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Seanad Éireann debate -
Thursday, 8 Nov 2018

Vol. 261 No. 3

Commencement Matters

Hospital Facilities

The capital programme for health projects, approved by the previous Government, included provision for a badly needed extension to the emergency department at Our Lady of Lourdes Hospital in Drogheda, my local hospital. The hospital has been synonymous with serious overcrowding. This project, worth more than €20 million, was a welcome addition to the health infrastructure in the area and was welcomed by the hard-working staff at the hospital and by the patients.

The project involves a four storey extension, 9,000 m2 which included the addition of additional theatre space, and of 83 inpatient beds. Nowhere in the country is this facility more needed. Our Lady of Lourdes Hospital is the de facto regional hospital and serves a rapidly growing area, Louth, Meath, Cavan, Monaghan and Fingal. The emergency department, ED, needs all the facilities, equipment and staff that a modern department needs to allow it function to the maximum. One such critical facility is an X-ray room. I was alarmed to learn this week that the plans to include a new X-ray facility at the expanded ED have been ditched in what appears to be a cost-cutting exercise. To add insult to injury, this appears to have been a unilateral decision that was taken without any consultation whatsoever with front-line staff at the hospital.

The new section opened this week but the bird is in effect flying on one wing. The space is there and the full expectation was that the new X-ray room would be provided but it was pulled at the 11th hour. Now we have a spanking new emergency department extension in Drogheda but no additional X-ray room. The existing X-ray room processes 53,000 images annually. Patient figures for throughput at the new emergency department extension would suggest that there would be an annual increase of 5% in patients going through that facility year on year for the foreseeable future. The existing room is operating above capacity. EDs of a similar scale in Limerick and Cork deal with 49,000 and 42,000 images, respectively, annually. The figures speak for themselves.

The Lourdes needs a second X-ray room in ED. It is not too late in the building project to revisit this and for the sake of the €1 million that I understand it would cost, the new room needs to be built now. If it is not, the good work done by staff and management at the hospital in recent years to address the overcrowding problems will be compromised. Patients will suffer as, to paraphrase the Taoiseach, a hospital cannot function at full whack if it does not have the full diagnostic capacity to move people through the system efficiently and get them well as quickly as possible. The space is there and it will be impossible to retrofit a new X-ray room into the ED building. This has to be reviewed. It is a short-sighted decision to pull this project now, a decision made by the bean counters in the HSE and it must be reversed.

On behalf of the Minister for Health, Deputy Harris, I thank the Senator for raising this issue and for the opportunity to provide an update to the House on the planned new X-ray facility to support the expanded ED at Our Lady of Lourdes Hospital, Drogheda. As the Senator is aware, the new emergency department is a part of the major capital infrastructure project that is taking place at Our Lady of Lourdes Hospital, which includes additional beds, theatres as well as the expanded ED. The Department of Public Expenditure and Reform governs the processes surrounding the development of healthcare projects by way of guidelines, principally the public spending code. Further rigour is demanded by, and set out in, relevant EU directives. All proposed projects must be submitted to the HSE's capital and property steering committee for approval and prioritisation prior to inclusion in its multi-annual capital plans.

The national development plan, announced earlier this year as part of the Project Ireland 2040 policy initiative, provides €10.9 billion for health capital developments throughout the country, including national programmes and individual projects, across acute, primary and social care. Health capital projects and programmes currently under way will continue. With regard to progress on this project, the Minister has been advised by the HSE that the new emergency department, which will be located on the ground floor of the hospital, will be completed and available to open in early 2019.

The HSE has further advised that some work is still to be completed in the old emergency department to allow for the installation of a new paediatric emergency department and an extension to radiology services. The HSE anticipates that the full extension will be ready in early 2019. The Department, the HSE, the RCSI hospital group and Our Lady of Lourdes Hospital are supportive of this project. It is recognised that this capital development is needed in order that the delivery of key services to patients served by Our Lady of Lourdes Hospital in Drogheda and the surrounding areas can be supported.

I hope that health service staff in Drogheda and elsewhere in the north east, particularly staff across all disciplines at Our Lady of Lourdes Hospital, will be reassured by what the Minister of State said. The additional X-ray room is critically important if the full diagnostic capacity of the hospital is to work. We have additional new beds. As I said in my opening remarks, if a new X-ray facility is not provided, the hard work that is done by staff day in, day out to address the trolley crisis and the overcrowding in the emergency department will come to naught. It will be difficult to move people through the hospital efficiently and efficaciously in the absence of a new X-ray room.

I am somewhat reassured by what the Minister of State said, having been alarmed to hear earlier this week that the estates section of the HSE appeared to have decided to pull this project. I will hold the Government and the HSE to account to make sure the commitment the Minister of State appeared to make when he said "that the full extension [to radiology services] will be ready in early 2019" will be delivered on. When he refers to a full extension, I hope he means the inclusion of the X-ray department. My understanding is that the new emergency department block at Our Lady of Lourdes Hospital became operational earlier this week. However, we are still waiting for a new X-ray room. I have referred to the number of images managed at the small X-ray room in the existing emergency department. That needs to be enhanced to allow the hospital to meet its commitments and targets. As already stated, the level of throughput at the emergency department is expected to increase by 5% per annum in the coming years. The emergency department at Our Lady of Lourdes Hospital cannot fly on one wing. This additional X-ray room is needed to enable the hospital to meet its targets and fulfil its obligations to the people of counties Louth, Meath, Cavan and Monaghan and north County Dublin.

The development that is under way at Our Lady of Lourdes Hospital in Drogheda is taking place in the context of the national development plan, under which capital funding for our health services will be 165% higher over the next ten years than it was in the last ten years. Such a commitment to capital investment in our health services marks a serious sea change. As I have outlined, the development of a new emergency department at the hospital includes a new paediatric emergency department and an extension to the radiology service. Both of those developments are at a very advanced stage and will become operational early next year.

Human Rights

I thank the Chair for allowing me to raise the deterioration of the human rights of the LGBT community in Tanzania. I welcome the Minister of State, Deputy Cannon. I think we will all agree it is absolutely appalling and shocking that LGBT people are being targeted and arrested in contravention of many international human rights agreements to which Tanzania has signed up. It is important to put this in context. A special task force has been convened to round up members of the LGBT community. LGBT people in Tanzania are facing increasing threats. Members of the LGBT community have been arrested, targeted, harassed and charged with unrelated offences. Since 2015, under the regime of President Magufuli, there has been a deterioration in human rights and the rule of law in Tanzania. I put it to the Minister of State that it is a disgrace that this is being allowed to happen. It is a contravention of justice. I am calling on our Government to intervene at every level to protest the establishment of a task force under the remit of the governor of Dar es Salaam. The Tanzanian Government has said that it is his opinion, but having an opinion does not give a person the right to have a 17-member or ten-member task force. It is wrong to call for the outing and arrest of LGBT people.

I know that Mr. Paul Sherlock is a very proactive ambassador in the region. I am aware that Tanzania is one of the fastest growing countries in Africa. I welcome the EU's decision to recall its ambassador to Tanzania. I am pleased that the EU is considering a review of its relationship with Tanzania. I do not necessarily think that recalling ambassadors is always the right thing to do, but on this occasion there would be merit in our Government intervening to make its case and state its position. I appreciate that the Tánaiste has written to the Tanzanian Government, but our approach must be about more than writing a letter. We must bring people with us.

I am glad the Minister of State is here. I know he is very proactive. It is worrying that the governor is looking for reports of gay people. This is not just about gay people, it is also about people who work in HIV clinics and non-governmental organisations to promote human rights. The overarching strategy that is emanating from Tanzania seems to involve violating privacy rights in a way that infringes on basic human rights. We have international agreements which must be upheld. I thank the Minister of State for being here. I look forward to his reply.

I thank the Senator for raising this important issue and giving me the opportunity to report on the steps the Government has taken and will continue to take to assist the LGBTI community in Tanzania. Ireland's support for the LGBTI community is clearly situated within a human rights framework. No one should be stigmatised or persecuted on the grounds of sexual orientation. Ireland engages with other countries at the UN Human Rights Committee to promote human rights for all. We specifically promote further support for the principle that sexual orientation should not be grounds for discrimination.

I learned with dismay last week that the regional commissioner of Dar es Salaam had called on the public to identify members of the LGBTI community to his office, thereby feeding prejudice against members of that community. It appears that there have been some submissions to his office. It has been reported that activists and members of the LGBTI community have gone into hiding across Tanzania. As the Senator will be aware, the Tanzanian statute books continue to have laws from the colonial era which can lead to homosexual acts being punished with terms of imprisonment of up to 30 years. When the Tánaiste learned of these developments, he immediately wrote to his counterpart, the Tanzanian Minister of Foreign Affairs, Mr. Mahiga, to express his deep concern at the regional commissioner's statements. The Tánaiste asked Mr. Mahiga and the Tanzanian Government to disown the statements and to bring such provocative action to an end. Last Sunday, which was two days later, Mr. Mahiga spoke on behalf of the Tanzanian Government to distance himself from the regional commissioner's views. He characterised the regional commissioner's views as personal and not reflective of the position of the Tanzanian Government. He reaffirmed the Tanzanian Government's commitment to upholding its international human rights commitments. In light of Mr. Mahiga’s statement, it seems likely that current tensions will abate.

The Department of Foreign Affairs, through Irish Embassy in Dar es Salaam, which works with other EU member state embassies in the city, will continue to actively monitor the situation in Dar es Salaam and more widely across Tanzania. We will continue to engage directly with Tanzanian Government and civil society on the issue of human rights protections for vulnerable groups, specifically with regard to members of the LGBTI community.

I thank the Minister of State. He will agree that the words of the Tanzanian Government provide little comfort. There is real fear and anxiety among people who want to avoid arrests and forms of discrimination that have no place in any society. The President of Tanzania has form in this area. The Tanzanian Government continues to have the punishment of homosexual acts on its statute books. We are trying to bring a cultural change in this regard to the continent of Africa, parts of eastern Europe and other parts of the world.

It is important to recognise that the Minister of State and the Tánaiste are supportive and I welcome their interventions. The President of Tanzania has form in this respect. The deputy health Minister defended a threat to publish a list of gay people by saying: "Give me their names". All of us who live in a free society recognise that has no place and no part to play.

Mr. Makonda, a staunch ally of the president, said he expected international criticism for the move, but added: "I prefer to anger those countries than to anger God." The God whom I believe in is a God of justice, mercy and love who loves us all unconditionally. We must make every effort and take every opportunity at international level to call out this disgraceful behaviour.

I thank the Senator for his comments. The Government places the protection of human rights at the centre of our foreign policy. It pervades everything that we do in that area. Officials in my Department will continue to closely monitor the situation in Tanzania and across east Africa where we have increasing concerns about the number of restrictions being placed on free speech, freedom of association, the preservation of a free press and the infringement of human rights. That tightening of civil society space is of concern to us all. We will continue to work closely with the partners in civil society, including in-country partners, to support efforts to protect and promote rights and ensure that the voices of those who are vulnerable are heard and amplified. This is a sensitive area of engagement and it requires a long-term commitment to support partners operating on the front line or protecting and promoting human rights in what can be difficult environments.

Missing Persons

It is great to have the Minister of State, Deputy Cannon, back in the House. Some Members may be aware that in recent weeks the remains of two people who had been missing for a significant period were identified. The process of reuniting them with their loved ones and giving them a dignified burial will happen, if it has not happened. It is a wonderful end to a tragedy that these families will be able to give their loved ones, who were missing for decades, a Christian and respectful burial. It closes a chapter that had dominated their lives for decades. This has happened as a result of the development of DNA profiling and technologies in that area. Such development is ongoing. As a result of recent DNA developments, it has been possible to identify the two remains and return them to their families.

As part of that process, it has come to my attention through the media and from watching people like Barry Cummins, who have done phenomenal work in raising these issues and keeping them in the media spotlight, that an audit has not been done of unidentified remains in this country. There are unmarked graves and unidentified remains in morgues and in other areas of this country. I call for an audit of all the unidentified remains and, also, the provision of a budget to further enable DNA profiling to see if more of these missing persons cases can be resolved.

Like other Members, I attended the National Missing Persons Day commemorative ceremony in Farmleigh House a few years ago. In all I have done in public life it was probably one of the most moving ceremonies I have ever been at. The Minister of State, Deputy Stanton, was Chair of the Oireachtas committee on justice at the time, and he and I travelled to it. It was an incredibly moving occasion. Deputy Frances Fitzgerald was the Minister for Justice and Equality at the time and Nóirín O'Sullivan was the Garda Commissioner, and they both attended. Families shared their stories of what they were going through on a daily basis in dealing with the fact that there was no closure for them. The format of what happens at one of these missing persons days is that if it is the 10th, 20th, 30th or, in some cases, the 40th anniversary of a missing person, the stories and experiences of those families are shared. It is an opportunity for all those families to come together and share their experiences and stories. People even travel from England and the United States for that day.

I request the Minister of State, in the first instance, to ensure an audit is carried out of all the unidentified remains that exist in this State and, second, to increase the funding to carry out the critical DNA profiling given that the technologies and the methodologies have advanced so much. If it brings closure to one family, it would be wonderful. I contend that with the advancement in the profiling that has taken place it will bring closure to many families.

I thank the Senator for raising this issue. I am responding on behalf of the Minister for Justice and Equality who, unfortunately, cannot be present today.

It is distressing when the remains of deceased persons are sometimes discovered on land often because of some construction activity or washed up on our riverbanks or coasts. I assure the Senator that the concerned State authorities make every effort to identify such persons by whatever means possible.

Unidentified remains are the subject of both a Garda investigation, assisted by the relevant State technical authorities and by the relevant coroner for the district where the remains are discovered. These investigations continue for as long as the possibility of a positive identification, by whatever means, remains possible. The Minister is informed that there are few cases at this point where remains cannot be identified within a foreseeable timeframe.

The Senator suggested the need to conduct a national audit of unidentified human remains to establish the numbers involved. The Minister is unclear as to the purpose of such an audit. The primary investigating authorities will hold either the remains, or more often, relevant samples for scientific testing. Forensic Science Ireland, FSI, is the State’s forensic analysis service and works in close partnership with An Garda Síochána in the investigation of crime and presentation of evidence at criminal trials.

The DNA database commenced operation in November 2015 and its implementation is one of the most important crime fighting tools introduced within the State in recent times. Using the database, information is supplied to the Garda about links between people and unsolved crimes. These crimes have ranged from burglary and criminal damage to crimes against the person, sexual assault and suspicious deaths.

The power of the database as an investigative tool is that it is providing the Garda with investigative leads in previously unsolved serious crimes. The database can replace more traditional and time-consuming police investigative methods and provide more focus to a criminal investigation. The DNA database currently contains more than 21,000 profiles and this figure growing all the time.

The Minister also notes the recent successes by FSI in identifying unknown remains, to which the Senator referred. These successful outcomes can finally bring some closure to the families and relations of these missing persons. These successes were possible due to advances in DNA technology. The DNA database can retain samples from relatives of missing persons and use these samples to aid in the identification of unknown remains.

The reason I tabled this matter is that when Barry Cummins revealed the good news that two families had received on "Prime Time" last Thursday night, he raised the issue of the necessity to carry out a national audit of unidentified remains. I thought that it made sense. I will do more research on it. I welcome the Government's commitment in terms of its attempts to bring closure for families in these awful, tragic situations. I thank the Minister of State for his reply and we will develop the story as we go along.

I thank the Senator for his further comments and for sharing his concerns, which we all share, that families at some point in the future may find it difficult to determine where exactly their missing loved ones have gone. I have endeavoured to set out as best I can the response of the Minister. I assure the Senator that his Department will continue to support FSI in this important work and that FSI has received increased funding in the area of DNA profiling for 2019, which is something to which he referred. In addition, FSI will continue to work closely with An Garda Síochána and the National Missing Persons Bureau in their ongoing investigations of missing persons for the purpose of identifying unknown human remains.