Saincheisteanna Tráthúla - Topical Issue Debate

Cancer Services Funding

I thank the Minister of State, Deputy Byrne, for attending. I rise to speak to her about the important and critical work of the Cuan cancer social support and wellness group in Cavan town. The service first opened its doors in the small town of Cootehill in 2012 and expanded to Cavan town in 2018 where it worked with Cavan County Council on the provision of a venue. Cuan provides support and nurturing for male and female cancer patients, in particular those who have come through their treatment. It is a community cancer support. This year, Cuan received a small but welcome grant from the Irish Cancer Society to assist with the provision of its service. Cuan is unique in the way it delivers its service. There are many good groups which provide comfort and services to cancer patients as they undergo treatment but Cuan's role is to provide services to patients and their families once their treatment has concluded. Cuan even provides services to families. It is about counselling and alternative therapies, including yoga, or even just a cup of tea and a chat with someone who has been through a similar experience. The ladies I have met who were among the founders of Cuan have all been through a journey of cancer treatment. The small grant towards the funding of its counselling service which Cuan receives from the Irish Cancer Society in no way meets the full cost of that service. Cuan offers a range of services free of charge and relies on fundraising and the generosity of the public. It feels that there is no transparent, equal or fair funding mechanism for support centres nationally, including Cuan.

In November 2018, Cuan joined with other services nationally and wrote to the Minister for Health, Deputy Harris, about fair and equitable funding for cancer support services. In the same month, the Minister responded to advise that centres were funded through the HSE, section 39 of the Health Acts and lottery grants. In reality, HSE areas differ nationally in what they offer. Some services are funded while others are not and the level of funding varies considerably. All centres were advised to apply to their HSE area but when Cuan applied under section 39 it was, unfortunately, unsuccessful. In July 2019, the survivors' needs assessment was launched. The assessment demonstrated the ongoing psycho-social needs of cancer patients and survivors. At this time, community cancer support services were urged to apply for funding from the national cancer control programme. Centres were asked to calculate the amount requested on the basis of services being provided by full-time equitable posts.

I attend on behalf of the Minister, Deputy Harris, and I thank Deputy Smyth for raising the matter. The Department of Health and the HSE's national cancer control programme have achieved significant improvements in the quality of cancer services over recent years. We have moved to system of care that consolidates cancer treatment in large centres with multidisciplinary decision-making and care, leading to better outcomes for patients. Cancer care in Ireland is provided across a continuum of primary care, acute hospitals and social services. In line with best practice, cancer surgery is centred in eight designated centres. There is clear evidence that patients who undergo cancer surgery in hospitals with a high patient volumes from doctors who see a high volume of cases have better outcomes. As such, cancer patients from Cavan have access to the services at the designated cancer centre at Beaumont Hospital and other centres as appropriate. Radiation oncology is also provided at Beaumont. At the same time, care is delivered to patients as close to their homes as possible. Therefore, medical oncology, mainly chemotherapy treatment, is delivered in 26 hospitals under the direction of the designated cancer centre. Cavan Hospital is one such hospital providing quality medical oncology care in the region. An aseptic compounding unit is also located at Cavan Hospital, enabling chemotherapy drugs to be made up on site. Cancer screening through the BreastCheck, CervicalCheck and BowelScreen programmes is also available to eligible people on a national basis.

The national cancer strategy 2017 to 2026 sets out a roadmap for the continuing development of cancer services over ten years. The strategy places a significant emphasis on cancer prevention, early diagnosis, access to quality treatment and maximising patients' quality of life. The need for the organisation of voluntary sector pyscho-social support is recognised. In response, the Irish Cancer Society has developed a programme of activities aimed supporting good practice and governance in cancer centres throughout Ireland. The programme aims to increase the collective strength of cancer support and provides valuable training to volunteers, managers and board members of affiliated support groups. I understand the Cuan cancer social support and wellness group in Cavan is affiliated to this programme. The national cancer strategy places a renewed focus on interaction with the voluntary sector. Recommendation 43 of the strategy targets increased collaboration with voluntary organisations to develop programmes which emphasise the physical, psychological and social factors that affect health and well-being. Funding to ensure the continued implementation of the recommendations of the strategy and the development of cancer services programmes is being sought in the Estimates process for 2020. Section 39 of the Health Act 2004 makes provision for the HSE to provide assistance to bodies that provide services similar or aligned to services that the HSE may provide. Voluntary cancer support centres may be eligible to apply for such and can also apply for lottery funding through the HSE. The Department of Health will continue to work with the HSE's national cancer control programme and voluntary organisations to address the needs of cancer patients in a holistic manner.

While the Minister of State touched on Cuan, my specific request is for the Department of Health to provide the group with the funding it needs to run its service. It costs at least €30,000 to do that. Those involved are volunteers and they do not have anything close to that money. They depend completely on the generosity of the public and the fundraising events they run. Some of the volunteers are cancer survivors themselves and they cannot continue in this way. To provide some specific detail, Cuan had 69 new clients in 2018. After it launched its new venue in September 2019, that went up to 121 clients. The numbers attending for complementary therapies went from 24 to 139 in September 2019. The numbers have jumped in the counselling service too. These are significant increases four and five times above the previous level within 12 months. The bottom line is funding.

I have testimonies from service users. They are emotive and real and it is important to hear them. One person says a cancer diagnosis is devastating and life-changing. He says that living with cancer is very difficult. While the initial care is fantastic, he points out that survivors continue to need support as they can feel isolated as check-ups are stretched further apart. According to his testimony, this is where the Cuan cancer support care has been a lifeline to this man and his wife. It offers a free and confidential service, even if it is just for a chat. It offers free therapies, which are very beneficial for cancer patients and family members. This man says he is a grateful survivor and Cuan member. I have numerous testimonies in the same terms which make the same passionate plea for support and funding for the Cuan cancer support service. As the Minister of State said, most centres like Cuan are run on a voluntary basis. None of the volunteers is complaining about that. The complaint centres on the need for transparency and equality.

They need to know they have a future and that there will be consistency so they can plan, safe in the knowledge that they are going to have funding.

I thank the Deputy again. What she said about the importance of community support for people who are recovering, or have recovered, from cancer struck home. There is a centre somewhat like that in my parish to which people can go after being diagnosed with cancer, during the cancer programme and when they come out the other end. It is important for a number of reasons. The Deputy mentioned a cup of tea, which is important, and interactions between people who have had cancer and those who are in the process of treatment or who are coming out the other end can be helpful.

I do not know why funding was not given to this particular service from the National Lottery and I am not sure the Minister will know either. However, I will inform the Minister and see if anything can be done. I cannot give a commitment on that but I understand the need for the service. There is such a service on the South Circular Road, near where I live. I attend their coffee mornings and I know that the need for people to sit down and talk to each other is obvious. People can get support from each other and that is what community services are all about.

I do not have an answer for the Deputy on why funding was not given to the group but I will certainly pursue the matter for her. I will ask the Minister to come back to the Deputy if I do not do so myself.

The Minister of State's commitment is appreciated. The next matter is in the name of Deputy Maureen O'Sullivan.

The relevant Minister is on his way but is not here yet. I can deal with the matter.

Is Deputy Maureen O'Sullivan happy with that, or does she want to wait for the Minister?

I will wait, if the Minister is coming.

He is coming but I do not know how long he will be.

Does Deputy Ferris want to go ahead of me?

Is the Minister of State also going to deal with the issue around greyhounds?

As an alternative, we could suspend proceedings for ten minutes.

If the Minister of State is happy to take my matter, I will go ahead.

That is fine. The Minister said he would be here but he has not arrived yet.

Greyhound Industry

The greyhound fraternity and the Irish Greyhound Board have expressed shock and disappointment at the decision of Fáilte Ireland and Tourism Ireland to suspend the promotion of greyhound racing in the national and international tourism markets. This will have a significant impact on many areas in rural Ireland, particularly those that depend on a strong greyhound industry.

I do not for a minute defend any cruelty towards animals and there are allegations of animal cruelty by a very small minority within the greyhound industry. This must be fully investigated by the appropriate authorities and stamped out. I would fully support that. I would not condone violence towards animals in other sports such as showjumping, horse racing and so on. However, this is focused specifically on the greyhound industry and many people feel, as I do, that the small boys and girls of the sporting industry in the country are being victimised by this decision.

The greyhound industry provides support and considerable employment, directly and indirectly, across the Irish economy and, in particular, in more rural parts of the country. The gross wage bill attributed to employment in the industry is estimated at €126 million. PAYE-PRSI pay per annum is estimated at €12.7 million. The net income generated by the industry is estimated at €113.8 million. Using a conservative income multiplier effect of 0.5, this would result in a total economic impact of €171 million per annum in additional spending. That is the type of money that is going into rural Ireland.

Many of us who come from rural communities are well aware of our local greyhound industry. Local greyhound tracks provide a facility for charitable organisations to run functions that benefit those organisations. Much money has been provided to University Hospital Kerry as a result of greyhound meetings organised by Kerry Hospice, the Friends of University Hospital Kerry and other charitable organisations. It is of significant financial support to those sectors.

This suspension of promotion of the industry will have economic consequences. More than 30,000 people come from overseas to attend greyhound meetings and that tourism will be lost. Over 12,000 people derive the economic benefits of the greyhound industry and could be the subjects of job losses. For the Minister to criminalise an entire sector because of the actions of a few unscrupulous individuals is scandalous. The same could happen in the showjumping or horse racing industries, or any other sector where animals are used for sport and entertainment. It is terribly wrong and an insult to the genuine individuals who are providing an amenity for the people in their respective areas. The Minister needs to reconsider this decision. He needs to talk to Fáilte Ireland and Tourism Ireland. This decision is penalising 99% of genuine, decent people because of the actions of the few. If the greyhound sector is going to be penalised, other sectors should also be penalised accordingly and I am quite certain that will not happen.

I thank the Deputy and apologise to the House for arriving a little late. I was discussing some crucial budget matters with the Minister for Finance. I thank the Minister of State, Deputy Catherine Byrne, for agreeing to take this matter in my absence. I also thank Deputy Ferris for giving me the chance to address it. I have had representations on this matter from elsewhere and I understand the strong feelings which are felt on all sides about this issue, although they all come from a completely different perspective.

Let me begin by clarifying the respective roles of my Department and the tourism agencies in the context of tourism development. As Minister, I set national tourism policy in order to grow a competitive and sustainable tourism industry, while the agencies have operational responsibility for the implementation of this policy. On the matter of tourism, marketing and promotions, Tourism Ireland is the all-island body responsible for overseas tourism marketing, whereas Fåilte Ireland is responsible for domestic tourism promotions. Accordingly, decisions regarding particular promotional channels or campaigns such as those relating to greyhound racing are operational matters for the tourism agencies.

There has been much coverage and debate lately, including in the RTÉ "Prime Time" programme that aired over the summer, regarding alleged cruelty to greyhounds. This is a matter of grave concern to me personally and I know that my colleague, Minister of State at the Department of Agriculture, Food and the Marine, Deputy Doyle, who has responsibility for the greyhound sector, also takes these allegations very seriously. I have also had a large number of representations from Deputy Ferris' constituency colleague, Deputy Griffin, on the issue. He is, of course, concerned about animal welfare and we have had robust discussions. Deputy Griffin shares Deputy Ferris' concerns, as do other Members of the Government. My conversations with Deputy Griffin have been very robust. I would not go as far as to say he is 100% in agreement with me on everything that is being done here but animal welfare is a prime concern which we share.

I welcome the fact that the Minster of State, Deputy Doyle, is ensuring that the Department of Agriculture, Food and the Marine conducts a thorough investigation and takes the necessary enforcement actions to deal with any offences. While his Department and Bord na gCon are seeking to address the specific issues identified, I am also keenly aware of the reputational damage these alleged practices have done to the Irish greyhound industry. I am very concerned that there could be consequential damage to Ireland's reputation as a tourist destination.

Accordingly, I asked the tourism agencies, Tourism Ireland and Fáilte Ireland, in this context to consider what role greyhound racing should continue to play in the marketing and promotion of Ireland. I also asked them to apprise Bord na gCon of any actions they proposed to take. The agencies subsequently informed me that they had met and decided to implement some changes relating to the promotion of greyhound racing in tourism marketing campaigns and on the agencies' websites, pending implementation by the Department of Agriculture, Food and the Marine of several reforms under way and to come.

I am confident that the Minister of State, Deputy Doyle, and his Department, in co-operation with Bord na gCon, are working hard to address the issues identified, to take enforcement actions against offences and to set the industry, for which they have great ambitions, back on a positive track. Nonetheless, while we work to right the wrongs and rehabilitate the industry and its reputation, we must be careful not to allow current negative publicity damage our tourism promotions. In that regard, I trust the tourism agencies to act in the best interests of Ireland and Irish tourism, guided by their insights and experience. I am happy with their decision to take a step back from active promotion of greyhound racing at this point in time and to keep the situation under review.

I thank the Minister for his response. I am not so sure about the justification for penalising more than 99% of the people involved in the industry for the actions of what is probably 1%. It is very wrong and is affecting their livelihood. It has a huge impact on the fabric of their communities because the industry is so greatly involved in local economies. I referred in my opening remarks to the wonderful contribution the greyhound racing makes to various charitable organisations, as well as organisations such as University Hospital Kerry in my constituency, for which events are run to raise money where the Government has failed to deliver.

Were the same stringent criteria applied to other sporting events such as showjumping or horse racing, I am quite sure that were one to look deep enough, one would find some unscrupulous individuals who treat animals terribly. I fully and absolutely concur with the Minister and anybody else who wants to stamp this out. It should be stamped out. It is criminal action and should be treated and dealt with accordingly.

Will the Minister take into account the effects this decision will have for an economy that will be in dire straits if this is allowed to proceed? I hope the recommendations coming from the Minister with the Irish Greyhound Board will be worked out speedily, as we cannot have this type of activity affecting the income of people who have done tremendous services for rural Ireland, for animals generally and especially for charitable organisations that have become dependent on their night at the dogs to raise funds that the Government has failed to meet.

I do not doubt Deputy Ferris’s bona fides on what he says about the greyhound industry or the employment it gives. I accept this is a concern but we must be aware that €16 million in Government money goes to the Irish Greyhound Board. We must be aware that the board commissioned a report from a firm called Preferred Results but when it received that report, it was not published. That report contained some unacceptable findings, including the fact that 6,000 dogs were culled simply because they could not race fast enough and that there was a culture of doing that sort of thing in the industry, which was obviously accepted. On top of this, there were other utterly unacceptable incidents, the frequency of which I am not in a position to tell, happening in the greyhound world. These were carried out regularly. That report was not published until the eve of the broadcast of the programme to which we referred. It seemed to me there was absolutely no anxiety on behalf of the board of directors to make public information that has now been found to be utterly unacceptable. It has cast a dark cloud over the entire industry, which is not of Deputy Ferris's making, but is of the making of those who decided not to publish the report because of the utterly revolting activities that were going on. I did what I feel was right, namely, that we should not use any promotion of activities that would be seen to condone in any way this disgusting behaviour. This is why I took the action I did and that is why I stand over it.

Ferry Services

Táim buíoch don deis atá agam inniu labhairt ar an ábhar seo. It is opportune to raise this after the recent Private Members' motion led by Deputy Connolly on islands, which referred to the reality of life for people living on islands. Our islands are places that have great natural beauty and a great welcome for people who visit, as well as amazing communities that work together on so many issues. The challenges are population decline, isolation and limited economic activity.

The economic activity usually comes from three areas, namely, agriculture, fishing and tourism, which provide employment. When I speak of Cape Clear, I am not speaking about what I have read but am speaking from what I know from personal experience from many years being associated with Oileán Chléire. As I was there most recently in August, I know the reality of what I am raising here. Winter months are very quiet so the months between April until late September are vital. They are prime time for tourism. They get national and international tourists, as well as family and relatives coming back to visit the island, and derive income from this tourism.

One initiative they have developed, supported by Comharchumann Chléire, is a tour to the Fastnet lighthouse. It is a major tourist attraction and boats go, supported by the comharchumann, from Baltimore, Schull and Cape Clear. It is weather-dependent but hundreds have done the tour. It has won many accolades. For example, it was recognised by National Geographic as one of the ten best on the Wild Atlantic Way, while the Irish Independent considers Fastnet to be one of the seven wonders of Ireland. The tour has had many beneficial effects on the island and in west Cork. Dún na Séad II is the new fast ferry, which would be a great advantage for Fastnet tours, as she is modern, comfortable and fast. I know this from personal experience. Even on rough days it is comfortable and sturdy. As cathaoirleach of the comharchumann, Niamh Ní Dhrisceoil, said, it is the future. However, the new fast ferry has been refused a licence to operate out to Fastnet within 500 m of the rock. It is this 500 m beside Fastnet that gives the unforgettable experience, which I have had. It is an amazing engineering feat.

Vessels of a smaller size are allowed to go up close, as are other boats, some of which are bigger than Dún na Séad II. From personal experience, I must say that maritime safety and passenger ferry safety are of utmost importance to the highly qualified and experienced crew who run these ferries. Consequently, I must query this decision from the Department of Transport, Tourism and Sport, which has responsibility for both tourism and certification of these vessels.

The 500 m distance is very important for the real Fastnet experience. The irony is that some Cape Clear boats, namely, the Naomh Ciarán, the Dún an Óir and the Dún Aengus, which are all bigger boats, can go within 500 m, as can fishing boats and yachts, so why not the new ferry? Is it that the rules have not been updated to take the faster boats into account? I hope that in his reply, the Minister will tell me this has been addressed and rectified but if not, can there be a review on what has led to this decision? I ask that there be a meeting in the Department with the industry providers because policies must be reviewed, updated and improved. It is in the bigger context that islands need to increase employment opportunities and attracting visitors to them is one way of doing so. Cape Clear is in a unique geographic position to have those tours to Fastnet. It is like a gateway there and this fast ferry is a vital element of it.

I hope there will be a positive response today from the Minister.

I thank the Deputy for raising this issue today. The Marine Survey Office, MSO, in my Department is the safety regulator for maritime transport in Ireland. One of its key responsibilities is the certification of vessels and to ensure the compliance of such vessels with the maritime safety requirements.

My Department cannot discuss individual vessels with third parties without the owners' permission. The vessel in question, however, is a class VI passenger ship. The safety certification of passenger vessels in Ireland is set out in the Merchant Shipping Acts and consists of a number of classes of passenger vessels which set appropriate safety standards based on the number of passengers carried and areas of operation. Thus the Merchant Shipping Acts reflect the risk of exposure of passengers when being carried by sea and provide for different classes of passenger vessel of different sizes and areas of operation.

The vessel in question is a class VI passenger ship and the Merchant Shipping (Passenger Ship Construction and Survey) Rules 1985 define class VI ships as those engaged only on voyages with not more than 250 passengers on board to sea, in smooth or in partially smooth waters, in all cases, in favourable weather and during restricted periods, in the course of which the ships are at no time more than 15 miles, exclusive of any smooth waters, from their point of departure and no more than 3 miles from land.

Class VI passenger ship certificates are issued in accordance with section 8 of the Merchant Shipping Act 1992, as amended. Section 8(1)(a) refers to the limits beyond which the vessel shall not ply being stated on the passenger ship certificate. For all class VI vessels, this will include the restriction of proceeding no more than 15 miles from the point of departure and no more than 3 miles from land.

From a maritime safety perspective, in identifying suitable land to be used as a basis for plying limits, the MSO assesses if locations are suitable for the landing of passengers in an emergency and this would include the mainland or any island which is normally inhabited and which has piers or berthing facilities which are in regular use.

The Fastnet Rock lighthouse is 3.5 miles from Cape Clear Island. The Fastnet Rock is not considered as land for the purpose of the determination of plying limits, as it is not a place of refuge. It is a small uninhabited island without any landing facilities. It would be inappropriate for the MSO to agree this as a suitable place of refuge.

For those reasons, the Fastnet Rock is not utilised by the MSO as a basis for issuing plying limits and class VI vessels are not permitted to operate there as it is more than 3 miles from land. Representations were made to my Department on this matter in August this year. The reply issued included alternative solutions to the matters raised.

I wish to advise that there are a number of passenger vessels of classes other than class VI which are certified for tours around the Fastnet Rock. These vessels are certified as different classes in accordance with the Merchant Shipping Acts and such vessels are compliant with the applicable maritime safety regimes and are offering tours around the rock.

I am quite embarrassed for the Minister given that answer. There were a lot of technical details in it which I will look at with the people there. I have to say categorically that nobody working on those boats would ever jeopardise their own or their passengers' safety. The answer is quite incredible. I hope the Minister gets the opportunity to see Fastnet because it is one of those really unbelievable experiences.

There is a special relationship between the island and Fastnet lighthouse. The lighthouse was originally on Cape Clear, where it was built in the 1800s. It was on Cape Clear for quite a number of years until it moved to Fastnet. One can land on Fastnet because it was a working lighthouse until some years ago, when all the lighthouses were automated. Nobody on the boat wants to land on Fastnet. All they want to do is to go around Fastnet to see up close the amazing architectural and engineering feat that it is. I am unsure if the Minister saw the amazing programmes on the lighthouses of Ireland that were on RTÉ. They gave a really good perspective on Fastnet.

I refer to the national marine planning framework and its vision. It states: "Our ocean wealth will be a key element of our economic recovery and sustainable growth, generating benefits for all our citizens, supported by coherent policy, planning and regulation, and managed in an integrated manner." This is one way to generate benefits for people on an island who are struggling because the population is going down and they face quite a number of challenges.

This boat can carry 100 people in comfort, style and safety. It came from Norway, where it was operating all year round. There are more severe sea conditions there, but it is not allowed to travel around or near Fastnet during the summer months. It is quite incredible that the other boats can operate but this particular fast and comfortable ferry cannot. I hope this decision can be reviewed because this is a new boat. Why can this not be looked at again?

It would be fair to say that I am impressed by the case Deputy O'Sullivan has put and I will seek a review of the reply which I have given today.