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Dáil Éireann debate -
Wednesday, 26 Jun 2019

Vol. 984 No. 3

Ceisteanna ar Reachtaíocht a Gealladh - Questions on Promised Legislation

To those who are here from County Kerry, a hundred thousand welcomes. That was Jackie Healy-Rae.

In the context of the programme for Government and industrial relations in the health service, I wish to reflect on today's strike which represents the dysfunctionality of human resource management in the health service. Yesterday the Taoiseach said the Government had accepted the outcome of the job evaluation scheme and the recommendations made and was prepared to pay. The only issues seemed to be implementation and the timelines. When I said the strike would have been averted by the payment of a couple of million euro, it was in that context because the Government has stated it is willing to pay and accepts the outcome of the job evaluation, yet the Taoiseach said the issues were the timelines and implementation in the next few years. He said payments would start in 2019. I think Deputy Howlin suggested the offer was €1 million.

It was the offer.

My sense is the union would settle for something higher than €1 million. I might be wrong, but my suggestion is that it would be in single digits. In the context of the massive overruns on a range of other projects, it would not have taken a whole lot to avert the strike. Three more days of strike action have been pencilled in for next week. There are, obviously, significant issues for patients and those who attend hospitals as inpatients and outpatients. In respect of the commitment in the programme for Government to better industrial relations within the health service, I put it to the Taoiseach that the strike could have been averted and that some creative work should be done to make sure we will not have strikes next week.

As I pointed out, the public sector pay bill is now at a record high.

It comes to approximately €18 billion a year. There is enough to build a children’s hospital every two months. We have set aside €400 million for public sector pay increases this year. Anyone who is drawing equivalence with the national children’s hospital or the national broadband plan needs to understand these figures.

The Government needs an extra €400 million.

The Taoiseach did not answer the question.

I was interrupted, but I am happy to answer it.

The Taoiseach is too glib.

We have 28 minutes left. Members on all sides of the House should not invite interruptions. If the Taoiseach wants to respond fully, I will give him the chance to do so.

Again, I am not fully sure what the question was. As I said, we believe the offer made at the Workplace Relations Commission was appropriate. We accept the outcome of the workplace evaluation process. It is about the timing and implementation of the additional pay increase on top of the other increases which are being paid this year. If the issue cannot be resolved at the Workplace Relations Commission, we are willing to go to the Labour Court for a binding determination.

Today the Minister for Health will hold briefings on the roll-out of the compassionate access programme for those who need cannabis-based oil for medical and clinical purposes. I commend Deputy Gino Kenny and many others who campaigned for this, as well as the Minister for Health who took the issue on board and progressed it. Several weeks ago in the Chamber Deputy Gino Kenny raised the case of the Stephens family in Waterford who must import cannabis-based oil for their daughter Cassie. They must travel to Holland to purchase the oil and pay for the costs of the flights. They are one of 21 families who have a licence to do so. They have been supported by Cassie’s consultant in University Hospital Waterford and her GP. She used to have many seizures, but they have reduced as a consequence of the cannabis-based oil treatment. It is one of several treatments she receives, but it complements them. However, the family have not been reimbursed one single cent. Four of the 21 families in question have been reimbursed but not the Stephens family. They have spent €9,000 so far, but they cannot afford to spend any more. They are now borrowing money. Will the Taoiseach personally look into the issue to see what can be done to support the family? I welcome the moves made by the Minister for Health today. However, the Stephens family need support. Will the Taoiseach personally intervene to ensure they will receive the reimbursements they are due?

The Deputy will appreciate the limitations I am under when it comes to responding to questions about individual cases. I imagine the Deputy is aware that it would be illegal for the Minister for Health to give a direction to the HSE in a particular individual case. There is a reimbursement system in place. I have been advised that the following steps have to be completed when it comes to reimbursement. The patient’s consultant must be satisfied that all therapeutic options have been exhausted and prepared to accept responsibility for the monitoring of the patient’s response, side effects, etc. A prescriber applies to the Minister for a ministerial licence. If it is granted, the consultant completes an individual reimbursement form, setting out the therapeutic benefit for the patient. It must be completed in sufficient detail for the therapeutic benefit to be demonstrated. Thereafter, an individual reimbursement form is considered by the Medicines Management Programme, MMP. Following a review of the documentation, the MMP makes a recommendation to the HSE in favour of or against reimbursement support for the patient and of the patient's eligibility and informs the Primary Care Reimbursement Service, PCRS, of that recommendation. That is the process by which somebody can apply for reimbursement. I cannot say why reimbursement may be refused in an individual case. I hope this information is of some help to the Deputy.

The Police Service of Northern Ireland, PSNI, gathers extensive data for crimes motivated by hatred. There are obvious reasons for this in the context of the Northern Ireland conflict. However, the data are not limited to sectarianism. The force collects and regularly publishes statistics for crime motivated by racism, religious hatred, hatred against people with a disability, homophobia and transphobia. As we approach Dublin Pride this weekend and Trans Pride the following week - pride festivals will be held across Ireland - we need to recognise crimes motivated by homophobia and transphobia continue to happen here. In Northern Ireland 281 homophobic incidents were recorded last year, of which 201 were classified as crimes. Some 33 transphobic incidents were recorded, of which 12 were classified as crimes. The population is nearly three times that of Northern Ireland and we can anticipate that we are not immune from that crime. Will the Taoiseach consider instituting the same level of monitoring? Will he require the Garda to record hate crimes and provide regular statistics to ensure we will understand the extent of the problem and that we will root it out in the State?

On Monday I had the opportunity to meet groups representing the LGBT community to mark the beginning of Pride week. Hate crime was one of the issues they raised with me. I am not sure what the situation is when it comes to Garda monitoring of statistics, but I will have it checked and reply to the Deputy by way of correspondence. The issue of hate crime is being examined by the Department of Justice and Equality. It is difficult to get it right because, while hate, anger and many other things may be sins, they are not crimes per se. Perhaps a way by which we might deal with it is that rather than trying to make it a crime, we do something as part of sentencing. For example, if somebody was to commit an assault or carry out a murder and was motivated by hatred on particular grounds, it would result in a stiffer sentence, rather than making the emotion or feeling of hate a crime which I think would be hard to do.

The medical cannabis access programme was announced by the Minister for Health today. Obviously, it has been a protracted process, but it is welcome. It is significant for the health system as doctors can now prescribe cannabis-based products. I commend the families who have been campaigning for this in the past three years, in particular, Vera Twomey and Paul Barry. The country owes that family a debt of gratitude for the sacrifices they have made. While the programme is welcome, it does not go far enough, in particular with reference to the stipulation surrounding the omission of chronic pain. Many will ask why a reference to chronic pain has been omitted from the programme. Will it be included in the access programme in the future?

I am glad that at long last progress is being made on this matter. It is a pilot programme that will run for five years. I recognise the Deputy’s work in helping to bring us to this point, as well as the families mentioned by him. The medical cannabis access programme provides for medical cannabis to be prescribed in three circumstances where a patient has failed to respond to standard treatments. They include spasticity associated with MS, intractable nausea and vomiting associated with chemotherapy and severe refractory treatment resistant epilepsy. Any decision to extend its use to other illnesses or symptoms would have to be made on clinical grounds, rather than it being a political decision.

I refer to Tipperary town and the task force. I am delighted to see that the Minister of State, Deputy English, is here. Will the Taoiseach try to bring together the different groups which want to collaborate? Will he let us know what is happening? Is funding in place and will the works be carried out? Tipperary town needs, deserves and is entitled to this. Will the Taoiseach organise a meeting between the Minister of State and his team, the groups in Tipperary and Oireachtas Members? We are tired of waiting. It is seven months since the Taoiseach announced it, but we have seen no action.

The Deputy contacted me yesterday, but I did not have the chance to get back to him. There was a debate on this issue last week during which it was confirmed that the funding was available and that it was only a matter of organising the details. As the Taoiseach announced it a couple of months ago, we want to put the task force together. The names of several people have been suggested and the money is available. We will work with the different local groups, as has happened, but we will formalise the arrangements in the next couple of weeks. I will be in touch with the Deputy later today to fill him in.

The Joint Committee on Communications, Climate Action and Environment which is looking at the national broadband plan met representatives of Eir yesterday. They indicated that the experience Eir had of rolling out broadband to 340,000 rural houses gave it a certain credibility. It believes it could achieve roll-out to the remaining rural houses for less than €1 billion, which is one third of the price projected under the proposed national broadband plan.

This is, however, the same charge that applies in the rest of the country. It would require slightly different service level arrangements but, again, these would be the same that apply in the rest of the country. Eir is adamant that it can do it. Contrary to what the Taoiseach said yesterday in response to questions on this matter in the Dáil, the company said the provision would include connection right to the house. It includes the last-mile connection - the overhead wire to the home. The committee is due to finish its work shortly. We are due to have a final meeting with the Department. Will the Government respond to the request Eir sent a year and a half ago to meet and to examine that cheaper option? Will the Department inform itself of the advantages, disadvantages, and possibilities in order that we can have an informed discussion as to whether this is a practical alternative at our latest meeting with the Department?

I have answered questions on this topic this afternoon. Perhaps I can summarise my response. The Department of Communications, Climate Action and the Environment wrote to Eir this morning to seek clarity on a number of aspects of what its representatives told the committee yesterday. There is a big gap between the bid they made only a year ago and what they told the committee. Eir made a bid of €2.7 billion, which was slightly higher than the bid made by Granahan McCourt. When it pulled out, the company had complaints about the high risks and the level of Government oversight requested, and it refused to give any guarantee in respect of the amount of equity it would put into the project. The Deputy will recall that there was a lot of criticism of the fact that Granahan McCourt is not putting in enough equity. Eir would not commit to putting in any equity at all. We have to take what was said yesterday seriously. The Department has written to Eir looking for clarity on a number of different issues. I hope it will respond quickly enough for the Deputy to get its replies before the committee finishes its deliberations. One key concern of ours is the difference between the €1 billion Eir talked about yesterday and its €2.7 billion bid. We want to understand how that can be explained. We would have concerns if that would involve higher user charges and higher connection costs for people in rural Ireland because one of the key objectives of the national broadband plan is to provide the 500,000 homes, farms and businesses in rural Ireland with broadband without connection charges or fees higher than those paid in urban Ireland. If the difference is being borne by people in rural Ireland, we need to know that and we need to know how much they will be expected to pay under the Eir plan.

Let it be understood that, although we are dealing with a carryover from yesterday, no one should expect a carryover for tomorrow because we cannot continue in that way. I have a list from the Ceann Comhairle of those being carried over from yesterday. The first Member on the list who is available is Deputy Munster.

The latest attacks in recent days have heightened the sense of fear in communities in Drogheda once again. There was another shooting in a densely populated area in broad daylight. Children who were out playing were forced to run for cover. Two homes were petrol-bombed in retaliation within hours. Another home was attacked last night. I acknowledge that An Garda Síochána has made some arrests in recent weeks but the situation is so serious that the response needs to be stepped up immediately. We need 24-hour surveillance of the key culprits in the feud to curtail their movements. There is every chance that, had that 24-hour surveillance been in place last Thursday, residents of the area would have been spared the horror and the fear caused by criminals attempting to assassinate one another on their doorsteps. Will the Government provide additional resources to enable such 24-hour surveillance to take place and to monitor those involved in the feud to bring this nightmare to an end?

Like everyone in this House, I am very concerned about the situation developing in Drogheda. Additional gardaí and Garda resources have been provided. I ask people to support An Garda Síochána in its work and to provide it with any information they have. I thank An Garda for the excellent job it is doing. Any decisions on the deployment of further resources or 24-hour surveillance are a matter for the Garda Commissioner, as it should be.

My question relates to the programme for Government and to the Taoiseach's suggestion, with which most people will agree, that as the economy improved, there would be more money for people with special needs. Does the Government intend to extend the July provision scheme to all children with Down's syndrome in light of a recent High Court settlement? The children at the centre of the recent action, who have various educational and special needs, will now receive additional schooling under the July provision scheme as a result of that judgment. Surely this area merits immediate review in light of that judgment. This issue has been raised with me on numerous occasions by quite a number of parents of children with Down's syndrome. I do not expect it today, but will the Taoiseach provide an update on the work of the implementation group convened to consider the recommendations of the National Council for Special Education's review of the July provision grant scheme, particularly the recommendation that the Government consider how an equitable national day activity scheme could be developed for all students with complex special educational needs, including children with Down's syndrome?

I am not sure if there is any particular legislation promised or a specific commitment in the programme for Government about the issue the Deputy has raised, but it is important. I will ask the Minister for Education and Skills or the Minister of State with responsibility for disability issues to provide him with a written response.

At approximately this time yesterday the Joint Committee on Agriculture, Food and the Marine launched a report on the status of beef production in Ireland and related issues. The report makes a number of recommendations, one of which relates to a serious threat to the beef industry in Ireland - the Mercosur trade deal. This deal will have damaging implications for the beef sector if it goes through. I ask the Taoiseach for a clear commitment that he and his Government will oppose that trade deal if it includes the importing of any beef from Latin America into Europe, because such imports would have a detrimental effect on the beef sector. Coupled with that, while we are discussing the major issues of climate change, we are talking about bringing beef to Europe from the other side of the world. It makes no sense whatsoever. It flies in the face of everything we are supposed to stand for in respect of climate change and other such issues. Will the Taoiseach confirm that the Government will oppose any trade deal that includes importing beef from Latin America into Europe?

Beef production in Europe is under serious economic pressure. As Deputy Martin Kenny has said, climate change will pose its own challenges but producers in Europe are able to provide food sustainably. Farmers cannot understand how the Commission can allow a Mercosur deal that will allow 80,000 to 90,000 tonnes of beef into Europe to go through, displacing food sustainably produced in Europe. We hear reports of rainforests being cut down continuously in South America to produce this beef. European producers cannot understand how the Commission can have one policy to deal with climate change while another allows these imports from South America.

In a similar vein, I will ask the Taoiseach a specific question regarding the ratification of any Mercosur deal agreed. Would such a deal have to come before the Dáil? Will the Taoiseach clarify the position in respect of trade deals, particularly those that contain an offering of beef?

Previous speakers have made a point that is more urgent and more pertinent. The EU's own cumulative assessment of the impact of trade deals indicated that a deal with Mercosur could lead to a €5 billion hit to the beef trade in Europe, which could mean a hit of up to €500 million to the domestic beef industry and a 16% cut in the prices received by farmers whose income from production already leaves them on the bread line. Will the Taoiseach ensure that this deal is stopped in its tracks and that this message is conveyed clearly to the European Commission? The agriculture sector and beef farmers simply cannot take this mooted deal.

Like everyone in this House, I am very aware of the pressures beef farmers and the wider beef industry are under at the moment as a result of low prices, competition from other countries, and climate change. At the same time, the industry is heavily protected through trade restrictions and tariffs. It is one of the most subsidised industries in the country.

When it came to the trade deals with Japan and Canada, we had to consider what is best for the country in the round, not just economically, but also in terms of social policy, because other sectors may benefit considerably from such a deal. We have particular concerns over a very sensitive sector, which is the beef sector. As a consequence of that I wrote a letter to President Juncker, the President of France and leaders in a number of other countries, expressing our strong objections to aspects of the deal, particularly as it affects the beef industry. That is on the public record, having been published last week.

On the particular issue of trade deals being ratified, my understanding is that any trade agreement is an exclusive EU competence and therefore would not require ratification of the Dáil unless it is a mixed deal. However, I will get clarity on that and reply to the Deputy later.

We could make progress, but I am asking for co-operation. This is today's list.

My question relates to promised legislation. Secondary schools have closed and primary schools are finishing for the summer this week. Obviously, plans are already being made for returning to school in August and September. There are many challenges for schools, one of them being policies on the use of smartphones and iPads. Proper consultation and collaboration needs to take place between parents, students and the schools because schools are complex environments to work within.

Considerable work has been done on the parent and student charter, and much engagement has taken place at the Joint Committee on Education and Skills. What is the status of the legislation for that? That Bill will help schools work more effectively in consultation with their communities, parents and students.

I ask the Taoiseach to give a short response if he can.

I understand the Minister, Deputy McHugh, intends to bring that Bill to Cabinet in July.

Page 92 of the programme for Government states that a new model of in-school speech and language therapy will be established. In that regard I refer specifically to a six year old girl in my constituency who is attending Stewarts Care Limited. She intends to progress to primary school in September and a referral has gone from Stewarts to the HSE. Unfortunately the response states:

We have received the response. Currently the team has reached full capacity with 750 children already in service. The application will be held on file and reviewed as soon as capacity within the team is available. Given the current circumstances, it is difficult to estimate when she will have access to speech and language therapy. However, given the current demand for the service and resources available, it is likely to be approximately 24 months.

A girl of six years of age cannot wait for two years.

If the Taoiseach is in a position to respond, he may do so.

I am very sorry to hear about that case. However, the Deputy will appreciate I am not in a position to comment about individual cases without having all the information and without having the right to waive privacy and all those things of which he will be aware. We all acknowledge, notwithstanding the additional resources and staff, that the current system is just not working, which is why we are pursuing this new model providing speech and language therapy through schools. I believe that pilot is supposed to begin this autumn in one of the community healthcare areas and if it works, it may provide the solution for the future.

I received a response from the office of the Minister, Deputy Regina Doherty, on delays in carer's allowance appeals. The letter states that in 2018 it was 9.6 weeks and in 2019 it is 9.1 weeks. I made an appeal on behalf of a constituent on 12 March, 14 weeks ago. I rang the appeals office this morning and discovered it had not even received the file yet. When I asked how long it would take to process after it got the file and I was told it could be up to three months. That is 26 weeks or six months.

The Deputy should put a question to the Taoiseach so that he can answer it.

I ask the Taoiseach to use his good offices. If extra staff are needed, they should be provided to deal with these. We pay a lot of lipservice to carers and repeat the same platitudes to them. They are at their wits' end.

Let the Taoiseach, if he can, respond.

I will have to ask the Minister, Deputy Regina Doherty, to reply to the Deputy because I do not know the details. However, we ensure that if an appeal is made in somebody's favour, that they receive the payment in arrears. I know that is not much good for someone who is waiting for it, but it ensures that nobody loses out if their appeal is upheld.

I ask about the approval of the drug Tagrisso for the treatment of advanced lung cancer. I believe the drug is going through the process of approval. I ask the Taoiseach to intervene to try to ensure it is approved. I know somebody who is very seriously ill and this drug would prolong their life. It is in the final stages of the approval process as I understand it. I ask the Taoiseach to use his good offices to get the drug approved with immediate effect.

The Taoiseach or the Minister for Health-----

I am afraid I cannot intervene on such a matter. The decision to license a medicine is for the Health Products Regulatory Authority or the European Medicines Agency. The Oireachtas passed legislation to ensure that decisions on which medicines are reimbursed are not political decisions and should be made objectively by the HSE on the advice of the National Centre for Pharmacoeconomics. About 30 new medicines this year have been approved for reimbursement. I am sure more will be approved, but they must meet the criteria and done within the law passed by this House.

I raise the policy of decongregation and the funding of it. Many young adults are now being taken from institutionalised settings such as St. Patrick's in Kilkenny and placed in community homes throughout the city. I believe the policy is successful but it lacks funding. The consequences for staff members are that they still remain within the setting but they are not being paid properly and are not being given redundancy. Their pensions are at issue and the HSE is not in a position to respond to them.

The other consequence is that the clients of the service who are waiting to be put in homes, where a home is available, are waiting for €600,000 to fund it.

As a further consequence, a young man has been left in St. Luke's Hospital since November of last year. The bed is costing €1,000 a day and everyone agrees it is an inappropriate setting, but the senior officials in the HSE will not give sanction for the funding necessary to take that young man, whose health is deteriorating, out of the hospital and put him into the appropriate setting he deserves.

I call the Taoiseach if he is in a position to answer.

I am afraid I am not. The Deputy has raised many important issues, including pensions, redundancy, decongregation policy and a question about an individual. I would not be able to do him justice by giving him an answer without having a better understanding of the issues he is raising. If he sends me something in writing, I will ensure the Minister of State with responsibility for disabilities is made aware of it.

The Deputy is happy with that.

I call Deputy Michael Collins. I ask him to be very brief as I am about to cut off-----

Page 69 of the programme for Government states that the Government is committed to conducting an evidence-based review of the current status of implementation of international best practice in the area of mental health. This has not happened in the Bantry centre for mental health and recovery, which has a major staffing crisis. A recent report by the Mental Health Commission found that the standards at the Bantry mental health centre have significantly dropped by 10% from 2017 to 2018.

The Deputy should ask a parliamentary question or submit it for the Topical Issue debate.

Is the HSE offering positions to nurses who are about to qualify this year, as the HSE needs to recruit nursing staff immediately for a very seriously overstretched Bantry centre for mental health?

We will have to have a serious look at questions raised on Questions on Promised Legislation. The matters would be more suitably raised as Topical Issue matters or in parliamentary questions.

I appreciate this is a very important local issue but there is no legislation promised on it, nor any specific programme for Government commitment.

The programme for Government-----

It is best raised as a Topical Issue matter.

I wish to ask about the Judicial Council Bill. As the Taoiseach knows, there is a crisis over the escalating costs of insurance impacting small businesses and community-based groups, especially those based in Louth, as well as across this State. They include childcare and sports facilities. Amendments to the Judicial Council Bill are aimed at bringing this crisis to an end. There is a need for those, particularly in the social economy, but also including drivers and other businesses, to have a guarantee that insurance costs will come down as soon as possible. When will the Judicial Council Bill be brought to the Dáil?

It is an appropriate question.

I understand it is intended to take all Stages next week.

I will not let down the last few Deputies because they waited all day, but I ask them to be brief. I call Deputy Breathnach, followed by Deputy Ferris and then finally Deputy Neville.

This is under the programme for Government on disabilities. The National Council for the Blind Ireland, NCBI, has informed Oireachtas Members today that in excess of 700 people are categorised as unable to drive a propelled vehicle due to varying degrees of sight impairment either by their doctor or under the regulations of the Road Safety Authority, RSA.

I know the constraints that the Taoiseach is under, but will he commit in the forthcoming budget to giving these citizens the free travel pass? Having signed up to the UN Convention on the Rights of Persons with Disabilities, that is the least we can do for the 700 people whose travel is being constrained on the foot of other agencies not giving them permission to drive.

I cannot make any commitments in advance of the budget and will not be able to until 8 October. However, it sounds like a good and fair idea that the free travel pass be extended to those 700 people. There may be more to it than meets the eye, but I will certainly have the Ministers, Deputies Regina Doherty and Finian McGrath, examine it to see whether it can be done.

On 13 January 2016, the Maritime Jurisdiction (Straight Baseline) Order was made from Malin Head to Carnsore Point, all along the west and south coasts, with the formalisation of the voisinage agreement through the passage of all Stages of the Sea-Fisheries (Amendment) Bill 2017 in the past few weeks. I have been told that a statutory instrument from the Minister of Foreign Affairs and Trade cut straight baselines from Carnsore Point right up beyond Dundalk. I cannot find the instrument. I was told by the Minister yesterday that Deputy Simon Coveney signed the statutory instrument, yet there is no record of it. Could I please be forwarded the instrument and a copy of the baseline?

My understanding is that all statutory instruments have to be laid before the House within a particular timeframe, but I will check that out and correspond with the Deputy.

I refer to page 36 of the programme for Government and the Action Plan for Jobs. In the past few days, particularly in respect of the summer economic statement, we have heard across the Houses about broadening the approach to the need for increased labour due to a lack of workers for the jobs being created in the economy. Approximately two years ago, I mentioned in the House the covert discrimination that older people looking for work and in the workforce face. The Government has gone some way to address this with the €10,000 incentive given to those who employ someone aged 50-plus who was long-term unemployed. However, those in the 55-plus age group who have done manual labour come to my office to say that they find work difficult because their bodies cannot stand up to it after having worked for 30 or 35 years. There could be another ten or 15 years' work in these people. We must drill down into that and look to these people to fulfil that need in our economy, which will aid our competitiveness.

The Deputy raised a pertinent issue. We face labour and skills shortages across the economy in the public and private sectors. Whether it is carers who no longer have caring responsibilities, people in their 50s and 60s or migrants, we should do anything that we can to activate and assist people to join the workforce. Any suggestions that the Deputy has in that regard would be well received.

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