Commencement Matters

Hospital Waiting Lists

I raise the issue of maternity services in Cork, of which there has been widespread coverage. There are more than 4,000 on the waiting list for gynaecological services in Cork University Hospital and this number makes up 42% of the total waiting list in the country. A brand new maternity unit was opened over ten years ago and two theatres were built. At present, one is open for three and a half days a week, while the other is not open at all. It is not available for use because staff are not available. I am looking for adequate resources to be provided. Over 8,500 babies a year are born in the maternity unit at Cork University Hospital and there are backup gynaecology services too, but the unit does not have an independent budget. It is simply part of the entire budget for the hospital.

We have had a number of meetings with the consultants and the Minister has met them too. Now is the time to move on and for a decision to be made to fast-track people on the list, some of whom have been waiting for over 12 months for an appointment. It is also possible to use facilities in one of the other hospitals, either public or private, to do this. I am not talking about using the National Treatment Purchase Fund because in that case patients would end up being reviewed by the consultants who are currently looking after them.

This issue needs to be given priority as 4,000 are waiting, many for more than 12 months. It is a matter of resources and providing theatre nurses and staff in order that one theatre can be opened five days a week and the other opened also. The latter is a longer term issue, but it needs to be addressed immediately.

I fully recognise the need to ensure patients have timely access to health services. The Department of Health works closely with the Health Service Executive and the National Treatment Purchase Fund to ensure they implement measures to reduce waiting times. Budget 2017 makes specific provision for the treatment of those waiting the longest. In that regard, €20 million has been allocated to the National Treatment Purchase Fund, rising to €55 million in 2018. In December the Minister, Deputy Simon Harris, granted approval to the National Treatment Purchase Fund for a €5 million initiative focusing on day case procedures, which will aim to ensure no patient has to wait more than 18 months for a day case procedure, including gynaecology, by 30 June 2017. The Minister has also asked the Health Service Executive to submit a waiting list action plan for 2017 for both inpatient day case and outpatient waiting lists. The focus of the plans should be on ensuring no patient will have to wait more than 15 months by the end of October 2017.

This week the Minister wrote to the Health Service Executive requesting that in developing the action plans a particular focus be placed on reducing waiting times in gynaecology. I am aware that there are difficulties with waiting times for gynaecology services in Cork University Hospital, in particular. On 12 January the Minister visited the hospital to meet hospital management, South/South West Hospital Group management and a number of consultant obstetricians and gynaecologists.

This allowed him to learn at first hand about these problems which are due, in part, to staff resource challenges, including those associated with recruiting theatre staff nurses. He has asked his officials in the Department of Health to work closely with the Health Service Executive and the hospital group to ensure the waiting list for gynaecology procedures is addressed as a priority in advance of his follow-up meeting. The hospital has advised that the provision of additional gynaecology operating capacity is a priority for the executive management board, as is the optimisation of operating output from theatre sessions which are already in place. In that regard, the board is working with the gynaecology department and the hospital group to maximise capacity in the theatre sessions already in place, recruit additional theatre staff nurses to provide additional theatre time and progress the introduction of pre-admission assessment for these patients to improve efficiencies and patient flow.

The governance structures for maternity services are being remodelled with the establishment of the Health Service Executive's national women and infants health programme and maternity networks across the hospital groups. The programme will lead the management, organisation and delivery of maternity, gynaecological and neonatal services to ensure the consistent delivery of high quality care in these services and oversee the development of maternity networks. The Minister has advised me that he expects the new maternity network which is being established in the South/South West Hospital Group to ensure better co-ordination and utilisation of maternity and gynaecological resources across the group.

I thank the Minister of State for her reply. My only concern is that a list was allowed to build up. My understanding is that in 2009 there was a waiting list of over 2,900. We are six or seven years on and do not seem to have a timeline for when action will be taken. When will the theatre be open five days a week? When will we progress to having the second theatre? How can we fast-track a review of patients? The HSE needs to give us a clear timeline for when it expects action to be taken on this matter. That clarification is needed at this stage.

I thank the Senator. I will get the specifics for him as soon as I leave here.

Tax Code

Cuirim fáilte roimh an Aire Stáit.

I thank the Minister of State for coming to the House.

The last report of the Commission on Taxation was published in 2009. Many of its comprehensive range of proposals have been successfully implemented, while others such as water charges continue to be controversial. One of the stated objectives of the report was to keep the overall tax burden low and enhance the rewards of work, while increasing the fairness of the tax system. It also sought to ensure the regulatory framework was flexible, proportionate and up to date. One of the key words is “fairness”. By fairness, I mean the impartial and just treatment of citizens without favouritism or discrimination, yet the taxation system continues to remain strategically skewed and inherently unfair. The personal taxation system is full of anomalies and the legal loopholes and business arrangements which facilitate tax avoidance seem to be infinite. Last year’s report of the Irish Tax Institute reminded us that the nine consecutive budgets between 2009 and 2016 involved over 50 tax changes that had impacted on Ireland’s personal taxation system. It not only brought about some unintended consequences, it also created anomalies across all salary levels. We all know about what is called the “squeezed middle” and that a self-employed person earning €18,000 will pay €1,820 more in tax than a PAYE worker on the same salary.

I am aware that the income tax reform plan 2016 sought to address some of these issues, but while we have been focusing on personal taxation, successive Governments have taken their eye off the tax ball. We now know to our immense cost that the Taxes Consolidation Act 1997 created loopholes which effectively allowed for the loss of taxes to the tune of €2 billion per year. This, added to the European Commission’s judgment that Apple owed the State €13 billion in unpaid taxes, points to a failure by the Government to stop a haemorrhage of taxes from the state, taxes which would have funded much needed infrastructural projects.

There has been a lot of focus on the so-called vulture funds and the charities which benefited from them, but the real question to be addressed by a commission on taxation is who was asleep at the wheel, who turned a blind eye to the wholesale strategic and legal avoidance of taxes in the past ten years and how can these loopholes be immediately closed. The report of the Commission on Taxation in 2009 was produced through a social partnership approach, with a serious input from trade unions, business, agriculture, the charity sector, financial advisers and academia, among others. The cynics among us might say the Government can no longer be trusted to be the sole decision maker on taxation policy and that it has not acted in the public interest. I, therefore, believe there is a real need to return to the stakeholder model, a model which encourages public engagement and wide sectoral consultation, would strengthen the work of the Department of Finance, the Department of Public Expenditure and Reform and the Revenue Commissioners and which would bring much needed transparency and reassurance to a now very disheartened public.

The reputational damage to the integrity and fairness of the taxation system by the vulture fund revelations is enormous and has left a very sour taste in the mouths of the thousands of distressed residential mortgage holders on whose backs these immense profits were made. We owe it to them to undertake a comprehensive independent review of the taxation system. It is the very least we could do.

I thank the Minister of State for his time and attention. I hope he will give my proposal serious consideration.

I apologise on behalf of my colleague, the Minister for Finance, Deputy Noonan, who, unfortunately has to attend an urgent meeting in Brussels.

I thank the Senator for raising this issue in Seanad Éireann. The appointment of a commission on taxation by any Government is a major undertaking which often takes several years to report. Commissions of taxation tend to focus on the medium term to long term as regards the appropriate development of the tax system and since it tends to take many years to implement all of their recommendations, they are, as often as not, a once in a generation event. The last Commission on Taxation was in place in 2008 and 2009, with the one prior to that having been in place between 1980 and 1985. Given that a commission on taxation has reported as recently as 2009, it is not clear what exactly would be gained by undertaking such a large-scale task again so soon.

It should be noted that, since the last Commission on Taxation reported, the Department of Finance has made major strides in improving the evidence base available to it to inform taxation policy. For example, a major review of the corporation tax system was undertaken by the Department in 2014, with the extensive range of analyses and outputs published with budget 2015. The purpose of the research was to quantify the effect of the three elements underpinning Ireland’s corporation tax policy - rate, regime and reputation.

Building on this successful review, in early 2015 the Department entered into a research partnership with the Economic and Social Research Institute. This agreement covers research in the areas of macroeconomics and taxation policy. As well as extensive analysis of the potential effects of Brexit on the economy, a significant volume of taxation-related research has been undertaken under the programme, including on important issues such as the relationship between corporation tax rates and foreign direct investment and the volatility of tax revenues. All of the research is published and available to inform the wider tax policy debate.

On the local property tax, LPT, the 2012 report of the interdepartmental group on the design of a local property tax, the Thornhill group, considered the structures and modalities for a full property tax which was subsequently introduced in 2013. The Minister for Finance commissioned a review of the local property tax in 2015 to consider its operation and, in particular, any impact on LPT liabilities due to recent property price developments.

The review was informed by the outcomes of a public consultation process which received over 50 written submissions.

Senators will be aware also that the Government’s commitment to continue the process of unwinding USC is not a measure that is being considered in isolation but as part of a wider medium-term income tax reform plan. In July 2016 he Department of Finance published a detailed review of the policy considerations relevant to this reform, including the necessity to maintain the breadth of the income tax base and retain appropriate levels of taxation for higher earners.

A detailed review of agri-taxation was published by the Department of Finance in October 2014. The following year, an independent review of marine taxation was also undertaken, resulting in the Government bringing forward changes to the tax code prompted by the reviews.

The last Commission on Taxation undertook a major review of tax expenditures. Again, the Department of Finance built on this work and subsequently developed a framework for the evaluation of tax expenditures, as set out in the report on tax expenditures published with the budget in 2015. From time to time, the Department carries out reviews of existing tax expenditures and ex ante evaluations of proposed new tax incentives, with the various reviews and evaluations being published in the annual report on tax expenditure.

The reason I have called for this - I appreciate that the 2009 review is quite recent, which means that it would require a very short commission - is to restore confidence and bring on board the partnership model, particularly to bring in representatives of business and trade unions and academics. Workers have suffered hugely from the cuts made in recent years. The local property tax is probably the most unfair tax, given that it is location-based. God help anybody in Dublin as one can have a massive house in rural Ireland and not pay nearly the same amount in local property tax. Also, local authorities are redistributing the receipts from the local property tax. I ask that we have a complete review of the entire tax system. The vulture funds, in particular, are hurting people. I am sure the Minister of State is in touch with his constituency staff. I know that he will be hearing the stories I am hearing about vulture funds which have ripped off the country. That is really the angle at which we are looking.

I listened attentively to what the Senator said. I described the recent reviews and research into taxation matters by the Department of Finance. Perhaps it might be more appropriate to outline some of the incentives that have been provided this year. For example, the development of a new small and medium-sized enterprise, SME, focused share-based remuneration scheme was announced in budget 2017 and is scheduled to be introduced in budget 2018. A public consultation process has been conducted by the Department as part of the development process and engagement with the European Union to ensure compliance with state aid rules. That will also be undertaken.

Also, in line with established practice in carrying out periodic reviews of key areas of taxation policy, the Minister for Finance announced in the budget that a review of Ireland's corporation tax code would be undertaken by an independent group, led by the economist Mr. Seamus Coffey. Since the review in 2014, there have been significant changes in the international tax environment, including new legislative proposals in the field of company taxation from the European Union and the ongoing Organisation for Economic Co-operation and Development, OECD, base erosion and profit shifting initiative. In that context, it is timely and prudent to carry out a review of the corporation tax code to take these recent developments into account. Terms of reference were published in the 2017 budget book. I note also that during the Committee Stage debate on the Finance Bill 2016 in the Dáil it was indicated that the Minister for Finance had asked Mr. Coffey to examine the strong performance of corporation tax receipts, evident since 2015. Accordingly, this matter will also form part of the review, which is important.

The examples I have cited demonstrate that detailed taxation research is effectively continuous and given high priority by the Minister for Finance and his officials, given the challenging times. I will take on board the Senator's views and convey to the Minister the issues he raised in his supplementary questions.

Senator Gerard P. Craughwell has a lot on which to chew in the next few days.

Immigration Support Services

I welcome the Minister of State at the Department of Justice and Equality, Deputy David Stanton. It is always nice to see a fellow Cork man in this Chamber.

I refer to the plans to open an emergency reception and orientation centre in the Abbeyfield Hotel in Ballaghaderreen. As the Minister of State will be aware, I have had many discussions with both him and departmental officials since first becoming aware on Thursday, 5 January of plans to open the centre.

As a community, we, in Ballaghaderreen, understand fully the refugees who are coming to the centre in Ballaghaderreen have been through the most horrific experiences. We want to reach out and support them in the best way we can. There has been huge media attention on the reaction of local people in Ballaghaderreen. I want to make it very clear that people in Ballaghaderreen will play their part. We will do our fair share in supporting people who have been through very difficult experiences. Yesterday we had a very lengthy meeting as part of the Ballaghaderreen town team with departmental officials in Roscommon. Arising from the meeting, I have a number of questions.

We want to be reassured he proper resources and services will be in place to support the refugees when they come in March. My understanding is there will be 82 refugees coming through Greece from Syria. They will have been vetted by officials of the Department of Justice and Equality. Initially, they will be coming to stay in Balseskin, near Dublin Airport, where they will undergo a full medical assessment and begin to a full needs assessment on their educational needs. They will then come to Ballaghaderreen where they will stay for a maximum period of six months.

It is really important that proper communications channels be opened. There is a national task force that brings together all of the different agencies. I urge the Minister of State to ensure communication channels will be opened locally to ensure engagement with local general practitioners, local schools, the Roscommon County Childcare Committee, the education and training board and all of the different and agencies and services that will necessarily need to be involved to support the refugees. Without doubt, there has been a difficulty. I ask that there be immediate communication and engagement with local service providers who want to provide support in the best way they can.

When we talk about the centre being opened in the Abbeyfield Hotel, as a community, we had high hopes the hotel would be reopened as a functioning hotel, but that has not happened. A two-year lease has been signed. As the facility is vacant, why not support people who need our help at this time? That is very much our view. However, we need to ensure we will properly support the community in doing so. My understanding from the meeting yesterday is that the Red Cross will be very involved in assisting the community and co-ordinating the provision of community support because there has been a huge and overwhelming response from people who want to help and be volunteers. That work needs to structured and assistance needs to be provided in the integration piece. From speaking to departmental officials yesterday, I know that the Red Cross will be very much involved in that process. As early as possible, we want to ensure the refugees will feel welcome and part of our community for however long they may stay.

I want to be reassured by the Minister of State that evidence will be provided for the local community that the proper resources - teaching, interpreter and GP services, as well as all of the other allied health professional services required to support the refugees - will be provided from additional resources, not existing resources. Services within the area are already at breaking point.

We need these assurances and to see evidence locally of communication channels being opened and plans being put in place to support the people who will be coming in the next couple of weeks. I understand from the discussions that took place yesterday that 82 people will be coming in March and that there is capacity at the facility for up to 200. Following my visit to the Monasterevin centre, I am seeking assurances from the Minister of State that if there are teething problems or difficulties in service provision, they will be properly addressed before additional people are brought to the centre. The plan is to place 82 people in the centre initially, with a further 80 to be placed there next month and more to come until full capacity of 200 is reached. It is important that initial challenges such as occurred in Monasterevin be properly addressed before further people are brought to the centre so as to ensure they will be properly supported.

On behalf of the Tánaiste and Minister for Justice and Equality, who cannot be here as she is attending the meeting in Malta of the Justice and Home Affairs Council which is discussing the migrant crisis, I thank the Senator for raising this important matter.

The Senator will be aware that in September 2015 the Government took the decision to establish the Irish Refugee Protection Programme, IRPP, through which 4,000 refugees and asylum seekers fleeing war and conflict would be offered sanctuary in Ireland. Many of those coming to Ireland have lost families and homes. Some 761 persons have come to Ireland so far and 2,000 are due to arrive this year. The intention is that they will be housed temporarily in emergency reception and orientation centres, EROCs, and then move to permanent homes across the country. The EROC recently announced for Ballaghaderreen is the third such centre in the country. The other centres are in the Hazel Hotel in Monasterevin and Clonea Strand in Dungarvan. Therefore, there is experience of the process involved. The principal aim of the Government in establishing such centres is to provide a safe and calm environment in which migrants, mostly young families who have endured unimaginable loss and suffering, can take time to recover physically and mentally, acclimatise themselves to Irish society, learn English and start planning for their future. I note that the Senator has acknowledged the awful situation in which the people concerned have found themselves.

The centres act as hubs for the important range of services that need to be delivered to these particularly vulnerable persons, including medical services, language training, education, cultural orientation and social protection services. Key services such as health and education are provided through mainstream services. The relevant mainstream service providers are engaged in the task of ensuring local services can meet increased demand. An IRPP task force chaired by the Tánaiste offers the framework for planning for future demands on local services. Moreover, as has become standard practice when opening a centre, a local EROC management group, comprising departmental officials and local service providers, is being established to oversee the delivery of required services to residents of the EROC and help to pursue solutions to resource issues that may arise for mainstream service delivery in the area. The EROC management group will include representatives of the HSE, Tusla, the local education and training board and the Department of Social Protection, as well as local community gardaí and IRPP officials.

Community involvement is crucial to the process of enabling refugees to build new lives in Ireland. As a consequence, I will shortly announce the launch of a funding programme to stimulate communities across the country to take action in support of integration. I have been very heartened by the welcome given by the people of Ballaghaderreen to the refugees and asylum seekers. This goodwill should be harnessed into community action and supported by the Government. I am examining what support is possible to encourage initiatives that will benefit the local community, refugees and asylum seekers. I met the Senator and other local politicians on 11 January to brief them on the opening of the centre. Their support and that of the people of Ballaghaderreen will ensure the refugees will receive a true, warm Irish welcome.

Like the community in Ballaghaderreen, I want to be proactive and constructive in supporting the people concerned. The group to be established, headed by an official from the Irish Refugee Protection Programme and tasked with bringing together all local service providers, will be important in ensuring proper communication and planning. My visit to the Monasterevin centre last week was very productive and helpful. We need to learn from what is happening in the centres in Monasterevin and Dungarvan. There will always be a need to improve. What I learned from my visit to the Monasterevin centre was that we could not make assumptions about what the people concerned needed. It must be based on individual assessment. As the Minister of State rightly said, they will need time to acclimatise, relax and put their lives back together following their horrendous and horrific experiences. For my part, I will work closely with the Minister of State, the Tánaiste and departmental officials to ensure we do our best such that the centre in Ballaghaderreen will be seen as a good example in this regard. Ballaghaderreen is already multicultural and people living there want to be seen as a good example in reaching out and supporting those who need our help.

I am glad that the Senator took up the invitation to visit the centre in Monasterevin and that she found the visit very productive and a good learning experience. Any advice she could give us based on the visit would be welcomed. If other colleagues want to visit other centres in a discreet and respectful manner, they can be facilitated.

The Senator has raised important issues that go beyond the Irish Refugee Protection Programme, including the needs of rural communities and small towns. The Government's rural development action plan provides a comprehensive framework for a series of initiatives to benefit rural Ireland. The opening of the EROC in Ballaghaderreen will create employment opportunities and increase demand for services and goods in the locality. The contractor is aware of the importance of providing jobs within the locality and sourcing goods and services locally, where possible. Bringing new people into Ballaghaderreen will boost the local area. This has been our experience with the other EROCs. However, I would like to examine how we can foster initiatives within the community to benefit locals and refugees. Work is being undertaken within the Department of Justice and Equality to see what is possible.

The IRPP task force, chaired by the Tánaiste, includes representatives of all statutory service providers. It provides the framework for planning to meet future demands and developing solutions where mainstream services are struggling to meet the additional demands following the arrival of refugees. Officials of the Department of Justice and Equality met local representatives on a number of occasions, most recently yesterday. They will continue to engage with them and officials to ensure planning for the arrival of the refugees and asylum seekers will go smoothly. As I said, the asylum seekers will not arrive until early March. As such, there is a good lead-in time for everything to be established. In that regard, we will take on board what we have learned at the other two EROC centres, as well as the direct provision centres.

I again thank the Senator for raising the issue.

Sitting suspended at 11.10 a.m. and resumed at 11.35 a.m.