Topical Issue Debate

Mental Health Services

This is an area with which the Acting Chairman, Deputy Durkan, is very familiar as it is in his constituency. I thank the Minister of State for being here for the debate. The Minister for Health, Deputy Simon Harris, visited Naas General Hospital recently. I know this through social media and newspapers. It is regrettable that other Deputies in the constituency were not invited, because it has always been a matter of respect and courtesy that all Oireachtas Members in a constituency are invited to meet a Minister to air the issues they have. This is not only with regard to this case, but I am speaking about Naas and it is regrettable it did not happen, particularly because I have raised the issue of Lakeview previously in the House with the Minister.

Having said that, and to get to the topic in question, Lakeview is a 29 bed unit in Naas General Hospital. The staff do an incredible job with people who have acute mental health issues. Not a day goes by in the House that some Member does not speak about the importance of mental health. I know the Minister of State is very conscious of it.

This is a crisis situation in Naas. I have spoken to the HSE and it acknowledges and recognises this is the top priority in the country for funding. To have a 29-bed unit in archaic conditions, and mixed wards which certainly do not help anybody in a crisis situation with their mental health, is appalling in this day and age. Many patients cannot be catered for there and must go to the ten bed unit in Portlaoise, which is putting pressure on that unit. There is a huge need for an investment of €5.5 million to be spent on Lakeview to modernise it, to have a positive environment for people suffering from acute mental health issues and to help restore confidence in the system. There is huge burnout among the staff because it is dark and dreary and no investment has been put into it for more than 100 years.

While community mental health support is vital, as are any actions we can take to place an emphasis on positive mental health, when people present with conditions they need to be in a safe and secure unit and it is imperative they are in the proper place and receive the proper care. The investment in mental health in Kildare is the lowest in the country. We have one of the highest rates of suicide in the country. Over the past ten years, there has been an average of 23 suicides in County Kildare, and most of them were in my town of Newbridge. Over the past two months we have had five suicides. We need a situation whereby people can present in an accident and emergency type unit for mental health issues. At present, people present in the accident and emergency department in Naas General Hospital, which is across the corridor from Lakeview. We need to put in place emergency measures and have a positive environment for those suffering from acute mental health issues.

I thank Deputy O'Loughlin for raising this issue. As the Minister of State, and as a Deputy from a county which is the equally lowest funded with regard to mental health, I understand where she is coming from.

As Deputy O'Loughlin said, Lakeview is a 29-bed acute mental health unit on the campus of Naas General Hospital. It was designed and built in the late 1980s to cater for the Kildare and west Wicklow population of 135,000 at that time. It succeeded the previous arrangement of services provided by the Carlow and St. Loman’s Dublin mental health services to the population of Kildare, and at the time was a ground-breaking development based on the then national policy, Planning for the Future. Some 30 years on, the current population of Kildare and west Wicklow has increased dramatically to 228,000, and is expected to rise over the coming years.

As the Deputy pointed out, increasing pressures on bed occupancy and levels of acuity have created a very high-risk environment for patients and staff. The HSE indicates the number of beds in Lakeview is inadequate for the current needs of the area, based on the national policy A Vision for Change. The occupancy rates of 140% provide further evidence of this increase in demand and obvious need. A temporary accommodation was reached three years ago, with ten acute beds being made available in the acute unit in Portlaoise for Kildare patients. However, this is not ideal by any means, the numbers remain inadequate and the demand and pressure on the Naas unit has reached unsafe levels again.

It is generally accepted there is a need to develop bed capacity in Naas. Development of the unit would have the effect of addressing the bed crisis situation and de-escalating acuity levels, by managing challenging patients in a more suitable environment. The Department of Health has provided sanction for €5.5 million funding to address some of the physical infrastructural deficits at the Lakeview unit. This funding will enable a design team to conduct scoping and design work, with a view to construction commencing in 2017 and being completed in 2019. This will deliver an additional eight beds and, most importantly, provide a high observation unit to alleviate existing service pressures at the facility.

The lack of appropriate step-down facilities in the form of high support hostels and community based teams also has an impact on the ability of Lakeview to deliver an appropriate service. A Vision for Change would recommend up to 60 high support hostel placements for a population of this size. There are currently only 27 places. The HSE is looking at possible solutions to maintain hostel support capacity in the area and is exploring the potential to increase it.

As part of the significant investment provided by Government over recent years to enhance all aspects of mental health services nationally, funding has been approved to recruit staff to populate three community-based mental health teams for the Kildare and west Wicklow area. This will mean that more patients, as appropriate, will be seen at a much lower level of complexity and will reduce the requirement for admissions to the Lakeview unit, which is where we want to take matters in future. Challenges are being experienced with the recruitment of psychiatric nurses to staff these teams, and work is ongoing nationally by the HSE to overcome acknowledged staffing difficulties. I assure the Deputy that, in light of the additional mental health funding being made available to the HSE for Lakeview, I will continue to monitor progress closely on the matter. I will update the Deputy and colleagues as it progresses.

I am absolutely delighted to hear this news. For the Kildare people who use the services and their families, as well as the staff at Lakeview unit, this is really good news. The fact that the physical design will be updated - making it a brighter building and a better place for people to be treated in and to work in - is also very welcome, as is the addition of eight new units. I am really glad that construction will commence next year. Will there be disruption to bed space in the two-year period during which this work will be undertaken? What are the plans for the interim period? I am glad about the commitment to more appropriate step-down facilities because these have to be part of the whole picture of treating mental issues. The funding for staff is really good too. I acknowledge the very good work done by Hope(d) locally and by the Samaritans and many other community groups in the area which are really struggling to support positive mental health, particularly among young people, as best they can. Generally, this is really good news and I welcome it.

I know that the Deputy's priority is that the additional funding be allocated. It is important that work progresses quickly and in an effective manner. My own view is that there will not be disruption but I will clarify that for the Deputy with the design team and those who are doing the scoping work. At present, the service asks staff to work in archaic settings and if we are encouraging staff to come home, and nurses to go into the profession, we need to invest not just in the staff themselves but in the facilities in which they are going to work and this will form part of the work we are doing to implement A Vision for Change. There is also a need to focus on our community-based services and it is a priority for the Government to make sure the approved posts are filled as quickly as possible.

I thank the Deputy and agree with her that the staff and community organisations and teams do a fantastic job. This will help them and we will support them as much as we can.

The next matter is in the name of Deputy Michael Collins who is not yet with us. Deputy Clare Daly is in the House, though, and she has the third matter. Is Deputy Helen McEntee taking the matter on behalf of the Minister for Transport, Tourism and Sport?

For topical issues, people really have to be about their business and be here on time.

I think Members thought the discussion on climate change would last longer.

We were contacted by e-mail and told that the schedule had been moved forward. We were told a number of times.

It is highly unacceptable that the proceedings of the House are held up in this manner. I do not want to suspend but we do not have Deputy Michael Collins and we do not yet have the Minister for the third matter. I think the Whips are not about their business.

Sitting suspended at 4.35 p.m. and resumed at 4.40 p.m.

Aviation Policy

I am delighted to have the opportunity to discuss this issue. I was shocked at the one-sided nature of the coverage of, welcome for and fawning over the announcement that Norwegian Air International, NAI, will operate transatlantic flights from Cork. The move has been long in the making and has been an issue of major concern for unions in the airline industry on both sides of the Atlantic. As we know, NAI is a wholly-owned Irish subsidiary of Norwegian Air Shuttle, NAS. The scheme is an effort to circumvent the US-EU Open Skies agreement and usher in a Walmart-style race to the bottom for cheap labour. These are the words of some of the American unions. This is the business model of NAS: a Norwegian airline registers its aircraft in Ireland, rents flight crews based in Thailand who are covered by Singapore labour laws and applies for a foreign air carrier permit from the US.

NAS already had the relevant US permits to fly. It could have operated from Cork to Boston for the past two years but held off until it got the US permit for its Irish subsidiary, NAI. Why was that? There would have been no difference at all to the consumer. The airlines in the group offer a common and identical product and brand. The only reason it held off was to cynically engage the Irish-American lobby and the Government to get the US permit for NAI to operate in what is, in effect, a policy of social dumping. The CEO of NAI has had meetings with the Irish Airline Pilots Association, IALPA, and other pilots unions in Ireland and has admitted that NAI's business model would not work without an Asian cost base on the EU to US routes. This is the only way cheap fares can be offered. While there may be a temporary advantage in getting people easy, lower-cost access to the US, it will ultimately be at a cost of undermining jobs and conditions in the airline industry. This is incredibly serious.

I have heard utterances from NAI saying it was not going to use Asian crew. This is not about the nationality or the base of the crew involved. It is about the jurisdiction of the contracts of employment under which they operate. An Asian crew is being paid between $400 and $450 per month. The precedent is already there. The airline has flown routes from Oslo to the US using crews that are 100% based in Thailand. Irish and American wages could not compete with it. With this arrangement, the Minister's Department is facilitating what is essentially, and could be called nothing but, social dumping. Ireland is a flag of convenience in a race to the bottom regarding labour laws. The pilots have asked to meet the Minister. I would like him to comment on this. They are desperately keen for the Minister to take them up on their offer if he is so sure this is the best way forward.

I welcome the opportunity to address the House on the recent very positive developments regarding Irish airline NAI and I thank the Deputy for raising the issue. I welcomed the decision last Friday by the US Department of Transportation to grant a foreign air carrier permit to NAI. Under the terms of the EU-US Open Skies agreement, this permit will allow the airline to fly from any airport in the 28 EU member states, as well as Norway and Iceland, to any airport in the United States. Although the airline had hoped to start transatlantic services from Cork Airport last summer, it was not possible without the permit from the US authorities. The airline has confirmed this week that the detailed planning is under way, with the first flights planned to take off next summer. Its immediate focus is on finalising plans for transatlantic flights from Cork and Shannon. However, work is also under way to consider further opportunities for expansion of services. It has said it will focus on making transatlantic travel affordable for all, with low-cost fares and a high-quality service.

NAI is an Irish airline within the Norwegian Group. The group also has airlines licensed in Norway and the UK. It is not unusual for an airline group to be made of up of individual airlines licensed in different countries. For example, Aer Lingus is also now part of the International Airlines Group, lAG, which comprises a number of airlines based in different European countries. NAI was licensed as an Irish airline in February 2014. Despite the delay in getting its US permit, it has been able to grow its European operations rapidly within the EU single aviation market. The airline is headquartered at Dublin Airport from where a sizeable team of aviation professionals operate nearly 50 aircraft, all on the Irish aircraft register. The airline operates flights throughout Europe. Now with a permit to fly to the US, NAI will be able to add transatlantic operations and to continue to grow its business from Ireland.

The Government has been very supportive of the airline from the outset and has shared in Norwegian Air’s frustration at the delay in making a decision on its application for a US permit. The airline has said the primary motivation for establishing an Irish airline was to have an EU based airline within the group, given that Norway is not an EU member state. The controversy created in the US facilitated a rather uninformed and misleading debate. A range of allegations were made against the airline’s business model. This does not undermine the Deputy's case, which was genuinely and sincerely made. There was also commentary on Ireland’s ability to provide effective safety oversight of NAI. The Government has always made its position on this clear, and it has been supported. Ireland has made it clear that there was no basis for the irresponsible, unfounded and damaging public statements that have been made about the standard of social and employment protection in Ireland and about the capability of the Irish regulatory authorities to effectively oversee the safety of NAI’s operations. The European Commission has also been resolute in its support for NAI and I have already thanked the European Commissioner for Transport, Violeta Bulc, for this. When first put in place in 2007, the Open Skies agreement with the US was designed to encourage competition in the transatlantic air market. New services from smaller airports such as Cork, which have never had transatlantic services, are precisely the type of innovation the agreement was designed to facilitate. Passenger numbers at Cork Airport have been slower to recover than those at Dublin and Shannon. I am happy to report that after seven straight years of declining passenger numbers, the past year has seen a return to growth at the airport.

The announcement this week by the CEO of NAI that it intends to launch its Cork to Boston route in summer 2017 will provide a further boost to the airport and help increase connectivity in the region. This announcement came on the back of another by the Icelandic low-cost operator WOW air, a new airline to the region, which is to commence a new service from Cork to Reykjavik and onward to the US east coast and Canada next year. The announcement of these new services is an example of the confidence the business community has in Cork and the south of Ireland. In addition, the provision of air access from North America to one of the starting points of the Wild Atlantic Way and Ireland’s Ancient East will be a significant boost to transatlantic tourism.

Why does the Minister think Norwegian Air Group, which has no connection whatsoever with Ireland and which already has a number of wholly-owned subsidiaries, decided to establish a base in Ireland? Given the size of its population, Ireland is not very attractive. The only conclusion one can come to is that this was done to avoid Norway's labour and tax laws. The carrier could have operated its base last year. It did not need to get clearance to operate last year. However, it could not have done it with access to the cheaper crews. Now, it can operate. It chose to do it, and the reason is backed up by its CEO's statement that it would not have worked if the company did not have access to the Asian cost base.

I make the point and register it. By allowing this arrangement to go ahead we are in reality standing over a type of social dumping. I want to nail any idea that there is any racism in this or anything like that. It has nothing to do with that. The objection is about the jurisdiction of the contract of employment, not the citizenship or base of the crew. For example, Irish crew working in different airlines all over the world are employed under contracts in different countries and have no right of access to the Labour Court even if they live in Dublin. This arrangement facilitates the employment of crew who are covered by arrangements in Asia where wages are sadly of the order of $400 to $450 per month. That is an incredibly serious threat to conditions of employment in Ireland, across Europe and in America, which is why AFL-CIO and America's unions in particular had huge concerns about this measure.

The last time Ireland was put out there as a lucrative base to attract people, it was in relation to our banking sector. Look where that ended up. We are now going to pimp the country out as a place for airlines with no connection here. Let us be clear that they said that no crew or pilots they will employ will be Irish. If they are not taking on any Irish staff, why are they here? This country is being put out there because of our laxity on labour law and tax rates.

What the Deputy says is speculative. Maybe she is right or maybe she is wrong. I do not believe she is right, but we will wait and see. All I can see is the evidence before me of what the airline itself has stated. It has stated that NAI has no Asian based crew and that US and EU based crew will be used on NAI transatlantic services. It has stated that Norwegian always follows the rules and regulations in all the markets in which it operates and offers employees competitive wages and conditions. It will not be able to do anything Aer Lingus or Ryanair cannot do already. It will not be in a different category.

As has recently been communicated in a reply on NAI's employment practices, my Department has not undertaken an examination of the specific employment practices of any Irish airline. All matters related to employment contracts are an operational matter for the airlines and not under my remit as Minister for Transport, Tourism and Sport. I reiterate to the Deputy that Ireland has a robust suite of employment rights legislation which offers extensive protection to employees.

I note to Deputy Daly that I will meet the people to whom she refers. It would certainly be wrong for me not to do so. I assure her that this decision and application will not be reversed and there will be no attempt to do anything of the sort. I am happy to meet them, however, because it would be right to hear their points of view.