Adjournment Matters

State Examinations

Senator Marie-Louise O'Donnell

I thank the Minister for Education and Skills, Deputy Jan O'Sullivan, for being here. She knows that the secondary school teachers are going on strike in December and January with very good reason, because they want the junior certificate externally examined in all subjects and forms of subjects. They do not want 40% internal examination regardless of what the 40% entails.

Teachers are in favour of new forms of assessment and new proposals and they welcome all new forms of practice. Down through the years they have initiated great creative and imaginative practices on practical assessments in their own subject disciplines. Many subjects have practical assessment procedures at their core, for example, science, art, history, CSPE, music and languages. However, these are always externally assessed. That is the key to their success and the key to why all students regard the State examination as relevant. It is also why teachers are going on strike. They are going on strike to maintain the truth of the external examination assessment, keep it above reproach, maintain its human objectivity, keep it at arm's length nationally, maintain national standardisation and above all to maintain its national honesty. They are in favour of all kinds of procedures in the future. They are not in favour of internal assessment.

There is a national impasse and the teachers are correct. I am going to be backing them. The reason the Minister is here today is to possibly tell me how the impasse is going to be resolved and what she intends to do about it because the teachers are experts and correct. The Department is not.

Senator Gerard P. Craughwell

Cuirim fáilte roimh an Aire. I am not going to ask the Minister to debate the issues she is negotiating with the unions here in public, nor am I trying to negotiate on behalf of the union that I once headed up as president. I know she has noted that members of the unions are in the Gallery.

I want to bring a very simple scenario to the Minister. For the sake of argument, let us take Rathkeale in County Limerick, where if children do not want to go to the secondary school in the town they have to go to Newcastle West or into Limerick. There are teachers living in the area assessing those children. Let me give an example of a case of which I have personal experience. A teacher with four daughters is living in a village where his father runs a shop with petrol pumps and an undertakers business. The four daughters have to go through their father's English, history and Irish classes because there is no other teacher to teach those subjects. Imagine if one of those daughters gets an A. The Minister can just imagine the talk in the village, "Ah sure why would she not get an A, with the father teaching above in the school". Imagine one of the next-door neighbours gets a D. That family will not be buying petrol in the teacher's father's shop any more. They will probably look elsewhere to bury their parents because the teacher gave their child a D.

The Minister has come a great distance from where we were and I congratulate her. She has done a tremendous job, but there is one small final step that needs to be taken. The 40% that she is proposing will be administered by the teachers in the school by way of compiling portfolios, and the portfolio should then be sent out for assessment as is currently done with 14 other subjects. Science would be a good case in point. If she makes that last little step, we will have peace in our schools and everybody will get back to work.

Minister for Education and Skills (Deputy Jan O'Sullivan)

I thank Senators O'Donnell and Craughwell for raising this issue. Since my appointment as Minister, I have consulted widely with all education partners on the proposed reform of the junior cycle. I have met with parents, students, management bodies, school leaders and teachers' unions. To progress the debate, it was agreed that Department officials would meet with the teachers' unions. Dr. Pauric Travers was nominated by the teaching unions to act as an independent chair for these discussions, and I accepted the timeframe and terms of reference for those talks which were proposed by the unions. The talks began on Friday, 7 November and concluded on Tuesday, 11 November without agreement.

I believe that I tabled a fair and sensible compromise proposal at the discussions, and I thank Senator Craughwell for his acknowledgement of the progress that I did make. I met the teachers' unions again this morning. However, I regret to note that there has been little movement in their position. A significant gap still remains. I reiterated my proposal which was presented to them last week. I highlighted that I am anxious to engage with them in relation to the resources required to support the implementation of these reforms, but based on my compromise proposals.

The previous framework proposed the removal of state certification from the junior cycle and would have seen 100% of marks assessed by the class teacher in most subjects.

The main elements of my compromise proposals included final examinations in third year accounting for 60% of junior cycle marks, which would be set and marked by the State Examinations Commission; a State certificate would issue to every student on completion of the junior cycle; 40% of junior cycle marks would be awarded for project or portfolio work during second and third year, which would be assessed by classroom teachers, and the State Examinations Commission, SEC, would check 10-15% of these marks to ensure consistency and fairness; and well-being would be a compulsory element of junior cycle, encompassing areas such as physical education, SPHE and CSPE.

Evidence shows that the current structure of the examination does not serve the best interests of students. The skills young people need for life - such as communications, teamwork and problem-solving - cannot be tested by a final written examination. Assessment practices must change to measure these broader skills. School-based assessment will give students the opportunity to demonstrate their many skills, other than those assessed through a written terminal examination. Unless assessment changes, teaching and learning practices in the classroom will not change. If it is only knowledge that we assess at the end point of three years, then the development of skills and attitudes will be, at best, incidental. Our students need these skills to create new solutions to problems, to be confident in themselves, to apply their unique abilities in different situations, to contribute to society in meaningful ways, and to assist Ireland in the future to compete in a global market.

Teachers will be given specific support to enable them to confidently and competently mark their own students and to participate in school-based moderation. This will be done through the continuing professional development, CPD, programmes run by the Junior Cycle for Teachers, JCT, along with National Council for Curriculum and Assessment, NCCA - apologies for all the acronyms - resources, including the assessment and moderation toolkit. It will also include checks of 10% to 15% of material by the SEC to further ensure consistency and fairness.

Having a substantial element of school-based assessment encourages the teaching and accrediting of a broader range of skills. Similar reforms have been introduced in Scotland, Finland, Australia and New Zealand - all countries with high-performing education systems. In Ireland we have been talking about junior cycle reform for nearly 30 years. It is high time that we took action. I am convinced that my proposal will allow for the broad range of skills achieved by students at second level to be assessed and reflected in their results. It will also respect the concerns of teachers. It is regrettable that the union leadership is not prepared to engage with the opportunity my proposal presents. I am willing to engage further with teacher unions on the reform of the junior cycle. I hope they will reconsider the decision to take strike action, and will re-engage on the compromise proposals which have been tabled.

Senator Marie-Louise O'Donnell

The teachers are going on strike, so they clearly disagree. They are not agreeing with these proposals. We have heard them before - I nearly know them off by heart. They do agree - and the Minister keeps making this point - that assessment practices must change. I know many brilliant, creative, imaginative teachers who have changed practices within schools for the benefit of young minds. That is not the problem. The problem is that they want the assessment to be external. That is the problem - not the great expansion of subjects and what teachers do beyond the call of duty, after 4 p.m. and on Saturday mornings. Even the brilliant all-Ireland choirs, for example, are externally assessed by adjudicators. It is not about subject matter or disciplines, but rather the externality of the assessment and the honesty - my God, it is the one thing we have, and Senator Craughwell will speak to this.

The other thing is that we are all over the papers. We are coming down with new skills, attitudes----

I know the qualifying criteria off by heart. An applicant needs to be without the use of one or two limbs and so on. Many people with Down's syndrome are very immobile, tend to be overweight and find it difficult to get around. Does the Minister of State know who William Loughnane is? I guess many Members would not know of him and neither did I until I did a little research. William Loughnane is a 26 year old Special Olympic gold medalist and the first and only person with Down's syndrome in Ireland to receive his driver's licence. There is one person in Northern Ireland and one person in southern Ireland with Down's syndrome who has a driving licence.

The Minister of State can imagine the pressure on parents with a child with Down's syndrome and a number of parents have contacted me. When one lives in rural Ireland, one is many miles away from facilities, as the Minister will well know, and from a little job one's child may have with Down's Syndrome Ireland, the Network of People with Disabilities or an employer who takes on a person with a disability and gives them a few hours work a week. The person with a disability must be driven to their job because they cannot drive themselves. A mother who is a widow has contacted me and she has to do all the driving as she does not have anyone to share it with her. She is exhausted, completely tied down and is managing under financial difficulties and stress. In some cases she has to make two journeys in that she drives to the facility and home and then drives back to collect her child.

I have been fighting for a primary medical certificate to be granted to people with neurological diseases such as Parkinson's disease, motor neurone disease and other diseases. The criteria are very rigid. Even despite appeals to Dún Laoghaire on the matter, those concerned do not seem to win the fight. They have been told that the position is laid down in the legislation, the criteria are set out and they are outside the criteria. I ask the Minister to consider this proposal in a sympathetic way and to say "yes" to it. These people will more than likely never drive and will probably always be a passenger or a passenger with a disability. I ask that the primary medical certificate be extended to facilitate people with Down's syndrome.

Minister of State at the Department of Arts, Heritage and the Gaeltacht (Deputy Joe McHugh)

I thank the Senator for raising this issue and I am also conscious of the fact that she said she has heard it all before-----

Senator Marie Moloney

I understand the Minister of State has to read the reply into the record.

Deputy Joe McHugh

-----but I am also conscious that the Minister for Finance gave me a job to do. It is important to read the reply into the record from a formality point of view.

To give a brief description of the scheme as it currently stands, it provides relief from vehicle registration tax and VAT on the purchase of a specially adapted vehicle, repayment of excise duty on fuel and an exemption from motor tax to drivers and passengers with disabilities who fulfil the medical criteria required to qualify for the scheme. The primary legislation authorising the Minister for Finance to make regulations providing for tax concessions to disabled drivers and passengers is contained in section 92 of the Finance Act 1989, and the regulations introduced subsequently to govern the scheme, including the eligibility criteria, are contained in the Disabled Drivers and Disabled Passengers (Tax Concessions) Regulations 1994.

Currently, to qualify for the scheme, an applicant must have a permanent and severe physical disability within the terms of the regulations and satisfy one of the six qualifying criteria outlined in the regulations. The senior medical officer for the relevant local Health Service Executive administrative area makes a professional clinical determination as to whether an individual applicant satisfies the medical criteria. A successful applicant is provided with a primary medical certificate, which is required under the regulations to claim the reliefs provided for in the regulations. An unsuccessful applicant can appeal the decision of the senior medical officer to the Disabled Drivers Medical Board of Appeal, which makes a new clinical determination in respect of the individual. The regulations mandate that the medical board of appeal is independent in the exercise of its functions to ensure the integrity of its clinical determinations. After six months a citizen can reapply if there is a deterioration in their condition.

The six qualifying criteria, of which the Senator will no doubt be aware, are both strict and precise, and relate only to very specific physical disabilities. They are to be wholly or almost wholly without the use of both legs; be wholly without the use of one leg and almost wholly without the use of the other leg such that the applicant is severely restricted as to movement of the lower limbs; be without both hands or without both arms; be without one or both legs; be wholly or almost wholly without the use of both hands or arms and wholly or almost wholly without the use of one leg; and have the medical condition of dwarfism and have serious difficulties of movement of the lower limbs.

The scheme and qualifying criteria were designed specifically for those with severe physical disabilities. The Minister for Finance frequently receives correspondence from applicants who do not meet the qualifying criteria but feel that they could benefit from the scheme. Those also include citizens advocating for the addition of intellectual disabilities to the qualifying criteria. While the Minister very much sympathises with those who do not qualify for the scheme, he cannot, given the scale and scope of the scheme, expand it further within the current context of constrained resources.

The Senator will appreciate that the scheme represents a significant tax expenditure. Between the vehicle registration tax and VAT forgone and the repayment of excise on fuel used by members of the scheme, the scheme represented a cost of €43.5 million to the Exchequer in 2013. This figure does not include the revenue forgone to the local government fund in respect of the relief from motor tax provided to members of the scheme. In terms of the numbers of beneficiaries of the scheme in 2013, 4,355 citizens availed of the vehicle registration tax and VAT relief, and 11,436 availed of the repayment of excise on the fuel element of the scheme.

The Minister for Finance recognises that the scheme plays an important role in expanding the mobility of citizens with disabilities, and he has managed to maintain the relief at current levels throughout the crisis and despite the requirement for significant fiscal consolidation. While recognising the Senator's position, in the still challenging fiscal environment, the Minister has no plans to expand the medical criteria beyond the six currently provided for in the Disabled Drivers and Disabled Passengers (Tax Concessions) Regulations 1994.

Senator Marie Moloney

I guess it is a bad time to come looking for something new but it is important to highlight the plight of people with Down's syndrome. My timing probably is not great but I hope as we move forward that the finances will be available to expand this scheme further. The cost of scheme at €43.5 million seems quite high when only 4,355 citizens availed of the vehicle registration tax and VAT relief and 11,436 availed of the repayment of excise on the fuel element, but I am sure the figures are correct when the calculations are worked out. For as long as I will be a Member of the Oireachtas I will raise this issue again and perhaps in the future the finances will be available to expand the scheme. As the Minister of State said, one of the criteria is for an applicant to have the medical condition of dwarfism. I agree that people with dwarfism should qualify for the scheme, but that criterion also includes the words "and have serious difficulties of movement of the lower limbs". Many people with Down's syndrome have serious difficulty with the movement of lower limbs. I accept that wording in that criterion was referring to dwarfism but it could be expanded. I know that I am not going to get the answer I want tonight but I will continue to highlight the issue.

Hydraulic Fracturing Policy

Senator Paschal Mooney

Cuirim fáilte roimh an Aire Stáit. The Minister of State is welcome back to the House. It is the first opportunity I have had to engage with him on an issue since he was promoted. I wish him every success in his role. As a Donegal man and a neighbour, the Minister of State will be very familiar with the fracking issue which, initially, is of particular concern in the north west, with particular reference to the Lough Allen basin which covers Fermanagh, Leitrim and part of south Donegal.

Last week there was a briefing in this House by the very well-organised lobby which has grown out of the concerns of people in Leitrim particularly and has expanded into the surrounding countries about the environmental impact of hydraulic fracturing on the terrain. Particular concerns have been raised.

If a licence were granted for exploration there would be a proliferation of wells across the exploration area which would result in severe and long-lasting damage to tourism. Of more immediate concern would be the effect it would have on groundwater. As the Minister of State is aware, the area we are discussing has a significant quantity of water through its rivers and lakes.

At the briefing there was a statement which I have incorporated into this question. The main group involved in the protest against fracking is called Love Leitrim. When visiting the Houses of the Oireachtas last week members of that group stated that the original licence granted by Mr. Conor Lenihan, who was then the relevant Minister of State, to carry out exploratory work, which effectively is desktop work by the two companies then but now one, Tamboran Limited, could or would oblige this Government or a future Government to grant them drilling licences. I am concerned over this.

The original licences were specific and were of an exploratory nature. I put my hands up and admit that initially I had no objection to an exploratory investigation being carried out because where I live in Drumshanbo in County Leitrim explorations have been going on since I was a child by the Canadian organisation Marathon. It was given a licence to explore the Leitrim and west Cavan area for commercially viable gas deposits. So it is nothing new in the area where I lived. It may have been very new to the people in Manorhamilton, Glenfarne and Kiltyclogher where Tamboran was to do its drilling. When the exploratory licence was granted I did not express much concern. However, when it became more apparent it was planning to carry out hydraulic fracturing, like many other people I naturally educated myself as much as I could and particularly investigated what happened in America where this had been carried out.

As a result we are where we are today and the wording of the motion is self-explanatory. I am seeking clarity on the matter.

Deputy Joe McHugh

I thank the Senator for the welcome back to my alma mater; we had many a good debate over a five-year period. It brings back nice memories indeed. I also thank the Senator for raising this matter. While I have outlined the Government's position on the issue of hydraulic fracturing on a number of occasions in Dáil Éireann, this is my first opportunity to discuss the matter in the Upper House.

Three onshore licensing options were granted in the term of the previous Government for the two-year period from 1 March 2011 to 28 February 2013, over parts of the north west carboniferous Lough Allen Basin and the Clare Basin. The licensing options were granted to Tamboran Resources, covering parts of counties Cavan, Leitrim, Roscommon and Sligo; Lough Allen Natural Gas Company Limited, covering parts of counties Cavan, Leitrim, north Roscommon and east Sligo; and Energi Oil plc, covering part of County Clare.

The licensing options awarded were preliminary authorisations designed to allow the companies assess the shale gas potential of the acreage largely based on desktop studies of existing data. Exploration drilling, including drilling that would involve hydraulic fracturing, was not permitted under these licensing options. The licensing options gave the holder the first right, exercisable at any time during the period of the licensing option, to apply for the grant of an exploration licence over all or part of the area covered by the licensing option. Tamboran Resources and Energi Oil plc have exercised that right and have submitted applications for follow-on exploration licences.

Successive Ministers and Ministers of State at the Department of Communications Energy and Natural Resources, including me, have confirmed that no decision will be made on these applications pending the outcome of the Environmental Protection Agency's research programme into the use of hydraulic fracturing. The key questions that the EPA research programme, which is to be carried out over a minimum of two years, needs to answer are as follows. Can unconventional gas exploration and extraction projects and operations be carried out in the island of Ireland while also protecting the environment and human health? What is the best environmental practice for such projects and operations?

The research will consider baseline characterisation with regard to water, seismic and air quality, potential impacts and mitigations and best practice regulatory frameworks. Detailed information on the regulatory approaches of other countries that have extensive experience with this activity will also be considered. The research programme is also expected to consider a minimum of five countries including at least one country where a moratorium on unconventional gas exploration has been introduced.

Any application proposing the use of this technology would be subject to the existing statutory framework which includes environmental impact assessment. Such an assessment entails consideration of the potential impacts of a project on population, fauna, flora, soil, water, air, climatic factors, material assets, including the architectural and archaeological heritage, landscape and the inter-relationship between these factors. It is not considered feasible to conduct such an assessment in Ireland until the EPA research programme has concluded and there has been time to consider its findings.

Senator Paschal Mooney

I am grateful to the Minister of State for bringing some clarity to the question. However, his reply has not totally reassured me. He said:

The licensing options gave the holder the first right, exercisable at any time during the period of the licensing option, to apply for the grant of an exploration licence over all or part of the area covered by the licensing option. Tamboran Resources and Energi Oil plc have exercised that right and have submitted applications for follow-on exploration licences.

That seems to indicate that the Minister of State's hands are tied and that he will effectively have to give them the licence because they have exercised their option.

I appreciate what the Minister of State has said in the rest of his reply concerning the EPA research programme and environmental impact assessment. He also referred to a regulatory framework that would have to be brought into play. However, all that points to creating a structure to allow drilling for shale gas using hydraulic fracturing. Essentially that is the question.

I am sorry to be pressing the Minister of State on this but I am sure he fully understands where I am coming from. Is the Minister of State saying that based on the granting of the exploratory licence the law as currently constituted has given Tamboran and Energi plc the right to ultimately drill using hydraulic fracturing if they comply with all the regulatory framework, with the EPA conclusions and with the environmental assessment? Presumably the EPA will provide recommendations, assessments and conclusions, but the EPA will not making the law and will just be making a recommendation. I am sure the Minister of State knows exactly where I am coming from on the matter.

Deputy Joe McHugh

Yes.

Senator Paschal Mooney

I am not totally convinced that the Government or any future Government might find itself obliged to grant the licence and then operate a regulatory framework.

Deputy Joe McHugh

Prior to the start of the EPA research project, I had a number of meetings even during the summer. I met representatives of groups from Sligo. The Minister, Deputy White, and I had a meeting in Dublin with a group from Cavan County Council and Leitrim County Council. There are obvious concerns and I take them very seriously.

While they exercised their right to make an application, the fundamental factor is that an EPA study has been initiated. I will list a few of the stakeholders to show that this is not just a tokenistic exercise. It is not simply a case of a group compiling a report and setting out a series of recommendations, but not being listened to. I will give the Senator an idea of the composition of this group, which operates on a North-South basis. It includes representatives of Queen's University Belfast, the British Geological Survey, the University College Dublin geophysics group, the University of Ulster geophysics research group and the Dublin Institute for Advanced Studies seismology and geodynamics group.

My confidence in the research is borne out of the time that has gone into the preparation of the survey initiated by the Environmental Protection Agency. I have asked my officials to examine the possibility of providing for something, perhaps next summer, that would give the Members of both Houses an update on the research findings in areas like health and the environment. I do not want to call it a mid-term review. I have asked my officials to consider that. They will set about a process in that regard. The important thing is that I have asked the people who are leading this survey, which will last for a minimum of two years and possibly for longer, to take the time to look at it properly. We are talking about what could hypothetically happen down the line. I am not going to presuppose what will come out of this survey. The important thing is for us to continue the debate and the dialogue. We need to feed into this process. I know it is happening at a community level. I will continue to engage in dialogue with people at local council and community levels who may have fears and concerns.

We have to look at the cross-Border institutional mechanism that is in place. I refer to the North-South Ministerial Council. This is as much a North-South issue as it is an issue for Leitrim, south Donegal, Cavan or Sligo. Inbuilt political mechanisms have been available since 1998. It would be important to get this issue on the agenda of the North-South Ministerial Council as soon as possible. Given that we have a mechanism involving the universities in Northern Ireland and the Northern Ireland equivalent of the Environmental Protection Agency, there is no point in having different narratives coming out from political parties in Northern Ireland and from political parties in Southern Ireland. A natural North-South dialogue is going on here. I encourage Senator Mooney, who has experience in the British-Irish Parliamentary Assembly and has built relationships with his colleagues in Northern Ireland, to continue this conversation on a North-South level. The Joint Committee on the Implementation of the Good Friday Agreement, which I have experience of as a former Chairman, is another mechanism that would enable this conversation to continue.

I reiterate that the two companies that have been mentioned had the right to submit applications for exploration licences. Those applications will not be looked at by me or by my colleague, the Minister, Deputy White, while the Environmental Protection Agency study is ongoing. No decision will be made and no licences will be looked at.

Senator Paschal Mooney

Can the Government legally stop it?

Acting Chairman (Senator Catherine Noone)

No further debate, please. I ask the Minister of State to conclude.

Deputy Joe McHugh

Nothing will happen for the next two years, at least.

General Practitioner Services

Senator Colm Burke

I welcome the Minister of State to the House. I know he is stepping in for the Minister for Health on this matter. Ireland has the highest rate of hereditary haemochromatosis, which is a condition caused by the gradual accumulation of excess iron in the body, in the world. Haemochromatosis can develop without symptoms until it reaches an advanced stage at which it can be fatal. The treatment of hereditary haemochromatosis simply involves the removal of a pint of blood. At the moment, the process in the Cork region is that it is dealt with in a clinic at Cork University Hospital, CUH. A number of general practitioners who are prepared to offer this service have come together. It is not about trying to take over someone else's territory; it is very much about trying to alleviate the problems in the clinic in CUH. All of this would have huge benefit for patients in the clinic in question. If the GPs were able to deal with it, a substantial cohort of patients would be rapidly and permanently removed from CUH. This would allow the relevant department in the hospital to service an additional clinic. It would be cost-neutral from an infrastructure and manpower perspective. Waiting lists would be gradually reduced.

I will set out what the GPs are basically looking for. University College Cork, UCC, is prepared to come on board to research the viability of the project. I understand the amount of money involved in putting it together is approximately €28,000. UCC is prepared to carry out the research. A number of GPs would work with CUH and UCC to develop a clear protocol for the management and treatment of hereditary haemochromatosis. The GP practices would rigorously implement the agreed quality protocol. When patients enter the maintenance phase of management, they would be referred to the Irish Blood Transfusion Service to become blood donors. Patients who are not eligible to become blood donors would continue to attend the treating GP. I understand that the blood taken from the patients attending CUH is destroyed. It does not even go to the blood bank.

It is being proposed that this service should be provided as part of a joint approach between CUH, the GPs, UCC, which will do the research, and the Irish Blood Transfusion Service. I understand the annual cost saving in the Cork region alone would be approximately €1.2 million. I am astonished that the HSE is not buying into the proposal. I have been told that the GPs who came forward with the proposal are talking about walking away from it because they feel it is being pushed down the road. I believe it should not be pushed down the road. If this cost-saving exercise leads to the provision of this service in local areas around the county of Cork, people will not have to travel all the way into CUH from north and west Cork, etc. I think that is another one of the advantages of this scheme.

Deputy Joe McHugh

I thank Senator Burke for raising this issue. It is close to my heart, if Members will pardon the pun, because I have haemochromatosis. It is important for me to declare that conflict of interest before we move on. I am delighted that the Senator has raised it. I have worked closely with Margaret Mullett, who is the chairperson of the Irish Haemochromatosis Association. Her husband passed away because too much iron had built up in his blood. Obviously, that was before she became aware of this issue. That is how she ended up getting involved in the association. Her objective is to raise awareness. I hope the raising of this issue by Senator Burke this evening will help Ms Mullett on her journey as she tries to create awareness.

I am responding on behalf of my colleague, the Minister, Deputy Varadkar. Haemochromatosis is a relatively common condition in Ireland. If a person has haemochromatosis, his or her body absorbs too much iron from his or her diet. After it has been diagnosed, it is treated by removing blood regularly to get rid of excess iron. This process is referred to as venesection. Patients with haemochromatosis in Ireland were traditionally treated through their general practitioners or as outpatients in a hospital environment. Under a framework agreement that was signed on 4 June last, the HSE, the Department of Health and the Irish Medical Organisation have commenced substantive talks on a new General Medical Services GP contract. The inclusion of chronic disease management for patients and the provision of mechanisms to ensure patients are treated in the community, where possible, will be prioritised in these discussions. I expect that haemochromatosis services will be considered in this context.

As the treatment for haemochromatosis involves blood removal, and because patients are often well and eligible to be blood donors, the Irish Blood Transfusion Service has developed a haemochromatosis service in recent years.

It has resulted in the cost effective treatment of people with this common disorder. It is provided free of charge to those with haemochromatosis and, in turn, the Irish Blood Transfusion Service, IBTS, can use the blood for transfusion.

The IBTS started a programme of treating haemochromatosis patients at its Stillorgan centre in 2007. The centre operates a full care model where the IBTS manages the ongoing care of the haemochromatosis patient while performing the necessary venesections. The patient must attend his or her referring clinician for annual review. A total of 600 patients are now being treated at the Stillorgan centre, which is at full capacity.

In August 2013, the IBTS commenced a second haemochromatosis service at its D'Olier Street blood donation clinic in Dublin. A further service commenced at its Cork centre in January 2014. At both locations, clinical responsibility for the patient remains with the referring clinician, but the IBTS provides an option of a maximum of four venesections per year. In many cases, where these patients meet all of the normal blood donation criteria, they can then become blood donors. I am delighted to inform the Seanad that the IBTS plans to expand its haemochromatosis service further at its Limerick centre. A planning application in this regard is being finalised by the IBTS.

The haemochromatosis service provided by the IBTS is positive for the overall health service. Eligible haemochromatosis patients are provided with a free service and the maintenance of the national blood supply for patients in our health care system is enhanced. Many haemochromatosis patients also have the satisfaction of becoming regular blood donors to the benefit of others. Services for haemochromatosis patients have improved significantly in recent years and I look forward to their further enhancement as current plans come to fruition.

Senator Colm Burke

I thank the Minister of State. His response was positive, but there is a great reliance on the IBTS developing services. We are discussing rolling out a small research project to a number of general practices across the country. By working with general practitioners, GPs, in Cork, Cork University Hospital, the IBTS and UCC could identify the best way of managing this system and set out a national template. The sum of money to allow for that research would be small at approximately €28,000. UCC is prepared to do this work. It has spoken with the HSE, but the latter is hiding behind the Irish Medical Organisation, IMO, negotiations. They should not be used as an excuse not to address this issue. This is a great opportunity to determine whether a more comprehensive service can be provided at a much reduced cost for the HSE and taxpayers. It should be considered carefully.

Deputy Joe McHugh

I acknowledge the drive of the Minister, Deputy Varadkar, and his officials in working with the IMO on a new contract. I hope that progress can be made on that front.

If there are areas of research and sums of money are required, it is important to be as inclusive of the stakeholders as possible. I am aware that there will shortly be a meeting between the Irish Haemochromatosis Association, IHA, and the Minister. The Senator has shown an interest, so it would be important were he at that meeting. I can give him the details.

Many people have haemochromatosis. I have it. As I do not know the technical details, I will not go into them. Basically, I must give blood every now and again due to my ferritin levels. Previously, the blood I gave was not used and was instead dumped, so I am delighted that, in recent years, people with haemochromatosis have been able to donate their blood. It is important that their blood can be used. Solutions may be possible at ground level in communities, primary care centres or GPs' surgeries. It is just a question of giving blood. It is not rocket science. It is done to monitor ferritin levels. Science is improving and more companies are getting involved on the monitoring end of things. I will name drop and refer to Randox Teoranta in Dungloe, County Donegal, which is involved in this business and introducing new technologies and sciences to ensure that people with haemochromatosis are diagnosed at an earlier stage.

My only anecdotal advice is this - if people are feeling fatigued, they should go to their doctors to get their blood checked for ferritin levels. They may have haemochromatosis. Since I started giving blood, my fatigue levels have improved immensely. I do not get any sleep anymore in my new job.

Acting Chairman (Senator Catherine Noone)

On that delightfully positive note, we have reached the end of matters on the Adjournment.

The Seanad adjourned at 7.50 p.m. until 10.30 a.m. on Thursday, 20 November 2014.

Seanad Éireann debate - Wednesday, 19 Nov 2014