I welcome the Minister of State at the Department of Public Expenditure and Reform, Deputy Moran. Tá fáilte romhat.
Commencement Matters
Heritage Sites
I welcome the Minister of State and acknowledge that it is the first time he has come to the House to address us.
In my Commencement matter I call on the Minister of State with responsibility for the Office of Public Works to let us know whether he plans to develop Desmond Castle in Kinsale as an interpretative centre, given the national and international significance of the Battle of Kinsale in 1601. As he is very much aware, Kinsale has an awful lot going for it as a tourism town. It is the start of the Wild Atlantic Way and has many attractions, including good food. This morning I will focus on the historical element.
Kinsale dates back mainly to the battle of 1601, which was one of the most pivotal in Irish history. It had an international element because not only did Irish forces fight the Crown forces, over 1,000 Spanish soldiers were involved in the siege and battle. The Spanish Government is very much aware of the battle and has been proactive about it. We need to step into the space and have an interpretive centre in Kinsale in order that we can promote the battle site. The centre could become a focal point not alone for Irish and other European visitors but also international visitors from the entire world to learn what happened during the battle and siege.
Desmond Castle is a unique structure located in the centre of Kinsale. It has been closed since September 2017. It housed a wine museum which is now closed. The castle could be considered by the OPW for use as an interpretive centre, thus allowing us to embrace everything Kinsale has to offer. In many ways, it has been blessed by the hand of history and geography. We have an historical building that could be used as a very important interpretive centre which would benefit Kinsale and the entire western seaboard.
I put it to the Minister of State that we should put a plan in place and ask the OPW to consider using the building in the way I have suggested. We must see what we can do to engage with the local chamber of commerce, as well as local businesses and tourism stakeholders, to put an interpretive centre in place. The initiative would have the effect of adding another string to our bow. We would also celebrate what really was one of the most significant battles in Irish history. As I said, there is a national element, but the international element must also be highlighted as there is a story to be told. We have the building and the story. All we need are the funds and drive by the Government to ensure we can deliver on the real potential of the castle and Kinsale.
I am grateful to the Senator for giving me the chance to come into the House to speak about this issue. Desmond Castle in Kinsale, or the French Prison as it is sometimes known, is one of the heritage sites managed by the Office of Public Works, OPW, that perhaps are not well publicised and which deserve a little more attention. They are excellent historical properties in their own right. I am always anxious, as is the OPW, to bring what are called tier 2 and tier 3 sites such as this one more to the fore in order that more people can visit them. This matter is very important from the point of view of local tourism and employment creation.
As the Senator knows, Desmond Castle is closed for urgent conservation works and visitors have been unable to visit since it was shut at the end of last year. When it was open, it was one of 70 visitor sites operated by the OPW and attracted visitors in the region of about 10,000 per year. It was managed by the guide team from Charles Fort, the OPW's other large site located close by in Kinsale. Charles Fort is a major year-round visitor site that attracted over 100,000 visitors last year.
Desmond Castle which was declared a national monument in 1938 has had a varied history.
This has led to a lack of clarity about the site at times, which really does not help in trying to market it to visitors. As mentioned, it is closed for urgent conservation works. However, it is not immediately apparent what the extent of the problem is or exactly how long it will take to fix it; therefore, we will have to wait for the full conservation architect and structural engineer assessments. While it is closed, the OPW is taking the opportunity to look again at the site and the approach to it in order that we might possibly reposition it as a visitor attraction and in future marketing. When the OPW looked at the issue previously, it met Kinsale Chamber of Commerce to discuss it. However, it struggled at the time to define the site clearly and not much progress was made. The closure offers another opportunity to look at the issue. I can tell the Senator that the theme of the 1601 rebellion has been suggested. Clearly, it will be a strong contender in the future presentation of the site. My officials shortly hope to present the future interpretation and presentation of Desmond Castle site as an application to Fáilte Ireland for funding under its capital investment programme. I know that the OPW has high hopes this approach will bear fruit. I am sure, however, that the strong views and suggestions the Senator has communicated to me will form part of the future plans for the castle.
The Senator may ask a brief supplementary question.
The location of the historical site in the centre of town offers much potential. I put it to the Minister of State that his officials might come to Kinsale to meet the chamber of commerce again, as well as the local tourism agency, to engage in dialogue on how we can find a suitable home for the interpretative centre. As I said, everything in Kinsale dates back to the battle of 1601 which is of international significance. If the departmental officials could sit down with the people of Kinsale, it would go a long way towards trying to tell the story Kinsale needs to tell about the battle of 1601.
As I said, tier 2 and tier 3 sites are the hidden gems of the OPW that I am trying to bring to attention for the local community and also for tourism purposes. Once we get word back from the conservation architect, we will know the extent of the work that needs to be done. We are in a position to apply to Fáilte Ireland for funding. That is a positive message to bring back to the people of Kinsale today. Once I receive the report from the conservation architect, I will set up a meeting to enable my officials to engage with Kinsale Chamber of Commerce. It was my initiative to allow young people under the age of 16 years to visit all OPW heritage sites free of charge, with people with disabilities and their carers. I believe heritage sites will benefit tourism and help the country to blossom. I share the Senator's views in that regard.
I thank the Minister of State. Without impoverishing the impartiality of the Chair, I am inclined to be on the side of Senator Lombard on this issue.
Preschool Services
I welcome the Minister of State, Deputy Catherine Byrne.
I, too, welcome the Minister of State. I acknowledge the co-operation of the Minister for Children and Youth Affairs, Deputy Zappone, on this issue and know that she is tied up at the Cabinet meeting this morning. Her officials have been in touch with me and very co-operative.
Baineann an cheist seo leis an rátá bunphá atá múinteoirí i gComhar Naíonraí na Gaeltachta ag baint amach faoi láthair. Tá na múinteoirí réamhscoile sin an-mhíshásta. Chuir siad in iúl dom agus do na Teachtaí Dála ó Thír Chonaill go bhfuil orthu obair bhreise a bhaineann le riarachán nó le páipéarachas a dhéanamh. Tuigim go bhfuil thart ar trí uair sa bhreis sa tseachtain ag baint leis an obair sin. Tá sé deacair ar na múinteoirí an obair sin a bhaint amach le cois na cúraimí eile atá orthu, agus ag cur san áireamh an ráta íseal pá atá ag na múinteoirí seo. Tá na múinteoirí ag iarraidh go mbeidh ardú pá i gceist ionas go mbeidh ráta pá fiúntach acu.
The issue is the level of remuneration available to preschool teachers in the Donegal Gaeltacht in Comhar Naíonraí na Gaeltachta, Donegal branch. These teachers have additional responsibilities. A classroom teacher in a primary school has equivalent responsibilities. The facilities and services provided by these preschool teachers are excellent, essential and of crucial importance to many families living in Gaeltacht areas. There was always a distinction made - in my view, wrongly - in the pay levels of preschool teachers outside and inside the Gaeltacht. There should be parity of esteem for preschool teachers both inside and outside the Gaeltacht and no difference in pay. In fact, preschool teachers in Gaeltacht areas have additional responsibilities in trying to encourage children to speak Irish and so on and so forth. The amount required is small and not a substantial financial ask. I am not sure whether the Minister of State will have the answer, but this issue must be dealt with.
I am a member of the Oireachtas Joint Committee on the Irish Language, An Coiste Gaeilge. In February we met representatives of preschool teachers when committee members visited the Donegal Gaeltacht. Following the meeting, we took on board the recommendations which had been made by the preschool teachers and made a submission to the Houses of the Oireachtas in which we recommended that the matter be dealt with. To date, as we approach the end of 2018, it has still not been dealt with. The issues are equality of pay and the availability of in-service training. The vast majority, if not all, of the preschool teachers are women who provide an excellent service locally. An added benefit is that many of the families who can send their children to preschool are able to continue working. This is an issue in a rural area, but it needs to be dealt with. It is wrong that a preschool teacher in Castlebar or Athlone is on one rate of pay, while another in Gweedore, Gortahork or elsewhere in County Donegal or Connemara is on a lower rate, although he or she is doing exactly the same work and has additional responsibilities because of the use of the Irish language.
Obviously, Údarás na Gaeltachta has a role to play and an agreement with the Department of Children and Youth Affairs, from which the financial resources to ensure parity in pay rates would have to come.
I thank the Senator for tabling this Commencement matter. I am delighted that he has had a conversation with officials from the Department of Children and Youth Affairs. The Minister, Deputy Zappone, has asked me to take this matter.
The matter concerns the remuneration of early learning and care practitioners in preschool settings. The Minister has been unequivocal in her support for better pay and conditions for staff in the sector. It is her belief early learning and care practitioners play a crucial role for families and children and that they deserve to be recognised and valued. In return, the evidence shows that a valued workforce deliver higher quality services to children. However, the Department is not the employer of early learning and care staff and does not pay the salaries of staff working in early learning and care settings. Therefore, the Minister cannot set wage levels.
In that regard, the preschool context is different from the situation in primary and post-primary schools. Given this context, the Minister has been clear that there are limits to the actions that her Department can take. However, the Minister has supported a range of measures to improve pay and conditions using the tools available to her. In particular, the Department of Children and Youth Affairs has seen a 117% increase in investment in the sector over the past four budgets, rising from a budget of circa €260 million in 2015 to €575 million in 2019. The Department of Children and Youth Affairs has used some of this budget to introduce additional capitation to services, for example, a 7% rise this September in the ECCE capitation rate. Programme support payments to recognise the administrative roles that services play have also been introduced totalling €18 million per annum for the past two years, with €21.4 million available in 2019. The Department has also continued to provide a higher rate of capitation payment for graduate-led preschool rooms to encourage the attraction and retention of graduate staff. This year, the Minister also introduced a pilot measure to fund services whose staff take part in continuing professional development, CPD. It is the Minister's hope and intention that these additional investment measures should be reflected in the pay and conditions of staff in preschool services.
The Minister has also repeatedly called for the sector to pursue a sectoral employment order, which offers a possible mechanism to establish appropriate wage levels. As the Senator will be aware, the Minister cannot initiate a sectoral employment order, nor can officials in her Department, but she is keen to co-operate with such a process if and when it is undertaken. Many early learning and care settings are open throughout the summer months and this is reflected in the remuneration to their staff. Some services choose to offer the ECCE programme only and as a result do not open during the summer months. The arrangement they make with staff in respect of remuneration during this time is a matter for the individual employer. However, the introduction of the affordable childcare scheme in autumn 2019 will for the first time allow an individual child to benefit from both the ECCE programme and a targeted funding scheme. The wrap-around character of the affordable childcare scheme will make it easier for early learning and care and school age childcare services to operate year-round, including during the summer months, if they should choose to do so.
On the question of in-service training with primary school teachers, I refer the Senator to First 5, the whole-of-government strategy for babies, young children and their families, launched on 19 November. It is important to acknowledge that early learning and care is a profession of and in itself, and not all training accessed by primary school teachers will be relevant to the preschool context or vice versa. However, there are important areas of shared responsibility and interest, including supporting children's transitions between preschool and primary school. First 5 includes a specific commitment to develop links between CPD opportunities for the early learning and care workforce and the national structure for CPD of primary school teachers. First 5 also commits to consideration of opportunities for joint delivery of CPD programmes, where appropriate.
I am missing a page somewhere.
The Minister of State is over time.
I apologise. I will get the rest of the document for the Senator.
I thank the Minister of State. I know it is not under the direct remit of the Minister for Children and Youth Affairs to deal with this, but what is happening is that preschool teachers, because the rates of pay are so low in Gaeltacht areas, are leaving to work as special needs assistants for the Department of Education and Skills. If this continues, we will have no preschool availability in Gaeltacht areas. The issue needs to be dealt with. I am encouraged by the Minister's commitment to consider a sectoral employment order or at least that she would be keen to co-operate in this matter. I will follow up on this.
I ask the Minister of State, if possible, to speak to officials in the Department to find out if they are willing to bring the key stakeholders together to try to find a solution to this issue. Perhaps the Minister could play the key or chairing role in facilitating such a solution. That would be the best way of dealing with this matter. It takes a leader to deal with it and the Minister is in a position to provide leadership by bringing the key stakeholders together, thrashing out the issue and dealing with it once and for all. That would be very welcome. I ask the Minister of State to raise this issue with the Minister, to whom I will certainly write about it also.
I will convey all the Senator's comments to the Minister. I agree with him in many ways. I know how difficult it is for staff to be kept in preschool. I have a niece who runs a Montessori school and she has often talked about the difficulty caused by staff moving on, which is related to the level of pay. I agree with the Senator in that regard. I will bring his concerns to the Minister, but I know from speaking to her on other occasions that she is committed to ensuring there is equal opportunity for people, whether in preschool settings or primary schools. I will ensure she hears the Senator's comments loud and clear.
Hospitals Policy
I was shocked last week to learn that the general manager of Our Lady of Lourdes Hospital had announced her intention to change the name of the hospital. A notice sent to some staff last week suggests the dropping of the name of this institution, which is more than 60 years old, is a fait accompli. There has been no consultation worth the name. It seems a decision is being handed down by a public official who has forgotten that public servants are accountable not just to their staff but also to the wider community, just as the Minister of State and I are.
For all my public life I have fought to separate church and State, whether in the campaigns to repeal the eighth amendment and for marriage equality or in fighting for pluralism and greater tolerance in this country. I assure the Minister of State that I have the scars on my back from those campaigns, which were far from politically popular or profitable until recently. As a real pluralist, the name of Our Lady of Lourdes Hospital does not offend me. The notion that we dispense with it and, as a consequence, the link to our local hospital's founders does not sit comfortably with me. This hospital was built, as the Minister of State might know, by the Medical Missionaries of Mary and Mother Mary Martin. Its bricks were financed by the people of Drogheda. There would be no hospital in Drogheda were it not for the vision of the Medical Missionaries of Mary. This is an historical fact that cannot just be airbrushed out in a rebranding campaign. One need not be a practising Catholic to understand and appreciate the abiding legacy of the Medical Missionaries of Mary, and thankfully there is no longer a Roman Catholic ethos in Our Lady of Lourdes Hospital. That has not been the case since the hospital transferred to State ownership through the North Eastern Health Board back in 1997, but that legacy, regardless of whether one agrees with the founders' religious perspective, ought to be honoured and the name of the hospital should remain. It is part of our identity as Drogheda people and part of the town's social and historical fabric. Will the Minister of State apprise me of who gets to make the final decision on this issue, in other words, who has the authority to do that in law? Is it the general manager, the board of the RCSI hospital group or the HSE, or is there a function for the Department of Health in this matter?
I am speaking on behalf of the Minister for Health, Deputy Harris. I thank the Senator for raising this issue and giving me the opportunity to provide an update for the House on Our Lady of Lourdes Hospital, Drogheda. Our Lady of Lourdes Hospital was originally opened by the Medical Missionaries of Mary as the International Missionary Training Hospital in 1957 and transferred to the North Eastern Health Board in 1997. The hospital is currently owned and run as a statutory hospital by the HSE. Our Lady of Lourdes Hospital is a 370-bed acute general hospital serving the local community in the north east. Services include an emergency department, an acute medical assessment unit, Louth-Meath paediatric services and the regional trauma service.
Recent media reports have suggested the hospital is considering changing its name. It has also been reported that the general manager of the hospital wrote to staff members recently seeking their views on potential names. The Department of Health has sought a full update on this matter from the HSE. One of the suggested names was Drogheda university hospital. The Senator may wish to be aware that use of the term "university" is regulated by section 52 of the Universities Act. The Companies Registration Office will not register any company wishing to use the term "university" without authorisation from the Department of Education and Skills.
Hospitals in the RCSI hospital group, including Our Lady of Lourdes Hospital, Drogheda, are not referred to as university hospitals because the RCSI is not a university.
As part of investment in and reform of health services, a phased major capital infrastructural project is taking place at Our Lady of Lourdes Hospital. The project includes the provision of additional beds and theatre capacity, as well as the expanded emergency department. The new emergency department which will be located on the ground floor of the hospital will be completed and available to open early in 2019. The HSE has advised that some work remains to be completed in the old emergency department to allow for the installation of a new paediatric emergency department and an extension of radiology services. It anticipates that the full extension will be ready in 2019. Additional bed capacity in the hospital is also expected to be made available early in 2019.
Further decisions on the name of the hospital will be considered by the HSE and the Department of Health and take account of the wishes of staff and the population served by the hospital.
I thank the Minister of State for her reply. She was incorrect to suggest this issue had only been raised in recent media reports. A decision was taken by the general manager of the hospital who stated in an email to senior staff that it was her intention to change the name of the hospital. It is extremely high-handed and arrogant for a public official to make that decision without consultation. It was almost presented as a fait accompli. Three options from an unknown source were put forward, namely, Drogheda regional hospital, Drogheda general hospital and Drogheda university hospital. The Minister of State has correctly pointed out that the RCSI does not have university status in Ireland. It can market itself as a university for the purposes of attracting students from abroad, but it does not have that legal status in Ireland. I have tabled an amendment to the Qualifications and Quality Assurance (Education and Training) (Amendment) Bill 2018 which would allow it to describe itself as a university in Ireland.
In this case, the general manager of the hospital jumped the gun, although I do not wish to personalise the matter. There is very little public support in Drogheda for the proposal. Perhaps a compromise might be reached. For example, the name of Mother Mary Martin might be more formally associated with the hospital. There is no doubt that if a new publicly funded hospital was being developed on a greenfield site, its name would, correctly, not have religious associations. I believe in a pluralist, tolerant, secular republic and that there should not be religious overtones, particularly where State funding is provided. However, in this case, changing the name of the hospital would reject its history and the reality that it was founded by the Medical Missionaries of Mary. We are proud of their association with Drogheda and that legacy should be honoured because in a few short years very few members of the order will remain. We should respect and honour our history and that legacy.
I thank the Senator. I fully agree with him. A decision by hospital management to change the name of the hospital should have been preceded by consultation with staff and the local community. I fully agree with the Senator on the ethos of hospitals. It is not a name that makes a hospital but the people who work in it. That said, many hospitals were founded by missionary sisters or other religious orders which should not be blamed for all that has happened in the history of religion in this country. I will convey the Senator's concerns to the Minister and ask him to contact the Senator about the intention to change the name of the hospital without consultation.
Hospital Services
I, too, welcome the Minister of State. I raise the issue of waiting lists in hospitals. Unfortunately, records show that November was one of the worst months in history for overcrowding. I am sure the Minister of State will agree that that is very unfair for patients and their families, as well as the hard-working staff in the hospital network, to whom I pay great credit. As I am sure the Minister of State will agree, this is a time of crisis. It may be time to think outside the box in terms of what we can do to alleviate the crisis, particularly in smaller hospitals throughout the country such as Monaghan Hospital. The minor injury unit at the hospital operates from 9 a.m. to 5 p.m., five days a week. It functions very well and provides an excellent service. However, its opening hours should be extended to seven days a week in order to alleviate the pressure on hospitals in Cavan, Drogheda and elsewhere in the region. Last year I pointed out that approximately 4,500 people had passed through the doors of the minor injury unit. This year more than 4,000 patients had been treated by the end of October.
I compliment the HSE on its campaign to raise awareness of the services available at the minor injury unit. People may be treated for injuries such as broken bones and have casts supplied and X-rays taken. The turnaround times and the speed at which people are seen are testimony to its great staff. More than 91% of respondents in a recent HSE survey stated they had had an excellent or very good experience at the unit. Many were unaware of the full range of services available, which indicates that a further awareness campaign is needed. Many complained about the restricted 9 a.m. to 5 p.m., Monday to Friday, opening hours. It is worth noting that it has the shortest opening hours of the 11 minor injury units throughout the country. It treats as many patients as some minor injury units which open for seven days a week. I encourage more people to use it and the Government to explore the services available at Monaghan Hospital. In particular, consideration should be given to an extension of the opening hours of the minor injury unit for the benefit of all citizens in counties Monaghan and Cavan and elsewhere. At a time when more than 700,000 people are on waiting lists, surely, smaller hospitals could be providing additional services to alleviate the waiting lists. An audit of all hospitals should be carried out to identify the additional work they could do to alleviate the problems in the health service.
I apologise on behalf of the Minister for Health, Deputy Harris, for his absence owing to Cabinet commitments.
I thank the Senator for giving me the opportunity to address the Seanad on services at Monaghan Hospital. Monaghan Hospital and Cavan General Hospital operate as a single entity, with an integrated managerial and clinical governance system, care pathways and support functions. The emergency department is located at Cavan General Hospital, while the facilities at Monaghan Hospital are focused on the provision of elective care and the streaming of appropriate patients to the minor injury unit located on site.
The smaller hospitals framework defined the role of smaller hospitals and outlined the need for smaller and larger hospitals to operate within hospital groups. It identified the activities that could be performed in smaller model 2 hospitals such as Monaghan Hospital in a safe and sustainable manner. In developing smaller hospitals the safety of patients is the first and over-riding concern. Significant progress has been made in recent years in the establishment and development of hospital groups. Hospitals are now working together and supporting each other in groups.
This new way of working provides a stronger role for smaller hospitals such as Monaghan Hospital in delivering a higher volume of less complex care in many cases closer to patients' homes. It also ensures patients who require true emergency or complex planned care are managed safely in a larger hospital environment. Through reconfiguration and consolidation of services, demonstrably better outcomes can be achieved for patients, as has already been shown and broadly accepted by the public in the case of cancer treatment.
With regard to the minor injury unit, as outlined in A Programme for a Partnership Government, the Department of Health is committed to undertaking a review of medical assessment units, minor injury units and similar units with a view to extending their opening hours. Minor injury clinics and similar units provide valuable services for local communities and alleviate the pressures on emergency departments. The minor injury unit in Monaghan Hospital is open Monday to Friday, 9 a.m. to 5 p.m. and can treat both adults and children over five years with non-life-threatening or limb-threatening injuries.
The Department of Health review of opening hours will have particular regard to distance from the nearest emergency department and existing workloads. Work on this review is at an early stage. The Minister for Health visited Monaghan Hospital in July this year to engage with staff and view the hospital's facilities. The Government is committed to securing and further developing the role of smaller hospitals with the expansion of services delivered in these hospitals, especially in services such as day surgery; ambulatory care; medical services and diagnostics.
I thank the Minister of State for her response. Is there a timeframe for the review? When does the Minister expect it to be completed? We are aware that the Minister visited the hospital in July this year and we met him that Saturday morning. We are disappointed he has not come back yet with his plans. There is a degree of urgency attached to this issue. There are patients lying on trolleys for hours on end. It is very unfair and I have no doubt that there are people going to Cavan Hospital and Drogheda Hospital who could easily be treated in the Monaghan minor injury unit. It makes perfect sense to extend its opening hours to seven days a week. I implore the Minister of State to do so as a matter of urgency.
I do not have the timeframe for the review but I will ask the Minister's office to tell the Senator. I support what the Senator is saying. Having sat in the accident and emergency department for 13 hours two weeks ago with my daughter I understand the difficulties, particularly for people who have minor injuries. The overcrowding does lead to people having to be there for a long time. Minor injury clinics deliver a positive outcome to people living local to them who do not have to travel further to major hospitals. We want to make sure people who are seriously ill go to the accident and emergency department and that those who are not are filtered into the minor injury unit. I will relay the Senator's concerns to the Minister about the opening hours and the timeframe for the review.
Sitting suspended at 11.15 a.m. and resumed at 11.30 a.m.