Ceisteanna ó Cheannairí - Leaders' Questions

There has been a good deal of debate in the House during recent days on the area of home help and the lack of, and curtailment of, home help hours and services throughout the country. There were questions during Leaders' Questions and there was a debate in the House last evening. Despite this, we are still no further on in terms of giving assurance to our constituents and the people we represent that hours will be available to those who need it, patients who need palliative care will have home help, patients who are in hospitals can go home with the assurance that home help hours will be available rather than being left in a hospital bed, or patients who want to stay at home will get the assistance available that is appropriate to their condition rather than what suits some clock-watcher or someone who does not understand the impact of the service.

One thing that has struck me is how the Government does not seem to get the importance of home help. It does not seem to understand the impact that the curtailment and cancellation of hours are having around the country. For every member of the Government, required reading this weekend is Marese McDonagh's piece in The Irish Times from last Monday about the impact in Sligo. It has the testimony of people whose hours are being curtailed and of people who have not got hours. It has the testimony of medical professionals who are seeing the impact of this curtailment and cancellation on their patients and on medical and hospital services.

From having listened to the Taoiseach's response to Deputy Doherty yesterday and having observed the debate last night, the Government does not get it. It does not understand what this is doing to families or patients. The Government is not joining the dots on the impact that the lack of home help services and other community care services is having on the health service generally, on beds and bed management or on waiting lists.

What I am asking for today is not the usual response. The Taoiseach has thrown out figure after figure and money after money. He is going to have a meeting next week. Why next week? This has been an evident problem for weeks. We are all getting emails in our constituency offices from people who were told they were entitled to home help hours but that the HSE does not have them to give. If all these extra resources are going in, why are there 6,000 people on a waiting list? Many thousands of others are not getting the time they need or the hours they require in their homes. They are left at home alone or in hospital beds waiting and families are being forced to pay for highly expensive private services.

I am asking the Minister for Communications, Climate Action and Environment to outline specifically the actions, rather than plámás, the Government will undertake to address the issue of the 6,000 people who are on waiting lists. What can we tell our constituents this weekend? What can doctors tell their patients this weekend about the specific actions the Government will take to try to show that it understands the seriousness of this situation?

I thank the Deputy for the question and give him absolute assurance that the Government is acutely aware of the importance of home help services. Every month, more than 1,500 new people are provided with home help services. In the period to the end of April, a total of 6,000 new people were provided with home help services. That brought the number of people receiving home help support to almost 53,000.

As Deputy Calleary has said, demand is very strong and there are people waiting for this service. That is regrettable, but the situation, as we all realise, is that we have allocated 18.3 million home help hours. The HSE tries to allocate the hours across the year in an equitable way. It does not keep a reserve of hours. It allocates them to people in need. New people are continually presenting and, unfortunately, there is a waiting period for people to receive care. That is unfortunate but it is the reality of the situation. It is not for the lack of desire to expand the service because, as Deputies know, because they heard the Taoiseach say it yesterday, the budget for this service has been increased by 50% over the past four years. This is a rapidly expanding service which the Government recognises is important and is putting extra resources into.

On top of that, the Government is developing a statutory scheme and work is ongoing with that. Deputy Calleary rightly said that people believe they have an entitlement to this service but then they face a wait. The solution is obviously to develop a statutory scheme. The Minister of State at the Department of Health, Deputy Jim Daly, has been doing significant work on developing the scheme and has held detailed consultation with people who are at the sharp end to develop it.

I can assure Deputy Calleary that the Government is determined to deal with this as effectively as possible, but Deputies will read elsewhere in the newspapers today of the pressure of managing spending within the spending limits that have been provided. Substantial new resources have been devoted this year to home help services but there is still an obligation to try to manage within that provision. That is a pressure throughout the health service in particular. There will be efforts next week to meet those who are at the core of deciding the allocation of resources to try to meet them in the most effective way possible.

I acknowledge the efforts of the Minister of State, Deputy Daly, and his commitment, but this is the reality of it. All of us in the Chamber have heard testimony from people whose hours are being cut. There is a perception that people have to die or leave the health service for new people to get home care and home help services.

We are indeed conscious of the pressures on the health budget, but at what stage will someone in the HSE or in the Government actually do a little work and a little maths?

The more community care services and expenditure on in-home community services are cut, the more pressure is put on the acute hospital budget and the more people will be on waiting lists. In this article, which every Minister should read, a surgeon from Sligo claims that people are deliberately not given home help hours because it is cheaper to keep them in long-stay hospital beds and it ensures those beds are not available to people who might need expensive surgery or other expensive procedures. I am sure there is no basis to that but when money is not spent on community care and community services, there will be health overruns and expanded waiting lists, and people will suffer. There is no understanding at Government level of the suffering of carers or families, and that is why the Minister needs to read this piece.

To reiterate, every element of the health service is providing a hugely important service from the Government's point of view. The Deputy seems to suggest that we can easily divert resources. Some 1.7 million procedures will be carried out this year, for example. People will be waiting for those procedures and we have to meet those needs. Similarly, other people need home help hours. Some 52,000 or 53,000 of them are receiving those and every month we add another 1,500 people to that.

The Government will not be doing that for the next five months.

This is not an area of neglect, and only a tiny number of discharges are delayed because of this. I have the figures from the Minister of State, Deputy Jim Daly, and they show that fewer than 4% of delayed discharges are due to a lack of home help. It is not the case that this is the area.

There is that tone deafness again.

How much is that in numbers?

The Minister can speak without interruption.

We recognise that there is huge growing need in this area and we are making provision not only to expand the-----

They are freezing the hours.

-----provision every year but we are looking at a statutory scheme, which is being developed by the Minister of State, Deputy Jim Daly. When the Oireachtas gets a chance to consider that, it will provide us with a long-term approach.

Yesterday, the Joint Committee on Health met to discuss the construction of the national children's hospital. Not for the first time, the public heard revelations that there are more rising costs, and this is an issue of major concern for people. This project was originally costed at €790 million in 2013. It went up to €983 million in 2017, and then we were told in December of last year that there was a guaranteed maximum price of just over €1.4 billion. However, yesterday we were informed by the chair of the National Paediatric Hospital Development Board, Mr. Fred Barry, that in addition to the final costing, there has now been a considerable amount of claims for additional money from the contractor. Time extensions are also being requested, which will undoubtedly push up the price far beyond the guaranteed maximum price the Taoiseach cited. This, we are told, is a result of construction inflation, which is higher than the 4% provided in the contract that was signed with the contractor, BAM. It was well flagged by many people, including my colleague Deputy Jonathan O'Brien, that construction inflation, which is at 7.5% at present, was running at nearly double what is set out in the contract. We are told that this project is facing risks of delays in meeting important milestones, and these delays would add around €10 million for every month it fails to meet its target. This is very concerning, and it demands a robust response from both the Government and the Minister for Health. What is being done here, because this is simply a runaway train? The amount of public money being spent on this project is not warranted to this level, and the public sees that. We cannot allow this situation to get further out of control. A plan needs to be put in place by the Government to ensure these costs are controlled once and for all.

The cost overrun is already having an impact. There are real concerns in communities right across the State about the impact it is having on them and the commitments that have been made to fund other projects. We heard from the Irish Fiscal Advisory Council that unless the Government gets a handle on dealing with major infrastructure projects, or if it those projects continue to run over at their current level, €2 billion per annum will have to be cut from smaller projects. These include flood defences, road repairs, school extensions, and other projects that are vital in local and rural communities. That is the reality. This is an issue in the paediatric unit at Cork University Hospital, for example, as well as in the Regional Hospital Mullingar, where the commitment for a new MRI scanner is now in question. What is happening with the second cath lab in University Hospital Waterford, which is also in question as a result of these overruns? What about the proposed upgrades in Cavan, or the community hospitals in Stranorlar and Ramelton in County Donegal? I could go on. The public wants to know what is the final price of this project. How much more is this project going to run over? We need answers to that. The public demands straight answers from this Government as to what projects will be cut or delayed as a result of these overruns. It is now June. We are six months into this year and there has been no clarity in respect of the HSE's capital plan for 2019. It is ludicrous that we still do not have a capital plan six months into the year. We need straight answers. We need to know what the final figure is and we need a Government that is getting a handle and a grip on runaway projects.

First, the new head of the National Paediatric Hospital Development Board, Mr. Fred Barry, appeared before the Joint Committee on Health yesterday and he answered the questions in full. There was no effort to spin this in any way. This is an honest answer. The position we have is that we know mistakes were made in the early development of this project. The Government has been very open on that, and Ministers have been before the committee on numerous occasions dealing precisely with this. A new approach has been adopted that included appointing a new development board, which is now in place. No project of this scale is going to be risk-free. If the Deputy thinks this can be run without having some risks managed between the State and the contractor, that is not the reality. As the Deputy is aware, one issue in the contract was that if there was construction inflation beyond a certain figure, the State would share some of that risk. That was in the contract. No-one concealed that, and it is not a new revelation that came from Mr. Barry's presentation. That was part of the contract that is in place. In terms of the mistakes that were made, the PwC report issued recommendations, and those recommendations are being implemented. A final plan will be presented as to how we make sure this project is managed in the most effective way, and that is being put in place. The Deputy mentioned that Mr. Barry suggested there were delays in some parts of the works but Mr. Barry equally emphasised that at this point, there are many opportunities to mitigate these delays over the lifetime of the project. While this project is expensive, there is no evidence anywhere that it could be done any cheaper.

In July, we will start to see the project take shape within Blanchardstown, where patients will be treated for paediatric and other needs. This project is going live. Substantial progress is being made on the construction, and it is going to be managed tightly, with tight oversight, drawing on the lessons we have learned. Honestly, mistakes were made. There had not been a major hospital project built in 25 years. One may ask why that was the case, but this one will be managed carefully. Mr. Barry has a very strong track record, and the contract will be managed. Any overruns that have to be paid for by the State, because they fall under the contract, will only be paid after a full audit and due diligence is applied to ensure that we are only paying for provisions that were under the contract. We have to manage that contract tightly, and it will be, but we still have to remember that this is providing state-of-the-art care for very sick children and their families. There will be 23 operating theatres, and it will provide a suite of services for which Members on all sides of this House have been calling for years. It is a project that is worthy of support. We have to manage the costs but we also need to deliver the services for the children.

Nobody disputes the need for a national children's hospital. What people question is why we are providing private units within that public hospital, and why mistakes continue to be made. Why were we told that there was a guaranteed maximum price of €1.433 billion and are now hearing that the contractor is making additional claims? It will cost €10 million extra per month for every month that the project is delayed, and we are told there are risks of delay. Why did the Government sign off on a contract in December which stated that the contractor could apply for additional claims if inflation ran over 4%, when we know that construction inflation is 7.5%?

It is not just that mistakes were made in the past. We know about them and they have been well ventilated. The Government is still making mistakes with this project.

The Minister did not answer the question on what projects will be cancelled or delayed as a result. It is madness that we are six months into the year and still do not have the HSE's capital plan for 2019. This goes to the heart of the Government's mismanagement of the health service's funding. For the past two days, we have raised the issue of home help hours. It costs €6,000 per week to keep someone in an acute hospital bed, but home care packages cost €160 per week. The Government and the HSE have decided to suspend all home help hours for new applicants up until November. It makes no sense whatsoever.

The Minister to respond.

Will the Minister answer the questions about the initiatives that would deal with this issue? What projects will be delayed? What will be the final figure? Why did the Government approve a contract when it knew that construction inflation was nearly double what was laid out? Will the Government support our Bill-----

-----which would allow for abnormally low tenders to be ruled out and for contractors’ past experience to be factored into the equation?

An Leas Cheann-Comhairle

I have to facilitate others.

The provision for private care will be at a low level. There are type B consultant contracts in place that allow for on-site private practice of up to 20%. The new building had to include some outpatient department, OPD, consulting facilities in the form of a private clinic, comprising eight outpatient consulting rooms.

It is a shame that-----

It is not a major element in what is a major public project to provide care to children who are in need.

The Deputy continues to pretend that the contract does not make provision. There are conditions whereby, if the contractor can show that certain events have happened and been duly audited, there is an exposure to the State. That is contained within the contract and it is not going to go away by shouting louder. It is a provision in the contract that was negotiated. The Deputy may say that a different contract should be negotiated, but we are not proposing to retender the project. If we did so, we have every reason to believe that we would incur a more expensive bill and do contrary to what the Deputy is advocating.

The HSE's capital budget will be presented when it is completed.

Well, that is an answer.

Work is progressing on that.

It should be well worked now.

I cannot comment on Sinn Féin’s Bill. I will have to refer that to the Minister, as I have not had a chance to read its content.

Veterinary Ireland has stated that mink on fur farms do not have a life worth living in any way. As solitary, wild and semi-aquatic creatures, packing mink into metal cages in groups is alien and unnatural. For that reason, Veterinary Ireland asserts that it is impossible to regulate the fur trade and somehow make it kinder because it is not farming at all. The mink are gassed at six months and their skins are pulled off.

Country after country has phased out or banned fur farming. I do not have time to list them all, but the UK, Austria, the Netherlands, Croatia, Slovenia, Norway, the Czech Republic, Luxembourg, Belgium, North Macedonia, Serbia, Bosnia, Germany, Denmark and Sweden have agreed to or are in the process of banning fur farming. Even Japan, New Zealand and others outside the EU are doing so. In the past three years, every major fashion house has gone fur free, including Prada just a few days ago. According to a RED C poll, 80% of people in Ireland believe that fur farming should be banned. They view it as cruel, backward and barbaric, and all for the sake of a luxury product that most people will never see and nobody needs. It is an example of capitalism willing to disregard life and welfare for pure profit.

On 3 July, we in Solidarity are due to move Second Stage of our Prohibition of Fur Farming Bill 2018, which has received widespread support at home and abroad. I thank the ISPCA, activists in the National Animal Rights Association, NARA, the Fur Free Alliance, the Irish Council Against Blood Sports and many others who have lobbied intensely on this issue.

Fianna Fáil, Sinn Féin, Labour, Independents 4 Change, the Green Party, the Social Democrats and Solidarity-People Before Profit have all stated that they support a ban. The only question now is what is Fine Gael’s stance. Is Fine Gael the only party in the Dáil standing in the way of ending this animal cruelty? In 2005, it was in favour of banning fur farming. Its Deputies, including the Minister, voted to do so. The Bill in question fell and, unfortunately, Fine Gael has done nothing in the intervening 14 years to ban it.

This is Fine Gael’s opportunity. Based on the figures, our Bill will pass. That leaves Fine Gael with three options. It can break with what it believed in 2005 and be the only party to vote to maintain fur farming, it can support our Bill or, knowing that the figures mean that the Bill must pass, it can decide not to waste valuable time for the animals themselves and the Dáil agenda and ban fur farming via ministerial order. Is the Minister willing to take the initiative and talk to the Taoiseach and the Minister for Agriculture, Food and the Marine, Deputy Creed, about making a ministerial order under sections 11 or 36 of the Animal Health and Welfare Act 2013? Of course, time must be given and there must be discussion about alternative industries or agribusiness and alternative employment for the 47 or so registered employees, who are mainly seasonal workers, on the three remaining fur farms. Is he willing to do the right thing?

The Deputy will get a further opportunity. The Minister to respond.

I regret that I have not seen a copy of the Bill that Solidarity is proposing.

I moved First Stage ages ago.

It has not been presented to the Government yet. However, I assure the Deputy that, when it is presented to us, it will get the proper attention that it deserves. Obviously, the Deputy feels strongly about this issue. There has been a great effort to tighten up the regulations on animal cruelty in respect of farming and other activities. The Government will undoubtedly assess Solidarity's proposal, but it would be foolish of me, not having been briefed on the issues involved, to try to anticipate the Government's response to the Bill.

That is a disgraceful answer. The Bill was moved many months ago. Every Deputy has received numerous emails about it, yet the Minister says that he has not seen it. It is a repeat of the Bill that he voted for in 2005. It is the exact same.

I am giving the Government time, as it has 19 days left to consider the matter before we move Second Stage. Will it be a laggard on animal rights, which Ireland currently is, or will it agree to support the Bill? Alternatively, will it do what it did with circus animals, an issue on which Solidarity had a Bill pending, when it made a ministerial order to ban the use of wild animals in circuses? At the time in November 2017, the Minister, Deputy Creed, stated that doing so was the general view of the public at large and that the ban was a progressive move reflective of our commitment to animal welfare. The exact same statement applies to mink and fur farming, as 80% of people believe it to be wrong. It is thoroughly backward, there is no justification for it and the farms in question are hardly making a profit at this point. Fine Gael must do the right thing now after not doing so for 14 years.

The House has set up procedures to deal with ideas proposed by Members. It is about taking the opportunity to have serious consideration. An issue such as this would have to be considered by the Cabinet so that we could take a collective view. That is only reasonable. With every other Bill, be it accepted or rejected, this is the approach that we take. Without giving any notice on Leaders’ Questions, the Deputy cannot expect me to have consulted other Cabinet members so that I might revert to the House with a collective view on how a particular Bill will be handled. That is not a reasonable expectation.

Like any other Deputy's proposal, Deputy Coppinger's must be taken seriously. We must evaluate proposals against all the criteria that the Cabinet is obliged to consider when considering issues such as this. I do not seek to stonewall; rather this must be considered by the Cabinet in the normal way.

Why has the Minister changed his mind since 2005?

It will be assessed on its merits. That is all I can assure the Deputy about.

I welcome this week's news, as confirmed by the Department of Communications, Climate Action and Environment on Monday, that Great Glen Resources has withdrawn its application for a prospecting licence in County Donegal. The mining of barytes, base metals, gold and silver in the Glenfin area would have had a negative impact on the environment, the landscape and the health of the local people. I believe the withdrawal of the application is a vindication of the strength of the local communities that came out in full force against the issuing of a prospecting licence. The proposed mining activities would have had a negative impact on 52 townlands across County Donegal. Last week, I attended a public meeting organised by people in the Glenfin area who objected to the issuing of an exploratory licence and the consequent granting of an extraction licence in the event of deposits being found. The residents of the Glenfin area have seen for themselves the problems caused by exploratory licences in communities like Greencastle, County Tyrone. A prospecting licence has been granted to a Canadian company, Dalradian, which is now exploring for gold in Greencastle. Dalradian has plans to mine for gold in the Sperrin hills and valleys and to build a massive toxic mineral processing plant. This will involve waste dumps full of discarded rock, which will have been processed using cyanide and other chemicals, being left behind all over the Sperrins, which have been designated as an area of outstanding natural beauty. An unprecedented 10,000 objections were lodged against the Greencastle plan as a result of the work of the Save our Sperrins campaign, which successfully galvanised local communities into action and is continuing to call for an end to the granting of mining licences in the North. This should indicate to the Minister how strongly the communities that will be most affected by the granting of mining licences are objecting to these proposals. Great Glen Resources has turned away for now, but the open call for applications for prospecting licences will remain open until the end of this week. Communities in County Donegal want to say "No" to Great Glen Resources and a permanent "No" to mining. They are looking for a commitment from the Minister that the granting of prospecting licences now and into the future will cease. Will the Minister commit to the preservation of our rural communities, natural habitats, biodiversity and climate action goals by ceasing the granting of all prospecting licences from here on?

Prospecting licences are controlled by a strict regulatory regime. As the Deputy said, when an application is made there is an opportunity for objections to be lodged. There are clear rules regarding protected areas where prospecting licences cannot be considered. If a licence moves beyond taking samples and investigating the opportunities to drill, there is a requirement for an environmental impact assessment to be carried out. This is a new requirement that has been developed. I assure the Deputy that there are strong protections within the existing Acts to ensure explorations for mineral resources are done in accordance with the strictest of criteria. That is the way in which this has been handled. A number of prospecting licences are in place. I think there are several hundred such licences. In the event of an attempt being made to develop further in the way about which the Deputy has expressed concern, there will have to be an environmental impact assessment as a major factor in deciding on any application. If any question of risk to public safety or damage to the natural environment needs to be considered, that will happen under the environmental impact assessment. A decision to allow such an application will not occur unless the public is being protected by the proposal being advanced.

The real situation is different from what the Minister has said. Legislation is extremely weak with regard to consulting local communities that are affected by mining developments. Current legislation regulating mining practices in Ireland does not sufficiently provide for proper consultation with communities from the outset. All the local community in Glenfin saw was a notice in local newspapers saying that people had two weeks in which to lodge objections. That was not consultation. It generated further distrust, which brought us to where we are today. Even with our economic lenses on, we must accept that mining in Ireland does not offer the best value for money and creates a marginal number of jobs. The Government is continuing to advertise Ireland at international events as a destination for extractive industries. A number of companies do not pay in lieu royalties or make one-off payments. It is obvious that Ireland is being presented as a flexible destination for mining companies. The Government has lobbied strongly for Ireland as a mining destination, including in the last year at the Prospectors and Developers Association of Canada conference. In 2015, the Fraser Institute declared Ireland to be the number one country for mining policy under the headings of tax, political stability and the industry's perception of Government policy. It simultaneously found that Ireland was performing poorly when it came to the certainty of rules surrounding environmental protection, which mining corporations obviously do not like. When will the Government, which is actively pursuing mining companies, protect the communities on which it is imposing this mining activity?

I assure the Deputy that there is no question of the Government "imposing" anything in this area. These applications are made on the basis of legislation that has been passed by this House, which sets out the requirements in relation to applications, public notice, objections, the evaluation of objections and environmental impact assessments. The House has agreed and set the stringent rules under which licences are issued. The rules require companies that are looking to move beyond prospecting to drilling to meet high standards, which have been set and are continually being tightened and monitored by the Environmental Protection Agency and the other environmental protection agencies we have appointed to ensure the public is fully protected under the legislation we have passed in this House. That is the approach. The Government is not attempting to impose anything on communities. This area is governed by a clear set of legislative provisions that have been decided on by this House.