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Seanad Éireann debate -
Thursday, 14 Dec 2017

Vol. 255 No. 3

Commencement Matters

Emergency Departments Waiting Times

I welcome the Minister of State to the House. I raise this matter because it is of significant importance in County Clare. I was on the way to Dublin on Tuesday while I listened to local radio. An independent councillor for whom I would have much regard in County Clare, Councillor Ann Norton, relayed her experience in the emergency department in University Hospital Limerick, where her daughter had been a patient. She outlined a series of events that were very worrying. The Government and the Minister have invested significantly, particularly through capital investment, in trying to deal with the ongoing challenges people face in the emergency department in University Hospital Limerick. The Government has opened a new unit in Limerick at a cost of more than €20 million to try to deal with the problem of people waiting on trolleys, etc. It was very disappointing to hear of Councillor Norton's experience with her daughter, as well as the experience of others who have approached me in recent times to say patients are on trolleys for significant periods in the hospital emergency department. The Government has made an investment in excess of €20 million but the problem persists.

After the Government and Minister have invested such money to deal with the problem, why are we in this position in Limerick, with patients on hospital trolleys waiting to be dealt with? Is there another issue of which people are not aware? Perhaps there is a management issue. I have tabled this matter because I am very concerned about what is happening in Limerick. It affects not only people in Limerick but also those who live in north and south Tipperary, as well as County Clare.

I thank Senator Conway for raising this very important issue. I am here on behalf of the Minister for Health, Deputy Simon Harris, who wishes me to update the House on the emergency department in University Hospital Limerick.

There is no doubt that too many patients continue to wait on trolleys for admission to hospitals on a daily basis. I wish to acknowledge the distress that overcrowding in emergency departments causes to patients, their families and the front-line staff who work in extremely difficult conditions in hospitals throughout the country.

Tackling overcrowding in emergency departments is a key commitment of the Government, and additional funding of €40 million has been made available in 2017, as part of the 2018 budget, to address the winter pressures on waiting lists across the country. This additional funding is aimed at reducing overcrowding in our hospital, including University Hospital Limerick through the provision of extra capacity and additional support.

The emergency department in University Hospital Limerick is one of the busiest in the country, with 65,000 attendances annually. Demand for service in the emergency department continues to rise. The HSE data for the end of October 2017 indicated that attendance in the emergency department has risen by almost 5% and that admissions through the emergency department has increased by more than 10% as compared to the same period last year. In recognition of the high demand, funding of €24 million was provided for the new emergency department at University Hospital Limerick, which opened in May 2017. The new emergency department is three times the size of the former emergency department and provides modern, safe and fit for purpose facilities that meets patients' and families' expectations. At the same time the new facility provides high quality comfortable accommodation that protects patients' privacy and dignity. Notwithstanding this investment, the emergency department at University Hospital Limerick continues to be challenged and there are too many patients on trolleys on a daily basis. Mindful of this issue, the Minister for Health and his officials in the Department convened a meeting in October with the chief executive officer of the University Hospital Limerick and the HSE to discuss this issue. Following this meeting, an emergency department improvement plan was submitted by the University Limerick Hospital Group. The plan is being implemented and is being monitored by the Department of Health. In addition, as part of the €40 million funding announced for the winter measures as part of budget 2018, 17 new beds have been opened in University Hospital Limerick in December and this site is availing of four additional home care packages and two additional transitional care beds per week during the winter months. In addition, as part of a proactive and integrated approach to winter planning, the hospital groups, hospitals and the community healthcare organisations, CHOs, and primary care providers have put in place winter plans in order that the health service is ready for the increased demand for health services and, in particular, for emergency department services in the months ahead. I can confirm that University Hospital Limerick has such a plan in place.

I welcome the detail in the Minister of State's reply. It is worrying to think that after an investment of €24 million in building the new emergency department in University Hospital Limerick the Minister has had to request a meeting with the chief executive officer of that hospital group in order to ascertain the reason patients are on trolleys for unacceptable periods. I have taken this opportunity to highlight the issue and I sincerely hope that during the Christmas period as few as possible will have to experience lying on a trolley in University Hospital Limerick.

I commend the Minister on making a capital investment of €24 million in the hospital, which is a significant investment. I hope the CEO of the hospital group will deal with the management issues so as to ensure that people will have a comfortable experience when they attend the emergency department in University Hospital Limerick. I thank the Minister of State for coming to this House to address the issue.

I acknowledge the Senator's contribution. Let me assure him that the Minister, Deputy Harris, and his officials will continue to monitor the performance of the emergency department. Members of the Oireachtas are concerned about the significant numbers attending emergency departments, particularly during the winter months. This puts major pressure on hospital staff. It is heart-wrenching to hear personal stories, be they on the radio or the television of people having to wait for lengthy periods, feeling that they are not progressing up the list. Let me assure the Senator that even in St. James's Hospital in my constituency, I know the staff are dedicated to implementing the programme of the HSE to be able to deal with the incoming patients at this time of the year. However, even after the significant investment in University Hospital Limerick, there seems to be other problems that need to be ironed out. I will bring this to the Minister's attention and I will ask him to reply personally to the Senator.

Children and Family Services Provision

I welcome the Minister of State, Deputy Catherine Byrne, to the House. It has been two and a half years since the Children and Family Relationships Act 2015 was signed into law. This historic legislation gave parental rights to same-sex couples across the State and truly embraced the notion that family formations are diverse, and there is no single proposition for Irish identify but only diversity.

Parts 2 and 3 of the Act provide for parentage through donor assisted human reproduction and as of December 2017, Parts 2 and 3 have yet to be commenced by the Minister for Health. Parental rights provide for an array of protections for a family - for example, allowing a parent to apply for an Irish passport and citizenship for their child; allowing a child to access his or her parents' estate, should they pass; and allowing a parent to make emergency health decisions on behalf of the child. I have received a number of emails from members of the public who are running into trouble in that regard, particularly in the area of passports. In response to a recent parliamentary question, the Minister for Health, Deputy Harris, indicated that the commencement of Parts 2 and 3 would be in place by "the end of the year". In response to further parliamentary questions tabled by Deputy Louise O'Reilly, the answers omitted a timeline that was requested by us, suggesting that the Department is working to resolve a small number of technical issues involving the commencement of Parts 2 and 3. My first question is whether there is a timeline for the commencement of Parts 2 and 3 of the Child and Family Relationships Act? A significant number of families are experiencing legal uncertainty and are having their rights deferred. I think same sex couples and their families have waited long enough for the commencement of these Parts of the Act.

I will read the statement that has been provided by the Minister's office and refer to some of the issues the Senator has raised. The Children and Family Relationships Act 2015 reforms and updates family law to address the needs of children living in diverse family types. As the Warfield is aware, the Minister for Health is responsible for the commencement of Parts 2 and 3 of the 2015 Act and associated regulations. As well as making regulations in respect of donor assisted human reproduction procedures, Parts 2 and 3 of the Act make provision for children conceived through the assistance of a donor. This includes mandating for non-anonymous donation and the establishment of a national donor-conceived person register to enable children to access information on their donor and genetically related siblings when they come of age, should they wish to do so. These provisions were specifically included in the Act to underpin the rights of the child under Article 42A of the Constitution of Ireland's commitment to the UN Convention on the Rights of the Child, including the right to have information on their genetic heritage.

Parts 2 and 3 also provide legal clarity on parental rights and responsibilities. While matters such as the registration of births are not directly encompassed within these parts of the Act, the Minister recognises that the commencement of Parts 2 and 3 is necessary for provisions in these areas to be fully effected. I assure the Senator that the commencement of Parts 2 and 3 is a matter that the Minister for Health wants to address as soon as possible. Officials in the Department of Health are preparing draft regulations to facilitate the commencement of Parts 2 and 3 of the Children and Family Relationships Act 2015 and they are working to resolve a small number of technical issues to ensure that the processes associated with Parts 2 and 3 of the Act can be commenced. I will address other issues that the Senator raised when I reply again.

I am disappointed that, having previously been given a timeline for the end of this year, that again, we are not being given an indication about the introduction of Parts 2 and 3. I have no doubt that the Department is working hard on this but I urge the Minister of State to give urgency to this issue. Same-sex families have waited long enough and we cannot claim to recognise all families equally until this obstacle is overcome. I urge that the Department and Minister give urgency to this issue.

I have just come from a meeting in the Department with the Minister, Deputy Harris, and departmental officials. There are details that have to be ironed out before it is brought in. I assure the Senator that January to early February will be the timeframe. If possible, it will be implemented by the end of January and if not, then the beginning of February. That is what came from the meeting this morning and I have nothing else to add.

School Transport Eligibility

I raise an issue regarding calls for protocols to be put in place for students repeating their leaving certificate examinations to have access to the school bus system. It is a huge issue in my part of the world. At the moment, we have up to 1,800 or 2,000 students repeating the leaving certificate examinations every year. A majority of these students have access to school transport but because they are outside the timelines for applying, they are not eligible to get a seat and are then outside the criteria. They could have used a bus for five or six years. However, because they are repeating the leaving certificate examinations, they do not qualify for a bus because they did not apply in time. The application date for a seat is 5 May. Students do not get their leaving certificate examinations results until 16 August so, realistically, the only way I can see around the issue, if a protocol is not put in place, is that students who do their leaving certificate examinations should apply for their seats for the next year just in case they repeat their leaving certificate. That is an illogical way of dealing with the issue.

This is a practical problem. We have people who are trying to improve their results, work hard and do what they can but they are denied seats on buses because they are outside the timelines despite the fact they had a bus seat for six years. This is not a budgetary issue but is in many ways a protocol issue to ensure that this cohort of students, who are doing their utmost to ensure that they improve their grades and where they go in life, can have ease of access to the nearest place of education. We need a special protocol for leaving certificate students who repeat the leaving certificate examinations. Over 1,800 are repeating the leaving certificate examinations this year. The majority of them were on the school bus system for five to six years and they need to have access to it. At the moment, if there is no seat available, they have no access and the line they get from the Department is that they did not apply on time. It is illogical to have leaving certificate students applying for a bus for next year just in case they do not get certain results.

We need to have flexibility in the Department. I can describe many instances where people who have been on the bus for six years repeat their leaving certificate examinations but because they did not apply on time, they have no bus for the year in which they are repeating the leaving certificate examinations. It is a huge issue. I hope I can get a suitable protocol put in place in the near future because these students deserve school transport and access to education. It is a very practical issue.

I thank the Senator for raising this matter. School transport is a significant operation managed by Bus Éireann on behalf of the Department. Over 114,000 children, including almost 12,000 children with special educational needs, are transported in over 4,500 vehicles on a daily basis to primary and post-primary schools throughout the country covering over 100 million km at a cost of approximately €190 million annually. The purpose of the post-primary school transport scheme is, having regard to available resources, to support the transport to and from school of children who reside somewhere remote from their nearest school.

Children are eligible for transport where they reside not less than 4.8 km from and are attending their nearest post-primary centre as determined by the Department and Bus Éireann, having regard to ethos and language. The closing date for applications for school transport is the last Friday in April each year and the closing date for submitting payment details is the last Friday in July. However, Bus Éireann continues to process applications and payments after these deadline dates and where possible children are accommodated on school transport services where spare seats are available. Children who wish to repeat their leaving certificate examinations should liaise with their local Bus Éireann office if they wish to avail of school transport for the next school year. Where there is spare capacity on existing services, Bus Éireann will issue tickets for these children. However, if all seats on a particular service have been allocated already then it may not be possible to facilitate children repeating their leaving certificate. It is not practical for Bus Éireann to maintain spare seats on every service to ensure that children who may repeat their leaving certificate can be accommodated. Children who pay for seats on school transport services who subsequently are not accommodated will receive a full refund.

There is not any eligible child in Ireland who does not get school transport or a payment to help with transport to school. The difficulty we have is with concessionary provision. The scheme was laid out in the first place to deal with eligible children going to their nearest school. The difficulty we have now is that we have almost 3,000 children availing of concessionary provision. I always make the point that it is important to know that if a bus is coming from a village, town or city and is a 20-seater bus with 18 eligible children on it, we will facilitate two children under concessionary provision on that bus. The difficulty is that if an eligible child from that village, town or place makes himself or herself available, we have no choice under legislation and criteria laid down to put that eligible child on the bus.

I take on board what the Senator says in that regard and might speak to him further about it. If he were to give me specific details, I would be delighted to talk to him and Bus Éireann to address it. My view has always been - I have taken many questions on this - that if I had my way, I would try to facilitate as many children as possible but we are restricted under the scheme laid down under the value for money review put in place in 2011, backed by the Dáil. The system is excellent. Some 99.9% of people are very happy with the system. It is one of the best in Europe.

It provides great value for money and as I say, an eligible child or a child with special needs is guaranteed school transport. The difficulty is that based on the criteria laid down in legislation, we cannot guarantee a place for concessionary children. When a bus is full, either with eligible children or eligible children and some concessionary children, we always have to remove a concessionary child from the bus and that creates a difficulty.

I am disappointed with the Minister of State's response. There are eligible children who have been eligible for six years and used the bus for six years. They were not concessionary, they were eligible. However, because they are repeating their leaving certificate examinations, they do not get a seat. Students receive their leaving certificate examinations results on 16 August. They currently need to apply for a seat on the bus on the 5 May. In other words, they have to apply before they actually sit their leaving certificate examinations.

The system is broken where people who repeat their leaving certificate examinations are concerned. I take on board that the Minister of State thinks it is a good system. However, it does not take into account the 1,800 people who repeat their leaving certificate examinations. That is a huge cohort. These people are going through stress. They have huge problems going back to sixth year, going into a new school environment and pushing themselves to get great results. They do not need this stress and hassle. They have spent six years on the bus, but because they are outside the timeline they do not get a seat. We need a special protocol for this cohort. The system is broken when one takes into consideration the way it deals with them.

The difficulty arises with the dates that are laid down for payment and for applications, which run from April to July. I understand that it is after that period that children who wish to repeat their leaving certificate examinations will want to avail of school transport. The problem that we face is a practical one. By that date, all of the buses are almost always full. By then we have allocated seats first to eligible children and then to concessionaries, though I note that it is almost always eligible children on the bus. I understand the Senator's concern and it is an issue that should be looked at. The date at which one of these students will decide to repeat their leaving certificate examinations falls outside of the April and July dates set down for payment and application.

I ask the Senator to let me come back to him on this issue. I will give him my word in that regard. I will talk to Bus Éireann and the Department. However, the difficulty does not arise from buses with spare seats passing areas by. If the Senator finds that there is a bus with spare seats passing by an area, and children who are repeating their leaving certificate examinations are not getting those seats, I invite him to come to me and I will change that. That is a guarantee. My difficulty at present is that almost in their entirety, all of the buses are full.

Local Authority Expenditure

I thank the Cathaoirleach for selecting this Commencement matter. I welcome the Minister of State at the Department of Housing, Planning and Local Government, Deputy John Paul Phelan, to the House. I wish to raise a very important issue. I ask for the Minister of State to consider whether local authority expenditure should be scrutinised by the Committee of Public Accounts. I call for this in the context of a need for greater transparency in the governance and scrutiny of local government finance, and to reflect the financial stewardship that is placed on the whole corporate body of a local authority via its members.

The members of a local authority have a particular role in scrutiny and accountability through the auditing process of local authorities. This does not just concern the executive of the 31 local authorities in this country. It is also about the role of the elected members and the oversight they provide. Five years ago, the Minister of State's constituency colleague, Deputy John McGuinness of Fianna Fáil, introduced a Bill to the Dáil to make the expenditure and income of local authorities accountable to scrutiny by the Committee of Public Accounts. That Bill was rejected at Second Stage and therefore fell. In 2012, the then Minister of State outlined the reasons the Government objected to the Bill. I do not intend to go into them now as he will be fully aware of them. However, a lot has changed since 2012. We now have the National Oversight and Audit Commission, NOAC, supervising local government. We also have local property tax, a new dimension to local government revenue and expenditure which was not envisaged when this Bill was considered, or when the previous unsuccessful Bill addressed the matter. I do not propose to go into the rights and wrongs of how the local property tax is disbursed across the country. That is for another day and another debate, although I would welcome the House holding that debate at some stage.

Now more than ever, however, people have a right to know how their local property tax and, indirectly, their income tax, is being spent by local authorities across this country. As credible as the National Oversight and Audit Commission is, and with all respect to the good work that it does, the Minister of State, Deputy Phelan, will be aware that its reports do not come under the level of national scrutiny that the Committee of Public Accounts would bring to this work. At a practical level, it is simple fact that Government expenditure comes under the spotlight of the Committee of Public Accounts. The national media pay attention to the work of that committee, as we have seen time and time again. Where there is a focus within this committee, the media take an interest and therefore the public hears about it. That very important fact is worth taking into consideration as part of this recommendation. I am not saying that there are wholesale inefficiencies or bad spending decisions taking place in local authorities. I want to make that clear. What I am saying is that the taxpayers are entitled to the highest levels of transparency and scrutiny around the expenditure of their money in each of these 31 local authorities.

What am I asking of the Minister of State? In simple terms, I am asking him one question. Will he and the Government consider drafting legislation in order that the Committee of Public Accounts, and thus the Comptroller and Auditor General, can have a role in scrutinising all 31 local authorities' spending across the country?

I thank the Senator for tabling this Commencement matter. The whole area of local government and local government expenditure was covered, as the Senator mentioned, by the Local Government Reform Act 2014, which established the National Oversight and Audit Committee. The matter of examining how local authorities expend their resources and the value for money delivered for rate-payers and taxpayers across the country is a very significant issue, and the Senator is right to raise it. The 2014 Act seems to have left a gap between the work that NOAC does and any measurable outcome at parliamentary level. In theory at least, the reports that NOAC produces can be covered by the Committee on Housing, Planning and Local Government, but in practice the housing aspect of that committee's remit is by far and away the busiest, and the local government reports do not seem to get as much coverage. Shortly after I was appointed I attended a meeting with NOAC when I heard one was taking place in the Customs House. I was the first Minister of State to go to one of their meetings. I was impressed by the personnel involved. They included former long-serving councillors and also long-serving management officials from across the country. These were people who had a very serious interest in the area as well as a significant level of expertise.

I am more than interested; I am, in fact, determined to ensure that the gap that exists at present between the activities of NOAC and those of the Committee on Housing, Planning and Local Government can be bridged in some way. As things stand, there will be a local government Bill next year. It is my intention that there will be provision in that Bill for strengthening the oversight of expenditure within local authorities. As NOAC is currently constituted, its functions include scrutiny of the performance of local authorities; support of best practice; overseeing implementation of national local government policy; and monitoring and evaluating implementation of corporate plans. It generally operates through subgroups, including a financial performance subgroup, that oversee different aspects of its work. Each subgroup consists of three or four members out of the ten members of NOAC, and publishes annual local authority performance indicators and composite public spending code quality assurance reports.

NOAC generally operates through subgroups, including a financial performance subgroup that has been set up to oversee different aspects of NOAC's work. Each subgroup comprises three or four members from NOAC's total membership of ten people. Each year, NOAC publishes local authority performance indicators and composite public spending code quality assurance reports.

I was interested to hear what the Senator had to say at the outset about the interest taken by the media in the activities of the Committee of Public Accounts. The perception and the work of that committee have changed greatly in the past ten years. It has become a very political committee. It was not as political in the past. This change has positive and negative aspects. I am not convinced that adding local authority responsibility to the areas the committee has to examine is necessarily the right way to go. I think we should try to make the NOAC system work more properly and fully than it does at present.

It is worth pointing out that when the reform legislation was being drafted and considered in the Oireachtas, consideration was given to the possibility of merging the Local Government Audit Service, which audits the 31 existing local authorities, and the Office of the Comptroller and Auditor General. While it was decided at the time not to merge the two organisations, the process led to engagement between senior managers in the two auditing bodies on enhanced co-operation arrangements in areas like professional training, value for money methodologies and approaches, and the possibility of issuing joint reports within their existing respective mandates.

The possibility of the Office of the Comptroller and Auditor General and the Committee of Public Accounts having a role in further ensuring appropriate oversight of expenditure of public funds by local authorities can be reconsidered by the Oireachtas with particular regard to commitments in A Programme for a Partnership Government. At present, my priority is to finalise the reports on local government which are promised under the programme for Government. At that stage, I will examine the matters that are to be addressed in the legislation that is to be introduced next year. Clearly, most of that legislation will flow from the reform reports. I am personally committed to the idea of greater national scrutiny and oversight of the finances expended by local authorities throughout the country.

I thank the Minister of State for his considered response. Ultimately, there are 31 local authorities and 31 chief executives. People are beginning to question whether those chief executives are accountable to anyone. They are well remunerated for their responsible jobs, which they do exceptionally well, on the whole. We need greater scrutiny of the financial affairs of these authorities. The real issues here are independent scrutiny, financial stewardship and public confidence in the 31 local authorities. The people who elect local authority members and pay their taxes to those authorities want to see accountability and transparency in local government finances.

I would like to leave the Minister of State with two little messages. I ask him to look again at NOAC. I understand NOAC has just five staff members. It is under-resourced. Representatives of NOAC attended a meeting of the Joint Committee on Housing, Planning and Local Government last week. I ask the Minister to examine this suggestion as a start. It is important. I have studied each of the 31 reports of the Local Government Audit Service. Certain themes recur in the qualified opinions in those reports year in and year out. The chief executives tend to reply to the service by noting the shortcomings that are highlighted in the reports and explaining that the financial structures of the local authorities do not have the necessary resources to carry out the extensive requests. I suggest that the officials in the Department of Housing, Planning and Local Government who look at the annual local government audit reports every year need to say that this excuse is not good enough. It is unacceptable for local authorities to respond to something that has been a recurring theme for three years by trotting out the idea that they do not have the resources to address serious financial governance issues. I thank the Minister of State.

The staffing issues at NOAC have been brought to my attention. In light of the amount of work NOAC is trying to do, I agree it is insufficient for it to have just five members of staff. The balance of powers between local authority executives and members is under consideration in the report that is being drafted. When we reflect on the possibility of providing for executive chairs of councils, we must consider whether that can happen right across the country, the timeframe for doing this and period of time for which they would remain in office. I have been an advocate of this approach for a long time. There are examples across the country of local authorities where the balance of power does not seem to work properly. As we all know, elected members are held accountable whenever there is an election. There is certainly a need for greater accountability at senior management level in our local authorities. I accept that there are many fine chief executives and senior managers at local authority level. As they know, they have nothing to fear from accountability. I assure the Senator that we are giving active consideration to the matters we are discussing.

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