I welcome the Minister of State at the Department of Jobs, Enterprise and Innovation, Deputy Perry, to the House.
Adjournment Matters
Employment Rights
I join the Cathaoirleach in welcoming the Minister of State, Deputy Perry, to the House. This motion has been prompted by the agency worker directive, which was adopted in 2008 and was to have been implemented by the end of December 2011. However, all Members recognise that the economy is in a far different place now than it was in 2008. The Government has stated that jobs and economic recovery are the top priorities and all Members would subscribe to that. The Minister will recognise from his background in business that many organisations use agency workers to give them flexibility and competitiveness in the marketplace. It allows them to introduce different terms and conditions of employment and prevents a haemorrhaging of jobs from the economy to other jurisdictions with lower labour costs. I have been contacted by employees from many such organisations who are not agency workers. The workers within such companies, most of which involve foreign direct investment, work beside agency workers and have expressed concern that if agency workers are no longer available to the company, it may have implications for that company's policy on remaining in Ireland into the future. Consequently, this does not only pertain to agency workers. It also potentially affects permanent workers in such companies.
The purpose of my Adjournment matter is to ask whether an evaluation has been undertaken by the Minister and his Department on the impact of the Protection of Employees (Temporary Agency Work) Bill 2011 and whether an estimate has been made as to the number of jobs that are at risk and may be lost on foot of its introduction. Moreover, has an evaluation been undertaken to ensure the legislation does not go beyond the transposition of the EU directive in question? This is set against the background of Ireland's current serious economic and employment issues. When the present Government took office nearly 12 months ago, it stated that job creation was being prioritised. Several measures were taken, about which some reservations were expressed as to how successful they might be or the impact they might have. However, the statistics do not lie. Unemployment has increased in the interim, which means there must be greater emphasis and urgency on ensuring that we avoid introducing measures that could undermine this policy.
The Bill states "the basic working and employment conditions to which an agency worker is entitled shall be the same as the basic working and employment conditions to which . . . a comparable worker is entitled". However, the directive's wording is much more restrictive. It states "the basic working and employment conditions of temporary agency workers shall be . . . at least those that would apply if they had been recruited directly by that undertaking to occupy the same job" now. That is different because a person could be doing a job that may have commanded a higher rate of pay some years ago. Alternatively, someone else doing a similar job may have been recruited many years ago and may have seniority and skills. In general, the nature of temporary agency workers is that they arrive relatively unskilled and their skill base must be built up. However, the Government now proposes to ask companies to take on people and that they be paid the same from the outset.
This runs counter to the stated policy of the Government. It definitely runs counter to what the economy needs at present and is somewhat reminiscent of what amounted to a populist decision to go back on the decision to reduce the minimum wage. If our economy is not competitive and does not become competitive, we will have serious difficulty in generating growth, attracting foreign direct investment, new business or new industries, both domestic and international, to create and generate these jobs. The proposed measure could lead not only to this not happening but to a haemorrhaging of existing jobs. I am concerned and those to whom I have been speaking in this regard share my concerns. I ask the Minister of State to take on board this point and to bring it back to the Minister for Jobs, Enterprise and Innovation, whose very title incorporates the objective of generating and creating jobs.
I thank the Senator for his timely and pertinent comments and observations on the proposed Protection of Employees (Temporary Agency Work) Bill 2011, which is aimed at fulfilling Ireland's EU obligations to transpose the terms of the EU directive on temporary agency work. As such, the Bill represents the last piece of a three-part matrix of employment rights protection geared towards employees engaged in non-typical work patterns, such as in the case of part-time and fixed-term employees.
The Bill is designed to give effect to the EU directive on temporary agency work that was finally adopted in 2008 after several years of discussion. The directive has a transposition date of 5 December 2011. At its core, the directive aims to establish in all member states of the European Union a legal framework in which agency workers are afforded equal treatment in respect of their basic working and employment conditions as if they were directly recruited by a hirer to the same job. In Ireland's transposition legislation, equal treatment is being afforded to agency workers as if they were recruited directly by a hirer to occupy the same job, in respect of basic pay, and any pay in excess of basic pay in the case of shift work, piece work, overtime, unsocial hours worked and hours worked on a Sunday. This is an exhaustive list of those "pay" components that come within the scope of the equal treatment entitlement of agency workers under the transposition legislation and are entitlements directly linked to the work undertaken by the agency worker while on an assignment. This excludes other elements of remuneration that are provided in recognition of the long-term relationship between an employer and a permanent employee, such as bonuses, profit sharing schemes, occupational pension and sick pay schemes, as well as maternity top-up payments and similar benefits.
In short, the directive established a set of minimum rules to be applied by all EU member states having regard to national law, custom and practices in force in each jurisdiction. This is geared towards improving the operation of the temporary agency work sector by promoting job creation and by making agency work more attractive and more amenable to employers' need for flexibility in the labour market. The underlying rationale for the directive, as explained by the European Commission at the time the proposal was first tabled in 2002, was that by extending the equal treatment provision to agency workers at the EU level and by creating a common framework for agency working, this would promote agency work. In the context of its analysis at the time, the Commission pointed to the main difference in terms of intrinsic quality of agency working compared with the terms and conditions enjoyed by employees on open-ended contracts as being related to pay.
The Bill, to give effect to the terms of the EU directive in Ireland, aims to strike the right balance between further protections and a fairer treatment of agency workers while respecting the flexibility for which this work form is known to provide to employers and hirers of agency workers in meeting business needs. In giving effect to the directive, the proposed Bill aims to respect the objective of ensuring fair treatment for agency workers while at the same time striking a balance with the need to ensure the necessary level of labour market flexibility that the employment of agency workers affords for workers and employers alike.
Agency work has a legitimate and valuable role to play in the economy and is the option of choice of some people who benefit from the flexibility, personal freedom and income it provides. It can often keep people in the labour market at times in their careers or lives when they might otherwise be unemployed. It serves the business needs of employers in that this type of atypical working can be used as a complementary workforce to assist in managing the peaks and troughs encountered in the normal business cycle.
In the preparation of the current legislation, my Department conducted a public consultation and obtained the views and observations of a range of key stakeholders, including employers, unions, the recruitment sector and other interested parties, including hirers of agency workers. The outcome of the consultation helped inform core elements of the published Bill. Simultaneously, a regulatory impact analysis was undertaken. This provided an overview by way of qualitative analysis of the potential impact on industry costs and on employment of transposition of the directive into Irish law.
The background to this approach is that it is very difficult to obtain an accurate profile of the agency work sector in Ireland as established statistical sources do not capture this type of atypical work. In general, estimates based on surveys conducted by private employment agencies suggest temporary agency workers represent approximately 2% of the total working population, which amounts to 35,000 agency workers operating in the private and public sector. The majority of agency workers are engaged in the private sector across a diversity of sectors ranging from security, manufacturing, services and ICT. In the public sector, agency working features predominantly in the health sector which employs significant levels of workers on an ongoing basis, a fact that is now more pronounced with the public sector recruitment moratorium. A key message from the impact analysis is that implementation of the directive brings agency workers and directly recruited staff closer together in terms of equal treatment in basic working and employment conditions. It has the potential, therefore, to increase the cost of employment in terms of payroll, holidays and the extension of amenities such as crèches and canteens.
It has been represented that the directive could have an adverse effect on employment, especially in the absence of any derogation facility under Article 5.4, in that for short-term assignments, employers simply will not take on short-term temporary agency workers and instead provide cover with existing employees through overtime or otherwise, with potential for making the black economy attractive. Furthermore, the case has been articulated that job losses could arise from the loss of future investment projects in Ireland due to a perception of the loss of labour market flexibility if a derogation facility under Article 5.4 is not available.
The Department of Health points also to increased costs in terms of Exchequer funding for the employment of agency staff in the health sector following transposition. This will arise as a result of changes that were made to the contracts of agency staff last year which placed agency staff on one of two points of a pay scale that will have to be rolled back given the requirement for equal treatment with direct employees after the directive is transposed. Furthermore, agency staff currently afforded only statutory annual leave will, after 5 December, be entitled to parity with direct employees which will have an incremental cost to the Exchequer in terms of employing agency staff.
The Bill, which was published in December, has the balanced approach required to meet the full and proper transposition of the EU directive. The Government will continue to ensure the necessary balanced approach is achieved in the proposed legislation as it proceeds through the Houses. In the current challenging economic times, growth and employment are necessary prerequisites of a well-functioning economy that can retain and grow employment.
I thank the Minister of State for his response and note the qualitative analysis recognised the directive could have an adverse effect on employment, particularly in the absence of a derogation facility. Am I right to assume we do not have a derogation facility and therefore this will have an adverse effect on unemployment? Loss of employment could arise from the loss of future investment projects. I was told by someone in the industry it will have implications for that person's business. A decision would be taken outside of here, but that business could end up moving to India or another lower labour cost country.
Yes.
The analysis seems to confirm these fears. Why are we going beyond the intent of the directive which limits it to taking on someone today at a lower rate than he or she would have been paid five years ago? The Bill will mean such an employee must be paid the same as someone who was employed five years ago.
The Senator has made his point.
I thank the Acting Chairman for his indulgence. This is an important point. We speak about job creation and reducing VAT, but if we lose a significant number of jobs as a consequence of changing legislation, it means we must be cautious.
The Senator suggests the Bill as crafted will have a negative impact on employment.
Yes.
I thank the Senator for his comments because he has come to the nub of the question. The Bill will fulfil Ireland's responsibility to meet the terms of the directive and ensure its correct transposition into Irish law.
Will we restrict it to this? We are going beyond——
I was Chairman of the Oireachtas committee that scrutinised EU legislation for two and a half years and it is about not gold-plating directives when transposing them. The Government does not intend to gold-plate any EU directive, and this is the mindset of the Minister, Deputy Bruton.
In the lead-up to the preparation of the Bill and following the consultation phase with key stakeholders, including union and employer representatives and other interested parties, the Minister impressed on all sides the need for a balanced approach which is all about practicality. As the Senator stated in his initial comments, there is a fine line. Implementation of the legislation should help sustain existing jobs and grow employment in the sector.
I am not speaking about job retention and growth at any cost. The transposition of the directive will provide agency workers with new protections and fair and decent conditions, and this is important. It is important that agency work continues to be an attractive prospect for workers who wish to pursue this option as a matter of choice and to help meet the flexible working patterns of firms, including small and medium enterprises, to meet business needs.
The Bill as drafted, with new protections afforded to agency workers through the application of equal treatment in respect of basic working and employment conditions, meets the needs of agency workers and employers alike. It will certainly help the sector to continue to provide job opportunities to meet employers' requirements to deliver services. The overall approach of the EU directive aims to protect temporary agency workers and improve the quality of agency work by ensuring agency workers benefit from equal treatment. A purpose of the directive is to recognise employment agencies as employers with a view to contributing to the retention and creation of jobs and the development of flexible terms. The Bill meets this objective and will provide in its implementation a positive platform for the future development of the agency sector for agency workers, employment agencies and hirers. It will also support job maintenance and retention in the sector.
Health Services
I welcome the Minister of State, Deputy Róisín Shortall.
Cuirim céad fáilte roimh an Aire agus gabhaim buíochas leis as teacht isteach le díriú ar an gceist seo. Ceist bheag í i gcomhthéacs na tíre í ach ceist mhór í i gcomhthéacs an phobail as a dtagaim.
I raise the issue of the public health nursing service in Connemara in light of the fact that we have heard that the public health nurse based in Roundstone who is due to retire will not be replaced. Roundstone is a very remote rural community and the public health nursing service is extremely important in that area. Other health services in the area are being curtailed, particularly dental services, due to staffing issues. We have also heard of the curtailment of services in terms of old people's homes in the area through the amalgamation of services, which is also due to staffing issues.
There is great concern, particularly in the Roundstone area, about how the service that was delivered by the public health nurse over the years will be continued, where the burden will fall and if it were to fall on public health nurses in areas nearby, would that have a detrimental effect on how they serve their existing communities? All the public health nurses working in that area are extremely busy and their jobs involve a good deal of travelling to see their patients.
In the matter I tabled I asked if the Minister could indicate the wider geographic area of Connemara and the Aran Islands which would be serviced by public health nurses. Can we expect similar situations to arise there? Are more curtailments and cutbacks envisaged in the number of health nurses there and in the provision of the services, or are the services to be rejigged? This issue must be viewed in the context of the number of people who applied for redundancy in the recent opening available to them under the public service agreement, whereby they could apply to leave the service. I understand some 3,500 people in the health service have applied to leave under that programme and there is the issue of whether that will impinge on the position. Cuirim fáilte roimh tuairimí an Aire go mbeidh sé in ann léiriú a thabhairt dúinn agus deimhniú a thabhairt do phobal Chonamara agus phobal Chloch na Róin agus pobal Oileáin Árann go mbeidh na seirbhísí in ann leanacht ar aghaidh agus go mbeidh seirbhís mar is ceart á chur ar fáil.
I thank the Senator for raising this issue as it presents an opportunity for me to make a number of comments on the future of the public health nursing service, particularly the service in Roundstone, County Galway, and in the wider area of Connemara and the Aran Islands.
The public health nursing service is a structure within the HSE, which consists of a director of public health nursing, assistant directors of public health nursing, public health nurses and registered general nurses and midwives. A small percentage of specialist posts are filled by clinical nurse specialists and advanced nurse practitioners. Registered general nurses work alongside the public health nurse in the community and assist with clinical nursing and caseload management. This involves the delivery of nursing care to various patient groups, including children and families, palliative care, the young chronic sick, those with disabilities and older people in the community. Care of children and families includes a universal child health screening and surveillance programme for children up to the age of three and a half years.
The changing demographic profile of Ireland, a rapidly growing older population, increases in the birth rate, increases in the number of people suffering with chronic conditions, reductions in length of hospital stay, technological advances in care delivery and increased demand for health promotional activities have impacted on the organisation, management and cost of the delivery of the public health nursing service.
The delivery of a sustainable community nursing service that effectively meets the health needs of the population within a primary care setting is the primary aim of the public health nursing service.
The HSE's primary, community and continuing care service in County Galway, which has responsibility for public health nursing services in the county, continues to make every effort to protect and maintain front-line services. Thanks to significant staff commitment and as a result of redeployment and revised arrangements for cross-cover, Roundstone will be covered by the primary care team nurse based in Clifden.
In the wider context of Connemara, a level of locum cover will be provided to ensure that essential public health nursing services are maintained throughout the area. The Aran Islands have public health nursing cover at present and it is the HSE's intention that this cover will continue to be provided. Individual staffing situations will be considered in light of existing resources and the challenges imposed by the recruitment moratorium.
Contingency planning is ongoing to ensure quality safe services can be delivered following the retirement of staff from services at the end of this month. The HSE is currently carrying out a review of public health nursing services, which is expected to be completed shortly. This review will inform national HSE policy in order to facilitate the integration of services and the delivery of efficient and safe care to patients in the community.
I want to give the Senator an assurance that I see a very bright future for community nursing and public health nursing in particular. I believe they will become the mainstay of primary care services. I look forward to receiving the report from the review group and restructuring the way in which we deliver public health nursing services but I see them as being an absolute essential in terms of the rollout of enhanced primary care services.
I am concerned about the position in terms of the answer I have got from the Minister of State. The public health nurse in Clifden under the primary care team is under pressure as matters stand and I would question if she is in a position to also cover this area. The Minister of State said the level of locum cover would be provided in the wider context of Connemara. Will she clarify what she means by that?
Sorry, Senator——
The Minister of State said: "In the wider context of Connemara, a level of locum cover will be provided to ensure that essential public health nursing services are maintained throughout the area." What does that mean?
I do not have the details. It is a service matter for the HSE but I have been given an undertaking that cover will be provided. It do not believe anybody is under any illusion about the kinds of challenges that will face us in the health service at the end of this month. It will be difficult, of that there is no doubt. What I am seeking to do in the primary care area is to ensure that we can recruit a certain number of front-line people. We have managed to secure €20 million to fill vacancies. We do not know at this point the exact number of vacancies that will arise in primary care but, to the greatest extent possible, we will use that ring-fenced money to fill vacancies at the coalface, professionals providing the services on the front line. That will be done by employing people but there is an employment control ceiling by which we are bound. If it is a case that our allocation of posts is used up, we will then have to take another approach in terms of employing people on a sessional basis, ensuring that we get much greater flexibility from the services that are in place. We were promised that the Croke Park agreement would deliver that kind of flexibility and that will be tested in the coming months.
Long-Term Illness Scheme
People who have long-term illnesses have a heavy load to bear in terms of cost of treatment, the effect on their lives and their ability to work. They deserve our every support in trying to live ordinary lives. The long-term illness scheme has not been revised since the 1970s and some very severe and long-term illnesses are not included in that list of illnesses. These include, as I understand it, Crohn's disease, Alzheimer's disease, ulcerative colitis and coronary heart disease, all of which have seen notable rate increases in the past number of decades.
I draw the Minister's attention to issue of systemic lupus erythematosus, or SLE as it is called, which is a chronic long-term auto-immune disorder that affects the skin, joints, kidneys, lungs, heart and brain, and which is more commonly known as lupus. Nine out of ten sufferers are female with the highest incidence occurring between the ages of 15 and 45. The symptoms of lupus are various, vague and often almost impossible to diagnose but many of the symptoms can be painful and severe. They include painful muscle swelling, skin rashes, fever, migraine and other neurological problems. They also include hair loss, weight loss, chest pain and lung problems, nausea, oral and nasal ulcers, high risk pregnancy and, in some cases, heart, kidney, brain and lung damage. While it can be mild for some, it can also be very severe and can affect vital organs such as the kidneys, heart, lungs and brain. The condition can cause severe attacks which can be triggered by stress, a virus or a traumatic experience, and environmental triggers such as the sun.
There is no cure for lupus. There was a time when lupus claimed many fatalities but, thankfully, lupus patients can now lead relatively normal lives, but only with the appropriate medication and the ongoing care of a rheumatologist. The condition can mean that sufferers will either spend significant amounts of money on treatments simply to be able to get on with work and life or they will be forced to go without. While there is provision for them in terms of the drugs payment scheme, that does not take into account the full cost of treatment.
The cost of treating the condition is not small. Many lupus sufferers require weekly check-ups with their GPs, as well as visits to consultants, which can cost up to €150 per session. This is still not the full cost. We should not penalise people for this condition, especially in the current climate. If we had proper universal health care in the State, the call I am making today would not be so relevant. However, we are where we are with the health service and this issue remains one that must be examined by the Minister. I ask that the illness be included in the list covered by the long-term illness scheme.
On a related matter, aside from medication or treatment, there is a lack of information, resources and support available to people with lupus and their families. Many sufferers must effectively diagnose and treat themselves by looking up articles on the Internet to find more information. This approach is becoming more common in Ireland owing to the poor health resources available. We will shortly have a nation of expert amateurs working in the health service as doctors.
Does the HSE have any plans to provide more information and greater support on this condition? I ask the Minister to revise the list of conditions covered by the long-term illness scheme and to include lupus in it. It would make the lives of many people tangibly and significantly better. Will she agree that the list is outdated, given that it has not been revised since the 1970s? There is a range of illnesses, including lupus, not covered by the scheme but which have an impact on the quality of people's lives and which should be included in the scheme.
The long-term illness scheme is a non-means tested scheme introduced in 1971. It provides free medicines and medical appliances to people with specified conditions. Some 16 conditions are covered by the scheme. Requests to expand the range of conditions are frequently made but at this point there are no plans to extend the list of conditions covered by the scheme.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. In the assessment process, the Health Service Executive can take into account medical costs incurred by an individual or a family. In recent times the situation with the assessment of applications on medical grounds has improved. There is a panel, headed by a GP, that assesses the medical applications. Those who are not eligible for a medical card may still be able to avail of a GP visit card, which covers the cost of general practice consultation.
Non-medical card holders and people whose illness is not covered by the long-term illness scheme can use the drug payment scheme which protects against excessive medicine costs. Under this scheme no individual or family pays more than €132 per calendar month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals incurring ongoing expenditure on medicines. In addition, non-reimbursed medical expenses can be offset against tax.
The diagnosis and management of systemic lupus erythematosus takes place in a number of health care settings. Patients with lupus are generally under the care of a rheumatologist and other specialists as necessary, such as dermatologists. The programme for Government committed to reforming the current public health system by introducing universal health insurance with equal access to care for all based on need, not on ability to pay. The universal health insurance system will be underpinned by the principle of social solidarity. Every citizen will have a choice of insurer and will have equal access to a comprehensive range of curative services.
The Government is also committed to introducing universal primary care within its first term of office. This commitment will be achieved on a phased basis to allow for the recruitment of additional doctors, nurses and other primary care professionals. A universal primary care project team has been established — we had our first meeting last week — and it has been tasked with working through the issues relating to this commitment.
While I take the points made by the Senator, it has been decided that the policy to be pursued will be in respect of providing universal free access to GP services. There is a clear commitment that we will do that within the next four years. That will cover everybody in the population. We cannot do everything, unfortunately, but we are on a clear course in terms of opening access across the population.
The reason I raised this issue is that I was contacted by a lupus sufferer. She has pointed out that she and many people have found themselves in a position where they are unable to get the supports they require from the State because they simply are not available. She made the appeal, not only on her behalf but for all lupus sufferers and people who suffer from other illnesses, that they get the proper supports. I accept the Minister's bona fides that we will move towards an improved system at some point in the future but I regret that she does not intend to review the scheme. It would have been the right thing to do. I appreciate that we are in straitened economic circumstances but I still believe we should ensure that people have access to proper services and supports when they suffer from illnesses through no fault of their own.
I accept that people who suffer from lupus and those who suffer from other conditions would make the case to be included under the scheme. In an ideal world, we could do that but the policy we have decided on is to pursue free universal access to GP care. As I said, we cannot do everything. However, the Senator raised the issue of information being made available. I will check that with the HSE and revert to him on that point.
The Seanad adjourned at 5.50 p.m. until 2.30 p.m. on Tuesday, 7 February 2012.