I welcome the Minister of State, Deputy Ann Phelan, and thank her for dealing with this matter. I am raising it in view of the fact that there has been a substantial delay in getting work done, particularly in Cork City Council. On the one hand, there are people saying they are not getting funding and, on the other, there are people saying that when they get it, there is a delay since they are receiving it later in the year. I understand that although there was some funding allocated in 2013 and 2014 and a programme of works in each case, some of the work was not done, the money was not spent and, as a result, it was refunded to the Department. I seek to identify exactly where the problem is and what now needs to be done to ensure this is not repeated in future years.
Commencement Matters
Local Authority Funding
I thank the Senator for raising this issue. Funding was allocated by my Department to Cork local authorities for social housing for the years in question across a range of expenditure subheads. In some cases, funding was issued on the basis of a distribution of the available national funding across all local authorities. For example, funding in respect of housing adaptation grants for older people and people with a disability is allocated to all local authorities based on a national budget secured by my Department and drawn down in line with the allocations issued. In other cases, funding is allocated for a specific project. For both Cork local authorities, variations in expenditure across the overall capital expenditure programme in 2013 and 2014 range from under-expenditure of 8% to over-expenditure of 42%.
The overspend was in programmes for upgrading, refurbishment and reinstatement of vacant housing units where both Cork local authorities were in a position to draw down additional funds over and above their allocation in 2014.
There can be a range of issues that give rise either to higher or lower spends against allocations. My Department officials stay in ongoing contact with their counterparts in the local authorities regarding drawdown levels and may make adjustments where one local authority notifies a potential underspend and another may have capacity and need to spend more. An underspend in one housing budget line in one particular year does not mean that projects go unfunded. For example, on social housing construction projects, a local authority may anticipate a level of funding drawdown on a project based on anticipated advancement of the project in a particular year. While funding may be allocated in a particular year for this purpose, it is not unusual, with construction activity, that projects may not progress at the speed anticipated and drawdown may, as a consequence, be less than allocated. However, as there are contracts to be honoured in respect of construction projects, my Department and the local authorities will provide funding for legitimate construction costs even where they are presented later than anticipated.
Given the variance that can arise with housing spending, the position revealed by the figures does not always tell the full story. As local authorities are the housing authorities for their areas, however, it is right and proper that responsibility is vested in them to deliver social housing services. Their performance in that regard is overseen, in the first instance, by the elected members of the respective local authorities. Social housing is a key priority for this Government and my colleagues, the Minister and Minister of State, Deputies Alan Kelly and Paudie Coffey, both in this House and the Dáil, regularly address issues relating to the overall national picture for delivery.
Social housing delivery for a particular local authority area should be and is, I have no doubt, a key issue of debate and questioning in the council chambers, in this case in Cork City Council and Cork County Council. The Government's important local government reform policy, Putting People First - action programme for effective local government, highlighted that a key requirement for an effective and accountable system of local authority governance is the effectiveness of the elected councils in setting policy and rigorously overseeing the performance of their organisations. For that very good reason, I believe the possibility of any social housing funding being unspent and returned to the Department should be rigorously overseen by the elected members locally.
My question asked for details of what funding had been allocated, but there were no such details in the Minister of State's reply, with which I am disappointed. My understanding is that €10 million was allocated to one project but €4.5 million was returned to the Department, something to which the Minister of State did not refer in her reply. I asked her to publish details of all housing allocated to Cork City Council. In other words, what moneys were allocated? That is not in the reply. We should be entitled to that information. I can obtain it under freedom of information legislation and do not understand why I cannot receive it in this reply.
I draw the Senator's attention again to my point that for both Cork local authorities' variations in expenditure across the overall capital expenditure programme in 2013-14 ranged from underspend of 8% to an overspend of 42%. If the Senator has specific projects in mind, we will undertake to obtain more detail for him. Perhaps he might engage with some of the local members to-----
I am sorry, but the Department should be able to give me figures for what has been allocated to a local authority.
I want to know what funding is allocated to local authorities because we have been told that insufficient funding has been given.
There is no provision for questions.
We need specific figures and I am entitled to them.
I shall undertake to see what we can get specifically for the Senator.
I thank the Minister of State.
Domestic Violence Policy
I thank the Minister of State for coming to the House.
Recently I have been asked to help with a number of cases specifically around the issue of domestic violence and abuse. One of these cases involves a woman in her fifties who was resident in council accommodation for over 30 years. I do not want to identify her due to the very real danger that she may find herself in and because of the obvious sensitivities. She found herself in a situation in which she had to leave her home recently after enduring decades of domestic violence. Owing to the impending closure of the emergency accommodation she is now living in, she will find herself homeless two weeks before Christmas. She will also find herself way down the housing list as a result, even though she has never missed a payment of rent on the council house that she has lived in for more than 30 years.
Domestic violence affects thousands of people, as the Minister of State will know. An environment needs to be created to encourage victims to leave the danger they are in. As many as 207 women have been murdered in Ireland since 1996. In 2014, Women's Aid heard 595 disclosures of sexual abuse, including 176 disclosures of rape by partners or ex-partners. Out of all of the contacts to Women's Aid, there were more than 1,600 disclosures of emotional, physical, sexual and financial abuse. It is with this in mind that I ask the Minister of State to outline how cases are prioritised in the system. I suggest the Department introduce a verified points-based system to enable those most in need to achieve safe, secure and permanent housing, rather than taking cases by date order, or a separation of lists, which would mean there was a tangible way of measuring need. Victims deserve protection from domestic violence. Owing to the increasing burden being placed on voluntary organisations which do a great job in providing emergency accommodation, will the Minister of State consider a new approach to the allocation of housing?
I thank the Senator for raising this very serious issue which, unfortunately, continues to be a blight on society and has a terrible impact on victims and their families. It is important to note that housing authorities do not provide or oversee services specifically designed for victims of domestic violence. Responsibility for the development and provision of services to support victims of domestic abuse rests with the Minister for Children and Youth Affairs, and the delivery of such services is managed through the Child and Family Agency, Tusla.
Victims of domestic violence who seek emergency accommodation from a housing authority are generally placed in temporary accommodation arranged by the council or operated by a voluntary service provider. It is not necessary for such persons to go on the general housing waiting list to avail of short-term emergency housing. Such support can be provided where victims of domestic violence meet the homelessness definition set out in the Housing Act 1988, which is not prescriptive and in practice will generally include victims of domestic violence.
Where victims of domestic violence need continued State support to meet their housing needs, housing authorities are encouraged to work with all service providers to ensure a victim's housing eligibility and need is assessed in a timely manner. This assessment is carried out in accordance with section 20 of the Housing (Miscellaneous Provisions) Act 2009 and the associated Social Housing Assessment Regulations 2011, which includes a review of the suitability of the household's current accommodation having regard to a number of considerations, including particular household circumstances or on exceptional medical or compassionate grounds. This provision allows a housing authority to consider victims of domestic violence as having a housing need and allows them to be placed on a housing list where all other criteria are met.
The allocation of social housing support to qualified households is a matter for individual housing authorities in accordance with their allocation schemes made under section 22 of the 2009 Act. Each housing authority is required to make an allocation scheme specifying, among other things, the manner of, and the order of priority for, the allocation of dwellings to households and classes of households on the waiting list.
Allocation schemes may also contain provisions for exceptional or emergency cases, allowing immediate housing outside of normal waiting list priorities, should circumstances warrant it.
While the allocation of support is a matter for individual local authorities, the 2009 Housing Act provides that the Minister may issue directions to a housing authority regarding the operation of an allocation scheme and the housing authority is required to comply with any such direction. Using this power, the Minister, Deputy Alan Kelly, issued a direction, which applies until 31 January 2016, to key local authorities requiring them to prioritise homeless and vulnerable households in the allocation of tenancies under their control. Victims of domestic violence who are considered homeless by the housing authority or who are in accommodation that is considered unsuitable, on exceptional medical or compassionate grounds and who are qualified for social housing support on or before 1 June 2015 may benefit under this direction.
I am satisfied that the current provisions and arrangements provide local authorities with appropriate mechanisms to ensure sufficient priority is afforded to victims of domestic violence and other vulnerable groups. In addition to the current provisions which allow for the adequate prioritisation of victims, my Department is involved in a number of initiatives which support victims. Under my Department's capital assistance scheme, support may be provided through housing authorities towards approved housing bodies, AHB, costs in providing accommodation for persons that are qualified for social housing supports that may have particular accommodation needs. There are a number of AHBs which have an emphasis on providing suitable accommodation to victims of domestic violence. It is a matter for individual housing authorities to prioritise the projects to be advanced under the capital assistance scheme. Furthermore, Cosc, the National Office for the Prevention of Domestic, Sexual and Gender-based Violence, which was established in 2007 as an executive office of the Department of Justice and Equality, works to ensure the delivery of a co-ordinated response to issues of domestic, sexual and gender-based violence across government. My Department continues to liaise with Cosc on the development of a second national strategy on domestic, sexual and gender-based violence which should be finalised shortly. While there is no proposal to redefine victims as a specific category of prioritised housing need, my Department will commit, under the strategy, to develop guidance for housing authorities to ensure effectiveness and consistency in local authority responses for victims of domestic violence.
I thank the Minister of State. Does Senator Máiría Cahill have a question?
I welcome the Minister of State's comprehensive answer. I note with some concern that the direction made by the Minister only extends to 31 January 2016. I will obviously be calling for it to be extended for much longer. We are talking about the need to remove barriers for those who urgently need to leave their homes. We are not talking about emergency accommodation but about long-term, safe and secure accommodation. With that in mind and while all of this is welcome, I believe that a national direction should be given in order to have a systematic, joined-up approach. In addition, some sort of regulated, uniform thinking is required among those allocating housing to assist based solely on need. This is one category of victims which should absolutely be based on high priority housing need. Would it be possible, therefore, to get a commitment that there will be some degree of creative thinking nationally, instead of dealing with such problems locally? In the case I am dealing with, it is clearly not working.
I am mindful that we sometimes need housing bodies to have a degree of flexibility. A local solution to a local problem is often the best way to go. Given that the Department is liaising with Cosc in developing a second national strategy on domestic, sexual and gender-based violence which will be finalised shortly, perhaps the Senator might wait to see what that strategy contains. I could, perhaps, assist the Senator in working with the Minister to see how we can have better recognition of domestic violence in that strategy.
I am mindful of not weighting things too much. Sometimes when we make changes we have to be careful about unintended consequences for another cohort of people. Perhaps we might wait and see what the strategy states and we will continue to work on it.
Motor Insurance Coverage
I welcome the Minister for Transport, Tourism and Sport, Deputy Paschal Donohoe.
I also welcome the Minister. In the past year or so we have seen many protests about water charges and so on. In some cases people were asked to pay an extra €160 when the conservation grant is taken into account. In some cases the charge was €80. In many cases there was no charge at all. We have a bigger problem with charges. The bigger problem is the major increase in car insurance, house insurance and health insurance costs. This year, many of the costs seem to have gone up by 25%, 30%, 50% or 60% for absolutely no reason whatsoever. I know of many examples. I have one example involving house insurance. A man made a claim for an iPad that broke. There was an excess on the policy and all he was able to claim was €150, but his insurance policy went up by €300. When he rang and questioned those responsible, they told him that if he paid back the €150, they would reduce his policy by €300. They seem to be making it up as they go along.
This problem arose in 1984 and, as a result, the Motor Insurance Advisory Board was set up. The board last reported in 2004. At that stage responsibility for those duties was transferred to the Department of Transport, Tourism and Sport. Now, it appears nothing is listed on the Department's website indicating that the Department has any responsibility. There seems to be no monitoring body. Consequently, these companies are showing no loyalty to their customers. Although I advise customers to shop around, it seems to be clear that there is a degree of cartelism operating with all the insurance companies. All of them are guilty of the same thing.
I am calling on the Minister to re-establish the Motor Insurance Advisory Board. I will set out two examples for him. An elderly man telephoned me. He is 73 years of age and drives a 2003 Ford Fiesta. The value of the car is €1,000. He has a 60% no-claims bonus. He is asked to pay €880 per year. A lady was on the telephone to me the other day. Her son drives a small 2002 Audi to bring him to college in Mountbellew every day. The college is not far enough away for him to get accommodation there. Last year his insurance policy was €1,400 on the basis of no claims, no penalty points and the car depreciating all the time. The premium has gone up to €2,648 this year. That is almost a 90% increase for absolutely no good reason. I heard from another young person who told me that cars 13 years or older are particularly targeted by the insurance companies. That is the reason the young man I referred to has had this dramatic increase in his policy.
We put cars through the national car test. Either the result of an NCT is of value or it is not. We have to get clarity on the matter because families are being crippled with these payments.
There is no evidence to suggest the reason for these hikes in insurance charges is vast payouts. In fact, there is €1 billion in the difference between premium income and the published awards.
My final point relates to the 3% levy policyholders pay. It is fine for people who are paying €200 or €300 for car insurance. They can get away with €6 or €9 per year extra. However, the young man I made reference to will have to pay an extra €158.88 because of the 3% levy. As well as re-establishing the Motor Insurance Advisory Board, I call on the Minister to introduce a set fee rather than a set percentage.
I thank the Senator for raising this matter with me.
I should clarify that the Motor Insurance Advisory Board, MIAB, was not originally established by my Department, nor do I have a legal role in that area or the re-establishment of the board. The MIAB was originally established under the Motor Insurance Advisory Board Act 1984, introduced by the then Minister for Industry, Trade, Commerce and Tourism.
My responsibilities, as Minister for Transport, Tourism and Sport, in relation to motor insurance are limited to the requirements under the Road Traffic Acts relating to compulsory insurance for drivers of mechanically propelled vehicles. To that end, I have responsibility for the current agreement with the Motor Insurance Bureau of Ireland, MIBI. This body was established in 1995, having as its principal role the compensation of victims of road traffic collisions caused by uninsured and unidentified vehicles. It is regulated under the terms of an agreement with me, as Minister for Transport, Tourism and Sport. The most recent such agreement is that of 2009. It is funded by all insurance companies underwriting motor insurance in Ireland which must by law be members of MIBI and contribute to funding the claim in proportion to their market share.
The area for which I have direct responsibility relates to motor insurance costs and the impact they have on road safety, which is my responsibility. On the broader point the Senator has raised, to which I want to respond, I am aware of the clear trend to which he refers, whereby there have been increases of between one fifth and one third in many premia within the motor insurance market in the past 12 months. The motor insurance industry itself is pointing to a number of factors that are causing this, such as the frequency and scale of claims and the cost of those claims. It is also making some observations about the operation of the insurance market and the particular requirement under the solvency II directive from January next year for insurance companies to increase their capital reserves, which could be a contributory factor in some of the premia to which the Senator refers.
The Central Bank is the regulatory body in respect of all this, but it is only able to issue directions to firms in respect of where they price, how they operate and whether any decisions they make would risk the sustainability of the company as a going concern and then cause further issues for policy-holders. I have met and engaged with representatives of the insurance industry regarding this matter and believe the Department of Finance, with the Central Bank, will be reviewing the circumstances that led up to the issues with Setanta Insurance, which have also been a contributory factor in this matter. They will then report back to the Minister for Finance to see what can be learned from this and whether anything can be implemented to deal with the matters to which the Senator is referring.
When I looked for this Commencement debate, I was looking for the re-establishment of the MIAB. I sent the request to the Department of Transport, Tourism and Sport initially because that is where it ended up once it had been disbanded. When my Commencement debate ended up on his desk, the Minister's Department said it had nothing to do with it. It sent it back to the Seanad Office which then sent it to the Department of Finance which stated it had nothing to do with it and sent it back to the Department of Transport, Tourism and Sport. Regarding the exact issue I wanted to discuss, namely, the re-establishment of the MIAB, is the Minister saying it was initially established under the Department of Industry and Commerce? If so, perhaps that is who I should have had in here, not the Minister. The Minister said the Central Bank was regulating insurance costs, but it is not. Costs are spiralling out of all control.
On the area of responsibility, when I became aware of what was happening, I said I would answer the question for the Senator because this matter is best understood relative to what is happening with car insurance, for which I have a responsibility in the context of road safety.
The re-establishment of the MIAB would best sit with either the Department of Finance or the Department of Jobs, Enterprise and Innovation. As I am answering the Senator's question in the House, I will pass this debate we have had on to the Minister for Finance this week because we are engaging within government on some aspects of what the Senator referred to and ask the Minister to revert back to the Senator with a response on this point.
Hospital Services
I welcome the Minister, Deputy Leo Varadkar.
I also welcome the Minister. I am pleased he is taking this Commencement matter.
I have raised this at least seven times as a Commencement matter in the Seanad in recent years. When the new hospital groups were being established - it was not under the Minister's leadership but under the leadership of a previous Minister for Health - Waterford was grouped with Cork in a new hospital grouping and we were promised 24/7 cardiology care for the south east to be provided in University Hospital Waterford as part of that new hospital grouping.
We have one catheterisation laboratory, cath lab, which is open five days a week from 8.30 a.m. to 5.30 p.m. and three interventional cardiologists. Patients may be treated in emergency circumstances from 8.30 a.m. to 5.30 p.m., but outside of these hours, if somebody presents as an emergency, although we have 24/7 consultant cover, we do not have the primary percutaneous coronary intervention, PPCI, cover and patients are transferred to hospitals in the south and south west for emergency treatment outside of these hours. On the previous occasion I raised this as a motion in the Seanad, I was told that an extension to the service would require three additional interventional cardiologists or consultant cardiologists, extra support staff and a second cath lab, involving a capital cost of €1.9 million and a revenue cost of approximately €2.7 million. The Government tells us constantly that the economy is recovering, there is more money and the Exchequer figures are up. If that is to mean anything to citizens, these are the types of service which should be provided.
Figures reported in the Waterford News and Star last week showed that the service in Waterford was the sixth busiest cardiology service in the State. St. James's Hospital in Dublin was the busiest, followed by the services Cork, the Mater Hospital in Dublin, Galway, Limerick and Waterford. A number of hospitals see fewer patients but yet have 24/7 emergency cardiology cover and two cath labs. It is the same old story for Waterford and the south east. While we have the population of 500,000 and there is clear demand given that it is the sixth busiest cardiology service, we do not have the 24/7 cardiology cover people feel they deserve and need and which was promised by the previous Minister for Health.
In the light of the response I received in August which referred to the cost and the resources that needed to be put in place to have 24/7 cardiology services, what is Government policy? Is there a commitment to provide a 24/7 cardiology service? Are we working towards it? Are there plans for additional services in this area for University Hospital Waterford and will the Minister update the House on the matter?
I thank the Senator for raising this matter.
Services at the regional cardiac catheterisation laboratory, cath lab, at University Hospital Waterford are led by three consultant interventional cardiologists and their teams.
The service is developing in line with best practice and the national clinical programme for acute coronary care. The cath lab at University Hospital Waterford performs approximately 40 invasive cardiovascular procedures each week and offers a comprehensive range of invasive and non-invasive diagnostic services. This includes the insertion of stents, pacemakers and implantable defibrillators. PPCI is undertaken on patients with ST elevation myocardial infarction, STEMI, heart attacks, which account for approximately 20% of all heart attacks. It is done in a cath lab by an experienced cardiologist. The cath lab at University Hospital Waterford is open five days per week from 8.30 a.m. to 5.30 p.m. Patients who require PPCI outside these hours are transferred to Cork University Hospital or to a Dublin hospital. However, 24-hour, seven-days-a-week consultant medical cover for cardiac patients, and all medical patients, is provided at University Hospital Waterford.
The acute coronary syndrome programme was established in order to standardise the treatment of patients. The model of care produced by the programme was informed by advice from the principals involved in centres in the United Kingdom and other European countries. Experience at national and international level highlights the importance of having sustainable rotas of clinical staff to support the 24/7 requirements of the service. University Hospital Waterford is committed to the progressive extension of the current PPCI service. Any extension to the service will require significant investment, both capital and revenue.
To provide 24-hour emergency PPCI cover requires, at a minimum, two cath labs on site and a minimum of six interventional cardiologists. As for any complex acute hospital service, a key criterion for deciding if a 24-hour PPCI service should be provided is whether there is a sufficient volume of appropriate patient activity to ensure the safe provision of the service. Without sufficient volume of patients or caseload, staff will not be in a position to maintain their skills, and in those circumstances it will not be possible to ensure a safe service with good patient outcomes. Given that funding for new developments is very limited, it is critically important that the available funds be targeted appropriately. University Hospital Waterford is a constituent hospital of the south-south west hospital group. The priority to be afforded to the expansion of the PPCI service in Waterford must first be considered from a hospital group perspective and in respect of the planning for the cardiology needs of the group population. The development must then be considered in a national context and in the light of competing demands for scarce resources. The issue remains to be considered and prioritised by the HSE, in the development of the strategic plan for the south-south west hospital group. It is expected that the groups will develop and complete their strategic plans in 2016.
The Minister's answer seems to be different from the one I received in May which seemed to be an outright "No". The Minister's answer may be somewhat positive in that the issue remains to be considered and prioritised by the HSE. The Minister has said one of the key criteria is that there be sufficient patient volume, which is the case. I gave him the figures earlier and we have the population. It is concerning that he has said the priority to be afforded must be in the context of the needs and population of the group of which the hospital is a member. This will worry many people. One of the concerns the people of Waterford had when we joined the south-south west hospital group with Cork was that what is now University Hospital Waterford was a regional hospital servicing the population of the south east. If we are now ignoring this population base, we are ignoring the fact that Waterford is the capital, if you like, of the south east, and facility services patients in Wexford, Tipperary, Carlow and Kilkenny, but is seen solely in the context of the population of the hospital group. It is a clear departure from how services were provided in Waterford in the past and I am slightly concerned about it. It remains to be seen what will be in the new plan for 2016. I appeal to the Minister to examine the facts and figures, the population and the patient throughput in the hospital. He will see that there is justification for full, 24/7 cardiology cover in University Hospital Waterford.
When we discuss patient numbers and caseload on the particular issue the Senator is raising, we are referring only to patients who could benefit from a PPCI, not patients or cardiology patients in general. General cardiology is already provided on call, 24/7, in Waterford. Only a few months ago, there were three 24/7 PPCI hospitals in Dublin serving the greater Dublin area.
That was reduced from three to two because the patient load was not sufficient to sustain three services in the greater Dublin area. That decision was made by the national programme. That is how these decisions should be made. It is a long time since Ministers or politicians decided where special centres or cancer centres should be. We are not going back to that. We are certainly not going back to it while I am Minister. Decisions will be made based on what is best in terms of patient safety and clinical outcomes. Consideration is being given to extending the existing service in Waterford to 8 p.m. Such a decision will have to be made in the context of the group's strategic plan. We will have to be sure it is safe, sustainable and staffable. Obviously, that is much more important than any financial issue. We need to know the caseload is sufficient to ensure any new service or extension of the service is sustainable and staffable.