Dáil Éireann debate -
Tuesday, 8 Jul 2014

Vol. 847 No. 1

Topical Issue Debate

Services for People with Disabilities

Deputy Mary Mitchell O'Connor

In Ireland there are approximately 200,000 visually impaired people and approximately 14,000 who are blind. They cannot see what is happening around them, including the beautiful view and the smile on their grandchild's face. They lose independence and confidence. However, most cases of blindness are preventable and some 75% of them need not arise. That they do is a scandal and a disgrace. Treatments and therapies, including preventive therapies, are available for the four main conditions, namely, cataracts, glaucoma, age-related macular degeneration and diabetic retinopathy. Preventable blindness is not just a Third World issue; it is also an Irish issue.

Approximately four years ago, my brother, Anthony, became one of the 14,000 who suffered from blindness in Ireland. My family has seen at first hand the difficulties he faces every day. Not only do he and others like him miss seeing beautiful things, but their day-to-day working lives are also complicated by practical difficulties. We should reflect on the fact that half of those aged over 80 years suffer from one of the four main eye diseases. Those with a visual impairment are eight times more likely to break a hip, three times more likely to suffer from depression and are admitted to nursing homes three years sooner than others.

It is not only the human cost that I want to consider because there are serious economic costs associated with sight loss. Blindness in Ireland cost €386 million in 2010 and that figure is expected to rise with current trends to €486 million by 2020. According to the National Coalition for Vision Health in Ireland, a fully implemented strategy to reduce preventable blindness would save thousands of people from blindness and visual impairment and the Exchequer an estimated €76 million per annum. There is a need to redeploy and invest in current services to achieve these savings. We need a national vision strategy in order that professionals can provide good care in community and hospital settings. Imagine preventing almost 200 people a year from going blind and making a saving for the Exchequer; it is a no-brainer and makes sense.

What do we need to do? The National Coalition for Vision Health in Ireland argues that if we introduce interventions such as screening for cataracts and diabetic retinopathy, in addition to early intervention, we could ensure the eyesight of hundreds of people would be retained. The human tragedy of blindness could be significantly decreased. The national coalition believes we should have a national strategy with strategic infrastructure and resources to deliver care. This includes attending opticians, patients accessing community and hospital-based eye services and service user groups such as the NCBI and the Irish Guide Dogs for the Blind. The strength of the national vision strategy is based on a coming together across the spectrum of all the groups involved, including the NCBI, Fighting Blindness, the Irish Guide Dogs for the Blind, ChildVision, the Irish College of Ophthalmologists, the Association of Optometrists Ireland, Diabetes Ireland and health care professionals, including Dr. David Keegan from the Mater Hospital.

Minister of State at the Department of Health (Deputy Alex White)

I am taking this Topical Issue on behalf of my colleague, the Minister of State at the Department of Health, Deputy Kathleen Lynch. I thank the Deputy for giving me the opportunity to outline the current position on health services for people who have a visual impairment or are blind. It is important to emphasise that the core objective of the health service is to maximise people's health status throughout their lives. The emphasis is on the prevention of disease and the management of health conditions at the lowest level of complexity which is safe, cost-effective and accessible to service users. These principles inform the approach to people's eye health, in addition to the wide range of other health issues that may affect them.

There are a number of eye conditions which require specialist health services, including cataract, refractive error, glaucoma, diabetic retinopathy and age related macular degeneration. There are detection and treatment services available at present in community and acute hospital settings for these conditions. In addition, the HSE has an established a clinical ophthalmology programme to improve access, quality and cost effectiveness.

The Health Service Executive, HSE, provides a sight testing service as part of the school health screening programme. Children who are identified as requiring treatment or intervention are referred to the HSE ophthalmic services. Urgent cases are given priority. Children between 12 and 16 years of age also receive services under the medical card scheme or are eligible to be seen by the HSE ophthalmic service when there is a medical reason for the eye condition, rather than refractive error. HSE community ophthalmology services also provide assessment, information and intervention for adult medical card holders with vision disorders. In addition, the HSE makes eye testing, treatment and optical appliances available to adult medical card holders through contracted optometrists and dispensing opticians.

The HSE is establishing an ophthalmology review group to examine issues around primary care ophthalmology services and many of the issues the Deputy has quite correctly raised this evening. This review group will consider the changes required and will identify any matters which it considers should be addressed on a priority basis. Screening by the national diabetic retinopathy screening programme is well under way and is on target to invite all eligible participants for screening by the end of 2014.

Deputy Mary Mitchell O'Connor

I thank the Minister for his reply. The national vision strategy is a roadmap to improved eye care in Ireland and points to an integrated care system that is effective, research evidence based and, most important, has visually impaired people at the centre of the decision making. Professor Keegan, in his presentation to the committee last Thursday, made the very strong point that the national cancer strategy, introduced in 2006, has led to improved patient survival rates and improved patient care, as well as internationally acclaimed, ground-breaking research. Professor Keegan firmly believes that a similar national strategy could improve the lives of the visually impaired. As I said earlier, preventable blindness is not just a Third World issue, it is also an Irish issue.

Deputy Alex White

The Deputy is absolutely correct. I have outlined the breadth of health service provision for people with visual impairment. The State's objectives in providing ophthalmic care include the elimination of avoidable sight loss; a focus on prevention and early intervention; equitable access to efficient high quality care, supports and treatment; to improve the quality of care; and improve cost effectiveness. The Government remains committed to the provision and development of vision services and supports through prevention, screening and intervention, all of which contribute to address the priority goal of Vision 20/20 which is to eliminate avoidable blindness in Ireland. I commend the Deputy on her emphasis on the importance of a national strategy and the importance of it being addressed in the way she has outlined. The Minister and I share her objectives in that regard and I thank her for raising the matter.

Mental Health Services Provision

Deputy John Lyons

Yesterday, service users of Tús Nua, which is a mental health day centre service in Ballymun, were informed by the staff of the imminent closure, most likely in September, of the day centre service in Ballymun for people in the area who are suffering with mental health related issues. Before that information was relayed to some of the service users, approximately 15 of those users came to my clinic yesterday morning with their concerns. If nothing else, it gave me a first-hand insight into who these people are and how the proposed closure of this service would affect them.

Tús Nua is a one-stop-shop for these residents. They explained to me that essentially it has become their lifeline. As I witnessed yesterday, these people are in perhaps the most vulnerable category of people in the area I represent in Ballymun. They rely heavily on this service. They see it as a place where they can drop in, and some of them drop in four or five times a week. It is where they have opportunities to chat to a professional and to look at ways to deal with their mental health issues, be it through arts and crafts or cooking. They also have the opportunity to look at the issue of money management and other basic life-related issues. Clearly, they were very concerned and I have taken on their concerns, given that they are very vulnerable people.

I understand that the proposed closure of Tús Nua, and the Minister may correct me if I am wrong in that regard, is based on a report from the HSE. It was initiated in 2013 in the HSE north Dublin city area, which comprises part of my constituency, to review all day centres. Obviously, given the imminent closure of the Ballymun Shopping Centre and the fact that the service is located in that shopping centre, there was a need to address the day services there, in particular. However, my concern is the 44 or 45 service users who essentially see this centre as a lifeline. They consider it a social outlet, a support structure and a learning environment. I received an e-mail from the daughter of one of the service users in which she told me that the only time her mother goes out during the week is to visit the service.

The people who use the service are exceptionally vulnerable. They are fearful of change. Fundamentally, they must be cared for and their needs must be taken into account before there are any changes. I am hearing proposals that some of these people might have to use a service elsewhere, such as in Coolock or further afield. These are people who will not get on a bus by themselves. This centre is located within less than a mile from their home. They can walk to the shopping centre, go into the day centre and have that connection. Often, that connection makes the difference between seeing the sun or not seeing it in their lives that day. I am very fearful and the service users are exceptionally fearful of what change might lie ahead.

I do not see why it is necessary to have a day service outside Ballymun when there is one in Ballymun already. Ballymun must continue to have a day centre mental health service provision. Not only that, it must be a high-quality service provision. I look forward to hearing the Minister's comments on this. Incidentally, I have been trying to get my hands on the report that suggests these changes but I have been unable to access it. It is hard to have a proper debate on this matter when some of the information has not been made available to me. I understand the information is probably private but it is hard to debate an issue when one does not know everything about why the report is making these proposals.

Deputy Alex White

I am replying to this Topical Issue on behalf of my colleague, the Minister of State, Deputy Kathleen Lynch, and I thank Deputy Lyons for raising this important matter.

The Deputy will appreciate that the HSE has statutory and operational responsibility for the planning and delivery of services at local level. North Dublin mental health services provide a range of adult mental health services within the specialties of general psychiatric, psychiatry of old age and a rehabilitation psychiatry service. This encompasses various settings such as service user homes, acute inpatient facilities, day hospitals, day centres and supported community residences. The service the Deputy refers to, which is community based with a focus on recovery principles, is delivered by consultant-led multi-disciplinary teams incorporating staff from a range of disciplines, including nursing, social work, occupational health and psychology.

The Deputy is correct that in 2013 the HSE, as part of the Dublin north city mental health service plan, identified the need to review all day centres within the area in line with A Vision for Change. A review group was established by the Dublin north city mental health management team with the following remit - to identify all mental health day centres in Dublin north city, general adult psychiatry; to review services provided within each day centre; to make recommendations, if required, to ensure that each day centre was fulfilling its brief; and, examine if clients' needs could be met in a more appropriate environment.

In the case of Tús Nua, the review group found that the day centre, which is situated on the upper floor of Ballymun shopping centre, was old and in poor condition, with only one fire exit from the building. There is no lift access and the shutters on the front window cannot be opened due to security concerns. Having considered all the issues, the review group recommended to the Dublin north city mental health management team that it would be best in the circumstances to close the Tús Nua facility. It should be further added that the lease on these premises has expired and, due to the regeneration plan for Ballymun, it cannot be renewed. In addition, the need to vacate the Ballymun shopping centre to allow the regeneration plan to proceed has left this service in a vulnerable position, and the HSE management cannot safely recommend the service continue.

I understand that the HSE is to establish an implementation group under the chairmanship of the clinical director and that an independent assessment of the needs of those attending the centre will be carried out. This assessment of needs will inform the process going forward and will ensure that the needs of service users, which is the main preoccupation of Deputy Lyons, continue to be met. The implementation group, as part of its remit, will communicate with all the relevant stakeholders during this period of change. I can assure the Deputy it is not the intention of the Dublin north city mental health management team to close this facility until the process of consultation with all relevant stakeholders is complete and appropriate alternative placements have been sourced.

Any changes that arise as part of this process will be communicated to patients and staff in advance of any change taking place. Accordingly, I would like to assure the Deputy that the HSE will, at all times, put the needs of service users to the fore in the relocation of this service.

Deputy John Lyons

I appreciate the Minister of State is speaking on behalf of the Minister of State, Deputy Kathleen Lynch, who has responsibility for this issue. However, it sounds like the door is already bolted on this issue. It is very frustrating to see in the very last line of the response from the Department that the HSE will "put the needs of service users to the fore in the relocation of this service". The needs are such that they cannot travel beyond where they travel to as it is. These are people who are so isolated from the general well-being of society that getting on a bus is as traumatic as can be. If the HSE is putting the needs of service users first, it will take into account that these are the genuine needs of many service users. It is not that they will not, it is that they cannot. Because of the situation in which they find themselves in their lives due to their mental health issues, they are just not able to engage in society. They have found some way to engage with a local service in Ballymun but if they have to move to another venue outside Ballymun, it will see these people put in an even more vulnerable position.

I am not playing to the gallery. I witnessed these people yesterday. They are so bloody vulnerable that they will not be in a position to travel elsewhere. If the HSE thinks it is acceptable to assess their needs and to ignore the reality that most of these people cannot get on a bus and engage in the way we do, it is not listening to their needs.

We all know of the shopping centre issue. However, where there is a will, there is a way. The HSE, with Dublin City Council, has a social inclusion unit. It needs to look at these people within their community and see what can be done with the new buildings in Ballymun in the hope that the new service can be located within the area, so all 44 or 45 members can continue to access this service.

Deputy Alex White

I thank the Deputy again for raising this issue. I understand the points he has articulated in regard to the individuals concerned. He has obviously met with the people concerned and he has a good appreciation of their needs and, perhaps, the limitations that apply in regard to people's ability to travel or to transfer. I understand that. While I would not hazard any further response in regard to the detail of this because I simply do not know all of the individual details, I would reasonably expect, as I know the Minister of State, Deputy Lynch, would, that those needs and limitations would be taken fully into account in regard to the planning of alternative facilities to address the very obvious needs that exist.

I assure the Deputy I will relay to the Minister of State, the Department, the officials concerned and the HSE the importance of taking completely on board all aspects of the situation which the Deputy has articulated. I thank him again for raising the issue.

Fisheries Protection

Deputy Martin Ferris

On 28 June, for the second time in a month, the same fishing vessel was arrested and brought in by the Sea-Fisheries Protection Authority, SFPA. As the Minister knows probably better than I, Kilmore Quay is a small fishing village whose entire vibrancy and economy are built around the small fishing sector. Whether it is the number of people employed, both onshore and offshore, or the ancillary services, such as oil deliveries, other service deliveries and food deliveries for the fishermen, all of it is intertwined. The whole community is totally dependent on the success of fishing.

A number of years ago the issue of discards and by-catch came to a head when fishermen from Kilmore Quay landed discards and gave them away. Many people believe that, as a consequence, they have been targeted by the SFPA, which is probably embarrassed. In any case, the perception is there, true or otherwise. I do not know of any fishing vessel that has had any serious charges made against it as a consequence of fishing.

When they landed the discarded fish and gave it away, this generated a wider debate among the public about how so many tonnes of good fish were being dumped overboard on a daily basis. It created that conversation and debate both within the country and further afield, and maybe they can claim some credit in regard to the negotiations around the proposals to try to alleviate the discards problem in the coming years, not to take anything away from the Minister, Deputy Coveney.

My point is that this is a community totally dependent on the fishing sector for survival. It is a very vibrant community and the fishing sector provides a lot of employment, onshore in particular. However, people who are trying their best to make a living are being handicapped by the lack of proper quota. All of this is contributing to the frustration and anger that is felt by the people involved in the sector, who are finding it hard to make a living. They have had a terrible time, with the whole fishing sector closed down from mid-December through to well into March, when nothing could happen because of the weather. As is well documented, there were the consequences of the storms, including their effect on the pier structures in the area. These people are just trying to make a living, not just for themselves but for the community.

The big problem is lack of quota. While it has been an ongoing problem for decades, something has to be done in order to ensure these people will have adequate quota to make a proper living and to survive in the industry. If they do not survive, that is another generation gone. It is this sector, not the big herring and mackerel sectors, that is suffering the consequences of very bad negotiations going back over the decades.

Minister for Agriculture, Food and the Marine (Deputy Simon Coveney)

I thank the Deputy for raising this issue. I know he is genuine in this regard as we have previously discussed his connection with the fishing industry.

Everyone wants more quota. Whether it is a whitefish boat, a mackerel boat or any other part of the quota fleet here in Ireland, everyone wants more quota. The quota for Ireland this year is more valuable than it has ever been at over €250 million, and it was something similar last year.

I will always try to maximise the quota opportunities for Irish fishermen. I will always talk this industry up and work with it to maximise employment and income opportunities for fishermen. However, I will not accept that because people are frustrated at a lack of quota, they can break the rules. Breaking the rules means that other people lose out. To be consistent with European law, the primary responsibility in terms of enforcement lies with the Sea Fisheries Protection Authority, SFPA, which is an independent law enforcement agency of the State. I do not get involved in its day-to-day operations, nor should I. It has a difficult job to do but its job is to provide a level playing field for everybody. If one boat, or two or six boats, are overfishing deliberately, that is not a victimless crime. It has an impact on others who are law-abiding and who are catching according to the quotas allocated to them when less quota is allocated the following month, because catches outside of quota count towards the calculation of the quotas allocated on a monthly basis, in a process in which the industry is involved. If we are unable to comply with the rules we negotiated last year, this also fundamentally undermines my position in December when I am trying to negotiate better quotas and improved total allowable catch, TAC, for fishing fleets around the coast.

The company at the centre of the case raised by the Deputy unfortunately has a history of non-compliance. Repeated infringements have arisen around quota, log books and sales regulations. There are some 54 files awaiting hearing before Irish courts. In 2013, the SFPA took the exceptional step of directing all of this company's vessels to port as a reaction to persistent non-compliance. Following a solemn undertaking by the company directors after a meeting I had with them to work within the requirements of the law, the company was allowed to resume fishing. However, less than a week later the infringements recommenced, and there have been six infringements detected on this company's vessels since the beginning of this year. SFPA officers have endured verbal abuse on an ongoing basis from the company's employees and directors in some cases and also, I am sorry to hear, from some public representatives simply for implementing EU and national law involving quota allocations recommended by the industry itself on a monthly basis.

The SFPA has an obligation under EU rules to link historical non-compliance with current levels of inspection. In other words, a risk assessment of boats is carried out in terms of likelihood of breaking the rules. The more infringements a boat has had in the past, the more inspections it will get in the future, until it proves that it is compliant over time. That is not a voluntary policy option for the SFPA. It is a requirement under EU rules.

There is a problem in Kilmore Quay. It is a great little town that relies on fishing. The companies involved here employ many people and they are a very valuable contributor to the economy in the south east, but we must apply the rules to everybody equally. The policing authority that ensures there is a fair playing field for every fisherman out there must apply the rules according to EU regulations. That means that the more infringements boats have had in the past, the more inspections they will get in the future in the medium term until the number of infringements changes. There is an onus here on everybody, and particularly on public representatives from all political parties, to be consistent in ensuring that we are implementing the rules fairly, so that everybody complies with the same rules. We cannot allow some people to do what they want because of frustrations with a lack of quota. That is what has happened here. I strongly support the SFPA in its efforts to ensure that everybody gets fair treatment. I want to encourage anybody who is breaking the rules to stop doing so because they are fundamentally undermining the industry when that happens.

Deputy Martin Ferris

I thank the Minister for his answer. As someone who was involved in the industry, I know the difficulties fishermen endure on a daily basis and the risks they take. I also know how difficult it is to be heavily in debt and trying to meet payments, by they to BIM or any other financial company. I am also very much aware of the responsibility that boat owners have to their crew and community. One would assume from the Minister's answer that these people are criminals.

Deputy Simon Coveney

No; that is not what I said.

Deputy Martin Ferris

He said they were breaking the rules. One would assume they were criminals. They are people out in the ocean fishing to make a living who have many obligations to live up to. It is not always possible to do so due to the weather or because they are unable to get their logs in on time. They could be minor misdemeanours. What I find impossible to understand is that there is a requirement under EU law for the SFPA to carry out more inspections on a person with a history. I think that is disgraceful. We are not talking about people who have done anything terribly wrong. They may be slightly over quota, may have had some discard on board or may not have logged in properly, but there are no serious charges against any one of these people that I know of.

Deputy Simon Coveney

They are not all small charges.

Deputy Martin Ferris

I do not accept that. There is no evidence against them. Go further south and one will found EU vessels that are probably never inspected.

Deputy Simon Coveney

That is not true either.

Deputy Martin Ferris

It happens off my coast.

Acting Chairman (Deputy Seán Kenny)

The Deputy is over his time.

Deputy Martin Ferris

There are EU vessels fishing off my coast which have not been inspected, while the local fisherman or fisherwoman finds him- or herself-----

Acting Chairman (Deputy Seán Kenny)

The Deputy is over his time.

Deputy Simon Coveney

I would love to continue this conversation with the Deputy. Perhaps I could do so afterwards, because this is something I feel very strongly about. The EU regulation in question, which is Article 98 of Regulation (EU) No. 404/2011, requires member states' controlled authorities to adopt a risk-based approach for the selection of inspection targets using all available information. It can be expected that if records indicate that an operator has a history of serious non-compliance, the operator will face additional inspections at sea and in port for a period of time until the records show that the operator has changed behaviour and is generally compliant. The records show that in 2013 and 2014, there were 66 infringements in the south eastern area of the country, 41 of which were associated with boats linked to the company whose concerns the Deputy is raising today.

Deputy Martin Ferris

What were the infringements?

Deputy Simon Coveney

I can get the Deputy a list of them. There are 41 of them, so I am not going to start listing them here today. I would like to think that there is nobody in this House who is more concerned about the future of the fishing industry than me. I worked tirelessly to ensure that we got the best possible deal in a Common Fisheries Policy. We have more than doubled our European Maritime and Fisheries Fund from the €70 million negotiated by the last Government to €148 million this year, and we will match or part-match that fund with Exchequer money, which needs to be negotiated over the summer.

Deputy Martin Ferris

Over how many years?

Deputy Simon Coveney

That is between now and 2020, until the end of the Common Fisheries Policy. The point I am making is that we want to support the fishing industry in Kilmore Quay and elsewhere, but we must ensure that people abide by the rules. If we do not ensure that and if people consider this a free-for-all, we will simply lose control of the management of stocks, we will have no fishing industry in the future and fishermen themselves will become deeply divided in terms of the way in which quotas are managed and fished. We need consistency here and we are trying to get it in Kilmore Quay. There is a problem in the south east from an enforcement and infringement point of view which needs to be resolved. Public representatives have a responsibility to help in that effort rather than frustrate it.

Child Care Costs

Deputy Robert Troy

I thank the Minister for taking this important debate. The affordability and accessibility of child care has been brought to my attention - and, I am sure, the Minister's attention - time and again by parents, professionals working in the area and various early childhood sector stakeholders. The 2014 report Key Data on Early Childhood Education and Care in Europe, published jointly by Eurydice and EUROSTAT, is the latest in a long list of reports that cast a worrying focus on the affordability and accessibility of child care in Ireland. One of the key findings in the report is that at all income levels, the cost of early childhood care and education services in Ireland is among the highest in the OECD. In previous reports, it was highlighted as the second highest. In some cases, the cost outstrips parents' weekly mortgage bills.

Earlier, the Society of St. Vincent de Paul, in a pre-budget submission to my party, cited the cost of child care as a cause of deep financial strain for suffering families. It also stated that this acted as a barrier preventing people, particularly women in low-income families, from returning to the workforce. This needs to be addressed quickly, because access to high-quality and affordable child care has a major positive impact on a child's future educational and life chances. This is a well-accepted argument across the political divide, but we also need to be highly cognisant of connecting factors in the child's life, the critical importance of the family environment, welfare dependency, mental health issues and child poverty. Unless we look on both the quality of child care and family support as inseparable, success may prove too tall an order for each in isolation.

Ireland currently only spends 0.2% of GDP on pre-primary education. The Nordic countries are often referenced for comparison; Sweden spends 0.7% of GDP in this sector, while Denmark spends 0.8% of GDP. At a time of financial constraint, we need to gradually increase in our investment in this area. We must begin by adopting a targeted approach to provide greater supports to middle- and low-income families that are finding it difficult.

Prior to the Minister's taking office, my party tabled a Private Members' motion earlier this year on investment in child care and affordability. It is important that, no matter what policy initiatives are taken to address this key issue, the quality of our services is never undermined. They must be of paramount consideration. Earlier this year, a nationwide report commissioned by the Donegal County Childcare Committee brought forward fully costed proposals to address this issue for the future. At the time, the Minister's predecessor, Deputy Fitzgerald, who launched the report and who lauded and complimented it, promised to give attention to its contents. She promised to review the two schemes in place to support low-income families in respect of child care provision, including the early childhood care and education scheme. Will the Minister outline what his Department has done over the past six months to address this crucial issue?

Minister for Children and Youth Affairs (Deputy Charles Flanagan)

I thank the Deputy. I welcome very much the publication of this report, which provides most useful comparisons on the structure and organisation of early childhood education and care in the countries that comprise the European Union. This most comprehensive report has only recently been published and it will require careful consideration by officials in my Department.

The report provides a European-level analysis of progress in the development of early childhood care and education across the region. It covers a wide range of issues relating to early child care provision, including governance, accessibility and affordability, and is based on information provided by 32 European countries.

In Ireland, early childhood care relates to children in the age range from zero to six and is provided through private commercial and community services. We assist parents by ensuring that there is sufficient quality infrastructure and by providing support funding which enables parents to access high-quality child care services. The Government provides approximately €260 million annually to help parents with the cost of child care. This funding is provided through a number of targeted programmes which benefit approximately 100,000 children each year. In many cases these supports are provided based on the income level or social welfare entitlement of the parents and are not universal supports.

Many European countries provide early years places for children by establishing a legal entitlement to or by making compulsory one pre-primary year. In Ireland, the introduction of the free universal early childhood care and education, ECCE, programme in 2010 was major milestone in the development of early childhood services in this country. The programme represents an annual investment of almost €175 million and ensures that approximately 68,000 children have guaranteed access to high-quality preschool services each year.

The report highlights the diversity of child care services throughout the European countries. It highlights aspects of child care provision in this country which could be considered to be in the lower half of the European league. In Ireland, before 2010, the emphasis was on ensuring there was sufficient infrastructure to meet the increased demands of the expanding Irish economy. The considerable capital investment made in this area between 1998 and 2010 has ensured that there is sufficient child care infrastructure, and the emphasis must switch to addressing quality issues and providing services that are affordable and accessible to this and future generations of Irish children.

Some of the issues raised in the report have already been identified in the early years quality agenda which is being advanced by my Department and on which considerable progress has been made. For example, on the issue of qualifications of staff working in the child care sector, the report highlights the fact that Ireland is one of two countries where no minimum formal qualification is required. The matter has been addressed and the necessary legislative changes are coming into place to ensure that by 2015 all staff will have a minimum level of educational qualification if they are to work directly with children in the child care sector.

The early years quality agenda is designed to ensure Irish children will be in a position to enjoy standards of care and education in Irish preschool settings that are on par with the best international standards. The provision of funding to support the new learner fund to assist staff in securing the new qualification requirements and the further funding allocated to support a specialist support service for child care providers are examples of the urgency the Government attaches to improving the quality of child care services. Considerable progress has been made during the past 15 years in the development of child care services. Opportunities to further develop the child care sector have been limited because of the prevailing budgetary situation, as Deputy Troy and others will accept. However, the progress made since 2010 represents a clear commitment to improving access to high-quality child care. While we have a distance to travel, we must be satisfied that our services match the best in Europe.

Deputy Robert Troy

While I welcome the fact that the Government acknowledges that much progress was made during the past 15 years, during the past three years, unfortunately, the Government has pursued an anti-family agenda. Last week, the one-parent family payment cut-off was reduced to seven years of age. Of the 6,000 places available under the after-school scheme, which was introduced to alleviate this and of which we spoke last week during Question Time, only 40 have been taken up. The Government has reduced child benefit and announced it would tax maternity benefit one week after launching a report that recommends extending maternity benefit to one year.

I asked about affordability in particular. Will affordability be addressed in the early years strategy? When will the strategy be published? Has the Department started the review of the community child care subvention, CCS, and child care education and training support, CETS, schemes? While the Minister is working under tight financial constraints, the Indecon report commissioned by the Donegal County Childcare Committee puts forward three very realistic proposals that would ensure a targeted approach to ensuring affordability for middle-income and low-income families. One of these proposals was to extend the CCS scheme, which is capped and restricted to community providers. The previous Minister, Deputy Fitzgerald, agreed to review the proposal. Will the scheme be extended to private providers and will the cap be lifted? Will the Minister, with his colleague, the Minister for Social Protection, consider addressing child care through the family income supplement? We must stop paying lip service to this extremely important societal issue and introduce policies to address this critical problem.

Deputy Charles Flanagan

The expenditure of €260 million annually cannot be regarded as lip service. Deputies will be aware of the very stringent financial parameters within which we are operating. I accept the Deputy's point that the Donegal report is a most valuable piece of evidence and it feeds into the review under way in my Department. The issue of early childhood education will be a priority not only for my Department but for the whole Government as part of its programme for the remainder of its term. Deputy Troy has agreed with me that quality is important, that progress has been made over the years on infrastructure and that we need to examine standards and personnel in the provision of education to ensure a minimum standard across the board. We must provide access to high-quality universal education that is particularly geared towards those on low incomes and is most affordable to those who engage in the process.