Dáil Éireann debate -
Wednesday, 24 Jan 2024

Vol. 1048 No. 4

Saincheisteanna Tráthúla - Topical Issue Debate

Mental Health Services

Deputy Pa Daly

The Minister of State is familiar with the CAMHS disaster that occurred between 2016 and 2021. That is the identified period for which there was overprescription of medication and inappropriate care. Children experienced massive weight gain. Risperidone was nearly universally applied and prescribed for children. Lives were ruined. Following the identification of some of the issues involved, the Maskey report was established. Following Maskey, a redress scheme was put in place to deal with children who were under the care of a particular doctor. However, the scheme is quite limited in that it deals with patients who were treated in south Kerry between 1 July 2016 and 19 April 2021.

There is a fundamental unfairness in who is allowed into the scheme and who is excluded from it. The Minister of State probably has the exact figures, but there are an awful lot of children and parents who have received apologies for the treatment, or lack thereof, in its care in the Kerry region. Anybody who was treated in north Kerry who had the exact same difficulties as people who have been identified by Maskey are not included in this scheme and cannot access it. In addition, some patients in south Kerry whose treatment may have commenced prior to 1 July 2016 are also excluded from the scheme.

What are the benefits of the scheme? One can avoid a lengthy and expensive civil litigation route. One is provided with €10,000 upfront in order to pay for medical reports that can often cost up to €3,500. It is only fair that the scheme be extended to all patients or former patients who have received the letters of apology so that they can avoid having to pay large sums of money, because it is an obstacle to justice for those people who the HSE has written to and apologised that their treatment was lacking and did not match the required standard of care that these people deserve.

It has been a long road for them. Following Maskey, they were waiting a long time for various audits and other procedures to be established. They feel they have been strung along a bit. If any cohort of patients in this country now deserves a break and quick access to justice, it is them. Where apologies have already been received and when, in effect, there has been an admission of liability, why not save the State some money while providing easier access to justice for these people by extending the scheme so they can be included in it?

Minister of State at the Department of Health (Deputy Mary Butler)

I thank the Deputy for raising this important issue. The independent report of the lookback review into child and adolescent mental health services, CAMHS, in south Kerry was published on 26 January 2022. This examined the files of everyone who received care from south Kerry CAMHS between 1 July 2016 and 19 April 2021, which is a five-year span.

Almost 1,500 children and young people were identified by Maskey as falling within the relevant time periods and requiring further review. No extreme or catastrophic harm occurred in 1,332 cases considered between July 2016 and April 2021. However, 240 young people did not receive the standard of care they should have received from CAMHS. Some 46 children, as the Deputy knows, had significant harm caused to them, and that number is subject to change.

In April 2022, the Government announced a non-adversarial compensation scheme, of which the "non-adverserial" piece is very important. As the Deputy knows, we turned this around in 11 weeks. I felt it was important that it be done quickly due to the level of the situation, the fact that so many children were harmed and the upset and distress it caused. We put in place a scheme to provide full compensation and clinical supports, if required, to those who suffered harm or injury as identified under the Maskey report. This also included, as agreed under the scheme, provision for some upfront payments to meet certain costs initially incurred by those eligible.

To qualify to receive compensation, patients must have suffered harm or injury while attending Kerry CAMHS from 1 July 2016 to 19 April 2021, be identified as being affected by the events outlined in the Maskey report and have been notified by CAMHS. Anyone who does not meet these criteria is free to pursue a case separately with the HSE.

It is important that the Maskey report notes there is no definitive number of people who suffered harm. Therefore, further evidence of levels of harm may be found and therefore the number of people eligible for the scheme may change.

That is the really important piece. In December 2022, the HSE confirmed that a file identification process in north Kerry was complete. The process involved the examination of files where the NCHD1, that is the person we had in south Kerry, was involved in care at any level. The outcome of this review was that an additional 25 children have suffered an adverse outcome. As the incidents involved NCHD1 and as these cases were identified as a continuation of the Maskey investigation into Kerry CAMHS, these additional cases fulfilled the criteria of the compensation scheme.

Separately, an audit of 50 sample files in north Kerry has also taken place to provide assurances around CAMHS in north Kerry. This was a broader random audit of CAMHS beyond the scope of the NCHD1 files originally identified. This file audit was not referenced within the original Maskey report and therefore sits outside the State compensation scheme arising from the Maskey report. The audit highlighted 16 cases of concern including some relating to prescribing practices and some clinical concerns about the professional practice of a clinician. Where concerns were raised by the audit team immediate contact was made with the families. The HSE took immediate action on the result of the files audit by setting up a look-back review similar to what happened in south Kerry to examine the files of anyone currently under the care of north Kerry CAMHS. A senior clinician, supported by a team of CAMHS consultants, has been appointed to lead this review which commenced in June 2023 and will be completed in due course. I will come back then.

Deputy Pa Daly

I thank the Minister of State for the reply. I accept it was acknowledged that 240 people did not receive an adequate standard of care. The problem is that anyone who does not meet these criteria, as the Minister of State said in the reply, is free to pursue a case separately with the HSE.

An example of what we are dealing with in north Kerry in particular is the case of one young fellow who was a talented footballer, who had a social anxiety that was the most serious, was prescribed with Risperidone. He put on four or five stone. He was a talented footballer but he hardly leaves his room now. His life has been ruined. He is in his late 20s. He has lost contact with all of his peers. That is a case which is not included as part of the scheme. It is hard to understand why it cannot be.

I know there was a small audit of 50 sample files. I was arguing that there should be a full review of all files. Some 16 out of 50 cases of concern have been identified but not all of those are included in the scheme. Why not save the State some money and expand the scheme and allow these people who have been wronged by the State - the State has been seriously negligent in their treatment - quicker access to justice? This is coming from the patients. It also comes from their legal representatives who feel that it would be much easier where an apology is issued and an admission of liability has been made, to get them into the scheme as soon as possible. These people are still dealing with the lasting physical effects of the treatment. It is an ongoing problem and they just do not need the extra hassle of a long civil litigation process.

Deputy Mary Butler

I accept everything Deputy Daly has said. He said it in good faith. People, families, children and young people have been through enough. This is not to say that the scheme in question is limited. The current situation where people from south Kerry were allowed into scheme occurred because we did a random sample audit of 50 files, then we did a complete look back over that five year period. That look back is now happening in north Kerry. As soon as we have the results from north Kerry, I expect more children to be eligible for the scheme.

Importantly, I also point out that as evidenced by the additional eligible children in north Kerry who have already been accepted into the scheme, any further appropriate cases in Kerry recommended by the HSE will be given full consideration by the State Claims Agency. Aside from the inclusion of such individual eligible cases it is not intended there will be any fundamental change to the compensation scheme introduced by the Government relating to the Maskey report, that is, the terms of reference of it. However, when we get the results of the north Kerry full look back currently being conducted I expect that more people will be eligible for the scheme.

In regard to the scheme, the latest information available to me is that 176 applications to the scheme have taken place with initial payments made. In regard to settlements, 23 mediations have taken place to date, of which 18 have been successfully resolved and others are ongoing. The Department, in conjunction with the HSE, continues to closely monitor developments in relation to CAMHS in north Kerry including any evolving issues in relation to the State Claims Agency compensation scheme.

As I already indicated, it is open to anyone to take a case privately but as the Deputy said, it is a non-adversarial scheme. It is good that so many people have decided to take up the scheme without going through that adversarial process. The scheme is not closed and we have to await the outcome of north Kerry.

Deputy Pa Daly

When will that look back be finished?

Deputy Mary Butler

It is currently under way. I hope to have it at the end of the first quarter of this year.

Sports Facilities

Deputy Gary Gannon

I thank the Minister of State, Deputy Malcolm Noonan, for being present for this Topical Issue. This is an issue I raised previously and it has still not been addressed. Frankly, ostensibly it should be a Dublin City Council issue but in the absence of actions I have been forced to bring it to the Chamber once again. I believe I raised it with the Minister of State, Deputy Noonan.

Sheriff YC in the north inner city is a football team that caters to some of the most vulnerable children in the area. It provides leadership, an outlet and at this present moment it is operating without any pitches. We are talking about at least 60 or 70 kids who every single weekend have had their games called off.

To give some context, in November the pitches on which they previously played on Alfie Byrne Road were destroyed as a consequence of a half marathon that was organised by a different group. It was organised I think by Clontarf running club and sponsored by Joe Duffy motors. The start and end point of that took place literally on the children's pitch. It destroyed the pitch. Nobody could have foreseen that would happen but it should have been addressed. Dublin City Council made a commitment that it would be. However, up till this point it has not. That pitch remains unplayable. East Wall use the pitches also.

Sheriff YC also plays in Fairview park. Clontarf cycle lane is being built and as a consequence of that the railings around Fairview park have been taken down by Dublin City Council to facilitate the works. In January this year a stolen car was able to penetrate the railings of Fairview park, go up and skid all over the pitches of Sheriff YC, East Wall and Marino. It absolutely obliterated them. Therefore, the pitches they previously had on Alfie Byrne Road are gone and the other pitches in Fairview park have now been destroyed. That means in the north inner city, children who play for Sheriff YC, East Wall and Marino and a couple of other clubs, have absolutely nowhere to play their games.

This has been relayed to Dublin City Council on a number of occasions. Its response was that the pitch experienced superficial damage. The children who will not be playing this weekend, last weekend or next weekend, do not consider the damage to be in any way superficial because it prohibits them from playing the sport they love. The club has been forced to book pitches in the Athletic Union League, AUL, complex but that is at an astronomical cost and is not being covered by Dublin City Council. It should be.

Dublin City Council made commitments to Sheriff YC initially that it would source alternative pitches on Clontarf astroturf which is operated by Dublin City Council. To date however, that has not materialised. Sheriff YC has engaged with the astroturf facility and has been told that Dublin City Council made one phonecall but the pitches are booked out. I am left in a dilemma. I am advocating to Dublin City Council but I have no remit to Dublin City Council. It does not have to respond to me and it has not. Therefore I am taking this issue into the Chamber. It should not be dealt with here but we are desperate.

I appreciate the Minister of State, Deputy Noonan, is stepping in for the Minister of State, Deputy Thomas Byrne. I need the Minister of State with responsibility for sports to intervene here because we are trying desperately to give children an outlet in the north inner city for all sorts of reasons. The connection they have to those clubs is invaluable. The work done by Sheriff YC is honestly incredible. I am a beneficiary of it myself. More to the point, every Saturday and Sunday morning those pitches were used twice a week by the kids, their families and everybody. They are not now and games are being called off. If they lose that connection we will suffer and the kids will suffer for it. It is becoming urgent. I ask the Minister of State to intervene.

Minister of State at the Department of Housing, Local Government and Heritage (Deputy Malcolm Noonan)

I am taking the matter on behalf of the Minister of State, Deputy Thomas Byrne, who has noted with dismay the reports of recent vandalism and damage to the sports facilities in Dublin.

I saw some of the reporting on it myself. It was more than superficial damage, from my view of it. I cannot stress enough the importance and value of such facilities to local communities.

The maintenance and management of the sports facilities of Dublin City Council is a matter for the local authority. The Department has been informed by DCC that the regime of annual pitch improvement works carried out over the past few years has improved the resilience of the playing surfaces to, and acted to protect the pitches from, excessive damage when recently vandalised. DCC also confirms that a sports turf contractor was engaged to carry out works last week, which has improved the surface and ameliorated much of the damage. That is welcome.

Increasing the level of participation in sport and physical activity across the whole population is a fundamental aim of the Government's National Sports Policy 2018-2027 and a priority for the Minister, Deputy Martin, and the Minister of State, Deputy Byrne. In pursuit of that objective, the Government is committed to a "sport for all" approach aimed at ensuring that all persons have the opportunity to partake equally in sport and physical activity, regardless of gender, age, social-economic status, disability or membership of minority groups such as the LGBTI+ community, the Traveller community or other ethnic minorities.

The Dormant Accounts Fund sports programme is the primary funding stream deployed exclusively to promote increased sports participation among disadvantaged communities and people with a disability. This programme provides financial supports to a wide range of locally inspired community projects undertaken by local sports clubs, associations and other interested parties generally, under the active guidance of the 29 local sports partnerships around the country.

The sports capital and equipment programme is the primary vehicle for Government support for the development of sports and recreation facilities and the purchase of non-personal sports equipment throughout the country. Over 13,000 projects have now benefited from sports capital funding since 1998, bringing the total allocations in that time to over €1.15 billion. We all agree that the SCEP has transformed the sporting landscape with improved facilities in every town and village in the country. The programme for Government commits to continuing the SCEP and to targeting the investment in disadvantaged areas. As well as being open to individual sports clubs, applications are accepted from local authorities. Dublin City Council has previously received significant grant funding for sports facilities projects, including sports pitches used by football clubs. The maximum grant available under the SCEP has been increased to €500,000. The latest round of the SCEP closed for applications on Friday, 8 September 2023. A preliminary examination of the submitted applications demonstrates that the programme has again generated a very large number of applications. The total number of 3,210 applications exceeded the record number submitted in the previous round. This includes ten applications from Dublin City Council, which is welcome.

The scoring assessment and assessment manual for the 2023 round has been finalised and published along with the full list of applications received by county, including the relevant sport type for each application received. The detailed assessment work has commenced, and it is planned to assess the "equipment-only" applications first and announce those grants in the coming months. Work will then commence on assessing the capital applications, with allocations likely to be announced later in 2024.

Any application for funding will be considered on its merits, based on the agreed scoring system. As the Deputy will be aware, the schemes favour projects that will increase participation and sharing of facilities among a number of sports and clubs, and priority is always given to applications from disadvantaged areas. The criterion the Deputy spoke about of the clubs all sharing these grounds is critical. As he said, many of the young people participating are from disadvantaged backgrounds. Again, what happened is very unfortunate. It constitutes criminal damage to the grounds, which is a disgrace. The work DCC has done is helping to build that resilience in pitches so they can be repaired more easily.

Deputy Gary Gannon

I thank the Minister of State for his response. Dublin City Council has done a lot of great work around the north inner city and the city more generally - there is no disputing that - but there has been an omission in respect of soccer pitches for predominantly working-class kids in and around the city centre. There is no 11-a-side pitch in the north inner city at all. There is an AstroTurf facility in Grangegorman. It is extraordinarily expensive, at €190 per game. There is the AUL Complex, where there are similar expenses.

The pitch was destroyed; it will not be possible to use it. It is not the first time vandalism has taken place on the pitch. In this instance Dublin City Council took down the gate. There was negligence involved on its part in not preserving the environment. I just want the pitches finished. I appreciate that nothing can happen overnight. There is a Taoiseach's task force specifically set up for the north inner city that has allocated a significant amount of funds, but that has not materialised in terms of sporting infrastructure, and not enough of an emphasis has been placed on that.

What I will convey to the Minister of State, Deputy Noonan, to the Minister of State, Deputy Byrne, and, if I must, to the Taoiseach is that we cannot lose these kids from sport. For the young boys and girls who play there, it is a discipline they are getting. It is a social outlet twice during the week and then on the weekend, and we need that to stay there. At a minimum, I would like to see the office of the Minister of State, Deputy Byrne, engage with the clubs themselves. I may potentially bring together a meeting between the clubs and Dublin City Council. I do not even need to be in the room for that meeting. We must find some outlet by which those kids can play football - home games - this weekend or next. If it is the case that Sheriff YC has to source alternative AstroTurf accommodation for their home games, that will mean an increase in subs for the kids, and many of those kids are living in varying degrees of poverty. They cannot afford the extra tenner or fiver that may come with that. Two kids on the team are brother and sister. The families will in no way be able to meet their costs, and Sheriff YC is certainly not carrying the cash either. May we please just agree that the Minister of State, Deputy Byrne, will engage with the clubs and the city council and find some degree of resolution? I thank the Minister of State, Deputy Noonan, for his response.

Deputy Malcolm Noonan

The Deputy has made a good suggestion. I will take it back to the Minister of State, Deputy Byrne. Critically, it would be important that DCC would engage with the clubs and try to find a solution, particularly when incidents such as this occur because they can leave a pitch unplayable for quite some time. The capital grants I spoke about will allow the works to be carried out on these pitches to make them playable. It can be quite significant to get drainage and all those issues resolved. It is really unfortunate. Okay, one of the incidents the Deputy spoke about was unavoidable, but the second incident, of which I saw reports, was terrible. The pitch was ploughed up to a point where it will make it very difficult. Thankfully, the remedial works the council has carried out will help. It is critical, when significant funding is going into the capital programme, that there is an opportunity for clubs to share facilities around Dublin city. That is what they are there for. DCC should engage on that as a starting point, but I will take the Deputy's comments back to the Minister of State, Deputy Byrne, to see if there is an opportunity for him to intervene as well.

Road Projects

Deputy Frankie Feighan

I thank the Minister of State, Deputy Noonan, for coming to Sligo last Friday. His trip was very informative and welcome. I also thank him for taking this Topical Issue on the community involvement scheme. The House, especially those of us who were members of our local authorities before being Members of the Oireachtas, will be aware that the CIS was fully embraced and taken up by many people living in rural communities. The scheme involves residents living around a section of public road putting forward that road under the scheme and paying a contribution of 10% towards the cost of resurfacing the road. Usually, the road selected sees a limited amount of public traffic and is not what the local authority calls "of strategic importance". In other words, it is not a road between two villages or towns. Nevertheless it is a public road and not a private road.

Over the past few years, funding under the CIS has been reduced by the Department of Transport. Many members of local authorities are disappointed by this trend and believe we should review the allocations under the 2024 roads funding to local authorities, which is due out in the next five or six weeks. We are all aware of the success of the local improvement scheme, which has received significant funding for private lanes. Funding has come from the Department of the Minister, Heather Humphreys, but we need more money from the Department of Transport. Last year, €30 million went to local authorities under the LIS, and now the scheme is fully subscribed, with a long waiting list. It is now time a similar funding budget was put forward for the CIS. Under the LIS we have done our bit, but we need to start a fund for some of these very important rural initiatives.

The CIS deals with public roads, roads programmes and schemes that are unable to proceed because of the demand to deal with other public roads with greater volumes of traffic.

In Sligo, Leitrim, Roscommon, Donegal and many other counties, engineers acknowledge the success of the scheme in completing so many rural roads. Now, with a lot of money in the country, it is time funding was restored to allow the CIS to be rolled out across local authorities for the benefit of many people living in rural communities on small public roads.

Deputy Malcolm Noonan

Gabhaim buíochas leis an Teachta as an gceist seo a ardú. I thank the Deputy for bringing the question forward. We were wandering the roads of Sligo together last Friday. I thank him for the hospitality shown to me last week.

I understand the Deputy’s question relates to the community involvement scheme which provides financial assistance to local communities for repairs and maintenance of local roads. As Deputy Feighan is aware and as outlined in the national development plan, the Government is strongly committed to protecting the existing regional and local road network. This network is fundamental for connecting people and places across the country. It facilitates business, education, tourism, healthcare, agriculture and the provision of critical services and activities. The network requires significant annual funding to ensure it remains fit for purpose, safe and resilient to the impact of additional factors such as climate change. As such, €626 million was allocated to regional and local road grants in 2023, with approximately 90% of this funding directed towards maintenance and renewal works. The regional and local road grants support local authorities in fulfilling their statutory responsibilities under the Roads Act 1993 to improve and maintain regional and local roads. The grants are provided to supplement local authorities' own resources, with each local authority responsible for selecting and prioritising road works within their regions and for managing their own budgets.

Ireland's regional and local road network spans over 96,000 km comprising almost 83,000 km of local roads. Due to the vast scale of the network, in 2018 the Department of Transport introduced ring-fenced funding for a community involvement scheme with the aim of facilitating local community participation in the repair of local roads. The primary focus of the programme is the repair of more lightly trafficked public roads which might not be high on the list of a local authority's annual roadwork programme. Since its introduction, the scheme has generated significant interest and has been used to support a variety of works including surface dressing projects, strengthening works, repair of potholes and drainage works. A condition of funding is that the local community must contribute towards the road project either with a monetary contribution or a contribution in kind, for example, by making labour or machinery available. Community contributions of at least 10% for monetary contributions or 20% for works contributions are required under the scheme. Typically, community work contributions involve activities such as providing hard stands at field entrances, removing grass verges, pothole repairs and the repair and construction of footpaths. In order to allow for sufficient planning and applications for the scheme, local authorities are invited to apply for funding for community involvement scheme projects for a two-year programme, with the latest round of applications received in 2023 for the 2024 to 2025 period. Within the overall budget available for the CIS grant programme over the two-year period, local authorities are allocated funding on a pro rata basis unless an individual authority has sought less than the pro rata amount.

At this point, it is important to highlight that the Department has maintained a relatively constant level of funding for the scheme throughout its life span. On average, €28.33 million has been allocated to the scheme for each two-year programme. In the 2022 to 2023 programme, €28.48 million was allocated. Allocations for the 2024 to 2025 period are currently being finalised and are expected to be announced in the coming weeks.

In summary, the Minister of Transport recognises the importance of the community involvement scheme to allow communities to access funds for repairs of more lightly trafficked public roads which might not be high on the list of a local authority's annual roadwork programme. In 2024, the Minister of Transport is committed to continuing support for the community involvement scheme, where possible from within resources available.

Deputy Frankie Feighan

I thank the Minister of State. I am happy that the Minister recognises the importance of the community involvement scheme and that it allows communities to access funds for repairs of more lightly trafficked public roads. I hope the upcoming budget will be more committed to continuously supporting the community involvement scheme because it is important. It is about residents living around rural sections of public roads so that those roads can be maintained and improved. I would like to see more funding for the community involvement scheme and a model that mirrors the local improvement scheme because it has been a huge success. As the Minister of State knows, living in rural Ireland, roads, particularly in rural areas, need as much assistance and upkeep as possible.

Deputy Malcolm Noonan

As I recall from my time on a local authority, the LIS similarly was always oversubscribed. There are very good schemes just like the CIS. Given the scale of our rural roads network, demand will always exceed supply. We understand that the road network suffers deterioration over time and these impacts are felt by communities especially on more lightly trafficked public roads that serve local areas. In some instances, local authorities may not be able to fund regular maintenance on these routes from within their annual roadwork programme. For this reason, the Department of Transport established and continues to fund the community involvement scheme. It is an innovative scheme that builds on the success of what was previously the LIS. The scheme facilitates local community participation in the repair and maintenance of local roads in collaboration with local authorities. I take on board the points the Deputy made. Projects in his constituency such as the Old Bog Road in Wardhouse, Drumcollip in Mohill and Kilfree in Gurteen were funded under this scheme. These projects have been beneficial to local rural communities. The 2024 regional and local roads programmes will be finalised and associated funding supports will be allocated shortly, taking into account the budget available. The objective is to allocate funding to eligible local authorities on as equitable a basis as possible, keeping protection and the renewal of the road network to the fore. Included in this programme will be the allocation for the community involvement scheme for each county. We will await the allocation and hopefully it will be good news for local authorities throughout the country.

An Leas-Cheann Comhairle

There is one Topical Issue remaining. The Minister of State is here. We have taken three Topical Issues and, unfortunately, we cannot take the fourth so I will suspend the House.