Seanad Éireann debate -
Wednesday, 20 Feb 2013

Vol. 221 No. 5

Adjournment Matters

Schools Recognition

Senator Martin Conway

Cuirim fáilte roimh an Aire go dtí an Teach. Mol an Óige national school in Ennistymon which is part of the Steiner family of schools was established a number of years ago by volunteers. It is based on the Steiner model, although it is more streamlined. Well in excess of 100 students attend the school.

There are well in excess of 100 students attending Mol an Óige national school, Ennistymon. The school has applied for permanent recognition for a number of years. It has temporary recognition. It believes, I have no reason to doubt, it has met the criteria required by the Department for permanent recognition. Because of growing numbers, permanent recognition is an important aspiration that needs to become a reality. Many parents have chosen to opt for this type of education. The alternative approach being proposed is not that much of an alternative. Having spoken to a number of parents who have made representations to me, they consider that their children are benefiting from Mol an Óige school. Given that it is in operation for a number of years, that the children are doing well, that the parents are happy and that it meets the vast majority of the criteria - there may be one or two areas on which discussions are taking place - permanent recognition should be granted. Were that to be granted it would give the school certainty and facilitate the building of a new school. At present the school is located in prefabs. It would provide the certainty it needs to further develop the educational offering being provided at present.

Minister of State at the Department of Education and Skills (Deputy Ciarán Cannon)

I am taking this matter on behalf of my colleague, the Minister for Education and Skills, Deputy Ruairí Quinn.

I thank the Senator for raising the matter as it provides me with the opportunity to outline the current position on the recognition status of Mol an Óige Steiner national school, Ennistymon, County Clare. Mol an Óige Steiner national school, which implements the Steiner approach to education, was initially awarded provisional recognition in 2008 and this has been extended year on year. As the Senator is aware, all recognised schools, regardless of their philosophy or ethos, are required to comply with the Education Act 1998 and the rules for national schools. Schools seeking permanent recognition must also satisfy specific criteria in relation to patronage, board of management, implementation of the curriculum, admissions policy and procedures for the appointment of teaching staff. Permanent recognition is contingent on schools demonstrating that they meet those requirements satisfactorily.

A process is under way in relation to the request for permanent recognition from the school referred to by the Senator. This process is based on the school's progress in fulfilling ten undertakings committed to by the school's patron in 2007. These undertakings were based on requirements outlined in the Education Act 1998 and the rules for national schools, as well on the aforementioned criteria which all schools applying for permanent recognition must satisfy. One of the undertakings is that the school will follow the primary school curriculum as laid down by the Department of Education and Science.

My Department met with the school authorities in October 2012 to discuss the school's current position in relation to those undertakings and with a view to enabling the school to meet the permanent recognition criteria concerned. I understand substantial progress has been made. However, significant issues remain to be resolved particularly in relation to how provision for pupils in the infant classes conforms with the primary school curriculum. I understand also that the Department and Mol an Óige Steiner national school have committed to ongoing engagement with a view to enabling the school to meet the permanent recognition criteria as soon as possible.

In that regard, further correspondence has been received recently in respect of the school which is under consideration. It is important to note that the decision regarding full recognition depends upon the satisfactory implementation of all the undertakings.

I again thank the Senator for allowing me the opportunity to outline the position regarding the application for permanent recognition from Mol an Oige Steiner national school in County Clare.

An Leas-Chathaoirleach

Senator Martin Conway can head away with his good news.

Senator Martin Conway

I am happy with it today.

Ambulance Service Provision

Senator Mark Daly

Before commencing I welcome the research staff of St. Vincent's Hospital who work with Senator John Crown. It is apt that my question is on the ambulance service, although a long way from St. Vincent's Hospital.

I welcome the Minister of State to the House. We miss him since he left. The matter I wish to raise concerns the people who will be affected by the proposed cut in ambulance services in Kenmare, Killarney and Cahirciveen. In reality it means people are going to die. That is the stark reality.

The ambulance service in Kenmare is 24/7. What we are hearing through the HSE grapevine is that the 24/7 service in Kenmare, Cahirciveen and Killarney will be reduced to an ambulance car at weekends and after 8 p.m. What that means is that if a person suffers a stroke or a heart attack or there is a serious incident requiring an ambulance in Kenmare, Cahirciveen or Killarney area he or she will get a reduced service. In an example given to me by experts in the field, it was claimed that if an accident occurs in Lauragh at a weekend and the ambulance has to come from Killarney, it would take up to an hour. First, an ambulance car would go to the area which, as described to somebody in the profession, is the equivalent of sending a fireman with a fire extinguisher to a blazing house fire when what is needed is the fire brigade. If the ambulance is required to transport a person to hospital in Cork or Tralee, it would then be called from Killarney. That ambulance could be out on call which means the ambulance from Tralee would have to be called. Tralee is an hour at speed from Kenmare and from Lauragh an hour and 20 minutes. At this stage, as I am sure the good doctor would know, the outcome would be very poor if one was left sitting on the side of a road two hours after the accident took place.

The reason I ask the question is that we have been told the service will be downgraded and that the reconfiguration will happen in the next few months. Public meetings are being planned in Kenmare to prevent this happening. We know that once the ambulance is gone it will not return. Ultimately, people will die. We have carried out an analysis of the ambulance service during the past 12 months which showed that outcomes would have been far worse for people in the community if they had not been transported to hospital by ambulance within an hour of an accident, stroke or heart attack. They were on the operating table within an hour and a half of the event happening. If the ambulance service is withdrawn and downgraded it will take two or three hours to get the person to hospital. As the Minister is aware what will happen is that the person who suffers a heart attack or stroke will occupy a hospital bed and instead of having a stent inserted and recovering in a day or a week, will need rehabilitation and physiotherapy and will cost the taxpayer more. We all know prevention is better than cure. By giving people the attention they need as quickly as possible, the taxpayer will ultimately save money. We are going to be penny wise and pound foolish. We have been told that we are at the tail end of the process, that money had to be allocated to other constituencies to beef up services in west Cork where a campaign was run, which the Leas-Chathaoirleach will be well aware of it, having been involved in it. The HSE will try to make the savings in south Kerry and ultimately lives will be lost and there will be worse outcomes as a result of the proposed and threatened downgrading of the ambulance service.

Deputy Ciarán Cannon

I am taking this Adjournment matter on behalf of my colleague the Minister for Health, Deputy James Reilly. I thank Senator Mark Daly for giving me the opportunity to address this matter.

The National Ambulance Service, or NAS, is not a static service. The NAS deploys its resources dynamically and on a regional and national rather than a local basis. Dynamic deployment of ambulance resources ensures the nearest appropriate resource is sent to an incident. Senator Mark Daly may be aware that following a Labour Court decision the NAS has been implementing the phased replacement of on-call with on-duty rostering in the southern region. On-call rostering means that a crew is not at work but is summoned for a call-out. The average time from call-out to a vehicle leaving a station is more than 20 minutes. On-call rostering significantly affects response times, operational capacity, compliance with the Organisation of Working Time Act and health and safety for staff. An on-call rostering risk assessment has been carried out for inclusion on the NAS risk register and discussions are pending with the Health and Safety Authority on its concerns about the use of on-call services.

On-duty rostering means that highly trained paramedic crews are in their stations or vehicles to respond immediately to emergency calls. On-duty ambulances and response vehicles are deployed dynamically according to need and demand patterns rather than on the basis of station location and can be at optimal locations at any time based on predictive needs assessments. This allows greater flexibility and responsiveness and will produce better response times and an improved service for the people of Kerry. The NAS has been taking a number of other steps to improve response times, including a performance improvement action plan, more efficient rostering, an intermediate care service for non-emergency clinical transport, the national control centre reconfiguration project and a trial emergency aeromedical service.

On the specific query raised by the Senator, the NAS advises that the current on-call static service in Kerry will be replaced. The NAS is considering the most appropriate model for ambulance services in the Kerry region. Consultation will take place with a wide range of interests including the public, staff, general practitioners and other health care colleagues. Other factors to be considered include the results of the implementation of efficiency measures in other regions, new arrangements under public service agreements, activity and demographic analyses and developments in emergency aeromedical support. In line with the Labour Court recommendations, any new service model must be delivered from within existing resources, not limited to main towns and not based on the current static on-call structure. When the process is completed an appropriate model will emerge. The HSE is committed to briefing Members of the Oireachtas, public representatives generally and community leaders before implementing a final service model.

An Leas-Chathaoirleach

An bhfuil an Seanadóir sásta?

Senator Mark Daly

Níl.

An Leas-Chathaoirleach

I will give you a brief opportunity to respond, but Deputy Cannon is not the line Minister and may not be in a position to answer.

Senator Mark Daly

I am sure the Minister of State will be able to find the answer for me. I am grateful for his statement and for the previous briefing I received from experts in the field. Hidden in the Minister of State's statement is Civil Service-speak for box-ticking and ensuring that benchmarks are reached. When average call-out times are referred to, what is really meant is that a person will be seen by a paramedic or a trained professional. What is not said is that it will not be by a person in an ambulance. It can be half an hour or an hour before emergency medical personnel arrive at a location in some parts of Kerry. When they get to the scene, it will be in an ambulance car. A person might need to be transported, at which point an ambulance will have to be called for. This means more time is lost. Any doctor will tell one that the more time lost in the case of a critical patient, the poorer the outcome.

I loved the reference - it has got to be great - in the Minister of State's speech to on-call risk assessment with regard to where ambulances will be placed. This implies that the HSE has a crystal ball and knows where people will have heart attacks and strokes around south Kerry. It has a risk assessment that tells the HSE to have an ambulance sitting at the Healy Pass or near the tunnel in Glengarriff on a Friday night because that is the part of the world where there will be heart attacks and accidents. The predictive needs assessment is what is being talked about. The HSE is predicting where accidents will occur and will locate ambulances there on Friday and Saturday nights or Sundays between 8 a.m. and 8 p.m.

I see that we will be told before the final service model is implemented but we are not being told what the range of options is. What we will get from the HSE is a briefing when the new service is about to be implemented but nothing about the practicalities on the ground or the effect it will have on people. The HSE is trying to say it will have an ambulance on call, but it will be an ambulance car, which is no good to a person who is lying on the side of the road in Sneem, Cahersiveen or Killarney while the ambulance he or she actually needs has gone somewhere else. That is what we are talking about. People are going to die because we are taking away the 24/7 front-line service provided by the people who were protesting this week in Tallaght. People are going to die as a result of the withdrawal of the ambulance service in south Kerry.

An Leas-Chathaoirleach

The point is well made. I have been more than lenient with the Senator.

Senator Mark Daly

You have always been like that, a Leas-Chathaoirligh. I acknowledge that the Minister of State is not the man in charge of giving the answer, but he might bring the matter back to the Cabinet.

An Leas-Chathaoirleach

We ask the Minister of State to convey the concerns of Senator Mark Daly to the senior Minister, Deputy James Reilly.

Deputy Ciarán Cannon

I shall do that. I just want to make two quick points.

An Leas-Chathaoirleach

No problem, but briefly.

Deputy Ciarán Cannon

Moving from the model of an on-call ambulance service, under which one may have ambulance personnel sitting in their living rooms at home waiting for a beeper to go off, to a model in which they are in their vehicles or local stations and capable of responding quickly to emergencies is a very positive development. I made the point that there will be extensive consultation with the public, staff, general practitioners and all other health professionals before the final model is arrived at. There is no question about that.

One can carry out reasonably scientific analyses of populations and historical ambulance calls in particular regions. One does not expect that ambulances will be located on the top of mountains with population densities of two people per square kilometre. One can use a lot of past data to inform a decision on the optimum location for an ambulance. The Senator's contribution indicates that there is a great deal of speculation out there, with little basis in fact, as to what might happen. Let us see what the process involves. There will be consultation and the Senator may be surprised by its outcome.

Senator Mark Daly

Pleasantly surprised, perhaps.

An Leas-Chathaoirleach

We were pleasantly surprised in west Cork last week. One never knows.

The Seanad adjourned at 6 p.m. until 10.30 a.m. on Thursday, 21 February 2013.