Seanad Éireann debate -
Wednesday, 9 Mar 2022

Vol. 283 No. 8

Nithe i dtosach suíonna - Commencement Matters

Victim Support Services

Senator Maria Byrne

I thank the Minister of State for taking this important matter. I thank the Minister for Justice, Deputy McEntee, and the Minister of State for their work and commitment in this area. So much has been done on gender-based violence, especially towards women. I am grateful for all the work they have done and I am grateful that it is a priority. It has been spoken about a great deal in both Houses in recent times.

Senators will be aware that many victims of gender-based crime find it difficult to report it when something happens. I have found this is especially true if there is a language barrier. I have been working with a company in Limerick that worked with the Department of Justice when it was part of the EU inHERE project, on the basis of which it developed its continuous professional development, CPD, accredited training for interpreters. So many interpreters are coming to Ireland. With refugees coming here as well, we are going to have to depend so much on people being able to break down the language barrier. While some of the refugees who will come here will have English, not all of them will. As a result, the matter I raise is important.

Women's Aid reported that calls from non-English speakers through its multi-language helpline increased by 90% in 2020 in comparison with 2019. That is a big increase. Of all of the minority groups who sought help from Women's Aid, 93% were migrant women, which is a very high number. Apart from Women's Aid, many other Irish organisations deal with non-native English speakers in the context of sexual violence.

I look forward to hearing what the Minister of State has to say. This is an issue which needs to be highlighted more.

Minister of State at the Department of Justice (Deputy James Browne)

I thank the Senator for raising this important matter regarding the commitment relating to the barriers facing non-fluent English speakers reporting sexual or gender-based violence. The Senator has been very much to the forefront on this matter, not only in this Chamber but also behind the scenes in working with the Department of Justice, the Minister, Deputy McEntee, and other Departments. The Minister is determined to do everything she can to combat all forms of domestic, sexual and gender-based violence. This has been a priority area for the Minister since taking up this post and she has the full support of the Government.

Becoming the victim of any kind of crime can be a deeply traumatic experience. This is especially true in the context of offences linked to domestic, sexual and gender-based violence. It can be incredibly daunting to enter a Garda station or criminal court for the first time. This can be intensified for the members of marginalised communities, particularly when barriers such as language and-or feelings of disenfranchisement may exist. The Department of Justice is working on a number of initiatives to support victims in order that when they engage with the system, they will know what to expect, what their legally enforceable rights are and what supports are available at every step in the process. Language or any other barrier should not get in the way of this.

The Department is in the process of developing actions to reach all communities in Ireland, including translating the posters and leaflets used to raise awareness of rights under the Criminal Justice (Victims of Crime) Act 2017 into other languages commonly spoken among Ireland's immigrant communities. This year, the Department will launch two campaigns, in partnership with the Dormant Accounts Fund, expanding awareness-raising activities of victims' rights and on the topic of consent to reach marginalised communities. The Department will do this by working with community organisations to adapt various assets and resources in culturally appropriate ways. I know An Garda Síochána is very aware of the difficulty language barriers can present when someone is seeking justice. If someone who is not fluent in English or Irish presents to gardaí, a free interpreter service will be provided in order that the person will receive the same quality of service, as far as possible, as any other victim of crime. An Garda Síochána's victim information booklet is currently available in 39 different languages, as well as in braille and audio versions. The Legal Aid Board provides a free legal advice service to victims of human trafficking and complainants in rape and certain sexual assault cases, which can include interpretative services where required. Interpretation is provided in criminal cases if directed by the court. The Department of Justice has also put in place victims of domestic violence immigration guidelines. The guidelines rightly state that no one should have to suffer domestic violence and recognise that migrants may have additional vulnerability in this area, as the perpetrator may threaten a victim with the loss of their status if they report the abuse.

Support services also do incredible work in trying to support people whose first language is not English. Women's Aid, which runs the national domestic violence helpline, offers a telephone interpretation service facility that covers 200 languages for callers needing support in their own language. The Dublin Rape Crisis Centre provides similar on its national sexual violence helpline.

I thank the Senator for raising this important topic and I reassure her that it is a focus for the Government. While there are services in place to support non-fluent English speakers in reporting domestic, sexual and gender-based violence, the Minister is committed to increasing the supports available to better support this particularly vulnerable group. At the end of last year, on foot of a mapping exercise carried out by the Department, the Minister made additional funding available to 18 organisations that support victims of domestic and sexual violence. This was provided to address gaps identified both in terms of the geographical availability of services and in services provided for specific categories of victims. The Department will be keeping this under review and will fill any future gaps identified in order that all victims in every part of the country will receive the supports they need to access the justice they deserve.

Senator Maria Byrne

I thank the Minister of State for that detailed response. Translit in Limerick provides a training course for many interpreters in the context of the sensitive nature of this issue, and it is my understanding that it is the only company that does training in this regard. The Minister of State indicated that the Department is keeping this matter under review and is looking at different ideas. There are organisations like Women's Aid, the Mid-West Rape Crisis Centre and many others to which women can turn for help. However, if people are to be interpreters, they need training, which is something the Minister of State might take back to the Minister. It is such a sensitive area that interpreters have to be taught how to handle it in a very sensitive way in order to make people feel comfortable about reporting.

Deputy James Browne

I again thank the Senator for raising this very important matter. I hear her point in regard to how sensitive these issues are. Those dealing with very vulnerable people need to understand how to deal with those situations in a very sensitive manner.

As the Senator will be aware, the Minister is leading on the development of a new whole-of-government strategy to combat domestic, sexual and gender-based violence. The goal of the strategy is zero tolerance for violence against women, and it recognises that added vulnerability of certain groups of women, including women in marginalised communities and migrant women. Separately, the Minister continues to work to implement all 52 recommendations of the O'Malley review, which looked at the journey a victim faces from the moment a crime is committed against them, to the initial reporting of the offence and right through to the end of any court proceedings and beyond. Their implementation will make our criminal justice system one that protects and supports vulnerable victims.

These initiatives include a campaign to raise awareness of the rights afforded to people under the victims of crime Act of 2017. This will include information being translated into a number of languages outside Irish and English that are commonly spoken in Ireland. The Department of Justice will soon be inviting partners to a newly established victims forum for State, social and community groups, including groups working for and representative of marginalised communities. The University of Limerick has been tasked with developing the framework for the operation and training of intermediaries who will partially facilitate communication with vulnerable people in the justice system in order to provide the best evidence possible. A nationwide roll-out of the divisional protective service units has been completed to ensure victims of sexual violence are met with respect, professionalism and compassion.

I again thank the Senator for raising this important topic. I reassure her that this is a priority focus for the Government.

Foreign Conflicts

Acting Chairperson (Senator Erin McGreehan)

Senators Seán Kyne and Barry Ward are sharing time. I call Senator Kyne.

Senator Seán Kyne

I thank the office of the Cathaoirleach for choosing this very important matter for debate. I welcome the Minister of State, Deputy Malcolm Noonan.

We see before our eyes the tragedy unfolding across Ukraine, where, a fortnight ago, people were living their lives, perhaps in trepidation and fear, but as normally as possible in their own country. Now, we see people leaving in their thousands and becoming refugees across Europe, including here in Ireland. Some 2,200 Ukrainians have arrived since the visa requirement was lifted on 25 February, many of them to come to live with family who are already in Ireland. It is important that the Irish State welcomes them, supports them and keeps them safe for as long as they need to be here. It is fair to say that many of them would wish to go home to their own country eventually and, hopefully, that can be soon, if it is safe to do so and if the war ends in a timely fashion.

Tá spiorad agus flaithiúlacht mhuintir na hÉireann le feiceáil agus iad ag cur cúnaimh agus maoinithe ar fáil chun cabhrú leis an gCros Dhearg agus le gníomhaireachtaí eile san Úcráin. Is iontach an rud é tairiscintí agus spéis na ndaoine ar fud na tíre lóistín a chur ar fáil ina dtithe féin ach ní haon ionadh é. Tréaslaím leis an gceannaireacht ón Rialtas agus ón Aontas Eorpach ar an tragóid seo san Úcráin.

Tá daoine a bhí ina gcónaí ina dtír féin coicís ó shin anois ina dteifigh trasna na hEorpa. Is é an rud is mó a theastaítear anois ná sábháilteacht do na daoine seo, go háirithe mná agus páistí agus na fir fágtha ag troid ar son na hÚcráine.

The Government is working hard to ensure that people get personal public service, PPS, numbers, rights to work and so on. It is important that we see the generosity of spirit of Irish people in pledging their support for families.

Senator Barry Ward

Gabhaim buíochas leis an gCathaoirleach Gníomhach agus cuirim fáilte roimh an Aire Stáit. Tá an-bhród orm as an méid atá á dhéanamh ag Rialtas na hÉireann faoi láthair. Is uafásach na heachtraí atá ar siúl san Úcráin. Táimid bródúil as an méid atá á dhéanamh ag an bpobal, ag muintir na hÉireann, ar son muintir na hÚcráine. Sular tháinig mé anseo, bhí mé ag caint le hambasadóir na hÚcráine, a bhí anseo i dTeach Laighean. Bhíomar ag iarraidh rud a dhéanamh le Cros Dhearg na hÉireann chun cabhrú. Bhí sí ag labhairt linn faoi na heachtraí atá ar siúl faoi láthair. Mar a dúirt mé, táim bródúil as an méid atá a dhéanamh againn.

As much as we can do, it is very important. All of us support what the Government is doing. These strong measures will hopefully yield strong results. It will not solve the problem but it will help the people who come to Ireland. The aid that is coming through here will also help the people in Ukraine. Earlier, the Irish Red Cross told us that it anticipates raising €20 million for Ukraine. It is an extraordinary amount. It is an extraordinary crisis.

I hope the Minister of State can allay our fears that we can cope with the people who are coming here and that, as Senator Kyne said, we will put in place all the things needed to support those people to ensure that they can come here and for the time that they are here, continue their lives in as normal a way as possible however awful and difficult it might be for them. I hope we will put at their disposal the facilities of the State the same as they would be available to any European Union citizen.

I welcome the announcements already made in relation to PPS numbers, health provision and education provision. Can the Minister of State give us any greater detail on what will be available to them?

Minister of State at the Department of Housing, Local Government and Heritage (Deputy Malcolm Noonan)

Gabhaim buíochas leis an gCathaoirleach Gníomhach agus leis na Seanadóirí.

Like Senator Ward, I share that pride that we have in the response of the Irish people and the Government. It has been really touching. We attended an event this morning with the Ukrainian ambassador and ambassadors of other countries and it was chilling to hear the testimonies coming out of Ukraine at present. It is an unjustifiable war; an attack on a sovereign state. Our thoughts and prayers are with those fleeing the war and those who are caught up in it because, as the former Minister, Mr. Pat Carey, said this morning, it looks like it could be a protracted war. We will have to continue these supports.

In Ireland, we are responding. I spoke to the Minister of State at the Department of Justice, Deputy James Browne, about driving licences and this morning, Deputy Ó Cathasaigh raised the issue of education in terms of integrating into the education system. There is a whole-of-government response happening. We are having to think on our feet. We are having to act quickly and adapt. We can take great collective pride in the fact that we are responding rapidly to what is a fast-moving and truly tragic situation.

On 4 March 2022, the European Council adopted unanimously the implementing decision regarding the temporary protection directive due to the mass influx of persons fleeing Ukraine as a consequence of this war. This will allow Ukrainian citizens and others fleeing Ukraine to avail of supports throughout the EU. I want to emphasise to the House that people arriving from Ukraine have been granted the status to avail of income supports from the Department of Social Protection under the EU temporary protection directive.

The Minister for Social Protection, Deputy Humphreys, and her officials have an excellent record in reacting quickly and appropriately to emergency situations and this was clear from the way they responded to provide emergency income throughout the pandemic.

The immediate priority for the Department of Social Protection will be the allocation of personal public service numbers, PPSNs, and the provision of immediate financial supports. A fast-track approach in processing these supports will include a simplified decision-making process and quick processing of PPSNs to allow access to public services that will be provided to people arriving here.

People will be eligible for financial support initially under the supplementary welfare allowance scheme. Under the temporary protection directive, Ukrainian citizens and others fleeing the war will satisfy the habitual residence condition, HRC, and the relevant associated means test.

The aim of the Minister, Deputy Humphreys, and that of her Department is to ensure that applications for supplementary welfare are processed as quickly and efficiently as possible to provide immediate financial assistance to these people. The Department of Social Protection will also arrange for payments such as child benefit to be made within a very short period.

The Department of Social Protection is working closely with the Department of Justice, which is responsible for providing such people with letters or certificates confirming that they are covered by the EU directive. From today, officials from both Departments will be based in Dublin Airport to meet people arriving from Ukraine and they will ensure that temporary protection permission letters and PPSNs are allocated, and the appropriate financial supports are provided. The Department of Children, Equality, Disability, Integration and Youth will lead on the provision of accommodation for those arriving in Ireland. All Departments will keep this position under regular review, in particular, to provide for people entering through other airports or ports. As the Senators will be aware, the Department of Social Protection has a network of Intreo offices around the country and they will be used to help people from Ukraine during their stay in this country. It could be a short period. It could be a much longer period. We do not know this yet.

For those people who have already arrived in Ireland, they will be invited into Intreo offices so that they can be provided with a PPS number and the appropriate financial supports. The Department is putting arrangements in place to provide information in the English, Ukrainian and Russian languages.

I know that the people of Ireland will support these people as they settle into our country, the generosity has already been quite overwhelming, and that they can help to rebuild their lives in our country. It is something that we are good at. It is something we do well constantly in time of crisis. We proved this during the Covid pandemic. Certainly, the Irish people will not be found wanting on this occasion as well.

Senator Seán Kyne

I thank the Minister of State for the comprehensive response. It is quite clear that the Government is doing all it can. It is acting proactively and quickly.

Of course, we are dealing with vulnerable people who have been through a trauma, who are leaving family and loved ones behind and who have seen their lives destroyed. They are particularly vulnerable to individuals who may not have their best interests at heart. That was evident in previous situations in this country in the past when people arrived here during the 2000s. It is important that there is a port of call - a first stop-off for people at the airports - in order that they can get that assistance and be told what is available for them and the supports that are put in place, and they have somewhere to go such as the Intreo offices.

The generosity of spirit of the Irish people is coming to the fore in terms of providing assistance. I am confident that will continue over the coming months and, if needs be, depending on how long this tragedy and this awful war lasts, years.

Senator Barry Ward

Ba mhaith liom a rá go bhfuil an-mhuinín agam de bharr an mhéid atá ráite ag an Aire Stáit.

The description of a whole-of-government response is tremendously important. I welcome commitments the Minister of State made to having people in the airports available to meet people as they come off planes because, as has been said already, they will be in a distraught condition in no uncertain terms.

I hope that we can extend that famous céad míle fáilte to them in every respect and accommodate them in every way that we can as they come here. It is the least that we can do. It is the least that we would expect to be done for us if the shoe were on the other foot. I welcome the moves and I look forward to delivery of those commitments from the Government.

Deputy Malcolm Noonan

I, again, thank both Senators for raising this. It is important we continue to respond, as I said, as this evolves.

We are in a wartime scenario. As a State, we are putting in place measures to ensure that people of Ukraine who are seeking refuge here will receive all the support they require. They will need psychological and other supports as well and this is something we have to respond to.

I acknowledge the important role that is being played by the NGO sector in responding to this humanitarian crisis. They will play a significant role in the coming months to provide supports across a range of areas for those needing assistance. The Irish Red Cross has stepped in to play a key role. I am deeply grateful to it, as we saw this morning with Mr. Pat Carey, as well as the fantastic response of the Irish League of Credit Unions.

The Department of Social Protection will work with the NGOs in assisting Ukrainians who are arriving here to ensure that those who require assistance from the Department will get it. The Department is already working with some of the NGOs, such as Crosscare, and will continue to do so in the weeks and months ahead.

I thank both Senators for raising this. I am overwhelmed by what has happened within a very short period of time. Within two weeks, due to the financial support, we see convoys leaving Ireland at present. Twenty million euro was the figure Mr. Carey mentioned this morning from the Irish Red Cross. That is phenomenal generosity. The Government will not be found wanting either. As this crisis will unfortunately deepen, we will continue to respond in a compassionate and humanitarian way.

Wildlife Regulations

Acting Chairperson (Senator Erin McGreehan)

Our third matter is from Senator Ahearn. I am very interested to hear the reply to this one. I thank the Senator for raising it.

Senator Garret Ahearn

I thank the Minister of State for coming to the House to take this important matter. This is slightly off topic, if the Chair will allow me, but I wish to thank him for the announcement this week on the built heritage investment scheme. He has given €10,000 to Knocklofty House in my parish. He met the group Save Knocklofty House. He committed to supporting it and he has now done that. On behalf of the people involved, who are very grateful, they wanted me to thank the Minister of State for supporting them. This will go a long way to protecting that building. The Minister of State might be able to expand on it if there are measures he can take in the future to support it. I thank him for that.

I visited the Ardfinnan-Ballybacon-Grange-Newcastle, ABGN, Gun Club recently on top of the beautiful Knockmealdown Mountains. I met with a number of its members in regard to heather mulching activities on the mountain. The club's red grouse conservation project is considered vital work by the club's members, of whom there are nearly 100. Since its inception in 2004, red grouse numbers have increased by more than 30%. The club's honorary treasurer, Mr. Pat O'Sullivan, and its members believe that ensuring young heather is available to the grouse is probably the most impactful work they can do in order to ensure the grouse's successful breeding and continued presence on our lands.

The preferred method of clearing old heather for new is that of controlled burning, an activity in which ABGN Gun Club has invested, for more than 18 years, a huge amount of its time and resources with great success. Club members' success has generated much interest over the years, and they have hosted representatives of the National Parks and Wildlife Service, Teagasc and the Irish Red Grouse Association on the mountain to witness the work they have done.

While they have had success in increasing the grouse population, the work is not without its challenges. Strip burning of heather to provide suitable habitat in terms of food and shelter for grouse to flourish is highly weather dependent. Since 2014, the club has not been able to undertake a burn due to the weather at weekends, the time at which members are mostly available to do this work because it is voluntary. It is for this reason that the club members have experimented with other heather management techniques. These techniques are less susceptible to disruption due to the weather but are, unfortunately, much less effective in providing a suitable habitat for grouse when compared with controlled burning. It is also very expensive. The machine they got, which I saw last week, cost €3,000. There is a great guy, Richie Long, who does it and is doing great work, but it is expensive and they have to cover the bill for that.

The current window for burning, 1 September to 28 February, is unduly restrictive, particularly when compared with our EU neighbours, whose windows extend to 15 April. A similar window here, or the ability to apply and be granted a derogation for conservation purposes, would greatly aid the voluntary work they do on the mountain. As per the Wildlife Act 1976, and the amendment made to the Act in 2000, it is not permissible to burn vegetation between 1 March and 31 August. The window to burn is between September and February but, in reality, it is only after Christmas that burning is recommended. There are a number of reasons for this. If the summer is good, the peat under the heather burns too easily, which is something one never wants. The heat of the burn helps dormant seeds to germinate. If this is done before Christmas, the seeds are open for too long and succumb to harsh weather as winter progresses. A heavy snow over winter will cover all but the tallest heather, reducing the food available to the grouse. As a result, it is better to wait until the snows have passed, which is normally in January or February. Consequently, there are only a number of weeks during which this work can be done. If there is weather like we have had in recent weeks with storms coming through, those involved really do not get any time to do this. They can only volunteer to do the work at weekends and can only do it in January and February. They are constrained in the context of time. I am interested in the Minister of State's response to see if there is something the Government can do to help them.

Deputy Malcolm Noonan

I will come back to the Senator on Knocklofty House in my summary.

In the context of the matter before us, I met with a number of gun clubs, the National Association of Regional Game Councils, NARGC, and other organisations involved that are representing the gun clubs. I recognise the important role they play in conservation, particularly of the red grouse, a very important species.

It has long been a common agricultural practice in Ireland to occasionally burn vegetation growing on uncultivated land, especially on upland farms. Much of the vegetation burned comprises gorse and mature heather. Light burning can remove old growth and, as the Senator said, stimulate new growth. The aim of such burning is to improve grazing and access for livestock. Fire was also often used in the past to dispose of waste arising from hedge and tree cutting. The burning of such dead vegetation as waste is regulated by laws concerned with air quality rather than with wildlife protection, and such law is not the responsibility of the Department of Housing, Local Government and Heritage.

The first Wildlife Act was enacted in 1976. Section 40 of the Act prohibits the burning of "vegetation growing on any land not then cultivated or in course of cultivation for agriculture or forestry" during the period beginning 15 April and ending 31 August. Subsequently, it was noted that birds began to nest earlier than before. Accordingly, the Wildlife (Amendment) Act 2000 restricted period to begin on 1 March. It also removed the wording "or in course of cultivation for agriculture or forestry".

The dates of the restricted period for the burning of living vegetation were reconsidered in 2018 and this led to the enactment of the Heritage Act 2018. Section 7(1) of the Act empowered the Minister with responsibility for natural heritage to make regulations that could allow the burning of vegetation during the month of March "in such part or parts of the State as specified in the regulations", notwithstanding section 40 of the Wildlife Act 1976. No regulations were made on foot of that power. Section 7(4)(a) of the 2018 Act provides that section 7 would expire two years after the enactment date unless continued by a resolution by each House of the Oireachtas. As no such resolution was passed, section 7 of the 2018 Act expired on 17 July 2020. The position now is that there is no provision allowing for the alteration of the dates of the restricted period as set out in the Wildlife Act 1976, as amended. Any such changes would require an amendment to the Wildlife Act 1976. However, it is my intention to review and strengthen our wildlife laws, including the Wildlife Act 1976.

On the issue of burning living vegetation, while I am aware of the arguments for and against a change of dates, I have no plans at present to propose any change to the statutory dates. I recommend that all stakeholders involved should establish a forum, which I mentioned previously. It might be for the Department of Agriculture, Food and the Marine to lead on. It is important that stakeholders, such as those involved in hunting, landowners, upland-hill farmers, fire services, etc. come together in a forum where these matters could be teased out further. It is critically important that we have a broader conversation. I do see a conservation role here, but I encourage the setting up of an initiative that would bring stakeholders together under some kind of a task force that could look at upland burning and its role in the management of our hills and uplands.

Senator Garret Ahearn

I thank the Minister of State for his response . I agree with him. The Department of Agriculture, Food and the Marine should play a greater role in this. The Irish Farmers Association, IFA, has taken this onboard in Tipperary. We have very good members in the gun club, including Pat O'Sullivan, who I mentioned earlier, Robert Phelan and Brendan McGill. There are almost 100 members and they do incredible and fantastic work. If a body is set up, perhaps the Department of Agriculture, Food and the Marine would take a role. The amendment of 2000 was on the back of research done which showed that birds were nesting earlier than before, and that was why the date was put back. There is certainly a strong argument being made by the group and the IFA that birds nesting in 2022 are nesting later than they did in 2000. That should be looked at as part of the review to see if that is the case. If it is the case, perhaps something could be done on the back of it.

I thank the Minister of State for his response. I agree with and would be supportive of the setting up of such a forum. I know the ABGN Gun Club would support that as well, because its members are best placed compared with anyone else to look after that land. They know it well and they love it.

Acting Chairperson (Senator Erin McGreehan)

I will add my tuppence worth in respect of the Cooley Mountains and the Cooley uplands farmers association, about which I have spoken to the Minister of State. We need an upland management programme that deals with invasive species, the protection of the heathers and the beauty of the biodiversity that exists. We have a great resource and we are not managing it correctly. I welcome this Commencement matter. The answer to it was great.

Deputy Malcolm Noonan

I welcome both comments. I was in the Cooley Mountains last week with an upland farmer. I met the Brandon Hill farmers and people involved in the Blackstairs EIP, European Innovation Partnership, project; they are fantastic people doing really important work. They need to be supported to do that. An initiative like this would be able to tease out all those issues and have a really good conversation on the best way to manage our uplands in a sustainable way. I would suggest that perhaps the Department of Agriculture, Food and the Marine would be a more appropriate lead. Certainly, we would play our part in such an initiative but it is critically important. These people are volunteers and they do important conservation work. We would like to support them in that way.

To return to Knocklofty, I am delighted that the built heritage investment scheme was able to support that. I would encourage the stakeholders involved in Knocklofty to look at our grant schemes and to look at a longer-term conservation plan for the project. The Department has really good grant schemes and if initiative is shown around a long-term strategy for Knocklofty I do not think any of us will be found wanting in support for having such an important built conservation project on the books.

General Practitioner Services

Senator Martin Conway

I welcome the Minister of State back to the House and thank her for taking this Commencement matter. Shannondoc is a community healthcare service, a co-operative of doctors as it were, in the mid-west region to provide out-of-hours service. We can recall how years ago, doctors were on call all the time. It could be 6 p.m. or 8 p.m. it did not matter; doctors were still on call. In order to give doctors a quality of life and to improve the quality of service, and to ensure that there was a service, the doctors came together and created Shannondoc. That has been emulated around the country. To be fair, the Governments stood up to the plate and did provide resources to support the community out-of-hours doctors initiatives around the country. However, while in some areas they have worked extremely well, in others they have been average or extremely poor.

The experience of Shannondoc in my area has been mixed. The doctors who work in it when they are available are very committed and do a very good job. They can take the pressure off our emergency departments. The problem is that the Shannondoc service has been consolidated and it has been curtailed and cut back to such a degree that there are real challenges to the provision of services. There was a time when there was a Shannondoc facility just outside the towns of Ennistymon and of Kilrush and in other areas. However, that has been consolidated and I believe that Miltown Malbay is the only facility that Shannondoc is providing in west Clare. That is a challenge.

There has been Covid and other things but the Minister of State will be very aware of the enormous challenges to the emergency department in University Hospital Limerick, UHL. It is the most overcrowded emergency department in the country. It regularly has 90 to 100 people on trolleys. Many, or at least some of them could be diverted from hospital if they were to present to a Shannondoc-type facility. We have minor incident clinics in places such as Ennis and Nenagh and so on but they close at 8 p.m. If somebody is injured after 8 p.m., it may not be life threatening but if it is something the person is concerned about, in the absence of a Shannondoc facility his or her natural reaction is to go to the emergency department in UHL. That is adding to the numbers. I know that a review of the Shannondoc out-of-hours service has been committed to. I also understand that there may be a national review on the out-of-hours service. The point is about whether we believe in primary care and in trying to care for people within their community as a first response. It may be that people need to attend an emergency department or hospital but the people at primary care level can make the decision that their care must be escalated but in many cases, they can deal with the injury at local level. The out-of-hours doctor service is a critical component of such a service. When someone is injured late at night, they can panic and worry. They may be over-panicked or worried. The out-of-hours doctor service is one which can give them reassurance and provide necessary medical interventions and maybe calm the situation, ensuring that people do not present at the emergency department's front door in Limerick. We want to avoid that where possible.

Is the review happening or has it happened? If not, when will it happen and what is the timeline for a report and recommendations for how we can improve the out-of-hours GP service?

Minister of State at the Department of Health (Deputy Mary Butler)

I thank Senator Conway for raising this issue as GP out-of-hour co-operatives are essential to the delivery of primary care health services. I thank the Senator for continuing to raise health issues in his own area in a constructive way.

As he will be aware, GPs are required under the General Medical Services scheme 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.

Shannondoc out-of-hours co-operative provides urgent GP services to patients in the mid-west region, including Limerick, north Tipperary and Clare. While GP out-of-hours co-operatives are private entities, the HSE provides substantial funding to support co-operatives through service level agreements covering a wide range of costs. Last year, the HSE provided over €5 million in funding for Shannondoc GP out-of-hours co-operative.

The HSE maintains regular contact with the co-operatives to help optimise out-of-hour service levels. Even greater engagement was undertaken to ensure that the services continued to provide the supports needed by local communities during the Covid pandemic. Since the emergence of the Covid-19 virus, the HSE provided out-of-hours co-operatives with a support grant to ensure continuity of care. Funding for Shannondoc was increased to over €6.8 million in 2020, including increased funding due to the pandemic.

Where there is increased demand in certain areas, Shannondoc can provide support from other treatment centres, to ensure services are provided where needed most. The service is demand led, and the HSE has advised that Shannondoc has continued to meet the targets for urgent and routine calls set out under its service level agreement. More generally, the Government is committed to increasing the number of GPs working nationwide and therefore improving access to GP and GP out-of-hours services across the country.

Under the 2019 agreement, investment in general practice is to increase by 40% between 2019 and 2023. Expenditure has already been increased to date by €206.6 million annually, increasing to €211.6 million per annum next year when the agreement is fully rolled out. This provides for significant increases in capitation fees for participating GPs, as well as new fees and subsidies for additional services.

The agreement also provides for improvements to maternity and paternity leave arrangements, introduces a €2 million support fund for GPs in areas of urban deprivation and increases the existing support funding for rural GP practices. The increased investment provided will increase the number of GPs working in the State and will help sustain general practice nationwide, both GP practices and out-of-hour services. The positive impact of the measures undertaken by the Government is evident from the increasing numbers of entrants to GP training, from 120 in 2009 to 233 trainees enrolled last year and 258 places will be made available this year. That is something I know everyone will welcome.

The 2019 GP agreement includes a commitment to undertake a strategic review of GP services to examine how best to ensure the sustainable provision of those services into the future. The sustainability of services is what we all want. The review will encompass a broad range of issues, including examining how best to provide for GP out-of-hours care, and will include consultations with relevant key stakeholders. The Department of Health is engaged in the preparatory work for the review which, once completed, will inform future contractual changes. I am sure the Senator will agree that over the past two years, between Covid and the cyberattack, a lot of time was lost. This review is very important and is a commitment under the 2019 agreement with GPs.

Senator Martin Conway

I again thank the Minister of State for coming to the Chamber with a logical answer to an important question. Of course, Covid has been a problem and much healthcare ended up being stalled because of it. Progress, and the incremental progress we like to see, has been challenged. The problem with Shannondoc is that on many occasions there has been no cover. That was simply down to the fact that GPs could not be got and were not available, as was the case for locums and so on. That is always a problem because the public need to have confidence that once GPs sign off on their practices, surgeries and so on, the Shannondoc out-of-hours co-operative service will kick in.

A review is good, and it should happen because it will consider the lessons where things have been done right and identify the gaps where improvements can be made. I see a review as positive and a way of incrementally improving the service as opposed to anything negative, or something the HSE or those in the services should be concerned about.

Deputy Mary Butler

I agree with the Senator that a review is a good thing. The provision of out-of-hours GP services will be examined as part of a wider strategic review of general practice for which preparatory work has commenced this year. That is welcome. I note the Senator's point that there have been situations where cover has not always been available. The agreement provides an initial €2 million support fund for GPs in areas of urban deprivation and increases the existing support funding for rural GP practices. The improvements to maternity and paternity leave arrangements are also very important for practices where there might only be one doctor. It can be very challenging if they are on maternity leave or, for example, they are out sick and it is difficult to get a locum. We await the results of the review with interest. I again thank the Senator for raising the matter.

Cuireadh an Seanad ar fionraí ar 11.23 a.m. agus cuireadh tús leis arís ar 11.30 a.m.

Sitting suspended at 11.23 a.m. and resumed at 11.30 a.m.