I welcome the Minister of State back to the Seanad to take the firstmatter.
Adjournment Matters
Suicide Prevention Services
I also welcome the Minister of State to the House. I wish to raise an issue on behalf of the Irish Institute of Naturopathic Medicine, which is located in Colliga House in County Wicklow. This is a European award winning centre that provides a range of services and specialises in the area of suicide prevention in particular. We all know the importance of that area, given the high levels of suicide, especially among young people, in this country.
The institute was informed in 2006 by the HSE that approval had been received from the strategic policy and reform implementation unit for the provision of €25,000 in funding, with funding of €50,000 agreed for 2007. The letter stated that this national funding would support the work of the institute, was intended to cover set-up costs, and would be made through the local health manager who would link with the institute on behalf of the HSE nationally. The letter also stated that formal allocation would be issued soon, and that the person from the HSE named in the letter would be in a position to put in place a service level agreement for the national funding at that stage. Unfortunately, this never happened and I would like to know why not. I also request, even at this late stage, that a service level agreement be put in place with the institute for its suicide prevention centre.
In 2011, the unit in County Wicklow intervened with 2,000 individuals. It provides an early intervention service for individuals in the areas of suicide prevention, self harm, violence, addiction, mental health issues, domestic violence and autism in children. The IINM provides outreach suicide prevention programmes to deprived and marginalised members of the community in Ireland. In 2010, it was the overall winner of the ICNM European award for integrated medicine for suicide prevention. Its aim is to meet the objectives of the Government's mental health policy for best outcomes for all of our citizens, as well as the reduction in the rate of death from suicide, hospitalisation, violence and dependency on welfare. The focus of the programme is on intervention for prevention and treatment of self-aggressive disorders. All referrals are done through a GP or a psychiatrist.
As I mentioned, the institute was approved for funding by the strategic policy and reform implementation unit of the HSE. I ask that it be given State support to carry on the excellent work that it has been doing to date. I have had very strong representations from many people who have a deep interest in suicide prevention in particular. From what I have been told, the method of treatment provided by the institute is highly effective and reputable, and I am very anxious that it be considered for State assistance to carry on its very important work, especially with the significant number of people who have had suicidal tendencies or who have self-harmed in the past. I ask the Minister of State to have a look at this. I also hope to meet the Minister of State with responsibility for mental health services, Deputy Lynch, on this issue in the near future.
I am taking this Adjournment debate on behalf of my colleague, the Minister of State, Deputy Lynch, who has responsibility in this area. I thank Senator Mullins for raising this issue today.
The Irish Institute of Naturopathic Medicine treatment programme provides support and holistic based therapies in addiction, autism, mental health issues and so on. Funding was provided for the institute in 2005 and again in 2007 to support its work. These payments were once-off supports and no arrangement was entered into by the HSE to support the institute on an ongoing basis. Since then, the HSE has supported some individuals who wished to access services provided by the institute. However, it is clear that these supports were of a limited nature and specific to the individuals concerned. Given the budgetary restrictions in more recent years, it is no longer possible for the HSE to offer financial support to individuals who may wish to access services at the institute. The institute provides a range of alternative and complementary therapies. These therapies are not endorsed by the HSE, and the executive does not refer clients to the institute for treatment. For that reason, there is no basis for the HSE to enter into a service level agreement with the institute.
In these extremely difficult financial times, it is necessary for the HSE mental health services across all regions to continually review the provision of services in an effort to maximise the balance of service access within the available resources. I assure the House that the Government is committed to the development of mental health and suicide prevention services. This commitment was clearly shown in budget 2012, which provided for a special allocation of €35 million for mental health services in line with commitments in the programme for Government. Funding from this special allocation will be used primarily to strengthen the community mental health teams in both adult and children's mental health services. Some of the funding will also be used to advance activities in the area of suicide prevention and response to self-harm presentations, and to initiate the provision of psychological and counselling services in primary care.
It is intended that the additional resources will be rolled out in conjunction with a scheme of appropriate clinical care programmes which are being developed. Three areas in particular will be prioritised in 2012: eating disorders, early intervention in psychosis, and suicide prevention. A fundamental principle of early intervention for any health condition is that identification, diagnosis and treatment should occur as early as possible to maximise the likelihood that interventions will successfully minimise the burden of suffering. By strengthening community mental health teams and enhancing the capacity of primary care to deal with people with mental health issues, I hope we will go a long way towards achieving that goal. I thank the Senator for raising the matter.
I thank the Minister of State for her response. I welcome the Government's additional commitment to mental health services, but I am disappointed with the response I have received. The alternative therapies that are available are worthy of consideration for funding. I ask the Minister of State to convey to the Minister of State, Deputy Lynch, my desire for a meeting with her and with a representative from the institute at an early date.
I will be happy to convey that request to the Minister of State.
Hospital Services
This is somewhat parochial, but I ask the Minister of State to outline the impact, if any, of the €900,000 cutback that has been announced for Bantry General Hospital. I have spoken to the Minister for Health, Deputy Reilly, on the issue on a number of occasions and he is fully aware of the significance of Bantry hospital due to its geographic location. It is on the list of unique small hospitals to be preserved and promoted. I accept that there must be budgetary constraints across the board.
The previous Minister, through the HSE, outlined a method of reconfiguration for Bantry hospital under which consultants from Kerry General Hospital, Tralee, Mercy University Hospital, Cork, or Cork University Hospital would attend every day. As evidence of that, one consultant, who is a plastic surgeon, comes to Bantry once a month, which is great for the people of west Cork and south Kerry. More of this should be done. The reconfiguration plan is still in its infancy and should be rolled out more quickly. This development was planned four or five years ago.
When I spoke to the Minister privately a few months ago, he said there was an ongoing review of small hospitals such as Bantry, possibly including such other hospitals as the Mid-Western Regional Hospital, Nenagh, the Mid-Western Regional Hospital, Ennis and Letterkenny General Hospital, after which he would be making certain decisions. The Minister of State may not know whether that review has been concluded.
I am encouraged by the fact that the Minister recently visited Bantry and that he has a grasp of the geographical difficulties we face in that area. When I hear people in Dublin arguing about whether the new children's hospital, which we need, should be at the Mater hospital or in Tallaght or Crumlin, I think of a woman from the Beara Peninsula who had two very sick children and used to leave at 3 a.m. to get the first train to Dublin. It would take her 24 hours to get here. People from west Cork, Kerry or the remote parts of Donegal hear the arguments about where the children's hospital should be located. If we had our choice it would probably be in Portlaoise or somewhere closer to home, but that is not going to happen.
There is a consultant surgeon post at Bantry hospital which is occupied on a temporary contract. The gentleman concerned recently performed a minor operation on my own son, who had a hernia removed. We chose to go to Bantry to support the hospital. More than €2.5 million has been spent on upgrading the surgical theatre there. The surgeon's contract should be put on a firmer footing. I have raised this concern before. We have only one consultant surgeon, although we have consultants in other specialties. If he were to go for any reason, the consultant anaesthetist would fall with him, as it were — they follow each other — which would have a knock-on effect on patients on the medical side of the hospital, where we have one of the best intensive care units in Ireland. That is a concern I have. The Minister of State's answer may not include this, but it is something she might convey to the Minister. There should be at least a three-year contract. GPs are telling me they do not know from month to month whether this person will go. I think he is an African. He is very good, but he is here on a temporary contract. That uncertainty creates concern in the community, and many of the GPs are saying he, or somebody else, should be put on a three or five-year contract — something more definite — in the short or medium term.
I thank the Senator for raising this matter. I am replying on behalf of my colleague, the Minister, Deputy Reilly. We are all aware that the health sector is facing significant funding challenges this year. However, the Minister is determined that the impact on services will be minimised by following best practice and through reform in the way services are delivered.
The service plan for this year reflects the programme for Government commitments for health and the savings targets set out in the comprehensive expenditure report 2012-14. With the scale of the financial challenge facing the HSE, there will be an inevitable and unavoidable reduction in services, but it will not be a straight line reduction. Bantry General Hospital, similar to other acute hospitals, must face this challenge of reduced budgets and align its 2012 activity and services with the budget allocated.
This year HSE South will continue its programme of reorganising acute hospital resources in Cork and Kerry to ensure the best possible outcomes for patients. Bantry hospital is actively participating in the clinical programmes, which will enable the hospital to maximise activity while reducing overall cost. These programmes provide a national, strategic and co-ordinated approach to a wide range of clinical services.
With regard to the Senator's query on bed closures, the HSE has informed the Department of Health that there are no plans to reduce bed capacity in Bantry hospital. The hospital management is aware of the retirement or resignation of seven whole-time equivalent staff in the hospital this year. Work has been under way since last autumn to prepare for this reduction, and the regional service plan of HSE South takes this into account. Furthermore, HSE South and the hospital management are seeking to mitigate the impact of the retirements on front-line services in a number of different ways. These include using the public service agreement to bring about greater flexibility in work practices and rosters, redeployment and other changes to achieve more efficient delivery of services. Some limited and targeted recruitment in priority areas will take place to help limit the impact of retirements on front-line services. Examples include a theatre nurse manager to secure the surgery service and a senior medical scientist to ensure continuity of the laboratory service. In response to the Senator's third query, hospital management is not aware of any other post that will be lost in the system at this time that may adversely affect the staff of the hospital.
The role of services in Bantry will be progressed as part of the Government's national framework for the reorganisation of small hospitals. In developing this framework the Government is clear that there is an important future role for smaller hospitals, in which they will provide services for more patients. The framework is expected to be submitted to the Cabinet shortly.
The main focus of the reorganisation of services at Bantry is the transfer of remaining complex surgery to Cork city, with a reciprocal transfer of day case surgery to Bantry. Surgical and medical specialties will also transfer outpatient work to Bantry. This will broaden the range of outreach services available to patients closer to home. A dedicated patient transport service is due to be made available in Bantry from mid-April. I hope this addresses the issues raised.
I thank the Minister of State for taking this matter on behalf of the Minister for Health, Deputy James Reilly, and the response is, by and large, positive. I am not being political or parochial, but since I became a councillor in 1985 Bantry General Hospital has been the backbone of my reason for being in politics. Even when Fianna Fáil was in government I did not have a problem in challenging its current leader, Deputy Micheál Martin, or the former Minister Mary Harney on certain issues. I continue to work for the sake of the hospital. I spoke to the Minister and I am encouraged by the fact that he has visited the hospital, is aware of what is happening there and has a grasp of what is needed. I look forward to positive outcomes for the hospital.
I thank the Minister of State for taking this matter in the Minister's absence. I will be glad to convey the news that, despite the financial cutbacks, the loss of jobs will be insignificant.
I hope that will be the case. The HSE has made a huge effort in ensuring cover to ensure services can continue, particularly in critical services. The Government sees a strong future role for Bantry General Hospital. The framework being developed for smaller hospitals is close to completion. While some activities, particularly the more complex work, will be transferred, there will also be movement in the other direction, including day case surgery. There is a strong and bright future for the hospital.
Anti-Litter Initiatives
I thank the Minister of State for coming into the House to discuss the issue of the plastic bag levy on biodegradable bags. There is a difference between biodegradable and degradable plastic bags.
On 4 March 2002 the Government introduced a levy on plastic carrier bags. It was, primarily, an anti-litter initiative to positively change consumer habits. It was a most welcome development. I absolutely recommend that it remain in place.
The first objective has been achieved, with fewer carrier bags being sold. However, research has shown that paper bag use has increased extensively. These have been proved to be even more damaging to the environment than plastic bags owing to the volume and cost of their production. For this reason, there have been calls from several environmental groups, including Friends of the Irish Environment, for paper bags to be incorporated in the levy.
The paper bag production process causes 70% more atmospheric pollution and uses 300% more energy than comparable production of plastic bags. The House recently debated the issue of energy and I ask the Minister to take this aspect into consideration. Paper bags that have been laminated to make them weatherproof — they have a shiny finish and we all carry them home from the shops — are not subject to the levy. They should be. These paper bags are supplied free of charge in retail stores. We should consider the damage they do to the environment and include them in the levy, as the legislation states bags made wholly or partly of plastic are liable to the levy. It should not make a difference that a bag is lined with paper. I, therefore, ask the Minister to consider making this type of bag subject to the levy, given the environmental damage this covering causes.
Consumer purchasing habits are changing. Research shows that the levy has affected the sale of plastic bin liners and nappy bags which has, in turn, added extensively to the amount of plastic going to landfill. The sale of biodegradable plastic bags has also increased since the introduction of the levy. The issue with this type of bag is that they can contain high levels of plastic. There are no controls over the plastic content and they may take up to five years to degrade. This aspect must be looked at.
Through the introduction of brown wheelie bins for compost waste, the Government has given the general public an outlet to recycle food waste, but this has also raised serious issues. Rodents, flies and odours are obvious immediate problems that the public faces. However, there is also a hidden hygienic health and safety aspect. The bins are seldom completely emptied. When they are collected, the residue within them is a breeding ground for bacteria and flammable gases. To help contain this problem, waste collection companies agree that lining a brown bin with a 100% compostable liner cuts back on a high percentage of these issues. In fact, some companies now supply these liners to their customers free of charge. I ask the Minister, in the next tender, to ensure all companies are asked to supply them free of charge.
There is a difference between a biodegradable bag and a compostable bag, despite the fact that compostable bags are considered to be biodegradable. The prefix "bio" should not be used when describing compostable bags, as they take only 12 weeks to break down. They are made from corn starch and break down in composting environments by natural means into simple elements such as carbon, hydrogen and oxygen. They are totally environmentally friendly and should be free of a levy, which is what we are looking for.
On 1 January 2011 Italy introduced a ban on all plastic carrier bags, following a report that showed Italian consumers were using more than 300 bags per person per year. Stores in Italy are now only allowed to offer fully biodegradable, cloth or paper bags. In Italy the fully biodegradable bags are actually compostable bags. Standard biodegradable bags take up to five years to break down. These are the ones that featured in the court case involving Dunnes Stores. The type of plastic bag used for fruit and vegetables should be levied and they are covered by the legislation. Similar bans have been imposed in France, Mexico City, Australia, South Africa and Taiwan.
According to a recent EuroCommerce report, Ireland did not consider compostable bags when the levy was introduced. The reason given was most probably that it would have been almost impossible at the time to determine the difference between a compostable bag and a plastic bag when waste was being collected. The broader concept of sustainability was also not taken into account with regard to paper bags or the life cycle assessment, LCA, of compostable bags, according to the same report. The segregation of compostable bags and plastic bags is no longer a problem, as every household in Ireland has, or will soon have, access to a compostable collection facility, either by brown bin, self-drop system or composting in a home composting system. The distinction between compostable and biodegradable bags must be made and reflected in legislation. They can be recognised instead as degradable.
This would not mean a huge decrease in Government revenue, but it would be a huge positive step in protecting the environment. The profit made by SMEs would be around €4 million instead of a loss of around €2 million. We all know what jobs mean to SMEs. These savings could be used to help businesses to continue trading and increase job opportunities within the industry. I, therefore, ask the Minister to consider the proposal to remove the levy on compostable bags which are fully degradable in the light of the evidence which suggests it would be a logical move. It would be environmentally friendly, energy saving and pro-job creation. The technology is available to differentiate between bags that have no plastic content and those that have some.
I thank the Senator for raising this issue, to which I am responding on behalf of the Minister for the Environment, Community and Local Government, Deputy Phil Hogan.
Since its introduction on 4 March 2002 the plastic bag levy has been an outstanding success and instrumental in changing consumer behaviour in discouraging the use of plastic bags. The levy applies to all bags made wholly or partly of plastic, subject to specific exemptions set out in the legislation, of which the most important is that plastic bags designed for reuse are exempt from the levy, provided the retailer charges at least 70 cent for the bag.
The legislation does not distinguish between biodegradable plastic bags and other plastic bags. Biodegradable bags still take a considerable time to degrade and while their use may be preferable in a final treatment or disposal, such bags will continue to have an environmental impact for a significant period. One of the prime objectives of the levy is to influence consumers to change their shopping practice by encouraging the use of reusable shopping bags. I am concerned that exempting biodegradable bags from the levy could encourage retailers to change from dispensing non-biodegradable bags to dispensing biodegradable bags, thereby failing to achieve any change in consumer behaviour in terms of reuse.
In addition, there would be practical difficulties for consumers, retailers and enforcement agencies in distinguishing between biodegradable and non-biodegradable plastic bags. One of the reasons for the success of the plastic bag levy is its simplicity. If a bag contains plastic, then it is, subject to certain limited exemptions, leviable. Local authorities are central to the enforcement of the levy through visiting retail outlets to carry out inspections. While it is relatively simple for an enforcement officer to determine whether a bag contains plastic, it would be extremely difficult to ascertain in the course of an on-the-spot check whether that plastic was biodegradable. Likewise, consumers who have generally been extremely supportive of the levy would not be able to tell whether the bag with which they had been supplied was biodegradable.
It is important to note that the plastic bag levy was primarily introduced as an anti-litter initiative. Data from the national litter pollution monitoring system are used to measure the impact of measures such as the plastic bag levy on litter. While plastic bags accounted for approximately 5% of litter arisings prior to the introduction of the levy, the most recent survey data, for 2010, show that they constituted approximately 0.25% of litter pollution nationally. Biodegradable plastic bags may take up to five years to degrade and thus cause a visible litter problem, thereby undoing much of what has been achieved in removing the blight of plastic bag litter from Ireland's landscape.
The plastic bag levy has been an outstanding success in reducing litter and changing consumer behaviour from the use of single-use bags to reusable bags. A national survey of the environment in 2003 indicated that 90% of shoppers were using reusable or long-life bags. Therefore, in the interests of maintaining the simple and effective levy system in place, it is not proposed to exclude biodegradable plastic bags from the levy.
I agree with much of what the Minister of State said, but it entirely missed the point of what I am trying to achieve. To clarify, I am totally in favour of the plastic bag levy. The Minister of State's main point was that it would be impossible to distinguish between a biodegradable and a non-degradable bag. That is like saying it is impossible to ascertain how much lead is in diesel. All I am asking is that legislation be introduced to allow for the inclusion of a symbol — a red triangle, for example — on plastic bags that are degradable in 12 weeks. I am fully supportive of the retention of the levy on biodegradable bags because there is plastic in them. However, new technologies have been developed which have vastly improved the timeframe for biodegradability. The inclusion of a symbol such as a red triangle would inform consumers of this. In the longer term these are the only plastic bags which should be permitted to be sold. It has been done in Italy and there is no reason it cannot be done here.
I am happy to convey the Senator's view to the Minister.
Water Services
I welcome the Minister of State and thank her for responding to this Adjournment matter. My objective is to ascertain the total amount of taxpayers' money invested in the necessary and most welcome upgrading of public wastewater treatment plants in recent years. This feeds into the current debate on private wastewater treatment systems, the owners of which the Government seems determined to oblige to replace them.
Any Revenue worker will say it is possible to impose a tax or levy on people so long as it is deemed to be fair and equitable. The issue in this case, as I am sure the Minister of State's figures will show, is that billions of euro were spent in upgrading wastewater treatment plants in Dublin and in towns and villages throughout the State at no cost to many of the individuals who benefited from the upgrades. Levies were imposed on developments when the developers applied for planning permission and that money met some of the cost of upgrading water treatments plants. However, for householders in Merrion Square and elsewhere in Dublin, any future upgrading required at Poolbeg, for instance, will not involve any charge. At the same time, taxpayers in County Kerry who receive no benefit from the service are paying for the upgrade of the facility at Poolbeg through their taxes.
If the Government does not put in place a grants system for the upgrading of wastewater treatment facilities for private householders, there will be a significant inequity within the system. Billions of euro have been invested in upgrading the public system at no cost to those who use it because it is the right thing to do. Any facility that does not meet the required environmental standards must be upgraded, about which there is no argument. However, considerably more is being asked of people with private waste water treatment facilities which were installed in accordance with the regulations at the time and at the owner's cost. The Government has now changed the rules and is insisting on these facilities being upgraded to meet new standards. I agree that where water quality is not as it should be, there is an obligation to upgrade water treatment systems to meet modern standards. However, the owners of these facilities should be given the same treatment as people living in Dublin.
The Government is meeting fierce resistance on this issue because people can see how inequitable it is. If a person in County Kerry has a system that is not working, it is only right that he or she should be required to upgrade it. However, while taxpayers fund the bill for the upgrading of public systems, the individual is expected to bear the cost in rural areas. That is where the Revenue Commissioners tell the Cabinet that unless a charge or levy is equitable and fair, it will not have the support of the people. Rural householders are entitled to grant assistance to help them in meeting the required standards. I look forward to the Minister of State's response.
I am responding to this Adjournment matter on behalf of the Minister for the Environment, Community and Local Government, Deputy Phil Hogan.
I thank the Senator for providing me with an opportunity to outline the improvements made in the area of wastewater treatment in the past 15 years. More than €6 billion in Exchequer resources has been invested in water services infrastructure since the early 1990s, with more than €5 billion of that spent in the past decade and a half. The focus of this investment has been on ensuring compliance with the European Union directives on both drinking water standards and urban wastewater discharges and improving water supply to keep pace with population and economic needs. Annual Exchequer funding for wastewater infrastructure has risen steadily since 1997, at which stage €116 million out of a total of €181 million was spent on wastewater services, to €220 million out of almost €350 million of Exchequer funding in 2011.
Some €3.7 billion, or 71%, of the overall €6 billion has related to wastewater infrastructure investment. Compliance with the EU urban wastewater directive has been a key driver of investment during this period, as well as the need to respond to the requirements of population growth and the needs of industry. There are 482 agglomerations with a population greater than or equal to 500, with the two largest treatment plants in Dublin and Cork representing 55% of all public wastewater discharges from these agglomerations. In the period 2000 to date, 341 wastewater treatment schemes and contracts have been completed. This has led to an increase in treatment capacity equivalent to the needs of a population of almost 3.9 million. Some 1,250 km of sewer network have been constructed and almost 160 km of the existing network rehabilitated.
Ireland is approximately 93% compliant with the 2005 deadline relating to the EU urban wastewater treatment directive, which requires secondary treatment for discharges from agglomerations above certain specified size thresholds. This compares with a compliance rate of 25% in 2000. Current investment plans under the water services investment plan 2010-12 will lead to the necessary infrastructure for secondary treatment in larger agglomerations being put in place by 2015. The monitoring of the effluents discharged by wastewater treatment plants falls under the control of the Environmental Protection Agency. The report of the agency for the period 2008 to 2009 was published recently. While it indicates improvements in performance and compliance since the previous report, its findings indicate a need for further and more comprehensive improvement in operational performance. It also highlights the need for continued investment in wastewater treatment infrastructure. The EPA has listed a number of areas in which secondary treatment or secondary treatment with nutrient reduction are still required and all of these locations are included in the current water services investment programme, with contracts under way or schemes in planning with a view to completion by 2015 at the latest.
The combination of investment, licensing and supervision of the sector is having a positive effect. The Department of the Environment, Community and Local Government will continue to work with local authorities and the EPA to ensure the investment made, combined with a continuous improvement in operations, leads to sustained improvements in compliance with standards.
I thank the Minister of State for her comprehensive reply. I accept that she may not have the relevant information in her possession, but I was under the impression that the EPA had indicated that 50% of current public waste water treatment units needed to be upgraded. This is an astonishing figure. I am somewhat confused by the fact that the report to which the Minister of State referred indicates a compliance rate of 93% in respect of the 2005 deadline. There is obviously a slight difference between these two figures. I would appreciate if it the Minister of State provided further information on this matter.
I will certainly ask the Department to communicate further with the Senator on the matter. However, I must take issue with him on the points he made on what was happening in the Dublin area. It is easy for people outside the capital to point the finger and state that Dublin gets everything. When one considers the figures, it is obvious that this is not the case. In that context, one could highlight the significantly higher level of investment in road projects, schools, health services, etc., outside the greater Dublin area. If one is determined to discuss these issues, one must compare like with like.
The Minister of State and I will have to engage in a debate on the rural-urban divide at some point.
The Seanad adjourned at 2.45 p.m until 2.30 p.m. on Tuesday, 6 March 2012.