Commencement Matters

Road Network

I raise the issue of the need for increased funding for local roads in counties Monaghan and Cavan and record our appreciation of the Minister for Transport, Tourism and Sport, Deputy Shane Ross, who met a delegation from Monaghan County Council a few weeks go, for which I thank him. The condition of roads in County Monaghan is particularly poor. There are a number of considerations we would like the Minister to take on board when allocations are being made for 2017. Monaghan has a number of unique characteristics which other counties do not have. First, 30% of the population live in rural areas compared to a national average of 62%, while the county has the highest density of local roads per kilometre outside Dublin. It is a strongly agriculturally-based county, with a large employment base in the agrifood and engineering sectors. Many of the facilities involved are located along minor local and regional roads and completely dependent on the roads infrastructure to get their goods to and from the marketplace.

Last year Monaghan County Council received an allocation of €12.3 million from the Department. While the money was welcome, it represented a 40% reduction on the 2011 allocation. The council has conducted a survey of the local and regional road network which indicates that 60% of local and regional roads need immediate attention owing to their poor condition. I appeal to the Minister to consider counties Monaghan and Cavan as a special case when making the allocation in order that roads can be brought up to an acceptable level.

I apologise on behalf of my colleague, the Minister for Transport, Tourism and Sport, Deputy Shane Ross, who is in the Dáil and asked me to take this matter for him. I thank the Senator for giving me the opportunity to address the House.

The improvement and maintenance of regional and local roads are the statutory responsibilities of each local authority. In accordance with the provisions of section 13 of the Roads Act 1993, works on these roads are funded from each authority's own resources, as supplemented by the State's roads grants. The initial selection and prioritisation of works to be funded are also matters for the local authority. Ireland has just under 100,000 km of roads in its network and the maintenance and improvement of roads, including national, regional and local roads, place a substantial financial burden on local authorities and the Exchequer. Owing to the national financial position, there have been very large reductions in the Exchequer funding available for roads expenditure in the past few years. As such, the focus has had to be on maintenance and renewal rather than major new improvement schemes.

The capital plan published in September 2015 outlines proposed transport investment priorities to 2022. The transport element of the plan was framed by the conclusions reached in the Department's strategic investment framework for land transport. The framework report highlighted the importance of the maintenance and renewal of transport infrastructure, together with targeted investments to address particular bottlenecks and critical safety issues. The capital plan provides €6 billion for investment in the road network in the period to 2022, with €4.4 billion earmarked for the maintenance and strengthening of the existing extensive network throughout the country. There is also €1.6 billion for new projects. Allowing for the commitments related to PPP projects, the balance available for new projects within the available capital envelope is limited. The Minister must work within the annual allocations set out in the plan. In this context, the capital plan provides for a gradual build up in capital funding from the current relatively low base towards the levels needed to support maintenance and improvement works.

While there will be a modest increase in funding for the maintenance and improvement of regional and local roads in 2017, it will take some years under the capital plan to restore steady State funding levels for land transport. The significant ramp up in funding will occur in 2020 and, by the end of the plan period, the Minister expects capital funding for the road network to be back up to the levels needed to support maintenance and improvement works in the future. While regional and local road grant allocations for next year have yet to be decided, the Minister expects to announce the details early next year. Given funding constraints, his objective must be to allocate funding to local authorities on as equitable a basis as possible, taking into account road lengths in each local authority's area of responsibility. It is important to reiterate that State grants are intended to supplement local authorities' own resources. In that context, the Minister is emphasising to local authorities that their commitment to contribute significantly from their own resources towards the cost of improving and maintaining the regional and local roads network is essential.

On the possibility of additional funding being provided within the plan period, the Minister for Public Expenditure and Reform indicated in his Budget Statement that he was bringing forward the capital plan review.

There is a strong case for additional funding for the transport sector which the Minister will make robustly. However, the parameters for the review and the final decisions on allocations are matters for the Minister for Public Expenditure and Reform and the Government as a whole. The Senator raised this issue previously and I took the Commencement debate on that occasion. I forwarded the contribution to the Minister, Deputy Shane Ross, and will undertake to do the same today. I understand the severity and complexity of the issue the Senator has raised and it has also been brought to my attention by the Minister, Deputy Heather Humphreys, as late as this morning.

I thank the Minister of State for his response. It is welcome that there will be an increase in funding for regional and local roads in 2017, but I am disappointed with the word "modest". Monaghan and Cavan are classified as a special case and I ask that additional funding be forthcoming.

I take on board what the Senator has said. He is quite right that in 2015 the allocation to County Monaghan was €7.6 million and that in 2016 it was €12.3 million. There was a substantial increase. He is correct that it is a long way from where it was in the good old days, but, unfortunately, so is everything else. We have a plan to get it back to where it was, but I take on board the points made by the Senator.

Road Projects Status

I wish to find out where the proposals to bypass Bandon sit in the list of priorities. Bandon is the biggest town in west Cork with a population of 6,500 people. It is the gateway to west Cork and the N71 runs through the town. If Bandon and west Cork are to develop, we need to have a plan to ensure the town is bypassed. There have been major developments in Bandon in recent years, some good and some bad. It has been flooded 12 times in the past 40 years and the town has suffered because of this. Movement has been made on these issues in recent years and flood defence systems will be in place by 2019, as will a new sewage treatment scheme. A multi-million euro revamp of the town centre has also been proposed with regard to the streetscape.

The main issue in Bandon is traffic, particularly the HGVs that pass through the town. We need to have a plan in order that Bandon can develop and its town centre can be used by pedestrians. The way forward is to have a long range plan for the northern bypass which is in the county development plan and a short-term measure for the southern side of the town, particularly the Old Chapel area. These issues are very important. We need to put them on the agenda by raising them in the Seanad to see whether they can be progressed in the coming years and there is the funding for the key infrastructure Bandon needs to develop.

I welcome the Minister of State, Deputy Patrick O'Donovan, who has family living in Bandon. He knows the town and the issues in it. I hope we can move it up the agenda in order that we can have developments for the people of Bandon and west Cork.

I thank the Senator for raising the issue. He is correct that I have family in Bandon, as my brother and my sister both live there. My brother is a publican. The Senator referred to the flooding in the town and my brother's premises has been flooded three times. I know acutely the difficulties the town has experienced with flooding. I am glad that the Office of Public Works and Cork County Council have a plan in place to remedy the issue.

As I did to Senator Robbie Gallagher, I apologise to the Senator for the absence of the Minister for Transport, Tourism and Sport, Deputy Shane Ross, who has responsibility for overall policy for and funding of the national roads programme. The planning, design and implementation of individual national road projects is a matter for Transport Infrastructure Ireland, TII, formerly known as the NRA, under the Roads Acts 1993 to 2015, in conjunction with the local authorities concerned. Within its capital budget, the assessment and prioritisation of individual projects are matters, in the first instance, for TII in accordance with section 19 of the Act. As I stated previously, Ireland has 100,000 km of road in its network and the maintenance and improvement of national, regional and local roads places a substantial burden on local authorities and the Exchequer. Given the national financial position, there have been very large reductions in Exchequer funding available for roads expenditure in the past few years. For this reason, the focus has been on maintenance and renewal rather than new improvements.

The capital plan published in September 2015 outlined proposed transport investment priorities to 2022. The transport element of the plan was framed by the conclusions reached in the Department's strategic investment framework for land transport. This report highlighted the importance of maintenance and renewal of transport infrastructure together, with targeted investments to address particular bottlenecks and critical safety issues. The capital plan provides €6 billion for investment in the road network in the period to 2022, with €4.4 billion earmarked for the maintenance and strengthening of the existing road network throughout the country and €1.6 billion for new projects, as I stated earlier to Senator Robbie Gallagher.

There will be a significant ramp up in funding from 2020, which will facilitate the construction of the road improvement projects included in the plan. In that context, a number of important projects in Cork are included in the plan, including the upgrade of the Dunkettle roundabout and the N22 road between Ballyvourney and Macroom. In addition, the plan also provides that the N28 upgrade scheme will commence, subject to necessary approvals.

The Minister understands from Transport Infrastructure Ireland that while it is aware of the N71 Bandon relief road extension as a potential improvement scheme, owing to a lack of funding, it is not in a position to progress the scheme. While available funding is not sufficient to address all the demands for improvement schemes, including schemes such as the Bandon relief road extension, by the end of the plan period, the Minister expects capital funding for the road network to be back up to the levels needed to support maintenance and improvement works in the future.

On the possibility of additional funding within the plan period, the Minister for Public Expenditure and Reform indicated in the Budget Statement that he would bring forward a capital review. As I stated in the previous debate, there is a strong case for additional funding for the transport sector which the Minister will make. I know exactly the position in Bandon. The existing relief road is not sufficient to meet the needs of the town. Towns throughout the country are in a similar position. The Leas-Chathaoirleach is familiar with Adare, Abbeyfeale and Newcastle West in my constituency and they are in the same position. We must try to progress the projects as best we can. I will bring the issue raised by the Senator to the attention of the Minister. The total estimated cost for the project, according to the Department, is approximately €7.5 million. It might be possible for the Senator to have an opportunity to discuss the matter directly with the Minister. I will certainly seek to arrange this.

I thank the Minister of State for his response. I want this issue on the agenda to ensure that when the capital review takes place, the Bandon bypass extension will be included. I would like to take up the Minister of State's offer to meet the Minister, Deputy Shane Ross, to discuss the issue. It is a key one for Bandon and west Cork. I thank the Minister of State for his response.

The proposed relief road extension involves bridging over the existing R603 to remove an existing steep gradient, which the Senator and I know, and the construction of approximately 2.5 km of a new single carriageway tying back to the existing N71 just west of the town near the Old Chapel area. The total cost is approximately €7.5 million. Cork County Council and other local authorities will be asked to consider what they want in the capital review which will be brought forward. As the Minister said, as I have heard others state umpteen times and as I have said myself, the Department will be a significant beneficiary of the mid-term capital review being brought forward to early 2017. While I cannot, should not and would not make any specific commitment on individual projects, representatives from Cork South-West and Bandon, in particular, should begin to do what the Senator is doing and bring the issue to the floor of the Seanad and elsewhere to ensure those who need to hear it, namely, TII, the Department and the Minister, are aware of it.

Hospital Consultant Recruitment

I welcome the Minister of State, Deputy Catherine Byrne, and thank her for coming to the House to deal with this matter. I know that she has a very busy schedule.

The matter I am raising concerns Mercy University Hospital in Cork which has an emergency department and a urgent care centre. When the emergency department was constructed, the view was that it would deal with 25,000 attendances per annum. In 2015 it received 31,946 attendances. By the end of November 2016, it had already received 30,297 attendances. In addition, its urgent care centre dealt with 15,430 people in 2015. By the end of November 2016, the centre had received 15,066 attendances; therefore. the figures are going up.

The hospital has accident and emergency consultant cover for only 55 hours per week in an emergency department that is open 24/7. It has cover for 55 hours per week which is equivalent to 1.4 whole-time equivalent consultants. A similar facility throughout the country would have five accident and emergency consultants. The unit faces major challenges. The other significant problem faced by Mercy University Hospital is the huge increase in the number of elderly people attending its emergency department. I understand the 2015 figure went up by 12%.

This is a great unit that is very welcome in the sense that the standard of care provided is excellent and, therefore, people have confidence in it. However, it needs sanction from the Department and the HSE for additional accident and emergency consultants to be appointed in order that it can deal with the volume of people attending. That is my request and why I tabled this Commencement matter.

I apologise for the fact that the Minister for Health cannot be here to take this Commencement matter which I have been asked to take on his behalf.

I thank the Senator for tabling this Commencement matter. Trolley numbers nationally were high in November and have been so far in December owing to increased emergency department attendances, greater incidence of infection in several hospitals and a high rate of elective activity in hospitals to address waiting lists. Similar to many other hospitals, Mercy University Hospital has experienced an increase in emergency department presentations since January when compared to the same period last year. According to the September HSE management data report, an additional 1,653 people have presented at Mercy University Hospital's emergency department, which represents a 4.6% increase. This is in line with the national experience. The Minister for Health believes it is unacceptable that patients wait on trolleys for long periods, especially elderly and vulnerable patients. In the coming months it is essential that the health service plan effectively for expected surges in emergency care demand. The Department of Health, working with the HSE, has been driving a range of measures to improve patient emergency department experience times. On 9 September, the HSE published the winter initiative plan 2016-17, which has provided €40 million in additional funding for winter preparedness and to help in alleviating the pressures on emergency departments during this time. The initiative seeks to embed measures during 2016 and into 2017 which balance hospital avoidance with supporting patient flow through acute hospitals and increased availability of social care services to facilitate timely discharge from hospitals. Within this funding, specific provision has been made for 18 step-down beds in Mercy University Hospital. In addition, national measures that will benefit Mercy University Hospital include an allocation of €5 million for additional aids and appliances enabling patients to be discharged from hospital sooner and €10 million for additional home help hours. Of course, no hospital operates in a vacuum. Mercy University Hospital forms part of the South-South West Hospital Group. The hospital groups are designed to deliver more responsive and equitable access to vital services for all patients. Hospital groups are responsible for performance outcomes, operating within budget and employment limits, with the quality and safety of patients at the core of their business.

The HSE has advised that approval has been received from the consultant applications advisory committee for a consultant in emergency medicine for Cork University Hospital. This post is being progressed by the hospital through the Public Appointments Service. I am also advised that two further consultant posts in emergency medicine have been referred to the consultant applications advisory committee for consideration. The HSE has confirmed that any increase in the number of consultants at Cork University Hospital will, in turn, facilitate the ongoing rotation of consultants to Mercy University Hospital. I understand a locum consultant is in place and, as a result, additional cover is being provided for Mercy University Hospital.

There is a very strong focus on reducing emergency department overcrowding in all the Minister’s interactions with the HSE, hospitals and the wider health service. The Minister is meeting the HSE on a weekly basis to monitor emergency department performance and progress on the winter initiative. The HSE recently convened a winter initiative health summit and the Minister met hospital croup CEOs, as well as hospital and community health organisation managers, to reinforce the importance of driving key performance improvements across primary, acute and social care to reduce emergency department overcrowding and plan for expected surges in demand in emergency departments in the new year.

I thank the Minister of State for her reply. My only problem with it is that it is very much HSE spin. I will give the figures. Between the urgent care centre and the emergency department, 48,000 people attend Mercy University Hospital. A total of 66,000 people attend Cork University Hospital. We have 1.6 consultants in Mercy University Hospital and are now talking about recruiting more consultants for Cork University Hospital thinking this will sort out the problem for Mercy University Hospital. This concerns the HSE because it controls Cork University Hospital where it does not control Mercy University Hospital in real terms. Yes, there is co-ordination between the two, but we need accident and emergency consultants to be assigned to Mercy University Hospital. It is dealing with the volume and delivering a very good service, but it only has cover for 55 hours per week, yet it is providing many of the same services Cork University Hospital is offering. We should go back to the HSE and tell it that while we know that it is recruiting another consultant for Cork University Hospital, we want to know what is happening about an additional consultant for Mercy University Hospital. That is my concern about the reply. I understand the Minister of State must get this information from the HSE, but I am concerned that we will now go down the same road where this time next year Mercy University Hospital will be in the next position with only 55-hour cover for accident and emergency consultants.

I understand the point made by the Senator and his anxiety about accident and emergency consultant hours at Mercy University Hospital. The reply I was given clearly outlines that funding has been made available and that the HSE is in the process of providing another consultant, be it through Cork University Hospital or Mercy University Hospital. I will relay the Senator's concerns to the Minister, particularly about the numbers, which I believe are very high. Money has been provided for community care services, particularly the home help service, and the provision of facilities to allow people to go back to their homes and communities. I understand the Senator's frustration that the reply did not specifically outline the urgent need to appoint more consultants, given the level of cover provided at Mercy University Hospital. I will relay his concerns and the matters he raised to the Minister.

I thank the Minister of State. If she ever visits Cork, she is very welcome to visit Mercy University Hospital where staff would be delighted to meet the Minister and the Minister of State because it is an excellent hospital. It is worth a call.

Sitting suspended at 11.20 a.m. and resumed at 11.30 a.m.