Ceisteanna ó Cheannairí - Leaders' Questions

Today, I want to raise the issue of the Debenhams workers. I was alarmed and disappointed with the Taoiseach's response yesterday when these matters were raised. His response was lacklustre and it was not the type of response that I believe is required from Government.

As the Taoiseach will know, the Debenhams workers have been in dispute with their employer for some months now. At the height of the Covid emergency, they were on the picket line and they are on the picket line still, 24-7, standing up for their right to be treated with respect but also fighting a battle that has a much wider significance than just Debenhams. Debenhams has used a tactical liquidation of its Irish stores to walk away from all of its responsibilities to its workers. It is now the intention of Debenhams to take possession of all assets and stock in its Irish stores to funnel the profits through its British operations, at the same time leaving its workers here high and dry.

The Debenhams workers are not the first to be treated in this appalling manner by their employer and because of Government inaction, they will not be the last. The use of tactical liquidation is not new to this State. The Taoiseach will recall that in 2015 staff who had given a lifetime of service to Clerys were unceremoniously dumped by their employers and left high and dry. They did not receive their statutory redundancy lump sum, they never got moneys owned in lieu of notice of redundancy or holiday pay and the State was left to foot the bill. This is the blueprint for what is happening in Debenhams. There needs to be immediate intervention by the State and Government. The Taoiseach will recall that in the case of Clerys we all said at that time that this could never happen again, but it has. Now is the time for immediate and effective action.

What the workers are looking for is not unreasonable, it is necessary. They want the Government to intervene and engage with KPMG, the liquidators appointed by the UK parent company. They want the Government to directly intervene with the parent company and they want Debenhams to honour previous agreements to pay two weeks' redundancy per year of service in addition to the statutory redundancy. They want to be treated with respect. They do not want a situation where Debenhams can simply walk away. It is now urgent that the Government act. It is also urgent that we legislate. I want the Taoiseach to move beyond the words he uttered yesterday, which were equivocal and non-committal. I want to hear a firm commitment from him today that the Government will act immediately to directly support these workers and will also act immediately to legislate.

I thank the Deputy for raising the issue and the question in regard to the Debenhams workers. My response yesterday was not lacklustre and it was not equivocal in terms of how Debenhams has treated its workers in Ireland. It has treated them very badly and very poorly. The State will do everything it can to support the workers who have been made redundant by the company in the manner described by the Deputy.

The programme for Government outlines the necessity to review legislation, particularly in terms of its utilisation by companies to lay off workers by way of the trading side of the company being insolvent and the separating out of the assets, which are then not available to facilitate the payment of redundancy to workers. There is a commitment in the programme for Government to review the Companies Act with a view to closing off the vehicles or mechanisms by which companies can treat workers so shabbily and badly.

Governments arbitrarily cannot intervene in liquidations as easily as suggested by the Deputy. That said, Debenhams should do the right thing by its workers. It should pay the levels of redundancy agreed in previous engagements. There are obligations on the company in terms of its workers. The Government will do everything it can within the law to support the workers. We will provide every resource possible to enable them to secure their rights and entitlement, but also future employment and other supports they may require to enable them to deal with what has been a very difficult and traumatic situation for them as workers. They have been treated very poorly in that regard. The Government is committed to reviewing that legislation and amending it.

Here is the problem. The State and the Government have not intervened in the appropriate way to protect these workers. I remind the Taoiseach that since 2015 he has been saying that there needs to be a review and a change to the legislation. In regard to the Clerys situation he said, "The most effective intervention is legislative". At that time, he challenged for a review of the law to ensure that this type of behaviour cannot continue. Five years on, the Taoiseach is still talking about reviewing legislation. That is not good enough. Deputy Micheál Martin may be new to the office of Taoiseach but he is not new to Government. Fianna Fáil supported the previous Administration for four long and very difficult years, during which it did precisely zilch, nothing, to ensure that this type of scandalous situation would not happen again.

This afternoon, we will publish legislation in line with the Duffy Cahill report to prevent these kinds of tactical liquidations and insolvencies.

I ask that the Government support this legislation and, furthermore, that we make time before we rise for the summer to ensure we have on our books the right law, which is long overdue to protect the Debenhams workers and all the other vulnerable workers out there at this time of economic crisis, so that this type of scandal cannot happen again. That requires the Taoiseach to act, not to contemplate, push things down the pipe or hide behind complexity but to lead from the front, to act and to legislate.

I think the Deputy was very disingenuous and dishonest in her presentation. I was not in government in 2015 and I have not been in government over the past number of years. We have been in government for one week. That is the reality, unlike the great political untruth and mantra that the Deputy and her party have been peddling for quite some time. It is disingenuous and it does a disservice to the issue. It does not help anybody to make these kinds of disingenuous political attacks on other political parties. It might suit the Deputy politically but it does not actually help anybody or the workers.

Will the Taoiseach tell us what he is going to do?

It is in the programme for Government that there is a commitment to legislating-----

-----in respect of the separation of property from trading entities that is being used. The Tánaiste and Minister will be examining that legislation. That will happen but it is not going to deal with the Debenhams workers' plight, and the Deputy knows that.

I know that the Government will not do anything.

It is important that when we are dealing with workers who have gone through a traumatic situation, it is not to try to raise expectations unrealistically and blame everybody else when it is the company that is fundamentally at fault in its behaviour towards the workers.

It is the Government that is at fault. Legislate.

It was not the previous Government's fault and it is not this Government's fault, but what the Government certainly can do is look at the legislation in dealing with it.

This week, it has been agreed that the Chief Medical Officer, Dr. Tony Holohan, is to be awarded the freedom of the city of Dublin, an honour he deserves. Together with the now Tánaiste and the now Minister with responsibility for further and higher education, he was the steady hand we needed as we navigated our way through the pandemic, and the nation drew reassurance from his calm demeanour during his daily briefings.

The time is now right to recognise also the work of all front-line health workers. Many of our doctors, nurses and healthcare assistants placed themselves at risk to go to work every day to keep us safe and to care for those who were seriously ill. Many of them made significant personal sacrifices during this time, including moving out of their homes and away from their families in some cases to keep them safe, while continuing to provide care, not only for those with Covid-19 but also for others who needed healthcare during uncertain times. These healthcare workers have worked long hours in extremely difficult circumstances and we must now stop and recognise the work they have done on behalf of us all. These people have been selfless and our country owes them a great debt of gratitude. If it is not possible to reward them with pay increases or some form of bonus system, at a very minimum we should offer them additional paid leave, that is, time to spend with their families, with whom they may have sacrificed precious family time, or time out to recover from the physical and emotional tiredness they are undoubtedly feeling.

Would the Taoiseach agree that now is the time for us to come together as a country and offer our healthcare workers more than a round of applause by acknowledging their work and sacrifices?

I thank the Deputy for his question and presentation. I agree with him, particularly on the contribution that front-line health service staff and those in the background have made to the fight against Covid-19, effectively contributing to the suppression of the virus for now and to a very low level of community transmission. I also share the Deputy's admiration for the work of Dr. Tony Holohan, the Chief Medical Officer, and the calm leadership he gave. We all wish him the very best at this time, as we do to the previous Taoiseach and the previous Minister for Health.

Without question, healthcare workers, especially in the acute hospital setting in the early phase of Covid-19, put themselves at risk for the betterment of their fellow citizens. We saw in the "RTÉ Investigates" programme the intensity of that commitment and of that contribution and the considerable emotional trauma that went with it in the additional duties that nursing staff and doctors had to take on to communicate with families who could not be near their loved ones. It also illustrates the value of a strong and good-quality public service, which is something we should never underestimate in this country. In a time of crisis, it is the State, fundamentally, that intervenes through the quality and expertise of its public service.

In the first instance, that is why the Government has committed to honouring, notwithstanding the enormous financial difficulties the State will be in, the pay agreements that will fall due in the autumn. It is to recognise the contribution of the public service in general to helping the country come through Covid-19 and it also applies to An Garda Síochána and other front-line workers, as well as those in retail and so on who also came to the front line to help people.

The Government will examine the Deputy's suggestion and proposal. I cannot make commitments here today but I will discuss it with others. I am conscious of the point the Deputy raised and the importance of recognition of people who went to exceptional lengths to help people on an individual basis and, by so doing, helped the country at large to get through this crisis.

One way in which we can help to relieve pressure on our front-line workers is by eliminating trolleys in our hospitals. In the past month, patients and trolleys are something we have again started to see within our hospitals throughout the country. We need to take action now to address the bed crisis. That is the very minimum we owe to front-line healthcare staff throughout Ireland.

Take, for example, Portiuncula Hospital in Ballinasloe. Since the start of June, on average eight patients have been on trolleys every single day. A total of 10% of the beds of the hospital have been lost as a direct result of the measures to reduce the risk of infection from Covid-19. We need to see direct and immediate action taken to address this problem. Would the Taoiseach not agree that our healthcare workers have been under enough pressure for the past four months from a virus we could not control? Let us not add to that. Let us take action now on something we can control.

Portiuncula Hospital has had a net reduction of about eight beds because, as the Deputy said, of the impact of Covid-19 and the desire to prevent the spread of the virus throughout the hospital, and to have sufficient isolation facilities for suspected cases and any particular case the hospital has of a patient with Covid. The Deputy is correct that the number of presentations at emergency departments is back more or less to where it was prior to Covid. It has been steadily increasing in all acute hospitals.

That poses significant challenges over the coming months because, on the one hand, we want to resume services, and non-Covid services in particular, as best we can. Clearly, however, living with Covid and with Covid ever present, we will have to develop innovative approaches to make sure we keep emergency department attendances much lower than would have been acceptable in previous times. Where hospitals' capacity was at 95% prior to Covid, which is too high in any event in emergency departments in terms of overcrowding, the ideal figure will be reduced to 80% to facilitate the management of any spike in numbers or surge in that regard.

We are very conscious of that. The HSE is developing a plan — it should be published by the end of the month — in regard to its strategy on resuming services and dealing with the crunch issue of overcrowding, particularly in the emergency departments.

The position on mental health services in Tipperary is very serious. It was serious all along prior to Covid.

I wish the new Minister of State, Deputy Mary Butler, the very best. Hers is a very good appointment. I look forward to engaging with and working with her. She has agreed to a request from Deputy Cahill and me to visit Clonmel.

There is not one single long-stay mental health bed in Tipperary. A Vision for Change was a disaster. We lost our wonderful St. Michael's unit, which many used for decades. It was closed. The last Minister of State responsible for mental health, Mr. Jim Daly, acknowledged it was a mistake. He admitted, and his officials now admit, that there is a deficit of 25 long-stay mental health beds in south Tipperary alone. Kilkenny just does not have room for us. It has to cover the whole south east.

I salute the volunteers in Clonmel and those who are picking up the slack, including those in Tipperary's Fight for Mental Health Services; Ms June Looby and all her team at River Suir Suicide Patrol; Fr. Michael Twomey, whom the Minister of State, Deputy Butler, has agreed to meet; and Mr. Joe Leahy and all his team at C-Saw. There are volunteers doing the work and providing the supports that the services should be providing. This is not fair or right. Covid has put major pressure on people's mental health and lives. We need action. Words will not suffice any more. We need the beds.

We need our crisis house to be expanded; we are waiting for that also. We need specialist nurses to be appointed on a 24-7 basis at the accident and emergency department to assess patients who present with mental health difficulties and require admission. Many have been sent home and, sadly, many have died.

Outside Dublin, Tipperary has the highest rate of suicide owing to mental health issues. That is appalling at this time. Clonmel, unfortunately, has the highest rate in the county. It is just not acceptable. People are crying out for help. Volunteers and families are trying to support them but there are no services. People are being turned away. I encountered a case last weekend in which a person was sent around from Billy to Jack and could go nowhere. The individual was sent home again and she was threatening to self-harm. Her family was very upset and there was considerable disquiet. Therefore, we need the beds.

I acknowledge that A Vision for Change has been replaced. It is three years out of date. It gave us no change or hope in Tipperary. It was a failure. We need the beds. It is acknowledged by the former Minister of State, Mr. Jim Daly, and the HSE officials that there is a deficit of beds but we need them now. We could find €600,000 recently to do up St. Michael's because of Covid. The authorities refused point blank to allow mental health patients back in or even to have a space there, or one room for those presenting at the adjacent St. Joseph's Hospital with a mental health crisis. Now the facility in St. Michael's is kitted out for Covid patients. I hope it will not have to be used for this purpose. We acknowledge the good work done in this regard but the facility must be kept open. It has been proven that where there is a will, there is a way. Money was found to open the facility for Covid. We must have the facility reopened for mental health patients. The 25 to 30 beds that were prepared, with en suite rooms, must be used to treat the people of Tipperary and west Waterford because they need the services. We must not have the terrible phenomenon of suicide. Too many lives have been lost.

I thank the Deputy for raising what is a serious issue, namely, mental health services in general, but specifically mental health services in Clonmel and the rest of Tipperary. There are two dimensions to mental health services. One is obviously physical facilities. I refer to acute capacity — in other words, acute beds — in particular facilities. The south east in general, including Tipperary, has been short of acute capacity in mental health services for quite some time.

The other aspect is securing the necessary personnel or staff to provide the services once a facility is available. It seems to me, having worked in the area and having engaged with previous Ministers and the HSE, that there has been a significant challenge in recruiting and securing qualified personnel. I welcome that the Deputy has already engaged with the Minister of State, Deputy Mary Butler, on this. I have no doubt she will respond diligently to the points he and his colleagues in Tipperary have made.

With regard to St. Michael's, the Deputy has said physical improvements have been made. We will have to ensure we can get the right personnel in place and recruit the professionals. In addition, we must work with non-governmental organisations, NGOs, some of which the Deputy has described. These can help in providing services to people who have been on waiting lists for far too long trying to gain access to very basic mental health services.

I am particularly conscious that Covid-19 will create additional burdens in terms of mental health need. Many will be impacted so we must improve our services to respond to this. I have heard what the Deputy has had to say. I believe he and Deputy Cahill are meeting the Minister of State. I will certainly work with the Minister of State to determine what we can do specifically to try to improve circumstances in Tipperary.

I thank the Taoiseach for his response. Has he the will to find a way? A Vision for Change has been a failure. A mental health crisis nurse was appointed on a 24-7 basis but did not get the go-ahead because of the embargo on mental health places. This embargo is not fair when people are losing their lives. It is just shocking. St. Michael's hospital has been transformed to deal with Covid. What is happening with mental health services cannot be allowed. The people of the county will not allow the hospital to be closed when Covid passes. We must have the beds used and we must have the qualified staff. The Rolls-Royce community service we were promised when St. Michael's was closed as part of A Vision for Change has not got into gear and we have lost too many lives. Too many families have been left distraught and devastated. There are now many more pressures on people, including businesspeople, owing to Covid so we need the beds. We need the Taoiseach and his Ministers to find a way and to have the will to find it.

First, I do have the will to deal with this issue. Second, as I said, the Minister of State will work with the Deputy on this.

Every region needs acute capacity but the Deputy should not underestimate the importance of strong community-based mental health services. In my view, a continuum is needed. The better and the stronger the community health presence, the less the need for acute admissions. I recall meeting the services in Monaghan a long time ago. At that stage, Monaghan was one of the leaders in developing the non-acute side of mental health services. It is extremely important that we develop both sides in tandem because one has a direct impact on the other. I take the Deputy's points.

In 2018 and 2019, the families of children with the rare muscle-wasting disease, spinal muscular atrophy, launched a campaign to have the drug, Spinraza, approved. The public and Deputies were targeted so they would support the campaign to ensure patients in Ireland would be reimbursed for the clinically proven and licensed drug. Many Deputies, including the Taoiseach and the now Minister for Health, Deputy Stephen Donnelly, supported the families in question. The Deputies raised the issue in the Dáil and supported the families in person at the protests and audiovisual room briefings. At the time, Ireland was the only one of the Beneluxa initiative partners that had not approved the funding of Spinraza. It was eventually approved on 11 June 2019, and the families involved in the campaign and those affected by the illness were greatly relieved that their children could access the drug.

I received a telephone call from one of the families just last Thursday and learned that 12 children are still waiting to commence treatment. One of those waiting is a 17-year-old woman. Her father, Pat, sent me an email.

It states:

I am looking for your help as the situation with my daughter is totally unacceptable. My daughter is deteriorating at an alarming rate while it is 391 days since Spinraza was approved and it sits on a shelf while my daughter lives in constant pain and discomfort.

His daughter sent a note, in which she states:

My case at the moment is that Spinraza, a life-changing drug for people with SMA, one of them being me, was approved on 11 June 2019. I have still received no access to it. Each day my muscles and body get weaker. When I was 12 I lost my ability to walk and by now, at 17, I have lost the ability to lift my arms up over my shoulders, brush my hair, turn myself over at night and even go to the toilet and have a shower alone. I need assistance to do every little thing.

I have lost so much quality in my life that I know Spinraza could bring back. Since my muscles have become weaker, I suffer from extremely bad anxiety. It has gotten to the stage that I cannot leave my house without my mam being by my side and I am so anxious that I am not able to sleep alone in my own room downstairs without panicking.

This woman's neurologist was in contact with the HSE before the pandemic and she was told no beds were available and the required care cannot be followed up. This is why the young woman has not been able to access Spinraza.

Why is this the case and will the Taoiseach find out the reasons? There are 12 people waiting for the treatment and they are concerned that the funding has stopped and they have not been told what is happening. Will the Taoiseach find out what is happening to these 12 people and provide a timeline on when their treatment will commence? I understand that Covid-19 has had an impact on our health services but these people should be given some sort of a timeline and told they will be treated by a certain date.

I thank the Deputy for raising the matter. I will certainly do what I can to find out what is going on with those 12 children, particularly the 17-year-old young woman referred to by her. I remember the campaign and the major commitment made by the families involved. There is an ongoing issue with orphan drugs, or drugs that are developed for what are classed as small populations in particular disease categories. I do not know why 12 children remain to be treated right now but I will follow up on the matter and see what we can do to facilitate access to the drug. I will come back to the Deputy but I will have to speak with the Minister and officials from the Department of Health. Perhaps the Deputy could forward the details of the individual to me or my office and I will certainly do what I can to get to the bottom of this and try to find out what is going on with the access to the drug for the children concerned.

I thank the Taoiseach. Some 18 people have started the treatment and 12 are still waiting. This was the case before the restrictions were introduced and it is important we deal with this. It is a small number of people who need this treatment urgently. I would really appreciate the Taoiseach following up on this with the Minister. I will send the correspondence to him.

Every day matters to the people concerned and I will certainly do that. I appreciate the Deputy raising the matter.