Dáil Éireann debate -
Wednesday, 21 Nov 2018

Vol. 975 No. 3

Saincheisteanna Tráthúla - Topical Issue Debate

Medical Card Applications

Deputy Seamus Healy

This Topical Issues matter concerns the need to address the delays in processing medical card applications. It is no reflection on the staff working in the medical card section. I compliment the staff, in particular, those dealing with the receipt, registration and processing of medical card applications. My office is in touch with them daily and find them to be very courteous and helpful. My office and I also appreciate the work being done by staff dealing with urgent and emergency medical card applications. My office also deals with them on a regular basis and find them to be professional, helpful and courteous.

I am making a plea for additional staff for the processing of medical card applications as there is a serious delay in the registration and logging of new applications and further information. I will give some examples, of which there are many. I refer to the standard application received from a single person, whose only income is jobseeker's allowance and who forwarded an application on 31 October. Notification of receipt was received by email on 31 October. On 14 November the application had not even been logged on the system.

Another example involves a request for further information. The information was sent on 10 October. Again, receipt was acknowledged very quickly on 11 October, but on Friday, 9 November its registration and logging had still not been completed.

I have another example of a request for further information. It dates from 12 November. Receipt of the additional information was also acknowledged quickly on 15 November, but as of today, 21 November, it has not been logged on the system for the processing team which was only dealing with information dating from 9 November.

In the logging and registration of applications there is a serious delay of two to three weeks and more in some cases. The delays are significant and causing distress and concern for applicants. I will give an example of what can happen. There was a case recently where further information was sent by an applicant. Its receipt was acknowledged by email, but a few days later the applicant receiving a letter requesting that the further information be sent or the medical card would be withdrawn. The applicant came back into my office. It was again confirmed that the information had been received, but it had not been logged on the system. It led to the medical card being withdrawn.

There is a serious issue in the registration of applications and additional information. It is taking two to three weeks and sometimes longer for registration to happen. It is causing major delays and the only reason is the lack of staff to deal with the work involved. Will the Minister of State talk to the Health Service Executive to ensure additional staff will be put in place to make sure applications are dealt with efficiently and speedily? The lack of a medical card can give rise to major difficulties and great distress for applicants.

Minister of State at the Department of Health (Deputy Jim Daly)

I thank the Deputy for raising this issue. The Government is conscious of the importance of the medical card system in ensuring people whose needs do not enable them to access general practitioners, GPs, and other health services will be provided with such supports in line with legislative provisions. As the Deputy will be aware, the medical card system is based primarily on the assessment of an individual's financial means. Therefore, the vast majority of applicants for a medical card are required to undergo the assessment process. The Deputy has raised concerns about the delays in dealing with medical card applications. I have been assured by the HSE’s national medical card unit that there are no delays in the processing of medical card applications for any category of applicant, either new or those subject to a review.

It should be noted that in the period from January 2018 to date the HSE's national medical card unit has consistently met its key performance target to have 95% of complete medical card applications assessed for eligibility within 15 days. It is currently processing all fully completed applications within 15 working days across all application form types. There will, however, be situations where the application process may take longer than the 15-day target time. In some cases, as part of the assessment process, applicants will be required to provide additional documentation to enable the national medical card unit to access whether a person is unable, without due hardship, to arrange general practitioner services for himself or herself and his or her family. Every effort is made to ensure ongoing engagement between the HSE and applicants during this process.

Additional time may also be required to process applications in situations where an applicant's income exceeds the medical card threshold and he or she is then assessed by the national medical card unit for a discretionary medical card. In this situation, in order to take full account of the difficult circumstances which may apply, additional information such as evidence of the extra costs arising from an illness, will be requested from the applicant. The national medical card unit affords these applicants every opportunity to furnish supporting information and documentation to take account of all relevant circumstances that may benefit them in the assessment, including medical evidence of cost and necessary expenses.

In summary, the HSE has indicated that there are currently no delays in processing fully completed applications for a medical card. However, where an applicant is requested to provide further or additional information, the process may take longer. The delay is necessary to allow the HSE's national medical card unit to make a comprehensive assessment of the application.

I also point out that where notice of a review of a medical card has been initiated, it is provided three months in advance of the date of expiry. This is to afford individuals an extensive time period to provide any required documentation. It is also important to note that during the review process persons will continue to hold eligibility. In addition, the HSE strives to have an application process for medical cards which is as streamlined and straightforward as possible for all applicants. Assistance is offered to persons completing application forms through the national medical card unit and local health offices. The HSE has also put in place a number of new measures oriented towards improving the efficiency and effectiveness of the medical card application process. On 15 January it launched its new medical card online service at www.medicalcard.ie. The new system enables people to make online applications for a medical card and is faster and more convenient than the current paper based system.

Deputy Seamus Healy

I know the Minister of State is reading information he got from HSE officials but they are simply burying their heads in the sand. There is a general problem with the registration and logging of applications, particularly with respect to further information. I see this on a daily basis and I know other Members are similarly aware of it. The HSE is assuring the Minister that there is no delay in the processing of these applications but I am not sure what that means. I ask the Minister of State to check this with the HSE as there is a general problem with logging on and registering further information with medical card applications. As of today, my office has been told the officials are dealing with information received on 9 November, which is a fortnight ago. That two-week delay is the current position. I ask the Minister of State to check this with the HSE.

Additional staff may be necessary to deal with applications and there is a need to upgrade information technology systems. There is a main IT system and an Oireachtas system and it appears these systems are not compatible and are not talking to one another. We also need to have a process similar to that provided by the Department of Employment Affairs and Social Protection, whereby Members can deal directly with dedicated staff dealing with these applications. There is definitely a difficulty with the area and I again ask the Minister of State to check this with the HSE as it is giving rise to serious difficulties for ordinary people trying to access medical cards. I compliment the staff at all levels in the medical card area as we find them courteous, helpful and professional. However, as there is still a problem in the system, I ask the Minister of State to look at it.

Deputy Jim Daly

I thank the Deputy and I welcome and acknowledge his comments about staff in the medical card section. As well as being a Minister of State, I am a constituency Deputy like Deputy Healy, and I often have occasion to deal with the staff in the medical card section who I find unfailingly courteous, obliging, helpful and responsive. I also note what the Deputy told me. According to the HSE, 95% of all completed applications are processed within 15 days. The Deputy is talking about incomplete applications. As a constituency Deputy, I appreciate that he is saying the application forms are difficult and often incomplete when submitted. Information is sometimes missing and has to be requested, as the Deputy highlighted.

I will check with the HSE the issue the Deputy brought to my attention. I absolutely respect his bona fides and I know he has no desire to make anything up or highlight the matter for the sake of it. The Deputy is a politician with a democratic mandate and if he or people in his office say they are experiencing delays, I have no doubt they are being experienced. I will check the matter with the HSE. The Deputy's comments were the first I heard about a two-week delay or staff advising that they are only dealing with information submitted on 9 November. That is news to me. As the Deputy will appreciate, when scripts are being prepared, we do not know what details Deputies will raise. He is around the House long enough to understand that. I will examine the issue with the HSE and convey the Deputy's concerns to the medical card processing unit. I thank him again for raising the matter as it is what we are all here for.

Hospital Facilities

Deputy Imelda Munster

This relates to the removal of the new X-ray room from plans for an extension to the accident and emergency department at Our Lady of Lourdes Hospital in Drogheda. When I raised the matter previously with the Taoiseach on the Order of Business he said he would refer it to the Minister for Health. I have since sent correspondence to the Minister but I have not had a response from either the Taoiseach or the Minister. It is very disappointing that the Minister is not here today. This is my third attempt to raise the matter and it is no wonder our public health service is the way it is when the Minister is not here to respond to a very serious issue.

A few weeks ago the HSE took a decision to remove the X-ray room from plans for an extension to the accident and emergency department at Our Lady of Lourdes Hospital in Drogheda. These plans have been in place for ten years and were costed and included in the tender. The staff had been patiently waiting for almost a decade. The medical personnel, including clinicians, nurses and radiographers - all those who work on the front line - have been crying out for years for a second X-ray room. This was accepted and that is why it was included in the plans. There is only one X-ray room in Our Lady of Lourdes Hospital and it is operating at or beyond full capacity. The equipment is ten years old and obsolete.

The Minister of State is aware that X-ray is a major diagnostic tool in emergency departments in all hospitals. The only people who will suffer here are patients. Given that the objective of building an extension to an existing accident and emergency department is to cater for higher turnover, how will the department cope without a second X-ray room? I said to the Taoiseach that this is like building a house without a roof. It is sheer madness. I presume the Minister had no act or part in this decision, or at least I hope that is the case. I will take it he did not know about this and it is just another example of HSE senior management lunacy.

Does the Minister intend standing over this unbelievably myopic mindset and the sheer incompetence at HSE senior management level? Is he happy to ignore professional staff on the front line when they have cried out for years for another X-ray room? The facility was included in the plans. Something that has been planned for almost a decade should not be pulled at the 11th hour, as was done three weeks ago.

I will refer to some of the radiology facilities across the State. University Hospital Limerick has two X-ray rooms, as has Cork University Hospital. There are also two at Beaumont Hospital and three at St. Vincent's Hospital. The hospital in Galway has two X-ray rooms, while Tallaght Hospital has two X-ray rooms and a paediatric X-ray facility. The Mater Hospital has two X-ray rooms and Our Lady of Lourdes Hospital in Drogheda, the second biggest trauma centre in the State according to the chief executive officer of the Ireland East Hospital Group, has one. There is no justification for the removal of this room from the planned extension. I want this decision reversed.

Deputy Jim Daly

On behalf of the Minister for Health, I thank the Deputy for raising this issue and giving me the opportunity to provide an update to the House on the planned new X-ray facility to support the expanded accident and emergency department at Our Lady of Lourdes Hospital in Drogheda. The Government is committed to making tangible and sustainable improvements in our health services. This includes a major capital development being completed in phases at Our Lady of Lourdes Hospital in Drogheda. The second phase of this project has already seen 29 ward beds opening in December 2017. The Department of Public Expenditure and Reform governs the processes surrounding the development of healthcare projects by way of guidelines, principally the public spending code. Further rigour is demanded by and set out in relevant EU directives. All proposed projects must be submitted to the HSE's capital and property steering committee for approval and prioritisation prior to inclusion in its multi-annual capital plans.

The national development plan announced earlier this year as part of the Project Ireland 2040 policy initiative provides €10.9 billion for health capital developments across the country, including both national programmes and individual projects across acute, primary and social care. Health capital projects and programmes that are under way will continue. With regard to the provision of a second X-ray room as part of this project, my Department has been informed by HSE estates that this development had been discussed with service user groups. However, the second X-ray could not be delivered within the capital allocation for this project and, as such, has not been included in the project brief. An additional computed tomography, CT, scanner is expected to be brought online in early 2019, which will see the hospital equipped with two CT scanners, one MRI scanner, two ultrasound rooms and one plain film room.

I have been advised by the HSE that the new emergency department, which will be located on the ground floor of the hospital, will be completed and available for opening in early 2019. The HSE has further advised that there is some work still to be completed in the old emergency department to allow for the installation of a new paediatric emergency department and an extension to radiology services. The HSE anticipates that the full extension will be ready in early 2019.

Further important capital developments are expected to be completed at Our Lady of Lourdes Hospital in the near future. These include 29 ward beds, planned to open in January 2019. Further, 24 additional ward beds and a theatre suite, comprising three fully equipped theatre rooms, are due for completion in the second quarter of 2019.

The Department, the HSE, the RCSI hospital group and Our Lady of Lourdes Hospital are supportive of this project, and the need for this capital development is recognised in supporting the delivery of key services to patients served by the hospital in Drogheda and the surrounding areas. As the Deputy will be aware, the new emergency department is a part of the major capital infrastructure project that is taking place at the hospital, which includes additional beds, theatres and the expanded emergency department.

Deputy Imelda Munster

That was some response. What it tells us is that the Minister is happy for plans, which have been in place for ten years, for an extension to the emergency department to proceed under his watch without an X-ray room. It is like building a house without a roof. How can the Minister stand over this? The Minister of State's reply was typical HSE spiel. He mentioned the 29 beds. They are welcome, but we already knew about them.

When an emergency department is extended, of course there will be more patients coming to it. Some 80% of patients who attend an emergency department need some sort of X-ray or scan. I have said until I have turned blue in the face that the current X-ray room is working beyond capacity and its equipment is obsolete. The programme for Government calls for capital funding to be invested in our health services, but this is rubbish. The Government is extending an emergency department without installing a badly needed X-ray room that was included and costed in the tender. Why was the money pulled at the last minute and where does patient care come into this? I will not let this go. It is pure and utter madness. I will raise this matter with the Minister again at the next opportunity. It is ludicrous, as it does not put patients first. Everything that is written in the programme for Government is baloney if this is the real action being taken and the Government is prepared to stand over such ludicrousness. It is unbelievable.

Deputy Jim Daly

I am not sure what to say to the Deputy. She has made her case. Were we to add up the totality of developments that are taking place at Our Lady of Lourdes Hospital in Drogheda, it would total almost €40 million. If the Deputy believes that is baloney, that is a matter for her.

Deputy Imelda Munster

No X-ray room in an emergency department. That is baloney.

Deputy Jim Daly

I did not interrupt the Deputy, so please allow me to continue.

An Leas-Cheann Comhairle

The Minister of State, without interruption.

Deputy Jim Daly

It is a significant investment. The Deputy may not be aware, but only a limited pool of resources are available for the developments that all of us seek for our hospitals throughout the country.

Deputy Imelda Munster

This was costed.

Deputy Jim Daly

Either I will let the Deputy speak or I will continue speaking, but I will not speak while the Deputy is speaking over me.

An Leas-Cheann Comhairle

Continue.

Deputy Jim Daly

We would all like to see many improvements to our local hospital network. We all fight for and champion same. That is the Deputy's right, but she must also respect and acknowledge that the contribution being made to the hospital in Drogheda and the well-being of the patients who use it is significant. It might not provide for everything she wants. That is fine, and it is her entitlement as a public representative for the area to highlight that not everything she wants is being provided for, but she can at least have the good grace and decency to acknowledge the very significant contribution that is being made to the hospital.

We are working within a finite budget and there are limited resources. As much as we would like one, we do not have an endless pot of money from which to give everyone everything he or she needs.

Cancer Screening Programmes

Deputy Stephen S. Donnelly

The Minister of State will be aware of a case that has come into the public domain in recent days, namely, the tragic case of a woman who developed cancer after she was incorrectly given the all clear by a genetic test at Crumlin hospital. She is calling for a full review of diagnostics at the hospital. She has also asked that a panel of experts in genetic medicine from outside the State be appointed to carry out the review. She has threatened High Court proceedings to seek an injunction against an internal HSE review on this.

The woman was told in 2009 that she did not have the BRCA1 genetic mutation that is linked to breast and ovarian cancer. Her solicitor has said that, tragically, she has developed cancer and is now in a "grave situation". The woman says that the mistaken result denied her the opportunity for intervention and preventative treatment almost a decade ago. Indeed, many people who are correctly identified as having the mutation take preventative measures to avoid developing cancer.

Professor Andrew Green of Crumlin hospital has written to the woman and apologised. That is on the public record. As I am sure the Minister of State knows, Vicky Phelan has said that the situation is eerily similar to her own experience with cervical screening.

Crumlin hospital has declined to comment publicly on the case or to confirm whether there are similar cases, and the Minister, Deputy Harris, has stated that he is prevented legally from commenting. In the absence of such comment, and as the Minister of State will appreciate, there is a great deal of fear and concern, particularly given everything that has happened this year in terms of cancer screening for women.

A report commissioned by the HSE was issued in 2014 by independent experts and made some serious findings. It criticised the standards in the genetics department in Our Lady's Children's Hospital, Crumlin, which was previously known as the national centre for medical genetics. The experts, who were from the University of Manchester, stated that communications among staff were "dysfunctional" and patients did not get timely access to tests. Shockingly, the experts could not find any example of good clinical governance in the genetics department. That is a stark finding for a group of international experts to make. The HSE commissioned the 2014 review after it emerged that hundreds of people at risk of cardiac disease were never informed.

These are serious issues, and now another woman is gravely sick because something was missed. I am not attacking the Minister on this, but he has stated that he cannot comment and Crumlin hospital is not commenting. Worryingly, I understand from communications with the solicitor that the solicitor has tried to get this report but cannot get it. My understanding is that the report is not in the public domain, but I stand to be corrected if it is. I am told that, not only is it not in the public domain, but the HSE, the hospital or whatever relevant authority is refusing to release it. If true, that is quite serious.

Will the Minister of State release the report to the woman and her solicitor? I am told that none of the report's recommendations has been implemented. I am not alleging that, as I do not know it to be true, but it is what I have been told by someone close to the situation. Will the Minister of State release the report immediately? Will he report to the House as a matter of urgency on what progress has been made, if any, in implementing the recommendations of what sounds like a very stark report?

Deputy Jim Daly

I will be taking this debate on behalf of my colleague, the Minister, Deputy Harris. I thank Deputy Donnelly for raising the issue. The Minister understands that the question is in the context of the recent incident in Our Lady's Children's Hospital, Crumlin - the Deputy has now confirmed this - that has been the subject of a number of media reports. While it is normal practice not to comment on individual cases, I would first like to express my sympathies to the patient and her family on this tragic incident. The HSE has advised the Department that Crumlin hospital is reviewing the incident as a matter of utmost priority.

The 2014 Donnai and Newman report on the review of genetics services in Ireland was commissioned by the HSE to recommend improvements in the governance, management and future development of genetic services. The report made 20 recommendations, the vast majority of which focused on the internal team working and clinical governance issues at Our Lady's Children's Hospital, Crumlin.

The Donnai and Newman report identified 56 actions to be undertaken by the HSE and Crumlin Hospital. The HSE has confirmed that 31 of these actions have already been implemented and a further 16 are currently being implemented. An external multi-professional team led by an experienced NHS health manager from the UK has been assisting the department of clinical genetics to deliver an improved service for patients and clinical service users. Investment is ongoing in the recruitment of extra staff resources and the purchase of new equipment to assist with the implementation of improvements to the service.

While the Donnai and Newman report raised issues with regard to the lack of resources for genetic services at Our Lady’s Hospital Crumlin, it also acknowledged that investment in genetic services in Ireland should be made in the context of developing a contemporary solution for clinical and laboratory genetics and genomics for the country. A key recommendation was that a steering group should be set up to develop a national genetic and genomic medicine network that reflects best international practice. This steering group was established by the HSE in early 2015 under the chairmanship of Professor Owen Smith. The group concluded that future additional investment could only be appropriately provided in line with the establishment of a national genetics and genomics medicine network. To this end, the Smith report recommendations included the appointment of a national director of national genetic and genomic medicine network and a clinical laboratory director. Funding has been allocated in 2018 as part of the HSE's national service plan and these two posts, as well as a business manager post, are currently being progressed for recruitment. On appointment the post holders, in collaboration with all relevant stakeholders, will develop the national strategic direction for genetic and genomic medicine services, including genetic laboratory services.

An Leas-Cheann Comhairle

Deputy Donnelly has two minutes.

Deputy Stephen S. Donnelly

Am I going to get an answer to the specific questions I asked?

An Leas-Cheann Comhairle

The Deputy has an opportunity now to pose them again.

Deputy Stephen S. Donnelly

I have great respect for the Minister of State, Deputy Jim Daly, and my comments are not a personal criticism of him. In deputising for the Minister for Health, Deputy Harris, the Minister of State has been consigned to reading out what is written on a piece of paper. This is topical issues and is meant to be a Dáil debate. The Minister for Health could have emailed me this response. I learned how to read ages ago. It is not fair to the Minister of State. It is certainly not fair to this woman that in parliamentary debate someone deputises for the Minister for Health and does not answer my questions. It is not the Minister of State's fault because the answers are not contained in the prepared response. I am not criticising the Minister of State but this is not satisfactory. The response given is not what Parliament is for; it is what email is for. I am going to ask the questions again. If the Minister of State cannot answer them now, so be it. The questions I am asking are important and relevant and I ask the Minister of State to answer them if he can. If he cannot answer them then I ask that the Minister for Health comes to the House to answer them. That is what this Parliament is meant to be about.

Will the Department instruct the HSE to release the report? It is my understanding that the woman's solicitor has requested a copy of the report on numerous occasions but has not received it yet. If that is true, then the HSE is leaving itself open to allegations of a cover up. It cannot be tolerated. A report was commissioned that made very serious findings, with 56 actions and 20 recommendations identified. I am sure the Minister of State will agree with me that it is not okay for the HSE to hide and to say that recommendations were made, it has implemented a bunch of them and that we should just go away. Will the Minister of State instruct the HSE to release the report? Will he also ask for a much more detailed response from the HSE on the recommendations and actions that have been implemented. We are talking here about life and death and in the context of everything that has happened this year in terms of failures of audit and testing, this is very serious. The Minister of State may not be able to answer me now but I ask him to report back on whether the technology, training and skills within the diagnostics team are the very best available. Has the team had the required capital investment, continuous professional development and so on and does it have everything it needs to do the very best job possible? Finally, I would like to see an audit done of other potential misses. It is my fervent hope that this is a one-off, isolated tragedy but given what we have seen in other areas of the country, I would like to see the HSE or another appropriate body ascertain whether this is a one-off incident. Is there potentially a cluster of misses here and if so, are they due to failures of technology, failures of governance or something else?

Deputy Jim Daly

In response to the Deputy, I read a prepared script on the issue that the Deputy presented for discussion, namely the 2014 report. I outlined to Deputy Donnelly the number of recommendations that were acted on. He has asked for clarity on the recommendations that have been implemented and I will request that clarity from the HSE which is the organisation that is delivering the service and responsible for it. I will also pass on his request to the Minister for Health, Deputy Harris, that the report be published and will ask the Minister to respond to the Deputy directly on that matter. It is not for me to instruct the HSE but I will certainly ask the Minister for Health to do so on behalf of Deputy Donnelly. I will also pass on to the HSE the Deputy's request that a detailed audit be conducted. I will ask the HSE to provide clarity on that. Deputy Donnelly is referring to a recent case about which I do not want to comment but I have been assured that it is an isolated case. That is our understanding but an investigation is ongoing, the result of which will be available in a couple of days.

Miscarriages of Justice

Deputy Maureen O'Sullivan

The central point of this topical issue is the human right to have access to justice and due process, which has been denied to the Craigavon two. We all understand the implications of wrongful conviction. In this case we have unsound forensic evidence as well as non-disclosure, mishandling and destruction of evidence and flawed eyewitness testimony. Mr. Brendan McConville and Mr. John Paul Wooton have been in jail for nearly ten years on the basis of that so-called evidence. We travelled to Westminster recently out of a sense of frustration at the denial of justice and due process for these two men. One can only imagine their frustration, having been in Maghaberry Prison for nearly ten years. While in Westminster, we heard an outline of the case from one of their solicitors. Reference was made to witness M, whose father signed an affidavit that his son was a fantasist and a very vulnerable person. What happened then? The father was arrested. What happened to witness M? He was looked after very well financially and the defence team was not given the opportunity to cross-examine him. It was also proven that witness M's poor eyesight could not have allowed him to make the identification.

Deputy Clare Daly

I do not describe myself as a republican. I am a socialist and an internationalist. There are two men who have spent almost ten years in Maghaberry Prison. These men were known republicans and probably known dissidents and the fear of speaking out against the injustice being suffered by them is a fear of association. However, as Martin Luther King argued, it is not possible to be in favour of justice for some people and not be in favour of justice for all. The fact of the matter is that no evidence was produced against these two men. The Crown never attributed any role to either of them in the murder of PSNI officer Mr. Stephen Carroll. Myself and a number of the Deputies here attended the appeal of these men in 2013 and met Mr. Carroll's widow. We expressed our sympathy to her on her loss but that loss will not be overcome by the incarceration of people on the basis of a flawed process. This is an incredibly dangerous precedent. Mr. John Paul Wooton was only 17 years old when he was incarcerated. Mr. Brendan McConville has young children but has spent almost ten years in prison. Their case has been before the criminal case review commission for two years, which is too long. This State needs to speak out and argue for it to be dealt with forthwith.

Deputy Mick Wallace

Brendan McConville and John Paul Wooton were convicted of a murder under the controversial joint enterprise doctrine, which holds that a person who assists or encourages a crime can be held just as legally responsible as the perpetrator of the crime. The lack of evidence in this case is frightening. Central to the prosecution case was the evidence of a man identified only as witness M, who came forward a year after the murder of Stephen Carroll. He was drunk when he came forward. He was shortsighted but claimed that he saw the defendants from a long distance.

As Deputy O'Sullivan pointed out, his father later came forward to say no one should be in prison on the evidence of his son because he is a Walter Mitty character, who got £50,000 from The Sun and several payments from the PSNI for his efforts. This is a complete disgrace. One would struggle to find a worse case of injustice than that of the Craigavon two and one of these days it will become very obvious. In the meantime, they are having to spend many years in Maghaberry Prison, deemed last year the worst prison in Europe.

Deputy Éamon Ó Cuív

As has been outlined by my colleagues, the case of the Craigavon two, Brendan McConville and John Paul Wootton, has been referred to the Criminal Case Review Commission and it has been there for some time. I looked up the website of the commission and part of it outlined the history of the setting up of the commission. It said: "In the 1970s there was a series of high profile cases where the convictions were later recognised as miscarriages of justice: The Guildford Four (1974); The Birmingham Six (1975); The Maguire Seven (1976) and Judith Ward (1974)." They all have the common theme that they relate to Ireland, even though this commission covers Northern Ireland, Wales and England.

The situation is that the case has been referred to the commission. It is our belief that there is substantial evidence that, in terms of proper process, this conviction should never have taken place and the appeal should have been allowed. We need the Government to press that the commission, which acts independently, and we accept that, gets on speedily with the job of reviewing this case and we would hope it would be referred back at least for a new trial.

Minister of State at the Department of Foreign Affairs and Trade (Deputy Ciarán Cannon)

I thank the Deputies for the update of their meeting in Westminster yesterday. My colleague, the Tánaiste, and I are aware of the case to which the Deputies refer. Officials from within our Department, both in Dublin and in the secretariat in Belfast, monitor the case as well as other cases relating to prisoners detained in Northern Ireland.

From the outset, I would like to say that the murder of Constable Stephen Carroll was an appalling act of violence which was rightly condemned by the two Governments and by political representatives across party and community lines in Northern Ireland at the time. It was an attack on the new policing dispensation brought about by the Good Friday Agreement, it was an attack on the Police Service of Northern Ireland which has cross-community backing and serves all the people of Northern Ireland, and it was an attack aimed at discouraging young people, especially those from the nationalist community, considering a policing career.

It is imperative that we in this House continue to voice our support for the PSNI and for the young women and men from both unionist and nationalist backgrounds who join that service. It is also imperative that we, as a society, adhere to the rule of law and that we support and have confidence in the policing and justice systems. I say that without equivocation in relation to the murder of Stephen Carroll and the convictions of Brendan McConville and John Paul Wootton.

Brendan McConville and his co-accused, John Paul Wootton, were convicted of murder by joint enterprise at their trial in 2012. Their appeal against the convictions failed at the High Court in Belfast in 2014 and the Supreme Court in London later refused them permission to mount a further appeal in 2015. As the Deputies are aware, at this stage the Criminal Cases Review Commission is looking at the case. The Criminal Cases Review Commission is an independent public body which is responsible for reviewing possible miscarriages of justice in England, Wales and Northern Ireland. Darragh Mackin, solicitor for Brendan McConville, spoke about his "real serious concerns as to the safety of the conviction" and that he believes " there are a number of issues that remain effectively unaddressed".

It is entirely appropriate and correct that these men are now pursuing this channel in the present circumstances. As I understand it, the solicitors of Brendan McConville have had significant engagement with the Criminal Cases Review Commission and have provided it with a substantial amount of evidence relating to the case. At this stage in proceedings, it would not be appropriate for me to comment any further. It is important that we respect the legal process and that we allow time for that to conclude.

That is not to say, however, that we should be unquestioning with regard to the judicial system. Officials from my Department who are based in Belfast regularly engage with the Northern Ireland Department of Justice, the Northern Ireland Office, the Northern Ireland Prison Service, the Criminal Justice Inspectorate, and the police and prisoner ombudsmen.

In addition, at the recent British-Irish Intergovernmental Conference, both the Tánaiste and the Minister for Justice and Equality, Deputy Flanagan, engaged with David Lidington and the Secretary of State for Northern Ireland on matters related to security co-operation. In these discussions and engagements, the two Governments are able to discuss matters of mutual interest or concern.

Officials will continue to monitor developments in this particular case. In the absence of a devolved Assembly, it is regrettable that we do not have a locally elected and accountable justice minister with whom we can engage on matters such as this, but we will continue efforts in this regard.

Deputy Maureen O'Sullivan

Two people in prison based on conjecture, circumstantial evidence, contradictory evidence and inconsistencies is not justice for the very regrettable murder of Stephen Carroll. This is all part of a bigger, unjust system in the North, with revocation of licences, evidence being withheld, legal teams not being able to defend their clients when they do not know what the evidence is. We have a parole commission hearing, which is incredible in a so-called democracy. I want to believe in a fair justice system but I do not see it at the moment when I look at all of those examples in Northern Ireland.

Deputy Clare Daly

These men were given, respectively, sentences of 25 and 18 years on the basis of no evidence being produced of any role attributed directly to them in the appalling murder of Stephen Carroll. The key point here is that many jurisdictions have proven there can be "No justice, no peace", to use the slogan of the ANC. It is the same here. This is an injustice that needs to be examined. It was a political decision because it was the first killing of a PSNI officer and any old republican would do. Sadly, the evidence and process do not back up the conviction. Anybody who believes in the rule of law has to oppose this judgment and call for an immediate review of the case.

Deputy Mick Wallace

The defence team could not cross-examine witness M. If that happened down here, we would be shouting from the rooftops about it. PSNI Constable Stephen Carroll was murdered and we entirely condemn those who did it, but it is no justice for that family that the wrong people could be in jail for it.

It was highlighted at the Commons committee that Amnesty International has not got involved in this case, which we are a bit concerned about, and I would remind Amnesty International of the saying of Malcolm X:

I am for truth, no matter who tells it. I am for justice, no matter who it is for or against.

I suggest Amnesty International takes that on board.

Deputy Éamon Ó Cuív

I think society now accepts that the convictions of the Guildford Four, Birmingham Six, Maguire Seven and Judith Ward were incorrect. That does not mean that the atrocities did not take place. It means that the convictions were not correct.

As the Minister of State said, the solicitor for Brendan McConville and the solicitor for John Paul Wootton have said they have real concerns for the safety of the conviction. That is what we are concerned about. Convictions can only happen in accordance with law and, if we want people to have confidence in the rule of law, we have to have people who believe there is justice before the law for all in an equal way. As I pointed out, it is interesting that this commission was set up primarily because of concern about Irish cases. Therefore, what we are looking for is not to influence the commission, but that it would deal with this matter expeditiously.

Deputy Ciarán Cannon

I fully understand the level of concern expressed by all of the Deputies about this issue. It is an emotive issue. On the one hand, we have the Carroll family grieving the loss of their husband and father and we also have the Wootton and McConville families who have concerns about the processes by which these convictions were made. The only way to ensure these concerns are considered and addressed is to follow the judicial process to its conclusion. Officials in my Department will continue to monitor developments in this case, ensure that the Government remains informed about the developments and, in that context, we will continue our work in supporting the peace process in Northern Ireland to ensure there are no more families grieving for the loss of their loved ones, no matter the context of that loss.