Saincheisteanna Tráthúla - Topical Issue Debate – Dáil Éireann (32nd Dáil) – Tuesday, 25 Sep 2018

Saincheisteanna Tráthúla - Topical Issue Debate

School Transport

Deputy Declan Breathnach

The school transport scheme is 50 years in existence. It started in 1968. It is commendable that 117,000 children are availing of it in the current year. Some 12,000 of them have special needs. Over 4,500 vehicles have covered what I am told was over 100 million km since the scheme started. As the old poem states, "The wheels on the bus go round and round", but unfortunately the doors of the bus open and shut. Sometimes they are shut to many.

Having just come from a meeting of the education committee, which was discussing this, I realise 450 special needs children are still waiting to be able to avail of this service. The reality is that between the contract with Bus Éireann and the Department, there are both planning and communications issues. I will start with the communications issues. Despite reviews and promises to examine the matter, the report in regard to communications could be to do better. We are told additional staff were taken on and that 35,000 calls were made, amounting to some 1,200 per day. The reality is that the lack of feedback to public representatives and parents has been nothing other than appalling. It is my firm belief that, where communication is concerned, one has to take responsibility. It is my belief and that of many others in this House, particularly the rural Deputies, who are particularly affected by this issue, that this scheme is demand-led.

We have been told that €190 million has been allocated for it, of which €27 million is a further allocation for children with special educational needs. It is not fit for purpose financially and the Minister of State must get a grip on that. I appeal for full reform of this.

Finally, with regard to planning, I was a school teacher for 35 years and talking about a small window of time during which all of this must be processed is not acceptable. As a school teacher, if I take a special needs pupil into my school, I must plan to do so two or three years in advance. Likewise, the same should be done when the pupil is going to secondary school.

Deputy Pat Casey

In the two and a half years the Government has been in office, there has been a sad and frustrating predictability about the school transport chaos that has hit different villages throughout Ireland, including in Wicklow, every September. It essentially has the same characteristics. Letters of notification of withdrawal of Bus Éireann school bus transport services to families in Redcross and Tinahely are due to what the company claims are capacity issues. In reality, a dysfunctional management system is failing to provide adequate school transport services to students and families who are willing to pay for them. These notices were issued in late August and, in some instances, families were not notified at all prior to the start of the school term.

In the case of Tinahely and Redcross, leaving certificate and junior certificate examination students lost their concessionary tickets even though they have been travelling on the bus for years. The start of these important examination years is being marked by unnecessary stress caused by a system that should have a student and family based approach to service delivery. More than 20 families received these notifications and many have no alternative method of getting their children to school in Coláiste Chill Mhantáin or Coláiste Bhríde. Parents are obliged to car pool, change their working hours, take time off or consider changing schools in what has turned out to be an annual farce in the school transport system. In both of these cases, the schools that are deemed eligible do not have transport services from Redcross or Tinahely. The pick-up point for the services are located some distance from the villages, over 4.5 km in the case of Redcross and over 3 km in the case of Tinahely, yet both villages have school transport travelling through the villages to Coláiste Chill Mhantáin and Coláiste Bhríde. There is no other public transport structure serving Redcross and Tinahely.

The stress caused to the students and their families cannot be underestimated and the poor response so far must be changed. The families in Tinahely and Redcross deserve better than this. The problem will not go away but will only get worse as more children will be attending these schools in the years to come.

Deputy Bobby Aylward

Every academic year children who are concessionary ticket holders are being left on the roadside. In the majority of cases the parents are not notified until a few weeks before the beginning of term. This places significant undue hardship on young families at what is a stressful time of the year. A number of key areas in the school transport scheme must be addressed urgently. The rules to determine eligibility must be changed as they are not fit for purpose. Parochial identity is important to rural people and the current rules dismiss family traditions of attendance at a preferred school within the parish, attendance of siblings at that school and the location of after-school and extra-curricular activities with local GAA or other sports clubs, which are important for people.

The rule stating, "Routes will not be extended or altered, additional vehicles will not be introduced, nor will larger vehicles or extra trips using existing vehicles be provided to cater for children travelling on a concessionary basis", must be scrapped. The school transport appeals office must also be scrapped and a new system put in place, as it is totally pointless. Since 2015, 558 appeals were made to the board, none of which was upheld, at a cost of €59,700 to the taxpayer. We need to establish an independent office to examine and consider these matters whereby a degree of discretion and common sense can be applied.

However, there can be no change unless the Minister of State goes to the Ministers for Education and Skills and Public Expenditure and Reform and requests that additional money be made available in budget 2019 to restore the criteria to the pre-2011 eligibility rules that applied before the changes were made. Fianna Fáil costed this in its 2016 general election manifesto at €3.2 million. Recent research we have conducted now puts the cost at approximately €4 million, which is a relatively small amount in the budgetary context. Will the Minister of State request the funding from his colleagues in Government in advance of the budget and sort out this problem once and for all? It is an ongoing problem every year. The Minister of State will be aware of that because I have been raising it at this time of the year every year since he was appointed. I ask him to seek the funding that is required from the Minister.

Minister of State at the Department of Education and Skills (Deputy John Halligan)

I thank the Deputies for their interesting questions. I concur with what has been said. The school transport scheme in Ireland is one of the best in Europe. We transport 117,000 children twice a day, including almost 13,000 children with special needs, in more than 4,500 vehicles covering 100 million kilometres annually at a total cost of almost €190 million. Parental contributions towards the cost of school transport is €15.4 million and the State carries the rest of the cost. We are currently transporting approximately 24,700 children who are concessionary ticket holders. My current estimate is that 350 children who are ineligible for school transport paid by the deadline date but were still unsuccessful in obtaining concessionary school transport.

This issue must be explained in detail. The school transport scheme was put in place for eligible children. I did not put the scheme in place. It was introduced by Fianna Fáil and is a very good scheme, so this is not a criticism of Fianna Fáil. The objective of the school transport scheme was to carry every eligible child and every child with special needs to school. Currently, every eligible child is either on a bus or getting the grant for going to school. The scheme that has been presented to me over the past number of years is a scheme for eligible children, not concessionary children, even though the scheme carries 24,700 concessionary children.

Deputy Breathnach made a valuable point about special needs. During the summer recess, I spent two weeks in Dublin dealing with special needs cases, which can be complex. The Government ensures that every child with special educational needs has school transport. Incidentally, half the school transport budget is being used to transport children with special educational needs. I agree with that. The transport of children with special educational needs is a specialised service. The difficulty we have is operating it on an individual door-to-door basis. For example, when an application is received, a vehicle and driver must be procured. A bus escort might have to be hired and, in some instances, we are hiring two escorts for a child. Garda vetting must be carried out. This means it can take weeks after an application has been received before the transport can be provided. The media have reported on some cases where there were unacceptably long delays and I have asked the officials to examine those cases. I was not aware of them. Representatives of Bus Éireann will meet me in the next couple of weeks.

The Deputy asked that the system be changed. I will outline the problem with that. The budget currently stands at €190 million. To increase that budget to consider concessionary children will put us outside the legality of the system and outside the criteria laid down to carry eligible children and children with special needs. I am aware that Deputy Aylward has been to the forefront in raising this issue. If I had my way, I would carry every child. However, every year we have more eligible children, more children with special needs and more concessionary children. The current budget is extraordinary and it has increased year after year. Again, I must point out that the emphasis of the school transport system is to carry eligible children according to the criteria laid down and to carry children with special needs.

All of these children are being carried. The difficulties in respect of children with special needs, which I explained, are being worked through. There may be a number of eligible children who were not allocated a place because of late payment. The applications are approved in April and payment must be made by July. Also, the payment can be made in two instalments. The difficulty is that when payments were not received other children were accommodated on the buses. Was I to direct Bus Éireann to not accommodate children who had paid? Deputies opposite would be the first to criticise me if a child who had been given a place on a bus had that place withdrawn three weeks later. This is the difficulty with which I am faced. I have been advised by the Department that to cater for concessionary children who are not eligible for the scheme in the first instance additional buses would be required. If I can secure the funding to accommodate every child this year or next year I would be delighted to do so. In my view, this might be possible in the context of the budget negotiations. If Fianna Fáil is willing to work with me to secure the additional funding, that would make my life easier.

I know that the Deputies mean well and that they are seeking to represent their areas. I do not like to see any child, concessionary or otherwise, without school transport. However, I have been provided with a deck of cards that I have to work with.

Deputy Declan Breathnach

As I said, there are 450 special needs students who have not been accommodated, which is an indictment of the scheme. I also acknowledged that the scheme was very successful for a time but, as stated by most people on this side of the House, it is now not fit for purpose and it needs to be recalibrated.

Twelve months ago, the Minister of State gave an assurance to the education committee that this problem would not be repeated. I could cite a myriad of examples of people in my constituency, from Dundalk to Drogheda, who are being discommoded but I do not propose to repeat what has been already said by my colleagues. Nationally, 18% of those who are eligible for this scheme are not taking up their places, which indicates the need for a review of the scheme. In rural Ireland, as alluded to by Deputy Aylward and others, because of difficulties with house building it is unsafe for children to be walking the roads, many of whom have to do so because their parents have to go to work.

Deputy Pat Casey

I thank the Minister of State for his reply. I would like to comment further on the two schools I mentioned earlier and ask that he engage with me later on the specific issues. First, Coláiste Chill Mhantáin in the village of Redcross opened in 2012 following the amalgamation of two schools from Wicklow town. In terms of distance, Redcross is closer to Coláiste Chill Mhantáin than the designated school. Second, every morning a 51-seat bus travels to Wicklow town via Redcross on which there are 33 students and 18 empty seats. There are 11 children who have been discommoded under the scheme. All we need to do is apply some common sense and allocate these children seats on the school bus to Wicklow town. Some of the children have been attending that school for five years and are now in their leaving certificate year, which is a critical stage in their lives.

On Tinahely, last year additional children were accommodated by way of the provision of a larger bus. The same could be done for the children who are being asked to attend school in a different county rather than a school with which they have always been associated.

Deputy Bobby Aylward

I accept the Minister of State's point that he has to operate within criteria that have been laid out for the scheme. It is our job as legislators and the Minister of State's job as Minister to address problems where they arise. There is a problem in rural Ireland in particular. The demographics of rural Ireland have changed because during the good times more people built in rural areas, such that more children need to be accommodated by the service. The changes that were made between 2010 and 2011 were in response to the financial crisis. We are out of recession, in recovery and en route to prosperous times again. The onus is on the Minister of State to review this scheme, as he has promised over the past two years he would do, with a view to the introduction of a scheme that is fit for purpose. As I said, the demographics of rural Ireland have changed. Mothers and fathers now have to work. The day of one parent going out to work and the other remaining in the home is gone. Many people live in rural areas and they depend on the school transport system to get their children to school and we are ignoring this. It is wrong to tell a child of the third generation - in terms of attending a particular school - that he or she must attend a school in an area to which he or she has no connection. It is wrong when his or her connection is to the parish school attended by the child's parents and grandparents. We must take cognisance of this and change the system to suit the needs of students and parents. I ask the Minister of State to take this on board.

Deputy John Halligan

In regard to the particular school mentioned, I have no problem meeting the Deputy to discuss it. On the issue of students not taking up places, the percentage in this regard has increased over the last number of years from 15% to 18%. This is difficult for us. The Department and I are not in a position to question families about whether they intend to seek a place on a bus for their child or children. As Minister of State, I cannot do that and neither can Bus Éireann or the Department. Families are paying but for some reason or another their child or children are not taking places on the school bus.

Deputy Bobby Aylward

There should be penalties for not doing so.

Deputy John Halligan

That would be difficult. Legally, we are not in a position to question parents about why their children are not taking up places on a bus or to question schools about whether a particular child is attending that school, which would mean they would have to take up a place on the bus. We also are not in a position to question the children. A review is under way in respect of the 18% who are not talking up places, which when completed will help us a lot.

Overall, 117,000 are being transported to and from school on a daily basis, including 13,000 children with special needs. The scheme is successful. I am not suggesting that there are not cracks in the system. Do children fall through the cracks? Yes, of course they do. I admit that emails are overlooked and mistakes are made which should be rectified sooner. I am not suggesting that everything is perfect with the scheme but 99% of those availing of the scheme think it is an excellent scheme. Since becoming Minister of State, I have endeavoured to ensure there has been no increase in the cost of this scheme, at detriment to myself in terms of my budget allocation each year. The independent value for money review showed that the amount paid by families for the school transport scheme would be four times greater if they had to drive their children to school. It is really good value.

My dilemma, and that of all other Ministers and Ministers of State, is that I am given a particular budget for the school transport scheme. The first priority is places on buses for special needs children. The second priority is places for eligible children. We then address the issue of concessionary places. This is not an easy task. As I said, only €15.4 million is paid by parents. The remainder of the cost is met by the State and it is increasing year on year. It was once remarked to me that the €190 million being spent on school transport would be better spent on replacement of prefabs and so on. I disagreed with that remark. I believe the school transport scheme is great. We need to continue to provide school transport for eligible children, including children with special needs. There have been two reviews of the scheme already. I have no problem with another review but it could recommend the provision of additional funding to provide for concessionary places. Currently, children who are not eligible under the scheme are awarded places on a concessionary basis. I will explain how this came about. When we provided buses for a particular village, town or city, and those buses were 15-seat buses but there were only ten eligible children on board, we decided that rather than have the buses operating with empty seats we would allocate the remaining seats on a concessionary basis.

We put concessionaries on it. What happened was that concessionaries started at 700 and they are now at 24,700. The scheme is creaking at the edges and it means that every year we have to put millions of euros into the scheme to keep eligible children and children with special needs in it.

Mortgage Book Sales

Deputy Dessie Ellis

As the Minister of State knows, we are in the middle of a major housing and homelessness crisis which the Government is failing to address. In the midst of all of this, the Government is complicit in the sale of mortgages by Permanent TSB. The state is a major shareholder, owning 75% of the bank. The bank was bailed out by taxpayers’ money to the tune of €4 billion. Permanent TSB recently sold its Project Glas loan portfolio to Start Mortgages, an affiliate of the vulture fund, Lone Star. This portfolio contains 10,700 home loans that were originally considered by the bank to be non-performing. Of these 10,700 home loans, 7,400 are owner-occupier mortgages and 3,300 are buy-to-let properties. However, it has since emerged that the portfolio also includes performing loans. We are not talking about people who have mortgages and have not paid them in ten years; we are talking about people who are genuinely paying their mortgages and have painstakingly made prior arrangements with Permanent TSB which they have adhered to.

Sinn Féin was opposed to this sale and we called on the Government and Permanent TSB to stop it. The bank, being 75% State owned as well as having been bailed out by the State, should not use vulture funds to evade its responsibility to these people and nor should the Government, as its primary shareholder. A typical example of these cases, which came to the attention of my constituency office recently, is that of a husband and wife who have resided in their house in Finglas for more than 20 years and who have their four children and a grandchild living with them. One child is disabled. The husband is in full-time secure employment, he has a mortgage of just over €100,000, and he has an agreed amount to pay per month and is currently up to date with his repayments. In fact, the husband has offered to increase his payment from the agreed amount to pay off what he still owes in a shorter time.

If their house is repossessed, a family of seven, including a disabled person, will be made homeless. This individual has had his mortgage sold to this vulture fund and it is causing him and his family great uncertainty and distress. Based on the cases I have received representations on in my constituency office, Permanent TSB has been duplicitous in not adhering to these arrangements by agreeing to sell the mortgages to these vulture funds. The bank said that if a borrower has agreed a restructure or an alternative payment arrangement and that they have consistently made payments in line with the terms of the restructure, then these terms will be honoured by Start Mortgages. What guarantee do we have that Start Mortgages will honour these arrangements made with borrowers and that no one will lose their homes? Additionally, another solution is that Permanent TSB could have looked to the local authorities to put in place a buy-to-rent scheme.

We need answers on this. There is a responsibility on the Minister of State and the Government to address this issue. What has the Minister of State done to address this issue?

Minister of State at the Department of Finance (Deputy Michael D'Arcy)

Since the onset of the financial crisis, progress has been made by the banks in reducing non-performing loans, NPLs, from their peak. NPLs at the banks in which the State has invested have reduced by approximately 70% from €54 billion in 2013 to €16 billion at the end of June 2018. This reduction includes the recently announced sale of a portfolio of NPLs by Permanent TSB, namely Project Glas. A major contributor to this progress has been the number of mortgage restructures the banks have agreed with their customers. At the end of June 2018, almost 136,000 mortgage restructures were in place throughout the system covering private dwelling homes and buy-to-let facilities.

Despite this progress, the NPL ratios of the banks remain at an elevated level and are well above the European average of 4%. Permanent TSB is a particular outlier in this regard with a ratio of 25% before the Project Glas loan sale. Given this position, the banking regulatory authorities have tasked the management and board of each institution with developing and implementing a strategy with the expectation that they will reduce their ratio towards the European average. Given the scale of the reduction required, it is unfortunate but inevitable that the recently announced loan sale was a necessary action taken by Permanent TSB. The consequences of the failure of this loan sale process would have been exceptionally serious for Permanent TSB.

It is important that I highlight the strong protections in place for borrowers following a sale of their loans to a non-bank. The Minister for Finance has stated on a number of occasions that the protections for borrowers in place before the sale remain unchanged after that sale. In this regard, it is important to note that there are no changes to the rights of a borrower whose loan is sold by a bank. All terms and conditions attached to their mortgage contract remain in place, including the terms of a restructure agreed with the bank before a sale. Permanent TSB has further reinforced this important point and has confirmed that, if a borrower has agreed a restructure or an alternative payment arrangement and they have consistently made payments in line with the terms of the restructure, then these terms will be honoured by Start Mortgages.

In addition, it should be noted that Start Mortgages is a retail credit firm regulated by the Central Bank of Ireland since 2008. When dealing with borrowers, retail credit firms are bound by the same regulations that currently apply to Permanent TSB. Like Permanent TSB, they are required to comply with the consumer protection code and the code of conduct for mortgage arrears when dealing with borrowers who are in arrears. The Minister for Finance has demonstrated his own commitment to strengthening these protections further, including his support for the Bill introduced by Deputy Michael McGrath, which seeks to regulate the purchasers of mortgage loans. In addition, earlier this year, the Minister asked the Central Bank to carry out a review of the code of conduct for mortgage arrears to ensure that it remains effective. He has asked for the report to be completed as soon as possible and the Central Bank has stated that the report will be ready at the end of this month. If, as a result of this review, the code requires amendment, a full public consultation process will be required in line with normal guidelines.

I wish to highlight the recent comments of Mr. Ed Sibley, the deputy governor of the Central Bank of Ireland. He said that there is no evidence that non-banks are being more aggressive in seeking a resolution than banks. In addition, he said that loans sales are a legitimate and necessary approach for banks to address non-performing mortgage loans and, to date, there has been no material difference in the number of legal proceedings issued between banks and non-banks as a percentage of the total number of accounts in arrears.

Separate to a loan sale, I draw the Deputy's attention to the publication of two recent financial stability reports in September by the Central Bank that highlight some key findings in terms of NPL resolution and long-term mortgage arrears. With regard to principal private dwelling houses, the term, "loan cure", is used to describe the return of previously defaulted loan balances to performing loan status, and the research shows that this is the biggest driver of NPL reduction. This reflects the success of the Government’s supports that have been put in place over the past number of years to assist those who find themselves in mortgage arrears. Furthermore, the paper shows that loans that go through the mortgage arrears resolution process framework are twice as likely to end up in a lower arrears state six months later, which is a positive indicator of how well this process is working and how important it is for borrowers who find themselves in difficulty to continue to engage with their bank.

The Minister for Finance cannot stop loan sales, even by the banks in which the State has a shareholding. These decisions, including the composition of loans included in any loan sale, are the responsibility of the board and management of the banks, which must run on an independent and commercial basis.

Deputy Dessie Ellis

I do not know if the Minister of State heard that this sale included performing loans and Permanent TSB has admitted that. The Minister of State did not give an explanation regarding how these ended up in this portfolio. Why were local authorities and others not given an opportunity to bid on these units?

What contact was there with the Minister? The Minister of State is saying the Minister will not interfere. Surely the Minister must give an opinion. He must call people in and tell them he does not agree with what they are doing, not necessarily to interfere with what has been agreed but to make his point clear that this involves ordinary people. Some of the loans are performing and people could end up homeless or out on the streets as a result of this deal. We have no guarantee that will not happen. We saw this with NAMA when all the properties were sold off. It was another tragedy. It could have helped solve the housing crisis but rental properties and private houses were sold off in large numbers. PTSB is 75% owned by the State. It is absolutely calamitous. It is wrong and the Minister of State and anyone with a bit of sense knows that this does not make sense. From the sound of it, this is a done deal. It is done and dusted and we are now picking up the pieces. In the future, we will pick up the pieces of some of these people who will be left on the streets. That is what will happen. These vulture funds are not buying these for the good of their health. They are out to make a killing. That is what they are doing. They are getting reduced rates instead of offering it to the people who have these mortgages. The same deal should be offered to them.

Deputy Michael D'Arcy

The Minister for Finance cannot stop loan sales even by the banks in which the State has a shareholding.

Deputy Dessie Ellis

Does he not talk to them?

Deputy Michael D'Arcy

It is Harry Potter-style economics.

An Ceann Comhairle

Please, it is not Hogwarts we are in. Can we contain ourselves?

Hospital Services

Deputy Mick Wallace

It is an issue that is a real worry for the people where I come from in the south of Wexford because we are in the absolute worst position of all when it comes to the problems around this issue. A few months ago, I submitted a number of questions to the Department of Health on ambulance response times between various hospitals in the south east and St. James's Hospital in Dublin and Cork University Hospital. The questions were devised by a 24-7 cardiac care campaigner, Matt Shanahan, who has done tremendous and intelligent work over the past number of years to highlight the madness of a lack of 24-7 emergency cardiac care in the south east. His aim was to try to establish how many patients in the south east are getting to a cath lab within the 90-minute window recommended in the Herity report. The 2016 Herity report states that the average blue light ambulance journey time between Waterford hospital and Cork is one hour and 20 minutes. The HSE's answers to my parliamentary questions have demolished this claim and made a nonsense of the report.

I appreciate the Department needs to make evidence-based decisions in the provision of health services but how can the Department continue to stand over the Herity report, especially considering its problems in terms of population calculations and the lack of consultation with consultant cardiologists at Wexford General Hospital? The data show that not one of the 37 emergency cardiac transfers from Wexford over the past three years was completed within 90 minutes. In the same three-year period, from the time the ambulance was called, just two patients made it from University Hospital Waterford to Cork in under 90 minutes. The dogs in the street in the south east know this. It is common sense. The Department, the HSE and Dr. Herity all have access to the national ambulance service response times. They must have been aware of the reality of these transfer times. Did the Department look at them and was it aware of the reality of the transfer times?

The Herity report estimates that approximately 175,000 people in the south east are outside the 90-minute window accessing Cork hospital and St. James's. In the real world, the data I received via my parliamentary questions suggest that the population outside the 90-minute window is closer to 0.5 million people, which is almost the whole south-east region. The Herity report uses a 90-minute journey time as its acute coronary syndrome, ACS, standard. This ACS standard does not exist anywhere else. The equivalent standard in the UK is based on 90 minutes from first responder time to balloon time, or when the patient is on the operating table. Elsewhere in the EU, they aspire to a 60-minute transfer time. Meanwhile for people in south Wexford and the south east, the data I received show transfers of closer to two hours. Consultant cardiologist at University Hospital Waterford, Dr. Patrick Owens, told "Prime Time" that people have without doubt died en route to Dublin or Cork because they have been unable to access the service in a prompt and timely manner. Does the Minister of State accept that statement as true? Dr. Herity told the Oireachtas committee that 150 STEMI cases per year in the south east was needed to justify 24-7 cardiac care in the region. I have been told that approximately 200 STEMI cases were treated in Waterford hospital in 2017. Professor Daly, who did the 2018 ACS report, gave a figure of 203 STEMI cases to cardiologists at Waterford Hospital as a predicted outcome figure for 2017. The Herity report does not stack up. If one takes on board the extra time, Dr. Herity did not look at the time it takes to get to the patient. He was only counting from the time the ambulance picked the patient up to the minute the patient got on the operating table. We cannot ignore the fact that in Wexford on average it took an ambulance 53 minutes from request and departing Wexford hospital to St. James's or to Cork.

Minister of State at the Department of Health (Deputy Finian McGrath)

I thank the Deputy for raising the important issue of 24-7 emergency PPI cardiac care at University Hospital Waterford. The Minister, Deputy Harris, met the Deputy and many other Oireachtas Members from the south east last week to discuss the issue. I am happy to provide an update to the House in this regard. I commend the Minister of State, Deputy John Halligan, for his determined efforts on behalf of the people of Waterford on this issue.

The Herity report of 2016 concluded that the needs of the Waterford catchment area could be met by a single cath lab but it recommended that the existing lab be staffed and funded to provide additional sessions. That funding has been provided and I am happy to report that recruitment, which is being progressed by local management and the HSE’s national recruitment service, is at an advanced stage.

On the issue of ambulance transfer times, the analysis of emergency patient transfer times between University Hospital Waterford and Cork University Hospital in the period October 2015 to June 2016, undertaken by Dr. Herity, was based on information from the national ambulance service, NAS, on the times of contemporary blue light journeys between the two hospitals.

As the Deputy is also aware, a national review of specialised cardiac services is taking place. This review is considering all adult cardiac service needs and their optimal service configuration as a whole. This will take on board not simply geographical location but also best international practice standards to provide a clinically effective safe service for all adults with cardiac disease. The national review will provide a sound scientific foundation for policy making in this area from 2019 onwards. As the Deputy will be aware from last week's meeting, the provision of 24-7 primary percutaneous coronary intervention, PPCI, services in University Hospital Waterford will be considered in the context of the National Review of Specialist Cardiac Services. The Deputy is also aware that the Minister is eager for a second cath lab to be operational in University Hospital Waterford to address waiting times at the hospital and provide a better service for the people of Waterford and the south east. As confirmed at the meeting with Oireachtas Members from the south east last week, plans for a second cath lab at University Hospital Waterford are now being progressed by the HSE and it will provide Members with updates throughout the process. In conclusion, and as set out in the National Development Plan 2018-2027, investment in cardiac cath labs and other cardiac services infrastructure nationally, and any decision with regard to the provision of 24-7 PPCI services in University Hospital Waterford will be informed by the outcome of the national review of specialist cardiac services, which is expected to be complete by June 2019.

Deputy Mick Wallace

While the new cath lab that is to be built in Waterford is welcome, it will not make any difference in terms of helping emergency cardiac patients outside Monday to Friday from 9 a.m. to 5 p.m. The meeting with the Minister last week was a decent one. He explained to us that he has been trying to get extra hours from 8 a.m. to 8 p.m. or 9 a.m. to 8 p.m. That would help but it still leaves a huge window when people can need cardiac help and it is not available within 90 minutes. That is not good enough. He told us that the cardiac review would be finished by the end of June next year. Does the Minister of State think it is fair in particular for the people in Wexford? This is not parish pump politics, it just happens that they are furthest away from care. From the time Wexford General Hospital requests an ambulance to its arrival in St. James' Hospital is an average of two hours and 30 minutes. If someone goes to Wexford General Hospital they automatically go to St. James' Hospital. If they go to another hospital maybe in New Ross, I do not know if people are taken in there but they can end up going to Cork. International best practice is one hour. Ireland is working towards 90 minutes. It is completely unfair that a person in Wexford has to put up with two hours and 30 minutes. The Herity report was not fair from our point of view and it was a bit of a whitewash and now we are waiting for the results of another report. It is not fair that people have to wait for the report. Given what we got in the Herity report, people are a bit dubious about what the next one will say. The Government should be more proactive about anything less than 24-7 care within an hour and a half of the ambulance being first alerted, as that is only fair.

Deputy Finian McGrath

I absolutely take the Deputy's point on Wexford and the south-east area, and his valid criticism. I will tell the Minister, Deputy Harris, about the time of two hours and 30 minutes. I live in Marino and Beaumont Hospital is only ten minutes up the road from my house. I met the consultants with the Minister of State, Deputy Halligan, and have heard their cases. I also will tell the Minister that there are 203 cases per year not 150 cases per year. We have to consider that. There is a determination to resolve this issue. It is recommended that the existing cath lab should be staffed and funded to provide for 12 sessions of four hours each every week. That is an extension of 20% in its hours. Certain posts have been appointed. The grade IV administrative campaign is under way and will be filled on a temporary basis by the end of this month via an agency. The porter position that it was not possible to fill as a temporary post on the HSE contract was converted from an agency on 30 July. The senior cardiac physiologist post was expressed to the panel, the senior radiographer has offered his post to the senior panel already in existence and the post has been accepted. The candidate, however, is on maternity leave but will return to take up the post on 6 November 2018. A staff nurse was appointed on 7 September 2018.

In respect of international best practice and University Hospital Waterford, I am well aware of the issue. It is very important. The people of Wexford and Waterford have the same rights as the rest of us in respect of cardiac services. I will bring all of the Deputy's reasonable and credible points back to the Minister.

Dáil Éireann debate - Tuesday, 25 Sep 2018