The first two matters will be taken by the Minister of State at the Department of Finance, Deputy Michael D'Arcy. I welcome him to the House. Senator Maria Byrne has four minutes to make her case.
Motor Insurance Costs
I welcome the Minister of State, Deputy D'Arcy, and thank him for coming to the House today.
I am looking for an update on the report on the cost of motor insurance. Many people, especially the self-employed, have come to my office to tell me about the significant increase in their insurance premiums. I know the Minister of State set up a committee and a working group was drawn together to deal with it. A report published recently showed that some premiums increased by up to 57% between 2011 and 2016. Last year, by shopping around some people had a small decrease in their premium. Insurance premiums are out of control. This is a major issue and I would like the Minister of State to give me an up-to-date report on what is happening.
I thank Senator Byrne for tabling a Commencement matter as it gives me an opportunity to outline the position.
Members of the Seanad will be aware that the report on the cost of motor insurance was published in January 2017. It made 22 recommendations, with 71 associated actions to be carried out. The aim of the implementation of this report is to try to remove the volatility that we have seen with motor premiums in the past number of years, both up and down, and bringing the premiums from the very high levels into line with lower levels.
The report recognises that as there is such a range of factors that influence pricing, including the natural cycle of the market, consequently it is not possible to transform the underlying dynamic overnight. It is worth noting that last month marked the first anniversary of the publication of the report. More than half of the 71 actions had been implemented by the end of 2017. Senators should note that the fourth quarterly update report will be published in the coming days. This will give full details of the implementation of each of the recommendations. The Government approved the general scheme of a Bill to establish a new national claims information database in the Central Bank of Ireland. It has been referred to the Office of the Parliamentary Counsel for drafting. This is a key recommendation of the motor insurance report as this database will collect aggregate information linked to claims for private motor business from motor insurers to provide greater transparency on claim trends.
I also acknowledge the work of the Personal Injuries Commission, which is chaired by former President of the High Court, Mr. Justice Nicholas Kearns. The commission delivered its first report in December. Its findings suggest that adopting a standardised, internationally recognised approach to diagnosis, treatment and reporting of soft tissue injuries by practitioners who are appropriately competent and trained will improve the personal injuries environment in Ireland.
The Government remains committed to the implementation of the recommendations of the report of the cost of insurance working group. In this regard, work is continuing on important issues such as the development of an insurance fraud database in the Department of Justice and Equality and an uninsured drivers database in the Department of Transport, Tourism and Sport. The report provides us with a very good opportunity to address a range of problems in the sector. The Senator can be assured that I will work with my ministerial colleagues to ensure that the cost of insurance is reduced.
There appears to have been greater stability in the market in recent months. The most recent data from the Central Statistics Office, CSO, indicate that private motor insurance premiums have reduced by 16.3% from their peak in July 2016. While the CSO statistics indicate a greater degree of stability overall, these figures represent a broad average and therefore there are many people who are still seeing increases. There is work to be done in this regard. The Senator can be sure that the Department of Finance, the Central Bank and the other Departments of Government, along with everybody involved in insurance, are attempting to ensure that the cost is reduced.
This is a very important topic. Senator Byrne may ask a brief supplementary question.
I thank the Minister of State for his comprehensive reply. I will just give him a small example. A person in their early 50s came into my office recently whose premium had previously been a little more than €800. This person had received a bill for close to €1,200 despite having a no claims bonus and having never had a crash in 30 odd years of driving. Some of the companies are definitely still abusing the system. They are the ones which need to be looked at. I look forward to the Minister of State returning with a more substantial report once it has been published. Perhaps he will give a commitment to keeping an eye on this issue because it needs to be acknowledged that some of the companies are definitely abusing the system, although some others are working to decrease premiums.
I would like to put it on the record of the House that I have also heard of dozens of such cases. One gentleman came to me whose insurance premium had increased from €700 to over €1,000. He pursued the company and went to a different broker. The broker went to a number of companies and eventually got back to the company this gentleman had been with. He managed to get his insurance for the same price as previously because he used a different broker. There are many anomalies in the motor insurance industry and it is difficult to put a figure on them. That is the way the insurance companies operate.
It is important for people to recognise a couple of factors. The 57% increase was from a base that was too low. Companies established themselves here and went after market share. There was a price war and price wars never turn out well. The cost of insurance was actually too low. They were not operating from a proper base. Reducing premiums by 16% is a good start, although it is only a start. There are many other recommendations which will eventually be implemented.
On the example the Senator gave, we are asking the insurance companies to explain why insurance premiums have increased. They have to put the reason down on paper and give a proper explanation to each individual as to why the underwriters feel the premium should increase. That is another example of one of the more than 70 recommendations upon which the Government is acting.
I thank the Minister of State.
I welcome the Minister of State and thank him for taking this matter, which relates directly to the Department of Finance. In the programme for Government, there is a commitment to develop a public community banking system. There is a well-worn and well-articulated narrative as to what has happened in the banking sector in this country.
There are many examples of misbehaviour by the banks in the past. When they got a bailout, they continued to misbehave. Unfortunately, many of them are continuing to misbehave. In Germany, where public and community banking was initiated, up to 70% of banking is done through community and public banks.
When I was in Ennis on Saturday, I spoke to a man who is promoting the concept of public banking along with a number of his colleagues. They have seen at first hand what has happened in the banking sector in this country. As this country enters what we hope will be a period of prosperity, I dread and fear that history will repeat itself. The one thing we should do as a society is learn from the mistakes of the past. There is no doubt that mistakes were made within the banking sector and with the regulation of the banking sector. Serious mistakes were made in the past by the Department of Finance, where the Minister of State, Deputy D'Arcy, is based, and by the Central Bank, which was governing the operation and regulation of the banking sector. We had light-touch regulation in this country for far too long. It did not work. We need to move forward in a spirit of positivity and in an engaging way to do things differently and to avail of the best of what Ireland has to offer. We have the best ICT skills in the world. We have the best financial services brains and they are indigenous and organic to this country. We can be the best in the world at community and public banking. We have the skill set. The Government should make this a cornerstone of its financial policy as it goes forward. I hope the Minister of State agrees with me.
We will soon find out.
As Senator Conway is aware, the Departments of Finance and Rural and Community Development are responsible for fulfilling the commitment in A Programme for a Partnership Government to "thoroughly investigate the German Sparkassen model for the development of local public banks that operate within well-defined regions".
Under the local public banking model, a state or another public body has ownership of a financial institution. Local public banks in Germany, which are called Sparkassen, are not permitted to operate outside specific geographic regions. Their aim is not to maximise profits but to promote economic development and financial inclusion in the regional areas in which they operate. Additionally, the business model of Sparkassen involves building close relationships with local small and medium-sized enterprises, SMEs.
Officials in the Department of Finance have been working closely with their colleagues in the Department of Community and Rural Development. Their investigation of local public banking has consisted of a consultation process with stakeholders and interested parties, including the credit union movement and An Post. They have analysed a detailed proposal on the Sparkassen model and its possible implementation in Ireland that was put forward by Irish Rural Link and the Savings Banks Foundation for International Cooperation, SBFIC, which is the international development wing of the Sparkassen group. Officials in the Department of Finance have had a number of meetings with representatives of Irish Rural Link and the SBFIC. Officials from both Departments have prepared a report on the findings of their investigation. The report is being reviewed and considered by the Ministers, Deputies Donohoe and Ring. When the two Ministers have approved the report, it will be brought to the Government for consideration and approval. If and when the report is approved by the Government, I anticipate that it will be published immediately.
The Senator should be aware that the Government is fully supportive of increased competition in the banking sector. It encourages any potential new market entrants to engage further with the Central Bank of Ireland on this matter. The Senator may wish to note that significant Government measures are already in place to support access to finance by Irish SMEs, including the Strategic Banking Corporation of Ireland, the supporting SMEs online tool, the microenterprise loan fund, the local enterprise offices, the Credit Review Office and the credit and counter guarantee schemes. I will give two examples of how Government supports are helping SMEs to access finance and supporting employment.
The Strategic Banking Corporation of Ireland began lending in March 2015, providing funds thorough bank and non-bank on-lending partners. To the end of December 2017, some €925 million of SBCI supported lending has been approved for almost 23,000 Irish SMEs, operating across all sectors of the economy, including agriculture, food, retail, health care, transport and manufacturing. The Credit Review Office, CRO, is a Government initiative that helps SMEs who had an application for credit of up to €3 million declined or reduced by the main banks and feel that they have a viable business proposition. This is a strictly confidential process between the business, the Credit Review Office and the bank. The CRO has received almost 900 applications, with almost 700 cases concluded to date. It has successfully overturned more than 50% of the decisions made by banks. Over €48 million has been advanced on foot of the CRO’s recommendations and 3,750 jobs have been created or protected as a result.
In addition to these supports, the Department of Finance is working with other Departments to develop tailored and innovative schemes to meet the evolving needs of Irish SMEs, such as the €150 million agricultural cashflow support loan scheme and the €300 million Brexit loan scheme announced by then Minister for Finance, Deputy Noonan, in budget 2017 and the Minister for Finance, Deputy Donohoe, in budget 2018. Rural and regional development and supporting Irish SMEs to create employment and economic growth are important Government priorities and significant overall policy considerations. The Department of Rural and Community Development will continue to focus on rural Ireland and rural and regional development generally and will provide a co-ordinating role across Government on this priority area. The Senator can be assured that facilitating a functioning and competitive banking and mortgage lending system, in addition to supporting economic growth and employment in rural areas and regional Irish SMEs, remains a crucial priority for the Government.
I thank the Minister of State for his comprehensive outline of Government initiatives. I acknowledge that much has been done but there is still a way to go in terms of creating a fair equilibrium in banking because, unfortunately, the community and public banking model has been thwarted in favour of traditional commercial banks. The initiative that has been tried, tested and worked wonderfully in parts of Germany is getting serious consideration and I hope that the Minister of State and his Cabinet colleagues will, with their Departments, make a decision on this report as soon as possible because people would be happy to see progress on this matter. I acknowledge that the rate of progress is slow but I would rather it be slow and done right than rushed and not done right.
My strongly held view is that the more competition in the market, the better, but it has to be the right type of competition. Members are aware of the result of having the wrong type of competition 12, 14 or 15 years ago. It completely skewed the pitch. I discussed insurance earlier. The wrong type of competition can have a hugely detrimental impact in many different areas. The model in place did not have the correct balance between equity and lending. Whether small, big or other lending, it is important to have a different model. The model in Europe is 80:20 lending versus equity, while in the United States it is closer to 70% equity to 30% lending. The best model is probably somewhere in between and that is where we would like to be.
I am very encouraged by the credit union aspect with An Post and possibly supported by Government funding. We will consider the report when it is concluded and it will be analysed by both Departments and then go to the Government for consideration. There will be no delay on behalf of the Department of Finance in trying to implement a new model and structure and better competition in the market.
Health Services Staff Remuneration
I welcome the Minister of State, Deputy Catherine Byrne. Senator Paul Gavan has four minutes.
I welcome the Minister of State. I raise the issue of Newport day care centre in County Tipperary. The centre was established in 1992 and now caters for hundreds of elderly folk from the parishes of Newport, Toor, Birdhill, Ballinahinch, Killoscully, Ballina, my own village of Castleconnell, Kilcommon and Rearcross each week in a manner that has changed the quality of life for many of them for the better. A small team of ten health care professionals provide a wide range of community, health, well-being and respite services. Without this facility, hundreds of service users would have to attend at the already vastly overcrowded University Hospital Limerick for their health care needs. The staff have an extremely heavy workload and, like so many others in the sector, regularly go above and beyond their job specifications to ensure the highest standards of care and support for their clients. Above all, there is a great sense of community that runs through the heart of everything that is done at the centre. The range of community and health services provided make a crucial difference to the lives of so many people in the Tipperary and Limerick region.
The staff who provide this excellent range of services had their pay cut without negotiation in 2008. A decade on, their pay remains exactly where it was after that cut. They see their colleagues and other HSE-funded organisations that have benefited from pay restoration or other section 39 organisations that now, thankfully, have a means of redress through a structured and transparent pay restoration mechanism agreed between my union, SIPTU, and the Department of Health and the HSE. Where is the roadmap for the workers at the Newport day care centre to achieve their pay restoration? Where is their means of achieving any kind of pay rise after a decade enduring a significant pay cut which was imposed without agreement? That pay cut was imposed as a result of a direct instruction from the HSE to the manager of Newport day care centre.
We know this facility is suffering from significant underfunding. We know it because the management of Newport day care centre has - in writing - cited underfunding as the reason they will not attend the Workplace Relations Commission; they have no financial means of addressing the claims of the SIPTU members working at the centre. As management will not attend the Workplace Relations Commission, the workers concerned have no choice but to ballot for industrial action. This is a publicly-funded facility. Surely the workers must have some means of redress, surely they deserve some hope after years of loyal service and surely there is a responsibility on the Minister of State to make this possible. I am asking her to include these workers in the mechanism for pay restoration for section 39 workers. Otherwise they will be left with no choice but to initiate industrial action. Nobody wants a strike to take place, least of all the workers themselves. It will take place, however, unless the Minister of State provides a means for these workers to press their legitimate claim for pay restoration.
I am responding on behalf of the Minister of State, Deputy Finian McGrath. I thank Senator Gavan for raising this issue.
The overarching policy of the Government is to support older people to live with dignity and independence in their homes and communities for as long as possible and to support access to quality long-term residential care where this is appropriate The HSE has operational responsibility for planning, managing and delivering health and personal social services including home help, home care packages, meals on wheels, respite or day care and a range of other community based supports. Services are delivered through the HSE and its funded agencies to people in local communities, as close as possible to people’s homes.
Our ageing population is one of the most significant demographic and societal developments that Ireland has encountered in modern times. Not only are people living longer, but a great many people are staying healthier and living better for a longer time. Demand for community services is rising as more people are supported in their own homes rather than in hospitals or nursing homes. Access to day care centres such as Newport can make an important contribution by providing invaluable support, advice and social interaction for older people who may for any number of reasons be experiencing isolation and loneliness.
The Senator asks about funding of the Newport day care centre. In 2017, the centre received funding of €228,000 from the HSE. This included national lottery funding of €1,500.
The HSE funds this organisation through a grant under section 39 of the Health Act 2004. Section 39 legally underpins the provision of services similar or supplementary to services the HSE may provide.
The Senator also referred to an impending ballot for industrial action in this organisation. I understand this is a ballot on the restoration of pay to staff. The Senator will be aware that last Friday, the Minister for Health, Deputy Simon Harris, welcomed a deferral of industrial action by section 39 workers. He has also confirmed that the Department of Health, the HSE and trade unions have agreed that the HSE would carry out an analysis to establish whether supporting evidence shows whether, when and to what extent reductions in pay rates were applied during the crisis in each relevant organisation; whether, when and to what extent restoration of pay reductions have happened; and to identify financial implications for such organisations, taking account of all of the resources of funding associated with addressing the issue and identifying and proposing an appropriate plan of phased resolution in each case. The HSE will continue the data gathering exercise immediately, initially in respect of an agreed list of organisations. The data gathering exercise should be completed as early as possible. An interim report is expected to be published by the end of March 2018.
Dispute resolution in Ireland is based on the concept of parties voluntarily seeking to resolve their differences with industrial relations mechanisms provided by the State. This would include availing of services provided by the Workplace Relations Commission and the Labour Court. The process I have set out should resolve the situation in respect of the pay issue in section 39 funded organisations at a national level. The Workplace Relations Commission plays a pivotal role in brokering agreement between the parties on such matters. On that basis, I cannot speak highly enough of these bodies and the support they provide to workers and employees. At a local level, I hope that staff and management in the Newport Day Care Centre in Tipperary continue to work towards progressing issues on a consensus basis using the recognised industrial relations channels which they have open to them.
I thank the Minister of State for her response. I note she stated that she hoped staff and management in Newport Day Care Centre in Tipperary would continue to work towards progressing issues on a consensus basis using the recognised industrial relations channels that are open to them. Unfortunately, a channel is not open to them given that the management has said it cannot attend the WRC because there is no funding from the Government.
It would be very helpful, given that the staff are being balloted this week and service users and staff are listening to this debate today, if the Minister of State could confirm that the staff at Newport Day Care Centre will be included in the section 39 pay restoration mechanisms she has outlined. A simple "Yes" would put the staff's minds at ease and guarantee they have a process open to them. If she cannot say "Yes" then, unfortunately, industrial action will be pursued. I am hoping she will give a positive answer in response to the workers in Newport Day Care Centre and the clients who value the service.
I will not answer for the Minister of State, but, unfortunately, she is not the line Minister. She can respond to Senator Gavan.
I will read a prepared statement and add to it. I again thank the Senator for raising the matter. He will appreciate that the Newport Day Care Centre is funded by the HSE under section 39 of the Health Act 2004 and neither the Minister nor the HSE has a direct role in determining the salaries or other terms and conditions applying to the staff. This means that I cannot get involved in local disputes arising in these bodies.
However, as I noted earlier, the services of the Workplace Relations Commission provide valuable resources and are available to bodies and individuals who find themselves involved in disputes in the workplace. I would urge all parties to take full advantage of this service where possible in order that a positive and workable solution can be found for all involved. I am clear in my view that any disputes which are ongoing in health care services should be minimised and addressed as early as possible. We must avoid any impact on the more vulnerable members of society, such as those availing of services at the Newport Day Care Centre.
The Senator has asked me to give him a "Yes" or "No" answer. I cannot do that. I have read the reply, but I will speak to the Minister later about what he said about the staff feeling that they do not have a channel to go through. Perhaps the Minister will come back to the Senator with a formal answer.
I thank the Minister of State.
The Minister will communicate directly with Senator Gavan to see if the issue can be resolved. It is obviously a sensitive issue.
Hospital Waiting Lists
Last night, a group of parents with children who are inpatients at Our Lady’s Children’s Hospital, Crumlin, along with some older children, held a candlelight vigil outside the hospital to highlight the crisis of waiting times for beds there. Ms Hazel Robinson is the parent of a 15 year old daughter with cystic fibrosis. She started this vigil because her daughter was recently obliged to wait over a week to secure a bed in the hospital after she contracted influenza, which compromised her health further. Ms Robinson has faced the same problem on numerous occasions when trying to source a bed for treatment for her very sick daughter. Many of the parents there last night share that experience. What are we doing wrong? Are we doing anything right?
I have been working on a document, now ready for publication, which specifically focuses on Our Lady’s Children’s Hospital, Crumlin, and what investment is needed and where it needs to go. The stark figures and data, from parliamentary questions and from the Department itself, show that the inpatient waiting times for the hospital are unacceptably high. The total inpatient day case waiting number for the entire children's hospital, which includes the other two hospitals, is at almost 5,000. Our Lady’s Children’s Hospital, Crumlin, accounts for over half of these. The position is unacceptable, especially considering that many of the children are waiting with life-threatening and progressively deteriorating conditions. The waiting list for children with musculoskeletal problems to access the orthopaedic unit is often 18 months. That issue has been highlighted several times by the national public broadcaster.
I want to know what plans are in place to tackle the trolley crisis in our children's hospital system. We know all about it in the adult accident and emergency departments, but the children and their parents deserve as much attention and dedication to solving the problem. Is it the case that we are going to have to wait until the establishment of the national children's hospital in 2020 or 2021? There is a significant timeframe involved here for sick children. They do not have that time available. I hope that the national children's hospital will be fit for purpose and have sufficient capacity, but what can we do in the meantime?
The Minister, who unfortunately cannot be here, has asked me to answer on his behalf.
I acknowledge that there are some challenges in accessing services in the three children’s hospitals at present. The Children’s hospital group works with the each of the three paediatric hospitals to manage capacity challenges, providing support in terms of bed utilisation on a daily basis. Within Our Lady's Children’s Hospital, Crumlin, all funded beds are open and currently in use, with the exception of one bed closed for renovation purposes. The hospital group is working with the National Treatment Purchase Fund to identify clinically appropriate groups of patients for treatment as part of a waiting list initiative. The hospital group also continues to work with the acute hospital division in the HSE as well as with staff in the mental health primary care and disability services to reduce the length of stay of patients in hospital and to improve pathways of care for children and adolescents, which will, in turn, ease pressures on hospital capacity.
The Minister is committed to significantly improving health care for all children in Ireland. We have already taken enormous strides to achieve this.
For example, an additional €9 million has been provided to the HSE in its 2018 budget allocation, specifically to develop paediatric orthopaedic services, including further increasing access to scoliosis services. As Members will know, the project to develop the new children’s hospital is an extraordinary opportunity to enhance paediatric services for children. Indeed, part of the rationale for the development of the new children’s hospital was to address the existing physical infrastructure across the three children’s hospitals in the group. There is limited ability to increase bed capacity in the existing hospitals between now and the opening of the new hospital. The design of the new children’s hospital and two outpatient and urgent care centres at Tallaght Hospital and Connolly Hospital was based on a thorough analysis of capacity and demand, and is in line with best practice.
The new children’s hospital is due to be completed in 2022. This will be preceded by the opening of the centres in Connolly and Tallaght hospitals in 2019 and 2020 to provide consultant-led urgent care and secondary outpatient services, including rapid access general paediatric clinics. Each centre is projected to deal with 25,000 urgent care and 15,000 outpatient attendances annually, resulting in a significant improvement in access to services. Overall, the new facilities are expected to provide an increase in capacity of 16% for inpatients, 26% for day cases, 47% for outpatient attendances and 7% for emergency department, ED, attendances. My Department is also progressing the Children’s Health Bill 2018 to establish a single body to govern and manage paediatric services across the three hospitals in Dublin in advance of the move to the new facilities. A clinical integration strategy has been developed to integrate the clinical services across the hospital in advance of the move and to ensure a smooth transition to the new facilities. There will be significant advantages to having integrated clinical and non-clinical services across the existing sites, one of which is the introduction of a central referrals system for all patients requiring paediatric services to maximise available capacity. The transition of staff and services to the new children’s hospital will ultimately mean that all specialist services will be provided under one roof, tri-located with adult acute facilities.
I thank the Senator. I will respond further on some of the other issues she raised.
I thank the Minister of State. I mean no disrespect to the Minister of State, but I thought that the Minister for Health, Deputy Simon Harris, would have a response as well. I note that the Irish Nurses and Midwives Organisation, INMO, has announced that it will include the national children's hospital in its daily Trolley Watch and started doing so at the beginning of the year. For the first two weeks at the beginning of the year the INMO counted 23 children on trolleys. This must be a focus for the Government again.
Our Lady's Children's Hospital in Crumlin went over budget by €500,000 last year. It has clearly not been getting the resources that it requires, and a lot of that money is spent on agency staff because of the moratorium and its effects. Some 2,818 more children attended the accident and emergency department in 2017, but the capacity levels in the hospital have only now returned to 2012 figures. There is a significant increase in our child population, and in the last decade many more births were recorded in Ireland. We are not matching capacity to the birth rate and the increase in population. We are doing an absolute disservice to our children.
I thank the Senator again. I absolutely agree with her that it is unacceptable that adults or children should have to wait any length of time to be facilitated in a hospital. I have outlined in the response from the Minister that a lot of money has gone into this service, and a lot of things are happening in Our Lady's Children's Hospital, Crumlin. That must be said in all fairness to the staff and doctors there, who deal on a daily basis with children from right across the country with very serious illnesses.
The Government is committed to doing all it can to support and ensure that the needs of children who are ill can be addressed as quickly as possible. Unfortunately in the three children's hospitals available to us at present, the facilities do not have the capacity at this time to avail of it. There are no options left in children's hospitals, to my knowledge and to that of the Minister, whereby more beds can be made available.
In saying that, I do think it is unacceptable that any child should be left to wait for any amount of time. Going over its budget does not really reflect on Our Lady's Children's Hospital, because a lot of hospitals go over budget for many different reasons.
There are many reasons a hospital might go over budget and it is not something that only applies to Crumlin. Since the beginning of October, we have had a long winter and a lot of children have been sick with respiratory complaints.
I have taken note of what the Senator said and I will forward her points to the Minister. As the children's hospital is in my own constituency, I will make it my business to correspond with it on the management of beds, particularly in respect of the services that are available at present. As the Senator said, parents have deemed this to be of such interest to them that they feel they have to hold a candlelight vigil.