answer unsatisfactory. The 2% figure to which he referred was inaccurate when it was first estimated and it has become even more inaccurate since then.

We are talking about 100,000 families.

This Government has to come up with solutions. In the United States, they have the national flood insurance program for areas such as Florida and Texas. In the United Kingdom, there is the statement of principles and memorandum of understanding involving a possible insurance levy of £10 per policy. A model was presented to the Joint Committee on the Environment, Culture and the Gaeltacht by the National Flood Forum. There are solutions out there. We need to pick them and move on.

I have been at this since 2002. It has gone on far too long. The Minister of State may not have created the problem but it has landed on his desk. We need a solution. I thought there was some hope when the Minister of State stated on "Prime Time" last night that the State may have to be the insurer of last resort. These families want to have insurance. They want to pay for insurance. They cannot access it. The upshot of it is that the taxpayer still has to pick up the bill. If homes are damaged or undermined by flooding, we will have to put an emergency fund in place.

There are good precedents elsewhere as to how this could be dealt with. There are good ideas coming from the National Flood Forum. We have gone past the time for talk and moved on to the time for action.

We are talking about a process of accreditation that exists in other jurisdictions, with which insurance companies operating in Ireland, such as Zurich, and others in Germany comply. It would mean that when the Office of Public Works or local authorities carry out accredited engineering, remedial or flood-prevention works in those areas, the insurance company would be compelled to buy into it.

The difficulty in Ireland is that this is even bad for the insurance sector. Households and businesses where works have been carried out are low-risk enterprises for the insurance sector, yet the sector has locked itself out of them. In fact, this is a devouring process and it is a race to the bottom that is in no-one's interest.

If we have a memorandum of understanding that does not have teeth, it will not have bite. I hope, and want the Minister of State to confirm, that we are not giving guidelines to the insurance sector because it has not adhered to guidelines to date. What they need is specific instruction, and if needs be, we then need to regulate. I am not saying that the insurance companies must be exposed to adverse risk. What I am saying is that in areas where the State has spent tens of millions of euro on rectifying works ensuring that these risks are removed and where the insurance company is still refusing to insure businesses and households, a process should be put in place where the insurance company must be brought to the table to give people insurance cover at an appropriate price.

I want to be clear about what I and my officials have been engaged in for the past year and a half. As I have stated repeatedly, we have been sitting down with the insurance sector to find an agreement: first, that where we do work, such as major capital schemes up and down the country, the insurance sector would understand that the standard of such work reaches a minimum threshold of a one-in-100-year event; second, that such data will be transferred to the insurance sector in such a way that it can understand that such work has been completed and it has confidence in the work that the OPW has stood over or that has been contracted by other authorities on behalf of the OPW; and third, that the insurance sector can communicate that to its members so that there is clarity about the standard of that work. It is a memorandum of understanding. It is a voluntary agreement between two parties: on behalf of the State, this party; and PLCs. Private entities in their own right, these insurance companies can come and go from the Irish insurance market as they choose and can decide to insure what they want. In the great majority of cases, as the Deputies will be aware, the insurance companies have the information ahead of the State. They have had the information for years. They know where the flood risks are and they know the local authorities that have been building on flood plains as well.

Agreement has been the objective of the exercise and I want to bring that to a conclusion. I am not standing in its way. I am not the person who is preventing this happening. It is a matter now for the insurance sector to agree and I appeal to it to agree. I appeal to them to accept that the memorandum is a sign of good faith on the part of the State to prove to them that the State has committed many millions of euro in funding on behalf of the Irish taxpayer - €390 million in the course of the past decade - for the purposes of flood defences. The objective of the exercise is that when we get to the end of this process they will at least accept that the work that has been done by the State reaches that standard. We cannot then compel them to insure people and I never said we could. Despite the misinterpretation by some, I never said that. What I want to do is have that agreement in place.

If others are talking about a State indemnification scheme for insurance, that is a wider issue that involves many in government, much more senior than I. I would suggest to my colleagues opposite, if they are arguing for that on this complex issue where the liability to the State is a multiple of billions of euro, which may well determine the amount of liability that the State can cover, that we need to have that debate. That is what I was referring to yesterday on "Prime Time".

My objective is to get the memorandum through so that everyone agrees what we have done and the standard is there, which will at least provide some opportunity for people to get flood insurance cover. If, however, commentators are looking for some centralist or corporatist approach to this by way of a State indemnification scheme, they need to say how much that will cost, how much it will increase insurance premiums and the total potential liability, because if they are saying so, that is what it involves.

Long-Term Illness Scheme Coverage

I thank the Minister of State at the Department of Health, Deputy White, for taking this Topical Issue.

The reason I raised the matter is that since I was elected last year it has continuously come to my door. I suppose it is an issue that has been raised on several different levels. I am not the first person to raise this topic, not by a long shot.

The Department of Health is under severe budgetary constraints and the Minister, Deputy Reilly, and the Minister of State, Deputy White, are doing an exceptional job with the funding available to them. Free GP care is on the cards for everybody in the coming years, and those under six years are the first recipients of this. It does not take away from the fact that parents of children with Down's syndrome and autism are being discriminated against. Many of them do not know what they are entitled to and this is where the problem lies.

The medical card is means tested. One is not awarded a medical card on the basis of one's medical condition; one is awarded it on the basis of whether one can pay for the care that is needed. With regard to the long-term illness card, this is not the case. There is no income requirement and it is not means-tested. It allows a person to get drugs, medicines and medical appliances directly related to the treatment of his or her illness. In order to qualify for the scheme, a person must be resident in Ireland, have a PPS number, and be suffering from one of the 17 illnesses or disabilities listed.

I welcome the recent addition of ADHD to the list. The recent investigation by the Ombudsman regarding the case of a child with ADHD found that a child with ADHD or autism was discriminated against on the basis of geography, which is a whole other area. The investigation of the office found that in some areas ADHD qualified as a mental illness and the child was included under the long-term illness scheme, whereas in other areas one did not qualify. There was a lot of uncertainty. Obviously, I welcome the fact that this has been addressed. However, the same problem is, perhaps, being replicated for those with Down's syndrome and autism. In most cases a child born with Down's syndrome will need some sort of medical attention for the rest of his or her life. These people grow up and live their lives with Down's syndrome.

A child born with autism has a severe disability that affects the normal development of the brain in areas of social interaction and communication. This, too, is a lifelong disability and there is no cure. Perhaps some day medical research might be able to do something about that, but for now these children and young adults should be entitled to some sort of long-term care scheme.

Perhaps the Minister of State could clarify that up to the age of 16, children with Down's syndrome or autism can avail of the long-term illness scheme on the basis of an intellectual disability. I am not sure whether this comes under mental illness or mental handicap. Perhaps he could clarify that.

Under the mental illness category, a person is only covered up to the age of 16 years. However, a person with Down's syndrome or autism who is being cared for by his or her parents or other next of kin should not be taken off the long-term illness scheme at 16 years of age. Coverage should continue for longer as the process is inconsistent. Down Syndrome Ireland told me recently that most children did qualify, albeit in a roundabout manner. Many such families, however, have to go through an appeals process which can be draining, upsetting and unnecessary. There are approximately 3,500 people in Ireland with Down's syndrome, of whom two thirds are under 16 years. If the majority already qualify for long-term illness cards, there would not be much of a change in the provision of necessary additional funding. As families spend thousands of euro in getting their children assessed every year, this would be a way to repay and help them. Last year the Minister for Education and Skills, Deputy Ruairí Quinn, announced that his Department would review the manner in which resource hours were distributed. Could such a review also take place in the Department of Health?

I thank the Deputy for raising this issue. The long-term illness, LTI, scheme is a non-means-tested scheme which was introduced in 1971. It provides free medicines and medical and surgical appliances for people with specified conditions. The conditions covered by the scheme are: mental handicap, mental illness - under 16 years only, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, diabetes mellitus, diabetes insipidus, haemophilia, cerebral palsy, epilepsy, conditions attributable to the use of thalidomide, multiple sclerosis, muscular dystrophies, Parkinsonism and acute leukaemia. Down's syndrome is classed as a qualifying condition under the mental handicap heading of the scheme. Persons diagnosed with Down's syndrome are supplied with an LTI scheme book and receive prescribed medication associated with the condition free of charge. However, autism is not a qualifying condition under the scheme.

Mental illness, under 16 years, is one of the illnesses covered under the long-term illness scheme. Previously some HSE areas regarded attention deficit hyperactivity disorder or ADHD as a form of mental illness for the purposes of the scheme, while others did not. The Ombudsman examined the operation of the scheme with reference to ADHD on foot of a complaint and issued a report to the HSE in July 2013 with recommendations for implementation by the end of October that year. In particular, the Ombudsman recommended that a uniform policy be put in place on ADHD across the country. The HSE advised the Ombudsman on 15 August 2013 that it accepted the findings made in the report and the recommendations in principle. Subsequently, it issued appropriate national guidelines for the uniform administration of the scheme. Implementation of the guidelines will ensure all children with ADHD are treated equally when they apply for a long-term illness scheme book.

There are no plans to extend the list of conditions covered by the long-term illness scheme. People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. In the assessment process the Health Service Executive can take into account medical costs incurred by an individual or a family. Those who are not eligible for a medical card may still be able to avail of a GP visit card which covers the cost of a general practice consultation. Non-medical card holders and people whose illness is not covered by the scheme,can use the drug payment scheme which protects against excessive medicine costs. Under this scheme, no individual or family pays more than €144 per calendar month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals incurring ongoing expenditure on medicines. In addition, non-reimbursed medical expenses can be offset against tax.

The Government is embarking on a major reform programme for the health system, the aim of which is to deliver a single tier health service, supported by universal health insurance, where there is fair access to services based on need, not ability to pay. The programme for Government commits that everyone will have a choice of insurer. Under the universal health insurance scheme, everyone will be insured and have equal access to a standard package of primary and acute hospital services, including acute mental health services. A new national insurance fund will subsidise or pay insurance premiums for those who qualify for a subsidy. Intensive work is under way on the preparation of a White Paper on universal health insurance which will provide more detail on the UHI model for Ireland, including its overall design, the standard package or basket of services, funding mechanisms and the key stages of the journey to universal health insurance.

The Government is also committed to introducing, on a phased basis, a universal GP service without fees within its term of office, as set out in the programme for Government and the future health strategy framework. Work is under way on legislation in that regard to offer a contract to general practitioners for the provision of this service.

Down's syndrome is classified as a qualifying condition under the mental handicap heading of the LTI scheme. In most cases that happens, but having spoken to Down Syndrome Ireland and some families affected, there are cases where families have to go through an appeals process. This is a lot of hassle for them and puts stress and pressure on them. Perhaps, therefore, this issue might be re-examined. There are different points on the spectrum of autism the autism which affects one in every 100 people in this country. One can go through his or her daily life without being affected, but those at the severe end of the spectrum should be considered for inclusion in the LTI scheme.

I have listened carefully to what the Deputy said and take her point on Down's syndrome and the difficulties she noted in the application of the long-term illness scheme to persons classed as having Down's syndrome. I was not aware that there was a particular issue in that regard, but I am willing to examine the specific problem the Deputy has identified. As I indicated, Down's syndrome is classed as a qualifying condition under the mental handicap heading. "Mental handicap" is not a term we use nowadays, but it is taken from the 1971 scheme. We are reviewing the entire operation of the LTI scheme and the classification of different conditions may be one of the issues we ought to examine. The general operation and application of the scheme is under review and we can and will address some of the issues the Deputy has raised in the course of that review.

My general approach to the medical card scheme and the issue of access to GP care is that we should have a universal system. We should not devise new schemes based on illness or conditions, with all of the complexities that go with this. The Deputy has identified some of the difficulties, including how to define various conditions in terms of whether they fall into categories. What is the diagnostic basis and do people constantly have to undergo assessments? Is there an appeals process and do they really have a qualifying condition? None of these matters should apply in providing access to basic health services, particularly GP care. That is why the Government is committed, with the support of the vast majority of Members of this House, to having a universal system of access to GP services. In such a system we would get away from the notion of people having to demonstrate they have this or that condition under this or that category, as defined in 1971. The LTI scheme is a drugs scheme, but there should be universal access to GP care, which is what we are dedicated to achieving.

Educational Disadvantage

I raise the issue of funding for the Life Centre in Sunday's Well in Cork city. It is one of four such centres in Ireland. There is one in Belfast, two in Dublin and the one in the heart of the north side of Cork city. I am sure the Minister of State, Deputy Ciarán Cannon, is familiar with the centre's work. The Department of Education and Skills is certainly familiar with it and the Minister, Deputy Ruairí Quinn, has commented publicly on it, as well as on future funding models and the difficulties the centre is facing.

To give some background information on the type of education provided by the centre, the director estimates the centre turns away two referrals on average a day. The centre is at saturation point and cannot take any more students. The centre has a staff of four full-time teachers and 70 volunteers, the majority of whom are qualified teachers who have been unable to find work. They have a passion for teaching and they are volunteering at the Cork Life Centre. The centre has 40 students, according to the latest figures, and just more than half, some 22, have been referred to the centre by various agencies such as the probation service, the HSE, and the national educational and welfare board. There are 25 full-time students, with the remaining 15 or 16 operating on a part-time basis. Some attend for only eight hours a week but the hours are used for educational advancement.

The difference between the Life Centre and mainstream settings can be summed up in the fact that all students attending the Life Centre have dropped out of mainstream education for varying reasons, some of which may be personal or social. Some students may have mental health issues. The Life Centre offers the opportunity to get back into education outside of mainstream settings. All teaching is on a one-to-one basis. This is something one could never find in a mainstream setting because of resources. The volunteers at the Life Centre and the nature of the work they do means all students receive one-to-one support.

Last year, 15 students completed the junior certificate and, this year, the centre hopes to have three students complete the leaving certificate. The issue facing the Life Centre is the uncertainty of its funding. The main contributor of funds until now was the Christian Brothers, its trustees, but the level of funding offered to the Life Centre by the Christian Brothers has decreased year-on-year. Now, there is no guarantee of funding. Without this, the centre faces huge uncertainty. If the centre goes, many of the students who have dropped out of mainstream education for varying reasons will not have the opportunity of educational achievement in any other setting. That is why I ask the Minister to examine the possibility of the Department of Education and Skills and the Department of Justice and Equality jointly sitting down with the trustees, or at least the directors and the teaching staff, to see what remedies can be arrived at to enable the centre to reopen in September. That does not look like it will be the case at present.

I thank the Deputy for raising this issue. My Department currently provides resources for the Life Centre in Dublin and in Cork. In the past academic year, my Department allocated a total of 2,768 teaching hours to the centres under the co-operation hours scheme operated by the local education and training boards, ETBs. In addition, €114,000 is provided annually to the two centres to help meet the day to day running costs. Almost 1,000 co-operation hours and €47,500 in funding are provided to the Cork Life Centre, which was established by the Christian Brothers in 1996 with the assistance of the Holy Faith Sisters. The centre caters for approximately ten young people between the ages of 12 and 16 years who are out of the mainstream school system. The centre provides a model of high-support educational provision incorporating intensive personal, social and educational support. With the hours allocated, tutors are employed by the Cork Education and Training Board to work in the centre and to deliver tuition in civic, social and political education, reading, literacy, arts and crafts, woodwork and home economics. The annual grant of €47,500 is used to meet day to day running costs of the centre. The centre prepares young people for the junior certificate and other education and training pathways.

In addition to the funding provided to the Cork Life Centre, my Department also funds a range of national programmes catering for early school leavers, such as Youthreach, community training centres and youth encounter projects that are represented in Cork. In Cork city, SOLAS funds 100 Youthreach places in four centres through the Cork Education and Training Board. The Youthreach programme provides two years integrated education, training and work experience for unemployed early school leavers with less than upper second level education who are between 15 and 20 years of age. Also, as part of the Youthreach programme, funding is provided for the Cork City learning support service, which caters for up to 70 young early school leavers aged 12 to 18 years of age. The service provides the junior certificate and some FETAC programmes for learners.

Through SOLAS, my Department provides 155 places in three community training centres which address the training and employment needs of early school leavers, primarily aged between 16 and 21 years. The Matt Talbot adolescent service in Cork provides residential drug and alcohol treatment for 14 to 18 year old boys. It provides educational courses at junior and leaving certificate level, ECDL and FETAC levels 3 and 4. My Department provides €190,000 through Cork Education and Training Board towards the cost of instruction staff at the centre.

My Department also funds the St. Kevin's youth encounter project in Cork, which can accommodate up to 25 children aged 11 to 15 years of age. Children are referred to the school by a number of agencies, including the court system, and mostly come from socially disadvantaged backgrounds, with a multiplicity of problems and issues. The major budgetary pressures within my Department place significant constraints on its capacity to support existing programmes and, consequently, given the significant range of educational disadvantage interventions already supported by my Department, requests for increased funding for the Cork Life Centre simply cannot be considered. Officials of my Department have met on a number of occasions with representatives of the life centres to discuss how the children and young people who avail of the out of school provision provided in the centres might best be supported in the future.

I acknowledge the partial funding to the centre from the Department of Education and Skills. The education and training board has been very supportive of the centre and has allocated teaching hours. The Minister of State knows the value of the work done in the centre. It is not just about aiming to pass the leaving certificate or junior certificate; the centre works on socialisation skills as the students who attend the centres come from some of the most disadvantaged backgrounds and have various skills deficits in terms of literacy and numeracy. The majority have dropped out of mainstream education and the centres provide an alternative, hope and opportunity for students between 12 and 18 years of age to get back into education and achieve an academic examination result, such as the junior certificate or the leaving certificate.

The response of the Minister of State was that under current budgetary pressures of the Department no further funding will be made available and that he has met representatives of the Life Centre to see the remedies that can come to pass with the people operating the centre and, more importantly, the students attending it. They are in the middle of studying for the junior certificate or leaving certificate. What remedies can be put in place? I do not know what the remedies will be or what the nature of the discussions can be, but we both know that the other centres doing the same type of work are at saturation point. If the Life Centre closes, it is not simply a case of transferring those 40 students into other centres, such as St. Kevin's, because they are all at saturation point and cannot take any more students. The stark reality is that the centre either closes, with fewer opportunities for a smaller number of people, or somehow funding is made available or an initiative is put in place by the Department, in conjunction with the Department of Justice and Equality, to come up with a remedy to keep the centre open.

I fully appreciate the points being made by the Deputy. There seems to be some discrepancy between the numbers given by the Deputy, which are described by the Deputy as being close to 40, and our information, which is that they are closer to ten. Perhaps we might try to establish the figure concerned. The issue has primarily arisen from the withdrawal of direct funding of the centre by the Christian Brothers. At this time there is unfortunately no scope to meet any requests for additional funds beyond the level of what is currently allocated. In the current economic climate, my focus and that of my Department must be on maintaining existing funding to all of our provision in Cork for the education of disadvantaged people to the greatest extent possible. Educational disadvantage remains a priority for the Government and we will endeavour to protect and enhance the educational experience of children, young people and students in disadvantaged areas.

I thank the Deputy for raising the issue of the centre. I assure the Deputy that my Department will endeavour to keep him informed of any developments relating to future funding of the centre, and I hope we will not arrive at a position in which the young people find there is no provision available. We will endeavour to ensure that does not happen.