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Seanad Éireann debate -
Tuesday, 7 Feb 2017

Vol. 249 No. 15

Commencement Matters

Road Improvement Schemes

Cuirim fáilte roimh an Aire go dtí an Teach. The Minister is welcome and I thank him for his attendance.

I refer to phase 3 of a project to remove bad bends on the N2, the Dublin to Derry road, along the stretch from Monaghan town to Emyvale.

In 2017 Transport Infrastructure Ireland allocated €600,000 towards the cost of this project, phase 3 of which extends as far as Emyvale village. Unfortunately, it will not allow Monaghan County Council to go to tender, which is very disappointing as the council is ready to go with its documentation and all it needs is the go-ahead from Transport Infrastructure Ireland to do so.

As the Minister is aware, the N2 is a particularly busy roadway. It takes traffic from counties Donegal, Derry and Tyrone to Dublin; therefore, it takes all North-South and South-North traffic on a daily basis and the numbers are very high. There are many dangerous bends and corners that need to be removed. It is a small enough project as it is only 3.5 km long. It is slightly ironic that we are discussing this stretch of roadway. I am disappointed and very saddened to report to the House that before lunch, I learned of a fatality on it. I take the opportunity to extend my sympathy to the family involved. It is a very dangerous stretch of road and the corners need to be removed as a matter of urgency. I ask that a fund be made available to Transport Infrastructure Ireland and that the Minister consider allocating funding in order that the project can move to tender. Failing that, I ask the Minister to give a commitment to the House that the project will be committed to in 2018.

I thank the Senator for raising this very important issue. I was not aware of the fatality to which he referred, but I join him in expressing my sympathy to the families involved in yet another tragedy on the roads. It is particularly sad, considering that the Senator is talking about the safety aspects of this road, a subject underlined by this tragedy. The dangerous aspect of the road will be a factor when consideration is given to changes to be made.

As Minister for Transport, Tourism and Sport, I have responsibility for overall policy and funding of the national roads programme. The planning, design and implementation of individual road projects such as the N2 are matters for Transport Infrastructure Ireland, TII, 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 Roads Act. The Government's capital investment plan entitled, Building on Recovery: Infrastructure and Capital Investment, provides the strategic and financial framework for TII's national roads programme for the period from 2016 to 2021. As Minister, I have to work within the capital budgets included in the plan.

In planning the construction schedule for individual projects TII must also take account of the annual budgets available. The focus of its activities during the coming years is, accordingly, being centred on the progression of the major national road schemes identified for development during the period of the Government's investment plan. In that regard, the proposed N2 Slane bypass has been included in the plan among the schemes planned to commence during the period, subject to necessary approvals. Funding totalling €1.2 million has been provided by TII in 2017 to prepare a new design for the scheme. Within the available finding, I understand TII is hoping to progress minor road improvement schemes on the N2 during the period of the plan. These schemes involve the realignment and/or widening of the existing single carriageway road and include phase 3 of the N2 Monaghan to Emyvale improvement scheme where land acquisition and finalisation of tender documentation are ongoing. In addition, road pavement overlay and safety schemes were completed on the N2 in 2016, including sections of the route between Balrenny and Knockmooney in County Meath and Emyvale village in County Monaghan.

Safety works at Blakestown Cross in County Louth are anticipated for completion in February 2017. TII also advises that Monaghan County Council appointed consultants last year to review the safety aspects of the existing N2 between Ardee and Monaghan. The findings of the review are being examined.

On the safety issue which today, sadly, is so topical and important, last year Monaghan County Council appointed consultants to report on safety on the N2 between Ardee and Monaghan. The short-term measures outlined have been identified and I will provide the table. The proposals must go before Monaghan County Council for approval. Until approval is received, no works can proceed at these locations. The focus is on getting the short-term proposals under way before medium or long-term proposals can be delivered.

I thank the Minister for his response. As he outlined, there is a serious problem on the stretch of roadway from Ardee to the Border, on which, unfortunately, fatalities occur too often. It is ironic and sad as we discuss this issue that there was a fatality this morning. It highlights the urgency attached to improving safety on this stretch of roadway. I do not know the total number of fatalities, but in the past two years the number on this stretch of roadway has been way above the national norm. It is something with which we should deal as a matter of urgency. I urge the Minister to focus his efforts and those of the Department on it in order that something can be done on this stretch of roadway to ensure the citizens who travel on it can do so in a safe manner.

I thank the Senator and reassure him road safety and the identification of roads for improvement will be high priorities. When this issue is being considered, the tragedies which have occurred will be a serious consideration.

Garda Stations

I thank the Minister of State for coming to the House to deal with the matter of the building of a new Garda station in Glanmire. The building used was an RIC barracks which had been burned down during the Civil War and refurbished. It is totally out of date. It has no showers, changing rooms, interview rooms or wheelchair access. In May 2010 an advertisement was placed in the newspapers for a suitable site. I understand one was identified but no progress has been made since. I understand there was litigation on the matter, but I am not sure why.

The population of the area is 17,000 and moving towards 20,000. It is not satisfactory that there is no Garda station for a population of this size. It is in that context I request to know the up-to-date position. When is it likely that a site will be identified? When is it likely that tenders will be invited to build a new Garda station for the area? The matter is extremely important.

The area, being on the outskirts of Cork city, will continue to grow and has a very young population. Therefore, it is very important that a new Garda station be put in place at the earliest possible date.

On behalf of the Minister who, unfortunately, cannot be here, I thank the Senator for raising this important matter. He has a keen interest in justice and equality issues. He will appreciate that the programme for the replacement and refurbishment of Garda accommodation is progressed by the Garda authorities working in close co-operation the OPW which has responsibility for the provision and maintenance of Garda accommodation. It includes identifying and progressing necessary new builds and remedial or refurbishment works required at individual stations. The Minister has no direct role in these matters. The Minister has, however, been informed by the Garda authorities that the proposed site for the new Garda station in Glanmire has been the subject of legal proceedings, which were settled towards the end of 2016. I understand the Garda and OPW are working very closely to progress the development as soon as possible.

The Senator will be aware that the proposed Glanmire station forms part of the Garda station building and refurbishment programme for the period 2016 to 2021 which makes provision for the major refurbishment of stations and facilities, including facilities for meeting victims of crime; essential remedial works to existing stations; the development of large-scale property and exhibit management stores; the upgrading of cells; and the provision of improved custody management facilities. Under the programme, in addition to the proposed Glanmire station, new stations will be provided in Bailieborough, Sligo, Macroom and Clonmel. They are in addition to the new divisional headquarters in Dublin and Wexford, as well as a new regional headquarters in Galway, the development of which is under way at a cost of over €100 million and which are expected to be completed in 2017. Of course, these measures cannot be viewed in isolation from the Government's overarching commitment to ensuring a strong and viable police presence throughout the country in order to maintain and strengthen community engagement, provide reassurance for citizens and deter crime. In furtherance of this objective, the Senator will be aware that in July 2016 the Government approved the Minister's proposal for an overall Garda workforce of 21,000 personnel by 2021, comprising 15,000 Garda members, 2,000 Garda Reserve members and 4,000 civilians. In addition, the Government's capital plan for the period 2016 to 2021 provides €205 million for investment in Garda ICT infrastructure and €46 million for investment in the Garda fleet. Taken together, the measures outlined reinforce the Government's commitment to enabling significant reform in An Garda Síochána and providing a high profile and visible policing service for communities.

An bhfuil an Seanadóir sásta?

The problem I have is that this project was advertised in 2010. I am concerned that seven years have been lost. As I outlined, there is a growing population and a totally inapt Garda station. Could any commitment be given to prioritise the works in view the seven-year delay? I am glad to hear the position on the legal proceedings. I am surprised a process such as this took six years to conclude. I am glad, after the time lost, that we can now fast-track the development and accord to it priority in a schedule of work.

I will bring the Senator's message on the Garda station in Glanmire back to the Minister. The Senator has made his points very well. There is a high degree of urbanisation in the general area in question and people need to feel safe in their own community. I regret that legal proceedings held up progress for five or six years, but the matter was resolved just before Christmas. I hope there will be further progress. Of course, I will relay the Senator's concerns to the Minister.

Senator Colm Burke might think of running in the north side constituency the next time. He seems to be spreading his wings.

Health Services Provision

I refer to the lack of physiotherapy services to meet the needs of children in the west. It is timely that this Commencement matter is being debated today after last night's programme on RTE. I commend RTE for the programme and highlighting what we all know has been happening for many years, that people are suffering in pain while they wait for vital treatment. I hope the focus on the issue in the programme will provoke consciousness among those making decisions in this area. This morning the Minister said it was unacceptable and it is certainly unacceptable to those who are waiting in pain. It is also unacceptable to those who are waiting in pain every day for physiotherapy services.

Notwithstanding the numerous representations I receive from parents all over County Mayo, I was prompted to raise this case by a particular woman in the county. She is called Karen and has an eight year old son, Jack, who has cerebral palsy. Four years ago he had surgery, without which he was facing life in a wheelchair. As the treatment was not available in Ireland, he had to undrergo it in the United States after funding of €70,000 had been raised in the local community. On returning and the advice of doctors in the United States, he began a physiotherapy programme at First Step Therapy Centre in Patrickswell, County Limerick, the only place other than Dún Laoghaire where this particular type of physiotherapy - spider cage and lokomat therapy - was available. The complex surgery carried out in the United States requires this specific type of physiotherapy to gain maximum benefit. The therapy Jack receives through the HSE is for just 45 minutes, twice a month, which is inadequate in terms of the amount he needs and the type of physiotherapy he requires. The therapy is paid for entirely by the family with no support from the HSE. He attends the centre every second weekend for two hours, on a Friday evening and again on a Saturday morning, and it is all self-funded, with Karen footing the cost of the diesel needed and fund-raising to meet the cost of accommodation and the therapy. It works out at between €400 and €500 for each trip. Why should parents like Karen have to depend on fund-raising to provide this vital treatment to keep her son from being wheelchair bound? Without follow-up care, the surgery becomes less and less effective. The physiotherapy is not an optional extra but essential for Jack to have any quality of life to alleviate his pain.

I have travelled to County Limerick with Karen and Jack to see the great work being done by the First Step Therapy Centre which was opened several years ago by then Minister for Health, Mary Harney. I am asking for two things from the Minister. Jack is not the only person in this position and I am only using him as an example to show what children have to go through when they do not have this vital physiotherapy available to them in their local area, by which I do not mean their own parish or county but region. Is it possible for the HSE to put in place a funding mechanism to help Karen and other families to pay for travel, accommodation and the therapy needed for their children? Can the Minister instruct the HSE to carry out a full cost-benefit analysis of the setting up of similar physiotherapy centres in each province to meet the needs of children?

I thank the Senator for raising this very specialised issue related to physiotherapy serivces. I welcome the opportunity to outline the current position on the matter.

I agree with her introductory remarks on the programme broadcast last night on RTE. I find it totally unacceptable and agree that we have to do something about the matter. That is the reality. Children, or anyone in pain, should not have to wait in pain for treatment. We have to deal with waiting lists. The Minister for Health, Deputy Simon Harris, has been very proactive in the last couple of hours in dealing with it through the hospitals and the HSE. However, it is unacceptable that people find themselves in that position.

To deal with the matter raised by the Senator, the HSE funds a range of community services and supports to enable each individual with a disability to achieve his or her full potential and maximise independence. Services are provided in a variety of community and residential settings in partnership with service users, their families, carers and a range of statutory, non-statutory, voluntary and community groups. Voluntary agencies provide the majority of services in partnership with and on behalf of the HSE. The HSE works very closely with a number of voluntary service providers that specialise in the provision of services for children with cerebral palsy, offering a number of therapy services, including physiotherapy and gait analysis. They include Enable Ireland and the Central Remedial Clinic, CRC. In 2005 the CRC commenced the provision of a range of services for people in the mid-west region, including the world's first gait laboratory. Significant resources have been invested by the health sector in disability services in the past few years, including additional funding of €31 million last year. The extra €31 million is also available for the social care and disabilities service plan 2017.

The First Step Therapy Centre is a private company based in Limerick that offers intensive physiotherapy programmes for children and adults with neuro-muscular disorders. The HSE acknowledges that service users may choose to access privately provided therapy services. However, it is not generally the policy of the HSE to fund private therapy sessions. I have set up a task force which I met in the past couple of days. It is looking at the idea of personalised budgets. It could be a situation where people might be given a certain amount to access physiotherapy services. Karen and Jack's case could easily fall within it.

The HSE is working closely with all service providers to ensure available resources are used in a creative and flexible manner in order to be responsive to the needs that present. However, the health service as a whole has to operate within the parameters of the funding available to it. In the current economic environment this has become a major challenge for all stakeholders, including the HSE, voluntary service providers, service users and their families. Physiotherapy services for adults and children are generally delivered through primary care teams, community therapy services, specialist disability service providers of early intervention services and children's teams which continue to be developed under the programme of disability services for children and young people aged zero to 18 years. The HSE also provides assistance devices for people with disabilities to enable them to maintain their health, optimise functional ability and facilitate care in the primary care setting. In addition, access to rehabilitation equipment is also provided, where appropriate.

The issues raised are very important. We have to look at some creative ideas to deal with cases such as that of Karen and Jack.

I thank the Minister of State. It is welcome that a task force has been set up, but the crux of the matter is ensuring the money is used to meet the needs of the individual patient because the same treatment is not suitable across the board. I disagree with the Minister of State on the picture he paints of children being able to access physiotherapy when they need it. That is not the case. That is not my understanding or experience. Providing access to physiotherapy twice a month for a child like Jack is absolutely unacceptable. There should be an examination of where the money is going. We need to ensure supports and services are provided for children in the areas where they are most needed.

I take the Senator's point on physiotherapy. When I took over as Minister of State with responsibility for disability services, I inherited a situation where there had been no investment whatsoever for seven or eight years. We had to start reinvesting and reforming services.

The Senator raised an important point, namely, that a cost-benefit analysis should be carried out. I will bring that point to the HSE, in particular those directly involved with disability services. Something must be done. If we are providing millions of euro for the reform of and investment in services, we need to ensure the money will go to people such as Jack. I want to focus on such cases.

The Senator referred to access to physiotherapy services. I have had the same experience as she has had, in particular in recent years. There is a major crisis. Most people on the front line accept that there is a crisis in speech and language therapy and physiotherapy services. I hear the same from people in counties Waterford, Wexford, Mayo, Galway and across the north side of Dublin. There is no point denying that that is the reality.

My objective is that no matter what budget we have available, we prioritise people and ensure a person with a disability will receive services. It may not be known that €1.688 billion will be provided for disability services in 2017, an increase of €96.3 million, or 6%. People like the Senator are also demanding other things. People are asking why, if that level of funding is available for services, children are on waiting lists. That is my job. We are going to try to reform the system.

The cost-benefit analysis and access to physiotherapy are issues I will bring to the attention of managers in the HSE.

Motorised Transport Grant Closure

I raised this issue last September. The Minister of State and I know about the situation at this stage. I refer to the motorised transport grant, payment of which was suspended in 2013. It was given to people with disabilities who needed to buy cars in order to retain employment or in exceptional circumstances those with severe disabilities who lived in isolated locations and could not use public transport.

When I first raised the issue, I gave the Minister of State the details of a woman who had been looking after her husband since 1995. He had contracted viral inflammation of the brain and suffered considerable brain damage. He has epileptic fits, suffers from depression, has word finding problems and problems with comprehension and memory. He had a further heart attack in 1999. The woman in question needs a car as there are consultant appointments on a continual basis. She is driving an eight-year old car. The motorised transport grant scheme allowed her to change her car every few years. She is in a desperate state following the suspension of grant payments. When I raised the issue last September, I told the Minister of State that her car was seven years old and that she would have a problem if it broke down. The engine collapsed and she bought a reconditioned engine using a loan from a credit union. She is now living from day to day. She needs to bring her husband out for a cup of tea. She cares for him 24 hours a day because she is the only one he will allow to care for him, given his medical condition.

Last September the Minister of State said the Government had decided that detailed preparatory work required on a new transport support scheme and associated statutory provisions should be progressed by the Department of Health. He confirmed the work was at an advanced stage and that the drafting of primary legislation was almost ready to proceed.

I have since received a copy of a letter sent in 2013 by the Secretary General of the Department of Health to those in the HSE in County Mayo. It stated the Government had agreed an interdepartmental group chaired by the Department of the Taoiseach would be asked to develop detailed proposals for the operation of a new scheme or schemes and that it would report back to the Government in October 2013. We are now four years on and it is four months since I raised the issue. I know that the Minister of State is aware of this case and I am sure there are multiple such cases throughout the country. Something really needs to be done to resolve the issue. As I stated when I previously raised it, this family could have pursued the State for the treatment as others who received awards of hundreds of thousands of euro did at the time, but they are so honest and all they wanted was for the support and care to be given at home and to save the State money. However, we are in a situation that has not improved. The problem is the woman in question feels she has no hope.

I thank the Senator for raising this Commencement matter and welcome the opportunity to outline the current position. I absolutely take on board and I am aware of the case about which the Senator spoke. As he Senator will be aware, conscious of the reports of the Ombudsman on the legal status of both the mobility allowance and the motorised transport grant schemes in the context of the Equal Status Acts, the Government decided to close both schemes in February 2013. It is important to clarify that there are no plans to restore either of the schemes as they previously operated. However, the Government is aware of the continuing needs of people with a disability who rely on individual payments that support choice and independence. In that regard, monthly payments of up to €208.50 have continued to be made by the Health Service Executive to more than 4,700 people who were in receipt of the mobility allowance.

The Government decided that the detailed preparatory work required on a new transport support scheme and associated statutory provisions should be progressed by the Department of Health. I am pleased to inform the Senator that A Programme for a Partnership Government acknowledges the ongoing drafting of primary legislation for a new transport support scheme. Both the Minister for Health, Deputy Simon Harris, and I are committed to its progression as soon as possible. I can confirm that work on the policy proposals is at an advanced stage and anticipate that they will be brought to the Government shortly. In that regard, the Health (Transport Support) Bill is included in the Government’s legislative programme. The proposals will seek to ensure that there is a firm statutory basis to the scheme’s operation; that there is transparency and equity in the eligibility criteria attaching to the scheme; that resources are targeted at those with the greatest need; and that the scheme is capable of being costed and affordable when introduced on an ongoing basis.

The Department is seeking a solution which would best meet the aim of supporting people with severe disabilities who require additional income to contribute towards the cost of meeting their mobility needs, while keeping within the available budget and satisfying all legal and equality concerns. The challenge is to develop a new scheme on a statutory basis, within a limited budget, targeted at those with the greatest need. The matter will be brought to the Government for consideration and a decision as soon as possible. I look forward to what will be a valuable and constructive debate when the Bill is brought before this House in due course.

I thank the Minister of State. He spoke about equity and the need to target resources. What does that mean for those whose case I have highlighted? What does it mean for those who cannot cope in such situations?

We spoke about a television programme that was broadcast last night. If a television programme were to carry out an investigation into the case I have raised, there would be further uproar. It is time the Government took a proactive rather than reactive approach to this issue. I urgently appeal to the Minister to ensure the criteria developed for the new system take account of cases such as the one I have raised.

When fighting for resources for various parts of the health and disability sector, I prioritise those most in need, particularly the 4,700 people who are in serious need. I accept the Senator's point about the specific case he raises and the need to be proactive and take the lead on this issue. When we entered government almost 12 months ago, we stated action was needed in introducing legislation on the motorised transport grant. I had not realised the issue had been discussed four years ago by the previous Government or other Secretaries General in the Department of Health. I give the Senator a commitment to do my best to progress the matter. While the legislation is being finalised, it is unacceptable that so little progress has been made in the past four years. I will work closely with the Minister to get up and running on the issue.

I welcome, by special request, a group of pupils from St. Brendan's College, Belmullet, County Mayo. Tá fáilte romhat go dtí an Seanad.

Sitting suspended at 3.15 p.m. and resumed at 3.30 p.m.
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