Dáil Éireann debate -
Wednesday, 11 Feb 2015

Vol. 867 No. 2

Topical Issue Debate

Special Educational Needs Service Provision

Deputy Olivia Mitchell

I am thankful for the opportunity to raise with the Minister for Education and Skills, Deputy Jan O'Sullivan, the overall shortage of secondary school places for children with autism spectrum disorder and the additional difficulties raised by the application of an admissions policy for ASD classes that protects a particular religious ethos. On the broader issue, currently on the south side of Dublin there are exactly 42 places at second level to cater for the 150 affected children who are currently in primary school. There is probably not a need for an exact match in terms of numbers because some children at the severe end of the spectrum will never proceed to second level. On the other hand, there are children in mainstream education at primary level despite the fact that they have autism to some degree. If they are to proceed to second level, they will need the special supports, at least for part of the day.

We can say for certain there is a very severe shortage of places at second level. I am sure the Minister knows only too well the anxiety this causes among parents whose children are coming to the end of primary school and who realise there may be no further educational opportunities for them. Those parents will see other children moving on but not theirs, despite the fact that many children on the spectrum are capable of moving on. Some are very capable of doing so.

Every year, parents start looking for places. If they do not get any that are suitable for their children in terms of educational supports, the outcomes are not good, for them or their children. Over the years, I have supported both individual parents and organisations in seeking additional places. We were really very pleased on the south side when a school finally agreed to provide additional classes. There were two special classes set up, which raised a number of places from 30 to 42. However, a problem arises in that all the places are in the Protestant faith school, which has informed the non-Protestant faith parents that their children are unlikely to be admitted to the classes because it gives preference to children of the Protestant faith. I fully support the protection of religious ethos for all schools where mainstream pupils are concerned but it seems absolutely unnecessary that there should be any such protection, and unlikely that there would be a threat to the ethos, when providing places to children with a disability. The children have nowhere else to go. The 12 additional places are the only new ones on the whole south side of Dublin that have been provided in recent times.

I acknowledge the Minister is proceeding with the education (admission to schools) Bill, which I believe covers this issue. People are quite happy with how it is to be dealt with but, in the meantime, the majority of children are excluded from the new places. The underlying problem is the shortage of places overall. A selection process of some sort is inevitable where there is a gap between supply and demand. I am putting to the Minister today the overall shortage of classes. If she refers to that and the religious ethos problem, I will be very grateful.

Minister for Education and Skills (Deputy Jan O'Sullivan)

I thank Deputy Mitchell for raising this important issue. I will outline the current position. The Deputy will be aware that the Government is committed to ensuring that all children with special educational needs, including autism, can have access to an education appropriate to their needs, preferably in school settings through the primary and post-primary school network. Such placements facilitate access to individualised education programmes that may draw from a range of appropriate educational interventions, delivered by fully qualified professional teachers with the support of special needs assistants and the appropriate school curriculum.

The Deputy will be aware that the National Council for Special Education, NCSE, is responsible, through its network of local special educational needs organisers, for allocating resource teachers and special needs assistants to schools to support students with special educational needs, including autism. It is also the role of the NCSE to make appropriate arrangements to establish special classes in schools and communities where the need for such classes has been identified. This is a particular issue. Special educational needs organisers engage with schools annually in order to plan for and open new special classes each year to ensure there are sufficient special class placements available at primary and post-primary levels to meet demand in a given area. Special classes within mainstream schools are intended for children who, by virtue of their level of special educational need, cannot reasonably be educated in a mainstream class setting but who can still attend their local school in a special class with a lower pupil-teacher ratio and special needs assistant support.

With regard to the requirement for secondary school places for children with autism in south Dublin, the NCSE set up an additional two special needs classes in the area last year, as the Deputy stated. She made the point that the denomination issue is part of this. The NCSE is actively engaging with all schools in the area to meet the established demand for 2015 and 2016. I am not sure if the Deputy knows whether there is unwillingness on the part of schools because it is sometimes an issue. I have come across it in other parts of the country. The NCSE will continue to monitor the situation and has the capacity to open such new special classes, where necessary. I hope that, with co-operation, the issue can be addressed.

Deputy Olivia Mitchell

I thank the Minister. I acknowledge that the number of places was increased by almost one third. That was very welcome. The Minister has put her finger on the fact in that there is unwillingness in some schools to set up new classes. Schools where there was not unwillingness already have as many special classes as they can cope with. The reality is that if schools will not co-operate, it is really down to the Government to do something for the children who are not provided for sufficiently.

I do not expect the Minister to give me a promise today but I ask her to bear in mind that there really is under-provision. We cannot just leave it to chance and the willingness of schools to co-operate. The schools' role is to educate all children, and they should be obliged to provide classes for the children with autism. We must be more active in insisting on this. The special educational needs organisers do so much work but they have limited powers. I ask the Minister to change the approach to bring some element of compulsion into the process. Every child is entitled to an education, notwithstanding his or her disability.

Deputy Jan O'Sullivan

Every child is entitled to an education, irrespective of whether he or she has a disability. The education (admission to schools) Bill that the Deputy referred to will contain a provision requiring all schools to have a statement in their admissions policy indicating they do not discriminate on any of the grounds included in the equality legislation. Disability is one of those grounds. That provision will help. We intend to publish the Bill relatively soon.

An issue has arisen in certain places where a school has not put its hand up to say it will take a class. Re-engagement by the NCSE has often resulted in getting it over the line. Certainly, I undertake to take back the concerns of the Deputy. I will ensure there is continuous engagement with the schools in the area.

Deputy Olivia Mitchell

I thank the Minister.

Educational Disadvantage

Deputy Brendan Ryan

I thank the Ceann Comhairle for the opportunity to raise this matter. The Delivering Equality of Opportunity in Schools, DEIS, scheme, launched in 2005, is a positive scheme aimed at tackling educational disadvantage. Its purpose is to address and prioritise the needs of children and young people from disadvantaged communities, from pre-school through to second level education, and to provide a standardised system for determining the levels of disadvantage and an integrated school support programme to respond to it.

The action plan for DEIS schools is grounded in the belief that every child and young person deserves an equal chance to access, participate in, and benefit from education, and that each person should have the opportunity to reach her or his full educational potential for personal, social and economic reasons. Unfortunately, we are not able to deliver fully the opportunity for every disadvantaged child to reach his or her full potential as there is currently no capacity to expand the DEIS programme.

The economic climate of the past few years impacted on the DEIS scheme and caused it to remain relatively static.

DEIS schools deliver results in terms of improved attendance, retention, progression and examination attainment. As we saw last week, completion rates in disadvantaged areas rose by 14 points in seven years, to 82%. In recent weeks, we saw reports detailing improvements in vocabulary, comprehension, algebra and data analysis. More needs to be done but with DEIS, we have a framework to assist and achieve progress.

Currently there are 849 schools included in this programme. Some 657 are primary schools, 336 of which are from urban areas while 321 of which are from rural areas. There are 192 second-level schools.

By my count, there are only eight DEIS schools in north County Dublin. This is an area which has seen rapid population growth in the past ten years and which suffered a great deal in terms of unemployment when the economy crashed. We in the Labour Party worked hard to protect the DEIS scheme during this difficult period but as we emerge now into economic recovery and growth, we need to ensure the disadvantaged children are not left behind.

The DEIS scheme is ten years old. To my knowledge, the initial classifications of schools happened when the scheme began and little or no changes were made in the intervening decade. Ireland is a different place than it was in 2005 and the economic crash and its effects demands a review of the classification of some existing schools, and of new schools which have come on stream since 2005, to be considered for DEIS. Now is the time, as the economy is returning to growth, to examine whether extra resources can be delivered to these schools.

Under this Government, and due to the commitment of Labour Ministers for Education and Skills, first through the former Minister, Deputy Ruairí Quinn, and now through Deputy Jan O'Sullivan, we built new schools, replaced inadequate prefabs and engaged in extensive refurbishment works, even during the worst of the economic crash. I commend Deputies Jan O'Sullivan and Ruairí Quinn for this resolute commitment to improving existing schools and building new ones.

Over the past few years, we established new schools which should qualify to be considered for DEIS supports. It is important that schools, particularly new schools in emerging towns with a high proportion of new communities, can be considered as DEIS schools and entitled to the supports that DEIS offers.

I ask the Minister to commit to an effort to find extra capacity within the Department to classify new schools and reclassify existing schools in which there is a high level of deprivation, with a view to those schools qualifying for DEIS support. We cannot lose the progress made through the DEIS scheme over the last decade. If we are to see progress continuing to be made through the next ten years, we need to invest now.

Deputy Jan O'Sullivan

I thank Deputy Brendan Ryan. Given the current economic climate and the target to reduce public expenditure, prioritising and maintaining resources for children at risk of educational disadvantage is a significant challenge. As the Deputy stated, even in difficult times, both under my predecessor and in the recent budget, we protected the DEIS budget. The current focus of my Department is on maintaining existing supports for schools catering for the most concentrated levels of educational disadvantage. This means that there is no capacity for additionality to the DEIS programme.

The aim of DEIS is to ensure that the educational needs of children and young people from disadvantaged communities are prioritised and effectively addressed. An extensive identification process was conducted by the Educational Research Centre on behalf of the Department in 2005 - as the Deputy stated, a full ten years ago - to select the schools for inclusion in the DEIS programme on the basis of their relative level of disadvantage, with priority being given to the most concentrated levels of disadvantage. In the primary sector, the identification process was based on a survey carried out in May 2005, from which a response rate of more than 97% was achieved. In the case of second-level schools, the Department supplied the Educational Research Centre with centrally-held data from the post-primary pupils and State Examinations Commission databases.

The DEIS programme is the subject of ongoing evaluation by the Educational Research Centre and the inspectorate of my Department. The focus of this research is to ensure the successful implementation of DEIS and that the best possible approaches to measuring progress and outcomes at both local and national level are being used.

As Deputy Brendan Ryan stated, the research to date demonstrates encouraging results. Literacy and numeracy rates in primary schools are improving steadily, second level attainment levels are also improving and attendance, participation and retention levels are increasing. Most importantly, learning from interventions in school planning, teacher education and parental engagement which have been developed in the DEIS programme is now being used in the wider school system to improve teaching and learning outcomes in all schools. However, there remains a gap between the overall achievements of children in DEIS schools and the national average which means that supports for schools catering for the most concentrated levels of educational disadvantage must be maintained.

An overall report on the learning from DEIS is currently being prepared by the Economic and Social Research Institute. This report will incorporate information on the various inputs, processes and educational outcomes contained in the findings from the DEIS research and evaluations conducted by the Educational Research Centre and the Department's inspectorate to date. It will also review other Irish and international related research on educational disadvantage. The report will assess the main findings of the evaluations and provide advice to inform future policy direction on educational disadvantage, including DEIS. This report is currently being finalised and I expect to receive it shortly.

Accordingly, for the present, my focus and that of my Department is on taking the learning from DEIS and applying it to future policy making. This will ensure that future policy direction to tackle educational disadvantage will be evidence-based and grounded in the solid body of experience provided by the DEIS programme.

I expect the report to which I referred in the next few weeks. As the Deputy stated, we have not really been able to expand. Despite the fact that the programme is in existence for ten years, there has not been expansion. This will give us an opportunity to look at the success of DEIS and whether there should be other areas in DEIS. There is quite a lot of evidence, including the retention figures issued last week, on the success of DEIS, but it is time to re-evaluate it and to ensure that we do anything that needs to be done to change it for the better.

Deputy Brendan Ryan

I thank the Minister for her response.

We cannot underestimate the role a school plays in improving social cohesion within a community. New communities, areas of economic deprivation and emerging towns need this strength in their local schools. I am glad to hear that we are expecting a report from ESRI in the near future and on foot of that report, I hope to see some action in this area.

Society does not remain static and Government policy instruments, such as the DEIS scheme, need to evolve with the dynamic nature of society. I cannot emphasise enough the need for the Government to act at this early phase in our recovery to strengthen disadvantaged schools and help individual pupils. Intelligence, ability and potential do not know income brackets, geography or privilege. Given the right supports, we can continue to assist more children to reach the limits of their potential through school by providing the relevant supports.

The Minister mentioned the initial assessments were made in 2005. At that stage, variables involved for primary schools were the percentage unemployment, the percentage of lone parenthood, the percentage of Travellers, the percentage of large families, that is, five or more children, the percentage of eligibility for free books and the percentage in local authority accommodation. The latter figure for the percentage in local authority accommodation might now also include the percentage on rent supplement because that has changed dramatically in the past ten years. A consideration today might be given to the percentage of non-English speaking pupils or parents in communities, particularly in the north and west Dublin areas, which is a big problem.

The Minister stated that her priority is to maintain existing supports as there is no added capacity at this time and to focus on the most concentrated areas, but I believe there are new schools which, if there were an evaluation based on those criteria, would meet the criteria and should be included in DEIS. Hopefully, the report to which she refers might lead to a wider look at this and determine whether there are gaps that need to be addressed - I believe there are. Now is the time to take a fresh look at it and I look forward to seeing progress on this matter in the near future.

Deputy Jan O'Sullivan

This report will certainly give us an opportunity to look at the whole programme, including whether there are areas left out.

The allocation from my budget for 2014 was €96.5 million. There is also €26 million for the school completion programme, which comes from the Department of Children and Youth Affairs and €36.7 million comes for the school meals programme from the Department of Social Protection. It is a considerable amount.

Deputy Ryan makes a fair point that after ten years, certain other criteria would certainly be worthy of consideration because of what has changed in the meantime.

Technological Universities

Deputy Jonathan O'Brien

I am sure the Minister is very well aware of the media attention on the proposed Munster technological university in recent days. Today, the Teachers' Union of Ireland lodged a dispute with the Labour Relations Commission. I do not know whether that affects what can be said on the matter. The press releases from the TUI in recent days outline some of the concerns it has raised. It is fair to say there are considerable challenges ahead if the proposed merger is to take place.

The TUI has expressed some concerns about the proposed benefits of a merger. It has laid the blame clearly at the door of the Department of Education and Skills. There is a requirement for the merger to take place before any designation of technological university status is given. The TUI has said a number of issues arise relating to the policy approach and the criteria. I will ask the Minister in more detail in the supplementary question about some of the criteria, which to be frank, are very restrictive in terms of the number of staff that must hold a PhD qualification, the number of staff who must hold a level 9 qualification and the fact that Cork IT and Tralee IT will not meet the criteria. With any proposed merger I expect there will be a reduction in teaching staff numbers and in course provision. They are issues on which concern has been expressed by the TUI. There is much concern about the proposed merger and whether it is viable any longer. I hope the Minister can provide clarity on the matter.

Deputy Michael Moynihan

Thank you, a Cheann Comhairle, for allowing me to raise this issue along with Deputy Jonathan O’Brien. There is a significant risk of industrial action over concerns about the proposed merger of the institutes of technology in Cork and Tralee for a technological university application. Deputy Jonathan O’Brien outlined that the TUI has lodged a complaint. Academic staff in both of the colleges have made it clear that they have no confidence in the process at any level, which is a worrying state of affairs. Neither are they convinced by the report published last year by a panel of international experts. Furthermore, they are not impressed by the Government's financial commitment. They are underwhelmed by the lack of engagement and consultation. In contacts I and my colleagues have had with the TUI and others and from reading media reports, it is evident that there is widespread concern. There is also concern that change will result in a reduction in the number of courses being provided in both institutes. That is an important issue as a wide variety of courses are on offer at present. We have always championed the availability of the proper courses.

The Government has a poor record of engaging with staff when advancing reforms in the education sector. The debacle over the junior cycle provides ample evidence of that. The prospect of industrial action looms once again. The staff are concerned that any merged entity may be refused technological university designation by the Higher Education Authority and remain as a merged entity indefinitely without gaining any of the envisaged benefits of technological university status. Does the Minister accept the contention that "the process adopted to date has ignored the expertise and experience of TUI lecturers and has failed to examine, in sufficient detail, the risks to which both institutes will be exposed as a consequence of a merger"? Will she ensure that any attempt to expedite this merger will be halted until such time as the participants have confidence in the process?

Deputy Jan O'Sullivan

I thank both Deputies. The objectives of the technological sector reform are to raise standards, to deliver better quality outcomes for students and for other stakeholders in the region and to enhance the performance of institutes of technology. This should be the case whether they are seeking technological university status or remaining as stand-alone institutes.

As part of the development of regional clusters in higher education we have also prioritised the development of more effective collaborations between all of the institutions in a cluster. Two priorities that have been set for each cluster are better student pathways between the institutions and co-ordinated academic planning to reduce duplication and improve quality of programmes. That work is ongoing.

In relation to the technological university designation process, as the Deputies will be aware, detailed plans were submitted to the HEA early last year by two consortia of institutes of technology as part of the process towards designation as a technological university. Cork and Tralee institutes of technology put forward proposals for a merger in Munster leading to an application for a technological university for the region. Dublin, Blanchardstown and Tallaght institutes of technology also propose to form a strong new institution for the city and county of Dublin. Both consortia have been assessed by an international expert panel appointed by the HEA. The panel has found that they are on a clear trajectory to meet the very robust performance and quality criteria that have been set down for merging institutes that wish to apply for the new technological university status. I stress the word “wish” because other regions did not apply whereas the institutes of technology in question decided to apply.

That concludes stage 3 of the four-stage process towards designation as a technological university for the two consortia. I know that the two consortia have been carefully considering the reports of the expert panel. Following merger, stage 4 consists of an application to the HEA to become a technological university. The HEA will consider whether the high performance bar has been reached following another independent international expert assessment. The HEA will then make a recommendation to me on whether technological university status should be awarded.

Both consortia have more work to do to complete their mergers, and to reach the criteria which have been set out by Government. In the initial stage of the process, institutions were asked to state how the transition from their current status to final designation would be financed. Both consortia acknowledge the costs involved in the merger and designation process, but they have also committed to meeting those costs from within their own budgets. For example, in Munster, while there is an upfront cost in meeting the criteria and implementing the project, the institutes have also shown that they expect to recoup the upfront costs in subsequent years. In the longer term, they anticipate that it will allow them to develop surpluses which will be available for investment in infrastructure in future years.

In addition, we are aware of the benefits that will arise for the institutions, students and the higher education system more generally from the reforms. As a result, the HEA has provided funding in 2014 to provide some support to institutions involved in mergers. That has included some additional funding to the Munster TU consortium, the Dublin TU consortium and for the amalgamation of teacher education colleges at DCU.

In terms of consultation, good communication between the leadership of any institute of technology entering into a merger and the staff and students of the higher education institution is extremely important in order that a shared vision and understanding of the new institution can be developed. That message has been conveyed by the HEA and by my Department from the outset. It is a message I have conveyed personally to those involved.

At national level, my predecessor published the general scheme of a technological universities Bill in January 2014. The scheme completed pre-legislative scrutiny by the Joint Committee on Education and Social Protection. The engagement by a range of stakeholders in the pre-legislative scrutiny of the scheme was very welcome. A number of changes to the published general scheme will be made during the drafting process on foot of the recommendations of the joint committee. There has been engagement with stakeholders on this aspect of higher education reform and I would obviously welcome further engagement as the reform programme continues to roll out.

Deputy Jonathan O'Brien

I thank the Minister for her reply. However, she failed to deal with the crux of the issue, namely, the fact that the TUI has now lodged a dispute with the LRC. She also failed to address any of the concerns the TUI has raised about the process, for example, the fact that it has no confidence in any aspect of it. We now face a situation where the very people who are being asked to deliver technological university status have no confidence in the process. They envisage a situation whereby a merged entity could be created but that it might fail to meet the strict criteria. The criteria were discussed previously in the context of Waterford and Carlow institutes of technology and the problems caused in that regard. I refer to the criteria for the number of staff, their qualifications and whether they will be able to meet the high standard which has been set.

The crux of the issue is that we are asking institutions to merge with the prospect of becoming technological universities but with no guarantee that they will achieve that designation once they merge. As a result, institutions having merged may have reduced their courses or rationalised the number of teaching staff and may not get the benefits of being designated as technological university. This issue must be addressed.

Deputy Michael Moynihan

I thank the Minister for her reply. This is an issue of concern to staff. Everyone needs to be brought on board with regard to mergers. I respectfully ask the Minister as a matter of urgency to meet the TUI which represent the staff at both institutes and to hear their concerns. Nobody wants this matter to go to industrial relations. There needs to be face-to-face meetings. I have asked the Minister to meet the Higher Education Authority and the trade union in an effort to resolve the issue. The governing bodies of both institutes should meet the unions. The staff have no confidence in the process to date. Where there is such a level of disengagement or lack of faith in the process, then the issue is heading into very difficult waters.

I ask the Minister if she will meet the TUI to discuss the issues relating to the policy and the merger. I ask her to ensure that the Higher Education Authority meets with the TUI to discuss the issues and to ensure that the governing bodies of both institutes meet the TUI to thrash out the issues of concern.

Deputy Jan O'Sullivan

Deputy O'Brien stated that a claim has been lodged with the Labour Relations Commission. Therefore, I must be careful as to my engagement with the matter. None of us is happy to hear that there are concerns. The criteria for the various stages of the process were always very clear from the start, such as the bar that had to be reached in order to move from one stage to the next. I do not think any of the institutions were in any doubt that this was the process. There has been wide consultation. The Higher Education Authority is dealing with the issue directly with the institutions and an outside body has set certain standards which must be achieved. The process is clear. My direct involvement may not be appropriate at this stage but I hope there will be engagement, in particular, by the two institutions in the Munster region.

With regard to the south east where there have been issues, I have appointed Michael Kelly to engage with all stakeholders, including those working in the institutions, those who run them, local interests and local public representatives. That process is under way in the south east. The issues in the south, in Munster, need to be addressed by way of consultation. It may not be appropriate at this stage for me to meet the trade union representing the staff.

Deputy Jonathan O'Brien

So no process is being put in place.

Deputy Jan O'Sullivan

I will give it some thought as to what assistance the Department can give.

Accident and Emergency Departments Waiting Times

Deputy Mattie McGrath

I thank the Ceann Comhairle for allowing me to raise this most serious situation in our country which is happening in front of our eyes and which is worsening by the day. I wish to pay tribute to the manager and front-line staff in Clonmel hospital and in the other Tipperary hospitals, St. Patrick's, St. Theresa's, St. Brigid's, Cluain Arainn and Tipperary, for their work. They are dealing under pressure with quite ill patients who are on trolleys in corridors. It is not acceptable in this day and age and the situation is getting worse instead of better. I had a call yesterday from a 98 year old who was on a trolley in Clonmel - or South Tipperary General Hospital, as they like to call it, but I know it as St. Joseph's in Clonmel. There were 19 patients on trolleys yesterday. South Tipperary General Hospital is an old hospital, albeit a very functioning and good hospital. However, it does not have the capacity, nor even the space in the corridors, to allow for any kind of treatment or examination of patients, because the physical width of the corridors is too narrow. The hospital had to employ a security man last week to move the accompanying families out of the corridor. These people were trying to stay with their family members to cover them and be with them while they were waiting to be seen. It is a disgraceful situation by any standards.

I welcome some people who are in the Gallery. I welcome the Dunne family who received an award from Uachtarán na hÉireann, Michael D. Higgins, for their 30 years of care work. I welcome Councillor Richie Molloy, who is manager of the carers. Only for all the work they do there would be many more people in hospital.

I remind the Minister of State that the reality is awful. The fair deal scheme is log-jammed with a 15-week delay. This is where that awful term "bed blockers" is used. It is an awful name. People who do not want to be in hospital and they have decided to go to a nursing home cannot get onto the fair deal scheme. This is costing the health service €4 million a week. Those people could stay in a nursing home for €1,000 a week while it costs €1,000 a day for a bed in a hospital. There is no logic and no joined-up thinking.

I refer to the HIQA report on patient safety which found in 2011 that of the total number of patients who attended the accident and emergency department in Tallaght hospital, 14% of those left without being treated. This is happening in every hospital and it is getting worse. People cannot bear it any longer because it is dangerous and unacceptable. If they have a family to look after them they leave and go to the GP.

I refer to what others have said, including Dr. Aidan Gleeson, head of the emergency department in Beaumont Hospital which is currently under siege from serious overcrowding. He said today that patients left on trolleys suffer increased risk of harm or death. He is an eminent doctor in Beaumont. Patients with heart attacks are being diagnosed late while patients with pneumonia and sepsis may not be getting the resuscitation and antibiotics quickly enough because they cannot get a doctor to examine them. Dr. Gleeson said that this is the reality in hospitals. Those are not my words. One would find better in the Third World. Who is going to take charge of this situation? It is outrageous.

There has been a national crisis in accident and emergency departments for years. I do not blame the Minister of State or the Minister, Deputy Varadkar. However, it must be dealt with and not by this so-called task force. As the Taoiseach told me last week, it is an expert panel. It is a case of all chiefs and no Indians. What we need is a manager like Grace Rothwell and other managers and front-line staff to be on that panel, not individual vested interests representing the consultants or the INMO - I agree they must be represented but at different forums. We need to take this out and look at it properly and to have a functioning and dedicated team of people who know what they are doing and above all, who will have the support of HSE senior management, so that they can deal with the crisis in accident and emergency departments. This task force is not fit for purpose because all the top guns are on it. They are pushing paper around, making decisions, looking for promotion, minding their own jobs and not looking after the health of the public who deserve it.

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

I am taking this topical issue on behalf of the Minister for Health, Deputy Leo Varadkar. I welcome the people in the Gallery who are in receipt of the acknowledgement of the help and care they have delivered to people in need of it down through the years.

I thank the Deputies for raising this issue today. I wish to emphasise that the Government regards trolley waits as unacceptable and it acknowledges the difficulties which overcrowding in accident and emergency causes for patients, their families and the staff who are doing their utmost to provide safe, quality care in very challenging circumstances. As of this morning, the 8 a.m. update from hospitals indicated 400 patients on trolleys. While 400 people waiting for a hospital bed is not in any way acceptable, it must be acknowledged that through the hard work of hospitals working together, supported by other HSE services, HSE management and the Department, we have significantly reduced the numbers which were experienced on 6 January of this year.

All hospitals have escalation plans to manage not only patient flow but also patient safety in a responsive, controlled and planned way that supports and ensures the delivery of optimum patient care. Triage is operated to prioritise patients so those with most acute needs are seen and treated as soon as possible. Senior clinicians are a key part of this system, and working with hospital management to minimise potential risk and ensure the safest possible care is a responsibility they deal with as part of their duties every day in hospitals.

Measures to manage emergency department surges involve the full health system including primary, community and continuing care services to ensure that all available capacity and options are utilised and brought to bear on the situation. Some of the measures taken by hospitals to reduce overcrowding include the opening of additional overflow areas, the curtailing of non-emergency surgery, the provision of additional diagnostics and focus on discharge planning, which I believe is key.

The House is aware the Minister, Deputy Varadkar, convened the emergency department task force to find long-term solutions to overcrowding by providing additional focus and momentum in dealing with the challenges presented by the current trolley waits. It is made up of relevant stakeholders, such as senior doctors, lead hospital consultants, GPs, HSE national directors, union representatives and senior officials from the Department of Health and the HSE. A representative of the nursing home sector should also be on the task force and I have written to the Minister in this respect.

At the task force meeting on 2 February it considered a draft action plan specifically to address emergency department issues, with a view to a significant reduction in trolley waits over the course of 2015. We are determined that the action plan is completed as soon as possible, taking the views of the task force into account, and then operationalised without delay. The task force is due to meet again on 9 March. I reassure the Deputy that we are working hard to find workable solutions to the management of emergency care, with optimum patient care and patient safety at all times remaining a Government priority. The Deputy and I know this is not an issue which arose recently. It has been with us for years. We are determined to find a solution to it. Everyone else in the world has done so and it is not beyond us.

Deputy Mattie McGrath

I am disappointed the Minister, Deputy Varadkar, is not here but I accept the Minister of State. I contend the service is not safe and it is not a quality service; this has been stated by consultants and not by me. The Minister of State said front-line staff endeavour to provide a safe and quality service, which they do, but they cannot do so without the tools or the means. If there is a fire we call the fire brigade, which is why I stated the task force is not fit for purpose and should be disbanded and the job given to people who know how to sort out the problem and who deal with it on a daily basis, not senior HSE officials who were all missing at Christmas when HSE officialdom was closed for almost 11 days. The trolleys backed up again because nobody received a letter.

What about the patients who are waiting in ambulances who cannot be taken from the ambulances and put onto trolleys because the hospital in Clonmel and other hospitals do not have a physical trolley in the building? The Government is looking in the wrong places. St. Michael's unit in South Tipperary General Hospital was forced to close and money was thrown at other services to pick up the slack for a while. It was the case that people who presented voluntarily for psychiatric care at South Tipperary General Hospital were taken by a private company to Kilkenny, but this service was withdrawn by e-mail last Friday week. It is a scandal. Now these patients must sit or stand and wait until 9 o'clock the following morning, on a chair if they can get one. This is exacerbating the situation in the accident and emergency department at the hospital. This is the result of a direct action by the Department, which gave us a service for a year and then took it away. When St. Michael's unit closed a service was provided for patients who present voluntarily, who do not feel well and know they do not feel well and need treatment, but it was taken away by an e-mail to the hospital manager last Friday week. It is scandalous and disgraceful. The actions being taken by one office is damaging and putting more pressure on accident and emergency departments.

The Minister of State does not know what is going on in the HSE and the sooner it is disbanded, as was promised by the previous Government and this Government, the better. Let the people who want to, and who are doing their best to do so, care for sick people, and let us not have officialdom choking everything, and the nonsensical situation of €4 million a week being spent on the fair deal scheme when people should be in nursing homes. The nursing homes sector should be involved. There is capacity in Tipperary and nursing homes will take patients, but official HSE is bonkers and cannot understand what is going on.

Deputy Kathleen Lynch

The Deputy cannot quote a consultant to me as if it were the word of God-----

Deputy Mattie McGrath

He is eminently qualified.

Deputy Kathleen Lynch

I am sure he is very eminent. The Deputy cannot quote in this way and also tell me the same consultant cannot solve the problem with regard to the task force, because that is what he is saying.

Deputy Mattie McGrath

No, I am not saying that.

Deputy Kathleen Lynch

It is a contradiction and he cannot do so.

Deputy Mattie McGrath

Senior officials-----

Deputy Kathleen Lynch

It is not acceptable that people must wait nine hours in some cases for admission when they need to be admitted.

Deputy Mattie McGrath

It is 48 hours in some cases.

Deputy Kathleen Lynch

We have put in place a system for transfers whereby separate services are provided by ambulances for acute transfer to accident and emergency departments and by ambulances which transfer people from hospital to hospital. If one is not acute and needs to be transferred, whether to another hospital, service or home such a service is in place and it is far more efficient-----

Deputy Mattie McGrath

It is invisible. I have not seen it.

Deputy Kathleen Lynch

-----and effective than going by taxi. I know in some instances taxis provide a very good service. The State must take responsibility for people being transferred, and we have done so by way of putting in place a second layer of ambulance transfer.

Deputy Mattie McGrath

There are no ambulances. You pulled the service from Clonmel last week.