Dáil Éireann debate -
Wednesday, 21 Jan 2015

Vol. 864 No. 2

Topical Issue Debate

Water Supply Contamination

Deputy Fergus O'Dowd

This is a very serious issue, not just for my own constituency, but for adjoining constituencies North and South of the Border. Last week, the Sunday Independent, in a very important article by Jim Cusack, pointed out that there is significant pollution of the drinking water supply to parts of counties Monaghan and Louth, particularly the River Fane in Dundalk. The article states that up to 60,000 homes are served by water from this lake. The problem is that vile, carcinogenic substances, put in, as the article states, by former or present members of the IRA, are coming into the water. They are poisoning the environment. It has the potential to kill, in terms of the toxicity itself, and to pollute the water supply.

We need to deal with it under two headings. The first is to deal with the public health issue. Will the Minister bring the urgent need to test all the drinking water supplies from these sources to the attention of the Department of Health, his own Department, the EPA and the Northern Ireland authorities? We must be reassured that there is no threat to public health and that neither is there a long-term threat caused by the carcinogens identified by the Sunday Independent, which can affect children in the womb and the genetic material people have at birth. The key issue is to reassure them. Louth County Council reassured the public yesterday on that matter, but there is deep long-term concern about this, because this criminality has been going on for many years. It is an absolute disgrace.

Second, the political solution is for the Minister, the Minister for Justice and Equality, and the Minister for Health to get together with their colleagues in the North, because the pollution in this case is in South Armagh.

An Leas-Cheann Comhairle

Go raibh maith agat.

Deputy Fergus O'Dowd

I am sorry. I have two minutes.

An Leas-Cheann Comhairle

The Deputy's two minutes are up now. He will have a further minute presently.

Deputy Fergus O'Dowd

It is important that we meet on the matter politically, North and South. It is important that all Deputies from all parties meet our Ministers, North and South, to get a resolution and to stop the pollution and poisoning of our water supply, North and South.

Deputy Seamus Kirk

I thank the Ceann Comhairle for the opportunity to raise this most important issue. The fact that Oireachtas representatives from Cavan-Monaghan and Louth are in the Chamber to speak on the matter illustrates and underlines the gravity and seriousness of the situation. The report in the Sunday Independent that the water supply for Dundalk was being contaminated came as a shock to many people in the town and surrounding areas. A population of approximately 40,000 to 50,000 is supplied directly from this modern water supply system. I understand the Cavan Hill facility was put in place in the late 1980s and that pumping and water extraction from the River Fane occurs at Stephentown Bridge. It was an urgent and much-needed supply at the time it was built. The survey work ordained that the Lough Ross and Lough Muckno catchment would be the ideal source and that the River Fane would carry the water towards Dundalk until it was extracted from the river. The Lough Muckno and Lough Ross water source is vital to the town's current and future needs. It is not only important for the domestic supply needs of the population in the area as the prospect of industrial development in the town will be dictated and determined by the availability of a good quality constant dependable water source.

The suggestion that diesel sludge was seeping into the streams flowing into the Muckno catchment came as a bolt from the blue. The Environmental Protection Agency must descend on the area immediately. Forensic testing of water quality must be undertaken and must be continued on a regular basis to provide reassurance for the consumers. At a meeting of Louth County Council last Monday the officials provided some reassurance to members, but the reality is that these toxins are flowing into the river and there is a cumulative effect. In the longer term there will be serious implications for users and consumers.

Deputy Seán Conlan

This is an important issue and it has been ongoing for many years. The report in the newspaper last Sunday did us a service because it highlighted the fact that the samples taken at Lough Muckno near Castleblayney, County Monaghan, were over 8,000 times above safe limits.

If there are carcinogenic toxins contained in the water supply we should not have to rely on a newspaper to provide us with that information. The EPA should be undertaking daily tests until the problem is resolved and the people responsible are dealt with.

People are fearful about the effect this is having on their families and health. It is not a new problem; it has been ongoing for many years but it has not been tackled or dealt with to date. It is important, therefore, that daily tests are carried out and proper information is given to the public. The public are scared at the moment and they do not know what is going on. Save for the information supplied in the newspaper report we would still be in the dark about the level of toxins in the water. According to reports, some of the toxins cause heart malformations in children and premature delivery. These are serious issues.

There are approximately 10,000 people in the catchment area in south Armagh and a further 40,000 people in the Dundalk area directly affected by the pollution in Lough Ross and the Fane river. Furthermore, Lough Muckno is a major amenity in the area and an area of natural beauty in Monaghan.

People are concerned. Acid sludge is being dumped alongside riverbanks in containers on a regular basis. It is costing the county councils in Louth and Monaghan vast amounts of money to deal with the problem. The lack of information provided to the general public on the level of toxins in the river and the water supply is concerning. Immediate action should be taken by the EPA to provide information to the public on a daily basis. If there is a discharge into Lough Muckno, Lough Ross or the Fane river it will have an immediate effect on the quality of the water supply. We need updated information on a regular basis from the EPA. The agency must get on top of this problem, find out where it is coming from and determine the source. Action needs to be taken by the authorities on both sides of the Border to deal with this matter immediately.

Deputy Brendan Smith

I appreciate the opportunity to speak on this important matter. The report in the Sunday Independent was alarming and is of serious concern to people in the north east. The report contained details of fuel smugglers pumping massive volumes of toxic waste linked to cancers and abnormalities in unborn babies into water supplies in our State. The highly respected security correspondent of the Sunday Independent, Mr. Jim Cusack, has done a good service by outlining in great detail these irregularities. As my colleagues have stated already, it is frightening to think that this waste is being pumped into major waterways, such as Lough Muckno and Lough Ross in County Monaghan as well as the Fane river. The report contained details of a sample of water taken by a representative of the Sunday Independent which was shown to contain 8,000 times more chemical pollution than clean drinking water. It is frightening and absolutely unacceptable. The agencies of the State must take every action possible to put a stop to this hideous behaviour.

Those of us living in the Border counties know about the additional costs to local authorities as a result of cleaning up roadways where people illegally smuggling diesel have spilt it as well as the vast cost to the Exchequer. To my knowledge, the agencies in our State, whether an Garda Síochána or the Revenue Commissioners, have been most diligent in pursuing this illegal activity. I hope that the authorities North of the Border are as diligent in pursuing these criminals and gangsters, who are doing untold damage to the people and the country's environment.

Minister of State at the Department of the Environment, Community and Local Government (Deputy Paudie Coffey)

I thank all of the Deputies for raising this serious matter. I am taking this matter on behalf of the Minister for the Environment, Community and Local Government, Deputy Alan Kelly. Like the Deputies who have spoken, I am also concerned about the reports of alleged pollution discharge at Lough Ross, County Armagh, entering the River Fane system. As we all know, this is the primary source of the drinking water supply for Dundalk. Deputies have referred to media coverage to date, which has covered the losses to the Exchequer as a result of this illegal fuel laundering as well as losses to the taxpayer and the loss to individuals who have had their engines and cars wrecked. However, the issue has been elevated to a far more significant level now, as outlined by the Deputies, because of the very real threat to human health that this alleged pollution could potentially cause. My Department and I recognise that this is a serious issue. It is totally unacceptable and should concern all Deputies of all sides in this House.

I understand that Louth County Council on behalf of Irish Water has already contacted the water pollution inspectorate in Northern Ireland to investigate this specific allegation. The council carries out regular sampling at various properties throughout the water distribution system for Dundalk and drinking water sample results for 2014 are fully compliant with the drinking water regulations.

The Local Government (Water Pollution) Acts carry a general prohibition on the entry of any polluting matter to waters. Any persons causing or permitting polluting matter to enter waters is liable, on conviction on indictment, to a fine not exceeding €15 million or imprisonment for a term not exceeding five years, or both. The primary responsibility of ensuring prevention of water pollution rests with local authorities, which are, in turn, supervised by the EPA for this purpose. Water inspections account for about half of all local authority inspections.

Local authorities issue hundreds of enforcement notices every year under section 12 of the Local Government (Water Pollution) Act 1977, as well as section 23 of the Local Government (Water Pollution) (Amendment) Act 1990. These enforcement notices require respondents to carry out actions to prevent or remedy water pollution. They are followed up by prosecutions where necessary. Prosecutions are also taken for allowing polluting matter to enter waters or in respect of licensable discharges.

Enforcement relating to illegal diesel laundering activities is primarily a matter for the Revenue Commissioners from the point of view of avoiding loss of revenue to the Exchequer. However, the Department of the Environment, Community and Local Government assists local authorities in carrying out their role as competent authorities under waste legislation. This role involves taking the necessary measures on behalf of the State to ensure that any waste generated and left abandoned by diesel launderers is disposed of without endangering human health and without harming the environment and, in particular, without risk to water.

I assure the Deputies present that the Department of the Environment, Community and Local Government will assist the local authorities and the EPA to take whatever steps are necessary to stamp out this illegal practice which, as the Deputies have outlined, is a threat to human health.

Approximately 1,200 incidents of diesel laundering waste dumping have been dealt with by local authorities since 2008 and to date the Department has reimbursed all of the costs associated with such disposal on a case by case basis. Almost half of the clean-up operations have taken place in County Louth alone with 596 incidents having been dealt with there at a cost of approximately €4.8 million to the State. This is significant expenditure, borne at present by the environment fund. The Department, as part of ongoing co-operation with the Northern Ireland authorities on the repatriation of illegally deposited waste in Northern Ireland, has held recent discussions with authorities in Northern Ireland on the need to develop a mechanism for dealing with waste from cross-Border diesel washings which would be factored into the overall discussions on waste repatriation. These discussions are ongoing.

A complete solution to this problem must necessarily involve effective and co­ordinated enforcement of the law from both a Revenue and waste management perspective. The Minister has committed to meeting his counterpart in Northern Ireland, the Minister for the Environment, Mark Durkan, MLA, to highlight the problems being faced in the Border counties represented by the Deputies here today. This is a matter of the most serious concern for the Department and I assure Deputies that the Minister is treating this as a matter of priority. He will be taking this issue up with his Northern Ireland colleagues and urging them to give it the same priority.

Deputy Fergus O'Dowd

I wish to correct one thing the Minister of State said - it is not "alleged" pollution. While I appreciate that he did not write the reply, it is not "alleged" but real pollution. It is measured, shown in the video and it is a disgrace, as the Minister of State said. I agree with the action the Minister is taking in meeting his colleague in the North. However, we need to go further. As representatives of two different constituencies South of the Border, we should meet the Minister for the Environment, Community and Local Government and the Minister for the Environment in Northern Ireland, Mr. Durkan. That will show that it is not just the administration which is rightly and properly fully engaged in this. We, as Members of the Oireachtas, say "No" to the pollution of our drinking water and "No" to the poisons that are being discharged into the water supply for Dundalk. Deputy Kirk is exactly right on that. We are also saying "No" to the extremely negative effects on the future of our environment and the creation of jobs. I would suggest that we get together afterwards, meet the Minister for the Environment, Community and Local Government and go up North to meet the Minister, Mark Durkan, MLA, and the public representatives from south Armagh to view the situation on the ground and to say, "Let it end forever". That is what this is about - finishing it off for good.

Deputy Seamus Kirk

I concur with Deputy O'Dowd and if a meeting is arranged with the politicians who have collective responsibility in this area, l certainly will attend. This is a vitally important issue that must be addressed urgently. It seems to me that there is a need for more co-ordination of the various agencies with specific and less specific responsibilities in this area. A structure must be put in place to ensure that there is tight, effective and efficient co-ordination of their work. This is a large water scheme and the distance between Castleblayney, Stephenstown Bridge and Cavan Hill is considerable. The river is flowing, with streams flowing into both Lough Muckno and Loch Ross, which means that the potential for pollution coming from different sources is quite significant. We need a monitoring guardian angel arrangement for the supply catchment and the river and a constant monitoring of the quality of the water.

Deputy Seán Conlan

To add to what Deputy O'Dowd has said, it is important that the Minister for the Environment, Community and Local Government, Deputy Kelly and the Northern Ireland Minister for the Environment, Mr. Durkan, visit the area in question. The Minister of State said in his reply that the sample was taken from south Armagh but it was not; it was taken in Castleblayney in County Monaghan. Therefore, it is primarily the responsibility of our Minister for the Environment, Community and Local Government and the EPA. I want them to be on the ground, checking out the river where the pollution took place to determine exactly the cause of the problem. These are not just allegations - there is video evidence and samples were taken and tested. The test results confirmed that there were over 8,000 times the safe limits for toxic pollutants in the water in that location. It would be very helpful if the Minister visited the area immediately to see exactly what is going on. It would also be very helpful if the Deputies from both constituencies and the representatives from south Armagh were on the ground too, with both Ministers, to get a proper handle on the situation. As we have said, it has been going on for far too long. It is very concerning and we should not have to depend on newspaper reports to get information.

Deputy Brendan Smith

It has been estimated that the revenue loss to our State amounts to approximately €150 million per annum. That is probably an underestimation, given the extent of this illegal activity over the past number of years. The Fianna Fáil councillor P.J. O'Hanlon, from south Monaghan, told me that he has had numerous calls from people in the Castleblayney area who are very concerned about this. Councillor Padraig McNally has also had numerous calls and I am sure every other public representative in south Monaghan will report the same.

I concur with Deputy O'Dowd's suggestion that the public representatives, North and South, in the affected areas should meet. I would also suggest, in reference to the proposed meeting between the Minister for the Environment, Community and Local Government, Deputy Kelly, and the Northern Ireland Minister for the Environment, Mr. Durkan, that they should have a high-level meeting involving the Garda Síochána, the PSNI, the Revenue Commissioners and their counterparts North of the Border as well. We must be assured that the agencies North of the Border are as diligent in pursing this illegal activity as our authorities have been. Over the years this has been a matter of absolute frustration for all of us. Apart from the very important issues of the loss of revenue to the State and the fact that illegal activity is going on, in many instances money has been used to clean up roads to make them safe after diesel spillages when that money could have been put to far better use. God knows how many accidents have happened as a result of diesel spilled on our roads, causing injuries to many people. This is an issue that must be prioritised and dealt with in the most urgent manner possible.

Deputy Caoimhghín Ó Caoláin

I wish to highlight the unanimity among the elected representatives across the constituencies affected. I have tabled a parliamentary question on this matter to the Minister for the Environment, Community and Local Government and await his response. I am in full concord with the sentiments expressed by the Members here with regard to this most vexed issue.

Deputy Paudie Coffey

Deputies have already outlined the seriousness of this issue, which is a fundamental threat to human health in the Border counties. I recognise that and I reiterate that the Minister will be raising this issue as a matter of priority with the Northern Ireland Executive and with the Minister for the Environment, Mr. Durkan. It will also be raised at the next meeting of the North-South Ministerial Council, which is welcome. All agencies must come together to stamp out this horrendous activity.

Again, I reassure Deputies that Louth County Council has carried out regular sampling at various properties throughout the water distribution system for Dundalk. The drinking water sample results for the Dundalk public water supply scheme for 2014 for PAHs show that it is fully compliant with the drinking water regulations. The river water results taken at the Dundalk water supply abstraction point on the River Fane during 2014 showed that COD was less than 40 mg/l during the year and therefore was compliant with the quality of surface water intended for the abstraction of drinking water regulations. The drinking water samples for Dundalk town and environs have all been compliant with the drinking water regulations of 2013 with the exception of one instance of lead detection. The investigation of this lead non-compliance showed that there was no lead on the public side of the public water supply.

While tackling the problem of diesel laundering and the subsequent waste which arises is both challenging and costly, the Department of the Environment, Community and Local Government is committed to working with the authorities on both sides of the Border to deliver more effective and co-ordinated enforcement of the law. The multi-agency approach for which Deputies are calling, whereby all of the relevant agencies would bring their skills and expertise together and apply them to the task at hand, is the best approach to tackling this irresponsible and dangerous environmental crime.

Deputy Fergus O'Dowd

All Deputies present would like the aforementioned meeting to take place. In that context, will the Minister of State commit to getting involved in arranging said meeting?

Deputy Paudie Coffey

I can commit to trying to facilitate a meeting with the Minister but it will be for him to decide.

Nursing Staff Recruitment

Deputy Caoimhghín Ó Caoláin

Deputy Martin Ferris and I raise the issue of the absence of nursing and medical support for the residents of the island of Inishturk off the County Mayo coast. Inishturk Island has a population of 58. When the resident nurse retired plenty of notice was given but no replacement was recruited. The island does not currently have a nurse and despite a promise of weekly visits, only three such visits have taken place since last September.

The population of Inishturk Island has the same health concerns that affect everyone living on the mainland. Some residents have contracted influenza, one woman is pregnant and many other islanders are elderly. They have been informed that a nurse has been recruited to the vacant position but certain paperwork remains outstanding. When will the appointee be in situ? As Inishturk is nine miles offshore, its population has great concerns that an emergency may present. The state-of-the-art health centre on the island is locked up and residents do not have access to the defibrillator located in the centre in the event of a cardiac emergency presenting.

I urge the Minister to ensure the population of Inishturk is provided with this most essential support in the interest of their ongoing health concerns.

Deputy Martin Ferris

As Deputy Ó Caoláin stated, Inishturk Island has 58 inhabitants, most of whom are elderly, with the age ranging from nine to 97 years. The island does not have a public health nurse. One of the residents is pregnant and a number of others suffer from diabetes and heart problems. The island also has a state-of-the-art medical centre. The resident nurse retired in September 2014 and the Health Service Executive was informed of the forthcoming retirement in December 2013. Since the nurse's retirement in September last, a public health nurse has made three visits to the island. Last week, the residents were told it was hoped to have a nurse in place shortly. While a replacement was recruited in November, the Health Service Executive is awaiting vetting clearance and so forth.

Deputy Gerry Adams received a reply on 3 February 2014 which stated the HSE was in the process of recruiting a nurse to cover Inishturk Island due to a retirement. It noted that while the process was taking place, the island would be covered on a whole-time basis. This letter was received almost 12 months ago, yet the issue has still not been addressed. It is an indictment of the health service that people living on an island nine miles off the coast are dependent on emergency services if they require medical attention.

It is Government policy that islands must be afforded health services on a par with their counterparts on the mainland. It is obvious that Inishturk Island is being discriminated against through the failure since September 2014 to implement that policy. It is a disgrace that any system would allow 58 people to have no medical cover or assistance.

Minister of State at the Department of Health (Deputy Kathleen Lynch)

Deputy Ferris will have to find different language to describe this issue because the word "disgrace" should not be used in this context. While I agree that people living in an exposed and isolated area deserve the same type of health service as everyone else in the community, the issue the Deputies raise is not the result of a deliberate action. Given the difficulty being experienced in recruiting nurses in large towns and cities, recruiting a nurse for an isolated area, as beautiful as Inishturk may be, clearly will present a difficulty.

The delivery of a sustainable community nursing service which effectively meets the health needs of the population in a primary care setting is the principal aim of the Health Service Executive's public health nursing service. The nursing post on Inishturk Island became vacant recently when the island's nurse retired. The HSE has advised that there are no service or budget reduction elements relating to this issue. Finding a suitably qualified candidate who wanted to live and work on Inishturk was a significant challenge. A nurse has been recruited to take up the position and the successful candidate is undergoing pre-employment checks. As part of this process, the appointed nurse must obtain occupational health clearances. As soon as these have been completed, the nurse will be in a position to take up the appointment.

No one, including the two Deputies opposite, would suggest that a person, however qualified, should be allowed to work in a community without pre-employment checks first being carried out. While waiting on the new nurse to take up her position, residents have been advised to contact their general practitioner directly if they have any health issues. I am sure they will have done this as a matter of course.

I will check the position regarding the weekly visits the Deputies indicated had been promised. The HSE is conscious of the need to provide appropriate health services for island communities. In this regard, it has committed in its 2015 operational plan to conduct a review of primary care island services, with a completion timeframe of the second quarter of 2015. Plans are in train to develop terms of reference and to establish a working group to proceed with this.

With transport and communications improving, I hope people will move to more isolated islands and residents will have more children. This will require a different response. I am conscious of the issues that arise and thank the Deputies for raising the matter. The news concerning a nurse for Inishturk Island is good. That a nurse has not been in situ before now was not intentional.

Deputy Caoimhghín Ó Caoláin

The Minister of State referred to residents being advised to contact their general practitioner directly if they have any health issues. Inishturk Island does not have a general practitioner.

Deputy Kathleen Lynch

I may not have a GP living with me but I can still contact one.

Deputy Caoimhghín Ó Caoláin

With respect, the Minister of State is not living nine miles offshore on an island in the Atlantic. When she refers to people contacting a general practitioner directly, she should note that they are dependent on other means of communication. It is not quite the same as the access she and I enjoy living on the mainland. Her answer is not adequate.

On pre-employment checks, when was the successful person identified and how long will the pre-employment checks take? When will a final decision be taken on the suitability of the new recruit to take up this opportunity on Inishturk Island?

In the interim, the services of a nurse from the adjacent Clare Island were to be used and she was to visit Inishturk Island weekly. Is that the case as this information does not correspond with the information available to us? We have been informed that only three visits have taken place since last September. Will the Minister of State clarify whether these visits are taking place weekly? The concerns raised are understandable given the circumstances Deputy Martin Ferris and I have described, including the age profile of residents, the presence of a pregnant woman on the island and the fact that islanders are no more immune to influenza than the rest of us, wherever we may live. Will the Minister indicate precisely when it is hoped the nurse will take up duties?

Deputy Martin Ferris

As someone who comes from a coastal community, I am well acquainted with islands and the logistics associated with trying to get medical care onto them, particularly in poor weather conditions.

The importance of having somebody present on the island in the case of emergency cannot be overstated.

What I find very disturbing is the reply from the HSE in Castlebar. This dates back to December 2013. When the HSE was approached about having a nurse in place, the residents' representative, Ms Mary Heanue, the co-ordinator on Inishturk, was told clearly that a nurse was not needed as there was no one in need of dressing full-time, there were no pregnant ladies on the island and there was nobody who needed injections. The HSE also made reference to the fact it did not have the resources necessary, whether it be personnel or otherwise, to fill the vacuum.

In November 2014 a nurse was recruited and is being vetted, which means, as we are almost into February, that it has taken four months to complete the recruitment. It is inexcusable that there is nobody in place yet. I am not blaming the Minister of State for this. At the end of the day, the ability of the HSE to provide medical care for people in need leaves an awful lot to be desired, in particular for those living in rural areas.

Deputy Kathleen Lynch

I want to read again from my initial reply as I do not know if people deliberately misunderstand or refuse to hear. I said the HSE had advised that there were no service or budget reduction elements relating to this issue. The nurse was recruited. It was a difficult process and I understand that difficulty because we have had a similar difficulty in looking for nurses in areas in which there has been major development. The pre-employment checks that need to be made in the case of every person employed in the medical profession are good. Yes, they take time, but it is important that they happen.

I am not certain about this nurse's personal circumstances, but it may, for example, be someone who was living abroad. What I am certain of is that a nurse has been recruited and it will be a great relief to the HSE, me and, I assume, the people of Inishturk to have someone available to them 24-7. That is what is of central importance and it is happening. While I do not have the information on the starting date sought by Deputy Caoimhghín Ó Caoláin, I will send it to him.

Nursing Homes Support Scheme

Deputy Brendan Ryan

I thank the Minister of State for coming into the House to take this debate.

The fair deal scheme was introduced on the basis of the core principle that long-term care should be affordable and that a person should receive the same level of support, whether he or she chooses a public, voluntary or private nursing home. The scheme was envisaged as enabling people in need of long-term nursing care and their families to access such care in a timely and cost-effective manner. It should be acknowledged that the fair deal scheme benefits a significant number of older people and is a considerable improvement on the level of support available under the previous subvention scheme.

We need to see an increase in the funding for the fair deal scheme which I understand stands at approximately €963 million. There is a cost argument as we are spending too much money in keeping qualified persons in hospital beds. However, there is also a compassion argument which is more important and compelling. It is costing taxpayers more than €500,000 a day, or €4 million a week, to keep qualifying persons in hospital beds, waiting for funding for a fair deal scheme nursing home bed. There are 2,135 people waiting just over 15 weeks for approval under the scheme. While that number fluctuates, the overall statistics point to a fourfold increase in waiting list numbers since January 2014, when some 500 people were on the list for an average period of just four weeks. It is no coincidence, therefore, that the increased waiting time in processing fair deal scheme applications is a contributory factor in the overcrowding crisis in accident and emergency departments in recent times.

It is a very emotional time for a family when they have to move a loved one into a nursing home; it is never an easy time. However, the current position is compounding the problem as the funding caps under the scheme are impacting on the processing time for applications and the waiting time for a suitable permanent placement. In summary, the funding cap placed on the fair deal scheme is adding to the crisis in accident and emergency departments, which is having a knock-on effect for patients, families and the overall cost of running the health service. It is my considered view that the fair deal scheme needs to be demand-led.

Deputy Emmet Stagg

I also thank the Minister of State for coming into the House to deal with this issue. Her dedication to the task of providing world class services for the elderly is not in doubt.

How we treat the elderly is a fair mark of our society. They were the creators of the society and systems we now enjoy. They worked hard, often for low pay, paid their taxes and are now entitled to the best care that can be provided, if possible in their own homes and, where that is not possible, in available care facilities of high standard. It is not acceptable that the elderly are left in acute hospital beds when what they need is nursing home care. It is not acceptable that they are left in their homes where they can no longer be adequately cared for.

The fair deal scheme is just that - a good deal for those who need nursing home care. This excellent scheme was intended to be - I emphasise this point - demand-led where the service would be provided when required. The current practice, inherited by the Minister of State, whereby the scheme is capped financially, leads to inevitable delays in the service being provided and real hardship for the elderly persons left waiting. I am asking that the resources needed to provide a demand-led service be provided by the Government and that the waiting for essential care for long periods be ended. Senior citizens deserve no less.

Deputy Kathleen Lynch

I thank Deputies Brendan Ryan and Emmet Stagg for raising this issue which is very pertinent at this time, given that we are in prolonged discussions with various Departments and desperately trying to do what they are asking for. As they rightly pointed out, the nursing homes support scheme provides financial support for those who require long-term nursing home care, with residents contributing a portion of the cost in accordance with their means, which is essential. It is a scheme which relieves families of potentially very onerous expense and even protects the greater part of the value of a participant's main residence. However, it is also expensive. The amount allocated to the scheme in 2015 is €948.8 million. Again, demographic trends mean that the scheme is under pressure because of the increasing numbers of older people in the population. The number of the population over 65 years is growing by approximately 20,000 each year and the population over 80 years which has the greatest need in terms of utilisation of health services is growing by some 4% per annum.

The scheme is demand-led but, as Deputy Emmet Stagg rightly pointed out, resource-capped. In the Nursing Homes Support Scheme Act 2009 a provision was included in order to ring-fence the funding for the scheme and ensure it was used for the provision of financial support under the scheme. To manage the available funds through the year, the HSE operates a national placement list in order of when applications are approved, which is very important, and funding is released in strict chronological order as it becomes available. As of 16 January, there are 1,313 people on the placement list, with an average waiting time of 11 weeks, down in some cases from 17 and 18 weeks. The budget for the scheme in 2015 is €948.8 million, an increase of €10 million on the figure for 2014. Some €10 million allocated to the scheme related to the delayed discharges initiative.

I will forward this reply in full to both Deputies, but I believe we need to talk about some other issues concerning the fair deal scheme. For example, the review of the scheme which I expect to receive in the next few weeks will tell us that it is unsustainable in its current financial make-up, given the demands on it. What it should tell us and what I would like it to tell us is that people will be able to access the fair deal scheme in the community, rather than having to avail of long-stay nursing home care, if that is their preference.

It is about preference and choice. I would hate to think that because I had reached a certain age and despite the fact I was capable of making these choices myself, my choices would be limited. We also need to look seriously at the issue of capacity. Even if we could provide a fair deal scheme place for everybody in hospital who needed one, there are certain areas of the country where we do not have the capacity to move patients from hospitals.

I am a great believer in identifying difficulties and finding solutions. If the fair deal scheme was resource and demand-led, it would provide comfort for both the public and private sectors and deliver more of the beds we so desperately need. The fair deal scheme must be a combination of the two options. It must be about choices in the community and ensuring that if people are offered a bed, it is in an the area close to where they live and those who might wish to visit them. For example, if the patient is in Naas or Kildare, the bed offered should not be in some place that is inaccessible to him or her such as in Waterford. We need a full and wider debate on this issue. We understand the difficulties, but we need to come up with perhaps different solutions.

Deputy Brendan Ryan

I thank the Minister of State for her comprehensive response which demonstrates the control she has of this brief. I agree fully that making the fair deal scheme demand-led would provide an incentive to provide a further supply of long-term beds to meet the additional capacity required. We know that there is the demand, but like the housing market, part of the problem is supply. The budgetary cap acts as a disincentive for investors in the private sector and adopting a demand-led approach would be of benefit and help to achieve a better supply. We have a scheme that is fair, but it can work better. We need more investment in it and a greater supply of beds, be they in the public, private or voluntary sector. We are in economic recovery, but this recovery should be felt by all, particularly those who are most vulnerable. The people who qualify for the fair deal scheme are predominantly elderly. I agree fully with the Minister of State on the importance of choice. There should not be just one solution for those in need of care. Where people need security and comfort that cannot be provided by family members, they will certainly not be found in hospital wards.

I thank the Minister of State for her sterling work in this area, but I must ask: why has the scheme been designed in such a way that it is not demand-led? She has responded to this question and obviously the cost of the scheme in recent times has been a significant factor. If we are entering recovery, this area is one in which we should see the benefits of that recovery.

Deputy Emmet Stagg

I thank the Minister of State for coming to the House to deal with this issue. The medical card system which is far more expensive than the fair deal scheme is entirely demand-led. If a person qualifies for a medical service, he or she receives that service, with no waiting time for access. Nobody says in November that all of the money is gone and that a service cannot be provided. The system should be similar to that for the fair deal scheme. If people qualify, the service should be provided when needed. I believe the Minister of State agrees with us on that point.

Has any calculation been made of the extra funding that would be required, over and above the current figure of €900 million, to fill the gap in order that the scheme would be demand-led and a service provided as required? Will the Minister of State also ensure the HIQA beds in the public sector are upgraded to the point where they would no longer be under threat? I understand there is a period of grace in which this could be done and that she is in the process of doing this. It is important that these beds are retained in the system in order that there will be no shortage of resources.

Deputy Kathleen Lynch

I could not agree more with the Deputies. I have made it clear that we cannot afford to lose any bed, private or public, for older people. In regard to the fair deal scheme, we also need to look at the issue of funding and the notion that if one lives in Dublin, X amount is paid per bed, while the rate is different if one lives in Wicklow or Galway. No account is taken of the needs of the person concerned. We need to look at this issue because the needs of some people are greater than those of others and they need more care and attention. We need to look seriously at the range of needs involved.

On the issue of cost, I am told that if we were to make the scheme resource and demand-led, it would cost an additional €30 million a year. In some years the cost would be higher and in others lower. However, if we do not do this in a planned way and a way we can see what we will be doing six months down the road, the cost will be twice that figure or more. It is about planning and ensuring we know exactly where we will find capacity and how we will meet demand as it arises.