Leaders' Questions

We now move on to the Topical Issue Debate.

We are taking Leaders' Questions now.

I can assure the Ceann Comhairle the issues raised will be topical.

Leaders' Questions would be postponed too, if it were possible.

The situation in our accident and emergency departments is chaotic and out of control. All of us in this House will have been shocked at the contents of a letter written by an emergency department consultant at Tallaght hospital to his chief executive officer, which was copied to the Minister for Health and referenced by me to the Taoiseach yesterday. It outlines how a couple in their 90s, married for 59 years, found themselves waiting for long periods in an emergency department. The man, who has advanced Parkinson's disease, was left a on trolley in a conduit between the psychiatric rooms and some cubicles for over 29 hours.

The consultant refers in his letter to there being 79 patients in the emergency department at 10.40 p.m., 19 of whom were waiting for beds and two of whom had been waiting in the emergency department for longer than two days. In regard to the man with Parkinson's disease, the consultant stated, "This man, like the others in non-designated patient conduits, had no privacy, no dignity, was subject to constant noise torture, constant light torture, resulting in major sleep deprivation and pressure effects causing pain as a result of lying for an advanced period on a trolley not designated for same, as well as boarding conditions that constitute an infection control hazard." He further stated, "Nobody of any age should be subjected to this inhumanity." He then spoke about gross governance failure evidenced by two patients who were boarded and deemed to be requiring isolation, a patient festering two days and 11 hours and a dedicated pressure control isolation room that currently lies idle in the expanded new emergency department, along with eight cubicles lying idle since June of this year. Chillingly, the letter concludes, "It's only a matter of time before we disclose our next crowding related death at Tallaght hospital while crowding is tolerated."

The INMO has now balloted for industrial action, citing record numbers on trolleys in our hospital emergency departments, the total figure for which amounted to 80,000 over the past ten months, which is an all-time high since the introduction of trolley watch. There were 8,000 people on hospital trolleys in the month of October alone. Two years ago, the Taoiseach announced to this House that he was taking personal charge of health services. This letter speaks to an absence of decency and dignity. The situation has worsened over the past two years. Can the Taoiseach explain the reason for this to the House?

The Minister for Health, Deputy Varadkar, is asleep on the job.

Is the Taoiseach not ashamed of this damning indictment of his stewardship?

It is a scandal. Where is the Minister for Health?

Please give the Taoiseach a chance to reply.

I agree with the consultant concerned-----

The shine has gone off this Government.

-----that this is a shocking example of dysfunctionality in the system. One does not need legislation to know that a 91 year old should not be left on a trolley for lengthy periods.

The same applies in respect of the man's wife. One does not need legislation to understand that.

I would like to know who is responsible for that 91 year old man being left on a trolley for 29 hours.

The Taoiseach is responsible.

I know that there are serious changes being implemented in many of our hospitals.

There are no beds available.

Sorry, would you stay quiet please?

Some of these changes are being resisted, as they always have been resisted.

We need more full-time staff.

It is important to understand, from any sense of humanity, that a 91 year old man should not be left on a trolley in the first instance, if that can be at all prevented and, if not, certainly not for that length of time.

Deputy Kenny is the Taoiseach.

As pointed out by the consultant, this indignity, lack of privacy and noise and light interference in this man's senior years is unacceptable.

It is a fire hazard.

Emergency department overcrowding remains a serious challenge. We were told earlier on this year that the provision of additional funding for the fair deal scheme would help to bring down waiting times under that scheme from 15 weeks to a more normal level and that this would end this particular problem. That funding was provided. It is now four weeks on and it did not deal with the problem as envisaged.

An extra €117 million has been allocated this year to free up hospital beds, to create additional beds and to hire more staff. I did not hear the hospital manager, or the bed manager, from Tallaght hospital speak on this particular incident. I do not have all of the details, other than the letter Deputy Martin has referred to from the consultant, with whose view I agree.

It is happening every day.

The task force set up by the Minister in respect of emergency departments meets on a regular basis. There are more beds. Delayed discharges have been reducing steadily since the start of the year. Beds in the community - for instance, in Mount Carmel - have been opened and 300 additional hospital beds are to open shortly, as already announced and in respect of which money is in place. A series of campaigns are going on to attract front-line staff. Since January of this year, there are 500 more nurses in the health service. Since September 2011, almost 300 additional consultants have been appointed, including 57 more this year. The number of NCHDs employed has increased by over 250 since last year.

I do not understand how what happened to this 91 year old man was allowed to happen. It is up to everybody in the health service to play their part, accept their responsibilities and to work to ensure that the plan works. All Members will be aware, in terms of hospitals they may have had to visit, that somebody has to make a decision about the extent of medical priority such that no 91 year old is left on a trolley for 29 hours. The facilities are being provided. The extra staff are also being provided, as is the money, but it is still not making the impact that it should. I am sure that over the next number of weeks other shocking cases will be brought to light.

Maybe the Minister would wake up and do something.

Please stay quiet.

This is a challenge for everybody. The Minister has provided the money through the budget. Extra staff have been appointed and yet these kinds of cases continue to arise.

The Government is responsible for the closure of wards.

I would like to hear the response from the hospital. I am not passing the buck-----

That is exactly what the Taoiseach is doing.

-----but the point is that anybody in an accident and emergency department who has to make choices knows that-----

The Government took 500 beds out of the system.

-----a 91 year old person should not be left on a trolley for 29 hours.

Staff should not be forced to make those kinds of decisions.

I agree with this consultant in his views.

This Government gave tax cuts to the rich instead of increasing hospital beds, which is an absolute disgrace.

Deputy Finian McGrath should-----

(Interruptions).

It is outrageous that a 91 year old man would be left on a trolley for 29 hours.

It is happening every single day.

Will the Deputy sit down? Do not be putting on a show for television and I ask the Deputy to resume his seat.

I make no apology for raising this issue.

The Deputy did not raise anything.

I will not resume my seat.

The Deputy will leave the Chamber.

It is outrageous. This is about beds. We need beds.

Leave the Chamber.

That is what we need.

I told the Deputy to leave the Chamber.

I have just raised this on behalf of my constituents. What we need is a solution.

Leave the Chamber. Does the Deputy want to be named? Leave the Chamber.

(Interruptions).

Shane Ross is missing.

Deputy Finian McGrath withdrew from the Chamber.

This is Leaders' Questions and no Deputy is entitled to interfere in Leaders' Questions to make a show.

Last February we were all shocked that a 100 year old woman spent 24 hours on a trolley and the Taoiseach said the same thing last February.

Last January the Minister, Deputy Varadkar, produced his 25 priorities when he published a budget, which provided for reducing accident and emergency department waiting times for the number of people waiting for longer than nine hours to more than one third. The Taoiseach has come in here today and said that he would love to know why this is happening, after he said two years ago that he would take personal charge and after the Minister establishing a task force, the co-chairman of which has said it has not made a dent on the problem. Then the Taoiseach says people are resisting change. That is an appalling assertion against the staff in our emergency departments.

The Deputy set up the HSE when he was Minister.

If the Taoiseach listened to the staff he would know that they are absolutely at the end of their tether in terms of the stress and strain in emergency departments. I saw a series on accident and emergency services on RTE last Monday week and the staff said it was appalling, from their perspective, to watch patients in such distressing conditions and under such stress and strain.

Will the Deputy put his question?

The Deputy opposite created the HSE.

It is not good enough for the Taoiseach to say that the staff are resisting change or that people by resisting change are slowing down progress, or for him to wonder aloud-----

Will the Deputy please put his question?

-----why this is happening. It is his job. He must accept responsibility and the Minister must accept responsibility. It is not about saying the staff must accept responsibility. The staff are accepting it. It is really the Taoiseach's job to accept it and he should be explaining it to me.

Will the Deputy put his question?

I did not get an answer to the first question I asked the Taoiseach. The first question I put to him was------

Remember a former Secretary General-----

-----why has the situation got worse in the past two years.

Thank you, Deputy.

I would like to know why that has happened because if we could find that out, then the Taoiseach might have some chance or people might believe there is a prospect of him getting to grips with what is a chaotic situation.

The Deputy created that chaotic situation; he created the HSE.

They called it Angola.

The Deputy opposite cannot remember that.

Has the Deputy taken over the role of the Taoiseach?

I am sorry, a Cheann Comhairle.

A Deputy

We would need the Army then.

I have listened to Deputy Martin on this matter on many occasions. He asked what has happened since then and why the situation is worse. I have already pointed out to him that the delayed discharges are reducing steadily since the start of the year freeing up beds, with beds in the community, such as for example, Mount Carmel which has opened and 300 more are due to open very shortly, as announced, and money is in place.

Bring back calamity James.

With an ageing population and those of senior years increasing in number and living longer, thanks be to God, obviously people are required and have occasion to go to hospital on a very regular basis.

So it is the people's fault.

They are living too long.

Given that statistic alone, we need further opportunities to treat people.

October just gone was the worst month on record.

I want to make it perfectly clear that the people who work on the front-line in our hospitals, and I have seen them do so, work under stressful conditions, under pressure at all times-----

Created by the Government.

-----and they do a marvellous job, but we get these cases on a pretty regular basis. We have had them in a number of other hospitals around the country recently and they are pointed out for whatever reason. Some hospitals are not able to be as efficient as others.

In 25 out of the 29 there have been increased numbers.

The chief executive of the HSE has visited 19 hospitals in the last number of weeks where the pressure in this kind of situation was more acute and more obvious than in other cases. I am not saying that staff are resisting change. Change is always difficult to implement but the Government, in response to queries last February and March, put more money into the system to reduce the delayed discharges to provide for the availability of the fair deal scheme and the waiting period was reduced from 18 weeks to four. That was supposed to deal with the problem; it did not deal with it. We now have an extra 300 beds coming onstream and extra money in the system.

If the facilities are there and the money is there, is this a management problem, or is it just being exacerbated because of a situation that can apply in any locality-----

It is a Government problem.

----- where more people have to go to hospital?

The Taoiseach is in government. He is the manager.

Who manages the manager?

Cubicles are lying idle in accident and emergency departments.

We try to provide the resources and the facilities to deal with the problems but in any line-up in any accident and emergency unit if the choice is to leave a 91 year old on a trolley for 29 hours, I do not accept that should be the case.

Deputies

Hear, hear.

It should not be the case.

The Taoiseach should tell that to his Minister.

I agree with the consultant who wrote his letter and sent it in publicly. Obviously there is a clinical review in this particular case taking place in Tallaght hospital-----

Tell Leo to wake up.

-----and I would like to hear from the person in charge as to the situation that actually applied in this case.

I gave that to the Taoiseach yesterday.

Patients on hospital trolleys are a direct result of the Government's policies and so, too, is the homelessness crisis. Since the Labour Party conference in February, the Minister for the Environment, Community and Local Government, Deputy Alan Kelly, has been promising the introduction of rent certainty. He said then what we are looking at is a process whereby people have some certainty as regards rent into the future while housing supply is being dealt with. The Minister said this was his number one priority and he said "I'm committing here, that I am intent on entering the market to change this; it has to be done." Now the Taoiseach disagrees. He has said: "It is clear that interference in the market, to its detriment, is not something we should do. While people are calling for what they call clarity on rent certainty, if we interfere in the wrong way, we will make matters worse". It is little wonder that there is chaos in the Taoiseach's Cabinet. The Minister, Deputy Alan Kelly, has referred to his Fine Gael colleagues as anonymous cowards because they briefed against the rent certainty proposal, but the chaos in the Cabinet is at nothing compared to the instability and the chaos inflicted by the Taoiseach on families who cannot afford to pay rents. Yesterday when I raised this issue the Taoiseach said the Minister for Finance and the Minister for the Environment, Community and Local Government would this week conclude discussions on proposals to deal with the housing crisis. Could the Taoiseach confirm for the Dáil today, and for those citizens who are suffering directly as a result of his Government's policies, that the Government will introduce rent certainty? Will he tell us that today and, if not, will he tell us why not?

I have said repeatedly to the Deputy that the Government is not going to do anything that would make the situation worse.

(Interruptions).

In respect of the construction sector, which collapsed completely under the previous Administration, we have come from a very low base to resurrect it, and that applies across a number of different areas.

How many houses did the Government arrange to be built last year?

There are those who are rough sleepers in this city. I listened to a very effective and very efficient official this morning speaking about what is happening in this city and the efforts that have been made, which are proving to be very successful, to deal with that particular problem even though the population of those who are rough sleepers has changed over the past period. There is the progress has been made clearly with more than 700 families now being put into what were voided units, or units that had to be reconstructed, renovated and made habitable. We have had the changes in the housing assistance programme, which provides a degree of certainty and a further option for those tenants who are under pressure from landlords. We have the figure of €4 billion on the table for the period between now and 2020, objectives and targets have been set for every local authority, and chief executives have been called together by the Minister for the Environment, Community and Local Government and told to get on with their jobs, which is to provide these houses for which the taxpayer is providing money. There are the other issues in respect of the private housing sector. Clearly, with every new facility that comes into the country with direct investment or expansion of employment, there is a need for further accommodation, and this is stalled effectively because of the situation that applied either because of a shortage of access to equity, the planning situation or the building regulations. These are all matters that are the source of discussion between the Minister for the Environment, Community and Local Government, the Minister for Health and the Minister for Finance.

The Minister for the Environment, Community and Local Government and his officials have done an extraordinary amount of work in the areas that I have mentioned. I hope the discussions taking place between the two Ministers can conclude this week with an agreement on effective responses for the short term, as well as for the medium to long term, which will ensure the viability of housing supply. This is the critical fault in all of this. If one does not have the supply of houses, one has extra pressure on existing accommodation units.

I referred yesterday to the decision to provide modular housing units. The first tenders for those are now being put in place. A small number, over 20, will be provided by Christmas. It is a challenging situation. I hope the discussions taking place will conclude this week, so we can move on and deal with the issues that will allow for accommodation to be provided for individuals and families with children and give them an opportunity to have proper comfortable accommodation with a longer term view for the future.

I asked the Taoiseach a direct question. Will the Government introduce rent certainty? If not, why not?

The Deputy raised that before. Will he ask something new?

He never answered the question and totally avoided it. Contrary to the Taoiseach’s protestations, his policies are making the lives of citizens worse. He is allowing the market to decide on this issue. Since he took office, rents have increased by 35%. Up to 90% of these cases are above rent supplement limits, meaning families cannot afford to live in homes. They are being evicted, and being forced from their homes into emergency accommodation. There are now 1,500 children living in homeless accommodation in Dublin city as a result of the Taoiseach’s policies. There is no other reason for it. The Government’s response has been incoherent, incohesive and chaotic with Ministers briefing against each other instead of dealing with the housing crisis.

A question, please.

The Taoiseach said the next election is a choice between stability and chaos. What stability is there for these families? The Minister promised rent certainty. Fine Gael is resisting this. Up to 24 Fine Gael Oireachtas Members are landlords. Is this a factor?

A question, please.

(Interruptions).

How many houses does Deputy Adams have?

Will the Government deliver rent certainty? Will it be the Labour Party’s way or Fine Gael’s way?

Will it be Gerry’s way?

How many houses does Deputy Adams have?

He would be spinning a different story in New York.

We got the answer yesterday. It will be Fine Gael’s way.

It will not be Sinn Féin’s way.

So, there will be no rent certainty.

Sinn Féin wants to drive down disposable income, increase taxes-----

No, we do not. The Taoiseach should stick to the question.

-----and drive jobs out of the country. That is the Sinn Féin way. It will not be Sinn Féin’s way, however. The Government is not going to do anything that will make this situation worse.

That is a great relief.

Is the Government going to do anything to make it better?

The fundamental issue to be dealt with is the supply measures for houses. Deputy Martin’s party destroyed our economy.

Destroyed the country.

Fine Gael has been in office for five years. What has it done?

Will the Taoiseach bring in the Army to mind the ATMs?

You brought in Dad’s Army.

AK47 might be needed yet.

The entire construction sector collapsed with the loss of 100,000 jobs. We now have to rebuild that, along with every other sector. As pointed out, in the context of rough sleepers-----

-----and homeless people, there have been changes in the housing assistance payment system and-----

HAP is not working.

-----modular units and social housing are being put in place.

None of that is working.

Not one policy is working.

Void units, as they are called, are being returned to habitable status.

The issue in respect of families who have been put out because of increased pressures in rents is a point of discussion between the two Ministers. The Minister for the Environment, Community and Local Government has changed the rules in respect of housing assistance programmes. That allows so many more people to be accommodated by the Department of Social Protection on a case-by-case basis, a development which I am sure Deputy Adams welcomes.

Rents have gone up 4.4% in one year alone.

We now have to deal with the supply side and the changes that can be made that will make an impact now, as well as in the longer term.

Rent certainty is the answer.

Building houses would help.

Fine Gael is the landlords' party.

That is the point of discussion that is taking place between the two Ministers.

When is this discussion going to end?

I hope it can be concluded this week. It will not be Sinn Féin’s way, however.

So, there will not be rent certainty.

It certainly will not be Fine Gael's way after the election.

Sinn Fein’s way would destroy this economy and drive hundreds of thousands of jobs out of the country.

The Taoiseach said the last thing he wants to do is to make this problem worse. I would argue that not addressing the underlying problems in the housing crisis is making it worse. It beggars belief how poorly the Government has dealt with the housing crisis. This week, the Children’s Rights Alliance pointed out that in January 2015, 400 families with children had to go into emergency accommodation. How could that figure have reached 700 by August 2015? How has the Government failed so miserably to deal with the problem? The Government is now talking about getting the homeless off the streets for Christmas. It talked about the same thing last year.

And the year before.

The Government has been nearly five years in office but the problems have not gone away. In fact, the housing crisis has got worse.

It is not all on the Taoiseach’s plate. The housing crisis is a result of decades of housing policy that followed the private, free-market version. There is nothing wrong with the private sector making money out of building houses. That is what it does. It is not a crime to make money or lose it. The private sector looks to make a profit on whatever it does. That is accepted.

I see the role of the State as being different, however. Its role is to provide an actual service. The State is not looking to make a profit but to provide homes to people who cannot afford to buy them. For several different reasons, from land-banking to the whole thrust of housing construction, there are significant problems with affordability and homelessness. The Taoiseach can throw all he likes at the housing crisis but he will not solve it until he accepts the fact that we need to build social housing through the local authorities again.

The Government is not actually doing that. Most of the social housing it is planning to provide over the next five years will be through the private sector, not through the State. Why are the local authorities not allowed to borrow money from the European Central Bank at the cheap rates to build social housing like the approved housing bodies? I do not understand the logic of this. Will the Taoiseach explain it to me?

NAMA building 20,000 houses was much trumpeted. Only 10% of this will be social. Why will the Taoiseach not make 50% of this social housing? It should be a mix of social and private, 50% of each, in the same buildings. We have a massive housing problem and the lack of social housing is at the root of the problem. Until the Government addresses that, it will not solve the problem.

The Deputy will never learn.

The Government has put €4 billion on the table for the provision of social housing. The Minister has called in all the local authority chief executives on two occasions. He has stated that they have their targets and they must get on with providing these houses. I expect 200 sites will be opened next year for building social housing all over the country.

In addition, NAMA expects, on the basis of the authorisation given to it by the Minister for Finance, to open 100 sites, most of which will be in Dublin. They will deliver about 80 units once they get started. This should be an addition to the system. As a builder himself, Deputy Wallace knows these cannot be provided overnight. We have to provide for the immediate term, as well as for the longer term.

Deputy Wallace recognises the supply element in dealing with the number of houses is absolutely critical. The fewer housing units, the greater the pressure on existing stock. That is what is causing the pressure in terms of rents. When higher rents are seen on the horizon by landlords, some go after them with a vengeance. We have to deal with this. That is why, unfortunately, there are people staying in hotel rooms and other unsuitable accommodation, as well as people on the street. This is a challenge with which we have to deal.

With all the measures being put in place, I hope we are making progress. We would like to think it could be done much faster, but that is not going to be the way it is. Some €4 billion will be spent on social housing between now and 2020. Instructions and authorisation have been given to get on with the task. Some 200 sites are to be opened. NAMA will provide 100 sites which once work starts will equate to 80 homes a week.

It has not done it and will not do it.

They will be an important addition to the housing stock and alleviate somewhat some of the problems.

There are 3,600 people on the social housing waiting list in County Wexford. The Government's five-year plan provides for the provision of 760 units, less than 100 of which - 20 a year - will be built by the local authorities in the next five years. That will not address the problem. Unless the Government changes its policy, we will see further boom and bust cycles and continue to have an affordability problem, homelessness and social exclusion. We sold the best sites through NAMA to investment trusts from abroad. Kennedy Wilson has just received planning permission to build 160 apartments at Clancy Barracks. It asked that no provision be made for social housing and no social housing is included. What will it do with the apartments? It will rent them out. What will that do? It will drive rents up further. There is a cartel of investors, most of them foreign, who control the rental market. Rents have increased from €1,000 a month for a two bedroom apartment in the city centre to €1,500 a month because the Government has sold half the country.

A question, please.

NAMA has acted ridiculously, given the prices at which stuff has been sold. The Minister for Finance, Deputy Michael Noonan, revealed-----

Will the Deputy, please, put his question?

In September 2013 the Minister for Finance said there was only one realistic bidder for and purchaser of Project Eagle. He was admitting that it was not a competitive process. Project Arrow, for which Cerberus has been agreed as the preferred bidder-----

This is Question Time.

Will the Taoiseach consider intervening and not letting Project Arrow go ahead? Will he stall the project and see what units are suitable as social housing? Will he take these units out of the sale and sell the rest of them?

The Deputy is way over time.

It is a non-competitive process.

What is the Deputy's question?

Will the Deputy, please, put a question?

Will the Taoiseach stall Project Arrow and examine what units could be used as social housing to address the question of homelessness and affordability in the short term?

That is not the original question the Deputy put.

I again ask the Taoiseach if he will reconsider-----

I ask the Deputy to resume his seat. He is way over time.

Will the Government start building social housing again because that is the only answer to the housing crisis?

As I stated, there are 200 sites to be opened next year for the provision of social housing between now and 2020. I hope that will be a useful addition. Deputy Mick Wallace seems to be implying that the State should tell every local authority to borrow the money to build houses, but it would come back onto the Government's balance sheet.

Not if the Government were to set up trusts.

That is what we are saying.

There is a housing emergency.

NAMA proposes to open 100 sites, most of which will be in Dublin, to provide a significant number of houses. It has always been the case that the State has had the option of taking elements from the NAMA portfolio. The national monument on Moore Street is now a State property and will be developed as a proper and fitting memorial to those who occupied the building after the Rising. Cerberus has been recommended as the preferred bidder for Project Arrow in an independent objective assessment.

The Government is responding to what is a very poor situation. For a number of years, there was no building at all and there were problems with planning and building regulations and in areas that had been rezoned to allow building to take place. This issue concerns eight or nine sectors, all of which have the intention of improving the quality and supply of accommodation. Tenants are under pressure because of a shortage of accommodation and, therefore, rent increases. The Government has put in place a variety of measures to attempt to deal with the issue. I would like to think we could do more quickly.

There are 20,000 on local authority housing waiting lists.