Commencement Matters

Schools Building Projects Status

St. Molaga's senior national school has 463 pupils. It is in the town of Balbriggan, County Dublin. Balbriggan is the fastest growing town in Ireland, has the youngest population in the State and the capacity to expand much more. Since 2000, over half the pupils and half the teaching staff have been housed in 16 prefabricated buildings. These are now in a desperate state of repair despite the best efforts of the principal, Pauline Costello, and her staff. They are overcrowded, cold and damp in the winter and too hot and stuffy in the summer. The conditions are intolerable. The school is at bursting point and, given the projected enrolment from the feeder school, Sts. Peter and Paul junior school, and the drop in the pupil-teacher ratio, extra capacity is urgently needed in St. Molaga's.

The school is on the major building works list for 2019-21 but nothing is imminent. I brought forward this matter on the Commencement on 26 October last. The Minister of State at the Department of Education and Skills, Deputy Halligan, told me on that day that substantial progress would be made on this project before the Christmas break.

Christmas came and went and no word came to the principal. This prompted the principal to apply for additional prefabs due to the urgent capacity issues. She did so very reluctantly due to their cost and the fear that the ultimate goal of permanent school structures being put in place would be put on the back burner for a further 17 years. In early January the Department made contact with the principal, organising a meeting to discuss the extension. I believe 7 February was finalised as the date for this meeting.

This afternoon Pauline Costello got word that approval had been granted for prefabs for two mainstream and one special education classrooms. This was less than she had requested but it is welcome. The focus, however, should remain on the extension which needs to be delivered immediately. Can the Minister give me a clear outline today of the appointment of a design team and planning permission application or will this be given to the team that is meeting the Department on 7 February in Tullamore?

I am also looking for a guarantee that the granting of additional prefabs does not mean that the extension date will be pushed out because 17 years is too long to wait and we need this permanent structure in place for the children of St. Molaga's and Balbriggan who will enter the school in the future.

I thank the Senator for raising this matter. I can understand what a frustrating experience it is for any school that is struggling.

My Department is planning on delivering 20,000 school places every year. We are facing the need to meet very strong population challenges across both primary and secondary level. It is a challenging area for my capital Department.

On the wider issue of the planning area of Balbriggan, it is indeed one of 314 planning areas across the country in which the Department is carrying out a demographic exercise to identify whether there is pressure for additional accommodation to be built in the longer term, that is, to extend the total number of places available in the area. That result should be available within a reasonable period although it is not yet available.

On the specific situation in respect of St. Molaga's school, I recognise that what the Senator says is correct. The school has had a permanent building and temporary accommodation. It has survived for a very long period on a mixture of the two, with eight classrooms in temporary accommodation as well as two special needs classes. The school is absolutely and rightly on the Department's building programme. I do not want to get into a dispute about timings. However, the note I have says there was contact during the summer months regarding a project brief for the school and the longer-term projected staff requirements, and that the Department is currently preparing the project brief following that discussion. As the Senator correctly stated, a meeting has been scheduled for early February to bring that discussion further, with a consultation with the school authorities. The completion of the project brief will facilitate the project to be progressed into architectural planning, which includes the appointment of a design team. This is a positive movement for the project. There is a project brief close to completion. There is this meeting and it will proceed then to the design phase.

I assure the Senator that my Department does recognise the importance of this. Providing additional prefab accommodation does not mean that the school will lose its position or the importance that is assigned to the work. As the Senator did, I also commend the principal, Pauline Costello, and the staff on the work they are doing in the school. I hope these scheduled meetings will assist the school in its planning and delivery of the service to which it is giving such commitment.

The principal and teaching staff are doing an excellent job, despite the challenges they face. I am sure they will continue to do an excellent job. However, the children and staff deserve a decent and safe work and learning environment. The contact during the summer months was merely in the form of acknowledgement letters to the letters Pauline Costello submitted. There was no information contained in them. The contact in January was the first of a substantial nature.

I am glad to hear that a project brief is being prepared. I hope details of it will be delivered to the board of management at the meeting on 7 February. I re-emphasise that this really is a priority at this stage. I understand there are other priority areas around the country but this is of urgent priority because of the census data and the desperate conditions in which the pupils and teaching staff have had to subsist for the past 17 years. Could the Minister tell me when we will see the extension being completed? Is the projected date in 12 months or 18 months? In the Minister's experience, what is the time scale between the project brief being completed and the actual delivery?

Unfortunately, I cannot give any such projection because every project genuinely does differ. There can be delays in a planning process or a design team. There can be issues around reconsidering some elements of the design when it is seen. There can be issues around tender. It is a process we have to go through and I would only be misleading the Senator if I said one phase will take X amount of time and another will take Y amount. It would be construed as a commitment which I simply cannot make.

The Deputy referred to the census data. It is being very closely examined at present to see if there is an expectation of additional capacity being needed in the Balbriggan area.

The project predominantly involves replacing capacity which has been provided on a temporary basis. As I understand it, at this point it is not based on trying to increase the overall enrolment numbers for the school or area. I will convey to my Department how the school community and the Senator feel about the project. I recognise that virtually every area to which I go has projects that are very urgent. It is the product of the fact that we are experiencing population growth which up to now has mainly been in the primary school system but which is now occurring in the secondary school system. We have to make sure we meet the needs of the school population every year.

It is heartening that the overall number of children accommodated country-wide in temporary prefab accommodation is reducing. Undoubtedly, to some degree, after a lost decade of investment in many public service areas we are catching up. The Department has been able to protect investment in the education sphere in order to provide for children. It will have to continue to do so within tight financial constraints.

The Minister has touched on the fact that this is not about creating extra capacity in the school. Extra capacity has been created in many other schools in the town of Balbriggan in the past few years, which is to be welcomed. However, the pupils and teachers of St. Molaga's who have built a great history and served the community in Balbriggan feel they have been left behind because the school has been allowed to run down and is falling apart. It is very important that the existing capacity be protected and that the pupils and teachers be given a decent school.

The Minister has responded as best he can. I should not have allowed the Senator to speak again, but she said she wanted to clarify something.

I thank the Cathaoirleach for his indulgence.

Passport Services

Gabhaim buíochas leis an Aire Stáit as a bheith linn don phlé seo inniu. 'Sé an fáth a chuirim an cheist ná go bhfuil ráchairt agus feachtasaíocht ollmhór ag dul ar aghaidh uirthi, go háirithe ó Thuaidh.

I thank the Minister of State for taking the time to come to speak to me about my request. I refer to the concerted call made by citizens and those in the North applying for Irish passports for a dedicated office and facility to meet the growing demand. The Minister of State will know that last year over 82,000 passport applications were received from the North and even more from Britain. The increase in the number of applications received from the North was almost one fifth on the number of applications made in 2016. The levels in 2016 were an increase on the numbers of applications made in 2015, while the levels in 2015 were an increase on the numbers of applications made in 2014. There has been a concerted pattern in the past few years.

First-time applicants for Irish passports accounted for almost one half of the requests received last year alone. The call comes not just from Sinn Féin, although we are proud to lead in the institution of the campaign, but also from other political parties in the North. The SDLP agrees with us, while Fianna Fáil has indicated that it would like to see something located in the North. The Alliance Party has stated there is merit in looking at the opening of a service. It is about the interest shown in improving infrastructure and service delivery across the country. There are two passport offices. I take the opportunity to commend the staff who have worked under immense pressure to deliver a vital and important service across the State. The offices in Cork and Dublin service those parts of the country very well. There has been incremental growth in demand not just from the Six Counties but also the broader north-west region. There is, therefore, merit in the Government considering how it can improve the infrastructure across all 32 counties. When Guy Verhofstadt addressed us a number of months ago, he highlighted the commitment to protect our rights as full Irish and EU citizens.

I call on the Government to put its money where its mouth is and to make a practical infrastructural service investment in the northern part of the country. The Taoiseach rightly said that on his watch no longer will Irish citizens in the North feel abandoned. I ask that the Government does not abandon us, that it shows us that the preparations and work are under way as the unwanted and negative impact of Brexit is rolled out, and that the Irish Government remains steadfast and that it is here to stay in terms of citizens' rights in the North. One way to do that, which would certainly be hugely symbolic, would be the opening of a passport office. It would also help immensely with service delivery and the practicalities of the increasing demand for Irish passports from Irish citizens in the North.

The year 2017 was a record breaking one for the passport service, with approximately 780,000 passports issued. This was an increase of over 6% compared to 2016 and an increase of over 15% since 2015. That strong demand for Irish passports includes an increased demand from Irish citizens in Northern Ireland and Great Britain - overall, almost 20% of the total number of applications received by the passport service last year were from Northern Ireland and Great Britain. As the Senator pointed out, a total of 82,274 applications were received from applicants in Northern Ireland and first-time applicants represented approximately half of all those applications from Northern Ireland.

We predict that increasing demand will continue to be a feature of our work in 2018, bearing in mind a range of factors, including a growing population and economy. Between 1 and 21 January 2018, the passport service has already received 53,554 passport applications. Of this total and in the same period, we have received 4,446 applications from Irish citizens in Northern Ireland; 4,020 of these applications have been made via the Northern Ireland passport express service, while 425 have been received via the passport online renewal service.

In anticipation of increased demand my Department has commissioned research to try to better understand the potential demand for passports from citizens who have not yet applied for a passport. That study will assist the Department in formulating plans on the resources required into the future.

Responding to this significant and growing demand, the passport service offers a range of convenient channels for submission of passport applications by Irish citizens at home and abroad. Advice and guidance on these channels and other useful information on passports is available on the Department's website at https://www.dfa.ie/passports.

The Department has worked exceptionally hard to ensure we provide a modern, secure and efficient passport service. An ambitious reform programme is in place to meet the unprecedented demand for passports from Irish citizens at home and abroad, and to continuously strengthen systems guarding against fraud and protecting the integrity of the Irish passport.

The award-winning online passport renewal service was launched in March 2017 and offers the convenience of an online application system 24 hours a day, seven days a week for adult Irish citizens anywhere in the world, without the need for application forms, printed photos or witnesses. The introduction of online service not only offers improved customer experience but is also resulting in efficiency gains which are assisting my Department to manage the large volume increases in applications.

Citizens who cannot or do not wish to apply online have the option of applying through their local post office. In 2017, over 400,000 citizens availed of this option and submitted their passport application through the network of more than 1,000 post offices across the State. The Northern Ireland passport express service offers an equivalent service to those living in Northern Ireland from more than 70 of its post offices. We are keenly aware of the importance of our post office network on this island and I want to acknowledge the valuable role it plays in administering the passport express service, offering a convenient and cost-effective option for citizens across the island of Ireland.

Bearing in mind the availability of both the online and postal application channels, very few citizens living on the island of Ireland are required to travel a significant distance in order to apply for their passport. In the relatively small number of cases where citizens need to travel very urgently and do not have a valid passport, the passport offices in Dublin and Cork offer an appointment service, including where necessary a rapid renewal one-day service. The passport service keeps passport demand under review on an ongoing basis.

To address the increased demand for passports during peak season, the passport service is this year employing over 210 temporary clerical officers to assist in processing. These staff have been hired and the roles are being filled. My Department has also been working closely with the Department of Public Expenditure and Reform to fill permanent positions across all passport offices and I am pleased to say over 20 permanent staff have joined the passport service in the past month.

Furthermore, it is already planned to further extend the online application facility to all citizens, including first-time applicants and children, by 2019. That will be a very significant step indeed in terms of enhancing the service for all citizens. That will allow additional efficiency gains and improvements in customer service. People who cannot or do not wish to apply online will still be able to submit their applications through a service provider with an extensive network of contact points throughout the country.

In all the circumstances, I am satisfied that the range of service options available meets the current needs of passport applicants and projected demand and I do not see a compelling rationale to open an additional passport office in Northern Ireland at this time. I should clarify that any new office would need to have the capacity to provide a rapid renewal service for applicants with urgent travel needs such as that available through the passport office in Dublin. That would require an on-site passport production machine in a specially controlled and secure environment. The purchase cost of a new passport printing machine alone would be approximately €1.7 million. That is without security, technical, fit-out, staffing and rental costs. An outreach office without production facilities could not offer a significantly faster service than the online option and it would do no more than duplicate the passport express service already offered through local post offices.

In all the circumstances, I am convinced that with the existing and future range of services, including passport express, rapid renewal and online services, my Department will continue to more than adequately meet the needs of all passport applicants, wherever in the island of Ireland they are living. My Department is also working on an outreach public awareness programme to inform the general public of all the services available in applying for a passport.

The response might not be entirely to the Senator's liking but I will allow him a brief supplementary.

Tá sé sin iontach spéisiúil. I do not disagree with most of what the Minister of State said. The passport service is first class. The staff in the post office network and in the passport office provide an immensely worthwhile service for citizens right across the State. I am disappointed that the associated cost is seen as a reason for not locating the service in the North. The Minister of State cited €1.7 million as the cost for the print facility, but I am sure all 82,274 people who applied for a new and renewed passport paid for the service. I do not believe, therefore, that cost is necessarily the best case to make. This is about investment, future planning and meeting a clearly identifiable need. In the broader political context, which we cannot ignore, this is about saying to Irish citizens north of the Border that we are investing in them and we see them as part of the life of this State and this country overall and we will meet the need with a service delivery to which they are entitled. While I agree that the service at this stage is first class, as the Minister of State rightly outlined, there is a growing demand which I expect will continue to grow. The very broad political call for this service will not go away.

The Minister of State can but we are out of time.

It is critical to point out that the rights of citizens on the entire island of Ireland to apply for and to retain an Irish passport is at the very core of the work that we do. I fully agree that significant challenges will arise in terms of what Brexit will bring but the service is available through the network of 70 post offices and increasingly online. Last year if one were to avail of the online service one had to be over 18 and renewing one's passport but we will shortly allow the service to be accessed by everybody applying for a passport, including for the first time. That is a significant development.

The purchase cost of the machine would be €1.7 million. The number of applicants submitting their applications through any additional or new office would not be sufficient to keep the machine running for more than half an hour a day, as it can print approximately 500 passports per hour. If we channel our resources through enhancing all the services already provided on the island which are available to all citizens of the island, that would be a far more appropriate use of those resources.

Care of the Elderly

I welcome the Minister of State to the House again and thank him for coming here so often.

We are all too aware of the problems with overcrowding that affect many hospitals around the country, particularly at this time of the year. We are all deeply concerned about this. None of us wants to see our relatives, or anybody’s, lying on a trolley, especially if they are elderly.

This problem has been with us for over 20 years. I acknowledge that there is no quick-fix solution. The issues are complex and require creative solutions. We know it is not just a matter of throwing more beds at the problem, and this becomes even clearer when one talks to people working at the coalface. It requires a multifaceted approach. An initiative I believe would lead to a significant reduction in hospital referrals is the rolling out of geriatric teams working specifically in the community. Such teams, led by a community-based consultant geriatrician and including specialist and prescribing nurses, could play an important role in supporting the management of the health needs of older people in community settings and in providing services that avoid the necessity for a hospital admission. There are regular admissions to the Midland Regional Hospital, Mullingar, of elderly people presenting with various needs, such as a requirement for intravenous medication. With more community geriatric teams, many of these elderly patients could be assessed and treated in the community. The team would visit local nursing homes, day care centres, community nursing units or people's own homes to assess and treat elderly patients without the need for the hospital admission in many cases.

People over 65 years make up 13.5% of the population but currently account for significantly more than half of all the inpatient beds. This segment of the population is projected to grow significantly in the coming years. Many older people admitted to emergency departments, once assessed by a triage nurse, end up spending prolonged periods awaiting treatment. HSE statistics show that patients over 75 years spend three times longer in emergency departments than those aged 65 or younger. Up to 40% of those waiting for more than 24 hours are over 75 years of age. Would it not be significantly better to bring the care to these people rather than bringing them to the care, where they have to wait for long periods exposed to additional infection and putting pressure on an already strained emergency department?

Such an outreach service, provided in an integrated manner, would be a significant support in maintaining older people in their own homes and communities, where we all know they do better. This would not only help to reduce overcrowding in hospitals, such as that in Mullingar, but also, and just as important, preserve the dignity of older people and reduce the stress on their families. I have been in communication with Nursing Homes Ireland and it has assured me that this initiative is one it would very much support.

When I raised this issue previously with the then Minister of State, Kathleen Lynch, she informed me the HSE was to put in place an integrated care programme for elderly people that would examine the variety of ways that health care services could be delivered to older persons and determine the most effective way to do so. Therefore, I ask the current Minister of State to update the House on the status of the integrated care programme for elderly people and, in particular, outline whether he believes a sufficient number of teams, each comprising a geriatrician and specialist nurses working in the community, could provide a more appropriate service for older users and help to relieve the pressure on emergency departments in hospitals, particularly at times of overcapacity.

I thank the Senator for raising this issue, which she has been raising for some time. There is nothing more impressive in politics than consistency. The Senator is certainly consistent, and she certainly has been consistent on this topic. She has been following it for a number of years. She referred to the predecessor of my predecessor, Kathleen Lynch. Therefore, it is quite a while since the Senator first proposed what she is now proposing.

It is the role of public representatives, including Senator McFadden in her role as a Senator, to continue to challenge the system. The HSE manages the delivery of services to elderly people and the entire population.

It is up to us as public representatives to continue to challenge how things are done. If we continue to do what we always did, we will not bring about the real change demanded by the people we represent. I thank the Senator for raising this matter because it gives my officials and I the opportunity to refocus our efforts on getting geriatric teams into the community to deliver health care. The last place for the elderly is in an emergency department or acute hospital. The health challenges they face in such environments are enormous. It is important we continue to help people to live longer and better lives in their own homes where it is safer.

The integrated care programme for older persons, working in conjunction with the national clinical programme for older people, is leading on the development of cohesive primary and secondary care services for older people with a specific focus on those with more complex needs and frailty. To date, 12 pioneer sites have been supported and are in development nationally. Six were commenced in 2016 and a further six in 2017. These sites are working to a ten-step framework informed by a local population based approach, delivered by multidisciplinary teams working across traditional service boundaries and adopting a case-management approach. The integrated care team for older persons in the pioneer sites works, in partnership with community services, primary care, social care and health and well-being services, to promote healthy outcomes and reduce morbidity to enable older people to lead independent and purposeful lives in their communities.

The integrated care programme for older persons pioneer sites has focused on developing improved care pathways which address areas of older persons care such as integration across acute and community services, emergency department older persons flow and inpatient flow. While delivery of the pioneer sites is in the early stages, initial indications are positive with the integrated care programme for older person teams demonstrating they are providing multidisciplinary interventions for the majority of older persons in their own homes or in a community day hospital setting. There is substantial emerging evidence, locally and internationally, to show that approaches that use the models of care outlined in the national and integrated care programmes for older people demonstrate improved outcomes, particularly with regard to frailty.

Further evaluation is ongoing to better understand the impact of integrated care on outcomes for older people in the Irish context.

I thank the Minister of State for his reply. I acknowledge and welcome his support and encouragement as it is refreshing. The elderly have worked all their lives, paid their taxes and never got anything for nothing nor looked for anything for nothing. They deserve the best. I urge the Minister of State to look at a system whereby geriatrician and nursing teams go specifically to nursing homes, community centres and elderly people's own homes to stop them having to go to hospital.

It is important we get to air these issues and continue to challenge the system. The Senator is 100% correct in what she is looking for which has been proved beyond any doubt. I look forward to working with her to bring it about.

General Practitioner Services Provision

I have raised this matter concerning the SouthDoc service in Kinsale, County Cork, because of a public meeting held there several months ago. The lack of a dedicated SouthDoc service in Kinsale has not been addressed since 2014 when we lost it due to a merger between two existing services in Bandon and Kinsale. The community in Kinsale has not had a dedicated SouthDoc service based in the town since.

SouthDoc services are a key part of the social and economic fabric of Kinsale and how it does its business. It is a large town with a significant urban hinterland and a thriving tourism industry which sees the town's population quadruple in the summer months. Due to the age profile of some of these tourists, the lack of the SouthDoc service has become an issue in the past few years.

At a public meeting I attended with other public representatives, it became apparent that it is a major issue in the town. I want the Minister and the Department to look at where we are going with the SouthDoc service for the people of Kinsale. There are genuine concerns not only for the residents but also for the tourism industry. It was taken away in 2014 because of financial constraints, but it is now appropriate to look at reinstating this service. The physical infrastructure, the building, is still there. All we need is the will on the part of the Department and I hope I might get some news on that today in order to progress this very important issue.

I thank the Senator for raising the issue. The Government is committed to enhancing primary health care services, including GP services, throughout the country.

Patient needs for health care can arise at any time and GPs contracted under the GMS scheme must make suitable arrangements to enable contact to be made with them, or a locum or deputy, for emergencies outside normal practice hours. While GPs are not obliged to participate in out-of-hours co-operatives as a means of meeting the contractual requirement, such services have been developed and expanded over time and are now an essential part of our primary care services. This helps to ensure that, to the greatest extent possible, urgent care needs are met in the primary care setting.

SouthDoc operates and provides out-of-hours GP services in Cork and Kerry. The HSE provides funding to support this service, including the costs of triage nurses, call centre, treatment centres, drivers, cars and receptionists. Of more than 215,000 patients that SouthDoc dealt with in 2016, approximately 10,000 were from the Bandon and Kinsale area. In 2013, SouthDoc undertook a review of the service across the Cork and Kerry area. The review considered issues such as levels of activity, availability and sustainability of GPs in each area as well as value for money. This review resulted in changes to service delivery in a number of areas, including Kinsale. SouthDoc took the decision to establish the main centre for this area in Bandon, and base the doctors there on weekdays from 6 p.m. to 11 p.m. and for the weekend service, while retaining a treatment centre in Kinsale. After 11 p.m., one doctor on-call is based in the Bandon treatment centre and travels out as required. If a backlog remains at the 11 p.m. handover, the second doctor will remain on duty as required to deal with the patients waiting to be seen. The levels of activity in this area and the access to an alternative location within a distance of 19 km were key considerations when making the decision.

The HSE has advised that at least two doctors continue to be on duty in the area, supported by additional doctors, when necessary. The doctors are also backed up by the wider SouthDoc infrastructure and resources, including a triage nurse team in headquarters. For all those in Cork and Kerry who contacts SouthDoc, a patient's condition will dictate the appropriate treatment and its delivery location in line with clinical protocols. Patients are contacted directly and given a suitable appointment time in the appropriate location which may be in either treatment centre or could be a home visit in the case of a patient being unable to travel. At all times, the progress of each patient is clinically managed on an individual basis in line with that patient’s condition. The HSE has advised that 80% of all patients are treated within 90 minutes of initial contact.

I thank the Minister of State for his very detailed response on what is a very serious issue for the people of Kinsale. I hope there will be a review at some stage into the service to see if this station could be reopened, particularly at night. That is the key issue. There is a feeling in the town that this needs to be looked at. If the Department were doing a review, it might consider Kinsale in light of that review.

I am sure the Minister of State will be only too glad to accommodate the Senator.

Of course. The HSE primary care division is carrying out a review of all out-of-hours GP services and obviously this issue will be looked at in line with others. Obviously, it is in my constituency and I am very familiar with it. I have also sought engagement with GPs in the Kinsale area to ascertain their feelings on it and to see what issues arise. As it is in my constituency, I will be more than happy to progress the issue.