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Dáil Éireann debate -
Wednesday, 18 Jan 2017

Vol. 935 No. 1

Topical Issue Debate

Road Traffic Legislation

I have brought up this issue numerous times in the House. The Government and senior gardaí have always responded by saying that this is already covered by legislation. I introduced the Misuse of Motor Vehicles (Public Spaces) Bill in 2012. The Bill was opposed by the Fine Gael Minister at the time. He deemed it unnecessary following advice. That view contradicted the advice I had received from local safety forums, gardaí and other relevant bodies. They indicated an anomaly in the current legislation.

When walking the streets of many of our towns and estates we can see vehicles like quad bikes, dirt bikes and scramblers being used repeatedly by some to damage property, threaten injury and cause many other problems for the local community. The law as it stands prohibits the use of these all terrain vehicles on public roads unless fully insured and taxed and meet other regulatory requirements, including the rules of the road. However, there is a hole in the legislation that allows people to use these vehicles for anti-social behaviour, sidestep gardaí in public spaces and avoid any penalties.

Currently, if someone is misusing one of these vehicles on a public street, gardaí have the powers to deal with the issue. The vehicle can be confiscated. Then, depending on the severity of the incident or the history of the vehicle and owner, it may be held or returned. This provision, when enforced, can work to slowly discourage such behaviour. Unfortunately, however, these vehicles are not simply used and misused on public streets. They are common in green areas and public parks and it seems the Garda cannot deal with them. It is understandable that members of the Garda will not chase people on these machines due to safety issues for all concerned.

Is the Minister aware of the case of Mr. Vnuk? He brought an action for compensation for injury in his native Slovenia as a result of an accident. Mr. Vnuk lost his claim for compensation in the domestic courts on the basis that the vehicles were only insured when in public places. He appealed his claim to the European Court of Justice. As in Ireland, Slovenian road traffic legislation requires vehicles to be insured when they are on the road or other public places but not necessarily when they are on private land. The ECJ has interpreted the directive to mean that any motor vehicle, whether on private or public land, must be covered by third-party insurance. Ruling in Vnuk v. Triglav, the court found that compulsory motor insurance has to cover any accident caused in the use of a vehicle that is consistent with the normal function of that vehicle. Does it follow, therefore, that the definition of public space in the Road Traffic Act must include parks and unused ground? The current definition is that a "public place" means any street, road or other place to which the public have access with vehicles whether as of right or by permission and whether subject to or free of charge. Can the Minister comment on this? Does he believe the legislation that exists is insufficient or ineffective due to the definition of "public place"?

The reality is that quads or off-road scramblers are not used on roads often and, in that capacity, that is their normal function under the ECJ directive. They are more commonly used in parks or fields. Does the Minister think that the Vnuk decision is relevant to the current situation?

I am keen to make it clear that the vast majority of people who use quads or scramblers do so responsibly, but legislation is needed to deal with the irresponsible drivers of quads, dirt bikes and scramblers.

I thank Deputy Ellis for introducing this subject to the Dáil again. I am impressed by one thing, that is, the frequency with which this has occurred. It persuades me that there is genuine concern about it and that there is obviously a problem. I have received queries on the matter during Topical Issues, through questions and in the Seanad as well. The queries tend to come through councillors rather than Deputies and Senators. They are in situ and they see the obvious concerns that arise. It seems to me that difficulties may arise. The powers are in place in theory. However, if they are not being enforced in practice, the Deputy has a point.

I will explain what I will do as a result of what he has said today. We need some solid statistics but I do not believe we have them. Certainly, I do not have them before me and I do not think the Deputy has quoted them – perhaps he can do so in reply. We need solid statistics with regard to the damage being caused, the number of accidents, the amount of vandalism, etc. I do not have the data to hand but perhaps that is my fault and I should have asked for it in advance. After the debate I will try to find out how real this problem is or whether it is only perceived because of the dramatic nature of what is going on.

Scrambler motorbikes and quadricycles are mechanically propelled vehicles. This means they are vehicles intended or adapted for propulsion by mechanical power. As such, irrespective of engine capacity, under road traffic legislation the user of a scrambler motorbike or quad bike in a public place must have insurance, road tax and a driving licence. The user must also wear a helmet. Severe penalties exist under road traffic laws, including fixed charge notices, penalty points, fines and possible seizure of the vehicle, for not being in compliance with these requirements.

Deputy Ellis asked a question related to the definition of a public place. For the purposes of the Road Traffic Acts, the definition is that a "public place" means any street, road or other place to which the public have access with vehicles whether as of right or by permission and whether subject to or free of charge. Road traffic law does not extend to the use of mechanically propelled vehicles on private property. Certain places, such as parks under the control of local authorities, can be subject to by-laws, which those authorities have the power to introduce, to prohibit the use of such vehicles.

The Road Traffic Act 2004 makes it an offence to supply a mechanically propelled vehicle to a person under 16 years of age. With effect from 24 January 2005, a person convicted of supplying a vehicle to a minor faces a fine of up to €5,000 or a term of imprisonment of up to six months or both. Mini-motorised scooters, micro-motorcycles and quadricycles also come within the definition of a mechanically propelled vehicle for road traffic law purposes. The supply of such vehicles includes giving a gift or loan. As a result, it is illegal to supply such a vehicle to a person under 16 years of age.

It should be noted that An Garda Síochána does not have any legislative power to deal with scrambler bikes being driven on private land.

Local authorities have the power to introduce by-laws to prohibit the use of vehicles in areas under their control such as parks. The Minister for Arts, Heritage, Regional, Rural and Gaeltacht Affairs has similar powers to control off-road vehicles in certain areas. For example, the unauthorised use of off-road vehicles is prohibited in certain national parks.

Section 41 of the Road Traffic Act 1994 and the Road Traffic Act (Section 41) Regulations 1995 set out the law relating to the detention of vehicles by An Garda Síochána in a public place.

This has been a major problem for many years. I have been chasing this issue from when I was a councillor years ago. I have also raised it with Ministers here in this Chamber. The problem is children of five years, six years and eight years of age going around on motorbikes in housing estates and council-owned lands. Seizing these vehicles is not covered properly in legislation.

There have been deaths caused by quads. A person in my area was killed as a result of a quad accident. The statistics are there. I have seen young kids of six or seven years of age on these small motorbikes with no insurance or tax. They are not tied to any sort of registration with a club. Clubs would be a good way of registering these bikes and could also provide proper training and facilities.

There are consequences from the European court judgment, a copy of which I will give to the Minister. Will the Minister and his officials examine it? Time out of number we have been told by senior Garda and officials that there is no need for legislation. I believe that is wrong. In cases where vehicles have been seized by gardaí, they have had to give them back with no fines or penalties, even though a six-year-old was using them, because a person said it was their property.

If the Deputy gives me the judgment, I will certainly ask my officials to look at it and to see what are the implications. I accept there appears to be a problem. People are not just raising it for the good of themselves or to pander to a group because it is coming from all areas. I will examine it seriously to see if we can address it.

I have made some commitments to at least one voluntary group of councillors to see what they are doing in this respect. The Deputy is aware of this document, Scramblers and Quads - Know the Info. Even if there is no need for legislation, we might get a clearer view of this when we get the statistics and the European Court judgment. In the meantime, I will support those groups who provide information leaflets on this matter. Voluntary groups can play a strong and useful role in this. The Scramblers and Quads - Know the Info pack is different from what usually tends to come from Departments, namely, the Garda has enough enforcement powers and come back again in three months. Instead, this document states certain actions can be taken while outlining the right equipment, the right vehicles, the law, the right training and the right environment. It makes a positive community effort to tell parents how to behave if their children are riding these particular vehicles and the safety measures which should be taken. If we cannot reach a legislative solution to this or if powers are available but are not being used or enforcement is not as great as possible, I will support voluntary groups.

In the meantime, I am due to meet the Tánaiste and Minister for Justice and Equality on this particular issue. I will raise Deputy Ellis's specific concerns with her then.

Respite Care Services Provision

I thank the Ceann Comhairle for allowing this Topical Issue matter. The Seaview respite care home outside Donegal town is owned and operated by the Health Service Executive, HSE, to provide residential respite care for physically and intellectually disabled people across south-west Donegal. Currently, there are over 100 families who use and access this service for much needed respite for them and the person for whom they are caring.

It is important to stress the families are happy with the services they and their loved ones get from the respite home. The issue today is about staffing. Previously, families used to receive respite care every six weeks where the child or person they were looking after could stay overnight in the home while the family or carer got a break. The facility was also able to accommodate them if the family had to go away for a short period at short notice or intended to go on holidays. Obviously, with limited facilities across the country, it is not always possible to take a disabled person on holidays. One of the families who uses the service told me the holiday for a disabled person was actually going to the respite home.

Unfortunately, now the home closes at 7 o'clock on a Sunday evening and does not open on Monday and Tuesday. This means the families are lucky if they get respite care twice a year rather than every six weeks as they had before. The home requires four nurses plus care staff to maintain the level of respite which had been available previously. I understand a nurse in the home is due to retire in the next several weeks, resulting in the staffing complement going down to two nurses. This means the availability of respite for the 100 families in question who desperately need it - it is the only break some of these families actually get - will be restricted even more if the situation is allowed to continue. It is vitally important the HSE in Donegal recruits the nursing staff required to allow the home to operate to full capacity and to the benefit of those families who depend on this vital service.

I thank Deputy Thomas Pringle for raising this important issue today. I convey the Minister’s apologies but he is unavoidably absent and would have liked to take this matter himself.

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide them with greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives. The Government is acutely aware of the changing needs of people with disabilities and understands that many people require additional or alternative services.

The provision of respite services has come under increased pressure in the past several years. There is an increase in the number of children and adults seeking access to respite. There are also increasing levels of changing needs, due to the increase in the age of people with a disability. The way in which residential respite services are provided has also changed as agencies comply with HIQA, Health Information and Quality Authority, standards and the national policy on congregated settings. In some situations, this means beds are no longer available. For example, vacated beds for residents who go home at weekends or for holidays can no longer be used for respite.

Seaview respite house, located in Mountcharles, Donegal town, was established in 2001. It provides respite for children from the age of six years upwards and adults with an intellectual disability and-or autism on a rotational basis for 100 families in the south-west Donegal catchment area. The maximum occupancy provides for five children or five adults. This valuable facility provides for a much deserved break for families and persons with an intellectual disability and-or autism.

A recent service user satisfaction survey was completed in 2016 which provided very positive feedback regarding the staff and quality of service provided. Respite service provides a range of services, including overnight respite, day respite and a drop-in service. We are all very happy to hear about that positive feedback. The service operates a person-centred model of care and is delivered by a combination of nursing and support staff. The service normally operates on a part-time basis Wednesday through to Sunday evening, as the Deputy noted.

The staff allocation for the unit is one whole-time equivalent clinical nurse manager, 3.6 whole-time equivalent nursing staff and 4.67 whole-time equivalent care assistants. I am advised by the HSE that, for a number of reasons, including staff transfers and retirements, the service is currently experiencing a temporary staff shortage. However, I am pleased to confirm the HSE has advised me that three posts for the unit are currently being recruited via the national recruitment service, which will ensure the service resumes to full capacity. The need for increased respite and residential facilities is acknowledged and the HSE is continuing to work with agencies to explore various ways of responding to this need in line with the budget available. I hope the information that three posts are currently being recruited will be good news for Deputy Pringle.

The Minister of State's response reads reasonably well until one turns the page, where, unfortunately, it states: "The service normally operates on a part-time basis Wednesday through to Sunday evening". That was not the normal operation of the service, which was a seven-day service. When she says the three posts will ensure the service resumes to full capacity, what is she actually talking about? Is it full capacity from Wednesday to Sunday or a seven-day service? That is the key issue in that what was a seven-day service is now operating from Wednesday through to Sunday evening, and even that is being put at risk due to staff shortages. The resumption of a full service is the resumption of a seven-day service, not a part-time service. I urge the Minister of State to clarify that point, given it is the key issue for the Seaview respite centre. A full service is a seven-day service. Will this staff recruitment mean the seven-day service is restored?

As I outlined, the HSE is recruiting for the posts that are vacant. My assumption is that it will be replacing the staff vacancies and that the service would resume to what it was. I will get the Deputy confirmation of that from the HSE. Obviously, we are very concerned that if it was a full-time, seven-day service, this is what will be restored when the full staff complement returns.

Hospital Services

I thank the Leas-Cheann Comhairle and his office for facilitating this Topical Issue, which represents cross-party and cross-county support. Fourteen of the 19 Deputies in the south-east are supporting this petition and I thank my colleagues for doing so.

As the Minister of State is aware, there is currently no provision for cardiology cover in Waterford and the south east after 5 p.m. every weekday, and no availability at all at the weekend. It is simply not acceptable in 2017 that time restrictions play such a role in the day-to-day lives and deaths of our people. Last Saturday in excess of 7,000 people took to the streets of Waterford to vent their anger, frustration and hurt.

I have a question to ask and, as I was hoping to ask it of the Minister, Deputy Harris, I want to put on record that I am disappointed he is not present. Why are we in Waterford and the south east being treated as second-class citizens? It is ironic that while we were taking to the streets in Waterford last Saturday, an Air Corps helicopter had to come to Waterford to bring a patient to University Hospital Cork and an ambulance was ferrying another patient to Cork. Why is the south east the only region without 24-7 cardiology cover? Why are we excluded from life-saving care? Make no mistake about it: cardiac intervention saves lives every single day. There is a solution and it is clear what is needed, namely, additional resourcing in the form of a second cath lab with sufficient staff to resource it. That is the solution and that is what we want. This solution would have a two-fold effect. First, it would save lives and, second, it would help to reduce waiting lists in Waterford and the surrounding counties of Tipperary, Kilkenny and Wexford.

The budget allocation for this year is in excess of €14 billion. The cost of providing this second cath lab is a €2.6 million one-off capital investment and an additional €2 million per year to cover running costs. This has to happen sooner rather than later.

I want to ask what is going on. We have 14 of the 19 Oireachtas Members in the south east involved, 12 of whom put their names to this Topical Issue today, yet the Minister for Health, Deputy Harris, is not present. On previous occasions when we have put down similar matters, again, the Minister for Health was not here. He sneaked into Waterford a number of months ago, met with local hospital clinicians and consultants and met with one local Oireachtas Member, although he did not meet with the rest of us. Announcements are being made by other Ministers but we still have not heard from the Minister for Health himself. We are being treated with absolute contempt, and when I say "we", I mean the people of the south east. The Minister for Health needs to brief, talk to and communicate with, in the first instance, the people of the south east but also through us as elected representatives. I am outraged that when we have gone to the trouble of showing the level of regional unity and cross-party support that exists on this critical issue, the Minister is not here.

The reality, as the Minister of State, Deputy Halligan, and all other Oireachtas Members know, is that there is a real problem of patient care and patient safety, and a lack of equality, in the south east. If a person has a heart attack after 5 p.m. or 6 p.m. any day of the week in any part of the south east, be it Waterford, Carlow, Kilkenny, Tipperary or Wexford, that person will have to go to Cork or Dublin for emergency treatment. It is the only region in the State which does not have 24-7 emergency cardiac care. We are not getting any justification from the Minister as to why we are being denied this. The Higgins report again committed the south east, in particular University Hospital Waterford, to providing interventional cardiology to the people of the south east. In addition, we hear today that this so-called mobile cath lab is not for the south east alone and that it is going to be for a number of hospitals across the State. This also needs to be clarified by the Minister of State.

I want to join with my colleagues in expressing my disappointment that the Minister is not present to face us and to discuss the supply of a 24-7 service in the south east. As has been said, it is the only region in the country that does not have a 24-7 service. Are we in the south east different to anyone else? Are we backward people who do not deserve the service everyone else in the country gets?

The situation surrounding cardiac care at University Hospital Waterford is at boiling point. Thousands of people took to the streets over the weekend in protest, despite the announcement by the Minister of State, Deputy Halligan, that a mobile unit has been made available to the people of the south east. I would like to know what a mobile unit is. Does this mean it will be there for one day in Waterford and somewhere else the day after? Will it be there for a week or a month before going somewhere else? If it is mobile, that means it is on wheels and it moves around. That is not an answer to the problem. We have no concrete details of this mobile cath lab and its capabilities. Will it be exclusive to University Hospital Waterford and will it be on-call 24-7? Will it be reserved for emergency cases or utilised in catering for those who have been on the waiting list for more than two years for vital cardiac procedures? How many people will the mobile unit be capable of catering for on an annual basis?

I remind the Minister that the catchment area for the current cardiac service in University Hospital Waterford consists of approximately 500,000 people in the counties of Carlow, Kilkenny, Wexford, south Tipperary, Waterford and further afield. The current cardiac service is simply not good enough for the people of the south east.

We have seven Deputies in the House today who have signed the motion to that effect. It is a petition to ask the Minister to look at this again. We have thousands on the streets to protest while there are over 700 on a waiting list for vital procedures, some of whom have been there for over two years. We have specialised doctors recognising the urgent need for a second cath lab and warning that some patients on the waiting list are deteriorating and need a procedure within the next seven days. We have advocacy groups saying that the mobile unit is a temporary solution to a permanent problem. The current situation in the south east is untenable as everyone has come to realise except the Minister for Health. We must take meaningful steps to implement 24-7 cardiac services at University Hospital Waterford immediately. I ask the Minister of State to bring that back to the senior Minister.

Is the Minister of State, Deputy Halligan, replying? Who is replying?

I am not. The Minister is replying. I am making a contribution. I am not replying; I cannot.

Is there not collective responsibility in government?

If I could reply, I would, but I am not allowed, apparently. I can only contribute. The Minister for Health can reply.

Any Minister can reply.

The Minister of State, Deputy Halligan.

On a point of order, any Minister can reply. The Minister of State says he cannot reply, but my understanding is that any Minister can do so.

No. Out of courtesy, what I said was that the Minister for Health replies.

The Minister for Health is not here.

That has nothing to do with me. I asked for speaking time on this issue. That is what I asked for.

We are happy to give it to the Minister of State.

On behalf of the Department.

I thank the Deputy. First, it is beyond question that cardiac waiting times in County Waterford and the south east are unacceptable. In fact, when I was in opposition, I brought this to the attention of the Dáil on a number of occasions and was the first Member to do so. I stand by my belief that the second lab is an absolute necessity and reiterate the point that it is not Waterford alone, but the south east that is involved. I stand by my belief that the Herity report was flawed, as many others have said, because of its terms of reference and because it did not include meetings, in particular with consultants in Wexford, Tipperary, Kilkenny or anywhere else in the south east. There is no question about that. Be that as it may, the Herity report is the Herity report and the Minister has said he will not change his mind on it.

The Minister acknowledged to me that he would come to Waterford to meet the consultants privately. I did not participate albeit I arranged for that meeting and for the Minister to come. The evidence of that meeting will be that I was there and did not participate in it. I had particularly asked the Minister to come. Nor did I participate in any announcements that the Minister had made for Waterford, some of which were quite good. I facilitated a meeting with all of the consultants. At that particular meeting, the consultants said they acknowledged they were gone past the Herity report and that we needed to go forward and it was their proposal, not mine, to use a mobile cath lab to deal with the 780 people on the waiting list and to carry out a further review. In my estimation, that is what has been agreed by the Minister. There will be a mobile cath lab in Waterford to deal with waiting lists and during that time a further review will take place with different terms of reference.

I can understand Sinn Féin being in opposition and not having been in government, but Fianna Fáil was in government for 20 years during which time we did not have a second cath lab. Fianna Fáil has the facility to put down a Private Members' motion to instruct the Government to deliver a second cath lab. The party has more power than the six people in the Independent Alliance. Fianna Fáil should come to the Dáil next week or the week after with a Private Members' motion, which would be supported by the House, including the Independent Alliance. The second cath lab would probably be delivered.

The Minister of State, Deputy Halligan, is passing the buck. He will have to deal with it. He has to stop playing politics with this issue.

Deputy Cullinane played a lot of politics with it. He is a nasty piece. He played a lot of politics.

Stop passing the buck.

Why does the Minister of State, Deputy Halligan, think we are here today?

I call Deputy Mattie McGrath to speak without interruption.

I thank Deputy Mary Butler for tabling this matter, contacting all of us and organising it. I was glad to sign it. We do not know where we are. We need 24-7 cardiac and emergency care. The Minister of State, Deputy Halligan, agrees and is fighting very hard for it. I know how hard he has fought at Cabinet and with the Minister as well as during the talks on the programme for Government. We in the south east are not second-class citizens and will not accept that status. The War of Independence was started in Tipperary and we are proud of that. Where Tipperary leads, Ireland follows and we are entitled to health care which is as good as that available anywhere else in the country. There are 780 patients waiting at the moment. They are sick people who have been referred for this treatment. I welcome the mobile cath lab, but I do not have a lot of meas in it. It will certainly deal with the backlog, but we still need a second cath lab in Waterford. If it takes all of us to come back and put down a motion as members of Fianna Fáil or as Independents to force the Government, we should do that. It is a downright insult, without any disrespect to the Minister of State, Deputy Marcella Corcoran Kennedy, that the Minister, Deputy Simon Harris, is not here today.

That is especially so with the difficulties the Minister of State, Deputy Halligan, has had, which are known in the public domain, and the pressure he has been put under at Cabinet.

I thank the Minister for Transport, Tourism and Sport, Deputy Shane Ross, for being here to support his colleague in the Independent Alliance. The Minister for Health's honeymoon is well over now. He got an extra bit of time because he is young and energetic. I wished him well, but he has been a slow learner as far as health goes and has been captured by the officials in the HSE. He is a puppet for them now. I do not mind him slipping down quietly to see a hospital, which is what he should do. I want him to do it in Clonmel also. However, it is time for him to step up to the plate or get off the field. He must look after the people of the south east as well as the rest of the country. Just because they have it here in Dublin or elsewhere, that does not mean the rest of Ireland is provided for. Dublin is not Ireland and the HSE must be held accountable. The former Ceann Comhairle spoke today about the massive budget overruns and the absence of accountability. We are elected and accountable, as we should be. The Minister must be accountable rather than to send a Minister of State with a script to read to us. It is an insult and a disgrace and we will raise the matter here again on the Order of Business and everywhere else.

I thank the Deputies for affording me the opportunity to speak to this very important issue for their constituencies this afternoon. The Minister, Deputy Simon Harris, has asked me to convey his sincere apologies to the Deputies present. Unfortunately, he has another engagement which he was unable to avoid.

It must be very important.

So is the south east.

Indeed, and I hope I will be able to emphasise how important and how seriously the Government, including the Minister, Deputy Harris, and the HSE are taking this issue.

The House will be aware that last year, in line with a commitment in the programme for a partnership Government, an independent review of the need for a second cath lab at University Hospital Waterford was undertaken by Dr. Neil Herity. The review concluded very firmly that the needs of the effective catchment population could be accommodated from a single cath lab. However, investment was recommended to enhance cardiac services at the hospital and to provide an additional eight hours of cath lab activity per week to address waiting times and provide improved access for patients. At the time of the publication of the report, the Minister committed to providing the additional resources to University Hospital Waterford as recommended. I am pleased to confirm, therefore, that implementation of the recommendations of the Herity report has been identified as a priority action in the HSE national service plan 2017. To this end, an additional €500,000 has been allocated to the hospital for the coming year. The Minister has also committed to a further review after these extra investments have been put in place.

Following his visit to the hospital last November, the Minister asked the HSE and the south-south west hospital group to address the waiting lists for cardiology procedures at the hospital as a priority. I am delighted to report that very significant progress has been made in recent weeks. Indeed, waiting list data compiled and published by the National Treatment Purchase Fund last week shows that the cardiology inpatient and day-case procedure waiting list at the hospital has been reduced by almost 20% since the end of November while the number of persons waiting longer than a year has been reduced by some 67%.

While the Minister acknowledged warmly the collective efforts of all concerned to tackle the issue, he believes it is very important that this focus on the cardiology waiting list continues in 2017. To this end, he has been assured by the HSE that the hospital group has a robust plan in place to address the remaining backlog which involves access to cath lab capacity across the region. I am advised by the HSE that patients currently waiting over 12 months will have their procedures completed in the first eight weeks of 2017 and that patients waiting three to 12 months will have their procedures completed by June 2017. I know the Deputies will welcome that news. The House will be aware that budget 2017 made specific provision for those patients waiting longest for treatment within the health service. In this context, the Minister is considering a national cardiology waiting list initiative to address cardiology waiting lists across the country. A range of measures are envisaged including sharing of facilities and resources among public hospitals, the use of private facilities and the deployment of a mobile cath lab, including in Waterford, to augment the current plan which has been drawn up by the south-south west hospital group to address the waiting list backlog.

Further details of this proposed initiative will be made available in the coming weeks. I do not doubt that Deputies will be glad to know that as soon as those details are available they will be made aware of them.

I have not been in the Chamber for a long time as I was elected at the end of February 2016. However, even I know that a Private Members' motion will not change the mind of the Minister. It will certainly raise awareness, which is what I am doing today, along with other Deputies. It may influence the Government. I brought a Private Members' motion through the House in regard to dementia care and raising awareness, which did not change anything. Only 69 people out of 500 received home care packages. I know exactly what a Private Members' motion will and will not do.

A vote of confidence could take place.

I ask the Minister of State not to interrupt me. I thank the Minister of State, Deputy Corcoran Kennedy, for her answer. My petition today does not concern waiting lists, to which the reply referred. Rather, it refers to 24-7 cardiology cover and the implementation of the Higgins report which clearly states, on page 87, that Waterford Regional Hospital will continue to provide cardiology coverage for the south east population working in collaboration with cardiology services in Cork and that the current service should be extended with new appointments of cardiologists.

I have the book from which I have taken that information, which was published in 2012. We have taken note of the Herity report but not the Higgins report. The people in Waterford and the south east will continue to wait for 24-7 cardiology cover.

I do not for one moment doubt the sincerity of the Minister of State, Deputy Halligan, on this issue but I do doubt the commitment from the Government to deliver for the people of the south east. It is not good enough that we are again being subjected to second best, second class services, with patients having to travel. When one strips everything away and takes all of us in the Chamber out of the equation, this is about 500,000 people who live in the south east. They want to be treated the same as everybody else. The reality is that across the south east we do not have access to emergency out-of-hours cardiac services, and that will continue unless the Government changes its mind.

The mobile labaratory is welcome, in so far as it will reduce waiting times. However, it should not be presented as some sort of solution to the problem. The consultants in Waterford and elsewhere in the region are not living in a post-Herity world and do not accept the Herity report. They are as resolute today as they were before the report was published. They argue that the terms of reference were flawed and the outcome was not good for the patients of the south east. They, along with all of us, want 24-7 emergency cardiac care for the people of the south east.

I accept what the Minister of State, Deputy Corcoran Kennedy, said. She has good intentions, but her reply was not good enough. We can all play politics with hospitals if we want to and talk about what we did and did not do over the past 20 years, but we are where we are today.

I travelled throughout south Kilkenny during a by-election and a general election during the past two years. Every house I went into in south Kilkenny referred to cardiac services. People asked me what would happen if they, their husband, son, daughter, father or mother had a heart attack because from 5 p.m. on Fridays until 9 a.m. on Mondays services are only available in Cork.

People living in south Kilkenny, south Wexford, South Tipperary or Waterford have to be brought to Cork for treatment. We all know that those who have had heart attacks need to reach services in time - we do not need to be doctors or professional people to know that.

Deputy Butler mentioned the Higgins report. The Herity report is a stitch-up because it overruled the Higgins report. The Higgins report made it plain that a second 24-7 cardiac service was needed for the people of the south-east. The Herity report counteracted that view.

I thank Deputy Cullinane. I am sincere in what I am trying to do. I am convinced that fairness will prevail in the end and a second cath lab will be delivered. There is no question about that. Do I think that the mobile cath lab is ideal? I do not, but it is a small step forward. That is all I am saying. I am not saying it is the answer. I agree with everybody that we need and deserve a second cath lab.

Yet the Minister of State chose to attack me.

Someone said this was not about politics but it is. Everybody here makes political decisions. The people on the other side of the House have the ability to put the Government and me out of office. If they are sincere-----

The Minister of State has threatened-----

Let me finish. Let us be honest about this. They, rather than the Independent Alliance, hold the majority say in the Government. They could table a motion of no confidence in the Government if it does not bring forward a second cath lab. That will do it. I am not sure whether such action could be taken in a vote on a Private Members' motion on which the Government was defeated, but I am sure if a motion of no confidence in the Government came from Fianna Fáil on the necessity of a second cath lab in Waterford it would be supported by Sinn Féin and many other Independents, and that would be the end of it. The Government would have to provide a second cath lab or fall. I know that is not the solution.

The Minister of State is passing the buck.

I am not passing the buck. Rather, I am making the point-----

(Interruptions).

He is passing the buck.

This is a very serious issue and we should not be fighting over it. The Minister of State, Deputy Halligan, should be careful for what he wishes. Christmas has gone and the turkeys have come home to roost, but he never knows what is coming.

The Higgins and Herity reports are HSE spin. I am not castigating the people who produced the reports but what is important are the questions they asked, the lead-in they had and the feed-in they got from patients. The officials who have now captured the Minister, Deputy Harris and the Minister of State, Deputy Corcoran Kennedy are control freaks.

Some 500,000 people in the south east are not less decent and do not deserve less respect than those in Dublin 4 and the leafy suburbs. We are their representatives and messenger boys, and are here to carry the message that we are entitled to a second cath lab.

We welcome the mobile unit. Perhaps we should take the wheels off it and see whether we can keep it in Waterford before it is moved Dublin or elsewhere because of shortages. I do not accept the reply of the Minister of State, Deputy Corcoran Kennedy. The Minister, Deputy Harris, should be here because this is his place. He is probably sitting in his office with officials watching the debate and will say I was very hard on him. I will be hard on him. He has had his honeymoon. He is accountable to the people of the south east and he must sit up and listen.

I wish to assure the Deputies present that the Minister, Deputy Harris, is not sitting in his office watching the debate. I will convey all of the points they have made to him. I wish to provide some reassurance on concerns around whether the area is being neglected.

At the end of December 2016, there were 4,623 patients on cardiology inpatient day case waiting lists nationally, of which 489 were in University Hospital Waterford. That shows that while there are challenges, University Hospital Waterford is not being singled out in any way. There has been an improvement, in that 14 patients within the cohort of the 489 have been waiting for more than 15 months compared to the November figure when 113 patients had been waiting for more than 15 months. The improvements are incremental, but they are still improvements and it is important that we acknowledge that.

We must also acknowledge the commitment of the people in the hospital to deliver on this. The figures provide evidence that 97% of patients are receiving an appointment for an inpatient day case procedure within 15 months, which is above the 2016 target of 95,000. I know there are concerns and that people are unhappy, but I wish to reassure everybody that every effort is being made bring down the figures. I also want to reassure people that the Government, the Minister, Deputy Harris and the HSE are absolutely committed to fulfil this.

On the 24-7 PCI services, the Minister for Health has made it clear that before there are any changes in how services are delivered he wants to establish how services are improved for the patients using them. The implications of ceasing the primary PCI services will be addressed by undertaking a national review of all primary PCI services, with the aim of ensuring that as many patients as possible of access to 24-7 PCI services. The review will be completed by the end of July 2017. I hope Deputies will accept our assurances that every effort is being made to provide services that people deserve.

Sitting suspended at 4.20 p.m. and resumed at 5 p.m.
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