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Dáil Éireann debate -
Thursday, 19 Apr 2018

Vol. 967 No. 6

Topical Issue Debate

Voluntary Sector Funding

I thank the Minister for coming in to bring clarity to a question that has been in the media for the last week with regard to the withdrawal of funding for Scouting Ireland. Scouting Ireland does excellent work around the country and this is down to the commitment, good work and will of the volunteers who keep it running. All the volunteer group's work should be properly supported and resourced by Government but, at the same time, organisations working with children and young people have a huge amount of responsibility and protecting children must be paramount to the ethos of everyday operation. Funding must be contingent on honouring this responsibility and on putting in place strong safeguards and processes to ensure that children are kept out of harm's way. I support and recognise the need to have strong child protection policies, including child protection officers and mandatory Garda vetting for all adults involved in the organisation. The Topical Issue matter was put down to understand the reason for the withdrawal of the funding and what processes are now in place to get the funding reinstated. The volunteers are reading about it in the newspapers and really want clear understanding as to why exactly it has come to this and what processes the Minister is putting in place.

I raise this issue along with Deputy Rabbitte on the basis that we are both concerned about it and are both members of the Joint Committee on Children and Youth Affairs. We are both conscious that this story seemed to emerge in the public domain through The Irish Times but, until now, this House has not had an opportunity to discuss the issue. We were conscious about giving the issue an airing. We want to move to a situation for the approximately 40,000 members of Scouting Ireland, 13,000 volunteers, 35 staff and approximately 500 troops that exist throughout the island of Ireland, both North and South, where we can clarify the funding position and collectively work on the issues of child protection. I am not aware of the content of the Ian Elliott report. I understand that Scouting Ireland brought in Ian Elliott as a person who would go through the Children First guidelines or kick the tyres on that. I understand that a barrister was subsequently appointed to go through the recommendations of that report. I am not sure if the Minister has sight of the Ian Elliott report. I do not have sight of the report but, in some respects, this is a little reminiscent of when I found myself in this House in 2007 advocating for the publication of the Cloyne report, which was the subject of Ian Elliott's reporting of issues relating to the diocese of Cloyne. I hope that we are nowhere near that kind of scenario and I suspect that we are not. I want to ensure that there is confidence in the work of Scouting Ireland. We all know there are people in our communities throughout this island who give their time voluntarily to ensure that all child protection procedures are adhered to. They do so on a voluntary basis and want to ensure the sustainability of the entity that is Scouting Ireland because it is an invaluable entity to our lives and it enhances the lives of communities throughout the island.

Scouting Ireland commissioned Mr. Ian Elliott to carry out a review into the organisation's handling of an allegation of a serious sexual assault on an adult volunteer by another adult volunteer. While this alleged assault took place in 2009, it was only reported within the organisation in 2016. The purpose of the review was to examine all matters surrounding the reinstatement of the individual in question, including the roles of individual senior volunteers of the organisation in the reinstatement process. I am aware that Mr. Elliott's report on this issue resulted in Scouting Ireland engaging a barrister to conduct a full investigation into this allegation, particularly with regard to the handling of the matter by certain senior volunteers. I will be provided with copies of both reports when completed and I would prefer to await the outcome of these investigations before making further comment.

As a result of media coverage of these events last week, I became aware that the alleged perpetrator of this alleged sexual assault had been reinstated without undergoing further Garda vetting which had been recommended by the gardaí. In addition, it was reported that he was subsequently promoted within the volunteer ranks. Funding provided by my Department to any youth organisation is contingent on that organisation meeting with a range of governance requirements. This includes its commitment to and compliance with its legal requirements in the area of child protection as set out in the Children First Act 2015 and the National Vetting Bureau (Children and Vulnerable Persons) Acts 2012 to 2016. All publicly funded organisations are required to meet strong governance standards. I have a duty of care regarding the public funding provided by my Department. In view of this, I decided to withhold any further drawdown of funding to Scouting Ireland until such a time as I can be satisfied that the organisation's governance standards are up to the required level. I am not satisfied. I have a responsibility to children and for the use of public moneys.

I wrote to Scouting Ireland on 13 April advising it of my intention to withhold funding from the organisation. I also requested an urgent meeting with the board of Scouting Ireland to provide it with an opportunity to clarify the issues raised in the media coverage and to provide assurances that I require with regard to the standard of governance that applies within the organisation. I will meet with Scouting Ireland this evening. That meeting will be with the chief executive officer, the current chief scout, who chairs the board, and the current treasurer. I have been informed that the chief scout will step aside from this evening pending the completion of the independent investigation and the treasurer will serve as acting chair of the board in his absence.

Scouting Ireland is part funded by my Department under the youth service grant scheme. This funding is provided to 30 national and major regional voluntary youth organisations for the support of voluntary youth work. The funding is to ensure the emergence, promotion, growth and development of youth organisations with distinctive philosophies and programmes aimed at the social education of young people. Funding is provided primarily to the head offices of these organisations and many are engaged in youth work activities on a regional or nationwide basis. In 2017, funding of €876,337 was allocated to Scouting Ireland under the youth service grant scheme. To date in 2018, the organisation has received €438,168. This means that Scouting Ireland is funded until the end of June.

I hope that it will use that time to constructively engage with my officials and to address all outstanding issues in regard to the standards of governance in the organisation.

I thank the Minister for her frank answer. The clarity she has brought to the matter is much appreciated, as is her openness in telling the House about what is to happen later today. The volunteers will welcome the clarity in regard to funding continuing until June. The Minister's reply has raised many questions about timeframes which it would not be fair of me to ask at this moment. She stated that funding is in place until June but we must know the timeframe for the completion of the report. I assume that is one of the questions she will ask later today. I note that she stated the chief scout is standing aside. There are many questions for the board in regard to compliance and governance procedures. The same policies and principles should apply in that respect whether an organisation receives €1 or €100,000 in funding.

I accept the Minister's answer to the House and support her in her endeavours. Although no Member wants funding to be unnecessarily withdrawn, if there are question marks over governance standards, the taxpayer investment in the organisation should be withheld until those governance issues are dealt with. I ask the Minister to keep in mind the volunteers at a local level because they are without sin in all of this. They are going about their daily and weekly activities and are vital to our communities. I hope the Minister can engage proactively as quickly as possible to achieve a desired outcome for all interested parties such that funding can be restored. I appreciate why Scouting Ireland might say it is funded up to the end of June but it may not be that simple when day-to-day running costs are taken into account, so I ask the Minister to give us some assurance that funding can be restored.

I assure the Deputies that children, young people and volunteers are at the centre of my attention, which is part of the reason for this decision. I will listen to what Scouting Ireland has to say this evening and then decide on the next step with the Secretary General of my Department. It is mid-April and Scouting Ireland has funding until the end of June, which gives it two and a half months to provide me with assurances that proper governance standards and practices are in place. That is a reasonable amount of time in which to do so.

Deputies will not be surprised to hear that since the news broke I have received other confidential correspondence from individuals in Scouting Ireland about additional matters of grave and serious concern. I will raise those issues with Scouting Ireland as part of the process. To address the sentiment expressed by both Deputies, I will conclude by saying that it was with a heavy heart that I made this decision but it is something that I had to do.

Water Pollution

I am glad to have the opportunity to raise this issue on behalf of the Barrow River Piscatorial Society. I thank my colleagues, Deputies Martin Ferris and Martin Kenny, for their support in this regard. I have been dealing with the society for over a year. It is very active in the community and has very serious concerns about the mainly commercial pollution of the River Barrow and the knock-on effect on fishing stocks and the river in general. It has continuously raised the issue with Inland Fisheries Ireland, IFI, which seems to be passing the buck or not taking the matter seriously. When the society came to me, I endeavoured to organise a meeting for it with Inland Fisheries Ireland and there was correspondence back and forth. Unfortunately, Inland Fisheries Ireland has not committed to a meeting. The society has the right to request a meeting and I do not see the problem with granting such request. We raise the issue to ask the Minister to ensure that the chief executive of Inland Fisheries Ireland, Ciaran Byrne, meets with the Barrow River Piscatorial Society so that it can raise its concerns. It believes it is being treated as a second class citizen because groups with an interest in other rivers have been granted meetings with Inland Fisheries Ireland.

My two colleagues and I met with a deputation from the piscatorial society during the week. Deputy Funchion has been raising this issue for a considerable period. The society brought the issue to our attention in the interests of the salmon stocks in the river. As Deputy Funchion stated, it has sought a resolution to the issue for a considerable period with the IFI but, unfortunately, that has not yet been reached. The river has been polluted by construction material which was dumped in the vicinity of a fish pass, blocking it. As a result, fish find it difficult to get up the river, with an inevitable depletion of stocks. I have read emails in which some members of the IFI at a local level have stated they did not see the relevance of the fish pass being blocked. However, I have seen other letters that say the opposite. To resolve the issue, Ciaran Byrne, the chief executive of the IFI, must meet with the society, listen to what it has to say and see if a remedy can be found. That can happen if the political will is there.

My colleagues and I met with the society earlier this week and it is very clear that it has genuine concerns about the situation. The River Barrow is a major river in the south east and the second longest in Ireland. It is an excellent salmon river but the society is very concerned that its stocks are being depleted. The construction debris dumped in the river and other pollution issues are not being adequately dealt with by Inland Fisheries Ireland or the environmental section of Carlow County Council, with which the society also engaged but which did not give it the kind of hearing it hoped for. The parties involved should come together to agree on a common sense solution. It is not beyond our reach to organise that and I hope the raising of this matter in the House will be the catalyst to make that happen such that a solution can be agreed upon. This is about the adequate management of our inland waterways. Inland Fisheries Ireland is responsible for that and must be brought to the table to work out a solution to this issue.

I thank Deputies Funchion, Martin Kenny and Ferris for raising this issue. A response drafted by my Department is being circulated but it does not deal with the issue as raised so I will not read it into the record, although it is available for Deputies to read. The problem is that there is a multifaceted approach to issues such as this and responsibility does not lie with any one agency, which is hugely frustrating. As Deputy Kenny knows, there is a similar problem in regard to the Asian clam in Lanesborough-Ballyleague. The local authority and Inland Fisheries Ireland should probably consider the matter. I do not know the details of the issue as I have only the documentation in front of me.

I am responding on behalf of the Minister of State, Deputy Kyne, who has responsibility for inland fisheries. He is out of the country representing me at the moment.

As the Deputies are aware, the provisions of the water pollution Acts come under the remit of the Minister for Housing, Planning and Local Government, Deputy Eoghan Murphy. I will commit to taking the points raised by the Deputies back to the Minister of State, Deputy Kyne, early next week. I will discuss this issue with him and we can try to see if we can progress it.

It is a simple request. We are asking the Minister to use his offices to insist that Inland Fisheries Ireland would meet this group. The society is an established group and its members have spoken to their local representative, which is not uncommon, but I cannot get any indication from Inland Fisheries Ireland that it intends to organise a meeting.

I accept that this is the area of responsibility of the Minister of State, Deputy Kyne, and I urge the Minister, Deputy Naughten, to speak to him and to try to organise a meeting. We will raise the issue again if a meeting is not facilitated. I do not accept that it is not the responsibility of one particular organisation. The group wants to meet with Inland Fisheries Ireland and it has its reasons for that. Such a meeting should be facilitated. It is pretty disgraceful that we have to come in here to raise the matter. The society is respected in its own right and it should have been able to arrange a meeting itself.

The way to resolve the issue is for there to be a face-to-face meeting. It could take half an hour. A meeting can take place if the will is there to do it. In a reply from David McInerney to Donnacha Byrne it was said that material should not have been put in the river which is an SAC area and that it is very poor practice. The problem is that an individual dumped construction material into the river which blocked the fish pass. The material needs to be taken out of the river to allow the fish to travel their traditional route. All that is required is for the parties to sit down face to face and the issue can be sorted out very easily. I thank the Minister for taking the time to address this issue.

I welcome the Minister's contribution. Sometimes when a Topical Issue is raised the question can be short and it may not spontaneously produce the right answer. I note that the scripted reply of the Minister states that the primary responsibility for the monitoring and management of water quality is the local authority under the Local Government (Water Pollution) Acts. While that is the case, local authorities are quite weak because in many cases they are understaffed and under resourced and I am sure Carlow County Council is no different from many others around the country, and it is difficult for it to try to do the kind of work it is expected to do in respect of water quality.

I would appreciate if something could be done to try to arrange a meeting as quickly as possible in order to resolve the issue. It is very poor that we have to come in here to try to get that to happen. If an angling organisation, environmental group or conservation group has an issue or someone involved in tourism who is trying to make a few bob out of whatever is happening on the river cannot meet with the proper organisations who have responsibility for it without having to raise it in the Dáil, it is a poor reflection on the situation. That issue must be addressed as well. I thank the Minister very much for his response.

I do not know the detail of this case. The priority is to get the issue resolved. I will take the matter back to the Department and to the Minister of State, Deputy Kyne, to see if we can try to resolve it. I do not know the ins and outs of the matter, but it seems there could be three Departments and two agencies under the control of my own Department involved. I do not know what the issues are but I commit that I will go back to the Minister of State, Deputy Kyne, and he will communicate directly with the Deputies on the matter.

It is not my role to interfere in these matters but it would be quite extraordinary if a reputable voluntary organisation, through public representatives, asked for a meeting with a statutory body and those representatives felt the need to come into the Chamber to progress the issue. The statutory body would want to have a pretty compelling reason it would not facilitate the meeting.

Hospital Staff Recruitment

I thank the Minister of State, Deputy Catherine Byrne, for coming into the Chamber today but I must say I am disappointed that, again, the Minister of State with line responsibility, Deputy Jim Daly, did not see fit to be here. This is the second time for me to raise the issue here and although he is a Corkman I do not know where his loyalties lie at this stage. I spoke on the issue previously in November 2017. The issue is the filling of the permanent medical officer position at St. Patrick's community hospital in Fermoy. There are many other issues in my constituency that I would love to raise in the Topical Issue debate in this Chamber but I feel that I need to further emphasise the importance of filling the vacancy for the medical officer position.

I remind the Minister of State of the contents of the programme for Government. I refer to page 53 which relates to health, which states: "Efforts to increase access to safe, timely care as close to patients' homes as possible will be a priority for the new Partnership Government". It also states on page 55: "The HSE will be mandated to employ GPs on a salaried basis where needed and put in place support structures and staff". How does the Minister of State stand over the current situation in Fermoy?

Herein lies the kernel of the problem. First, there is not a full uptake of respite beds at present in St. Patrick's community hospital and, second, some eligible patients end up being sent to alternative nursing home or community hospital locations. That is not good enough, as we have a state-of-the-art facility in Fermoy. Families are being pressurised to second GPs to provide cover when the availability of a respite bed arises. I remind the Minister of State that not all patients or their GPs are from within the confines of Fermoy. Some patients who have been allocated a respite bed at St. Patrick's community hospital cannot avail of the care there. The reason is that their own family doctors cannot put themselves in a position to travel to the hospital and attend to them if and when the need arises. The offer of a bed, therefore, has to be declined. The HSE can cause a cold relationship between families and their doctors by passing on the blame. That is not going down well in the area.

In fairness to the HSE, it has communicated with me. It acknowledged the problem but does not consider it to be a crisis situation. How can we allow a situation where there is a half-filled temporary position to continue? The situation is beginning to reverberate around the entire north Cork area. The HSE seemed to indicate there was no problem in the context of Fermoy but in recent weeks I was shown a letter which was written to a constituent who was seeking a respite bed for her mother in another facility. She was advised that due to circumstances beyond the control of the HSE the availability of respite to clients across the north Cork community services area has recently been reduced. The letter went on to say that this had greatly increased the demand for respite services in Nazareth House in Mallow. That suggests the problem in Fermoy is starting to have a knock-on effect on other community hospitals. I urge the Minister of State to intercede or to ask the Minister with line responsibility to take urgent action to address the issue.

I apologise that the Minister is not here. I do not know where he is but I have been asked to respond.

I hope he is not missing.

He has gone missing; I do not know where he is. I am sorry that he is not here.

On behalf of the Minister of State, Deputy Jim Daly, I thank Deputy O'Keeffe for raising this issue. The Health Service Executive is responsible for the delivery of health and personal social services, including those at facilities such as St. Patrick's community hospital, Fermoy. Fermoy Community Hospital is an integral part of the Fermoy community and plays a major role in the care of older people from the town and the surrounding areas. The hospital currently has 71 beds, 54 of which are for long-term care with the remaining 17 providing convalescence, respite and palliative care. Medical cover in Cork and Kerry community hospitals and nursing units is provided by medical officers who are local general practitioners employed under contract by the HSE. This service is not a full time, on-site service, with GPs visiting at agreed times and when required during normal day time working hours. Out-of-hours cover for all residents is provided by SouthDoc after 5 p.m. on weekdays and at weekends or bank holidays. The Deputy will be aware that the provision of full medical officer cover has proven difficult at Fermoy since September 2017, following the retirement of the one of the local GPs, and more recently with the resignation of another in March 2018.

Medical cover at Fermoy Community Hospital is currently provided by a local GP. The latter provides 0.8 whole-time equivalent medical hours cover. In effect, this means that full medical cover is provided for all 54 long-term care residents, three convalescent patients and one palliative care patient, in addition to any respite admissions who are registered patients of the GP's practice. The HSE has acknowledged that the difficulties in attracting a GP or GPs to take on unfilled parts of the medical officer post is impacting on the take-up and full use of the nine respite beds in Fermoy. However, respite beds which are managed through public health nurses in the community remain open and are being utilised. It should also be pointed out that the other community hospitals and nursing homes in the surrounding areas are offered and utilised when respite care is required.

Due to the lack of full medical officer cover, respite admissions require a person's own GP to complete the assessment and administration process and to be available, if required, during the core hours of 9 a.m. to 5 p.m. It should be noted that difficulties have arisen when some GP practices in the local area have advised that they are unable to provide medical cover for their patients during respite due to work pressures and capacity issues within their own practices. Cork Kerry Community Healthcare continues to seek a permanent and sustainable solution to providing full medical cover at Fermoy Community Hospital. The GP who currently provides this service has indicated to the HSE that he is willing to provide full medical officer cover to the hospital once he has resolved the GP locum situation that continues to be problematic for him and his practice.

I thank the Minister of State for her reply. As I said previously, the response is glamorous but it does not solve the problem. The Minister of State has said that there has been a problem in Fermoy since September but the problem did not start then. The HSE would have been aware that a problem was going to arise well before September 2017. I do not want to be seen to be repeating myself. In that context, the Minister of State was here on the previous occasion when I raised this matter. She promised then that she would ask the Minister to get back to me with more constructive answers but I have heard nothing. I have been in communication with the HSE on the matter in the meantime and have received various different answers. At one point, the HSE, in a rushed response - the Ceann Comhairle may recall this - referred to five days but forgot about the other two days in a week.

As I indicated earlier, this is having a knock-on effect throughout north Cork. It is jeopardising other families who have access to other community hospitals in the area. Previously, these families were getting more than the minimum respite period because they were able to avail of respite at other facilities but now they are being restricted. If families cannot get a GP to go with their loved ones to the respite care unit in Fermoy, the HSE diverts them to Mallow or, in some instances, to other nursing homes. Questions arise in this context too because many families send their loved ones to nursing homes at their own expense. Those nursing homes often have more beds than community hospitals but are not required to provide full medical officer cover. Why is the requirement for such cover so rigorously enforced for community hospitals? Ironically, SouthDoc is situated on the same driveway as Fermoy Community Hospital. SouthDoc has a resident doctor available 24-7. Why can the HSE not liaise with SouthDoc when locums cannot fulfil their temporary contracts?

Again, I thank the Deputy for raising this very important issue. Respite care availability is an issue with which all public representatives deal on a daily basis. I am sorry that this is the second time that Deputy O'Keeffe has had to raise this issue in the House. I have been present on both occasions to deliver the departmental response. I emphasise to the Deputy that when I deal with a Topical Issue matter in this House, I go back to the Minister with line responsibility and explain the situation, verbally and by email. I am sorry that today's answer does not meet the Deputy's requirements. However, I reiterate that the GP who is currently providing cover is willing to provide full medical officer cover but, unfortunately, he is having problems finding a locum to fill in for him in his practice. I read a report on this matter before coming to the Chamber. The HSE is willing, ready and eager to fill this post but has not been able to do so to date. In view of the Deputy's ongoing concerns and the fact that he believes that today's reply is not adequate, I will make it my business to contact him either later today or Monday and speak to him about the matter again at length. I offer my apologies to Deputy O'Keeffe.

Hospital Services

I thank the Ceann Comhairle for allowing me to raise what is a very important issue in my constituency, namely, the future of services at Midland Regional Hospital Portlaoise. I am disappointed that the Minister for Health, Deputy Harris, is not here this afternoon. Indeed, I raised this matter last autumn and the Minister was not here on that occasion either.

Essentially, the Minister is the source of the problem in respect of Portlaoise. A report has been on the Minister's desk since September 2017 relating to the hospital in Portlaoise. The report includes proposals to close the emergency department and the maternity department and to ensure that all deliveries take place at the Coombe hospital in Dublin. It also proposes closing the paediatric care unit and the intensive care unit as well as ceasing all inpatient surgery. This report was drafted by the HSE and after detailed engagement between the HSE and departmental officials it was presented to the Minister last September, which is seven months ago. At this stage, the future of Portlaoise hospital is out of the hands of the HSE and is in the hands of the Minister for Health, the Cabinet and the Government. Nobody other than the Minister can make a decision on this matter. Therefore, it is up to him to bring the uncertainty regarding the future of the hospital in Portlaoise to an end. This uncertainty is undermining the hospital and causing damage to its future. As I have already mentioned, I raised this matter last November but got no detailed response on that occasion. Since then there was a large rally in Portlaoise in early December. I was pleased that Deputy O'Loughlin from Kildare attended that rally. She is with me in the House today because many people in the Kildare area use the hospital in Portlaoise.

The Laois Oireachtas Members met the Minister in December. He said that he would commence a process of consultation with local GPs and the community and he issued a press statement to that effect before Christmas. I tabled a parliamentary question for written reply on Tuesday last which asked the Minister who is chairing the consultation process that he announced last December, what meetings have taken place since that announcement and the timescale for the conclusion of the consultation process. The Minister's reply was that he had asked for a consultation process to be undertaken and that this is currently "under consideration". It is totally unacceptable that seven months after the Minister received a report, the consultation process on same has not even commenced.

I stated clearly last September that what was needed was a rejection of the report in its entirety and I told the Minister that arrangements should be put in place to improve services at Midland Regional Hospital Portlaoise. The continued delay while this report sits on the Minister's desk is undermining confidence in the hospital and the staff who work there. It is undermining the confidence of patients and people who may want to avail of the hospital's services in the future. It is also undermining the potential recruitment of essential staff at the hospital. Why would anyone take up a senior medical post in the hospital when its future is not clear? There is a report on the Minister's desk which proposes the effective elimination of all services in the hospital. The Minister has allowed that report to sit on his desk for seven months and by doing so, he is deliberately contributing to an undermining of the future of Midland Regional Hospital Portlaoise.

The only thing the Minister needs to do is to get formal Cabinet approval to reject that report in its entirety. He should ask himself why, at a time of such crisis nationwide, officials in the HSE and the Department of Health are spending so much time drawing up reports on the closure of the accident and emergency and maternity departments at Portlaoise hospital. He should have rejected the report when he received it last September, but he did not do so. I am calling on him to reject it now.

On behalf of the Minister, Deputy Harris, I thank Deputy Fleming for raising this Topical Issue. I hope the reply that has been provided to me reflects the points that have been made by the Deputy, some of which I have noted on paper. I will read the reply before coming back to the Deputy on any further points he may have. I assure the Deputy that, as the Minister for Health has stated previously, the most important issue in the consideration of services at the Midland Regional Hospital in Portlaoise is the need for patient safety and outcomes to come first. The Minister is committed to securing the further development of the role of Portlaoise hospital, a constituent hospital within the Dublin Midlands hospital group. Since 2014, there has been a focus on supporting the hospital to develop and enhance management capability, implementing changes required to improve clinical service and incorporating the hospital into the governance structures within the Dublin Midlands hospital group. Significant work has been undertaken to strengthen the stability of services at the hospital. Funding has increased by 35% relative to the 2012 budget. Staffing levels have increased by 29% from the 2014 base. Governance and management arrangements in Portlaoise hospital have been strengthened. Additional clinical staff have been appointed. Staff training, hospital culture and communications have improved.

The Dublin Midlands hospital group has been working for some time on a draft plan for a new model of clinical service delivery at Portlaoise hospital which takes account of the need to develop services at the hospital in the context of the development of a model of service provision for the entire hospital group. The draft plan has been submitted to the Department of Health. I emphasise that patient and public requirements are paramount and have underpinned the Department's consideration of the draft plan. The HSE group involved in developing the draft plan for Portlaoise included eight national clinical programmes, the National Ambulance Service and the HSE's national acute hospitals division. HSE consultations took place with the clinical staff and management in Portlaoise hospital, general practitioners, the Irish Prison Service, Tallaght Hospital's surgeons and emergency department services and the Master of the Coombe Hospital. As agreed at a meeting with Members of the Oireachtas from County Laois, no decisions have been taken on the draft action plan. The Minister, Deputy Harris, is giving consideration to a process for wider consultation. I know Deputy Fleming will have other questions to ask. I will reply to some of them when I come in again.

I thank the Minister of State. I appreciate that she was sent in here to read a script on behalf of the Minister for Health. It is very troubling that four months after the Minister said he was setting up a consultation process, he now seems to have back-tracked. The reply the Minister of State read on his behalf suggests he is merely "giving consideration to a process for wider consultation". The problem is that the HSE and the Minister have caused almost three years of uncertainty. In 2016, the regional management announced the possibility of scaling back the accident and emergency department. From day one, that undermined the future of services at Portlaoise hospital. During 2016 and 2017, the draft report went up and down between the Minister's office, the Department and the HSE before it landed on the Minister's desk in September 2017. The uncertainty must be brought to an end. There is nothing more damaging to a hospital than uncertainty. The Minister, Deputy Harris, is the only person who can eliminate the uncertainty that has put a cloud over the future of Portlaoise hospital for two and a half years now.

It seems that four months after the Minister met us, he is now considering a further process of consultation. We do not want a consultation process at this point in time. We want the Minister and his Cabinet colleagues to take a definitive decision to reject the report that is on the Minister's desk. I do not want to spend another year discussing a report that essentially wants to close most services in the hospital, including the accident and emergency, maternity and paediatric units. We do not want further consultation on that. As the Minister of State has outlined, people were consulted before the report was given to them. The consultation period in relation to the drafting of the report should be over. We want the Minister to decide to reject the report in favour of increases in investment, funding and staffing to ensure the people who rely on Portlaoise hospital enjoy safe and high quality services. This needs to happen as quickly as possible. There should be no further talking. This report needs to be rejected for once and for all so that the cloud of uncertainty that lies over the hospital in Portlaoise can be lifted by the Minister.

I assure the Deputy that I was taken aback by one aspect of the script when I was reading it on behalf of the Minister. The Deputy mentioned that the report was received last September. I think there is some justification for some of the issues he has raised. There is nothing as bad as a hospital and its patients being left with uncertainty. I promise the Deputy that I will do my utmost to allay his frustrations and concerns regarding the services at Portlaoise hospital. I hope the Minister for Health will come back to the Deputy as soon as possible. I will emphasise to him that a decision on this matter is needed as soon as possible. Maybe he will correspond with the Deputy on the matter at a personal level. I cannot provide any other information because I do not have it in front of me.

On a procedural matter, Deputies Fleming and O'Keeffe both suggested that the responsible Minister should attend Topical Issue debates. Everybody appreciates the helpfulness of the Minister of State, Deputy Catherine Byrne, in these matters. I understand that when a Topical Issue is submitted and selected, the office of the responsible Minister communicates with the Deputy who has been selected with a view to reaching an understanding about who will answer the question.

That is the procedure that should be followed.

It has never happened.

If it is not being followed, the matter will have to be dealt with.