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Dáil Éireann debate -
Wednesday, 24 Jun 2015

Vol. 884 No. 1

Topical Issue Debate

School Accommodation

I thank the Minister of State for taking this debate. As he knows, and as the Acting Chairman pointed out, Dunboyne College of Further Education recently received independent status and an enrolment number. This time a number of months ago, the college, while operating as a post-leaving certificate college, was under the umbrella of St. Peter's secondary school in Dunboyne. This meant that staffing and budgets had to be shared. The college has been in temporary accommodation since it started ten years ago.

I take this opportunity to thank the Minister for Education and Skills, Deputy Jan O'Sullivan, and the Minister of State, Deputy English, who is my colleague in Meath West, for working with me, the college, departmental officials and the college advisory board on which I sit. The new independent status changes matters for the college and means a great deal for the people who work there and its students. It changes the direction in which the college is going, allowing it to become the college that it is capable of becoming.

While the college has many constraints, it has become the centre of excellence in the county and, indeed, the wider area. It serves a large catchment area of approximately 400,000 people. It integrates school leavers, mature students and non-national students. It has grown out of nothing with just a handful of courses a number of year ago into a college that has developed new programmes in conjunction with business, industry and third level needs. More than 90% of its graduates go on to receive third level offers, which is a fantastic record.

Until now, the college's main impediment was its status. The staffing, budgets and everything else had to be shared. While the college has just received its enrolment number, for which we are grateful, and the feeling among some is probably one of "go away and leave us alone for another while," the main problem that the college now faces is that it is not able to grow in numbers or in size. While this is mostly due to the post-leaving certificate allocation, it is also because its temporary accommodation is located in a business park. While the accommodation has served the college well up to this point, it comprises business units. Recently, the college had to give back space because its lease had ended. Obviously, the units went back to their owner to be leased out to somebody else. There is a fear that such could happen again and the college would have to downsize once more.

Funding for post-leaving certificate colleges comes through SOLAS, which is funded through the Department. SOLAS has stated that it does not have money for capital projects. After ten years, though, the college is now paying €100,000 in rent per year. Obviously, the rent did not start out at that amount, but it makes sense to invest now. We will or already have a demand for an educational training centre in the region, which comprises a catchment area of 400,000 people in Meath, north Dublin, Kildare and Offaly. As SOLAS is not just the new further education authority, but the new training authority, Dundalk is the nearest facility. As the Minister of State has mentioned, given the fact that his portfolio crosses the Departments of Jobs, Enterprise and Innovation and Education and Skills, it will not be a shortage of jobs that is likely to be the problem in a few years' time, but finding people who are sufficiently skilled and trained to fill those positions.

The Minister of State has been supportive of the college on its journey so far. I know he will continue to do that. I ask him to support this endeavour. A new building is needed not just for the county but also for the 400,000 people served by the college.

I thank Deputy McEntee for raising this matter and giving me an opportunity to outline the current position regarding the application for a new building for Dunboyne College of Further Education, which is currently based at the business park in the town. As the Deputy is aware, Dunboyne College of Further Education was awarded stand-alone status by the Department in February 2015. It has been acknowledged that there was a long battle behind that. A great deal of good work was done by many people over the years to try to make sure that happened. I am glad that it has happened and that the great work which has been done at Dunboyne College of Further Education has been recognised. As Deputy McEntee has said, the college's catchment covers a massive area that is much bigger than County Meath. We are familiar with the great work that the college does and the presence it has. It is right and just that it has been given a chance to operate as a stand-alone college. I hope it can develop its numbers over time.

After the decision to award stand-alone status was made, the college was allocated a separate roll number for administrative purposes. This entitled the college to appoint a principal to the separately located post-leaving certificate college. This allowed the principal of St. Peter's College to concentrate on the second-level school. In making the application for stand-alone status, Louth and Meath Education and Training Board acknowledged the fiscal constraints which direct the Department's capital spending decisions in the context of any expectation that the application might have for capital investment by the Department. Subsequently, in granting stand-alone status last February, the Department advised the board that in view of the need to ensure every child has access to a physical school place, the main focus for capital investment in schools in the coming years will be the delivery of major and smaller school projects to meet demographic demands nationally. For that reason, according to the Department, it was not possible to give consideration for a dedicated new building for Dunboyne College of Further Education at that time.

Deputy McEntee outlined many of the reasons that a new building needs to be constructed. As a local Deputy, I share much of her understanding of the matter. It is a question of actually finding the capital budget. There is a great deal of pressure on the budget at primary and secondary levels. That is where much of the money will be concentrated in the near future. All applications for major capital funding, including Louth and Meath Education and Training Board's application for a dedicated new building for Dunboyne College of Further Education, must be assessed in the context of the competing demands on the Department's capital budget. The Deputy will be aware of the demographic challenge facing the education system. I will go through the numbers. Total pupil enrolments in primary and post-primary schools are expected to increase by approximately 107,000 between 2012 and 2019. This comprises an increase of over 70,000 at primary level and over 35,000 at post-primary level. It is projected that pupil numbers at post-primary level will continue to increase up to 2026 at least. That is as far as we can predict. The challenge for the Department is to ensure our school system at primary and post-primary levels is in a position to cater for increasing pupil numbers.

As the Deputy may be aware, the current five-year construction plan contains details of major projects, including new schools and extensions, that are planned to commence construction over the duration of the period of the plan. I hope there will be a new additional plan on that front as well. A nationwide demographic exercise is being carried out by the Department currently to identify the location and distribution of the additional projected pupil numbers and consequently the need for additional primary and post-primary accommodation in all our counties. The provision of this accommodation continues to be the Department's over-riding objective. That is where funds will be prioritised. Quite a high rent is being paid at Dunboyne College of Further Education. The security of having a place is also an issue. I am sure there is scope to look at other premises or come up with other initiatives using the same money. Maybe some other place could be rented. I think the current site is quite ideal and good. It is a question of having permanency. While we accept that this is an issue, we just do not have the capital budget at the moment. It is something that is well known in the Department. I hope that in the years to come, we will find some way to make it happen. As it stands, there is no capital money to assign to it.

I thank the Minister of State for his response. I understand where we are coming from. We have just come through one of the toughest recessions this economy has ever seen. We have managed to turn things around. I understand we do not have the money to invest in all the projects we would like to invest in, or to undertake all the capital spending we would like to undertake. We need to look at the bigger picture. Obviously, we need to continue to invest wisely. Dunboyne College of Further Education is already catering for more students than it receives funding for. Over the past year and a half, I have got to know the staff at the college and the staff who have been loaned to it through St. Peter's College. The staff have done everything in their power to make sure as many students as possible are taken on, to refuse entry to as few students as possible, to expand their courses and to work with neighbouring colleges and businesses to suit the needs that are out there currently. I think they need to be rewarded for the work they have done. It is important that the post-leaving certificate allocation for the area is increased. Obviously, the space needs to be there to cater for that as well. I know the Minister of State will continue to work on this with me, my colleagues and the advisory board. I ask him to ensure it is not put on the back burner because it is too important.

I can confirm that I will certainly be working on it. I am happy to work with the Deputy and all our colleagues on this important issue. I want to recognise the great work that is being done at the college, which is demonstrated by the progression rate of the students who go through the post-leaving certificate courses and into further and higher education or into jobs. I understand that the success rate is over 92%, which is very positive. We recognise the high level of demand on numbers. A national review of post-leaving certificate places is being carried out this year. I hope it will allay some of the concerns about the distribution of post-leaving certificate numbers around the country. I think the demand for places in County Meath is certainly higher than supply is at present. The capital end of it is close to my heart. I will certainly be watching for an opportunity. I assure the Deputy that the line Minister, Deputy Jan O'Sullivan, and I will be banging the table to try to get more money into education and into capital expenditure. In the years ahead, as more money comes in as a result of our job creation successes, naturally we will have more money to spend. I hope that in the future, we will eventually be able to find some capital money for projects like this. Currently, the priority has to be to have enough accommodation for existing pupils coming into primary and secondary levels and thereafter.

Mortgage Resolution Processes

According to reports that were published in today's The Irish Times and elsewhere, seven lenders are in breach of the mortgage arrears code that was drawn up by the banks and the Government. They are breaching the code in four areas: not seeking timely solutions, communications, fair processes, and process improvements and controls. Some of them have committed offences like seeking additional ad hoc payments from borrowers with whom they have agreements in place and making unilateral changes to arrangements without prior agreement. There was also a policy that permitted lenders to remove borrowers from the resolution process if they did not agree to an arrangement over the telephone. Given that the ordinary people of this country have slaved and toiled to bail out the banks over the last seven years, it is quite incredible that the banks are still allowed to operate in this way. Why has the Government given the banks such largesse? I suggest that Government policy is leading directly to many of the problems in the banks.

I would like to draw the attention of the Minister of State, Deputy Harris, to the only penalty that looks likely to be imposed on the banks, which seems to be that they will be written to on 30 November. There will be no 7 a.m. dawn raids like those that followed water charge protests, for example. The banks are doing what the Government has directed, which is to take back possession of properties while prices are going up. This has allowed the banks to operate in whatever way they like. The rules do not really apply. A slogan that is chanted on marches - "the banks got bailed out, we got sold out" - is very apt on this occasion. Anyone who looks at what is happening with the banks in this country will have to agree that it is true. When will the Government introduce some control over the banks, in the interests of working-class and ordinary people? Repossessions have increased by 500%. I ask the Minister of State to imagine a world in which the banks are owned and controlled by the 99% rather than the 1% - "I wonder if you can", to quote from a John Lennon song.

I suggest that rather than people being evicted from the properties they are renting, which is happening every day of the week, there should be an agreement that those people would remain in their homes. It is coming up to the first anniversary of the eviction of Violet and Martin Coyne, two pensioners who were turfed out onto the street by a receiver for Rabobank. I have been asked on numerous occasions when the Government will introduce an order to protect sitting tenants in buy-to-let properties, rather than adding to the homelessness crisis. All of the replies from the banks, including AIB, of which we own practically 99%, suggest that the bank will honour the terms of formal leases. In other words, they will evict tenants when their leases are up in a few months. Even though ordinary people are bailing out the banks, there is nothing to keep tenants in situ. The Minister of State with responsibility for housing, planning and the Construction 2020 strategy, Deputy Coffey, has said that "bringing in the rules too soon could result in property prices stalling [which] would be undesirable" and that "the falling incidence of negative equity is helping to restore banks' balance sheets". Those comments reveal that Government policy is contributing to this crisis.

Threshold and others have asked for a code of conduct for people like that.

The Minister of State might spare a thought for somebody who did get a helping hand recently from the banks, Deirdre Foley, co-founder of the property investment company D2, who has little sympathy for the Clerys workers. She would not be in the position to fire them if she had not got a write-down from the bank in her hour of need. She was struggling to cope with her company debts, estimated at €450 million, but she was given a sufficient write-down to help her trade and operate.

The Deputy should refrain from naming names.

It is in the newspapers. It would be ridiculous for us to refrain from naming names that are in the newspapers.

The rules are that we do not name names here in the Chamber.

I welcome the opportunity to speak on this important issue and I thank Deputy Coppinger for raising it.

The code of conduct on mortgage arrears, CCMA, provides a strong consumer protection framework to ensure that borrowers struggling to keep up mortgage repayments are treated in a fair and transparent manner by their lender, and that long-term resolution is sought by lenders with each of their borrowers. It is essential that the code is fully implemented by all lenders and that borrowers are dealt with fairly in line with the code and that they can be confident that any breaches of the code will be swiftly identified and dealt with by the regulator.

The Central Bank, in its supervisory role, must ensure that the banks comply with the CCMA and take appropriate and timely actions to ensure that they do. The publication this morning of the findings of the Central Bank's themed inspection of lenders' compliance with the code is useful and timely in this regard and where weaknesses were identified by the Central Bank it is important that lenders address them immediately to the satisfaction of the Central Bank as the supervisory authority. The Government expects the Central Bank to use the powers available to it and to take whatever steps are necessary to ensure that all customers are protected. I note that the Central Bank has stated that it has the necessary powers to manage this process effectively and that it has undertaken to use its supervisory powers where compliance levels are not in line with the Central Bank's expectations.

It is essential that all lenders deal with their customers in accordance with the provisions of the CCMA and it is very disappointing when shortcomings are found. It is through the publication of the findings of such inspections by the Central Bank and rigorous follow-up with lenders by the Central Bank that any shortcomings are identified and resolved. That way we can be confident the code is fulfilling its objective of providing a strong consumer protection framework for distressed borrowers.

While obviously, and understandably, our focus is on the weaknesses found, which I and the Government see as utterly unacceptable, we should also note that the Central Bank found that the examined lenders have implemented frameworks as required by the CCMA and a number of good practices were identified that go beyond the minimum regulatory requirements. For instance, many lenders engage with borrowers and attempt to resolve arrears, even when borrowers have been classified as not co-operating by the lender and when legal proceedings have commenced.

The Government has put in place a broad strategy to address the problem of mortgage arrears. This has included an extensive suite of interventions designed to address the problem including specific Central Bank targets for the banks through the mortgage arrears resolution targets, MART, extensive recasting of the personal insolvency legislation, the mortgage-to-rent scheme and the provision of advice through Department of Social Protection-led initiatives, such as support through the money advice and budgeting network.

On 13 May last, the Government announced a number of new measures to further strengthen the framework to support mortgage holders who are in arrears. Building on action previously taken, the measures aim to increase the supports available to people in arrears and to increase the number of people availing of them. This further enhanced the personal insolvency framework, the mortgage to rent scheme and the services offered by the Money Advice & Budgeting Service, MABS.

In this context it is important to also recognise that the numbers of mortgage accounts in arrears is declining and that many home owners are reaching solutions with their lender. In its most recent statistical publication on this issue, the Central Bank reported that at the end of quarter one in 2015, over 117,000 principal dwelling houses, family homes, mortgage accounts were classified as restructured and the vast majority were meeting the terms of their current restructure arrangement.

I would like to assure the House that the Minister for Finance, I and the Government as a whole are acutely conscious of the impact of debt on families across the country and are determined to see it resolved. In these difficult circumstances borrowers must be dealt with in a fair and transparent manner and on a case-by-case basis. The CCMA is a central pillar in this regard and any shortcomings are not acceptable. The Central Bank has the powers to deal with these issues and having identified the weaknesses it is critical that it follows up in a speedy and strong manner to ensure that all lenders fully implement the CCMA to ensure that the best interests of consumers are protected.

The mortgage to rent scheme would assist some of the people I have mentioned who are literally landing on our streets. I do mean that literally, not metaphorically. Where has it been implemented? How many banks have agreed mortgage to rent schemes? I would wager a handful in the entire country because it does not seem to be sought and I would appreciate it if the Minister of State could give me figures for that.

The Minister of State said that he is acutely aware of the impact of debt on families. When this Government came to power five years ago, one of the biggest issues facing it was mortgage debt but it has done nothing to lift that debt or to ask the banks to reduce the debt. Most people bought houses during the property bubble that were completely overpriced. They are still saddled with 30, 35 and even 40 year mortgages. The Government could have brought in rules for AIB because the State owns it. It could have brought in a policy of no evictions of sitting tenants, if it really is concerned. That policy has not been issued and I think that is because the bank is being fattened up for privatisation. That is why it has been told to purge its loan books of bad debts as soon as possible. It is now implementing rules the Government favours because it wants to sell the bank off, to privatise it, which is a real mistake.

Developers are getting write-downs from the National Asset Management Agency, NAMA, which was never intended to happen. The late Brian Lenihan and the then Taoiseach, Brian Cowen, promised that would never happen and it is happening. There is one law for the rich, the 1%, and another for the ordinary people, the 99%, who get only cutbacks in supports such as the lone parents allowance and get no bailouts from this Government.

Nobody has a monopoly on concern. Deputies on all sides of this House are concerned about mortgage arrears. We all see the issue in our clinics and communities but it is not fair to say nothing is being done because the Central Bank statistics show that 117,000 family home mortgages had been restructured by the end of quarter one of this year. Those are real people, some I would guess in the Deputy’s constituency and some in mine. They are engaging with their lenders and are able to get their lives and their family finances back on track. It is also true to say, however, that there is much more to be done. I take the Deputy’s point about the mortgage to rent scheme. It could be of great help but it needs to be modified. I will contact the Deputy with a note on the information she has requested on that scheme.

It is important to note the Central Bank has identified shortcomings but it has also identified good practice. It is important and right that we focus on the shortcomings. It now needs to deal with those shortcomings in a speedy manner. It has the powers it requires as it reiterated this morning. There are several options available to it if it is not satisfied that a lender is in compliance with the code. I encourage the Central Bank to act swiftly and I have every confidence that it will. The letter it has sent to seven lenders is published on its website for all to see. It sets out the shortcomings, the good practice and what now needs to happen. Mortgage arrears and debt will continue to be a priority for this Government, which wants to sort it out. I do not share the Deputy’s view on the fattening up of the banks. We have a commitment to recoup every cent the Government put into the banks so that we can do exactly what the Deputy wants to do, get it back into the taxpayers’ coffers and spend it on the crucial public services we need.

Nursing Staff Recruitment

This Government is fully committed to job creation and ironing out the red tape that prevents employers from taking on staff, yet at the moment there are 300 vacancies in the private sector nursing homes across Ireland largely due to the delays experienced in registering nurses with the Nursing and Midwifery Board of Ireland.

This issue has been raised with me on a number of occasions, particularly by nursing home owners in County Galway, who struggle to replace nurses when they leave. Currently, there are nursing home beds in County Galway that are closed awaiting the registration of nurses.

Nursing home beds in County Galway have been withdrawn from service as the homes await the registration of nurses. This delay in registering nurses has knock-on effects, including the possibility that further nursing home beds will be withdrawn, leading to difficulties in discharging patients from acute settings and placing pressure on accident and emergency departments. The lack of registered nurses means that many owners of nursing homes must use recruitment agencies or engage directly in recruiting nurses internationally. This creates a significant cost burden for nursing home owners, who, in addition to experiencing difficulties in registering nurses, face costs of between €8,000 and €10,000.

The current waiting time is listed as 90 days. Up to 700 applications are before the Nursing and Midwifery Board of Ireland, NMBI, awaiting processing. If a query is raised about an application, as is common for applications from foreign-registered nurses, the application is placed at the bottom of the list and the nurse in question may not be registered for 90 days, six months or 12 months. This is a bureaucratic nightmare. Nursing home owners have informed me that it is very unusual for foreign-registered nurses to have registrations successfully concluded within 90 days. Six months is too long for any business to have to wait for registration. The Nursing and Midwifery Board of Ireland will cite a lack of resources as the reason for delays in the registration process. I also note that the board failed in its attempt to have the nurse registration fee increased by 50%. The current impasse and the delays experienced by nurses and nursing home owners must be addressed.

Rigorous procedures for the registration of nurses are necessary, and I do not propose any relaxation in current procedures. However, faster turnaround times for registration are required, and if additional resources are required, they must be found. Approximately 300 vacant posts could be filled and the additional taxes that would result could be used to offset any additional resources needed.

The lack of available nurses in Ireland is resulting in ever-increasing recruitment and retention costs for nursing homes. Nursing homes in rural areas are at a particular disadvantage because it is assumed that they have lower costs, and this assumption is reflected in the much lower fees they are allowed to charge by the National Treatment Purchase Fund. The fees paid to many nursing homes in rural areas have remained static for the past five years, during which time the crisis in nurse recruitment has greatly increased the cost of recruitment and resulted in offers of ever-increasing salary packages in an effort to retain qualified registered nurses.

The Government has adopted a common-sense approach to job creation. The current delays being experienced in nurse registration could be addressed through simple action that would allow 300 vacant posts to be filled and remove a bottleneck in the health system. I look forward to the Minister's response.

I thank Deputy Connaughton for raising this issue. Delays in processing nurse registration applications are directly connected to the volume of requests arising from current initiatives to attract and retain nurses. My Department and the Health Service Executive are collaborating in sourcing several solutions to the issues affecting nurse recruitment and retention.

The background is that nurses who trained in a country outside Ireland and wish to work in Ireland are required to apply to register as nurses with the Nursing and Midwifery Board of Ireland, formerly known as An Bord Altranais. In assessing an applicant for registration, the board seeks evidence from applicants of comparable standards of education and practice to protect the public, as nursing qualifications vary significantly from country to country. According to the NMBI, the timeframe for completion of the assessment of qualifications for registration is up to 90 days, provided all necessary documentation has been supplied by the applicant. The main difficulty in expediting timely applications, as reported by the NMBI, is delay or failure by the applicant or third parties to furnish the necessary documentation required to assess eligibility for registration.

The NMBI, following the assessment of an applicant's qualifications, may require the applicant to undertake a six- to 12-week period of adaptation and assessment. A period of adaptation is designed to make up for differences in education and ensure competence for working in the Irish health service. If this adaptation is required, it must be successfully completed as a prerequisite to registration. Two HSE adaptation courses are still available this year - in June and August - and these courses are between six and 12 weeks in duration. They facilitate the integration of overseas nurses into nursing in an Irish context. It may be of interest to the Deputy to know that since the nationally co-ordinated pilot adaptation programme commenced in June 2014, 151 candidates have completed the programme, 58 candidates are currently undergoing assessment and 126 candidates are due for assessment up to the final programme in August 2015. In addition to the current provision for placements in 2015, 293 requests for placements have been received from employers. These numbers are not reflective of a national total, as some hospitals have also run independent adaptation programmes.

A collaborative group, including my Department, the Health Service Executive and Nursing Homes Ireland representatives, continues to explore options to facilitate adaptation and thereby registration with the NMBI. It is important to acknowledge that the NMBI is dealing with a significant volume of applications. The board is processing all applications as quickly as possible while ensuring appropriate procedures and checks which are designed to protect of the public. I should also advise the Deputy that the NMBI has been allocated additional resources to address these issues.

Notwithstanding the real challenges we are facing in nurse recruitment and retention, 500 more nurses are working in the public health system than at this time last year and more than 1,000 additional beds will be provided under the Fair Deal scheme this year, all of which will be staffed by nurses.

I thank the Minister for his response. The issue raised with me by nursing home owners is that is taking a long time to inform nurses of problems with their registration applications. Applications are being placed at the bottom of the pile when problems are identified. A similar approach was taken some years ago in respect of student grant applications to Student Universal Support Ireland, and the same practice has been evident n local authorities for many years. Surely, if an application is found to be incorrect, a call should be made to the applicant within one hour informing him or her what documentation needs to be submitted. The NMBI can only deal with the applications it receives. However, if it takes six or eight weeks to request further information from applicants, the entire process slows down, which is extremely frustrating for owners of nursing homes, who must wait six, nine or 12 months before a nurse can start work.

While I accept the Minister's comments on changes to the Fair Deal scheme and the increase in the number of nurses as the economy improves, this issue is entirely a matter of red tape and bureaucracy. As I stated, no one wants to cut corners in the recruitment process. We expect nothing less than the best trained, most skilled and most qualified staff in our nursing homes and hospitals. Surely it would be possible, with some additional resources and further consultations with the relevant stakeholders, to inform applicants of problems with a registration application much sooner than is currently the case. I am informed that this process can take six or eight weeks, during which time the application does not advance, which is extremely frustrating for the nurse seeking registration. I expect that nurses in many of the countries from which we are recruiting are able to move to other countries with much more efficient systems for recruiting nurses. If we want to recruit the best nurses, we must clean up this minor bureaucratic mess.

Additional resources have been provided and consultations are taking place on the matter with stakeholders, including Nursing Homes Ireland. The Deputy makes a valid point about efficiency. While I am not sure precisely how applications are processed, I would be concerned if applications were allowed to mount before being examined one by one. In such circumstances, an application could be left in a pile for several weeks before an administrator identifies that something is missing. It would make sense to carry out an initial check to ensure all the documents are in order. Any steps that would make the process more efficient would be welcome. I meet periodically with representatives of the NMBI, and the chief nursing officer in the Department meets them more regularly than I do. We will definitely raise this matter in our conversations.

Hospital Waiting Lists

I thank the Ceann Comhairle for selecting this important matter for discussion in the Topical Issue Debate. Waterford Regional Hospital, now known as University Hospital Waterford, is the closest hospital to a large number of people in south County Kilkenny, many of whom are waiting for an outpatient appointment or inpatient day case treatment in the hospital. The number of people on waiting lists for treatment at University Hospital Waterford is shocking. In May 2015, some 26,553 people were waiting for outpatient treatment, an increase of 4,188, or 18.7%, in 12 months. It is especially appalling that 10,866 people have been waiting to see a consultant for more than a year. While the figure decreased slightly in April 2015, it increased by 1,744 between January and May and by 7,767, or almost 250%, in the 12 months preceding May 2015.

As such, 41% of those awaiting an outpatient appointment at Waterford have been waiting for more than one year, which is twice the national average of 20.5%. If one examines the figures further, matters get worse as there are 2,965 people who have been waiting for more than two years for an appointment. No other hospital in the country has so many people who have been waiting for more than two years and only Tallaght comes close with just over 2,000. Of the almost 3,000 people who have been waiting more than two years in Waterford, more than one third have been waiting for more than three years. That means 1,067 people have been waiting since May 2012. There are a further 452 people who went on the list in May 2011 and are still waiting.

It is not only outpatients who are suffering of course. The latest National Treatment Purchase Fund figures from May 2015 show that 4,210 people are on waiting lists for day case inpatient treatment at University Hospital Waterford. This compares to 3,773 in January 2015, 2,336 in May 2014, and 1,581 in May 2013. Of the 4,210 waiting in Waterford in May 2015, 624 have been waiting for more than 12 months, which compares with 64 in January 2015, 20 in May 2014 and none in May 2013. The numbers on the day-case inpatient list in Waterford have almost trebled in two years. No other hospital in the South/South West Hospitals Group has experienced this. Nationally, the waiting list has increased by 39.5% in over two years whereas in Waterford the increase has been of the order of 166.3%, which is appalling when the Minister is seeking to have this addressed and substantially reversed. We all accept that health services are demand-driven, but to have so many people waiting for so long is a scandal.

I was in University Hospital Waterford at the weekend. The pressure front-line staff are under is enormous and something must be done about it. We must spend more money and appoint more front-line staff in Waterford because the hospital is unable to cope at present.

I thank the Deputy for the opportunity to outline the concerted actions being taken to reduce waiting times, nationally and in University Hospital Waterford. I recognise fully that too many patients are waiting too long for treatments and that this needs to change but reducing wait times is not that simple. If it was simple, it would have been done by now. As the Deputy will be aware, it is not long ago that his own party leader promised in office to abolish waiting times altogether, but that was not done.

However, I can assure the House that reducing waiting times is a key priority for this Government and much work is under way. Structural change in the organisation of our hospital sector, which is currently under way, will improve quality and access. Hospital groups will help us to better manage patient flow and patient demand. The reality is, however, that the major changes under way will take some time to implement and further time to show results. In the meantime, we must address the significant pressures on hospitals, including pressures on waiting times for inpatient and day-case treatments and for outpatient appointments. The HSE has specific measures in place to manage waiting lists more efficiently. These include the national waiting list protocol, the national clinical programme guidelines, prioritising day-of-surgery admission over inpatient surgery and the validating of inpatient waiting lists. Regarding this last measure, many waiting list entries are duplicates or relate to people who have since gone private.

I want to drive improvements in waiting times and ensure that we make maximum use of all available resources. Taking into account current pressures on acute hospitals, I have set a maximum permissible waiting time such that by the end of this month, nobody should wait more than 18 months for treatment or an outpatient appointment. By year end, that outer limit will be 15 months. This will be achieved in all but a small number of specialties in which there is a shortage of adequately trained staff which we cannot resolve. The HSE is focused on delivering this objective through maximising capacity across hospital groups. However, there are key limiting factors, primarily theatre nursing staff and consultant numbers in particular specialties. Consequently, some outsourcing to private hospitals is required, which is being managed through a public tendering process.

For my own part, I believe that new pathways to improve patient flow, such as medical assessment and local injury units, urgent care centres and non-hospital settings, can and must be used to provide a range of care to support the efficient use of hospital resources. There is significant potential to further improve hospital performance and efficiency. We must achieve the highest levels of efficiency ahead of providing new resources. The Irish hospital redesign programme is working with clinical programmes to support local change and innovation and raise national standards through internationally recognised redesign and improvement methods. I welcome this initiative. It is now advanced in Tallaght and Limerick is next on the list. At national level, the HSE's acute hospitals division is responsible for and manages hospital performance. Weekly meetings are held with the hospital groups to review performance against agreed clearance plans for treatment waiting lists and for outpatient appointments.

University Hospital Waterford is contributing to the South/South West Hospitals Group plan to reduce waiting times through additional outpatient clinics in all specialties. I am also advised that evening or weekend clinics are being held for ENT, orthopaedics, general surgery, vascular, neurology and urology. In terms of staffing, two consultant urologists have taken up posts this year and a temporary part time ENT consultant will begin at the end of June. Two much-needed consultant dermatologists are also expected to start in 2015 and a replacement consultant orthopaedic surgeon post is awaiting approval. My Department will continue to work with the HSE and hospital groups to ensure an appropriate focus and drive to improve hospital waiting times, including that in Waterford.

The figures I have quoted today give the lie to the December 2013 outpatient figures, which claimed that no one was waiting more than one year at Waterford. On a national basis, the figures were much trumpeted by the then Minister, Deputy James Reilly, to show how well he was doing. To say the least, the figures from December 2013 are inconsistent with the figures for last month which I quoted in my initial remarks. The May 2015 figures indicate that 1,067 people have been waiting for an outpatient appointment since before May 2012, 452 of whom went on the list in May 2011 or earlier. Nevertheless, the published figures for December 2013 told us no one had been waiting more than one year in Waterford; a complete fabrication. The published figures for May 2014 indicated that just nine people had been waiting since before May 2012 with just two waiting since May 2011. How does the Minister explain a hospital waiting list in 2013 which said no one had been waiting since 2012 when the waiting list from 2014 indicated that nine had been waiting since the middle of 2012 and the recent figures show that more than 1,000 have been waiting since the middle of 2012, almost half of whom have been waiting since 2011? The figures do not add up. The Minister has given me an assurance in his reply, but this is not going to do anything in University Hospital Waterford where waiting lists are double the average of those in every other hospital in the country. There are over 3,000 people waiting. The Minister must give a reply and explain how the list will be brought down and into line with the rest of the country.

Obviously, operational responsibility for the hospital lies with the hospital management and the South/South West Hospitals Group board. I do not individually manage 50 hospitals. That is not something any health Minister has ever done or could ever do. However, I can discuss the issue in general. I find it hard to get my head around the figures also.

I can give them to the Minister.

I have them and I find them anomalous.

I can hand them over to the Minister.

No, I have them. In pointing to the anomalies, the Deputy makes a valid point. I wonder if the major increase we have seen in people waiting in the last couple of months is a reflection of the fact that the numbers were not accurate before rather than anything else.

This is May 2015.

The Deputy does not understand what I am saying but if he reads back over what he said, he might. It is important that when the Deputy uses the figures, he understands them. There may well be 400,000 people awaiting an appointment of some sort in our health service. Some of those people are waiting a few days or a few weeks. What matters to most people is how long they are waiting not what number they are on a waiting list. If one is No. 120 on a general surgery waiting list, one may be seen in a couple of weeks, whereas if one is No. 60 on a particular surgery list, one might be waiting years. What is most important in my view is ensuring that we reduce waiting times. One must bear in mind that every time we establish a new service, there is a new waiting list and that every time a new consultant is appointed, people will be waiting to see him or her. We have waiting lists now for services we were not providing a year or two ago. As such, this is a trickier matter than people may think.

In terms of the most up-to-date figures for Waterford, the total waiting list on 28 May for inpatient or day-case treatment is 4,210, of whom 1,195 have been waiting for less than three months.

A further 1,700 are waiting less than nine months, but there are more than 1,000 waiting more than nine months and 624 waiting more than 12 months. With respect to outpatient appointments, approximately 6,000 are waiting more than 18 months and we would expect all of them to have appointments by the end of this month. When we consider the figures in the round, 26,553 people are waiting for treatment but the largest single number of that group are waiting less than three months.

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