Commencement Matters

Health Services Staff Recruitment

I welcome the Minister of State at the Department of Health, Deputy Jim Daly, and thank him for coming here to discuss such an important issue. Tomorrow is World MS Day and in the past I was very involved in the Limerick and mid-west committee of the MS Society, so I am very aware of its needs. In 2014, the approved recommended number of MS nurses for those diagnosed not only in Limerick but in the mid west was three. Currently, the figure is zero. In 2014, approval was given by the Department but it was very hard to recruit people at that time and it just did not happen. It is now 2018 and the number of patients is growing. There will be an MS awareness day in the mid-west offices tomorrow and people have been invited along to highlight the lack of an MS nurse.

The nurse is responsible for giving advice when symptoms arise with MS patients and is very knowledgeable. Currently, people in the mid west who are diagnosed with MS have to contact a clinical nurse in Cork or Galway and obviously those nurses have their own waiting lists and patients, so it is not always feasible that the patient receives help or support within the timeframe required. Many calls are made to the MS office where there the staff comprises social workers and administrators. These are not clinical nurses or qualified multiple sclerosis nurses and they are not able to deal with the issues and queries. This is a big issue.

The number of people being diagnosed has grown. University Hospital Limerick contacted the Multiple Sclerosis Society this morning to say it would be prioritising this in the coming year but there was no indication that it would be looking to appoint somebody. As I already said, the current recommendation is that there should be three nurses in the area but there is none. I would like to hear the Minister of State's opinion on this issue.

I thank the Senator very much for raising this issue and I welcome the opportunity to address the House on this matter.

The condition of multiple sclerosis is managed within the HSE clinical programme for neurology. The role of the clinical nurse specialist in neurology is to provide for the care and ongoing management of patients within agreed clinical practice guidelines. In addition to multiple sclerosis, clinical nurse specialists roles in neurology can include a range of specialist services to support particular conditions such as headaches and Parkinson's disease.

I am advised that the UL Hospitals Group recognises the need for a second clinical nurse specialist post in neurology and has approved the further post in recent weeks. A job description for this position is currently being finalised by UL Hospitals Group.

It is expected that the filling of the clinical nurse specialist post will improve and enhance patient care and will assist in the overall continuity of care as well as optimising the quality of service provision. The clinical nurse specialist will be required to work as a key member of the multidisciplinary team and provide physical, psychological and emotional support to patients and their families.

I would like to take the opportunity to draw the attention of the House to the model of care for neurology which has been developed and published by the national clinical programme for neurology in collaboration with consultants, nurses, health and social care professionals and patient support groups. This model of care aims to address the need for strategic development of neurology services in the provision of better care for Irish patients. It, therefore, provides a framework for neurology services into the future which will be delivered within an integrated service approach that is in line with international best practice. While the clinical programme has identified current service deficits in terms of staffing, it has recommended increasing the number of consultant neurologists, nurse specialists, including clinical nurse specialists in multiple sclerosis, and other healthcare professionals.

The implementation of the new model of care is a work in progress. The model will be implemented over the coming years and will, it is envisaged, improve access for neurology patients, including patients with multiple sclerosis in the mid-west. UL Hospitals will continue to work with the national clinical programme to progress the implementation of the model of care for neurology in the mid-west and will consider, as appropriate, any additional resource requirements in the context of the 2019 Estimates process.

To conclude, UL Hospitals has recognised the need for a clinical nurse specialist post and will provide funding for this post as a priority this year. Looking to the future, the national clinical programme for neurology has identified certain resource issues regarding neurology services but it is intended to address these deficits through the implementation of the new model of care.

I am sure the Senator will want to thank the Minister of State for a very positive response.

Yes. The one point I would make is that while it is a neurological specialist nurse that has been approved, an MS specialist nurse is slightly different in that the medication patients with MS take is very specialised and they need a lot of monitoring and care. However, while there is still no MS nurse, it is a very positive response that a neurological nurse will be approved and put in place during the year. I ask that MS as a speciality could also be considered.

The possibility of appointing an MS specialist nurse can be considered during the recruitment process.

Blood Donations

Cuirim fáilte roimh an Aire Stáit. The Minister of State is welcome. I appreciate that this is obviously a very busy period for him and his Government colleagues, not least the Minister for Health. In such circumstances, I understand that the Minister cannot be available to be with us this afternoon.

It is fair to say we can all can see that the best elements of our health care services work best when they work together, in particular when they work in a unified way and deliver good, positive health care for people right across the island, in all of our Thirty-two Counties. That is demonstrable in paediatric cardiac services where children from the North are able to avail of a world class service here in Dublin and in the cross-Border cancer care provision provided by Altnagelvin Hospital, which has seen significant investment from the Executive and, indeed, from the Government here as well.

This issue came to my attention from talking to work colleagues here in Leinster House who were resident in the North or in Britain, and who, perhaps, formally tried to donate blood here in the State or wanted to do so upon coming home, but found that, because they were resident in either the North or Britain, were unable to donate blood because of the variant Creutzfeldt-Jakob disease, CJD, crisis, which we all remember as mad cow disease or BSE. What I am asking is, given the positive understanding we have of cross-border co-operation and the identifiable need for additional blood donations in this jurisdiction, whether consideration can be given to reviewing that ban with a view, ultimately, to lifting it and also, given the passage of time, if there is now scientific and medical evidence that points towards freeing up such people. A number of the people who said this to me are actually Members of the other House, including Deputies Quinlivan and Ó Broin, who was a Belfast city councillor during that period, and Senator Conway-Walsh, who is our group leader in the Seanad and who was working in Britain at the time. All of them would wish to step up and heed the call from the Minister, the Government and the Department.

I thank the Senator. The remit of the Irish Blood Transfusion Service, IBTS, is to provide a safe, reliable and robust blood service to the Irish health system. A major objective of the IBTS is to ensure that it always has the necessary programmes and procedures in place to protect both the recipients and the donors of blood and blood products. The IBTS constantly keeps all deferral polices under review to ensure the ongoing safety of blood and the products derived from it.

The IBTS currently has a permanent deferral policy in place for individuals who have resided for more than one year in the United Kingdom, including Northern Ireland and the Channel Islands, between the years 1980 and 1996. This policy is designed to prevent the risk of transmission of variant CJD to recipients of blood transfusions.

A new case of variant CJD was indicated by the UK in 2016, as a consequence of which a decision was taken by the IBTS at that time that no change would be made to the measures in place to mitigate the risk of transmission of variant CJD in the short term. The IBTS now feels that sufficient time has elapsed to consider whether the measures in place to prevent the transmission of abnormal prions from the food chain, and the resultant risk of asymptomatic individuals being a threat to the blood supply, can be reassessed.

The medical and scientific director of the Irish Blood Transfusion Service will make a presentation on the current state of evidence on the transmission of variant CJD via blood transfusion to a specially convened meeting of the IBTS medical advisory committee in July. The meeting will be presented with the most up-to-date information on the risk of variant CJD. This may lead on to a risk assessment being carried out to inform whether a change to current donor selection guidelines in respect of people who have resided in the UK for a cumulative period of 12 months or more during the period between 1980 and 1996 is warranted. If the medical advisory committee feels that a case might be made for a change in the deferral policy, further consideration of all aspects of the matter will be undertaken with the input of relevant experts. If the outcome of the deliberations of the medical advisory committee and the subsequent expert input indicate that the IBTS could safely relax the current deferral polices regarding variant CJD, a case for such changes will be made to the board of the IBTS.

It is acknowledged that the current deferral arrangements in place for variant CJD can be frustrating for members of the public who find themselves unable to donate blood. However, the safety of the blood supply must remain paramount. The focus of my Department will at all times be to ensure the provision of a quality supply of blood to the Irish health system. Decisions on changes to deferral policies for blood donation must always be supported by rigorous scientific and medical evidence.

I thank the Minister of State for his concise response. There is a glimmer of hope in it, and I always try to look for one. I look forward to the IBTS bringing forward that review and the assessment in July this year. I am sure we will watch it closely, as will the Government.

Local Authority Housing Maintenance

I welcome the Minister of State. As we say in west Cork, better late than never.

Cuirim fáilte roimh an Aire Stáit go dtí an Teach and I thank him for his presence. I want to discuss the issue of the ongoing remedial works scheme for Mullaghmatt housing estate which, as the Minister of State probably knows, is located in Monaghan town, and consists of more than 180 dwellings constructed in the 1970s. Unfortunately, many issues have been associated with the development over the years, and the residents have had to put up with many defects affecting the properties, which have been anything from defective wiring to fractured chimney breasts to drafty doors and windows just to name but a few.

The Department of Communications, Climate Action and Environment finally acceded to addressing the issues but, unfortunately, decided to do so on a phased basis. Phase 1, which commenced more than a decade ago, resulted in a number of dwellings being completed at the time. Unfortunately, we are now onto phase 4 which, I hope, will be the final phase, and we await positive news on this. As a result of the approach taken by the Department over the past decade, the people of Mullaghmatt have effectively been living on a building site.

The works completed to date have enhanced the quality and appearance of the estate but, unfortunately, there are 81 dwellings yet to be remediated and they are still awaiting commencement of the fourth stage of this process.

The people of Mullaghmatt have put up with living in defective dwellings for between 30 and 40 years. While I welcome that the Department is addressing the issue, these works need to be commenced as soon as possible so that the people of Mullaghmatt can lead normal lives and plan works that they would like to do their dwellings but have been holding off on until such time as these works are completed. I hope the Minister of State, Deputy Phelan, will confirm that the tender for the works will be accepted shortly so that they can commence without delay.

I apologise for my late attendance. I thank Senator Gallagher for raising this matter which I am taking on behalf of the Minister, Deputy Eoghan Murphy.

I am pleased to say that I have good news in regard to this scheme in Mullaghmatt. The Department approved the fourth and final part of the scheme to go to tender in March. Tenders have now been received by Monaghan County Council and are being examined with a view to submission of a tender report and recommendation as soon as possible to the Department for approval. I can assure the Senator that whatever proposals are received from the county council will be examined as quickly as possible by the Department and there will be no delay in a response issuing to Monaghan County Council.

Approval of the tender recommendation should allow the county council to get works commenced later this year. The estimated cost of stage 4 is €2.9 million. Overall, this scheme has a long history, with almost €10 million having been already invested in phases 1, 2 and 3 of the scheme involving the carrying out of remedial works to local authority and privately-owned houses. A pilot refurbishment project was approved in August 2004. Works on this phase, which included the provision of new windows and doors, installation of central heating and associated insulation and wiring, etc., were completed in November 2006 at a final cost of in the region of €3.2 million. Phase 2 was approved in May 2009, with works completed in 2012 at a final cost of €5.4 million. A substantial element of phase 3 of the scheme was the provision of an access road to the front-door of a number of houses in the estate. Funding of over €1.3 million was approved for this work and it has now been completed. When the overall scheme is completed, inclusive of phase 4, improvements will have been carried out to 180 houses.

I reiterate that the Department will deal expeditiously with the tender report for phase 4 on its receipt from Monaghan County Council.

I am sure, Senator Gallagher, that news was worth the wait.

I thank the Minister of State for the response. I am heartened by its content. I trust that there will be no delay on the part of Monaghan County Council in submitting the final documentation and that the Department will, in turn, expedite the matter so that works can commence as soon as possible. I am heartened also by the Minister of State's reference to the works commencing before the end of this year.

Garda Stations

I welcome the Minister for Justice and Equality, Deputy Flanagan. I call Senator Lorraine Clifford-Lee. She has four minutes to outline her request on Rush Garda station.

It was announced at a meeting of the Committee of Public Accounts in November 2017 that Rush Garda station was among six that An Garda Síochána was recommending the Government reopen as part of a pilot programme. This was welcomed in Rush and across north County Dublin. The town has a population of 10,000 people and it is growing rapidly. It really felt the loss of its Garda station. By way of Commencement matter a few weeks after the announcement, I asked the Minister to give an outline of the timescale for the reopening. The people of Rush were anxious that the Garda station be reopened as soon as possible. I was informed that the head of estate management in An Garda Síochána had written to the Office of Public Works, OPW, to start a dialogue on the requirements of An Garda Síochána and to allow the OPW to complete an assessment of what is needed, taking into account current building standards and regulations. I was further informed that a tender process would commence once the assessment was complete. Contracts would be signed when the tender process was finished and the work started. The Garda station would finally be opened when the work was complete.

Will the Minister let me know where stands this process? Has the assessment been completed? If not, when is it envisaged that it will be completed? When will the tender process be commenced if the assessment is completed and how long is it envisaged that this process will take? It is also important to note that extra Garda resources are required when the station does eventually reopen. Fingal is the most rapidly growing area in the country and there are not enough gardaí there at present. Will the Minister provide an update, in so far as is possible, on the reopening of Rush Garda station?

I thank Senator Clifford-Lee for raising this important matter. The Senator will appreciate that the programme of replacement and refurbishment of Garda accommodation is progressed by the Garda authorities in close co-operation with the OPW. The latter has responsibility for the provision and maintenance of Garda accommodation. This includes identifying and progressing any necessary remedial or refurbishment works required at individual stations. As Minister, I have no direct role in those matters.

As the Senator will be aware, there is a commitment in A Programme for a Partnership Government regarding a pilot scheme to reopen six Garda stations - both urban and rural - to determine possible positive impacts that such openings will have on criminal activity. There will be special emphasis on burglaries, theft and matters of public order. The then Garda Commissioner's final report, which is available on my Department’s website, recommends that Rush Garda station, along those at Ballinspittle in County Cork, Bawnboy in County Cavan, Leighlinbridge in County Carlow, Donard in County Wicklow and Stepaside in County Dublin, be reopened.

I am informed by Garda authorities that a brief of requirements was provided to the Office of Public Works, OPW, on the reopening of these six stations, including the station at Rush. The Garda authorities requested the OPW to undertake technical surveys to determine the works which would be required to enable the stations to reopen and the estimated costs involved. I am further informed that this key stage is now complete and the OPW has conducted the necessary technical surveys of all six stations and has written to the Garda Commissioner outlining the works required and the estimated cost involved. I understand An Garda Síochána is considering the detail of those reports and any outstanding questions on the brief in each case; and that An Garda Síochána and the OPW continue to liaise closely to progress the reopening on a pilot basis. Works will commence once the appropriate procurement process has been finalised. I reiterate that the OPW and An Garda Síochána are working closely to progress this pilot project and my Department is also closely following the case, with a view to enabling the reopening at the earliest opportunity.

I am delighted to hear the vital assessment stage has been completed and we can move to the next stage in the process. Can the Minister indicate when the procurement process is likely to be completed?

At this stage it is not entirely possible to provide a strict timeframe for the opening of Rush Garda station. It depends on a number of factors, including, for example, the extent of the required refurbishment based on current building regulations. There are also agreed standards and specifications for Garda cell areas and custody suites that may well have to be incorporated into the refurbishment. I acknowledge the importance of the matter for Senator Clifford-Lee and I would be happy to keep her and the House informed of developments. I confirm that detailed work is ongoing in the projects. The technical surveys, an important step, have taken place and they were based on the brief of requirements from An Garda Síochána. The Garda is currently considering the detail of the reports in conjunction with the Office of Public Works and my office has a role to play in monitoring the position and reporting to the House here. I remind the House of the Government's commitment to achieving a progressive increase in Garda numbers over the next number of years and that will involve extra infrastructural developments, including stations. The Garda station at Rush has been approved as one of the areas for the pilot project.

I would be happy to provide the Senator with further information on the timeframe as soon as I am in a position to do so. If I speculated, I am sure the Senator and the House would hold me to it. I am not in a position to do so at this point.

The Senator should be brief. The Minister has been as honest as he can.

Would I be better off redirecting these questions to the Minister of State responsible for the Office of Public Works or is the Minister's Department responsible for this?

I am happy to assist the Senator. I am sure if she contacted the Minister of State at the Department of Public Expenditure and Reform, Deputy Moran, he would be equally obliging with appropriate information.

I would like a timescale for the tender process. I will be in correspondence with the Minister and his colleague.

Sitting suspended at 3.10 p.m. and resumed at 3.30 p.m.