Leaders' Questions

Today, more than 530 patients are on trolleys in accident and emergency departments. In some hospitals the situation is truly chaotic, and it is extremely stressful for many patients throughout the country. In Beaumont Hospital 45 patients are on trolleys. I am reminded of the Minister's statement in December that the situation in Beaumont Hospital would be alleviated fairly quickly, but it is getting far worse. In Cork there are at total of 53 patients on trolleys at Mercy University Hospital and Cork University Hospital. The number in Our Lady of Lourdes Hospital is 50. In Galway the number is 30 and in Limerick, where sources state that the situation is absolutely chaotic, it is 37. In Wexford the number is 32. Last week we learned about a 100-year-old woman who spent more than 24 hours on a trolley, and the story was well covered in the Irish Daily Mail. She was one of up to ten people aged over 80 who spent up to 23 hours on trolleys, which is a truly scandalous situation.

This could have been avoided. When Deputy Billy Kelleher tabled a parliamentary question last week about people availing of the fair deal scheme, the real story came out as to why the accident and emergency departments were in such crisis before Christmas. In January 2014 only 512 people were waiting for four weeks for approval under the fair deal scheme, but these numbers progressively increased over the year. In May, 1,265 people were waiting for up to eight weeks for approval. It got decidedly worse by October, when 2,114 people were waiting 15 weeks for approval.

It was a deliberate budgetary decision that the Taoiseach took to neglect health and that then led to delayed discharges from acute hospitals and, ultimately, to the accident and emergency crisis we are currently experiencing. As of 29 January, 1,333 people were waiting an average of 11 weeks.

A question, Deputy, please.

The HSE asked for €200 million to deal with demographic pressures for 2015 and it got €25 million, which is clearly inadequate. When one reads the consultants' analysis of the draft action plan, they say it lacks any concrete, clear recommendations in regard to increased capacity. The question is why did the Taoiseach deliberately choose a policy at the beginning of 2014 of starving the fair deal scheme, neglecting our elderly and creating this crisis about which he was warned? Does he accept that current plans are inadequate to deal with the enormity of the situation that faces acute hospitals and what does he propose to do about it?

The reason the Government made the decisions it made was that the Deputy's party left the country in an absolutely catastrophic economic situation. The Deputy denies that and denies all responsibility for it.

The Taoiseach has been running the shop now for four years.

This Government does not do that. We recognise the scale of the challenge we have faced as a country and as a people from the point of view of the economy and how that impacts on people every day. Today, on 10 February, the number of patients on trolleys was 462 at 8 a.m. The Irish Nurses and Midwives Organisation also counts patients on trolleys on wards and that increases the number to more than 500. Yesterday, on 9 February, the number was 332 at 8 a.m., and 253 at 2 p.m. The day before, on Sunday, it was 280 at 8 a.m. and 189 at 2 p.m. On Saturday, 7 February, it was 237 at 8 a.m. and 150 at 2 p.m. The Minister has recognised the challenge that is there and has set up the particular task force to deal with emergency departments and numbers on trolleys. He has also pointed out how this has been exacerbated in respect of the flu-related admissions where approval was given to open up 173 extra beds in 15 units across the country for a specific 13-week period. The Department and the Minister have not tried to sweep under the carpet the scale of this challenge.

An allocation of €25 million was given to the fair deal scheme to reduce the waiting periods from 16 weeks and 17 weeks to what might be regarded as much more manageable periods of 11 weeks and eight weeks. It is not a satisfactory position but the simple fact of the matter is that it is very difficult to determine all the issues that can arise in health from week to week given that one does not know the scale of flu-related incidents or whatever else. The HSE is now accessing all suitable non-acute accommodation for dealing with and providing services to people who come in through emergency departments. The €25 million allocation in the national service plan is being used in addition to funding 50 transitional beds in the greater Dublin area, 65 beds that are to come on-stream in Mount Carmel on a phased basis from April and additional home care packages. Having regard to some hospitals around the country, I know of one nursing home which sent in nine patients one evening because of flu-related illnesses; these were elderly people who were not able to be attended to in an appropriate medical service within the nursing homes in question. These matters make the situation worse and it is not satisfactory but the Minister is acutely aware of it. He set up a particular unit to look at this and the HSE, as the Deputy knows, has the capacity to recruit necessary front-line services where that is necessary. As we pointed out on a number of occasions, we hope that the situation can be regularised and made more amenable.

I point out to the Deputy that €600 million more was allocated to the health budget for 2015 in order to deal with the challenges which arose from 2013 right through 2014.

The Taoiseach deliberately under-funded health throughout 2014 and he knew that when he pushed his budget towards the end of 2013. The then Minister, the Minister, Deputy James Reilly, knew it at the time, but the Taoiseach sacrificed him and the Taoiseach probably knew he was going to be sacrificed at some stage during 2014. It was a deliberate policy of neglect and that is why thousands of elderly people were waiting more than 15 weeks for a fair deal bed, and why we had such an extraordinary increase in delayed discharges. The Taoiseach had choices and, above all, he knew about it. The Minister, Deputy Varadkar, knew about it as well because he was told about it in his briefing notes when he became Minister. He was told there would be a crisis if something was not done but nothing was done before Christmas in terms of the fair deal scheme or making additional beds available. The Taoiseach took a calculated political decision that we will fly by the seat of our pants in regard to health and we hope we will get there by the end of the year, but he did not.

A question, Deputy, please.

The result is that people suffered because of the Taoiseach's deliberate political decision. He has choices in everything he does but he chose this particular route and he has not allocated enough for this particular area for 2015. The only reason €500 million extra was allocated is because that is the amount the Taoiseach deliberately short-changed it in the preceding year, and he was told that at the time. I remember it well in this House and there was an extraordinary scene where the then Minister disowned his own allocation at the time of the budget. He said they were not his figures, that he was handed them by the Minister, Deputy Howlin, and the Government and the famous Economic Management Council of the Cabinet. It was a diktat and it was one that short-changed the people and elderly people in particular. If the Taoiseach does not believe me, he should go out to the hospitals and talk to the doctors, nurses, care staff and others and they will tell him morale has never ever been so low in our health service.


It is because of the lack of leadership and the absolute neglect by the Taoiseach and his Government during the past number of years.

That is the same old story from Deputy Martin. When €16 billion was being spent on the health service, the situation was actually worse. Doctors and those managing hospitals will tell him that if he talks to them.

They were not waiting 16 weeks for a fair deal scheme bed.

They are delivering more now with less than they were before because of changes to the structure and the way services are delivered.

Is that what the Economic Management Council has told the Taoiseach?

Regarding the fair deal scheme, as of 20 January, there were 1,260 people on the national placement list with an average waiting list of 11 weeks.

That is a disgrace. That is something the Taoiseach started.

Deputy Martin had his chance to raise his point. Everything with him is right and his memory is very short term.


Hear, hear.

The budget for the NHSS in 2015 is €948.8 million and that includes €10 million allocated specifically for the initiative related to delayed discharges. That increase of €10 million will allow for the provision of an additional 300 long-stay care places under the national homes support scheme. That has reduced the waiting period for allocation under the fair deal scheme from 17 weeks to 11 weeks. As the Deputy is aware, last year there was a further €5 million allocated for an initiative to improve access for appropriate care for older people. Nobody on this side of the House is suggesting, and this is now the Deputy's mantra, that the Government made a deliberate decision to do down elderly people. That is beneath the Deputy. It is a disgraceful comment from him.

The Taoiseach did that. He calculated it-----

That was his policy decision.

The Taoiseach might not like to hear that but that is what he did.

Deputies, please. We are over time.

When Deputy Martin stood on this side of the House and denied all responsibility-----

I am not making it up. The Taoiseach can read his Minister's replies to parliamentary questions.

-----for his actions, when a national crisis and emergency was declared-----

The Minister, Deputy Varadkar, has said it. It is there in black and white.

It is a giveaway for the elections.

Deputies, please.

We are four years on and there is a crisis now.

I am not suggesting that everything is the way that it should be in the Department of Health.

These are the Taoiseach's figures.

We put in €600 million more this year and we hope to regularise that. The Minister for Health has admitted that the situation is not the way it should be.

He has been a very good commentator.

That is why we are working to change that system-----

The Minister is great at spin but there is no substance.

-----so that people get the very best attention at the front line that they need.

Thank you. I call Deputy Adams.

A major global conspiracy assisting the wealthy elite, including individuals from this State, to conceal wealth and to avoid tax was publicised this weekend. The Swiss branch of HSBC advised clients on how to keep money hidden from State authorities and offered deals to aid and abet tax dodgers. Irish money held in that bank, on which due tax was not paid, is ultimately - I am sure the Taoiseach would agree - money taken from ordinary citizens, citizens such as the 530 who lie today on hospital trolleys, including 50 in Our Lady of Lourdes Hospital in my constituency. The people who pay the price are those citizens and moneys have been taken from Irish hospitals, schools, children's benefits, carers' allowances, allowances for children with disabilities and from the elderly. The Swiss HSBC account contained €3.1 billion.

I repeat, €3.1 billion, linked to 350 clients associated with Ireland, yet only 20 Irish account holders made settlements, worth just over €4.5 million, with the Revenue Commissioners. Unlike the anti-water charge activists, there were no early morning raids or arrests. In the USA, France, Belgium and Argentina, the bank now faces criminal investigation, but not in Ireland, which is the smallest, best country in the world in which to avoid tax if one is wealthy. Why did the Revenue Commissioners not pursue a case against HSBC for facilitating tax evasion by Irish citizens? As I have said, it involves Irish accounts containing €3.1 billion held by 350 clients. Does the Taoiseach believe that €4.55 million is a reasonable amount for the State to have recovered in tax settlements? Does he agree that this scandalous and corrupt behaviour is a matter for the Committee of Public Accounts to investigate?

The existence of a foreign bank account is not evidence in itself of tax evasion and clearly no liability will arise where relevant tax is paid on funds or any interest accruing on them. The Revenue Commissioners received data under the double taxation agreement from French authorities in June 2010. On receipt of that, they undertook an assessment and evaluation process which indicated that no further liability arose in the State in a number of cases and that further investigation would be required in a number of other cases. Where required, the Revenue Commissioners, as is their responsibility, initiated an investigation. To date, it has initiated 33 investigations as a direct result of the data received and there have been 20 settlements related to that information. The total amount received was, as Deputy Adams indicated, €4.55 million. A further €174,444 has been received to date as payment on account in two investigations which are ongoing.

The Revenue Commissioners took relevant action in any case where sufficient admissible evidence was available to bring a criminal prosecution in respect of any identified Revenue offences. To date, three prosecutions have been secured and one case is under criminal investigation. The Revenue Commissioners are perfectly entitled under the responsibility given to them by the Act to take criminal cases where they believe that is appropriate, and that is what they are doing and have done to date.

The Taoiseach did not answer the two important questions I put to him, a point to which I will return. We all know that the activities of some of the banks and a small wealthy elite, facilitated by some politicians, caused the financial crash in this State. It is not that well-known that €62 billion in private bank loans was in the hands of just 190 individuals. It is not that well-known that half of the Irish bank loan book of Anglo Irish Bank was held by just 20 individuals. They are the people, aided and abetted by others in the golden circle, who impoverished the vast majority of citizens in the State.

Has the Government learned a lesson from this experience? It appears to me it has not. For example, Michael Geoghegan was the chief executive of-----

Please do not mention names in the Chamber.

I am stating the fact that he was the chief executive of HSBC at the time that its Swiss operation facilitated tax evasion. The Government knew this, yet the Minister for Finance, Deputy Michael Noonan, appointed Mr. Geoghegan as an adviser to the Government on the operation of NAMA. Did the Minister ask Mr. Geoghegan about HSBC prior to his appointment to NAMA?

I refer to my earlier questions, which the Taoiseach did not answer. Does he think that the return of €4.55 million, when €3.1 billion is linked to 350 clients, is a reasonable tax settlement? I would like a direct and clear answer to my second question. Does he agree that this behaviour is a matter for the Committee of Public Accounts to investigate?

It is a long-established practice in this House, since the foundation of the State, that we do not mention the names of people who are not here to defend themselves. I would appreciate if that long-established principle would be maintained.

I respect the ruling of the Ceann Comhairle. The position is that Deputy Adams is questioning the Revenue Commissioners.

I am questioning the Taoiseach.

He is suggesting that their investigations should have yielded more than €4.55 million.

I am asking the Taoiseach.

I do not speak for the Revenue Commissioners, nor does Deputy Adams. They have very extensive powers under the Act which set them up.

Why was the Dáil not informed in 2010?

The Revenue Commissioners are well able to speak for themselves. They initiated 33 investigations as a direct result of the data given to them by the French authorities in June 2010, and 20 settlements have been reached in regard to those data. That amounts to €4.55 million.

Were there any arrests?

A further €174,442 was received in payment on account in respect of two ongoing investigations. Deputy Adams is asking me to question the authority or the way the Revenue Commissioners have gone about investigating information that they were given by the French authorities, in respect of which they have taken three criminal cases. Another case is under criminal investigation.

Did they raid any houses for the information?

The Committee of Public Accounts, with its Chairman, can reflect upon this. The Revenue Commissioners are completely independent in the way they do their business-----

What about the Minister, Deputy Noonan?

-----and have very extensive powers to take criminal cases, which they have done under what they said here. In respect of the Deputy's second comment, Mr. Geoghegan-----

It is a matter of public record.

The person mentioned was referred to by the Minister for Finance. He advised, not in respect of taxation issues, but in respect of the remuneration of senior executives and other issues of the strategy proposed by NAMA.

The Taoiseach did not answer the question.

We are over time.

I tend to constantly remind Deputy Adams of this because every time------

Did the Minister, Deputy Noonan, ask Michael Geoghegan about HSBC?

The Minister, Deputy Noonan, will answer that question when he replies to questions here.

I am asking the Taoiseach.

I do not know in their entirety the conversations any Minister has had. I assure the Deputy that the Minister, Deputy Noonan, has been very clear-----

He knew about this. He should have known.

Deputy Adams, please.

-----about the work that the person he appointed was asked to do, and that was in respect of the strategy proposed by NAMA. I remind the Deputy again that every time he speaks in the Chamber he has all the answers to all of the questions.

No, I do not. I do not have any answers.

He is the person who continues to say that the EU should take its money and go away-----

Come on. Answer the question.

-----and does not want the Irish people to get back money they put into AIB.

This is not Deputy Gerry Adams's question time. It is Leaders' Questions.

I remind him of those two black holes in his economic policy and I will remind him of them every day I can do so.

In about an hour's time the Taoiseach will frogmarch his backbenchers in here to vote down my Private Members' Bill, a Bill designed to support families who receive the devastating diagnosis that their pregnancy has a fatal abnormality incompatible with life. My Bill enables them, if they feel they cannot continue with that pregnancy, waiting for the baby to die, to terminate it here in Ireland surrounded by their families and friends. Instead, the Taoiseach proposes inaction, condemning those people to a lonely journey, most likely to Liverpool, surrounded by holidaymakers and businesspeople while the bottom falls out of their world, and then to come home and have the ashes sent in a jiffy bag in a DHL van.

It is cruel, inhumane, torture and a violation of human rights, and it is avoidable. Some 80% of the people have said they want the Government to do something about this. The three masters of the maternity hospitals, the United Nations Human Rights Commission and 43 legal experts have said it can do it. Not just that, 50 Deputies, including half of the Cabinet, have said something must be done. What is that something and who is going to do it? If not us, who? If not today, when?

People are sick of excuses and the only reason advanced to oppose this is the allegation that it is unconstitutional.

The Taoiseach knows that is rubbish because only the High Court and Supreme Court can adjudicate on whether something is constitutional and they have not done so in this instance. All the Government has is the opinion of the Attorney General. With the greatest respect to her, she is not infallible; she is a human being and, at least once, she has been proved wrong, specifically in the case of the children's referendum. These issues are too important to leave it at that. I want to see her opinion before this vote because so many people disagree with it.

Will the Taoiseach publish the Attorney General's decision so we can see it? Does he think it appropriate that highly paid parliamentarians are expected to come here to vote on such critical issues like nodding donkeys without full possession of the facts? At the very least, may we have the date of the opinion and confirmation that it relates to my Bill and not other generalities? Finally, will the Taoiseach justify why the constitutional amendment which he claims gives rise to the reason the Government cannot support my Bill was brought in here on a free vote, without a Whip, over 30 years ago, and in this era of democratic revolution, the Taoiseach cannot give his backbenchers a free vote on this? Would it not be better with regard to adhering to human rights if the President could be allowed refer this to the Supreme Court under Article 26 of the Constitution? In 60 days, we could have an end to the misery that families are going through today or could feel tomorrow. Does the Taoiseach think it is okay to have us violating international human rights?

The first comment I make to Deputy Daly is that the reason she can bring her Bill in here is that the Government reformed Dáil procedures to allow for backbench Deputies like herself-----

There has always been Private Members' business.

We thank the Taoiseach.

-----to be able to bring Bills before the House. It is right and proper, and it is the Deputy's right to bring a Bill before the House. This is a very sensitive matter and all these cases are quite tragic for the woman, in particular, who is involved, the mother of the unborn child. However, Deputy Daly does not own the Constitution and neither do I. She cannot change the Constitution and neither can I. It is the people's Constitution and it is only they who can change it.

There has been a long-standing position in this country where the advice given by the Attorney General of the day has never been published. Article 15.4 of the Constitution, of which the Deputy is well aware, states quite clearly that it is not lawful for legislators to vote for something which they know is "repugnant" to the Constitution. The Deputy wants to fly in the face of all that, pass a piece of legislation and then have it tested by the Supreme Court. I suggest to Deputy Daly that it is not the way to go. This is a far more serious matter than the sensitive case she mentions. When we speak about the eighth amendment, we are talking about a range of other complicated issues beyond this particular example. When the Deputy asks that something be done, it will not be done in respect of Article 15.4 and this particular issue.

The Deputy is quite entitled to bring forward her Bill under the reform process but she does not own the Constitution. It is the people's Constitution and they are the only party who can change this. The Deputy believes we can introduce legislation contrary to the Constitution and then send it to the Supreme Court but that is not the way to go about business.

What will be done?

The Taoiseach's retort, or lack thereof, is an absolute insult to the families enduring this issue. It is the people’s Constitution and laid down in law is the fact that only this House can bring in legislation and only the courts can interpret it. How dare the Taoiseach attempt to have the arrogance to interpret the Constitution when it is something that only our courts can do?

Is there a question, please?

That is a fact. We have had bodies that are hardly the most radical, such as the Irish Council for Civil Liberties, Amnesty International, the National Women’s Council, the Irish Family Planning Association, as well as multiple legal people, telling the Government that this can be done under the Constitution. The Attorney General is one person.

The Taoiseach is correct that Article 15 indicates we cannot introduce measures “repugnant” to the Constitution. “Repugnant” means something which is clearly and undeniably unconstitutional. This is clearly and undeniably not such a case. How do I know this? The previous Attorney General argued exactly as I am now arguing that this is entirely within the remit of the eighth amendment to be legislated for now.

What the Taoiseach has done is a cop-out. If he believes the Constitution is a problem and he wants to help the families, as some of his backbenchers and Ministers have said, what will he do about it? How does he justify the fact that before Christmas, when I tabled a precise Bill for constitutional amendment, the Government voted against it? Is the Taoiseach now telling us that in the spate of referenda planned for the spring, this will be included? If he is not saying this, he is letting down these families and, quite frankly, he is a hypocrite.

That is very unparliamentary language.

As I have said to Deputy Daly, the reason she has the right to bring a Private Members' Bill before the House is because the Government reformed the way we want to do business here.

It could have been done under Private Members' business anyway.

The Deputy chose to bring this Bill before the House, as is her right and entitlement.

Answer the question.

The eighth amendment to the Constitution is very clear and it refers specifically to where there is a threat to the life of the mother. I cannot change that and neither can the Deputy. It is a matter for the people to decide by a vote. The Deputy expects that the House will follow her advice and proposal and pass her legislation - clearly it is in conflict with the Constitution - and have it interpreted as such within 60 days. I do not propose to do that.

The Deputy knows as well as I do that when the conversation starts about fatal foetal abnormalities, complications, sensitivity and the tragedy involved, it would automatically go along the line with respect to when pregnancy occurs because of incest or rape.

Rightly so, too.

The discussion starts about the entire issue with respect to the eighth amendment. I do not propose to go there, arising from the Deputy's Bill. Clearly, on the advice of the Attorney General, the Bill is unconstitutional. It has been a long-standing tradition over very many years that the advice of the Attorney General is given as formal legal adviser to the Government.

Why not publish it so?

What about Barry Desmond in 1983?

We are over time.

Of course, the Deputy can have all the legal advisers she likes. I have one and it is the formal legal adviser to the Government, the Attorney General. On that basis, I do not propose to publish the advice given by the Attorney General.

Where are the Members from the Labour Party?

The Labour Party is hiding out again.