I welcome the Minister of State to the House.
Nithe i dtosach suíonna - Commencement Matters
I thank the Minister of State for coming to the House. We have previously spoken about Gaelscoil Choláiste Mhuire on Parnell Square and yet again unfortunately this morning we are back to talk about this school because there is another delay. Last year we were told by the Department of Education that the sod would be turned in November 2021. That has not happened. At the start of November, we were dubiously told that stage 2b would be complete by the first week of December and that the tender stage would commence in January. This week we learn that the design stage will not be completed until the end of January, tenders will not go out until the end of March and the sod could be turned next September. There is great frustration at this stage. Anyone who is familiar with this project would have to be sceptical about those timelines. This school has been waiting for 17 years for a new building.
I have a list of all the primary schools in this country in temporary accommodation, either prefabs or private rented accommodation. There are approximately 418 schools on that list. Gaelscoil Choláiste Mhuire is fifth longest in private rented accommodation on that list. According to the list, the school moved into its temporary accommodation in 2006. I understand it moved into its current building some time before that, but we will go with the Department's list. The list of schools in private accommodation shows that, of the five on the list from 2006 and before, there is a 42-pupil school, a 29-pupil school, an 80-pupil school and a 113-pupil school. Gaelscoil Choláiste Mhuire has 194 pupils. It is a medium-sized school yet, year after year the Department sees fit to keep this school in private rented accommodation, stump up €300,000 for a building that is decrepit and only made work by the amazing and wonderful efforts of the school staff and the entire school community.
Today, I hope to get assurances and cast-iron guarantees from the Minister of State with regard to how this project will commence. She might say that some of this is out of the Department's hand and that it is with the design team. That is not good enough. What is the Department doing to ensure the design team will deliver on time? What measures are being taken to ensure that whatever payments are being made to the design team will include a fine if it does not deliver on time? With regard to the tender process, originally we were told that the Department would take approximately four weeks to turn around the opening up of the tender process from when it received the detailed design. We now hear it could take eight weeks or more. What is the Department going to do to assure the school and the school community that it will prioritise and move as quickly as possible on the opening up of the tender process?
Finally I understand that in correspondence from the design team that working from home has been given as an excuse regarding a potential slippage in the new timeline set out. We are now 20 months into the pandemic. It is simply unacceptable that anybody would use working from home as an excuse for slippage in timelines. What assurances will the Department give that the school will receive the utmost priority within the Department? Being frank, it has not received that attention up until now and the frustration among the school community, the parents and staff is at an all-time high. We need positive news from the Department.
I thank the Senator for comprehensively setting out the status of the school building project for Gaelscoil Choláiste Mhuire, and her views. I am sure that she will appreciate that I am taking this matter on behalf of the Minister, Deputy Foley, and I will convey the Senator's contribution to the Minister.
The Senator will be aware of the fact that this project is included in the Department's construction programme that is being delivered under the national development plan. The project brief is to provide a new 16-classroom school on a site that has been purchased by the Department from Dublin City Council. The new school building will abut and be directly connected to the listed building on the neighbouring site that is occupied by Youth Work Ireland, YWI.
I understand that there was a meeting between Youth Work Ireland and the Department's technical teams on 5 October on the relocation of an air vent and replacement of the existing YWI boiler room. Youth Work Ireland undertook to revert with a worked-up proposal, including costs, on or before 22 October. This proposal was delayed as YWI's technical team awaited confirmation from Bord Gáis concerning the proposal but it was received last week. The Department has approved this proposal in principle and has agreed to cover the costs to relocate the boiler room.
I understand that there are ongoing conversations with the school on a regular basis. The Department met representatives of the school on 4 November and provided an outline of the programme and timelines. The Department also met the full design team on 10 November and provided an update to the school thereafter. The design team has now committed to submitting the stage 2(b) report to the Department by the end of January 2022 with a target date to commence tendering for a main contractor by the end of quarter 1 of 2022. The target to have a main contractor start construction would then be by the end of quarter 3 of 2022.
Required statutory approvals need to be lodged to give effect to amendments to a right of way agreed with Youth Work Ireland. It would be preferable if the lodging of these planning applications by the Department's design team and Youth Work Ireland happened in close proximity. The Department's design team lodged its application on Tuesday, 7 December. The Department and its design team will continue to liaise with Youth Work Ireland regarding the lodgement of its planning application.
Agreed changes on the right of way will also need to be given effect in a formal legal document. The Department has commenced the process to progress this through Office of the Chief State Solicitor in parallel with the completion of stage 2(b) and the tender process to appoint a construction contractor. The Office of the Chief State Solicitor will also liaise with the legal representative of Youth Work Ireland to progress this process.
In November, the school submitted an application for an emergency works grant on electrical wiring in its current building. I understand that the school has been approved for the necessary funding, under the emergency works scheme, to carry out the works.
I have noted what the Senator said in terms of the fact that the Gaelscoil is a medium-sized school with 194 pupils, that it has one of the longest waiting times and is placed fifth on the waiting list.
I understand and appreciate her comments around working from home. I am not sure where that comment came from but I will pass it on to the Minister.
I hear the Senator's frustration in respect of this matter, in particular the fact that it is 17 years since this school was promised and the fact that a sod was due to be turned and so commence building in November 2021.
I have outlined the information that the Department has given me in terms of the steps that are involved. I understand that there is a further meeting due to take place with the school on Tuesday, 14 December, which is relatively soon. I hope that things will progress at a pace from now on.
I thank the Minister of State. I am conscious that she has had to convey the situation of the Department when the matter does not strictly come within her remit.
I am more worried now on foot of this written response from the Department than I was when I made my opening contribution. First, the reply seeks to pin the delays on the negotiations with Youth Work Ireland. It is very clear that the issue with Youth Work Ireland concerned 1% of the site, so the design team could easily have worked on the remaining 99% of the site. There has been a failure in this response to deal with the reality of the situation, which is that there has been a failure to progress the bulk of the design for the school building.
Second, we have not heard an assurance with respect to the timelines or how the Department proposes to work with the design team and, indeed, the tender process. I ask the Minister of State to seek assurances from the Minister, Deputy Foley, in that regard because that is what the school needs right now.
I note the comments made by the Senator and I will relay them to the Minister.
To be clear about the tender process, there is a target date to commence tendering for a main contractor by the end of quarter 1 of 2022. That will be over the next few months.
I appreciate that there have been delays and I have outlined some of the reasons for the delays. Things need to progress at speed now. I will convey the comments that the Senator made about the negotiations with Youth Work Ireland.
There are and have been a number of conversations with the school. The next meeting is on 14 December where I hope that things can be collaborated on, particularly the synchronisation of the rights of way and planning applications. Everything should be done in parallel rather than sequentially, which means that things can happen at a pace.
General Practitioner Services
I welcome the Minister of State at the Department of Health, Deputy Feighan, to the Chamber and thank the Cathaoirleach for choosing my Commencement matter.
I raised this topic in October 2020 with the Minster of State's ministerial colleague, Deputy Butler, who was here on behalf of the Minister for Health, Deputy Stephen Donnelly. I mentioned the Westdoc service that covers the general area of Moycullen, Rosscahill, Oughterard and the outskirts of Galway city. On that occasion I mentioned that when GPs are on call, they are on call for 48 hours every fourth weekend and every fourth night, as well as providing full weekday services. My concern was the inability to get a new doctor in Oughterard and one of the reasons is the pressures of work. Despite a willingness of doctors to join the Westdoc service, the funding was not provided. At that stage the Minister of State said that she would raise this matter. She also said that she found it strange that where there is a shortage of doctors, they find it difficult to access a co-operative.
A sum of €3.9 million was provided through a service level agreement with the HSE and community healthcare organisation, CHO, 2 in 2020. A number of weeks ago, Mr. Paul Reid and Ms Anne O'Connor attended a meeting of the Oireachtas Joint Committee on Health. We talked about the winter plan and acute beds, of which there are none planned for Galway. I asked what would be put in its place and said one of the areas that we are looking at is enhanced funding for GPs. Ms O'Connor, as the director of operations for the HSE, said that there would be €10 million in additional supports for GP services to support those practices and areas that come under pressure, particularly single-handed GP services. She also said that the HSE would look at enhanced GP services and cover in the west as part of the winter plan. So it is quite clear that there is a gap in service provision. There is some funding available through the HSE. As there is pressure on the emergency system in Galway, clearly there is a need. There is funding and of course this is a preventative measure that will reduce pressure on emergency departments. The winter plan is an opportunity to put in place Westdoc services for the Moycullen, Rosscahill and Oughterard area.
As I said, I raised this matter more than a year ago with the Minister of State's colleague who was speaking on behalf of the Minister, Deputy Donnelly. This is good value for money and it is an area with a growing population. While they put their own services in place, it is putting a strain and pressure on those doctors who provide a huge service to the general area and who are exceptional in what they do but who, unfortunately, are under pressure. Enhanced GP services for Westdoc, with funding from the HSE, would alleviate much of the pressure they are facing. I look forward to the Minister of State’s reply, which it is hoped will be positive based on the fact that last year the Minister of State, Deputy Butler, said there was an issue and that it seemed strange. Second, Anne O’Connor, director of operations at the HSE stated that funding is available under the winter plan for those areas that would be under pressure. I would expect that the Moycullen, Roscahill and Oughterard area could be looked after with enhanced Westdoc funding.
I thank the Senator for raising this issue. General practice is at the heart of primary care, and a robust general practice and GP out-of-hours service is essential to the delivery of primary care health services. As the Senator will be aware, GPs are required under the General Medical Services, GMS, to make suitable arrangements to enable contact to be made with them, or a locum or deputy, for emergencies outside of normal practice hours. Most GPs meet this obligation through GP out-of-hours co-operatives that facilitate the provision of GP services outside of normal surgery hours. The Westdoc co-operative provides out-of-hours GP services in Community Healthcare West, covering counties Galway, Mayo and Roscommon. It is acknowledged, however, that the Westdoc service does not extend to certain rural areas within the region. This mainly refers to GPs in east and west Galway who are not members of Westdoc. The four GPs in Moycullen, Roscahill and Oughterard are not Westdoc members. As such they operate a rota between them in respect of the out-of-hours cover.
While GP out-of-hours co-operatives are private entities, the HSE provides substantial funding to support the out-of-hours co-operatives, covering a wide range of costs. Since the emergence of the Covid-19 pandemic, the HSE has provided out-of-hours co-operatives with a support grant to ensure continuity of care. In addition, the HSE continues to support GP practices and out-of-hours services through the provision of personal protective equipment, PPE, supporting safe service provision in the context of Covid-19. HSE funding for Westdoc is provided through a service level arrangement with HSE Community Healthcare West. In 2021 and 2020, the organisation received approximately €4 million in funding from the HSE. Also in 2018, HSE primary care operations allocated an additional sum of €150,000 for the provision of extra staffing for the Westdoc GP rota to extend weekend cover in north and south Connemara and Achill. However, specific requests for funding for out-of-hours co-operatives must be looked at in the context of the availability of resources and the competing demands for health service funding generally.
The workforce issues facing general practice in certain areas, in particular rural areas, are well recognised by the Government. Rural GMS vacancies can be more difficult to fill as they are often single-handed practices with smaller patient panel sizes, and I thank the Senator for raising that important issue. To increase the number of GPs working nationwide and therefore improve access to GP and out-of-hours services, the Government has increased investment in general practice. Under the 2019 agreement, investment is to increase by 40% or €210 million between 2019 and 2023. Funding has been increased by nearly €144 million up to this year, and an additional €63 million will be provided in budget 2022. For this winter, an additional €10 million in funding is being provided to support general practice nationally, given the extra pressure the winter period can bring, in particular on single-handed practices. The rural practice support introduced previously has been increased under the agreement to support rural GPs and make rural GMS panels more attractive. Improvements to maternity and paternity leave arrangements and a €2 million fund for GPs in disadvantaged urban areas have also been introduced.
The continuing investment in the wider primary care sector will help attract doctors into general practice, as is evident from the increasing numbers of entrants to GP training, from 120 in 2009 to 213 in 2020, with 233 trainees enrolled this year. These actions will help sustain general practice and improve the level of care provided to patients nationwide.
I thank the Minister of State for his reply and I received much of that information last year from his colleague, the Minister of State, Deputy Butler, on behalf of the Minister, Deputy Donnelly. The Minister of State said of this winter, "an additional €10 million in funding is being provided to support general practice nationally, given the extra pressure the winter period can bring, in particular on single-handed practices". This is what the director of operations of the HSE, Anne O’Connor, said at the Committee on Health a number of weeks ago. Where will that funding be directed and can it be directed towards enhanced Westdoc services in Moycullen, Roscahill and Oughterard? That is the question I have asked which the Minister of State has not answered today on behalf of the Minister or the HSE. How will this funding be allocated? Who decides?
Galway is under pressure, there is a need for a service and GPs are willing to be part of that service. Funding of €10 million is available nationally. How can that be matched to the local need in the Moycullen, Roscahill and Oughterard area to join with Westdoc? That is the question I am looking for an answer to.
I thank the Senator for raising that question on enhanced Westdoc services in Moycullen, Roscahill and Oughterard. The Senator knows the importance of general practice as part of primary care is evident at this time. GPs are playing a critical role in combating the Covid-19 pandemic, performing additional services while continuing to provide non-Covid care. The commitment of GPs in that area to patient care is laudable and I thank them for that dedication.
GP out-of-hours services are a necessary component of general practice and the HSE provides significant funding. The Senator is asking that, when this funding is issued, his area of Moycullen, Roscahill and Oughterard will be included. I will bring that back to the Minister and we will ask the HSE to do that. It is to be hoped the Senator’s voice will be listened to on this occasion. I thank him again for raising this issue and I hope that in the coming weeks there will be a successful outcome to this.
Senator Ruane has had to withdraw her Commencement matter so we will go to Senator Malcolm Byrne.
I thank the Acting Chairman for notifying me of that in time and I thank the Minister of State for coming in to address this issue. One of the most frightening phrases I have discovered since coming into this House is being told a matter falls between a number of Departments or agencies. The issue of international students’ health insurance unfortunately is one of those that seems to fall between the Department of Health and the Department of Justice, and there is an interest on the part of the Department of Further and Higher Education, Research, Innovation and Science.
International students are important to this country, as the Minister of State is aware. They enrich the fabric of our higher education institutions and we are fortunate we have top-class higher education institutions here that can provide international education. As a result of a court challenge and case taken by the Health Insurance Authority, a student who comes to this country to study for longer than a year is deemed ordinarily resident here. The problem is he or she is no longer able to avail of the discounted health insurance of which such students, who for the most part are healthy individuals, are able to avail. This is a huge cost for international students and it has been a problem I have signalled in this House for well over a year. I have a Bill before the House which I would hope we could move to Second Stage, but rather than us having to deal with it through legislation, I would prefer that a decision would be taken on the part of Government to resolve this matter.
It is something that is of great concern to international students, the Irish Council for International Students, the Union of Students in Ireland and the higher education institutions themselves. They have all raised this as a matter of concern for well over a year. My frustration reflects their frustration that we have not been able to see a resolution from Government. It is a relatively small issue in the overall scale of things.
There are a number of potential solutions. We should be able to come to a solution to ensure students have the necessary cover while, at the same time, ensuring the cost of it is not prohibitive.
I have raised this matter with Ministers in various different Departments. I have raised it with the relevant civil servants, who, in fairness, have tried to resolve it. It is well over a year since this issue first came to public attention and I cannot figure out why we do not have an answer from the Government. I appreciate international students are not travelling to the same extent because of Covid-19 but in the new year, our higher education institutions will be encouraging international students to come to Ireland and we, as a Government, need to be clear about what measures are going to be in place for their health cover. I am disappointed this issue has been running for so long. I hope the Minister of State will be able to provide us with some information as to progress today.
I thank the Senator for his question and for the work he undertakes in supporting this sector, ensuring Ireland remains an attractive place for international students to study. It is important that every effort is made to encourage these students to make this decision and support them once they come here. I also understand that it is important for any jurisdiction to have in place certain restrictions and requirements on those people who choose to come to the State, to live or to study, and in that context, my colleague, the Minister for Justice, has policy responsibility for immigration matters. I accept that the Senator has been raising this matter for more than a year.
From my understanding of immigration policy, in order for these students to first come to Ireland, they must meet certain visa requirements, one of which is to hold health insurance for the duration of their stay. Therefore, in respect of the Senator's question as to whether there has been progress on easing this requirement, officials in my Department have been engaging with officials in the Department of Justice to explore if this requirement should be necessary for these students at all. In this regard, discussions with those officials are at an advanced stage and in the coming weeks I hope to have positive progress to communicate to the Senator.
Given that I do not have the role or the remit to speak directly on issues concerning immigration policy, I will speak on the matter of health insurance and Ireland's community-rated system of health insurance, as it is directly within my remit and policymaking role. As the Senator will be aware, we have a voluntary, community-rated market in Ireland. This means that there is no requirement for any person to procure private health insurance under Irish health insurance legislation. A community-rated market means that when someone does decide to purchase health insurance, they are not risk rated and, therefore, are not discriminated on the basis of age, gender or health status. This is long-established Government policy and it ensures that health insurance policies are affordable for everyone. It is legislation with which we can all agree.
To maintain this policy of community rating, and under the Health Insurance Acts, any person who is ordinarily resident in the State and purchasing private health insurance must buy a community-rated health insurance policy from a registered insurer. This ensures the products these consumers are buying are regulated by the independent regulator of health insurance, the Health Insurance Authority. Providers who sell health insurance to consumers must also comply with the provisions of the Health Insurance Acts, which include open enrolment, community rating, lifetime cover and minimum benefits.
Irish health insurance legislation does not currently contain any reference to persons who are required to hold health insurance. This requirement is a part of a person's visa checklist when they are preparing to come and stay in this country, and the policies and procedures around visas are not within my policymaking remit or that of my Department.
I again thank the Senator for his question and commend his work in this area, ensuring these students continue to come to Ireland to study and are supported appropriately once they are here. As I said, there are new works in the Department and I hope we will be in a better position in a few weeks.
I appreciate the Minister of State's answer. Part of the difficulty I had in tabling this question was whether to direct it to the Department of Health or the Department of Justice. My worry, if I had tabled it to the Department of Justice, was that Department would say this is a health insurance matter. I appreciate the answer the Minister of State has given but the reality is that it comes back to buck passing between the two Departments. I do not care which Department is responsible for it. I know the Department of Further and Higher Education, Research, Innovation and Science wants to move on this issue as well. I want the issue sorted. I put the question to the Department of Health because when I spoke to different Departments, I kept being informed that this is a matter for that Department. I had discussions with the Minister of State's colleague, the Minister of State with responsibility for insurance, Deputy Fleming, and he told me this is clearly a matter for the Department of Health. At the end of the day, I understand the Minister of State, Deputy Feighan, is saying advanced discussions are ongoing, but we have been waiting for more than a year. I ask him to have good news for us before Christmas.
I again thank the Senator again for his contribution and for raising this important issue. As outlined in my opening reply, this issue concerns international students coming to study in Ireland who are required to adhere to particular immigration visa requirements, one of which relates to having private health insurance. I repeat that it is not within my policymaking role within the Department, as the Senator said. Officials in my Department have been engaging with officials in the Department of Justice to see if this requirement should be necessary for these students at all. It is good that those discussions are at an advanced stage and, in the coming weeks, I hope to have some positive progress to communicate to the Senator. Perhaps in two months, or certainly at some time next year, this issue will be resolved.