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Seanad Éireann debate -
Tuesday, 18 Jun 2019

Vol. 266 No. 4

Nithe i dtosach suíonna (Atógáil) - Commencement Matters (Resumed)

Social Welfare Code

Gabhaim buíochas leis an Seanadóir fá choinne an cheist. Bhí an ceart aige faoin Aire atá freagrach as an cheist seo. Tá sé as láthair ag an bhomaite. Tá brón orm fadúda sin ach má eíríonn aon cheist as an fhreagra seo, beidh mé sásta teagmháil a dhéanamh le mo chomhghleacaí chun aon bhearna a líonadh nó sonraí a fháil.

In 2011, public officeholders became liable to pay class K PRSI of 4% on their officeholder income. Payment of the class K PRSI charge does not establish any social insurance entitlements. Prior to 2011, this income was exempt from PRSI and then, as now, social insurance entitlements were established and protected based on their non-officeholder activities or by paying voluntary contributions. This class K charge was introduced for public officeholders because, unlike employees and the self-employed, they did not pay a 4% contribution on this income. With the abolition of the PRSI earnings ceiling for employees in 2011 and the introduction of the 3% universal social charge on self-employed earnings over €100,000, also in 2011, this meant that public officeholders had a lower marginal rate of income tax, universal social charge and PRSI when compared with other workers. As a measure of solidarity with those workers, the Oireachtas voted to apply the 4% class K contribution to public officeholders.

Public officeholders are now not the only group paying class K contributions. Since 2013, modified rate contributors, including civil and public servants recruited prior to 1995, who also have earned and unearned income from self-employment pay class K PRSI on this previously exempt income. In 2014, class K was applied to the previously exempt income of employees and occupational pensioners under 66 years where they have unearned income only. These class K charges yield nearly €40 million per annum for the Social Insurance Fund from over 88,000 contributors.

This would have a significant impact on the future health of the Social Insurance Fund.

I thank the Minister for his response, the last paragraph of which is most telling. First and foremost, I will be exercising my right, following a High Court case, to be moved to class S. Second, I object to this nonsense about "generous Exchequer funded salaries and pensions". My pension, were I to lose my seat at the next election, is the princely sum of €8,000. However, because I am a teacher my pension will be on the single pension scheme so there is no "generous" pension for me. The Government must deal with the problem it has with other class K contributors who have unearned income like shareholders, people who have rental income and the like. I have no terms and conditions of employment; nor have any of my colleagues. We are officers of the State. I assure the Minister and the Department of Employment Affairs and Social Protection that if they think I am going to sit down under this, they can think again. If I have to go back to the High Court, I will do so and by God, the next time I go back, they will pay dearly for it.

This is an outrageous statement on the part of the Department. I appreciate that this is not from the Minister for Education and Skill's Department but it is outrageous. There are young people in these Houses whose PRSI records are being destroyed. The departmental reply refers to "generous Exchequer funded salaries and pensions" which is a load of poppy cock. We all know that the days of great pensions in the civil and public service, particularly for elected members, are long gone. If anyone thinks I am going to take this nonsense, he or she can think again. I will be back on this one. I am sorry for giving it to Deputy McHugh between the eyes. He is the Minister for Education and Skills and it is to him I will be going when I finish up in this House. Half of my teacher's pension is made up of my class A PRSI contributions but my contribution record has been broken by the Oireachtas class K designation. I have no idea where my teacher's pension will end up as a result of this so rock on - I am on the way back on this one.

Well said. Does the Minister wish to respond?

In terms of the education component on a general level, participating in this debate has been an education in and of itself. If there are any specific education related matters, I am more than happy to facilitate a communication plan in that regard. The next budget is scheduled for 8 October. There will be a lot of deliberations and conversations on where we are going in regard to that budget. The approach to that budget will be in keeping with the challenging times ahead in terms of heightened expectations, lower growth rates and Brexit. In the context of the specific issue raised by Senator Craughwell on class K PRSI, I am sure conversations will be happening within the Department of Employment Affairs and Social Protection in advance of the budget.

Insurance Costs

I thank the Minister for taking this Commencement matter. I discussed the issue of Saplings special school a few months ago with the Minister of State at the Department of Health, Deputy Finian McGrath, but am delighted to welcome the Minister for Education and Skills to the House today to discuss it. I want to tell the Minister about an incredible school about which I have spoken in this House previously. It is doing amazing work but is facing a desperate situation because of sky-rocketing insurance costs. A national conversation is ongoing about insurance costs and businesses being put to the pin of their collar while insurance companies report massive profits. Last week when I heard that a number of special schools in Ireland were facing closure because of spiralling insurance costs, I knew that things had gone too far.

The insurance premium for Saplings special school in Carlow had sky-rocketed from €3,000 to €10,500. Last week, the premium increased again to €13,500.

The school has incredible staff, a passionate principal and terrific parents, and the parish and wider community are very supportive. Each fundraiser, however, dips into the same pot. The annual capitation grant of €20,000 to run the school seems incredible when, just last month, it received an insurance bill of €13,500 and a utility bill for one month alone was more than €4,000. The school has no choice but to constantly fundraise to maintain the services it provides so well. It is one thing for parents to feel frustrated that they cannot give the best to their children, but for a principal and staff to feel they are facing into a grim future under extreme financial pressure is simply soul destroying. Saplings special school caters for children from the age of four to 18. This model of school was first established by a small group of parents and professionals in the Kildare area because there was a need for the service; it did not exist elsewhere. Saplings now has five schools located around the country providing quality education for pupils with autism and complex needs. Each school offers a range of child-centred autism-specific education that draws on a range of evidence-based interventions.

In Carlow in 2007, a group of parents came together to set up a school in their community. It began with 12 pupils. It will have 30 in September. In 2010, it became a Department of Education and Skills special school and was granted temporary recognition as a primary school by the Department in 2011. With regard to capital plans for the future, only when a school has permanent recognition can it apply for capital funding provided by the taxpayer. The school received such recognition in September 2016. The Department has to examine how it can support these schools, their staff, and the children and their families with regard to funding. I ask that the school be assisted in securing a permanent building. It currently rents accommodation with the help of the parish of Graiguecullen and Killeshin, which straddles the Carlow-Laois border.

The 32 staff in the special school, including support staff, are highly trained and highly skilled. If they had proper funding, they could be supportive and excel in their areas of expertise. Saplings provides speech and language and occupational therapy through a private company, the costs of which are met through fundraising. It does not receive supports such as these centrally from the HSE, despite needing them. That is another problem; it gets no support from the HSE. Saplings is sometimes called the last resort for many families whose children's needs cannot be met in autism spectrum disorder, ASD, units. While attending Saplings the children get the opportunity to reach their potential and, in some cases, eventually move to a mainstream setting. The model of education in the school uses evidence-based interventions and behavioural analysis to provide individual education and behaviour support plans for each pupil. Each pupil has his or her own analysis. There is always a plan and this helps explain the frustration staff feel when financial threats are looming as these plans become tenuous and uncertain.

Members of the school's board of management work voluntarily and none of them wishes to see this kind of financial pressure on the school, its staff, and the parents. The Department of Education and Skills' special education section needs to step in and figure something out for Saplings special school Carlow and similar schools throughout the country. Some 15 schools contacted the Department with their concerns last week. The National Association of Boards of Management in Special Education commissioned a report on increasing costs and recommended that a group scheme be established for the schools in question. Something can be done here and I look forward to hearing the Minister's response regarding the supports available to schools such as Saplings special school Carlow. This is very important. I have also met the Minister of State, Deputy McGrath, several times but I ask that all relevant Ministers and Ministers of State work together. We need to keep these schools. We cannot lose the likes of Saplings and other schools across the country because of increasing insurance costs. It is just not acceptable.

Gabhaim buíochas leis an Seanadóir fá choinne an cheist seo, ceist atá iontach tábhachtach do scoileanna speisialta timpeall na tíre. Tugaim aitheantas do na daoine uilig atá ag obair iontu - na múinteoirí agus na daoine eile - fá choinne an cheannaireacht a léiríonn siad sna scoileanna atá i gceist. Tá míbhuntáistí ann maidir le hárachas. Táim cinnte go bhfuil obair de dhíth ach tá dul chun cinn déanta go dtí seo freisin. Tá sonraí agam anseo.

I thank the Senator for raising this matter. My Department is aware of issues relating to significant increases in insurance costs in some special schools. St. Teresa's special school in Ballinasloe was the first to raise this issue through my colleagues in the Oireachtas.

I want to acknowledge my colleagues for bringing that to my attention. The issue the Senator is raising relates to Saplings special school in Carlow. We have made progress over the last period in discussions with the National Association of Boards of Management in Special Education. The increased insurance costs of special schools appear to be due to annual increases in insurance costs generally and, in some cases, increases in claims. The Department of Education and Skills is working as a matter of urgency with relevant Departments, including the Department of Public Expenditure and Reform, and with the State Claims Agency to seek a resolution to the issue of increased insurance costs in special schools.

A number of options have been identified to address the issue. These include the development of a group insurance scheme for special schools. The National Association of Boards of Management in Special Education is engaging with its member boards of management in this regard. A meeting of the boards and patrons took place on 6 June to discuss the matter and the options available. This meeting was attended by an official from the Department. The group scheme proposal appears to be the most viable option at this stage. The importance of all schools signing up for such a scheme was emphasised at the recent meeting. All school representatives who were in attendance were in favour of exploring the group scheme option. Although the Department of Education and Skills has advanced school capitation payments on an exceptional basis to a small number of schools that recently experienced difficulty in paying insurance premiums, it is not sustainable for the Department to continue to advance capitation payments as a way of meeting vastly increased insurance premiums. I know this is a cause of concern for schools as well. Officials from the Department have been in contact with Saplings special school in Carlow on this matter. Representatives of the school have been briefed on the situation. I hope a speedy and cost-effective resolution can be secured for impacted special schools.

This is important because, as the Minister is aware, Saplings and 15 other schools have been affected by huge increases in insurance costs. It is a worry for the parents, the school and the principal. Everyone to whom I have spoken agrees that the group scheme proposal would be the best way to go forward. I would appreciate the Minister's support. I know Saplings special school would appreciate it too. We need to make sure this cannot keep happening. Schools will close if insurance costs keep increasing. It is unacceptable. We need to look forward. I look forward to getting a good result from this. I thank the Minister. I apologise for missing him last week when I raised an issue relating to special needs assistants. The Minister of State, Deputy Mitchell O'Connor, responded to me on that occasion. I have addressed my query regarding special needs assistants to the Minister now and I hope he comes back to me on it.

The Senator never misses an opportunity.

I never miss an opportunity.

I apologise for not being present at last week's debate. I had another engagement.

I am working closely with the special schools on this important issue. Approximately €1.9 billion, or almost 20% of the education budget of €11 billion, is spent on special education. There are things we get right, things we miss and things we get wrong. Much of what we do is focused on collaboration. I believe the idea of schools working together as part of a single entity represents the way forward. The first time this matter was raised with me, I learned that an insurance company had asked St. Teresa's special school to pay its annual premium with a single cheque. This approach can cause a difficulty for schools. I do not want to see schools looking for the capitation grant to increase for this specific purpose. I believe that if we can get the schools working together and get the premiums into a reasonable sort of place, it will be seen that the collaborative approach represents the way forward. Ba mhaith liom arís mo bhuíochas agus m'aitheantas a thabhairt do na daoine uilig a bhíonn ag obair sna scoileanna speisialta. Tá sé iontach tábhachtach go bhfuil córas sa Teach seo a thugann deiseanna dúinn bealaí a aimsiú chun bogadh ar aghaidh. Gabhaim buíochas leis an Seanadóir arís fá choinne seans a thabhairt dom labhairt ar an ábhar seo.

Health Services Staff Remuneration

I will share time with my colleague.

Senators are not permitted to share time if they do not co-sign a Commencement matter.

I welcome the Minister of State, Deputy Finian McGrath, although I hoped the Minister for Health, Deputy Harris, would take this Commencement matter. I mean no disrespect to the Minister of State; it is just that I have more time for him than I do for the Minister.

The Government is denying pay increases to support staff in the healthcare sector who, as the Minister of State is aware, will be taking strike action on Thursday in 40 hospitals and care centres across the country. The staff include healthcare assistants, maternity care assistants, laboratory aides, surgical instrument technicians, catering staff, porters and maintenance workers, some of whom I have just met. Their salaries start at €24,500, or €28,000 for a healthcare assistant. The figure of €24,500 is approximately 14% of the salary of the Minister for Health.

The strike promises to be very disruptive. It has been caused directly by the Government's inability or unwillingness to keep its promises. In 2015 job evaluation for support staff was reintroduced under the terms of the public service stability agreement, PSSA, having been suspended at the height of the economic crisis in 2009. It was signed off on by the Departments of Health and Public Expenditure and Reform, as well as by the HSE. My union, SIPTU, has honoured the terms of the PSSA in full and its members voted to accept the first Lansdowne Road agreement on the basis that job evaluation would be reintroduced. According to the Government, the recession is over. In spite of this, wages have not been restored in line with recommendations.

In the spring of 2016 SIPTU balloted support staff on strike action as the HSE was prohibited by the Department of Public Expenditure and Reform from implementing phases 1 and 2 of the job evaluation exercise. In the spring of 2017 the Workplace Relations Commission intervened and brokered an agreement which set out dates for phases 1, 2, 3 and 4 of the job evaluation exercise to be completed. The Minister of State will be aware that all deadlines in the Workplace Relations Commission agreement have been missed. Phases 1 and 2 of the job evaluation exercise were completed in August last year. Some 6,000 members in support grades represented by SIPTU were deemed to be entitled to upgrading in line with the agreement. In fairness, the HSE and the Department of Health accepted the outcome of the evaluations and applied for the €16.2 million - a paltry figure in the context of the overall health budget - needed for the pay increases. The application was declined and no budgetary provision was made.

Following meetings with the Departments and the HSE, SIPTU support staff grade workers voted to take action. The Workplace Relations Commission intervened and all parties met several times, including yesterday, with no resolution in sight. The Department of Public Expenditure and Reform has confirmed that what is owed to SIPTU members will not be paid until at least 2021, possibly under a new public service stability agreement. The presumption and arrogance of the Department of Health in aligning with that position are unbelievable and completely unacceptable. Not only is payment due now, it should have been made two years ago.

What is the point of an agreement if one side - the Government side - cannot be trusted to uphold its promises? The behaviour of the Government has been interpreted by the workers, some of whom I have just met, as disrespectful and dismissive, to put it mildly. They are furious. They believe their jobs are of no value in the eyes of the Government. That view has been reinforced by the lack of a ministerial intervention in the dispute which is heading for a very disruptive strike on Thursday. It will be the first of many such strikes. The Minister of State is responsible for the welfare of the workers and the upholding of their rights. How does he defend the deceitful actions of the Government?

I thank the Senator for giving me the opportunity to address this matter. I am taking this Commencement matter on behalf of the Minister, Deputy Harris.

I raised this issue with the Government this morning and had discussions with Paul Bell of SIPTU at the weekend. The background to the dispute is that on 5 June SIPTU announced that up to 10,000 of its members working in 38 hospitals and healthcare facilities would engage in industrial action for 24 hours on Thursday, 20 June.

SIPTU has advised the HSE of a further five dates of proposed action to take place on 25 and 26 June, as well as 2, 3 and 4 July. I genuinely hope we can avoid that. The grades to engage in this action include healthcare assistants, maternity care assistants, porters, laboratory aides, surgical instrument staff and cleaners. The HSE has advised local management in the healthcare providers concerned to engage in contingency planning on the basis of emergency cover arrangements.

The background to the dispute goes back to the talks that took place under the Lansdowne Road agreement. At the time, a chairman's note was agreed by all parties on the introduction of a job evaluation scheme in the health sector. This scheme had previously been in place but was discontinued in 2008. SIPTU sought the introduction of the job evaluation scheme for the support grades along the same principles that operated in 2008. On this basis, discussions commenced in 2016 between the HSE and the relevant unions, namely, SIPTU and IMPACT, which is now Fórsa, in respect of the establishment of the schemes. Successful engagement with Fórsa led to the approval of a job evaluation scheme for the clerical and administrative grades in August 2016. However, as agreement on a scheme for the support staff grades could not be reached, that issue was referred to the Lansdowne Road agreement oversight body in early 2017. The chairperson of the body issued a recommendation stating that the parties should proceed with the scheme as planned but that the question of its implementation would be considered at the conclusion of the exercise. The Workplace Relations Commission, WRC, agreement provided that the scheme was to be carried out in four phases. Phases 1 and 2 included support staff in the laboratories and the theatres. The larger categories of support staff grades, the healthcare assistants and the multi-task attendants were also included. In October 2018, a report was produced setting out the results of phase 1 and phase 2 of the exercise. The report recommended that a significant proportion of those grades evaluated should move to a higher pay band. While the WRC agreement states that any payments arising as a result of the exercise would apply no earlier than the completion of phases 1 and 2 of the exercise, there is no agreement at this stage on the implementation of the result of the exercise.

In a separate issue, the chefs are engaging in industrial action over a claim to have their roles and pay scales aligned with those of the craft worker grade. No commitment was given to this particular claim. Senators will be aware that the Workplace Relations Commission invited the parties to talks that took place last Thursday and resumed yesterday. These talks ended without agreement. While it is clear that all parties are committed to reaching a resolution to avoid this strike action, it is regrettable that this has not been possible at this point. The position is that we will continue to utilise the State dispute resolutions machinery to maximum effect. I will do anything in my power to assist that development.

I realise the Minister of State did not write the reply. I know it is a scripted response from a civil servant. It is highly cynical. The HSE accepts the job evaluation exercise but does not accept that it has to implement it. That is the height of hypocrisy from the civil servant who wrote that line.

I want to finish by saying one thing. The Government will not avoid industrial action unless there is a political intervention. The industrial relations process has been completed and the awards were made. The HSE applied for the money and was turned down by the Government. What we need is political action. Without it, the Government is heading into a public relations disaster. If the Minister of State thinks the nurses dispute was bad for his Government, he should wait until this kicks off because there are far greater numbers of support staff. They are going on strike. They are absolutely furious. We are talking about the lowest-paid workers in the health service. The attitude of the Government is absolutely appalling. The message is ringing out clearly now that those in the Government have no idea how these people live, struggle and work against all the obstacles in the health service in the midst of the crises there every day. People are furious. This will not be solved by the industrial relations machinery. It will be solved by a political decision by the Department of Public Expenditure and Reform to fund the increases awarded under the public service stability agreement and the associated process. The Minister of State must honour the agreement.

The Minister for Health wants to see the strike action averted, if at all possible. Of course, I accept the concerns raised by the Senator about terms, pay and conditions. The salary rates are €24,500 and €28,000. There is no disputing that element of the debate. The Minister has asked both sides to redouble their efforts to avoid the disruption of health services. The industrial relations machinery should be used. The Minister acknowledges the vital role played by the support staff and the HSE is continuing to prepare plans in the event that strike action is taken. I will do everything in my power as Minister of State to avert the strike. At the Cabinet table this morning I raised the point made by the Senator in this debate. Everybody is aware of my personal position and I will continue to push that agenda. I hope we can avoid a strike on Thursday.

Hospitals Building Programme

The next Commencement matter concerns the need for the Minister for Health to provide an update on the medical rehabilitation unit at Roscommon University Hospital.

Almost eight years ago the downgrading of the Roscommon University Hospital emergency department was a matter of national importance. Many times 5,000 people marched to save the emergency department. I stayed in government at the time and I am delighted that Roscommon University Hospital is now so busy that people are complaining about a lack of parking spaces at Dr. Hyde Park. There is an air ambulance with advanced paramedics and some €20 million has been spent on the hospital. I am delighted to say hundreds of lives have been saved. There are 500 jobs in the hospital which is busier and safer. Anyone who has any intention of contradicting what I am saying should visit the hospital and ask the consultants and management staff.

One last piece of the jigsaw to ensure the future of Roscommon University Hospital remains. It is the need for an update on the medical rehabilitation unit project. The planned medical rehabilitation unit represents a very significant development. The 20-bed unit will be of huge benefit to patients in the western region. It will enable patients from the west who previously have been treated at the National Rehabilitation Hospital in Dún Laoghaire to be treated in Roscommon University Hospital. It will also assist in reducing waiting times for patients who require access to the National Rehabilitation Hospital.

There is a clear demand for such a medical rehabilitation facility in the west. Almost one quarter of patients treated at the National Rehabilitation Hospital in Dún Laoghaire normally reside in the HSE West region where there are no dedicated rehabilitation units. As things stands, the National Rehabilitation Hospital is the only comprehensive rehabilitation centre for patients with physical and cognitive impairments in the Republic of Ireland. As we know, the demand for its services continues to rise.

Turning to the details of the capital project, we are looking initially at the development of inpatient ward accommodation with ten beds on a greenfield site on the Roscommon University Hospital campus. A further ten beds will be delivered on a phased basis. The unit will operate as a satellite centre under the auspices of the National Rehabilitation Hospital and relieve pressure on existing services. This will allow patients to be treated in their own community. Towards the end of last year the project took a significant step forward when the design team was appointed. Funding of more than €560,000 was allocated for the design stage of the project. This was a major milestone in the development of the project, on which I seek an update. I look forward to hearing a progress report on it.

I thank the Senator for raising this issue and giving me the opportunity to outline to the House the position on the proposed development of a specialist rehabilitation unit at Roscommon University Hospital.

A Programme for a Partnership Government places a particular focus on several key programmes and strategies, including the publication of a plan for advancing neurorehabilitation services in the community. The Health Service Executive recently published its implementation framework for the recommendations in the national policy and strategy for the provision of neurorehabilitation services in Ireland in the period 2011 to 2015. The strategy made a number of recommendations for services for people with rehabilitation needs. It also covered a range of supports for them, including clinical, therapeutic, social, vocational and community supports.

The redevelopment of the National Rehabilitation Hospital in Dún Laoghaire is well under way with the construction of phase 1 nearing completion. It is expected to become operational next year, it will be a significant enhancement to rehabilitation services in the country and it will have a direct and significant impact on patient recovery by providing an optimal ward and therapeutic environment for patient treatment. This will enable staff to deliver optimal quality care and treatment in a facility which affords dignity, respect and privacy to all.

Funding for phases 1 and 2 of this major redevelopment project, along with the development of a specialist rehabilitation unit at Roscommon University Hospital, has been included in the Government’s Project Ireland 2040 policy initiative, announced last year. This provides €10.9 billion for health capital developments across the country, including both national programmes and individual projects across acute, primary and social care. The delivery of these projects and programmes, including developments at Roscommon University Hospital, will result in healthcare facilities that allow for implementation of new models of care and for delivery of services in high quality modem facilities. Roscommon University Hospital plays an essential role as a model 2 hospital within the Saolta University Healthcare Group and will continue to do so in the future. It provides a significant range of hospital services to patients in the region, including extended day surgery, certain acute medicine services and local injuries services. It also provides a wide array of diagnostic services including endoscopy, laboratory medicine, point-of-care testing and radiology, as well as specialist rehabilitation medicine and palliative care. Future growth in healthcare will be in the areas of chronic disease management and day surgery, diagnostics and rehabilitation. The activity levels of model 2 hospitals, such as Roscommon University Hospital, will continue to increase over the coming years as they specialise in providing these services to meet the needs of their local populations.

The HSE has advised that a design team for the proposed development of a rehabilitation unit at Roscommon University Hospital was appointed in October 2018. The design team has commenced preliminary design and is currently conducting site surveys and site investigations as part of this process. The HSE has previously advised that the hospital is also experiencing traffic congestion and parking difficulties, for which solutions will need to be addressed as part of the planning process. Subject to the successful completion of this process, it is anticipated that a planning application could be lodged in late 2019. Once the final design options have been approved, the required capital allocation will be determined. This unit will deliver 20 beds and therapy suite accommodation upon completion and will operate as a satellite centre under the auspices of the National Rehabilitation Hospital to provide intensive interdisciplinary rehabilitation to patients in the west.

I am delighted that a planning application could be lodged by late 2019. I understand that these applications take time but it must be ensured that the significant development under the auspices of the National Rehabilitation Hospital will be located in Roscommon. When it becomes operational, it will lead to 50 jobs. That means there will be more than 500 jobs in Roscommon University Hospital and I take great pleasure that this is so, given that people said the hospital would close. The Minister of State said the hospital was experiencing traffic congestion and parking difficulties, for which solutions will need to be found as part of the planning process. However, I take a little bit of credit in this regard and I laugh to myself about the fact that people said there would be no business in Roscommon hospital. In fact, we are experiencing significant traffic problems because it is twice as busy. I thank the Minister of State for his response. We will continue to ensure that the National Rehabilitation Hospital will be located in Roscommon for the west of Ireland.

I accept the Senator's points about the additional jobs, as well as the point about the total number of 500 jobs.

Roscommon University Hospital provides quality patient care for the people of the region, which is delivered safely by skilled and valued staff through the best use of the available resources. My Department continues to work with both the Department of Public Expenditure and Reform and the HSE in the process of finalising a multi-annual capital plan for the HSE as soon as possible. It will include capital projects to be funded in 2019, having regard to the available capital funding and the large number of national capital projects under way. It is important to recognise that all capital development proposals must progress through detailed appraisal, planning, design and tender stages before a firm timeline or funding requirement can be established.

I will bring all of the issues the Senators have raised back to the Minister for Health.

Sitting suspended at 3.20 p.m. and resumed at 3.35 p.m.
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