Commencement Matters

Coroners Service

I welcome the Minister of State, Deputy Catherine Byrne.

Go raibh maith agat, a Chathaoirligh, for selecting this matter for discussion.

It gives me great pleasure to welcome the Minister of State, Deputy Catherine Byrne, a lady for whom I have enormous regard. I wish her well in her portfolio. She is already doing a great job. It is a difficult portfolio, but it gives me great pleasure in the Seanad to acknowledge and salute the work she is doing.

I have tabled this matter because I firmly believe the set-up for coroners must be reviewed and updated. It is fair to say the coroners legislation governing the operation of all coroners in the country is outdated and badly needs to be upgraded. Certainly, in the light of issues that have recently been raised in hospitals, particularly when it comes to newborn babies dying or being found dead, a coroner's inquiry should be mandatory in all such cases. We have seen scandalous examples in a tiny minority of hospitals where mothers and their babies have died and it is totally unacceptable for no inquiry to be held. It should be mandatory to have a coroner's inquest into all maternal deaths.

Having the Coroner Service under the auspices of local authorities does not make sense in the modern era. I know that the Department of Justice and Equality is the lead agency, but in all cases coroners are paid by the local authorities and the money comes from local authority budgets. Many Senators regularly receive correspondence from local authorities seeking additional funding for various services. In fairness to all local authorities, they have made great strides in reducing costs, cutting waste and so forth.

The cost over which they have no control is that of coroners. They receive a coroner's bill every year which they must pay. They cannot question it, negotiate a reduction or seek value for money. They never know whether the bill will be large or small. Therefore, it is difficult for councils and finance officers in local authorities to budget for the expense. Unfortunately, there have been many tragedies in my county, Clare, and many other counties with a coastline. In fact, the services of coroners are required a great deal more than we would like. For the sake of all citizens of the country and in the interests of the profession of coroners, we need the long promised legislation to be delivered as a matter of urgency. This is one particular statute and set-up that badly need to be brought into the 21st century.

I thank the Senator for his statement. On behalf of the Tánaiste and Minister for Justice and Equality, Deputy Frances Fitzgerald, who cannot be here, I thank him for raising this subject as it affords me an opportunity to update the House of the most recent developments. I acknowledge his active involvement in promoting reform of the system under which the coroners operate.

With other members of the Joint Committee on Justice and Equality, the Senator met officials from the Tánaiste's Department on 23 November 2016 to continue engagement on the matter. The officials updated the committee on the extensive work already undertaken on the legal and medical aspects of the comprehensive review of the Coroners Bill 2007 directed by the Tánaiste.

The Tánaiste has now established a dedicated coroner unit in her Department. The unit will develop policy and contribute to the review of the legislative provisions, with the clear mandate to do what needs to be done to bring about reform as soon as is practical. The unit became operational at the beginning of this month. It has started engagement with relevant stakeholders and a review of the latest developments in coroner organisations in similar states with a common law heritage.

The critical issue is that any proposal brought forward to the Oireachtas to move to a modern coroner system must be coherent and cost-effective. Most importantly, the new coronial law and service must meet our obligations to the people and also those obligations under the European Convention on Human Rights.

The Coroners Bill 2007 was a significant attempt to bring about modernisation of both the law and practice of the coroner's investigation and the nature and role of the office of coroner. Responsibility would be transferred from local authorities to the Minister for Justice and Equality, with a new post of chief coroner, full-time coroners and a new central coroner service to provide enhanced support for coroners and liaise with bereaved families. To operate the intensive requirements for improved coroner death investigation services, as set out in the 2007 Bill, and allowing for developments since, we must examine and decide on an appropriate delivery system. The new coroner unit will have to urgently consider whether the full-time model proposed in 2007 is still the optimum approach. This would end the current part-time coronial service, provided by either lawyers or doctors, in jurisdictions based on county or sub-county divisions. Such an approach has already been taken in the modernised coroner services of Northern Ireland and New Zealand. These states also operate a lawyer-only coroner model.

While not the focus of this discussion, I should mention the recent proposals to amend the law to make certain deaths subject to mandatory inquests and to add to the range of permissible inquest verdicts put forward by Deputy Clare Daly and Senator Pádraig Mac Lochlainn, respectively, in the Dáil and the Seanad. Their proposals will be integrated into the review being conducted by the coroner unit in the Department.

I thank the Minister of State for her positive and comprehensive reply. It would be remiss of me not to pay tribute to Deputy Clare Daly and Senator Pádraig Mac Lochlainn - a former Deputy - for the immense work they have done on this issue.

The news from the Department is good. I sincerely hope that by this time next year we will have new coroners legislation in place and that the system will be in line with international best practice.

I have taken note of what the Senator said. I concur with the reply from the Tánaiste and Minister for Justice and Equality, Deputy Frances Fitzgerald, to the effect that the current cohort of coroners strive to offer the best possible service within the confines of the existing administrative framework. The Department agrees that there is a need to get on with a long-term plan to modernise the system. The aim is to move from the original 19th century approach to one that is suitable for the 21st century. The new coroner service must provide for a better service in the nature and speed of its response to persons touched by deaths reported to the coroner.

The Senator made particular reference to the death of babies and argued that some cases were not taken seriously enough. I agree with him in that regard. I again thank him. I have taken notes on his contribution and will bring them to the attention of the Tánaiste and Minister for Justice and Equality.

Redundancy Payments

My question relates to outstanding Labour Court recommendations Nos. 21162 to 21181, inclusive, and 21185, which refer to SIPTU members who were formerly employed at the Tipperary Hostel on the basis of a job initiative scheme. The hostel closed in 2010 and in 2011 the Employment Appeals Tribunal determined that there was a genuine redundancy. As a result, SIPTU made a direct application to the then Department of Enterprise, Trade and Employment for the payment of statutory entitlements through the Social Insurance Fund. It took the workers approximately 14 months, through their union, to receive these payments. SIPTU then progressed a claim for enhanced redundancy payments in line with previous agreements of the Labour Court which issued its findings on 16 March 2016. The court recommended in all cases the making of an ex gratia payment of three week's pay per year of service over and above the statutory redundancy payments made. The former workers covered by these recommendations are Gary Ryan, Seán Twomey, Patrick Merrigan, Seamus McCarthy, Carmel Mc Grath, Denis Hansen, Michael O'Dwyer, Oliver Keogh, Richard Capliss, Michael Ward, Ian Dawson, Richard Brennan, Michael Cohen, David Ryan, Gerard Culhane, John Joseph Lyndon, Dominic Frewen, Pat Morrissey, Seán Carew, Philip Wilson and Cornelius Connors.

In its efforts to secure payment of the outstanding moneys, SIPTU wrote to Ms Deirdre Shanley, principal officer in charge of employment schemes at the Department of Social Protection, on 29 April and 28 June last year. There followed a meeting between Ms Shanley, representing the Department and-----

It is not appropriate for the Senator to name officials.

I apologise. The Cathaoirleach is quite right and I am sorry for doing so.

Departmental officials are entitled to some protection.

The Cathaoirleach is right and I apologise.

There followed a meeting between the Department and SIPTU on 13 June to discuss the outstanding moneys due. SIPTU again wrote to the Department on 11 July, detailing these cases alongside a number of others involving former workers under a number of other schemes. SIPTU received no response and again wrote to the Department on 13 September in pursuit of outstanding moneys for its members. In this correspondence Mr. Eddie Mullin, a SIPTU senior sector organiser, detailed that the union had written to the Department in 2014 confirming its intention to refer a breach of the community employment supervisor enhanced redundancy agreement of 2002, as amended in 2005, to the Workplace Relations Commission, WRC. In October 2014, at the request of the Department, SIPTU had agreed to put the referral on hold to allow further talks to take place between the two parties. One meeting took place but no progress was made. SIPTU referred the matter back to the WRC last September. Almost five months have passed and the WRC has still not received a response from the Department to its invitation to attend a hearing.

With the greatest of respect, I genuinely do not understand why the Minister of State at the Department of Health, Deputy Catherine Byrne, is here. I did not direct this question to her or her Department.

Is it okay for a Minister to ignore Labour Court recommendations? It is the Minister of State's colleague, Deputy Leo Varadkar, who is ignoring them. What signal does this send to employers and unions that a senior Minister is ignoring the highest body in the State's industrial relations machinery? What message does it send that the Department of Social Protection did not even bother to tell SIPTU that it had chosen to pass on this issue to another Department, if that is what has happened? What about the Workplace Relations Commission, WRC, which has been waiting for a response for five months on whether the Government will attend the hearing to resolve the related matter of the breach of the community employment supervisor enhanced redundancy agreements? Will the Minister of State at least confirm that the Government will accept the WRC's invitation to talks? Is she even aware that the invitation has been outstanding for the past five months? We have Ireland's largest union waiting for a response that has not come. We also have the Workplace Relations Commission waiting for a response. We have 16 men and their families, seven years after they lost their jobs, waiting for this payment and the Labour Court's recommendations to be honoured. I hope the Minister of State will be able to give me some precise answers today.

I thank the Senator for tabling this Commencement matter. As he correctly pointed out, it is not within my area of responsibility. I have been asked to take it on behalf of my colleague, the Minister of State at the Department of Education and Skills, Deputy John Halligan, who sends his apologies that he cannot be here. I will read the statement I have been given. I have taken note of what the Senator has said which I will relay back to the Minister of State.

The Tipperary hostel project was a community based project set up in 2000 by Tipperary Hostel Limited. Its objective was the transformation of a Famine era workhouse in Tipperary Town into a facility which was expected to operate primarily as a local community based hostel under community and voluntary management. The project was part funded under a FÁS job initiative programme. FÁS provided financial support to assist with the job intervention programme, for example, with participants' wages. Funding was also provided for the project by Pobal. The aim of the job initiative programme was to assist long-term unemployed persons to prepare for work opportunities by providing participants with work experience, training and development opportunities.

In April 2010 the board of Tipperary Hostel Limited informed FÁS that it would be ceasing work on the project on 30 April 2010. This followed on from an internal audit investigation by both Pobal and FÁS. At the time of the closure there were 22 employees participating in the scheme. FÁS arranged alternative employment on community schemes for 22 participants, however only one availed of this offer.

A case on behalf of the employees was taken to the Employment Appeals Tribunal where it was established that the employer of the job initiative programme participants was Tipperary Hostel Limited, not FÁS. FÁS ceased to fund and manage all job initiative schemes in 2011 as this function was transferred to the Department of Social Protection. In October 2013 FÁS was abolished and SOLAS was established. SOLAS has no liability for redundancy payments to the former participants as its predecessor, FÁS, was never their employer as was confirmed at the Employment Appeal Tribunal. SOLAS was not a party to the Labour Court recommendations of March 2016, LCR21162 to LCR21181, inclusive, and LCR21185. The parties involved were Tipperary Hostel Limited and SIPTU. In the recommendations of the Labour Court the finding was against Tipperary Hostel Limited. Tipperary Hostel Limited stated it had no funds as during its operation it had relied on funding from FÁS and POBAL. The Labour Court recommended that the parties, Tipperary Hostel Limited and SIPTU, jointly co-operate in seeking the necessary funds from the funding agency to discharge the amounts recommended. Tipperary Hostel Limited and SIPTU have not at any stage sought funding from SOLAS or the Department.

In relation to the decision on the provision of funding, it should also be noted that there is an outstanding liability due to SOLAS of €159,960 from Tipperary Hostel Limited.

SOLAS has continued to pursue this funding from the company.

I thank the Senator for giving the Minister an opportunity to outline the position on the Tipperary hostel project.

I hope the Minister of State can understand why I am extremely disappointed with her response. The least the workers deserve is respect. They have been shown no respect by the Department of Social Protection. The Minister of State acknowledged in her reply that responsibility for job initiative schemes had been transferred to that Department. When officials from the Department met representatives of SIPTU, they did not say this had nothing to do with the Department. A WRC invitation has been outstanding for five months. I have to say the Government is playing ducks and drakes on this issue. It is ducking here and ducking there. The workers are waiting for moneys that are due to them on foot of a Labour Court recommendation. The disrespect shown to them is in stark contrast to the affording of moneys to banks and developers by the Government. I do not mean it personally when I put it to the Minister of State who has a rotten job here today that this is a disgrace. I am extremely dissatisfied because it is a disservice to the Seanad that I have been unable to get a single straight answer on behalf of the workers. I hope the Minister of State can do more than that before she leaves.

I do not think this issue will be resolved today. Does the Minister of State want to-----

Will the Minister of State accept the WRC's invitation?

I know that the Senator is very passionate about this matter, but, as he has admitted, the Minister of State is not the line Minister in this area. As she is standing in for somebody else, she does not have all of the answers. I do not think the issue will be resolved today. I ask the Minister of State to make some brief remarks in conclusion.

I thank Senator Paul Gavan. I appreciate that the reply has frustrated him. To be honest, I could raise my own concerns in that regard. I will bring the issues he has outlined to the attention of the Minister. The Minister and his office will reply to the Senator in more detail and answer some of the questions he has raised. Unfortunately, I am not in a position to provide detailed answers. It would be wrong of me to try to do so, but I will give a personal commitment to pass on the concerns and frustration expressed by the Senator during the debate.

I appreciate it.

I am sure the Senator will raise the issue again if the line Minister does not heed the Minister of State's hints. I hope it can be resolved without another debate.

Ambulance Service Response Times

Cuirim fáilte roimh an Aire Stáit, an Teachta Corcoran Kennedy, go dtí an Seanad.

Ba mhaith liom fáilte a chur roimh an Aire Stáit.

I am raising the issue of ambulance response times to call-outs in counties Monaghan and Cavan in the context of two very serious and life-threatening incidents that occurred in the north Monaghan area at the end of December 2016 and the beginning of January 2017. One person collapsed in a shopping centre in Monaghan and another person fell down the stairs of her family home. There was a delay of two hours in one case and two and a half hours in the other while those involved waited for an ambulance to arrive. It subsequently transpired that the ambulance had to travel from County Longford. An ambulance was called last week in Killeshandra, County Cavan after a young pupil began to feel unwell. The school was informed that it would take 45 minutes for the ambulance to arrive. The school principal who is to be complimented on acting so quickly was concerned and decided to contact a local general practitioner who, in fairness to him, left his practice and went straight to the school. The case was so serious that he decided to travel with the child in a car to Cavan General Hospital. Surely that is not good enough in this day and age. I am sure the Minister of State can appreciate the trauma the family went through. Family members were worried about their loved ones and extremely annoyed and upset about the delays that took place.

They join a long list of cases in counties Monaghan and Cavan in which there were similar life-threatening delays. Unfortunately, this has been a problem in County Monaghan for over a decade. When acute hospital services were removed from Monaghan General Hospital, the people of the county were promised a beefed-up ambulance service to compensate for the lack of services at the hospital. Unfortunately, they are still waiting.

I wish to clarify the definition of a "golden hour". It is a term with which people living in counties Monaghan and Cavan are rather familiar. The golden hour is a period of one hour, or less, following traumatic injury being sustained by a casualty or medical emergency, during which there is the highest likelihood that prompt medical treatment will prevent death. Today there is a real and palpable fear among people living in counties Monaghan and Cavan that a delay will occur following an ambulance call-out. Ambulance response times in counties Monaghan and Cavan are well outside the recommended levels. The same applies in the north-east region generally, according to the latest National Ambulance Service statistics. HIQA guidelines are clear: an ambulance should arrive at the scene of a life-threatening emergency in fewer than 19 minutes in 80% of cases. However, last September this target was met in only 67% of the 809 calls in the north-east region, well below the national average of 74%.

Last week, to great fanfare, the Taoiseach, with senior Ministers, told us how the Government was going to look after and focus on the needs of rural Ireland. The most basic need of any citizen lving in rural Ireland is access to health care. Surely, the Minister of State will agree that the ambulance call-out consistency rate is abysmal.

The Minister and the HSE have much to do to establish confidence in the provision of health care in rural areas in counties such as Monaghan and Cavan. In no way is any criticism directed at front-line staff. They are put in a difficult position and arrive at a scene where people are upset and distressed. They deserve great praise for the professionalism shown in adverse circumstances, as well as for the care and kindness they show to the people concerned and their families. The lack of resources explains inadequate ambulance cover and delays. Ambulances are trying to cover areas that are too extensive to be feasible within time targets. The problem of accountability for delays and poor service must be fixed as a matter of urgency. I call on the Minister of State to arrange for a commitment to be given to the people of counties Cavan and Monaghan to the effect that delays of this nature will not continue and that adequate resources will be put in place to ensure people will be attended to when the need arises.

I thank the Senator for raising this important matter. I welcome the opportunity to address the House on it.

Monaghan ambulance base provides a 24/7 ambulance service. In addition, the National Ambulance Service has been moving to a policy of dynamic deployment, whereby vehicles are strategically located in the areas they are most likely to be required, rather than located at a particular station. In that regard, County Monaghan can also be served by resources based at Castleblayney, Cavan, Dundalk, Ardee and Virginia.

While response times are helpful for performance measurement, it should be recognised that sole reliance on response times does not provide a comprehensive picture of modern ambulance service performance. A steering group set up by the HSE has been working to define a new set of key performance indicators for the ambulance service. They will include patient outcome indicators to assess performance.

The National Ambulance Service has undergone a significant process of modernisation in recent years and a number of important service innovations and developments have taken place. The national emergency operations centre has been established. At the centre emergency calls are received and emergency resources are dispatched. The National Ambulance Service has visibility of all available paramedic resources and vehicles in real time, ensuring the closest available resource is dispatched to an emergency. In addition, the National Ambulance Service has developed the intermediate care service to provide lower acuity hospital transfers. This frees up emergency ambulances for the more urgent calls. Furthermore, a permanent emergency aeromedical support service has been established to provide a more timely response time for persons in rural areas.

The National Ambulance Service is considering alternatives to the current model of care which requires every patient to be brought to an emergency department.

The options under consideration include hear and treat whereby clinical advice is provided over the telephone for callers who can then, if appropriate, be referred to other care pathways. I am advised that a recruitment process is under way for the necessary staff to facilitate the roll-out of a pilot hear and treat model of care. This ambulance reform programme is taking place against the backdrop of the Health Information and Quality Authority's review of ambulance services which was published in late 2014 and the National Ambulance Service capacity review which was published last year. The capacity review examined overall ambulance resource levels and distribution against demand and activity. Implementation of the recommendations made in the capacity review will require a multi-annual programme of phased investment in ambulance manpower, vehicles and technology. I am happy to confirm that in that context, additional funding has been made available to the National Ambulance Service in 2017 which will provide for the recruitment and training of additional staff, the development of alternative care pathways and the implementation of the electronic patient care record.

I thank the Minister of State for her response. I welcome the statement that additional resources will be allocated which, as I said, are very much needed.

When I was first alerted to this incident in County Monaghan in the first week in January, I contacted the HSE. The incident caused great concern for the people of that county. I asked for the reason for the delay. We are now entering February and I have not received a response. I do not expect the Minister of State to have the answer to that question, but this issue needs to be addressed. With respect, I take cold comfort from the contents of the Minister of State's statement. It is an issue that has to be addressed. If someone is in a critical and life-threatening situation and lies waiting for two and a half hours for an ambulance to arrive, we have a serious problem. Unless we address it, fatalities will occur.

I cannot comment on specific cases, but I absolutely understand the Senator's concern. Perhaps it might be more appropriate to refer the specific cases to the National Ambulance Service for investigation. I am sure if the Senator provides it with the details, it will investigate the instances mentioned.

That has been done.

Sitting suspended at 3.05 p.m. and resumed at 3.30 p.m.