Commencement Matters

I welcome the Minister of State.

National Maternity Hospital

Fáilte arís, an tAire Stait. This matter relates to the proposed new facility for the National Maternity Hospital and the lack of progress in recent years on its governance and ownership. I am asking for clarity regarding who will own the hospital or have influence and control over it. There is a lack of clarity and transparency about that, a tactic used frequently by the religious organisation that owns the land on which the new facility is being built. The National Maternity Hospital is being built by the State, so we will probably own the bricks. The project will cost at least €350 million and the facility will then be handed over to the Sisters of Charity order, which is a subsidiary of St. Vincent's Healthcare Group - a major shareholder in the project. The assurances from the religious order that it is giving up ownership of its hospitals or removing itself from the boards, and that it will not dictate the parameters of healthcare given two women in these hospitals, are not adequate. It is our National Maternity Hospital, it is not the religious order's hospital. We can go through the legacy of cruelty and torture by the religious orders, in collusion with this State, of women and children, and we will not take that any more. We have an opportunity to provide what the Sláintecare's report recommends, namely, universal healthcare without interference from private or vested interests or religious interests.

The ethos of the nuns disallows in vitro fertilisation, IVF, gender reassignment, abortion and other necessary procedures. They took the Minister, who asked the Health Information and Quality Authority, HIQA, to inquire into the death of a 34 year old patient from an ectopic pregnancy, to court and won. HIQA is not allowed investigate that death. Despite all the reassurances from the religious orders, women do not believe them. We had the Uplift petition which yielded almost 120,000 signatures. Dr. Peter Boylan, a former master of the National Maternity Hospital, Holles Street, resigned saying he never thought this would happen again following the referendum. The Master of the Coombe Hospital resigned in the same vein. Fergus Finlay of Barnardos was aghast at what happened in this case. Women need to believe that they will be cared for and not judged, like Savita Halappanavar, on the basis of the religious ethos in a hospital. That needs to be gone from our healthcare system. We have had enough of that.

I thank Senator Devine. I am taking this matter on behalf of the Minister, Deputy Harris.

I welcome the opportunity to address the House on this matter. The National Maternity Hospital, NMH, was originally established at Holles Street in 1894. The buildings have aged considerably over the years and, understandably, have accrued significant infrastructural problems which have impacted on the ability of the hospital to deliver clinical services. It is clear that the current hospital needs to be redeveloped.

The national maternity strategy reaffirms a commitment by Government to co-locate the remaining stand-alone maternity hospitals with adult acute services in order to provide mothers with access to a full range of medical and support services. The availability of these services helps to ensure the delivery of an optimum, safe service, particularly for high risk mothers and babies.

Against this background, the Government approved the NMH relocation project, which involves the development of a new maternity hospital on the campus of St Vincent’s University Hospital at Elm Park. The new hospital will be funded by the State and is included in Project Ireland 2040. This relocation project came to fruition following extensive mediation discussions led by Kieran Mulvey, which resulted in an agreement being reached between the St Vincent’s Healthcare Group and the NMH on the relocation of the facility to the Elm Park campus. One of the guiding principles of the Mulvey agreement was the requirement for the protection of State investment and interests. It is vitally important that the legal and governance arrangements associated with this very significant State investment are robust.

Considerable work has been undertaken, therefore, to develop a legal framework to protect the State’s significant investment.

This legal framework will underpin the operational and clinical independence of the new hospital, ensuring care in the new maternity hospital will be delivered without religious, ethnic or other distinction and any medical procedure which is in accordance with the laws of the land will be carried out there. The proposals will require consideration by Government, the National Maternity Hospital and the St. Vincent’s Healthcare Group before they are finalised.

I mentioned at the outset that the model of stand-alone maternity hospitals is not the norm internationally. Government policy is therefore to co-locate all remaining maternity hospitals with adult acute services in order to provide optimal clinical outcomes. In this context, it is proposed to relocate not only the National Maternity Hospital, but also University Maternity Hospital Limerick to University Hospital Limerick, Dooradoyle; the Rotunda Hospital to the Connolly Hospital campus in Blanchardstown; and the Coombe Women and Infants University Hospital to St. James’s Hospital.

Unfortunately that was not really an answer in respect of the governance and the concerns that have been expressed. The history of this hospital has been one of chaos, political fallout, and public outcry with regard to governance. Essentially it is a Catholic and private hospital. There is an idea to compulsorily purchase the land so that it would be truly national - it is called the National Maternity Hospital for a purpose - but it seems politicians are deaf to the concerns of the public they serve. One seat at the table for an extra public interest member is being proposed. The National Children's Hospital and Our Lady's Children's Hospital have granted and signed over the land, building and governance of the new national children's hospital to the State. There will be at least two patients' advocates on the board of that hospital. There will only be one on the very concentrated board of this hospital, which will be privately owned and religiously run and which will have that ethos. We are trying so hard in this country to get rid of that ethos and to shake off the shackles of religious influence over our health. The interests of the public and of women are not being served here. The response just does not cut the mustard.

The Minister of State is unfortunately not the line Minister so maybe we can find another way to bring the issue up with the senior Minister. The Senator might write to him or raise the issue on the Order of Business when the Leader is present. The issue the Senator is pursuing does not seem to be adequately dealt with in the response because it is about the future location of the new hospital building. The Minister of State is not to blame for that.

That is fine. I will just read the response I have been given by the Minister, Deputy Harris. I reaffirm to the House that the Minister's commitment is to this hugely important project and similarly his commitment is to ongoing progressive development of the maternity services in this country. The new national maternity hospital is a key strategy pillar in the development of those services. Substantial time and effort has been spent in ensuring that the State's significant investment is protected through robust legal and governance arrangements. The Minister is fully satisfied that the new company to be established, the National Maternity Hospital at Elm Park DAC, limited by shares, will have clinical and operational independence in the provision of maternity, gynaecology, and neonatal services as well as financial and budgetary independence. I will bring Senator Devine's concerns back to the Minister, Deputy Harris.

That goes some way towards satisfying the Senator. I thank the Minister of State.

Commencement of Legislation

I welcome the Minister, Deputy Cannon, back to his alma mater, even though we are in a different room. I am sure he has fond memories of it.

He is very welcome. There is a warm seat here for him next time around.

I thank the Minister of State for coming to the House. I know this does not relate to his own brief. I do not intend to pre-empt his response, but far too often we are left a bit unsatisfied with the responses. We have just had a discussion on that issue. I suggest we really need to look at the slot for Commencement matters because many are not satisfied with the responses received.

It has been three and a half years since the Children and Family Relationships Act 2015 was signed into law. This legislation should have meant that same-sex parents could register as legal parents on the birth certificate of their child and that their families would be recognised and protected as such. That is what people understood the national conversation around civil marriage equality to be about. That is what we understood the knock-on effects would be. I have been dealing with affected families for some time. Many of us in these Houses would have received striking correspondence that painted a grim picture. Over the last week and over the weekend Heather was in touch with me. She says:

[A]s the non-biological mother, one of the biggest emotions I feel right now is anxiety. It is taking over what should be some of the happiest days of our lives. This anxiety comes from knowing that despite being a mom to my baby, my name won’t go on the birth certificate, and that I will have no legal rights to my own child, solely due to the fact that it is my wife who is the birth mother and not me. Anxiety from being made a second class citizen, fighting to have our rights as parents recognised. Anxiety (and a bit of humiliation) from having to email my employer’s HR department and ask them to please ensure my parental benefits will be intact, even though legally I won’t be a parent at all, despite being a mom. Anxiety that comes lying awake at night from wondering what will happen to our child if something were to happen to my wife.

Since the Bill's passage in April 2015, the Government has stated deadlines for commencement six times. Each and every time, those deadlines have been missed. Every time, these parents have been let down. The Minister, Deputy Harris, stated in the Dáil and the Seanad that an amendment Bill would fix the errors. He committed to a deadline of the end of October to commence all parts. That has not happened and now further typographical errors have been identified by the Department of Employment Affairs and Social Protection. That is why I tabled this Commencement debate today. We now have to go through another round of legislative process.

Notwithstanding that it has taken the Department three and a half years to realise that these errors were present, the Minister for Employment Affairs and Social Protection recently indicated that the errors will be fixed by an amendment to the Social Welfare, Pensions and Civil Registration Bill 2017, a Bill that has languished on Committee Stage for more than a year. I cannot see how its speedy passage through the Oireachtas can be guaranteed.

Given that the Government's track record on this is not great and given the upset it has caused, has the Minister of State received a statement about bringing forward any standalone amendment Bill, similar to the Bill the Minister, Deputy Harris, brought before this House in July, that would address those typographical errors and which would not be contingent on the passage of legislation completely unrelated to the issue which is stuck on Committee Stage?

I thank Senator Warfield for raising this matter. As he has already outlined, certain sections in Part 9 of the Children and Family Relationships Act 2015 provide for the registration and re-registration of the birth of a donor-conceived child and, in particular, make possible the registration of details of “parent”, as well as “mother’ and “father”, where required. The current position is that these sections need to be amended to correct technical errors and have yet to be commenced. Our intention is to correct these technical errors by means of Committee Stage amendments to the Social Welfare, Pensions and Civil Registration Bill 2017, which the Minister hopes to see taken early in the new year.

Commencement of these provisions is also dependent on commencement of Parts 2 and 3 of the Act, which is the responsibility of the Minister for Health. In this regard, the Children and Family Relationships (Amendment) Bill 2018 was enacted on 24 July 2018. It was introduced to correct typographical and technical errors in the Children and Family Relationships Act 2015, which will facilitate the subsequent commencement of Parts 2 and 3 of the Act. There are important administrative and operational arrangements to be put in place to facilitate the implementation of Parts 2 and 3, including the establishment of the national donor-conceived person register and the appointment of authorised persons under the Act. I know that it is Minister for Health’s intention that Parts 2 and 3 of the Act will be commenced as soon as possible.

In order to progress this, officials from the General Register Office, the Department of Employment Affairs and Social Protection and the Department of Health are working together to ensure that the appropriate legislative, regulatory and operational mechanisms are in place to allow for the earliest possible commencement of all of the relevant legislation that will allow for birth registration of donor-conceived children.

On the specific question posed by Senator Warfield about introducing a stand-alone Bill, the intention is to include the legislation in the list of Committee Stage amendments to the Social Welfare, Pensions and Civil Registration Bill 2017, which is expected to progress early in the new year to allow for a prompt commencement following enactment. In the circumstances of the anticipated early conclusion of that legislation, it is not considered necessary to introduce a stand-alone Bill. Given the 2017 Bill has passed some Stages of the legislative programme, continuing to progress the measures as part of that Bill is seen as the most efficient way to proceed.

Is Senator Warfield satisfied?

I have some concerns. There is also a Social Welfare, Pensions and Civil Registration Bill 2018, which I understand will appear on Committee Stage in the Seanad next week. There are significant problems with the 2017 Bill and it is unclear to us whether it can be enacted any time soon or whether there will be support in the Oireachtas to do so, but we will examine the 2018 Bill in the Seanad next week.

Crucial lesbian, gay, bisexual and transgender, LGBT, family and children's rights have been endorsed by these Houses and people have suffered for too long. I appreciate the Minister of State's response, given that he does not have responsibility for that Department, but will he be an advocate and add urgency to this issue? I would appreciate it, as would the families involved.

The Minister of State was quite clear that it may be dealt with next week or, if not, certainly early in the new year. If it does not progress, I am sure the Senator will have another opportunity to speak on the issue.

I will speak on the issue again.

The Senator promises to revert to the Minister of State if it does not progress.

I undertake to raise the Senator's concerns with the Minister.

Seniors Alert Scheme

I welcome the Minister for Rural and Community Development, Deputy Ring. It is great to see him because he is always positive and always appears personally to tell the good news.

I acknowledge the work of his Department and its excellent website, from which I glean more information than any other Department's website. It is on the ball, active and covers real issues of community engagement and community supports, particularly rural but also urban, which is never missed by the Department. It is important that we support people, not least those who are vulnerable, to remain in their homes, and any supports that feed in to securing and allowing people to stay in their homes and live there are vital. The seniors alert scheme, also known as the personal emergency response scheme, offers fast and easy ways for both elderly and vulnerable people to access important health services and provides support during an emergency for those who live alone. Whether the emergency is a medical issue, a fall, a fire or merely feeling vulnerable at home, these people have the capacity and ability to use the seniors alert scheme, which is fantastic.

As I said, it supports people staying in their communities and is beneficial for rural and urban areas. Are there additional resources for the scheme or plans to roll it out for more people who want this scheme, which is simple and great technology? Will the Minister outline any further roll-outs of the scheme and, more importantly, will he give reassurance that there are sufficient funds for people to avail of the scheme? How should people tap into the various schemes available? It is a good scheme and I thank the Minister for making a personal appearance.

I thank the Senator for his kind comments, which I appreciate because my Department is new and it underwent three moves of offices in the past year although we have a permanent office now. I have a fine team with a new Secretary General, three assistant secretaries and fantastic staff in Dublin and Ballina. I take this opportunity to thank them because they found it difficult that there were so many changes while we were expected to be a functioning Department, which we were. A fantastic Department is now up and running, and I thank the Senator for his comments and the staff for the great work they have done in difficult circumstances over the past 15 or 16 months. I am proud of how the Department was set up, and it recently won an award for a public library initiative it created. We do not often have the opportunity to thank our staff and, therefore, I am taking this one.

Following the relaunch of the seniors alert scheme in November 2017, which was accompanied by a major publicity campaign, the scheme has seen considerable growth over the past 12 months. The objective of the seniors alert scheme is to encourage community support for vulnerable older people in our communities through the provision of personal monitored alarms to enable persons over the age of 65 of limited means to continue to live securely in their homes with confidence, independence and peace of mind.

A significant change in the new version of the scheme is that users no longer have to live alone or with another qualifying person to qualify for the scheme. The criteria were widened to include elderly people who are not living on their own but may be alone for a substantial part of the day and elderly people who are primary carers for other people in their household. The issue of isolation, whether in urban or rural areas, should concern us all and I am committed to continuing my Department’s response to the issue through programmes such as the seniors alert scheme.

Funding is available under the scheme for the purchase of equipment, such as a personal alarm or a pendant, by a registered community or voluntary or not-for-profit organisation. All users have a base unit installed in their home which is connected to a national seniors alert scheme helpline using landline or mobile telecommunications. When the user activates the personalised alarm, it puts a call through to the national call centre, which is open 24-7, 365 days a year. The call centre operator talks to the person in his at her home and decides whether to alert a local volunteer responder or, in potentially serious circumstances, the emergency services.

Funding for this scheme is made available by my Department. The equipment is free for the end user although there is a small charge should the applicant require a SIM card for the mobile phone. Under the new scheme, free monitoring is provided for the first year of use and recipients are required to pay a modest annual charge for the second and subsequent years. At the end of 2017, just over 18,000 participants had been approved, while 601 community groups provided support. By the end of the third quarter in 2018, in excess of 35,000 participants were approved with 660 community groups providing support. This is strong evidence of the growth of this scheme, providing real support and peace of mind for elderly people in their communities.

The seniors alert scheme is a demand-led programme. My Department was allocated €2.3 million in 2018 to administer the scheme. As a result of the unprecedented increase in participants in the scheme, I was determined to secure additional funding from within the resources of the Department to ensure we continue to meet the surge in demand and that every single applicant was catered for. The amount spent on the seniors alert scheme for 2018 stands at €5.4 million, and I ensured we funded that money from our Department. Funding is being allocated from my Department for a further roll-out of the seniors alert scheme nationwide for 2019. As it is a demand-led scheme, I will closely monitor it with a view to ensuring funding will continue to be available to meet the demand.

I thank the Minister for that comprehensive response. As he said, the seniors alert scheme is in demand, and the Department was allocated €2.3 million in 2018 yet the Minister confirmed the amount spent on the scheme for 2018 stands at €5.4 million. That increase is testament to him and I acknowledge him for driving this significant matter.

This is positive news for anyone who wanted to be given confidence and assurance about the Government's commitment to elderly and vulnerable people living in their homes who wish to stay in their homes, urban or rural. Sometimes people think this scheme is not available to those who live in urban communities. I thank the Minister. It is a really good scheme. I acknowledge the work of the Department and how it manages its news and press relations. Someone said to me, "If Ringer can't do it, nobody can do it". He does share his information. People have to get up and look for it and I look for it. There is not a day that I do not tap into the website. It is crystal clear and I can see how systemically the whole thing is done. Well done and I thank the Minister for his comprehensive report.

I think the Senator and the Minister both get up early in the morning.

We do not go to bed late.

The Senator has a great concern about rural issues. I am glad to receive his acknowledgment. We brought in a few new schemes in the Department, for Tidy Towns, the shows, the men's sheds, all organisations that deal with the problems the Senator is talking about, namely, rural and urban isolation. He is quite correct. I want to see this scheme rolled out. We did put a fair bit of money into the scheme, but we also put a bit of money into making sure that we advertised that scheme. I did the local newspapers, the local radio stations, the national media and we put out a tender for the groups to apply. I am delighted the community groups are out there actively promoting this scheme.

I will finish with this very positive example. This is not a lie. I met a woman last week who fell in her home. She was in a very serious condition and but that she pressed that pendant she would not be here today. She spent five days in hospital and she is home again. The pendant and the senior alert scheme saved her life. She just happened to mention it to me. She did not know that I had responsibility for the scheme but she had the pendant on her wrist. I encourage more people to take up that scheme because it does give them peace of mind.

Sitting suspended at 11.02 a.m. and resumed at 11.30 a.m.