I ask Deputy Seán Kyne to defer the Topical Issue matter he raised.
Topical Issue Debate
In the absence of the Minister, Deputy Kelly, and the Minister of State, Deputy Paudie Coffey, I will defer until Wednesday.
That will be deferred. I ask the Minister, Deputy Varadkar, if the Minister will be available next Tuesday or Wednesday.
Yes. I do not know what day it will be but it will be next week.
Deputy Kyne is happy with that. I call Deputy Terence Flanagan.
Anti-Social Behaviour
I thank the Ceann Comhairle for giving me the opportunity to raise this very important issue and the Minister for Justice and Equality for being here to hear about it. Anti-social behaviour in Dublin city centre is an obvious problem, particularly around O'Connell Street, which is our premier street in the city centre along with Grafton Street. Tourists coming from abroad are getting a very bad impression. I am particularly concerned about the amount of drug taking and the negative impact of that on businesses in the city centre. Some constituents have contacted me to say they are scared going around different parts of the city centre. They are being approached and there is an element of aggressive begging, as mentioned recently in an edition of "Prime Time". Some Dubliners do not feel safe in the city centre. The problem here seems to be worse than in some other capital cities. Obviously, the Garda does a lot of hard work on the ground. Community policing has become the new norm in many areas and a lot of good work is done. However, we need to ensure that there is dedicated policing for our city centre streets to target drug dealing in particular. People want to see more Garda patrols not just in the city centre but around different parts of the city. Obviously, I welcome the fact that there will be more gardaí on the beat to do that. That is a good result.
New York City, which had a major problem over the past number of decades, has cleaned up its streets and has been successful in a number of strategies it adopted to target outdoor drug dealing. It also has the stop-and-frisk policy. I am not saying that we need to adopt all these strategies, but could we look to other cities which have been successful in cutting down on the element of anti-social behaviour that can take place in all cities?
One proposal I made to the gardaí at Store Street Garda station was that a Garda shed or booth should be available on O'Connell Street to ensure more of a Garda presence. Certainly, one should see a Garda within a certain distance in major cities. Having visited Paris, I know there are always mobile police units around which are available to respond to various crimes that may be committed. Has the Minister looked at this measure?
I am glad to see the Minister for Health here. We know that the budget for local drugs task forces has been retained in the most recent budget. This is good, but more could be done for people who find themselves in difficulty, particularly those who are addicted to drugs and who use crime to feed their habit. I do not remember the situation being as bad five or even ten years ago. The situation has escalated and this issue needs to be examined. I know zero tolerance has had a bad name because of other Governments which abused the word, but a zero-tolerance approach is needed in the city centre to ensure that people feel safe, encourage more tourists into the city centre and ensure that businesses do well.
I am grateful to the Deputy for raising this important matter for debate. I am, of course, very much aware of the concerns about crime and anti-social behaviour in the city centre and the potential impact for all who live in, work in and visit our capital city. Of course we want our capital city and its thoroughfares to be safe and secure places for the residents of Dublin and our visitors. As the Deputy will be aware, the Garda Commissioner is responsible for the deployment of Garda resources. However, as Minister for Justice and Equality, I am committed to supporting An Garda Síochána in providing a strong, visible policing presence in communities right across the country in order to help reduce crime. This includes Dublin city centre.
There is a Garda plan in place which is called the Dublin City Centre Policing Plan. I welcome this important plan. The Deputy spoke about zero tolerance. The vision expressed in the plan is to create a safe city to live, work, visit and enjoy, with Garda operations following the principle that no offence or behaviour will go unnoticed or unchallenged. In implementing the plan, the Garda approach includes dedicated high-visibility, uniformed patrols in key commercial and public thoroughfares. That is what we want to see, and we want to see more of it. A number of targeted city centre policing operations are in place. Operation Pier concentrates on the south quays, an area about which many people speak, and the Temple Bar area while Operation Spire is focused on O'Connell Street and the north inner city. There is also a specific public order unit which operates on a reactive basis as the need arises. Gardaí have also conducted a number of targeted operations in respect of the effects of begging in the area, particularly aggressive begging, which is very upsetting for people and which I am sure has been mentioned to the Deputy as well.
Gardaí have increased their activity in targeting the supply of illegal drugs in the area, with increased numbers of drug seizures and searches. According to the provisional statistics from the Garda Síochána Analysis Service for the first nine months of the year, the total number of drug searches has increased by 5% in the North Central (Store Street) division and by 24% in the South Central (Pearse Street) division. I also wish to acknowledge the work of An Garda Síochána, including work with the entertainment and night-time sector, in seeking to address problems of disorder associated with the abuse of alcohol. This remains a very serious issue in our society generally. Huge Garda resources must be deployed to support this effort, with a dedicated public order patrol van assigned to the city centre every Friday and Saturday night.
The Garda is very active. The latest provisional statistics collated by the Garda Síochána Analysis Service for the first nine months of the year show a positive trend. It is important that I put this on the record, because we do hear about a lot of particular incidents, but public order offences are down 7% in the South Central (Pearse Street) Garda division and down 19% in the North Central (Store Street) division. There is a very active police presence, which is having a deterrent effect.
I will be the first to say that we should not rely solely on statistics, but neither should we allow high-profile reports of individual incidents to cast our city in an unfairly negative light. We need a fair discussion about this. What is most important is the first hand, day-to-day experiences of shoppers, visitors residents and workers, who should feel safe in the city centre at all hours. I acknowledge that challenges remain to be addressed but I am confident that the ongoing efforts of the Garda and others will make a positive difference.
Our commitment to policing was very clearly demonstrated in the budget 2015 announcement on increased expenditure in the justice sector. This week I also announced that the Garda college in Templemore would take in 200 new recruits, which means that we will have 300 new recruits in 2015. A further 75 gardaí will be freed from their current airport duties because this work is being civilianised, and 75 gardaí who work on border and visa issues will also be freed up. This will provide a total of 450 gardaí who can contribute to the active policing of our communities. The budget also provides funding for the purchase and fit-out of more than 400 new vehicles which will offer a more visible Garda presence in all areas, including Dublin city centre.
The anti-social activities that the Deputy described are not simply policing issues. The context for finding solutions must involve Dublin city management, drug treatment centres and the business community. Tackling homelessness will have to be a part of the solution. My colleague, the Minister for the Environment, Community and Local Government, has allocated an additional €10.5 million to deal with homelessness. I commend Dublin City Council on the leadership it has shown in working with the Garda and facilitating the Dublin city joint policing committee, which includes a range of stakeholders whom I intend to meet at an early opportunity to investigate how I can further support these ongoing efforts to deal with the issues outlined by the Deputy.
I thank the Minister for her response and welcome the new Garda recruits, who are badly needed. Gardaí on patrol are experiencing considerable pressure and low morale at times. Can some of the new recruits be deployed to city centre type activities? The Garda Reserve should also be more visible. I ask the Minister to comment on the increased use of the reserve. People want to see gardaí on the beat, especially on our main streets, because it helps them feel safer and more confident. Businesses are suffering a negative impact from the number of people who are either begging or are drug addicts. These people need extra services. The poverty problem is an important part of the reason people go begging.
In regard to sentencing, there are people walking our streets who have received 100 or more convictions. The revolving door is a big problem in this regard, particularly where people persistently commit offences and are still walking the streets. Would the Minister consider anti-social behaviour orders as a measure to target certain people and stop them engaging in anti-social behaviour? Rehabilitation services for drug addicts need more money. As the Minister for Health has a lot on his hands, the Government should consider appointing a Minister specifically to deal with drugs and alcohol because these are key areas.
I ask the Minister, Deputy Fitzgerald, for her assurance that she will investigate solutions to the issues arising for policing and improving the quality of the environment in the city centre, which we have to face every day.
I take note of the Deputy's comments. The context for finding solutions must encompass a co-ordinated approach from State agencies involved in social housing, health and drug treatment services, as well as through partnership with business, community and voluntary groups. I support the multi-agency approach to tackling this issue.
I agree with the Deputy that we must ensure the city centre is a safe place for residents, workers and visitors. I intend to meet shortly senior gardaí and members of the Dublin city joint policing committee and its associated stakeholder groups with a view to identifying how I can further support and strengthen these ongoing efforts to enhance the policing and public safety of the city centre area. The centre of our capital city is important not just for those of us who live there but also for the many people who travel there to work, shop and enjoy their leisure time. It is also important from a tourism perspective. I share the Deputy's general concern that we must make every effort to promote a safe and welcoming environment in the city centre. I have discussed the matter with the acting Garda Commissioner on a number of occasions. I raised it most recently when I met her earlier today to discuss other issues. The number of gardaí who should be deployed to the city centre is an operational issue but clearly there are big demands in that area and I am sure the Garda will make the best decisions in deploying the new recruits. It is important we send the message that Dublin city centre can be safe and secure.
Will the Minister comment on the Garda Reserve?
We can examine that.
Orthodontic Service Provision
I thank the Minister for Health for coming into the Chamber to respond to this Topical Issue matter. The parents of children in my constituency who are on orthodontic waiting lists for treatment at the dental clinic at Ashtown Gate, Navan Road, have been notified recently that they can transfer to the waiting list at the orthodontic unit in Louth County Hospital in Dundalk. This would involve not only considerable travel costs, particularly as orthodontic treatment can involve several return visits to the dental clinic, but also consume considerable time for children and their parents. I will read a letter which one of my constituents received last week from the orthodontic service at Ashtown Gate, because it takes an interesting tone. The letter reads:
Dear Parent or Guardian,
We are now in a position to offer [Jack] an orthodontic treatment place in the Orthodontic Unit, Community Care Building, Louth County Hospital, Dundalk, County Louth if you are willing to travel to Dundalk for the duration of the treatment.
Please note that [Jack's] complete orthodontic treatment will take place in Dundalk and patients who commence their orthodontic treatment will not be able, under any circumstances, to transfer back to the orthodontic unit at Ashtown Gate. If you accept this treatment place [Jack's] record will be forwarded to the Orthodontic Unit in Louth County Hospital and the orthodontic staff in Dundalk will be in contact with an appointment by post within the next four to six weeks.
Please confirm if you wish to avail of this treatment place in Dundalk or remain on the waiting list in Ashtown Gate by completing the section below and returning it to the above address. I cannot give you the waiting time for orthodontic treatment in Ashtown Gate.
Please respond immediately on receipt of this later and no later than two weeks from the date at the top of this letter to indicate your preference for treatment.
Please note a complete orthodontic treatment typically equates to approximately 30 to 40 visits to the Orthodontic Unit in Dundalk over a period of two to four years. It is imperative that you attend all of these appointments punctually. Failure to do so may result in you being removed permanently from the orthodontic list.
The letter is signed by the manager of orthodontic services, HSE Dublin north-east. The tone of this letter is interesting. In effect, it is putting a gun to the patient's head.
As Jack's parents found this notification disturbing, I wrote to the director general of the HSE asking him to review the orthodontic clinic location for children in Dublin city north of the Liffey to find a more convenient location for a dental clinic. Today, I received a reply from Mr. O'Brien's office to tell me that my correspondence had been referred to the HSE's parliamentary affairs division. This response is not good enough, which is why I have sought to raise the matter in the House as a Topical Issue matter. I ask the Minister to intervene with the HSE as a matter of urgency to find a more accessible orthodontic health treatment clinic for the Dublin region north of the Liffey.
I wish to thank the Deputy for the opportunity to address the issue of orthodontic services. I am taking the debate on behalf of the Minister of State in my Department, Deputy Kathleen Lynch, who is attending to business elsewhere.
Orthodontic treatment is provided by the HSE to patients based on their level of clinical need. The HSE provides orthodontic treatment to those who have been assessed and referred for treatment before their 16th birthday. Patients are assessed by the HSE orthodontic service under the modified index of treatment need. Patients with the greatest level of need are provided with treatment first. The HSE endeavours to provide patients with services close to where they live. Occasionally, when there is capacity to provide this treatment sooner in another centre this option is offered to patients. In this way, patients on a waiting list who live in Dublin may be offered treatment in Louth County Hospital. Should they choose not to avail of this option, treatment will still be provided in Dublin. Most patients - approximately 75% - who are given this option choose to accept it. At the end of the second quarter of 2014, a total of 23,982 patients were in treatment, 6,658 were awaiting assessment and 16,518 were awaiting treatment. While patients with greatest need are given priority, long waiting times for orthodontic assessment and treatment are a matter of concern for my Department and the HSE.
The HSE commissioned an independent review of orthodontic services in 2012. The key issue highlighted by the review, which assessed services nationally, is that the orthodontic service should be fully integrated within the primary care service. This recommendation will be implemented as part of the HSE's wider reform programme. The HSE has also recently established a pilot scheme which will involve the use of orthodontic therapists. The HSE Dublin north east, or DNE, orthodontic service has been chosen as the pilot area for this new and innovative training programme. One member of the dental hygienist staff and one member of the dental nursing staff commenced this training in September 2014. During the course of their training, the students will work under the direct supervision of specialist orthodontists currently working in HSE units in the Dublin north east region in the treatment of a select number of children eligible for HSE funded orthodontic treatment. In addition, orthodontic treatment for certain categories of misalignment will be provided over the next three years by a panel of independent practitioners under contract to the HSE. A tender process is underway and provision is due to commence in 2015. It is expected that these changes will have a positive impact on waiting times and on the services available to patients.
I have a copy of the standard letter sent out to patients which Deputy Kenny's constituent would have received. The only thing that is wrong with its tone is that it does not give an indication as to where a person is on the waiting list for Ashtown Gate. If it did, parents could make an informed choice as to whether to wait it out at Ashtown or go to Dundalk. I am very familiar with Ashtown Gate as the service which serves my own constituents and is located in my own constituency. It is not practical or appropriate for me to start deciding where clinics should be located for reasons the Deputy will appreciate.
The reason the policy is pursued is a good one. In the HSE Dublin mid-Leinster area, there is only one person who has been waiting more than seven months for assessment yet there are 556 children in the Dublin north east area waiting between six and 12 months for assessment. If it is not possible or we do not have the resources to bring waiting lists down everywhere, does it not make sense and is it not fairer to allow people who live in an area where there is a very long waiting list to choose to transfer to an area where there is a low or no waiting list? That is why this is being done. It is an attempt to provide some equity across the regions so that people do not face excessive delays just because they happen to live in the wrong place.
I thank the Minister for his response. The letter from the HSE does not tell the parents of Jack where he stands in regard to the Ashtown Gate waiting list and therefore, as the Minister says, they cannot make an informed decision. If they thought they could get treatment sooner by going to Dundalk perhaps that would change things. However, the problem is that Jack's father is in full-time employment while his mother is a person with Crohn's disease. It would be difficult for her to travel with her son to Dundalk for what we are told may be treatment requiring 30 to 40 visits. It is quite expensive to purchase a return train fare from Kilbarrack to Dundalk for a child and an adult and it would amount to a significant sum for 30 to 40 trips. There is also the question of the health of Jack's mother.
The policy of the HSE is not focused on the needs of the particular client and his or her family. As the Minister pointed out, there is no information in the letter as to whether they would be better off remaining on the Ashtown list. The implication of the letter is clearly that they will be seen more quickly if they go to Dundalk but it does not say that directly. In the absence of definite information, the family is in a quandary. To have to go to Dundalk for 30 or 40 visits would pose difficulties for the family. I am disappointed with the director general of the HSE who did not take up the points I made and simply referred the matter to someone else. I would appreciate it if someone could persuade the HSE to give more information to children like Jack as to whether they would be better off staying on the Ashtown Gate list or seen more quickly by going to Dundalk.
The figures I gave the Deputy earlier related to the time it takes to get assessed. In fact, HSE Dublin north east is better than Dublin mid-Leinster. One is assessed more quickly in the former but gets to the treatment stage more slowly. Of the 4,000 cases in HSE mid-Leinster, only 87 have been waiting more than two years whereas 748 of the 3,786 cases in HSE Dublin north east have been waiting for more than two years. However the Deputy's point is well made. It is right to give people the option to travel a certain distance to get better treatment but we should allow parents to make an informed choice as to how long they may have two weight if they do not accept the offer of going to another location. It is certainly something I will take up with the dental section of the HSE. That is a fair point.
I note, however, that no matter where one draws the boundaries, there will always be some issues. As politicians who deal with constituency boundaries, we know that well. There will be people who live in parts of Meath who are just as close to Dundalk as they are to Ashtown Gate. The offer to go to Dundalk may even be more convenient for them. That is just the nature of boundaries and catchment areas.
As the fourth Topical Issue matter has also been deferred, the Dáil will adjourn.
The Dáil adjourned at 5.20 p.m. until 10 a.m. on Friday, 17 October 2014.