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Dáil Éireann debate -
Thursday, 23 Apr 2015

Vol. 875 No. 3

Topical Issue Debate

Taxi Regulations

Since the taxi industry review and the announcement of a host of reforms and new regulations, a number of problems have arisen for drivers trying to make a living and operate within the law. Some of these problems were not obviously going to arise but some were fairly clearly going to come up and taxi drivers were telling us this from the word go. Some of these issues have again been brought to my attention by taxi drivers who feel they are getting nowhere with the regulatory authority, the NTA, and the taxi advisory committee.

One issue which is raised across the board is the taxi decals, which were brought in for the sides of cars. These were hailed as a security measure to stamp out rogue taxis operating without a proper licence and to give confidence to passengers, but they have done neither. It is important that prospective customers can tell that a car driving by is a taxi for hire, but a taxi driver cannot now use their car in any private circumstance without people assuming that they are plying for hire. In the past, taxi drivers were able to remove their signage and place it in the boot or elsewhere and drive their car on their day off or on holidays as a private car. They were able to park up in towns or at their home and not be seen from a distance to be a taxi. To some, this might not seem important but for those who make their living as a taxi driver it is crucial for safety and comfort.

With these decals a taxi is never not a taxi and this puts taxi drivers at risk for a number of reasons. I will illustrate the scenarios in which this becomes a problem. A car parked outside a home, advertising to the world that it is a taxi due to its decals, is a beacon to criminals who can expect the car or the home to have cash in higher sums than normal. This is especially the case when parked on the streets as taxis are more likely to have a stash of cash, expensive equipment or other things. It also provides information to anyone who might wish to clone the driver's licence as one can now quite easily find out a person's address from these decals. One may be a customer or just passing down a street. One driver showed me how it was possible to change the name of the driver attached to a certain car with use of the app and details from the decal and plate. Some people's details have been available even after they have passed away.

One driver to whom I spoke had refused to use the decals on his brand new luxury car, which he invested in for his business, because he was worried that it would be damaged by sticking the decals to it, thus losing him money when it came to resale. The decals also cause problems when the car is used in a foreign country or even across the Border, drawing attention from potential undesirables or the police, who may be confused. One driver told me of driving to a town on a weekend night with his family and having people attempt to enter his car or flag him down in the street. Fortunately nothing more happened but it is not unusual for drunken people to cause problems for taxi drivers when they refuse to pick them up. One only has to read the paper to see that taxi drivers are often victims of violent crime.

We need our taxis to be identifiable and to carry relevant information for customers and for security, but it seems we cannot allow them to be safe in their jobs and in their private life. There are also issues with insurance because of these decals and taxi drivers are finding it incredibly difficult to find information on the regulations affecting them from the NTA or the advisory committee. They do not know whom to ask and they get very little response when they do ask questions. Drivers need more supports to access grants needed to increase wheelchair accessible vehicles and to stay within regulations. One driver with whom I am dealing was awarded a wheelchair access grant but was unable to take it up until he had raised the money he needed. When he did raise the money he could not find out if the grant was still available to him. There is a major communication problem and it is causing serious morale problems with drivers, who are feeling increasing frustration. This is seen in the lack of knowledge among drivers about what can be done with a licence when a driver is deceased and a family member might want to keep it on.

The regulation of the small public service vehicle sector is a matter for the National Transport Authority, NTA, pursuant to the Taxi Regulation Act 2013. This includes responsibility for signage. As such I have no function in this matter. I can however set out some background and some information in relation to the operation of the scheme which has been provided to me by the NTA. The requirement for taxi branding arises from the relevant recommendation of the taxi regulation review report published by this Government in January 2012.

The taxi regulation review group which prepared this report included representatives of the taxi industry as well as representatives of the hospitality industry, consumer interests and disability groups. Action 31 of that report sets out the recommendation to "introduce distinctive branding of taxis (and wheelchair accessible taxis)". It further sets out that this "would take the form of semi-permanent decals applied to the vehicle body, potentially to the doors on either side of the vehicle."

The report identified issues with the current reliance on the roof sign as the primary means of taxi identification and stated that "given the varied fleet, a degree of uniform branding would serve to better identify the licensed vehicle to the consumer, while ensuring that the professional operator make the same level of investment and commitment to the industry."

Branding is an issue which was given extensive consideration before its adoption by the review group and subsequent endorsement by Government. A prescribed livery, often including prescribed vehicle types or permanent roof signage, is a common feature of taxis internationally. Regulations were introduced by the National Transport Authority which required that, from 1 January 2013, taxis must have the prescribed vinyl self-adhesive external branding affixed to the front doors of the vehicles. The current statutory instrument containing this requirement is SI33 of 2015, the Taxi Regulation (Small Public Service Vehicle) Regulations 2015.

While I do recognise that taxis are privately owned, they are being licensed to provide a public service and a condition of operating as a public service taxi vehicle is that the vehicle is branded in accordance with legislation now in place. There have been a very small number of complaints that the imposition of a branding requirement renders a vehicle identifiable as a taxi at all times. It is acknowledged, by me and the NTA, that the imposition of a decal on the side of the vehicle does render it more visible as a taxi. However, it is still the case that, even with the roof sign removed, the vehicle is always identifiable as a taxi through the prescribed tamper-proof discs that are affixed to the front and rear windscreens at licensing stage.

One of the additional benefits of the new taxi signage is that it is more difficult for vehicles to operate illegally as taxis. As the door signage is semi-permanent, the vehicle is still identifiable as a purported taxi even when the roof sign is removed, which was not the case previously.

The Minister keeps kicking to touch to the NTA and saying that it lays the rules but it was pointed out to the review group that this would cause problems. I do not see why there is a problem in allowing people to have decals that can be taken away and put aside instead of permanently having them on the vehicle. A big issue is burglary and theft from vehicles and taxis are a major target. In many cases, taxi drivers work at night so if taxis with signage are parked outside houses, people know their owners are not there. Another example is where a driver travelling across the Border is pulled over by the PSNI which tell him that it is not wise to drive the car in certain areas. There are health and safety and other issues involved as well as the right of a person to drive their own car. When drivers pull up at traffic lights or elsewhere, people try to open the car doors when they see the decals. The sign on the roof is gone. What is the problem with going back to that? I do not see a major problem. We have dug in our heels. Hackneys and limousines do not have do it. Why should taxis have to do it? I am asking the Minister to talk to the NTA.

There is also an issue with insurance companies which say that they will not provide private, social or domestic insurance because of the decals. We have a problem which we never had previously. It means that, in many cases, a person or their family needs a second car. It is an outrageous expense. We brought in rules like the nine-year rule, in which I could never see any sense. Cars went through their NCT tests. In the US and other places, some cars are 20 and 30 years old. Some of the rules introduced never made sense. Anyone who is entering the industry must have a car that is between one and four years old. That is a significant expense and excludes many people in working class areas who cannot afford the expense.

Deputy Ellis would be the very person to come into the House to criticise regulations if they did not play a role in reducing the illegal use of vehicles within the taxi industry. He made the assertion a moment ago that the taxi advisory committee is not playing a role in relaying information and consulting with the industry. I invite him to tell that to the unions who are represented on the committee. They will find it very interesting that the Deputy has made that assertion in the Dáil. We have a taxi advisory committee that contains the very bodies and unions that are elected to represent taxi drivers. It is a very large body and its breadth is designed to facilitate organisations to pass feedback to the NTA. If the Deputy feels this is inadequate or if he has an issue with it, I would invite him to talk to the unions on that body who are engaging with the NTA on this and other matters.

In respect of the point the Deputy made about the impact of this signage on vehicles, I accept that it makes clear that vehicles are being used exclusively, or for the most part, as taxis. The very reason this is happening is in response to concerns the taxi industry had about illegal use, the quality of cars and difficulties it was facing in respect of the reputation and the growth of its industry. This regulation is in place to give the taxi industry the regulatory framework and support it needs to grow safely. If it was not in place, Deputy Ellis would come into the House to criticise me for it not being there.

Local Authority Rates

I thank the Minister of State for taking this Topical Issue today. On 16 April, we enacted a very welcome amendment to the Valuation Act which gave partial relief or exemption from commercial rates to all sports clubs which had some commercial activity, be it a small bar or renting out some of their AstroTurfs. We did that because we recognised it was unfair to rate the entire club, which is a voluntary organisation and which is the backbone of probably all our communities, on the basis of it having a small bar or renting out its AstroTurf.

All politics is local so I wish to talk about my local GAA club which, historically, has had a commercial rates bill that is astronomical. It is off the wall and the club has not been able to afford it for the past number of years because the entire complex was rated. Our local council has taken four trustees of the club, who are very elderly men and who are only active in the club in a very recreational way these days, to court. They now have a judgment against them for this very large commercial rates bill and the council is pursuing them.

The reason I raise this with the Minister of State is because he directly manages, controls and directs our councils. I am asking him to intervene in this particular action and ask the council to look retrospectively at the commercial rates owed and, in the spirit in which the Valuation (Amendment) (No.2) Bill was passed on 16 April, to possibly recalculate the historic commercial rates and come to an amenable agreement so that four elderly men in Ratoath do not go to bed at night worrying about whether the courts will come after them for their houses. The GAA club in Ratoath wants to pay what is owed but it only wants to pay what is fair and what it can afford. Will the Minister of State intervene through his Department with local authorities, including Meath County Council, to find an amicable, fair and amenable outcome?

In the past months, two very well-known GAA clubs in north County Louth have received rates demands for 2015, one in excess of €16,000 and another in excess of €15,000. Both clubs are in the north of the county and cater for over 1,000 children ranging in ages from six right up to 18 and also include adult members and players. They are voluntary, not-for-profit organisations and rely on the goodwill of the community to stay alive. Each year, the cost of running the clubs is increasing and they rely heavily on fund-raising efforts to remain open for the members and the community. I have met representatives from both clubs and other sporting organisations in County Louth and it is clear that the additional expense of the rates bill will have a very detrimental effect on the clubs. They face very stiff competition in their fund-raising efforts from other very worthwhile organisations.

I have spoken to representatives from Louth County Council who have explained that from their point of view, there is no provision in law for the waiving of rates and have told me that "rates apply to all commercial outlets which include bars". The law, as it stands, states that sports club facilities are normally exempt from rates but where the club has a bar, all of its premises are valued for rates, including buildings which are purely for sporting purposes. I welcome the fact that the Valuation (Amendment) (No. 2) Bill has completed its passage through the both Houses of the Oireachtas in the past week and will allow commercial and community areas within these clubs to be separated for rates purposes. Will the Minister of State and his officials actively engage with Louth County Council and the Valuation Office in respect of the commercial rates bill already issued to both clubs with a view to re-evaluating the outstanding bills on the new rateable basis?

I thank the Deputies for raising this issue. I understand and appreciate the concerns they have expressed but I must clarify some aspects of the issue for them. As they are aware, local authorities are under a statutory obligation to levy rates on any property used for commercial purposes in accordance with the details entered in the valuation lists prepared by the independent Commissioner of Valuation under the Valuation Act 2001. The Commissioner of Valuation has sole responsibility for all valuation matters. The Valuation Act 2001 comes under the remit of my colleague, the Minister for Public Expenditure and Reform.

I am aware there has in the past been discussion at a local level regarding aspects of the rateability of some sports clubs and child care providers. The Deputies are correct in saying that this has been a matter of debate in this House in recent times.

In this regard, as stated by the Deputies, the Minister for Public Expenditure and Reform included in the Valuation (Amendment) (No. 2) Bill 2012 an amendment to provide for changes to the valuation of sports clubs and child care providers. This Bill was passed by both Houses of the Oireachtas on 16 April this year and now needs to be signed by the President.

The Minister for Public Expenditure and Reform has ministerial responsibility for this Bill. The levying and collection of rates are matters for individual local authorities. In accordance with section 29 of the Local Government Act 1946, as amended, local authorities are obliged to make one rate for the whole financial year. This must be levied upon those liable for rates according to the valuation of each premises contained in the latest valuation list transmitted by the Commissioner of Valuation at the time of the adoption of the budget by the council. The annual budget is adopted before the start of each financial year. Rates bills issued to ratepayers in the current year are not subject to amendment by any alteration of valuations within that year.

Contingent on the enactment of the Valuation (Amendment) (No. 2) Bill 2012 in due course, the valuations of affected sports clubs and child care providers will require the Commissioner of Valuation to amend the valuation lists to which rates are applied for the future. I understand that the Commissioner will commence this process upon the enactment of the Bill. In respect of rates that have been levied on these businesses for the current and previous years, these remain a liability for the business under ratings legislation and it is a matter for the local authority to manage the collection of any outstanding debt.

As the Deputies will be aware, the local authority is the rating authority and each authority is responsible for the collection of rates in their jurisdiction. The Minister and the departmental officials cannot, therefore, become directly involved in specific rates collection issues.

Everything the Minister of State said is true, including that the statutory obligation to collect levies on property used for commercial purposes is the council's. Why then is the council still seeking to collect rates in respect of the changing rooms, upstairs playing hall and gym of the sports club in my area, none of which have a commercial aspect? They are run on a voluntary basis and funded by way of fund-raising events in the village.

I appreciate all of the palaver with regard to the legalities around this issue, but I take this opportunity to inform the Minister of State that the day the sheriff arrives to remove items from the four elderly men who are trustees of my local club, I will be standing in front of them to prevent property from being taken away. There is no goodwill in this regard. The Department needs to look at this from the point of view the many organisations that are the backbone of our communities and are volunteering their time, services and effort to the provision of sports and recreational activities and the fund-raising events required in this regard. These people are being told, leaving aside the services they have provided for the past year, that they will continue to be pursued for commercial rates, which, as has already been acknowledged through the changes made to the legislation, were wrong.

I call on the Minister to intervene in this matter with the local authorities involved and ask that in the spirit of goodwill they renegotiate the outstanding rates on the new commercial rates basis.

I thank the Minister of State for his response. I urge him to bear in mind that, as in the case of many other GAA clubs in this country, both of these clubs are run on a voluntary basis. It is vital that a suitable arrangement is arrived at by all the parties involved.

I am a lifelong member of the GAA and I understand fully the commitment and effort required of thousands of GAA members across the country. In the majority of cases, the commercial profit derived from club bars is very small. These bars are generally only open once a week and in many cases are losing money. The clubs appreciate that they must pay rates, but they cannot afford the current very high rates.

I again urge the Minister of State and officials of his Department to work closely with Louth County Council and the Valuation Office to ensure a satisfactory solution to this issue.

I understand the Deputies' concerns in regard to this particular issue. I am the chairperson of my local GAA club, and as such, I do understand their concerns. As stated, the law has been changed to address their concerns going forward. The Valuation (Amendment) (No. 2) Bill 2012 contains provisions to alter the basis of valuations of certain sports clubs and child care providers into the future. I welcome the granting of a specific exemption to community sports facilities, as it resolves this long-standing anomaly, and the extension of the exemption to not-for-profit child care providers, as this will ensure consistency of approach with regard to the child care sector, while respecting the principle that those who operate with the intention of making a profit remain rateable. It is important to make that point.

Nevertheless, in accordance with current rating law, these exemptions can only be reflected in ratepayers' bills from 2016 at the earliest. In terms of outstanding rates liabilities owed by any businesses that may become exempt or partially exempt in the future, management of the collection of rates due is a matter solely for the local authority as the statutory body. I would expect, however, that given the changes in the law, local authorities would proactively engage with stakeholders affected to try to resolve any outstanding matters in keeping with the principle of the laws now being developed.

Exceptional Needs Payments

I thank the Minister of State, Deputy Kevin Humphreys, for coming to the House to deal with this issue, which relates to two very sad cases that occurred around the same time. It involves the death of two people, one after a very lengthy illness, following which the household was left with various financial and other difficulties. However, I do not propose to go into those details in this public arena. The second case involves the death of a young child in equally tragic circumstances. In this case, the parents, who had been employed up to a year ago, did not have the resources to meet the cost of the child's funeral. Previously, such people would have been entitled to a bereavement grant. The bereavement grant has been replaced by the exceptional needs payment, which has the capacity to address individual household cases in terms of assistance required.

In the first case, a payment was made but it was insufficient to meet the cost of the funeral expenses. As we all know, funeral expenses are considerable, and hugely so for families in financial difficulty, particularly following a period of long illness prior to death. In both cases a payment was made, and in both cases it was insufficient. I discussed these cases on a number of occasions with a very helpful person in the Department, following which further payments were made, but, again, these were far short of what was required in terms of addressing the issue. In an effort to have this issue addressed, I have raised it by way of parliamentary question on a number of occasions. Sadly, it has not been addressed. To my mind, it reflects poorly on the institutions of this State that we are not in a position to respond in the way that we should. I am not suggesting that everybody should get full payment of their funeral costs. The cases I am highlighting involved particularly extenuating circumstances, which were clear to everybody. Even a cursory examination of the means of the households in question would lead to the conclusion that close to the maximum payment would be necessary. However, this did not happen. The neighbours then had to rally round and organise events to help out. Good neighbours are greatly appreciated and this type of activity should be always encouraged. Those involved did a great job. However, I would not like to see this happen again.

I am asking today that the two cases I have highlighted be reviewed with a view to ensuring some semblance of parity with the funeral costs involved and that in future such cases only one visit would be required to allow assessment for payment, thereby reducing the cost to the State in terms of administration.

A bereavement at any stage is always very difficult for families.

I sympathise with the two cases Deputy Durkan has brought to my attention. It would be worthwhile to outline the policy position.

The administration of the supplementary welfare allowance scheme was transferred to the Department of Social Protection on 1 October 2011. The Department of Social Protection's assistant principal officers and higher executive officers administer the supplementary welfare allowance scheme.

The objectives of the scheme are to provide a standard minimum income, in an immediate and flexible manner, to those whose means are insufficient to meet their basic needs. The scheme also provides income support in the form of a weekly or monthly supplement to those with specific needs that cannot be met from their regular weekly income. In addition, the scheme can assist, by way of a single payment, individuals who have one-off exceptional or urgent needs that cannot be met from their regular weekly income.

In the context of the administration of the supplementary welfare allowance scheme, governance in the community welfare service involves implementing the highest standards in the process of decision-making and the process by which those decisions are implemented. In this regard, this means strict adherence to the Department's legislative policies and guidelines.

Section 201 of the Social Welfare Consolidation Act 2005 provides the legal basis for exceptional needs payments. The Government has provided €29 million for the exceptional needs payment scheme in 2015. The purpose of the scheme is to assist the recipient with one-off expenditure, which is exceptional and unforeseen and which, given the circumstances of the case, they could not reasonably be expected to meet out of their normal weekly income. Exceptional needs payments are not intended to cater for expenses that are of a predictable and recurring nature, such as fuel or clothing, which should be budgeted for out of regular weekly income.

In making a determination on an exceptional needs payment application, the community welfare officer considers the nature and extent of the need in deciding the appropriate nature and level of assistance. In performing this function, the Department's officer must take into account the available guidelines issued by regional and local management.

A claim for assistance with funeral expenses under the social welfare allowance scheme is treated as a claim for an exceptional needs payment. In 2014, the Department supported approximately 3,000 applicants with financial assistance towards the costs of funeral expenses, at a provisional cost of some €4.6 million. Entitlement to an exceptional needs payment for assistance towards funeral expenses is discretionary. The application is means tested and the primary consideration in determining that a payment is warranted is that there is an inability to pay the costs, in part or in full, by the family of the deceased person without causing hardship.

In determining eligibility for an exceptional needs payment towards the cost of funeral expenses, the community welfare officer must establish that the person applying for the payment has difficulty in meeting the funeral costs without causing hardship while also considering the ability of other members of the family to meet, or contribute to, the cost involved. In performing this function, the community welfare officer must take into account the available guidelines on funeral expenses.

There were 189 exceptional needs payments awarded to assist with funeral expenses by the Department in Kildare from January 2014 to February 2015. The maximum payment made was €2,500 and the minimum payment made was €100. In total, €314,090 was paid, representing an average payment of €1,661.

In the case of the first person concerned, a payment of €1,500 was awarded initially by the community welfare officer towards the cost of the funeral expenses. This was increased to €2,500 following a review by the review officer at the request of the person concerned. In the case of the second person concerned, a payment of €2,000 was awarded by the community welfare officer towards the cost of the funeral expenses. This was increased to €3,000 following a review by the review officer at the request of the person concerned.

In any circumstances where an applicant is unhappy with the outcome of an application for an exceptional needs payment, the applicant may have the original decision reviewed by a supplementary welfare allowance review officer. I am satisfied that the procedures and guidelines relating to the provision of assistance towards funeral costs through the exceptional needs payments scheme were adhered to in respect of these two cases.

I thank the Minister of State for the comprehensive reply. There is a little inaccuracy in it that I will convey to him privately-----

I can imagine what it was.

-----so as to avoid any embarrassment to anybody.

In the first case, the unfortunate situation was that a young person had to become the statutory carer for the remaining siblings in the family and, in fact, had to become their guardian and take on guardianship responsibilities. In those circumstances, there is no more pressing case that I can think of where the maximum payment applicable should be paid, and it was not done. Even after two attempts, it still was not done. I ask the Minister of State to have a look at the case because, having been in a previous incarnation an incumbent in exactly the same position in which he is now, I can assure him strange things happen when one looks closely at the smaller print.

The second case, where all the children in the household were very young, involved very difficult circumstances. They also had nowhere to turn to except the statutory authorities that can be relied on in these circumstances. It goes without saying that where a child dies, as the Minister of State rightly said, it is particularly tragic for any family, but, also following two visits, the payment did not come near what was required to make an indent of some consequence on the cost of the funeral expenses.

I ask that the Minister of State have a look at both of those cases. I guarantee that he will find adequate support for what I have said.

Deputy Durkan knows me well. Of course I will look into the issue.

In the case of the first person concerned, a payment totalling €2,500 has now been made towards the funeral bill of €5,505. In the case of the second person concerned, a payment totalling €3,000 towards the funeral bill of €6,845 has now been made by the Department. Considering the pressure families come under at a difficult time, those are quite considerable sums.

The cost of funerals is something that has concerned me for quite a long period and Deputies Eamonn Maloney and Robert Dowds have raised it consistently in the House. My concern is that people are in delicate circumstances when a close family member passes away. For a long time, I have been particularly concerned about the cost of funerals. When a person loses a loved one, a funeral is not something for which he or she would shop around. It is difficult, and often families have relationships with particular undertakers, but there is an onus, possibly on the State, to ensure that the cost of funerals is competitive, people are not overcharged and there is not profiteering. I am not suggesting that this happened in these cases, but both Deputy Durkan and I know many people who have come back to us stating that if they had known beforehand the cost of the funeral they might have gone elsewhere. There is possibly something we can do in that regard.

With regard to the two cases Deputy Durkan raised, for which he has already provided the contact details and arrangements, I will have officials in my Department look at them again.

I thank the Minister of State.

Hospital Services

I thank the Minister for Health, Deputy Varadkar, for being present to take this matter. Indeed, I acknowledge that he has a good record of attendance to deal with Topical Issues.

There has been some confusion about this matter. I had agreed earlier that we might defer the matter until Tuesday but, apparently, decisions were made elsewhere on the matter. However, I am deeply grateful to the Ceann Comhairle for selecting this topic relating to pancreas transplants.

It was reported last week that the former director of the national pancreas transplant programme has accused Beaumont Hospital of abandoning gravely ill patients on the waiting list. Mr. David Hickey was quoted as saying that the hospital and the HSE were taking an "unethical and callous" approach to patients on the waiting list by seeking to wind up the programme without telling them.

He said, "I hate to see a pancreas programme that has been run well with minimal resources, with patients urgently needing transplants, being squashed because no one gives a damn." Finally, he said that the HSE could find itself facing charges of corporate manslaughter if it failed to provide appropriate levels of care for seriously ill patients. These are extremely serious charges coming from a surgeon who has had an illustrious career.

It would appear that no pancreas transplants have been carried out in Ireland since Mr. Hickey retired last December. Mr. Hickey, who has carried out over 1,500 kidney and pancreas transplants, said he offered to stay on for two years but this was rejected by the hospital. He maintains - it is difficult to disagree - that it is unconscionable that no plan has been made for seriously ill patients four months after his retirement. His retirement date was known for 30 years, but no plans were put in place for that.

It is fair to say that this is a rather bad situation, to put it at its mildest. What does the Minister think? When is it going to be rectified? I appreciate that by the standards of some waiting lists, eight people waiting is not a high number. That was the figure mentioned, although I believe Mr. Hickey has referred to 18 people. Either way, it is not a vast number, but I suspect four months without activity is not a situation the Minister would stand over.

Situating a national transplant programme in a regional hospital was a mistake, Mr. Hickey said. He claimed the hospital was run by people with clipboards who cared only about budgets. I understand that from next month, pancreas transplants are to be carried out at St. Vincent's University Hospital. Moreover, under new arrangements for combined kidney and pancreas transplants, consultants from Beaumont will carry out kidney transplants. However, it is not clear who will carry out the pancreas transplants. Mr. Hickey was trenchant on this matter as well, saying that those in Beaumont had "no idea what they're talking about" in respect of the proposed transfer of services to St. Vincent's. He continued:

You can’t just flick a switch and call it a transplant centre. Who is going to do the work?

Given the critical nature of this particular issue, it is appropriate that we raise it in the House and provide the Minister with an opportunity to address these rather trenchant criticisms. I imagine it is our universal desire to see the problems rectified as a matter of urgency, and I look forward to hearing how the Minister proposes to do just that.

I thank Deputy Ó Fearghaíl for raising this issue and for giving me the opportunity to address the matter in the House.

The national kidney and pancreas transplant programme is currently provided at Beaumont Hospital. In 2014 Beaumont carried out 192 kidney transplants, including 152 from deceased donors and 40 from living donors, as well as six pancreas transplants. The transplant programme at Beaumont Hospital is provided through the surgical specialty of urology. As an aside, this is the first time I have ever heard Beaumont described as a regional hospital. It is recognised as the national centre for neurosurgery and kidney disease as well as many other things. I am surprised to hear someone who worked in Beaumont for so long downgrading the hospital to a regional hospital. It is not; it is a national centre in several specialties. When fully staffed, the urology department in Beaumont has 11 full-time posts. In whole-time equivalent terms, 8.5 of the consultant urologist transplant posts are based in Beaumont, with the remaining 2.5 whole-time equivalent urologist posts based at Connolly Hospital in Blanchardstown. At the end of 2014, two consultant transplant surgeons left the renal and pancreas transplant programme at Beaumont, one on retirement and the second on leave of absence for professional development purposes. Currently, there are three transplant vacancies, which equates to 1.5 in whole-time equivalent posts among the 11 posts - that is, three consultants who would work half time on transplants and half time on urology.

Giving the limited number of surgeons who specialise in transplantation, the filling of vacancies poses a challenge at any time. While Beaumont Hospital is making every effort to recruit suitable people to fill these vacancies, the hospital is also collaborating with St. Vincent's University Hospital on a combined approach to kidney and pancreas transplants. It is now proposed that pancreas transplants, of which six were performed in 2014, will commence in St. Vincent's later this year. While the transfer of this work has been agreed in principle, it will take some time to make the detailed arrangements to facilitate the commencement of pancreas transplants.

Management and clinical staff at the hospital are committed to ensuring that an optimal service is put in place which will benefit all those in need pancreas transplants. Given that St. Vincent's is already established as the national liver transplant centre and the designated centre for pancreas cancer services, this initiative makes sense and will enable two transplant centres to share resources and support and promote improvements in overall transplant services.

There are nine people on the waiting list for pancreas transplants, eight of whom require simultaneous pancreas and kidney transplants. Pancreas transplantation as a stand-alone procedure is relatively uncommon. The arrangements being put in place for simultaneous kidney and pancreas transplants will involve transplant surgeons from St. Vincent's University Hospital and Beaumont working together on the St. Vincent's campus. In addition to working with St. Vincent's on a combined approach to kidney and pancreas transplants, Beaumont is also co-operating on the development of intra-abdominal organ retrieval service that will facilitate a more effective and cohesive overall procurement and transplant service.

I am confident that the measures being put in place will enhance our organ transplant service in future. Six new organ donation nurse managers will be appointed shortly, one to each of the six new hospital groups. This will facilitate the development of the transplant programme over the coming years. Officials from the HSE and my Department are working with senior management and the transparent surgeons at Beaumont and St. Vincent's on the development of transplant services. All parties are committed to ensuring that the transplant programme will be developed to the further benefit of patients.

I appreciate what the Minister has said about what is going to happen in future. It makes sense that there would be a certain level of collaboration between Beaumont and St. Vincent's. However, I do not understand why we have had this hiatus. It has been known for 30 years that this man, the lead surgeon, would retire. Why were plans not put in place in advance of his retirement in order that there could be a seamless transition from the old to the new system? I was a member of the old Eastern Health Board. I admit that during its existence there were significant problems with recruitment and personnel management. To this day there seems to be major problems within the HSE in the area of services and recruiting vital personnel. As I understand it, a pancreas transplant is one of the most complex organ transplants that can be undertaken. The survival rate after five years is of the order of 74%, with a 51% survival rate after 15 years. I recently read that providing a transplant to one person effectively saves the HSE €700,000 over a 15-year period by comparison with the cost of providing that person with dialysis.

This needs to be tackled urgently. People's lives are affected. Moreover, the budget of the health service is being adversely affected. The problem is almost universal within the HSE. I am referring to its inability to effectively manage personnel, forecast where vacancies are going to arise and show initiative and do what those in the private sector would do. It would be unimaginable in any private operation that an impending vacancy would not be filled in such a way as has occurred in this case.

This current issue relates to pancreas transplantation, not kidney transplantation. Dialysis is for kidney treatment and not pancreas problems. The renal unit seems to be working relatively well in Beaumont. Certainly, it has not been the case that any kidneys that could have been transplanted in Ireland were exported or anything like that.

I am not involved in recruitment to individual posts in Beaumont or any other hospital, but I understand the hospital had difficulty filling the post in question. It was advertised and the hospital was unable to get someone. That is an ongoing problem in our health service. What would happen in the private sector is that an organisation would go out and head-hunt someone and pay the person whatever had to be paid, but that is not how the public service works. We do not give market rates to individual people. For various reasons, the public service is different from the private sector in that regard, for better and for worse. Anyway, the important thing now is that the new arrangements are being put in place. It is anticipated that the arrangements will be fully in place within the next couple of weeks.

The Dáil adjourned at 2.50 p.m. until 10 a.m. on Friday, 24 April 2015.