Seanad Éireann debate -
Tuesday, 28 Mar 2006

Vol. 183 No. 4

Adjournment Matters.

Health Services.

Mr. U. Burke

I welcome the Minister of State at the Department of Health and Children, Deputy Tim O'Malley. The matter concerns the need for the Tánaiste and Minister for Health and Children, Deputy Harney, to intervene with the western health executive to appoint a school dentist in Portiuncula Hospital, Ballinasloe, where there are 24 national schools in the area without a dental service for the past three months. That is a reasonable request.

A quick look at the history of the dental service in the schools in east Galway will clarify the urgent need and the poor service provided to the schoolgoing children in the area. On 20 January 2006 the dentist in that area resigned, having been appointed on 28 April 2005. By coincidence I raised on the Adjournment that he be appointed at that time. He was appointed to provide a two-day per week service to the 24 national schools. Approximately 1,500 students in the catchment area were served by that dentist. Since 20 January 2006 an emergency service operates three days per month. It responds only in the case of an emergency, that is, when somebody is in exceptional pain.

In the last days of December 2005 the dental practitioner for County Galway also resigned. Neither of those posts have been advertised in the meantime. It is time the Minister of State and the Tánaiste and Minister for Health and Children intervened in order that children in the area be provided with a proper dental service. It is unbelievable that such primary care is not provided at an early stage for children. There have been many campaigns and much money has been spent on promoting dental care, particularly among the young. Given the response of the Health Service Executive it is appropriate that the Minister of State and the Tánaiste intervene to ensure a proper service is provided for children in the 24 national schools in east Galway, from Ballinasloe to Portumna.

Given that the Health Service Executive cannot hold on to these appointments something must be wrong. In the past we were told we could not get orthodontists in the west. The position now is that we cannot retain dental practitioners. Hence the region has had a stop-go service for the past six years. It has had a dental service for a short period which, until recently, only operated two days per week. That is not good enough. The backlog means that many children have serious dental problems and nothing is being done for them. I look forward to a positive response.

Minister of State at the Department of Health and Children (Mr. T. O’Malley)

The Health Act 2004 provided for the Health Service Executive, which was established on 1 January 2005. Under the Act, the executive has the responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. This includes the delivery of school dental services. Nonetheless, I am happy to set out the position as regards the development of policy in this area, as well as to convey the information provided by the Health Service Executive on the specific question raised by the Senator.

At present children in specific classes in national school, usually second, fourth and sixth class, are targeted for preventive measures under the school-based approach. The children in these classes are screened and referred for treatment as necessary. The programme has been specifically designed to ensure that children are dentally fit before they leave national school. The screening provided in second, fourth and sixth classes ensures that follow up appointments for examination, treatment or orthodontic review are made, as necessary, with the dental surgeon in the clinic designated for the particular school.

The Health (Amendment) Act 1994 amended the Health Act 1970. The regulations made under this Act — the Health (Dental Services for Children) Regulations 2000 — extended eligibility for free primary dental care to all children under 16 years of age, who have attended national school. Additional funding of over €5 million has been provided to the health service for this extension of eligibility.

The Department of Health and Children has been informed by the Health Service Executive that the vacancy arose at the dental clinic at Portiuncula Hospital, Ballinasloe, when the dentist working there moved away. Furthermore, the Department has been informed that the dental department of the Health Service Executive, western area, has a policy to recruit dentists wherever and whenever a vacancy arises. At present the Health Service Executive, western area, is pursuing a recruitment campaign in respect of vacant dental posts, including the post in Ballinasloe. In the meantime there is provision in the western area of the Health Service Executive for emergency treatment for all children under 16 years of age to be available where required.

There are ten dental teams delivering the school screening services in the Galway area of the Health Service Executive and it is inevitable that vacancies will arise from time to time. I am satisfied, based on the information provided by the Health Service Executive, that where such vacancies arise the process of recruitment is initiated in a timely manner.

Mr. U. Burke

Will the posts be advertised?

Mr. T. O’Malley

I am told by the HSE that it is in the process of recruitment and it is possible that it is drawing up the recruitment advertisements. I do not know whether the advertisements have been placed but that is my understanding of the situation.

Mr. U. Burke

So an appointment will be made.

Mr. T. O’Malley

Yes.

Mr. Feighan

I welcome the Minister of State to the House. I raise the very serious issue of the provision of a new health centre in Keadue, Boyle, County Roscommon. I speak on behalf of people in the area who want to establish a new health centre in Keadue. The premises from which the health centre currently operates is in a very poor state of repair and is inadequate to provide the full service to the outpatient population base. The area has grown extensively in recent years and a health centre that can deliver the various practices in an area is essential.

The centre urgently needs to employ a practice nurse. It is trying to run specialist asthma and diabetic clinics from a room measuring 5 ft. by 11 ft. It is the only spare room the centre has in the premises and at peak times there is a need to have an extra room. Unfortunately, because there is no extra room, the public health nurse is unable to attend and, in addition, the psychiatric service was withdrawn. The public health nurse cannot hold development clinics for children. We would very much appreciate funding or even a timeframe for the allocation of funding to ensure this problem will be rectified and a new health centre provided in Keadue, Boyle, County Roscommon.

Keadue is equidistant from Carrick-on-Shannon, Drumshanbo and Boyle. It is in the parish of Kilronan, which includes Arigna and Ballyfarnon. It is a growing area and I hope the Minister has a positive reply to ensure the issue of this health centre would be dealt with.

Mr. T. O’Malley

I thank Senator Feighan for raising this matter and I am happy to have the opportunity to respond.

The question of the provision of health centres is the responsibility of the Health Service Executive under the Health Act 2004. The role of the Department of Health and Children in regard to capital is to monitor and evaluate the executive's capital programme overall and to ensure that the programme, under the multi-annual capital investment framework, is in line with service priorities and policy objectives.

The approval of the capital programme of the executive is the responsibility of the Tánaiste. The HSE has informed the Department that a priority list for health centre developments in County Roscommon has been drawn up and that, following consideration of the populations to be served and the staff to be accommodated in each location, Keadue has been placed fourth on that list.

The HSE is currently examining all such proposals from around the country in the context of available capital funding for 2006 and future years. It is therefore a matter for the executive to progress this particular proposal in the context of its overall capital programme.

The national strategy, Primary Care: A New Direction, is the roadmap for the future development of primary care services in Ireland, both as the appropriate service for the delivery of the majority of people's health and social care needs and to complement the services provided by acute hospitals. Up to 95% of people's health care and social services needs can be met in a primary care setting.

At the heart of the strategy is the aim of developing services in the community to give people direct access to integrated multidisciplinary teams of general practitioners, nurses, therapists, health care assistants, home helps and others. The strategy is also about the reorientation of existing resources to develop new ways for clinicians and other professionals to work together to provide more accessible primary care services to people in their own communities.

In order to support the further development of primary care services in 2006, additional revenue funding of €16 million has been provided. Of this, €10 million has been earmarked for the development of primary care teams. The objective is to establish between 75 and 100 primary care teams to include 300 additional frontline posts. The HSE has indicated that funding will be targeted to provide the potential for each local health office to establish and enhance up to three primary care teams.

I understand each local health office will identify local opportunities in partnership with general practitioners and other stakeholders. The focus will be on creating a critical mass of primary care professionals — GPs and their support staff, nursing and other professional staff — who will work within a primary care team model in line with the national strategy. This approach is a very effective way of harnessing the significant existing capacity in our community services, and supplementing this important resource with new additional staff. I am sure the Senator will welcome this investment.

Garda Deployment.

Mr. Kenneally

I thank the Cathaoirleach for allowing me to raise this matter on the Adjournment and the Minister of State, Deputy Tim O'Malley, for coming to the House to take it.

The proposal I put forward is self-explanatory. There is a problem with gardaí doing clerical work in that they are not doing what they were trained to do. We send them to Templemore for 18 months or two years; I am not sure about the period of training. If we wanted them to work in offices we could send them to secretarial school. We have talked for many years about putting gardaí on the street and employing civilian staff to carry out the duties in the various Garda stations.

I have spoken to senior gardaí both in Waterford city and county and it is my understanding that because of the Civil Service embargo, they have a problem in recruiting the additional clerical staff they currently need. They are trying to minimise, as much as possible, tying up gardaí with clerical work but it is causing its own difficulties. They can get somebody from FÁS or elsewhere on a temporary basis, perhaps for nine or ten months. That person is trained to a certain extent but he or she must then move on. If they are fortunate enough they may get somebody else but again that will be somebody who does not know the system, which is not satisfactory.

I understand that under current legislation the statements gardaí take must be provided in advance in writing to those involved in various court proceedings. Many of those statements are sent in handwritten form. They are handwritten by the gardaí and obviously that is not satisfactory. The Minister may not be able to read my writing and I may be unable to read the Minister's, and God knows what could be lost in the translation. Other work is backing up as a result of that. This is happening at a time when Garda numbers are on the rise, on which I commend the Government. They appeared to stagnate somewhat in the mid-1990s but they have risen steadily since then. The Minister for Justice, Equality and Law Reform promised to increase the strength of the Garda to 14,000. He is living up to that promise because at the end of this year, between gardaí who are fully attested and those in training, there will be 14,000 gardaí on the streets, which everybody will welcome.

On that, I commend the chief superintendent in the Waterford-Kilkenny division on what he has done in the past day or two. In Waterford city he has increased the number of community gardaí by six. There are now two sergeants and 12 gardaí assigned to community policing. That has been warmly welcomed because everybody wants to see more gardaí on the street. All Members believe that greater contact with the public will lead to benefits to all in future. There are disadvantages in other respects. It is entirely a matter for the Commissioner, and not a matter for the Minister or the Government, as to where gardaí are deployed. However, Stradbally, which is a village in County Waterford, lost a garda on the retirement of the incumbent. He has not been replaced despite the fact that the village is close to Dungarvan and is growing considerably. This is an example of the frustrations which exist.

I firmly believe that it would help if some gardaí could be freed from clerical duties. I am told this can be done and has been done in other areas, where one can get a derogation or permission to take on additional clerical staff. Perhaps the Garda authorities could conduct an exercise to demonstrate that the acquisition of a given number of additional clerical staff would facilitate the deployment of extra gardaí, whatever the number might be, on the streets. This might be a useful exercise and perhaps everyone could live with it. It could be a sensible way to move forward. Perhaps the Minister might examine this possibility.

Mr. T. O’Malley

I thank Senator Kenneally for raising this matter on the Adjournment. Unfortunately, the Minister for Justice, Equality and Law Reform is unable to be present. However, on his behalf, I am delighted to take this opportunity to clarify matters regarding clerical recruitment for the Senator and to inform him of the substantial progress that has been made by the Government in increasing the civilian and other staffing resources available to the Garda Síochána.

As the Senator may be aware, at present 1,857 civilians are employed in the Garda Síochána, which works out at almost 13% of total staff. This figure includes approximately 1,000 staff carrying out clerical and administrative duties, as well as 49 staff employed in professional and technical areas such as financial accounting, information technology, teaching, nursing, research, and human resources. The remainder are employed on general duties as traffic wardens, cleaners, services attendants and general operatives.

At present, the equivalent of 42 civilian posts are vacant within the Garda Síochána. Of these, just 15 posts are at clerical officer or staff officer level, with the remainder in professional, technical and general services grades. At any point in time, there will be a number of vacancies in the system arising from the time lag between a post becoming vacant and the sourcing of a replacement from the central transfer list or by recruitment through the Public Appointments Service.

The Minister is committed to filling all civilian vacancies in the Garda Síochána and his Department works to ensure the length of time that posts are left unfilled is kept to a minimum. Where necessary, the Garda Síochána has the capacity to employ staff on a temporary basis. pending the recruitment of permanent staff. In the Waterford-Kilkenny division, two clerical officer vacancies exist at present. One arises from work sharing and the other from a career break. In both cases, replacements have been provided on a temporary basis.

Hence, there is no embargo on the filling of clerical vacancies in Garda stations. As the Senator is aware, there is a cap on Civil Service numbers. However, as the figures show, this has not been allowed to have an impact upon the filling of vacancies in Garda stations. The Government has decided to transfer 300 staff from the Department of Agriculture and Food to the Department of Justice, Equality and Law Reform to assist with the civilianisation programme in the Garda Síochána.

The first phase of this transfer is under way, with the establishment of the Garda information service centre, GISC, in Castlebar which, when fully operational, will employ more than 160 civilian staff. The Garda information service centre has already yielded considerable benefits to the Garda Síochána as it frees gardaí from entering data on PULSE and from reviewing that data for quality assurance.

The GISC is just one part of a civilianisation programme which is making significant progress. A total of 113 civilian finance officers have been appointed and carry out the district finance officer duties which were hitherto performed by gardaí. A number of other posts that were previously held by members of the force have been, or are in the process of being, civilianised. Discussions are under way with staff interests with a view to transferring responsibility for civilian staff to the Garda Commissioner under the terms of the Garda Síochána Act 2005. This transfer is due to take place on 1 October 2006.

In addition, the Department, working with the Garda Síochána, reviews the possibility of civilianising other posts on an ongoing basis. This is in keeping with the understanding that civilianisation allows certain jobs to be done at a more economic cost and allows gardaí to focus on work more suited to their training and skills, thereby increasing overall operational capacity within the Garda Síochána. While the level of civilian vacancies in Garda stations is low, a number of posts filled by members of the force could be filled by civilians and the Minister is determined to make progress on this issue, notwithstanding some obstacles, including the equal pay case taken by the Civil and Public Services Union, which is currently under appeal.

However, I assure the Senator that the Minister is determined that the additional gardaí being recruited under the current historic expansion of the force will be deployed to frontline, visible and effective policing duties. I should also note that the timescale for achieving the target strength of 14,000 members of the Garda Síochána in line with the commitment in An Agreed Programme for Government will be met. The phased increase in the strength of the Garda Síochána to 14,000 will lead to a combined strength, of both attested gardaí and recruits in training, of 14,000 by the end of this year. This project is fully on target and will be achieved.

The Minister values the contribution that civilian staff make to the success of the Garda Síochána. The Minister is committed to further civilianisation of posts in the Garda Síochána. Pending the full implementation of the civilianisation programme, the Minister is determined to ensure that vacancies in Garda stations are filled without undue delay.

Mr. Kenneally

I thank the Minister of State for the his reply. His comment that a number of posts that are filled at present by members of the force could be filled by civilians echoes my point. I hope the Minister will be in a position to sort that out as soon as possible.

The Seanad adjourned at 8.05 p.m. until10.30 a.m. on Wednesday, 29 March 2006.