Vol. 1025 No. 3
86. Deputy Brendan Smith asked the Minister for Health if an international recruitment campaign for healthcare professionals, including therapists, is under way in the context of employment with the HSE; and if he will make a statement on the matter. [37477/22]
There has been a welcome increase in the number of personnel employed by the HSE in the past two years. I presume some of those people were recruited through an international recruitment campaign. I know from working with advocacy groups that are outlining the need for better services for children with a disability that they are very anxious that additional therapists be recruited. Apparently, such therapists are not available in this country or on the neighbouring island. The groups have been strong advocates for recruiting internationally for speech and language therapists, occupational therapists and physiotherapists.
I thank the Deputy for raising this important issue relating to recruitment generally, as well as for health and social care professionals and therapists and, as the Deputy rightly stated, in the area of children's disability services. I acknowledge that recruitment is very challenging at present, particularly as we are dealing with the effects of the global pandemic. However, it is worth noting that recruitment in the past two years has been the highest in the history of the HSE. There is a lot more that needs to be done. Hundreds of posts have been sanctioned in disability services and those posts need to be filled. The quickest and most effective way to make sure that every child gets the assessment and treatment he or she needs is to hire those therapists. I know the Minister of State, Deputy Rabbitte, is working every day to fix this problem. We have sanctioned hundreds of posts around the country that are not yet filled. As they get filled, there will be a substantial increase in the number of therapists available and that will make a big difference. Ultimately, we have to get these waiting lists down to zero. No child should be waiting for an assessment or therapies.
More broadly, the workforce has grown by nearly 15,000 whole-time equivalents since 2019. It is continuing to grow at an unprecedented rate and is on track to grow by approximately 5,500 whole-time equivalents this year, which would be an increase of approximately 4% in just one year. To put it in context, the workforce grew by approximately 2,400 whole-time equivalents since the end of 2021.
I thank the Minister for his response. I am glad that he indicated his particular concern regarding the lack of adequate numbers of therapists to deal with children with additional needs or a disability. I have been engaging with the Minister of State, Deputy Rabbitte, on the problems in Cavan-Monaghan, the area I represent. The House recently dealt with legislation aimed at ensuring that children with additional needs get a placement in an appropriate setting in a school. All present are aware that, in many instances, delays in getting assessments for those children deprives them of an appropriate placement in a school. It is essential that assessments take place in a timely manner and that the follow-up treatments and therapies, if needed, are put in place at an early date. Many families are buying services. They cannot afford to do so but are doing it for the sake of their children. I cannot emphasise strongly enough the need to ensure that as many therapists as possible are recruited to reduce considerably the unacceptable delays that exist at present in places such as Cavan and Monaghan.
There are two groups specifically providing the service for children with disabilities. One is the community disability network teams through the progressing disability services strategy and the other is what we would consider to be normal primary care teams. The hundreds of vacant posts are in the area of progressing disability services. They are being filled but we need to do so as quickly as possible. As regards primary care, I am delighted to be able to say that we have sanctioned 3,500 staff across the country in enhanced community care programmes. More than 1,600 of them have now been recruited and over 500 more are at an advanced stage. Nearly 80% of the allocated new developments posts in CHO 1, which includes Cavan-Monaghan, the area represented by the Deputy, have been filled.
The recruitment in the Cavan-Monaghan area particularly relates to the enhanced community care programme, the launch of which I recently attended with the Minister at Cavan General Hospital in Lisdaran. I compliment Suzann O'Callaghan, the manager of the hospital, and Rose Mooney, the manager of services for the elderly in Cavan-Monaghan. They have put a great system in place there. The general hospital and services for the elderly are working together to bring as many services as possible nearer to home for people who need them. That is particularly beneficial for older persons. Good progress is being made in that regard.
As regards children with a disability, we have to ensure priority is attached to this issue. I have another question tabled on a related matter but I do not know if it will be reached. I have received representations that, as a country, we should be employing more therapy assistants. Apparently, that works very well in Britain. I know that is outside the remit of this question but it may be an area that should be given further consideration.
It is certainly something that can be examined. Many different areas, such as advanced practitioners in health and social care professional grades, are also being considered as well. We are looking into a lot of innovation in this regard.
To go back to the original question on international recruitment, we are supplementing the national workforce through international recruitment across several professions. The recruitment of doctors from overseas has long been a feature of HSE recruitment but, last year, in addition to doctors, approximately 1,000 nurses were recruited from the international market. So far this year, an additional 650 nurses have been recruited into posts in hospitals and community settings. There is a strong international recruitment campaign under way.
87. Deputy Michael Moynihan asked the Minister for Health if he intends to review the medical card assessment process for persons with disabilities; and if he will make a statement on the matter. [37502/22]
Does the Minister intend to carry out a review of the medical card assessment process for people with disabilities? What shape would such a review take?
Eligibility for a medical card is primarily based on a financial assessment in accordance with the Act of 1970. The issue of granting medical cards on the basis of illness or a disability was previously examined in 2014 by an expert panel on medical need and medical card eligibility. The panel concluded that it was not feasible, desirable or ethically justifiable to list medical conditions in priority order for medical card eligibility.
An example was where there was discussion around medical cards for cancer patients. The answer we got back was not to create a hierarchy of diseases, such as a cancer patient versus someone with motor neurone disease and so forth. That was not recommended in the 2014 report. However, since December 2018, the medical card earnings disregard for people in receipt of disability allowance was substantially increased from €120 to €427 per week. It applies to the assessment process for single people and to family assessments. This very significant policy change gave effect to the important recommendation of the Make Work Pay for People with Disabilities report. This substantial increase in allowable earnings acknowledges that a medical card is a particularly significant support and ensures that people with disabilities can continue to be supported to access care where needed. Furthermore people who have been on a disability payment for at least a year can retain a medical card for a further three years on return to work provided they were in receipt of the payment for a period of at least 12 months prior to commencing employment.
Week after week at the Joint Committee on Disability Matters, disability advocacy groups and people with disabilities come in. They constantly say that the medical card is gold for a person with a disability. It is hugely important that it is maintained. In some instances people with disabilities can get therapeutic work. They can earn extra income on top of the disability allowance. There is a stop in the system whereby people lose their disability benefits if they are able to get part-time work, which would have a huge impact on their lives and how they live their lives. The previous review was eight years ago. It is important that a review now takes place and we look at ensuring that someone who has a disability continues to have the medical card rather than lose it.
I fully agree that we should not have a situation where somebody with a disability can and wants to go to work, but if he or she does, he or she will go over the income threshold and thereby lose the medical card. We all appreciate how important it is, as the Deputy pointed out, particularly for people with disabilities to retain the medical card. In that regard, I will be happy to discuss it further with the Minister of State, Deputy Rabbitte. No doubt Deputy Moynihan will continue to do so as well. If there is a review and if there are specific barriers catching people in what traditionally would be viewed as a poverty trap, when going to work leaves them worse off, we need to make sure that going to work leaves them better off. Everybody, whether they have a disability or not, needs to be able to lead the fullest life possible. If there are such perverse incentives, we should certainly undertake a review.
In regard to the medical card, there is one other issue on disabilities. I do not wish to list the disabilities, but I refer to a person with a diagnosis of a lifelong disability and who got a medical card in his or her younger years. At some point, there is a review. The person's income has not changed as he or she is on disability, and probably will be for life. Documentation comes back and the person must submit again a letter from his or her GP or consultant outlining the specific diagnosis. The diagnosis is not going to change. There should be an in-built mechanism within the medical card system whereby if a person has a disability or a chronic illness that is life-changing and for life, that should be noted. Families should not be asked whether the person is still disabled or whether he or she still has a specific diagnosis. This happens and it is completely unjust.
I am reminded of a session I was at a few years ago in the audiovisual room where this was brought up. Parents of children gave testimony. They had been through awful things. One mother said she had been asked whether her child still had autism. We all understand that is not an appropriate question. It is quite a ridiculous question to ask. My understanding is that some of this arises when a child transitions to adult schemes. When the child turns 16, there is another process regarding adult payments and supports. Some of it may be linked to that. It is an issue of which the Minister of State, Deputy Rabbitte, is aware. No doubt she will be happy to engage further. If we can find ways to alleviate that, we should do so.
88. Deputy Gino Kenny asked the Minister for Health the steps that he has taken to ensure that an organisation (details supplied) is granted the pay parity with their laboratory colleagues that they have been seeking for 21 years; and if he will make a statement on the matter. [37645/22]
92. Deputy Bríd Smith asked the Minister for Health the progress that has been made in talks with laboratory workers who are members of an organisation (details supplied) to resolve their dispute; if he will be seeking additional funding to deal with historic issues of pay and conditions amongst these workers; the current number of vacancies among these grades in the health service; and if he will make a statement on the matter. [37685/22]
We saw during Covid-19, which is ongoing, the importance of laboratory scientists. A number of months ago those same laboratory scientists had to go on strike in relation to pay parity. What steps is the Minister taking to resolve this issue?
I propose to take Questions Nos. 88 and 92 together.
I thank Deputy Kenny for raising the issue. Like the Deputy, I respect and acknowledge the huge work the medical scientists have done and continue to do. Following the strike action on 18 May and 24 May, health management and the MLSA attended an exploratory engagement at the Labour Court on 25 May for the court to establish whether or how it might assist the parties in finding a resolution to the matters in dispute. Following engagement at the Labour Court, the parties agreed to reconvene at the Workplace Relations Commission, WRC, for a final engagement process. This process took place over a three-week period. Parties agreed that any outstanding issues which could not be resolved through the WRC process would be referred to the Labour Court for a final recommendation. During these talks an agreement was reached on a process to assess a claim it has had for 20 years. They have been looking for a resolution to this for 20 years.
As the Deputy will appreciate, because this is an ongoing industrial relations process, it would be inappropriate to discuss the funding of any outcomes that are yet to be determined. It is positive that the MLSA agreed to lift its strike action and that parties reached agreement on a process to assess the claim. I acknowledge the recruitment challenges in relation to medical scientists. The HSE aims to recruit 160 new medical scientist roles in 2022 and in each subsequent year. We are investing in and expanding this really important professional group. A recruitment campaign is planned along with other initiatives to address the various challenges that have been raised.
I welcome the fact a settlement may be possible in regard to the ongoing discussions. These laboratory scientists have waited for more than 20 years for pay parity. Some of their colleagues doing similar work have been paid about 8% more than them. They were very patient indeed. The strike was hugely popular, publicly. Obviously the laboratory scientists did not want to be on strike. They were compelled to go on strike because of that issue around equal pay for equal work. It is important that not only the pay issue is resolved but that so too are other issues to which I will allude in a supplementary question.
There were various parts to this. An assessment was done in regard to the grade and the following year that was changed as part of benchmarking which led to one of the anomalies. Another anomaly relates to medical laboratory aids. The medical laboratory aids were uplifted from band 2 to band 1 under a job evaluation scheme. This led to an anomaly whereby they were paid more than medical scientists in year 1, even though they are on a different level. In year 2 the anomaly rectifies itself. The medical scientists earn considerably more at every point of the scale thereafter. However, it is just one example of an anomaly which has caused real frustration and needs to be addressed as part of the ongoing discussions.
Hopefully, this anomaly can be resolved. The workers have been waiting a considerable amount of time. Another issue the laboratory scientists have touched on relates to vacant posts in the profession.
They said one in five posts are vacant. That is obviously worrying in the context of qualified staff such as those. Hopefully, those posts can be filled.
The Minister cannot predict what could happen with regard to the WRC talks, but they sound positive. Hopefully, the matter will be resolved and some of these posts will be filled as soon as possible. As we saw during the pandemic, front-line staff such as laboratory scientists are crucial. In fact, the Minister will have seen that when they went on strike.
There is a pressing need to hire a substantial number of additional medical scientists. The workforce stands at a little over 2,100 whole-time equivalents. However, the HSE has done an analysis of the numbers that need to be hired and projected a requirement to recruit nearly 400 this year because many replacement posts need to be filled. The HSE is estimating a need to hire 400 this year and 160 every year after that. The chief clinical officer, Dr. Henry, is leading a piece of work looking at the future direction of this. As we invest more in technologies as genetics and the various scientific disciplines come more to the fore, we will need to build out and continue to invest in the profession and in this workforce.
90. Deputy Donnchadh Ó Laoghaire asked the Minister for Health his plans to ensure that all positions within the children's disability network teams, CDNTS, are filled and that there are no staffing gaps. [37487/22]
On Question No. 90, I call Deputy Cullinane on behalf of Deputy Ó Laoghaire.
I am taking this question on behalf of an Teachta Ó Laoghaire. It relates to the resourcing of the CDNTs but, more specifically, the staff positions and the high numbers of vacant positions, and seeking an update on plans that have been or will be put in place to try and fill all of those vacant posts.
It is important to clarify the position on the reply to a parliamentary question that Deputy Ó Laoghaire received a number of weeks ago, which attracted many headlines. At the time, the Deputy referred to 714 vacant posts. Let us be clear that 555 of the posts in question are vacant. Some of that figure relates to people who are on maternity leave, a total of 120. The Deputy would have got the breakdown, but it is important to lay out the position.
On recruitment and the filling of those posts, in the context of workforce planning, we in the Department of Health are, in conjunction with the Minister and the HSE, putting a number of measures in place. First and foremost, we want to bolster the teams. How we plan on doing that is by looking at targeting international recruitment. This involves: national and international recruitment to the CDNTs being targeted; an apprenticeship programme for therapy grades; employment of graduates to therapy assistants as they await their CORU registration; and an expansion of the therapy assistant systems within the HSE. My colleague, Deputy Brendan Smith, explored the position regarding the latter earlier on.
We are also looking at the recruitment of behavioural therapists. Behavioural therapist is not currently a grade within the HSE. The executive is working through the plan of giving it a particular pay grade. We are training these therapists but we are not recruiting them. When one is looking at the spectrum within disability teams, it is important to have everything from occupational therapists to the physiotherapists. We also need to have behavioural therapists on those teams. We are looking at that model.
In the context of social care workers, we are looking at link workers as well. We are expanding the range of what should be within the team also to recruit into it. We are not only looking at a medical model; we are looking at a social model and a more holistic approach. Disability teams no longer need to look only at the medical aspect. We need to meet all the needs of all the children.
I accept that the number of vacant posts changes and fluctuates because people who are on maternity leave come back and because the HSE is constantly recruiting. However, I would be interested to hear what the accurate figure is. At a recent meeting of the Joint Committee on Children, Equality, Disability, Integration and Youth, we had a good discussion on all of these issues. We talked about the CDNT census, which identified 542.5 whole-time equivalent posts as being vacant at that point. In budget 2022, an additional 190 posts were funded. How many of the 542.5 posts that were identified in the census are still vacant and how many of the 190 additional posts are vacant? Maybe that figure can be given. What we really need to know is how we will fill those posts and what additional measures can be taken, in terms of international recruitment, domestic recruitment and other ways, to fill them.
If I was to talk specifically about what is happening around the CDNTs in the various CHOs, I would say that CHO 4 - if Deputy Ó Laoghaire was here I would have explained - is piloting recruitment within Ireland to the colleges. As they are exiting, they give them the opportunity and show them the attraction of work. One of our biggest challenges is the fact that in our CDNTs the population of clinicians is so low and we do not have a critical mass of clinicians. We are failing to grasp the opportunity to give that training on the ground. Perhaps next year, one of my plans is to work with the Department of Education on special education where the summer programme will give the opportunities for trainee therapists to have practical engagement so that they can build towards their CORU hours. That is a practical way we are looking to build on.
I thank the Minister of State. I would say to the Minister for Health as well that we need to increase training places in this area. Obviously, we need more of a pipeline of staff coming through.
I welcome that this is an area that was added to the critical skills lists as well in recent times, which means that international recruitment is now an option. The reply I received recently to a parliamentary question referred to a relocation payment that could be provided as well to entice some people to come here from abroad. That should not be a substitute for dealing with the many reasons why we have disparities in some of the teams because there are 16, 17 or 18 different providers of services. The HSE is the biggest provider for these teams but there are many section 38 and 39 organisations. There are pay parity issues at play which need to be resolved as well.
The HSE says it is looking at a sponsorship programme, an apprentice programme and other measures. All of those are needed. Everything that can be done should be done to fill those vacant posts because there are far too many hours which are not being delivered to the children.
91. Deputy Brian Stanley asked the Minister for Health if he will provide an update on the future of the 24-hour status of the accident and emergency unit in Portlaoise hospital given the situation regarding Navan hospital. [37480/22]
I want to raise with the Minister the issue of the emergency department in Portlaoise. As the Minister will be aware, the Dr. Susan O'Reilly plan, which was handed to me in October 2017, was to close the emergency department. That was put on the shelf. What is the current update on this because this is important for Laois and the surrounding counties?
I assure the Deputy that no plans have been presented to me and there has been no discussion with me about any considerations to downgrade any of the services currently in operation at the Midland Regional Hospital Portlaoise, including the emergency department. Since 2014, the focus has been on supporting the hospital to develop and enhance management capability, implement change required to address clinical service issues and incorporate the hospital into the governance structures of the Dublin Midlands Hospital Group. I am fully committed to ensuring that these efforts continue. The Deputy would agree that great progress has been made by the fantastic healthcare professionals we have working in Portlaoise hospital.
The budget for Portlaoise hospital this year is over €71 million. The Deputy will be happy to hear that is an 11% increase on the 2019 figure and nearly a 60% increase on the 2012 figure. There has been a very significant increase in funding. Staffing levels are now at 824 whole-time equivalents. To give the Deputy a sense of it, that is a 50% increase on 2014. If we go back to 2014 and ask what has happened in the past eight years, we have seen a very significant increase in funding in hospital and a 50% increase in the workforce in the hospital. That is a really clear statement of intent from Government that this hospital is a priority and ongoing investment in the hospital will remain a priority.
Furthermore, €20 million in capital investment is enabling the reconfiguration and extension of laboratory services and a new respiratory assessment unit, and more besides is going on at the hospital.
I thank the Minister for that reply. I acknowledge the investment and the increase in the budget. I lobbied the Minister and previous Ministers in regard to the respiratory assessment unit, the laboratory and other facilities. That is all positive and more than welcome in the area. I have no problem doing that and I always will.
The Dr. Susan O’Reilly plan is there and has been put on the shelf and no other plan has been presented. That is fair enough but a plan for the future is what we want to nail this down once and for all. There has been a significant population increase, according to the census, not just in Laois but also in surrounding counties, which affects the Laois accident and emergency service. There are two motorways and significant national primary routes and two massive prisons across the road. There is huge demand for the services and it is the second-busiest accident and emergency unit outside of Dublin.
In the context of Navan, we want to find out who is in charge. There are three Ministers present tonight for this discussion, which I welcome. What is the situation if the HSE says it wants to downgrade?
I give the Deputy the assurance in regard to Portlaoise that nothing has been brought to me and there has been no conversation with me in the past two years about anything in Portlaoise hospital other than ongoing investment. I am fully committed to investing in the services for the people in the area, investing in staff and investing in infrastructure. As we said, more than €20 million in capital spend has gone in over the past two to three years. I acknowledge the Deputy’s advocacy. I have had many conversations with the Minister of State, Deputy Sean Fleming, in this regard. There has been an expansion of services, including, as the Deputy will welcome, the new ambulatory gynaecological “see and treat” centre opening this month in the hospital. The impact that will have locally in the coming months and years will be very substantial.
I want the Minister to say the magic words that the future of the accident and emergency services are guaranteed in Portlaoise. I welcome all of the progress but the concern is a possible downgrade. We see the situation in Limerick and what happens when emergency departments are closed, as happened in Ennis and Nenagh. The problem is pushed on and is made worse, and it was made worse in Limerick. We do not want this happening in Laois.
The Minister is right about the networks and we agree with him on that. The networking that happened with the grouping of the hospitals is good and it has worked very well in maternity. All of the figures show that and the patients are telling us that, as well as the staff. I acknowledge the work of the staff and management, particularly Michael Knowles, the manager, for pushing for some of these improvements and capital investment. He has been instrumental in this regard.
We all agree there is not enough capacity in the system across the country. Portlaoise is very busy and we need to maintain the level of care that we have. It is not a parochial argument. I know we cannot have everything at every crossroads but this is a significant regional hospital and is the second-busiest accident and emergency unit outside Dublin. Along with welcoming all that has happened, which is good, I would love to have a statement from the Government that this is here to stay. That is what we want to hear.
On top of what I have already said, we can point to additional investment in the emergency department. For example, the nursing complement in the emergency department in Portlaoise, from post-pandemic to now, has increased from 28.5 whole-time equivalents to 36.5 whole-time equivalents, so not only is the service not being downgraded and not only have I had no conversations about that, in fact, if we look at the hard figures, what we see is that money is going in and services, including in the emergency department, are being increased.
They were under fierce pressure. One of my neighbours is an accident and emergency nurse.
I fully accept that. There is an emergency department plan being put in place for every hospital. There are pressures all over the country. The influx that has been caused by Covid is immense. As we were discussing earlier, May of this year is the highest year on record for attendances to emergency departments, and I emphasise that is in May. We are planning for the winter now.
96. Deputy Brendan Smith asked the Minister for Health if consideration is being given to the recruitment of additional therapy assistants in the delivery of healthcare services; if therapy assistants will have a role in the provision of healthcare services for persons with a disability, particularly in areas in which there are unacceptable delays at present; and if he will make a statement on the matter. [37494/22]
As I mentioned earlier, I have tabled this parliamentary question in the context of the shortage of occupational therapists, speech and language therapists and physiotherapists. My concern is about the delays in children getting assessments and follow-up treatment. I understand that in Britain much more extensive use is made of therapy assistants, not just in general hospitals but in the provision of services for children with a disability as well. I also understand that our colleges of further education provide necessary courses to enable people to gain those necessary skills or to upskill.
I thank the Deputy for giving me the chance to answer this question. He is right. Therapy assistants work with, and report to, therapy managers and children’s disability network managers, and work under the supervision and direction of nominated supervisors, as appropriate to the healthcare area and role. While a FETAC level 5 qualification or an equivalent qualification from another jurisdiction is desirable, some staff are employed in therapy assistant roles and are undertaking further training to develop therapy assistant skills and a FETAC level 5 qualification. As part of the ongoing development of the team, all staff, including healthcare and therapy assistants, should participate in ongoing training and development. Within HSE services, there are many ways that staff benefit from education and training from on-the-job learning and HSE courses.
On the question asked, there are opportunities for care assistants and therapy assistants to make up the complement of the teams within the disability network teams. In fact, what we want to do within our disability network teams is create a pathway for employment and career progression and training people on-the-job, coming in at a base level. It does not always have to be a senior clinician post and there are various opportunities along the way, and the therapy assistant post is one of those under consideration.
I very much welcome that response. The Minister of State will recall a meeting I attended, along with other colleagues, with the Minister of State and the Cavan Monaghan parents committee. One of the very strong demands they outlined that day was the need, due to the shortage of therapists, for the HSE to employ therapy assistants. The Minister of State took it upon herself at that meeting to follow up on this matter and I am very glad she is indicating to us tonight that there will be progress and that additional services will be provided.
Again, I cannot emphasise enough the desire of all of us to ensure that delays are eliminated in children getting assessments and follow-up treatment. On that day and at other meetings in counties Cavan and Monaghan, the Minister of State listened to the passion, concern and worry of many parents who are doing everything possible to give the best chance to children with a disability. Sadly, today, too many children do not get an appropriate school setting because of delays in getting assessments and treatment. Hopefully, that can be reversed.
As I said, it is a whole-of-Department of Health response and I am ably supported by the Minister, Deputy Stephen Donnelly, and the Minister of State, Deputy Butler, in trying to find those solutions and putting proposals to the Department of Health and the HSE to take this on board. That is why we met Paul Reid a number of weeks ago in terms of trying to redesign the progressing disability services, PDS, programme and that transition piece and the gaps that are there, trying to work it all out as to the various complements to ensure children get timely access to a service, to assessment and, most importantly, to intervention. This is about having the proper clinical oversight and support and supporting the therapy assistant levels, whether in psychology, in occupational therapy or in physiotherapy. We are totally open to that proposal.
The Minister of State in her introductory answer referred to on-the-job learning, continuous training and upskilling. I very much welcome that. There are a huge number of very talented people within the general health service who could benefit from upskilling and on-the-job training, and who would then be able to provide additional services to people and enhance the overall delivery of services. There would be a win for everybody, particularly for the people who need the services, who are the most important people in the discussions we have had here tonight with the Minister, Deputy Stephen Donnelly, and the Minister of State, Deputy Rabbitte.
There is a clear desire within the Government to ensure that all of our teams are filled. There is a clear desire among the Deputy’s colleagues in government to attract as many staff into the service as possible. It should not be just in urban areas and we need to ensure we can get staff out to rural areas. Creating a career pathway and ensuring people have the ability to engage with these teams, support the families and, most importantly, deliver intervention is what we want to achieve.
I thank the Ministers, Deputies and members of the House staff for their co-operation. Some 25 minutes later than scheduled, that concludes the day's business.
