John Deasy
Ceist:98 Mr. Deasy asked the Minister for Health and Children if the external audit procedures of fluoridation plans have been put in place as recommended by the forum on fluoridation. [6895/04]
Written Answers
The following are questions tabled by Members for written response and the ministerial replies received from the Departments [unrevised].
Questions Nos. 1 to 12, inclusive, answered orally.
Questions Nos. 13 to 89, inclusive, resubmitted.
Questions Nos. 90 to 97, inclusive, answered orally.
Water Fluoridation.
The use of fluoride technology is known to manifest a positive oral health outcome. Local and national surveys and studies conducted since the introduction of fluoridation in this country attest to the reduced dental decay levels in children and teenagers in fluoridated areas compared with those residing in non-fluoridated areas. The safety and effectiveness of water fluoridation has been endorsed by a number of international and reputable bodies such as the World Health Organisation, the Centre for Disease Control and Prevention, the United States Public Health Service and the United States Surgeon General.
As the Deputy is aware, I established the forum on fluoridation to review the fluoridation of public piped water supplies in Ireland. The forum's report was launched on 10 September 2002, and its main conclusion was that the fluoridation of public piped water supplies should continue as a public health measure. The forum also concluded that: water fluoridation has been very effective in improving the oral health of the Irish population, especially of children, but also of adults and the elderly; the best available and most reliable scientific evidence indicates that, at the maximum permitted level of fluoride in drinking water of one part per million, human health is not adversely affected and dental fluorosis, a form of discoloration of the tooth enamel, is a well-recognised condition and an indicator of overall fluoride absorption, whether from natural sources, fluoridated water or the inappropriate use of fluoride toothpaste at a young age. There is evidence that the prevalence of dental fluorosis is increasing in Ireland.
The forum consisted of people with expert knowledge spanning the areas of public health, biochemistry, dental health, bone health, food safety, environmental protection, ethics, water quality, health promotion and representatives from the consumer and environmental areas. That diversity of professional backgrounds and representation was reflected in the comprehensive way in which the forum conducted its work and research. Ultimately the forum took an evidence-based approach to its examination of water fluoridation.
The report of the fluoridation forum made 33 recommendations covering a broad range of topics such as research, public awareness, and policy and technical aspects of fluoridation. The establishment of the expert body recommended by the forum is now well under way.
The terms of reference of the expert body are: to oversee the recommendations of the forum on fluoridation; to advise the Minister and evaluate ongoing research — including new emerging issues — on all aspects of fluoride, its delivery methods and as an established health technology and as required; and to report to the Minister on matters of concern, either at his or her request or on its own initiative.
The expert body will have broad representation, including from the areas of dentistry, public health medicine, toxicology, engineering, management, the environment and the public identified in the forum on fluoridation report. Letters of invitation have been issued to prospective members of the body. I am pleased to say that, based on the acceptances which have been received, the body will have strong consumer input through members of the public and representatives of consumer interests, in addition to the necessary scientific, managerial and public health inputs. My Department is discussing the chairpersonship of the expert body, and I expect to be able to announce a decision in that respect very soon.
I am pleased that the secretariat of the body will be provided by the Irish Dental Health Foundation, an independent charitable trust which has been very much to the fore in securing co-operation between private and public dentistry and the oral health care industry regarding joint oral heath promotion initiatives. The foundation's stature and expertise place it in an excellent position to support the work of the forum in its initial stage. As the House is aware, the forum's report envisages that the work of the expert body may be subsumed into the health information quality authority in due course. The support of the foundation allows us to press ahead now with the establishment of the expert body in advance of the establishment of HIQA. Indeed, I understand that the intention is to have an inaugural meeting of the expert body in early April.
The expert body will oversee the implementation of the wide-ranging recommendations of the forum — including the one to which the Deputy referred — and advise me on all aspects of fluoride; in particular, ongoing research related to fluoride will continue to be evaluated by the expert body and expanded to deal with emerging issues.
Cancer Screening Programme.
Michael Noonan
Ceist:99 Mr. Noonan asked the Minister for Health and Children the current status of BreastCheck for the western area; and if he will make a statement on the matter. [6911/04]
Brian O'Shea
Ceist:168 Mr. O’Shea asked the Minister for Health and Children his views on the proposal lodged with his Department in June 2003 by BreastCheck to extend its services nationwide; the likely completion date for the rollout of BreastCheck; and if he will make a statement on the matter. [7071/04]
I propose to take Questions Nos. 99 and 168 together.
The national breast-screening programme commenced in March 2000 with phase one of the programme covering the Eastern Regional Health Authority, Midland Health Board and the North Eastern Health Board region. Last year I announced the extension of the BreastCheck programme to Counties Carlow, Kilkenny and Wexford and also the national rollout to the southern and western counties. The national rollout of BreastCheck requires detailed planning to include essential infrastructure.
The BreastCheck clinical unit in the western area will be at University College Hospital, Galway, with two associated mobile units. The area of coverage is Counties Galway, Sligo, Roscommon, Donegal, Mayo, Leitrim, Clare and Tipperary NR. The BreastCheck clinical unit in the southern area will be located at South Infirmary, Victoria Hospital, with three associated mobile units. Counties covered include Cork, Kerry, Limerick, Waterford and Tipperary SR.
Two project teams, one in each region, have been established to develop briefs for the capital infrastructure needed for the static units in the south and west. For the southern region, the South Infirmary considered it necessary to commission a site strategy study to ensure the integration of the breast-screening service into the present and future development of the hospital. In 2003 my Department made available a capital grant of €230,000 for a study to be undertaken by professional architectural, engineering and quantity-surveying experts. It is expected that it will be completed in March or April 2004. As regards the west, BreastCheck submitted several options for the construction of a static unit on the grounds of University College Hospital, Galway. Those are being considered by my Department in the context of the framework for capital investment from 2004 to 2008, which is being discussed with the Department of Finance at present.
An essential element of the rollout of the programme is investment in education and training of radiographers. BreastCheck employs qualified and experienced radiographers who have specialist postgraduate training and qualifications related to mammography. BreastCheck and the symptomatic breast cancer services combined have a significant ongoing recruitment and training requirement in that area. I have announced the development of a training centre for radiographers and mammography at Eccles Street. Resources are being made available to BreastCheck to support that initiative, which will cost in excess of €750,000 and is expected to be completed in the second half of 2004.
Public Service Pay.
Richard Bruton
Ceist:100 Mr. R. Bruton asked the Minister for Health and Children the number and value of awards withheld under benchmarking; and the recommendations of the performance verification group in each case. [4704/04]
The health service performance verification group, or HSPVG, withheld no awards in respect of the first phase of the performance verification process relating to pay increases due from 1 January 2004. A full range of documents detailing the first phase of the performance verification process, including the HSPVG assessment of the process and the reports received, is available on my Department's website at www.doh.ie.
National Drugs Strategy.
Dan Boyle
Ceist:101 Mr. Boyle asked the Minister for Health and Children if his attention has been drawn to the views of the Irish Pharmaceutical Union that the methadone treatment programme is in danger of collapse. [3164/04]
As the Deputy is aware, responsibility for the provision of drug treatment services rests with the health boards or authority in the first instance. The overall objective of the national drugs strategy for 2001 to 2008 is to reduce the harm caused to individuals and society by the misuse of drugs. That is to be achieved through a concerted focus on supply reduction, prevention, treatment and research with the ultimate aim of leading a drug-free life. The health-related aspects of the national drugs strategy focus in particular on education and prevention, and treatment and rehabilitation, including substitution treatment under the methadone protocol.
The number of methadone treatment places has expanded considerably in recent years, in line with the Government's commitment under the national drugs strategy. At the end of January 2004, there were 6,860 people receiving methadone treatment. That compares with a figure of just over 5,000 at the end of 2000. The involvement of community pharmacists is a vital element in the operation of the methadone protocol. In particular it allows for the expansion of drug treatment services, and for large numbers of opiate-dependent persons to be treated in their own local area. At the end of January 2004 there were 298 community pharmacies providing methadone maintenance treatment to 3,738 patients.
There has been no suggestion to the Department by the Irish Pharmaceutical Union that the methadone protocol is in danger of collapse. However, the IPU has raised a number of issues regarding the operation of the scheme with the Department and has expressed concern that those issues could discourage participation in the scheme. I understand that some day-to-day operational difficulties have been discussed and dealt with at health board level. At national level, the methadone implementation committee, which includes pharmacy representation, is finalising a review of the operation of the protocol. In addition, officials from my Department and representatives from the IPU are meeting today to ensure further the smooth operation of the scheme at national level.
I understand that among the concerns that have been raised is the suitability of patients for placement in a community setting and personal security issues for pharmacy staff. As regards patient management, there is a system in place whereby clients are assessed by a GP co-ordinator and liaison pharmacist before being transferred to community-based services. That is to ensure that service users have attained a high degree of stability regarding their drug misuse. The practice of assessment before placement is a standard operating policy of the addiction services. Furthermore, if difficulties arise with a service user in a community pharmacy, a system is in place to allow the service user to be reassigned to treatment in an addiction centre within 24 hours.
The liaison pharmacist in each health board acts as the interface between the community pharmacy and the health hoard. I understand that the model is working extremely well. Indeed, its success is indicated by the increase in community pharmacists becoming involved in the provision of methadone in recent years. In that context, I can assure the House that the issues raised are being addressed at health board, departmental and methadone implementation committee level.
Accident and Emergency Services.
Joe Costello
Ceist:102 Mr. Costello asked the Minister for Health and Children if his attention has been drawn to the comments made by a person (details supplied) who described conditions in the casualty unit of the Mater Hospital as a disgrace, unsafe and inhumane; the steps being taken to address such conditions in that and other accident and emergency departments; and if he will make a statement on the matter. [7010/04]
At the outset, I should say that both my Department and the Eastern Regional Health Authority accept the need for upgrading of the accident and emergency department at the Mater Hospital. In October 2002, my Department approved a capital grant of €1.355 million for that purpose. That upgrading will, apart from benefiting accident and emergency patients, staff and clinical risk management in general, reduce hospital admissions and expand the available complement of hospital beds.
Due to the nature of the accident and emergency department, it was necessary to phase work on the project, which commenced in April 2003. My Department is advised by the ERHA that a new three-bay resuscitation area and wound care clinic have now been completed, while the final stages of the project, which relate to security and upgrade of the entrance, are expected to be completed within eight weeks. It is acknowledged that, owing to ongoing pressure in the accident and emergency department, programming of the project has been difficult. However, the Deputy will appreciate that clinical priorities have at all times taken precedence over project work.
Pressures on the hospital system arise, inter alia, from demands on emergency departments and difficulties associated with patients who no longer require acute treatment but are still dependent. There are several initiatives under way to deal with those pressures. Planning for the discharge of patients by acute hospitals and liaison with the community services has been prioritised on an ongoing basis by the Eastern Regional Health Authority and the health boards. ERHA initiatives such as Homefirst, Slán Abhaile and home subvention are all contributing to providing alternative care packages for older people so that they can be discharged.
The single most important factor for admission to hospital is bed availability. Acute Hospital Bed Capacity — A National Review, a report published by my Department, identified a requirement for an additional 3,000 acute beds in acute hospitals by 2011. Some 568 of the 709 beds in the first phase have been commissioned, of which 253 are in the eastern region. Revenue funding of approximately €40 million has been made available to the ERHA for those beds. Funding is available to enable the balance of the beds to be brought into operation this year. Also under the acute bed capacity initiative, my Department has allocated an additional €8.8 million to the ERHA and €3.8 million to the Southern Health Board to facilitate the discharge of patients from the acute system to a more appropriate setting, thereby freeing acute beds.
My Department is also advised by the ERHA that it is working closely with the major acute hospitals in Dublin with a view to re-opening beds closed owing to staffing difficulties. An additional 20 accident and emergency consultants have been appointed from the 29 approved. Additional appointments are being worked on by the health boards and the ERHA. Reviews of the bed management function and nurse staffing levels in emergency departments are being progressed by the Health Services Employers Agency in consultation with health service management representatives and the nursing unions.
Emergency medicine departments sometimes deal with injuries and conditions which are more appropriate to a primary care setting. General practitioner out-of-hours co-operatives have been established and are operating in at least part of all the health board areas, with one health board, the North Eastern Health Board, having a region-wide project. A total of €46.5 million was allocated for the development of out-of-hours co-operatives between 1997 and 2003.
A media campaign has been undertaken on radio and television and in the newspapers highlighting the pressures that exist in emergency medicine Departments and encouraging people to attend only if absolutely necessary. This initiative is an attempt to focus on the need for only those in need of emergency care to attend and for others to use the primary care services. I would like to assure the Deputy that I will continue to work with the various health agencies in looking for short-term and longer-term solutions to the current difficulties.
Hospital Staff.
Jack Wall
Ceist:103 Mr. Wall asked the Minister for Health and Children the position regarding his discussions with the Irish Hospital Consultants’ Association regarding the proposed new system of medical insurance; and if he will make a statement on the matter. [7068/04]
Richard Bruton
Ceist:136 Mr. R. Bruton asked the Minister for Health and Children the current status of the dispute regarding enterprise liability between his Department and the IHCA; and if he will make a statement on the matter. [6900/04]
I propose to take Questions Nos. 103 and 136 together.
I have kept in regular contact with the Irish Hospital Consultants' Association and the Irish Medical Organisation on the issues which led to the recent threats of industrial action by hospital consultants. At a meeting held on 17 February, the IHCA agreed to defer for a period of four weeks any further escalation of its industrial action threatened for Monday 23 February. It also agreed to resume work on patients due be treated under the national treatment purchase fund and to participate in selection boards for consultant appointments. Last Tuesday evening meetings took place with both the IHCA and the IMO to brief them on progress in the discussions which officials of my Department have had with the Medical Defence Union on resolving the problems associated with liabilities which predate the establishment of the clinical indemnity scheme.
Kathleen Lynch
Ceist:104 Ms Lynch asked the Minister for Health and Children the progress made to date with regard to the implementation of the recommendations of the Hanly report; and if he will make a statement on the matter. [7018/04]
Pat Breen
Ceist:106 Mr. P. Breen asked the Minister for Health and Children the progress that has been made in achieving the acute hospital changes envisaged for August 2004 in the two pilot areas, East Coast Area Health Board and the Mid-Western Health Board in terms of additional acute beds for the two regions and additional consultants, new contracts for consultants and NCHDs, and improved ambulance access and training. [6929/04]
Pat Rabbitte
Ceist:161 Mr. Rabbitte asked the Minister for Health and Children when he expects to appoint project groups to progress detailed implementation at local level of the two pilot areas identified in the Hanly report (details supplied); the provision of services and facilities required; the staffing and financial requirements involved; the timeframe envisaged for the implementation of these pilot projects; and if he will make a statement on the matter. [7055/04]
I propose to take Questions Nos. 104, 106 and 161 together.
I am committed to ensuring that the Hanly report is implemented in the best interests of patients. The recommendations will mean a much better service for patients, with considerably more consultants working in teams. The report also involves reducing the working hours of non-consultant hospital doctors, which will benefit both patients and doctors. In addition, the Hanly report proposes a reorganisation of our acute hospital services so that patients receive the best possible treatment in the location most appropriate to their needs.
Last month I announced the composition of an acute hospitals review group, to be chaired by David Hanly, for this purpose. It will be asked to prepare a national hospitals plan for the Interim Health Service Executive, building on the principles of the Hanly report. The group will be asked to examine the role and structure of acute hospital services on a national basis.
The Hanly report made specific recommendations on the organisation of acute hospital services in two regions, those covered by the East Coast Area Health Board and the Mid-Western Health Board. I recently announced the composition of the implementation groups in these areas. Both groups will prepare a detailed action plan for the implementation of the recommendations of the Hanly report relating to the organisation of acute hospital services in the two regions. They will also assess the detailed staffing and capital requirements necessary for implementation of the report.
The Hanly report also makes important recommendations regarding the reduction in junior doctors' working hours and the development of a consultant provided service. My Department and the Health Services Employers' Agency have initiated discussions with the medical organisations on the industrial relations and contractual aspects of these issues. I am committed to pressing ahead with the agenda set by the Hanly report so that the best possible services for patients are provided.
Proposed Legislation.
Thomas P. Broughan
Ceist:105 Mr. Broughan asked the Minister for Health and Children the legislation planned arising from the health reform programme; the status of the Bills listed in the current legislative programme; and if he will make a statement on the matter. [7027/04]
The Government's legislation programme makes provision for the enactment of legislation to give statutory effect, where required, to implement the proposals in the reform programme. The first element of the programme is the preparation of an establishment order under the Health (Corporate Bodies) Act 1961, as amended, establishing the Interim Health Service Executive on a statutory basis. The order is being finalised and I hope to sign it shortly. This will empower the interim executive to perform the preparations necessary to enable an orderly transfer of functions to the Health Service Executive, HSE, when permanently established with effect from January 2005, under new primary legislation.
It will be necessary to introduce new legislation to provide the main legislative basis for the implementation of the health sector reform programme. This legislation will establish the new Health Service Executive which replaces the Eastern Regional Health Authority, the authority, and the health boards. It will also provide the legislative basis for other aspects of the reform programme such as improved governance and accountability, planning and monitoring and evaluation. It will also provide the legislative basis for the establishment of the health information and quality authority, HIQA. I also intend that the statutory framework for complaints procedures in the health services, as proposed in the health strategy, will be included in this legislation. My intention is that this legislation will be enacted by December 2004 so as to have the Health Service Executive in place in January 2005.
The Government's legislation programme for the spring session provides for the introduction of a Health (Amendment) Bill to cope with the situation arising following the local election in June 2004. Given the impending establishment of, and formal transfer of functions to, the HSE, the Government has considered whether it would be appropriate to proceed in the normal way with the appointment of local representatives to the health boards. This Bill will provide for changes in the legislative provisions regarding the membership of the authority and the health boards. It will also provide for the abolition of the distinction between reserved and executive functions and the assignment of reserved functions of the authority and the boards to the chief executive officers and the Minister for Health and Children, as appropriate. I expect to be in a position to publish the Bill in the near future.
Question No. 106 answered with QuestionNo. 104.
Question No. 107 answered with QuestionNo. 97.
Departmental Investigations.
Arthur Morgan
Ceist:108 Mr. Morgan asked the Minister for Health and Children if terms of reference have been agreed for the inquiry into the obstetrics and gynaecology unit at Our Lady of Lourdes Hospital, Drogheda; if it is his view that such an inquiry should be confined to the activities of a person (details supplied) or if it will be a broad based inquiry covering the operation of the unit between 1974 and 1998; and if he will make a statement on the matter. [6881/04]
Jan O'Sullivan
Ceist:167 Ms O’Sullivan asked the Minister for Health and Children if the terms of reference of the inquiry, to be chaired by Judge Maureen Harding Clarke, into the activities of a person (details supplied) have yet been finalised; when the inquiry will begin; the form it will take; when he expects it to be completed; and if he will make a statement on the matter. [7023/04]
I propose to take Questions Nos. 108 and 167 together.
Arising from the report of the fitness to practice committee of the Medical Council into the professional conduct of the person in question, the Government has agreed to establish a non-statutory inquiry into certain matters of concern at Our Lady of Lourdes Hospital, Drogheda. Following consultations with the Attorney General, Judge Maureen Harding Clark of the International Criminal Court has been appointed to chair the inquiry.
Judge Clark is currently studying the transcript of the proceedings at the fitness to practice committee and other relevant background documentation. Premises have been secured and recruitment of staff, both legal and administrative, is under way. The terms of reference and format of the inquiry are being finalised and I intend to bring recommendations to Cabinet in the near future.
Compensation Scheme.
Emmet Stagg
Ceist:109 Mr. Stagg asked the Minister for Health and Children the progress which has been made by the working group on the development of a no fault compensation system for birth damaged children; when he expects the group to report; if he will seek to expedite the introduction of proposals in this area, having regard to the recent awards in the High Court and the increasing difficulties facing practitioners, especially obstetricians, in finding insurance cover; and if he will make a statement on the matter. [7062/04]
The advisory group examining the feasibility of introducing a "no fault" compensation scheme for infants who suffer cerebral damage at, or close to, the time of birth is engaged in the process of drafting its report. I expect that the report will be completed and submitted to me by the middle of this year.
Smoking Ban.
Pat Breen
Ceist:110 Mr. P. Breen asked the Minister for Health and Children the stage he became aware that the measures implementing the smoking ban would be likely to be the subject of a legal challenge; the steps he then took to guarantee the legal soundness of all legislative measures implementing the smoking ban; and if he will make a statement on the matter. [6922/04]
Since the announcement on 30 January 2003 that I would introduce measures to make workplaces smoke free in 2004 a number of groups have indicated that they might consider mounting a legal challenge to the measure. The most recent media reports indicate that a legal challenge is now less likely.
When drafting the legislation required for the introduction of the measure, legal advice was received from the Attorney General. It is not possible to guarantee that any legislation is immune from a legal challenge. An individual or group is entitled to use the courts to address whatever grievance they may have about legislation. It is not possible to pre-empt decisions of the courts.
Vaccination Programme.
Eamon Gilmore
Ceist:111 Mr. Gilmore asked the Minister for Health and Children the steps he intends to take to address the decline in the number of children receiving the MMR vaccine, especially in view of the fact that many parents may have been misled by research published in the UK some years ago, the validity of which has now been questioned; and if he will make a statement on the matter. [7012/04]
The MMR vaccine protects against measles, mumps and rubella and, in accordance with the recommendations of the immunisation advisory committee of the Royal College of Physicians of Ireland, can be administered to children between 12 and 15 months of age. A vaccine uptake rate of 95% is required to protect children from the diseases concerned and to stop the spread of the diseases in the community. Measles, in particular, is a highly infectious and serious disease; approximately one in 15 children who contract measles suffer serious complications.
I am concerned about the unsatisfactory MMR immunisation uptake rates because of the risk of unimmunised children contracting the potentially serious diseases concerned. The outbreak of measles in 2000, which resulted in approximately 2,000 cases and three deaths, is evidence of the consequences of insufficient immunisation uptake. Based on information available from the National Disease Surveillance Centre, NDSC, there was a significant increase in 2003 in the number of reported measles cases. In 2002, 243 cases of measles were reported but provisional returns for 2003 indicate that there were 586 measles cases during that year. This underlines the importance of raising the immunisation uptake to the optimal level of 95% against measles and the other potentially serious infectious diseases.
However, I am encouraged by the most recent statistics from the NDSC which show that for the third quarter of 2003 MMR uptake for children up to 24 months of age was 81%. This uptake rate had increased from 77% in the previous quarter in 2003 and from 73% in the comparative quarter in 2002.
In 2003, CEOs in all health boards and the ERHA were asked to ensure that specific immunisation measures were prioritised in all regions to prevent a serious measles outbreak. A national immunisation steering committee was established to address a wide range of issues relating to the childhood and other immunisation programmes, including the identification of issues that are hampering the achievement of uptake targets. I launched the report of the steering committee in April 2002 and a national implementation group was subsequently established to draw up a phased national implementation plan based on the report's recommendations.
Following consideration of proposals about childhood immunisation which were submitted by the national implementation group through the Health Boards Executive, HeBE, on behalf of the health boards, €2.116 million was allocated by my Department in 2003 to fund initiatives to improve childhood immunisation uptake. A further €2.778 million has been allocated for that purpose this year.
There is concern among some parents about the measles, mumps and rubella, MMR, vaccine. Negative coverage on this issue has added to the confusion of parents in deciding whether to vaccinate their children. In April 2002, I launched the "MMR Vaccine Discussion Pack", an information guide for health professionals and parents. The pack was produced by the NDSC and the department of public health, Southern Health Board, and was published by HeBE on behalf of the health boards. The pack sets out the facts on the most common concerns about MMR in a way that will help health professionals and parents to explore these concerns together, review the evidence regarding MMR and provide the basis for making an informed decision. The information is presented in such a way as to allow full discussion between health professionals and parents on each issue.
The pack also contains an information leaflet for parents. It is set out in question and answer format and addresses such issues as the alleged link between MMR and autism and Crohn's disease, the safety and side effects of the vaccine, the purpose of a second dose of vaccine, combined vaccine versus single doses and contraindications to the vaccine. The pack will enable health professionals to respond to the real concerns of parents.
There is a sound evidence basis for the use of the MMR vaccine. Since the original publication of the UK research from Dr. Andrew Wakefield about a possible causal link between MMR vaccine and autism, many researchers have investigated the proposed causal relationship and concluded that there is no link between MMR vaccine and autism or inflammatory bowel disease. My Department's submission to the Oireachtas committee contains further details on the scientific evidence in this regard. In Ireland, this issue has been examined by the immunisation advisory committee of the RCPI and the Irish Medicines Board. The conclusions are that there is no evidence to support the association between MMR vaccines and the development of autism or inflammatory bowel disease and the vaccine is safer than giving the three component vaccines separately. The Oireachtas committee also endorsed the safety of the MMR vaccine.
The international consensus from professional bodies and international organisations is that the MMR is a safe and effective vaccine. The institutions include the Medical Research Council expert committee and the British Committee on Safety of Medicines in the UK, the Centres for Disease Control and Prevention, CDC, and the American Academy of Paediatrics in the USA as well as the World Health Organisation. Studies by the United States Institute of Medicine concluded that there is no link between the vaccine and autism or inflammatory bowel disease. A large Finnish study involving 1.8 million individuals demonstrated that no case of inflammatory bowel disease or autism was linked to the MMR vaccine.
A recent UK study where researchers analysed 2,000 studies from 180 countries found no evidence of a causal link between MMR vaccine and autism or inflammatory bowel disease. A similar Swedish study found no increase in cases of autism in the ten years during which MMR vaccine was introduced. In late 2002, the New England Journal of Medicine published details of a study of more than 500,000 children born in Denmark between January 1991 and December 1998 which indicated that the risk of autism was the same for children regardless of whether they were vaccinated with MMR. The World Health Organisation, WHO, strongly endorses the use of MMR vaccine on the grounds of its convincing record of safety and efficacy.
Dr. Simon Murch of the Centre for Paediatric Gastroenterology, Royal Free and University College Medical School, London, who had originally questioned the safety of the MMR vaccine, categorically supports use of the MMR vaccine. In the November 2003 edition of "The Lancet" he states that "..by any rational standards of risk/benefit calculation, it is an illogical and potentially dangerous mistake for parents to be prepared to take their children in a car on the motorway or in an aeroplane on holiday, but not to protect them with the MMR vaccine. An unprotected child is not only at personal danger, but represents a potential hazard to others, including unborn children". I am aware that the editor of "The Lancet" has said in recent days that the journal had learned of a "fatal conflict of interest" concerning the research carried out by Dr. Wakefield. The British General Medical Council is to examine this matter.
Some health boards have undertaken measures to improve vaccine uptake in their region. These include: information sessions for professionals, for example, doctors and nurses in the area; information sessions for parents; distribution of information to the public, for example, leaflets on MMR available in public areas; advertisements taken out in local papers; advertisements on local radio stations; advice regarding immunisation, including MMR, forms part of every public health nurse consultation with parents; information leaflets displayed prominently in all health centres; information given to schools regarding the booster MMR; follow up of parents by letter and telephone where children have not been vaccinated; follow up with GPs and nurses regarding children in their area who have not been vaccinated; and information sessions for staff. I am currently considering proposals for carrying out a nationwide media campaign to increase awareness of the need for immunisation.
I urge all parents to have their children immunised against the diseases covered by the childhood immunisation programme to ensure that both their children and the population generally have maximum protection against the diseases concerned. This is particularly important at present in light of the increase in reported measles cases.
Water Flouridation.
Damien English
Ceist:112 Mr. English asked the Minister for Health and Children if the regulation amending the optimal level of fluoride in drinking water from 0.8 to 1.0 ppm to between 0.6 and 0.8 ppm as recommended by the forum on fluoridation has yet been implemented. [6889/04]
The use of fluoride technology is known to manifest a positive oral health outcome. Local and national surveys and studies conducted since the introduction of fluoridation in this country attest to the reduced dental decay levels of children and teenagers in fluoridated areas compared to those residing in non-fluoridated areas. The safety and effectiveness of water fluoridation has been endorsed by a number of international and reputable bodies such as the World Health Organisation, the Centre for Disease Control and Prevention, the United States Public Health Service and the United States Surgeon General.
I established the forum on fluoridation to review the fluoridation of public piped water supplies in Ireland. The forum's report was launched on 10 September 2002 and its main conclusion was that the fluoridation of public piped water supplies should continue as a public health measure. The forum also concluded that: water fluoridation has been effective in improving the oral health of the Irish population, especially of children, but also of adults and the elderly; the best available and most reliable scientific evidence indicates that at the maximum permitted level of fluoride in drinking water at one part per million, human health is not adversely affected; and dental fluorosis, a form of discolouration of the tooth enamel, is a well-recognised condition and an indicator of overall fluoride absorption, whether from natural sources, fluoridated water or from the inappropriate use of fluoride toothpaste at a young age. There is evidence that the prevalence of dental fluorosis is increasing in Ireland.
The forum consisted of people with expert knowledge spanning the areas of public health, biochemistry, dental health, bone health, food safety, environmental protection, ethics, water quality, health promotion and representatives from the consumer and environmental areas. This diversity of professional backgrounds and representation was reflected in the comprehensive way the forum conducted its work and research. Ultimately, the forum took an evidence based approach to its examination of water fluoridation.
The forum on fluoridation made several recommendations concerning the continuing use of fluoride technology in this country. Re-defining the optimal level of fluoride in drinking water was one of the recommendations of the forum and these changes are part of a long-term strategy to reduce levels of mild dental fluorosis in children. The report made 33 recommendations covering a broad range of topics such as research, public awareness and policy and technical aspects of fluoridation.
The establishment of the expert body recommended by the forum is now well under way. The terms of reference of the expert body are: to oversee the recommendations of the forum on fluoridation; to advise the Minister and evaluate ongoing research —including new emerging issues —on all aspects of fluoride, its delivery methods and as an established health technology and as required; and to report to the Minister on matters of concern, either at his or her request or on its own initiative.
The expert body will have broad representation, including from the areas of dentistry, public health medicine, toxicology, engineering, management, environment and the public. Letters of invitation have been issued to prospective members of the body. Based on the acceptances which have been received, the body will have a strong consumer input in terms of members of the public and representatives of consumer interests, in addition to the necessary scientific, managerial and public health inputs. My Department is in discussions about the chair of the expert body and I expect to be able to announce a decision in that respect in the near future.
The secretariat of the body will be provided by the Irish Dental Health Foundation, an independent charitable trust which has been to the fore in securing co-operation between private and public dentistry and the oral health care industry regarding joint oral heath promotion initiatives. The foundation's stature and expertise place it in an excellent position to support the work of the forum in its initial stage. The forum's report envisages that the work of the expert body may be subsumed into the health information quality authority in due course. The support of the foundation allows us to press ahead with the establishment of the expert body in advance of the establishment of HIQA. I understand that the intention is to have an inaugural meeting of the expert body in early April.
A large body of research on different aspects of fluoride technology has been completed and this will be considered by the expert body. It is anticipated that the work of the expert body will impact on the applicable regulations and that the amendment to the recommended level of fluoride will be addressed in that context.
Drug Abuse.
Ruairí Quinn
Ceist:113 Mr. Quinn asked the Minister for Health and Children the steps he is taking to provide a preventative programme to reduce the level of opiate related deaths, especially in the Dublin area where the death toll from opiates is now running at the same level as from traffic accidents; and if he will make a statement on the matter. [7016/04]
The Central Statistics Office, CSO, compiles the general mortality register's official statistics on direct drug related deaths each year. The figures on direct opiate related deaths in Dublin from 1997 to 2000 are as follows: 1997—50; 1998—50; 1999—70; and 2000—63. I am informed by the Department of Transport that road accident fatalities in Dublin from 1999 to 2002 are as follows: 1999—57; 2000—69; 2001—53; and 2002—49. The breakdown of figures for 2003 is not yet available.
At present, drug related deaths are recorded by the general mortality register of the CSO, based on the international classification of diseases, ICD, code system. Other countries have developed dedicated systems for recording drug related deaths and it is important, for the purposes of comparative analysis, that the Irish system is capable of generating an equivalent level of information. It is for this reason that one of the actions contained in the national drugs strategy calls for the development of an accurate mechanism for recording the number of drug related deaths. Overall responsibility for this action rests with the coroner's service and the Central Statistics Office. Work has commenced on progressing this action and my Department is continuing to co-operate with the relevant agencies to establish a mechanism to record accurately the position with drug related deaths.
The overall objective of the National Drugs Strategy 2001-2008 is to reduce the harm caused to individuals and society by the misuse of drugs through a concerted focus on supply reduction, prevention, treatment and research with the ultimate aim of leading a drug free lifestyle. The health related aspects of the national drugs strategy focus in particular on education and prevention and treatment and rehabilitation, including substitution treatment under the methadone protocol.
The number of methadone treatment places has expanded considerably in recent years, in line with the Government's commitment under the national drugs strategy. At the end of December 2003 there were 6,883 people receiving methadone treatment. This compares with a figure of just over 5,000 at the end of 2000. In the Eastern Regional Health Authority there are currently 59 drug treatment locations. This compares with 12 locations in 1997. Outside the ERHA, treatment clinics have been established in the South Eastern Health Board, Mid-Western Health Board, Western Health Board and Midland Health Board. General practitioners and pharmacists also provide treatment services and their involvement has also increased over the last number of years.
The boards aim to address substance abuse by providing effective and sustainable services working in partnership with clients and with fellow service providers. All clients entering the addiction services are assessed and appropriate treatment plans are identified based on clients' needs. Decisions concerning the appropriate treatment for patients are made in accordance with best practice guidelines. Overdose prevention is an inherent part of the comprehensive range of services which the boards provide, including education and prevention, treatment and rehabilitation, counselling and harm reduction. International evidence supports the view that opiate users are safer in treatment. Every effort, therefore, is made to encourage clients to engage in treatment.
For opiate users outside of treatment, outreach workers and needle exchange services actively engage drug users to promote safer drug using practices to address the risks involved in terms of overdose, transmission of blood borne viruses and unsafe sex practices. Harm minimisation is at the core of the three area health boards' outreach strategy and this includes the risk of overdose. Building on existing initiatives, one area health board has designed a series of posters and leaflets, due to be piloted in spring 2004, directly addressing risk factors contributing to overdose and how individuals can best provide assistance to those who may have overdosed.
This is taking place as part of a health promotion programme, which has been designed to promote service users taking a more active role in their own health in a range of areas. With regard to the increased risk of overdose facing opiate users who are released from prison, there are protocols in place for the transfer of those who are engaged in substitute treatment while incarcerated to facilitate their take up for treatment on release.
Hospital Services.
Olivia Mitchell
Ceist:114 Ms O. Mitchell asked the Minister for Health and Children the number of specialist breast units that have been established as recommended in the 2001 report on the development of services for symptomatic breast disease; and the number that have the full recommended complement of multidisciplinary professionals. [6892/04]
Since 1997 there has been a cumulative additional investment in excess of €550 million in the development of appropriate treatment and care services for people with cancer, including breast cancer. This is reflected in a significant increase in activity, with breast cancer surgery increasing by 39% nationally. A total of 81 additional consultants have been approved during this period. Specialities include oncologists, histopathologists, radiologists, haematologists, palliative care, radiation oncologists and surgeons with a special interest in breast disease. This data, broken down by speciality, is set out on the following table.
|
Oncologist |
Histo-pathologist |
Radiologist |
Haematolo- gist |
Palliative Care |
Radiation Oncologist |
Surgeon SI Breast |
Total |
|
|
ERHA |
5 |
5 |
6 |
0 |
3 |
2 |
5 |
26 |
|
MHB |
1 |
1 |
1 |
1 |
0 |
0 |
1 |
6 |
|
MWHB |
1 |
1 |
0 |
2 |
1 |
0 |
1 |
8 |
|
NEHB |
*2 |
3 |
2 |
1 |
1 |
0 |
2 |
10 |
|
NWHB |
2 |
1 |
0 |
2 |
1 |
0 |
1 |
8 |
|
SEHB |
3 |
1 |
1 |
1 |
1 |
0 |
2 |
10 |
|
SHB |
2 |
3 |
1 |
1 |
0 |
0 |
1 |
8 |
|
WHB |
2 |
4 |
1 |
1 |
1 |
1 |
1 |
11 |
|
Total |
15 |
19 |
12 |
9 |
8 |
3 |
14 |
81 |
*ERHA posts linked to the NEHB
In addition, 195 cancer nurse specialists have been appointed during the period 2000 to 2002, including nurses in breast care, palliative home care and oncology. A separate table by health board and speciality is set out below.
|
Nurse Specialists |
ERHA |
MWHB |
MHB |
NEHB |
NWHB |
SEHB |
SHB |
WHB |
Total |
|
Breast Care |
5 |
2 |
1 |
1 |
2 |
1 |
2 |
3 |
17 |
|
Cancer Co- Ordinator |
3 |
3 |
|||||||
|
Chemotherapy |
2 |
2 |
|||||||
|
Oncology |
3 |
5 |
5 |
3 |
7 |
5 |
28 |
||
|
Oncology Liaison |
3 |
1 |
2 |
6 |
|||||
|
Oncology/ Breast Care |
3 |
3 |
|||||||
|
Oncology/ Palliative Care |
1 |
1 |
|||||||
|
Palliative Home Care |
39 |
14 |
7 |
10 |
6 |
16 |
14 |
11 |
117 |
|
Stoma Care |
8 |
3 |
2 |
1 |
1 |
2 |
17 |
||
|
Stoma and Breast Care |
1 |
1 |
|||||||
|
63 |
17 |
9 |
19 |
15 |
25 |
24 |
23 |
195 |
With regard to the development of specialist units on the basis recommended in the report on the development of services for symptomatic breast disease, five units are operational. These are at the Mater Misericordiae Hospital, St. Vincent's Hospital, St. James's Hospital, Tallaght Hospital and Waterford Regional Hospital. The other eight units are at various stages of development.
Private Provision of Health Services.
Bernard Allen
Ceist:115 Mr. Allen asked the Minister for Health and Children if he will clarify his Department’s policy in respect of the private provision of health services and specifically if there is a procurement policy; and if not, if one is envisaged in respect of areas of new and costly private provision such as dialysis and radiotherapy and in the less specialist but equally important area of nursing home provision. [6924/04]
The provision of private health care has been a long-standing feature of the Irish health care system. The issue of procurement of services from the private health care sector, including the areas referred to by the Deputy, is a matter for individual health agencies in the first instance.
Health agencies, in line with all agencies spending public funds, are required to comply with the public procurement law regime. The regime applies to the procurement of works, services and supplies by agencies financed in whole or in part by public funds.
Obesity Incidence.
Joe Sherlock
Ceist:116 Mr. Sherlock asked the Minister for Health and Children the steps he intends to take to deal with the threat to health posed by the rising level of obesity identified in the recent annual report of the National Nutritional Surveillance Centre; and if he will make a statement on the matter. [7064/04]
John Gormley
Ceist:131 Mr. Gormley asked the Minister for Health and Children the reason his Department is not doing more to promote cycling and walking as means of protecting against obesity; if he will undertake a joint programme with the Department of Transport to ensure that there are safe cycling and walking routes to schools; and if he will make a statement on the matter. [7072/04]
I propose to take Questions Nos. 116 and 131 together.
The Slán survey published in 2003 highlights that 47% of the Irish population are overweight or obese in 2002 compared to 42% in 1998, with levels of obesity increasing from 10% to 13% in the same period. In addition, the numbers of those reporting no physical activity at all have increased among both men, from 21% to 30%, and women, from 20% to 25%. The results of these surveys reflect a similar situation at global level. Developed countries are documenting increasing levels of overweight and obesity. A position paper prepared by the international obesity task force recommends that national obesity task forces be established to develop and implement strategies to counteract the epidemic of obesity.
In response to these trends and in line with the EU Health Council conclusions that member states need to address the issue of obesity using established national structures, I am currently in the process of establishing a national obesity task force. The task force will be drawn from a broad range of representative and relevant bodies and I plan to announce the establishment of this initiative shortly. The task force will develop a strategy to address the obesity levels in Ireland. This will require a societal approach and cross sectoral working. Included among these will be the need to address transport policies, especially initiatives and programmes aimed at young children.
Over the last number of years there has been a significant increase in health promotion activities and campaigns targeting obesity. These will have a long-term impact in addressing this issue. The campaign "Let it Go — just for 30 minutes" focused on the message that even minor increases in the level of activity can lead to positive health benefits. The national healthy eating campaign has, over recent years, concentrated on encouraging people to eat four or more portions of fruit or vegetables per day. As part of these campaigns health boards provide regional and local focus in schools, communities and other settings.
As a direct result of funding from the cardiovascular health strategy there are now 36 additional community dieticians in post. These dieticians have formed partnerships with community groups to provide nutrition education, cookery programmes and healthy eating projects. The majority of boards have been resourced to run specific targeted, focused, sustained programmes aimed in particular at those on low income. Physical activity co-ordinators have also been appointed in each board, promoting physical activity among the population as recommended in the national strategies. In 2002 the physical activity campaign promoted walking as an excellent means of increasing levels of physical activity.
The health promotion unit, in partnership with the Department of Education and Science, has been involved in the development of the social and personal health education curriculum which is now being implemented in primary schools. An important element of this initiative is the emphasis placed on physical health, recognising the importance of promoting physical activity as an essential component of a healthy lifestyle. The health promotion unit has also partly funded the Irish Heart Foundation's "Get Kids on the Go" campaign which aims to increase the levels of physical activity in school-going children.
"Playground Markings", a component of the "Get a Life, Get Active" campaign, is an initiative supported by the health promotion unit of my Department. This initiative, using traditional games, aims to encourage children to participate in physical activity in the school playground. Slí na Sláinte is an initiative which is partly funded by the health promotion unit. There is ongoing development of the walks nationwide giving people the opportunity to walk in healthy safe environments. The routes are marked in kilometre intervals to enable people to gauge the distance they have walked.
Home Births.
Trevor Sargent
Ceist:117 Mr. Sargent asked the Minister for Health and Children the plans he has to encourage home births; his views on whether there are now fewer opportunities for women to avail of a home birth; and if he will make a statement on the matter. [7090/04]
The policy of my Department is that on medical grounds, the delivery of babies should take place in consultant staffed maternity units. It is generally accepted that this policy has contributed to the marked decrease in the level of maternal, perinatal and infant mortality. The maternal mortality rate decreased from 24.8 per 100, 000 live births and stillbirths in 1971 to 1.8 in 2000. The perinatal mortality rate fell from 22.8 per 1,000 live births and stillbirths in 1971 to 9.0 in 2000 while the infant mortality rate fell from 18.0 per 1,000 births to 5.8 in 2001 — Source: Health Statistics, 2002, Table B11.
Three pilot home birth projects were established between 1999 and 2001 with funding from my Department: a community midwifery service, conducted in Cork by the Southern Health Board; a hospital outreach approach conducted by the Western Health Board and based at the University College Hospital, Galway; and a DOMINO/outreach project, domiciliary care in and out of hospital, based at the National Maternity Hospital, Holles Street. The Galway project was suspended by the Western Health Board in 2003. This has resulted in fewer opportunities for women to have home births in the Galway area.
The external evaluation of the three pilot home birth projects in Dublin, Cork and Galway and the service in the South Eastern Health Board area has now been completed. This evaluation was carried out under the auspices of the national domiciliary births group, established by the health board chief executive officers in 2003 at the request of my Department. The national domiciliary births group plans to hold information sessions during this month and report to the CEOs by mid-June. The group's report will make recommendations on the long-term approach, arising from the outcome of the pilot schemes. This report will inform the development of future national policies, procedures and protocols for domiciliary births.
Meanwhile, health boards in general make available grants towards midwifery services in respect of home births where women contract an independent midwife. The maximum grant is €1,270 for full midwifery service.
Air Pollution.
Paul Nicholas Gogarty
Ceist:118 Mr. Gogarty asked the Minister for Health and Children if his attention has been drawn to the links between air pollution caused by car exhausts and ill health; the steps his Department intends to take to deal with this; and if he will make a statement on the matter. [7085/04]
On 5 June 2002, the then Minister for the Environment and Local Government introduced the air quality standards regulations 2002 for the purpose of giving effect to Council Directives 96/62/EC on ambient air quality assessment and management, 1999/30/EC relating to limit values for sulphur dioxide, nitrogen dioxide and oxides of nitrogen, particulate matter and lead in ambient air, and 2000/69/EC relating to limit values for benzene and carbon monoxide in ambient air. These regulations are, inter alia, intended to avoid, prevent or reduce harmful effects on human health and the environment from these emissions, which arise as a result of combustion generally but, to a significant extent, from the internal combustion engine.
The regulations: establish limit values and, as appropriate, alert thresholds for concentrations of certain pollutants in ambient air intended to avoid, prevent or reduce harmful effects on human health and the environment as a whole; provide for the assessment of concentrations of certain pollutants in ambient air on the basis of methods and criteria common to the member states of the European Communities; provide for the obtaining of adequate information on concentrations of certain pollutants in ambient air and ensure that it is made available to the public, inter alia, by means of alert thresholds; and provide for the maintenance of ambient air quality where it is good and the improvement of ambient air quality in other cases with respect to certain pollutants.
The Environmental Protection Agency has overall responsibility for the co-ordination of ambient air quality monitoring in Ireland in accordance with EU directives. My Department has no responsibility for monitoring of air quality.
Psychiatric Services.
Dinny McGinley
Ceist:119 Mr. McGinley asked the Minister for Health and Children if his attention has been drawn to the proposals contained in the Sainsbury report into the psychiatric services in the north west; if he will detail the concerns in the area regarding these proposals; and if he will make a statement on the matter. [6825/04]
I am informed by the North Western Health Board that the report referred to is a review commissioned by the board on the delivery of mental health services in the region, which makes proposals for development of the services in the future. It has not been submitted to my Department.
I am further informed by the board that the draft report has been circulated and a consultation process with staff and service users has been engaged in, and that a report will be presented to the board members shortly with recommendations based on the review and the consultation process.
Medical Cards.
Jan O'Sullivan
Ceist:120 Ms O’Sullivan asked the Minister for Health and Children the number of persons who held medical cards in June 2002 and at the latest date for which figures are available and the proportion of the population this represents in respect of each such date [7024/04]
The details requested are as follows:
|
Date |
No. of medical cards |
No. of persons covered |
Percentage of the population |
|
June 2002 |
783,612 |
1,207,096 |
30.81% |
|
February 2004 |
759,654 |
1,149,081 |
29.33% |
The reduction in the number of persons being covered by medical cards in recent years can be attributed in some measure to the rise in the numbers of persons in employment. Another factor was the data cleaning exercise which was carried out on medical card lists on health boards' databases. Since early 2003 this has nationally resulted in in excess of 80,000 persons being removed from the registers. It should be noted that most of these deletions arose from normal medical card review activity.
Hospital Services.
Ruairí Quinn
Ceist:121 Mr. Quinn asked the Minister for Health and Children the steps being taken to address the continuing crisis in the acute hospital service, especially in the greater Dublin area, as a result of which many patients have to spend long periods on trolleys in accident and emergency units awaiting admission; the steps in particular he intends to take to deal with the problems of bed blockers; and if he will make a statement on the matter. [7014/04]
Bernard J. Durkan
Ceist:232 Mr. Durkan asked the Minister for Health and Children the extent to which adequate accident and emergency staff are available to meet requirements at the various hospitals throughout the country; the areas in which deficiency has been identified; and if he will make a statement on the matter. [7258/04]
I propose to answer Questions Nos. 121 and 232 together.
There are a number of initiatives under way at present in order to deal with pressures in emergency medicine departments. Planning for the discharge of patients by acute hospitals and the liaison with the community services has been prioritised on an ongoing basis by the Eastern Regional Health Authority and the health boards. I have provided an additional €12.6 million — €8.8 million to the ERHA and €3.8 million to the Southern Health Board — to facilitate the discharge of patients from the acute system to a more appropriate setting thereby freeing up acute beds. A report entitled Acute Hospital Bed Capacity — A National Review, carried out by my Department, identified a requirement for an additional 3,000 acute beds in acute hospitals by 2011 and this requirement is reflected in the Government's health strategy, Quality and Fairness — A Health System for You. Some 568 of the 709 beds in the first phase have been commissioned to date of which 260 are in the eastern region. The ERHA is currently working closely with the major acute hospitals in Dublin with a view to re-opening beds which were temporarily closed last year. As part of the winter initiative, an additional 20 emergency medicine consultants have been appointed from the 29 approved. Additional appointments are being progressed by the health boards and the ERHA. It is also worth noting that the number of emergency medicine consultants in the eastern region has increased from ten to 21 in the past five years. A review of the nurse staffing levels in emergency departments is also being progressed by the Health Services Employers Agency in consultation with the health service management representatives and the nursing unions. Emergency medicine departments may sometimes have to deal with injuries and conditions which are more appropriate to a primary care setting. General practitioner out-of-hours co-operatives have been established and are operating in at least part of all health board areas, with one health board, the North Eastern Health Board, having a region wide project. A total of €46.5 million has been allocated for the development of out-of-hours co-operatives between 1997 and 2003.
I assure the Deputies that I will continue to work with the various health agencies in looking for short-term and longer term solutions to the current difficulties.
Health Reform Programme.
Breeda Moynihan-Cronin
Ceist:122 Ms B. Moynihan-Cronin asked the Minister for Health and Children the progress made to date with regard to implementation of the Prospectus report on health structures; when he expects to introduce legislation to provide for the establishment of the four new regional health authorities; the provision there will be for democratic accountability in regard to these new authorities; when he expects that the new authorities will be operational; the plans he has for appointments to health boards in the period between the local elections in June 2004 and the establishment of the new authorities; and if he will make a statement on the matter. [7020/04]
Kathleen Lynch
Ceist:164 Ms Lynch asked the Minister for Health and Children the progress made to date with regard to the implementation of the recommendations of the Brennan report; and if he will make a statement on the matter. [7019/04]
Brendan Howlin
Ceist:165 Mr. Howlin asked the Minister for Health and Children the steps taken to date to implement the recommendations of the Commission on the Financial Management and Control Systems in the Health Service; when it is expected that the HSE will be established; the terms of reference and the programme of work for the interim HSE; and if he will make a statement on the matter. [7017/04]
I propose to answer Questions Nos. 122, 164 and 165 together.
The Deputy is aware that the reports of Prospectus on structures and functions of the health system and of the Commission on Financial Management and Control Systems in the Health Service form the key base documents for the Government's health services reform programme together with the report of the National Task Force on Medical Staffing.
The implementation of these reports is currently under way and will result in a single unitary national structure for health service planning and delivery. The Deputy should note that there will not in fact be four regional health boards. Instead, there will be a single unitary structure, the HSE, which will be supported by three pillars, one of which will manage the delivery of primary, community and continuing care services. This pillar will be organised through four regions for administrative purposes. I have already clarified this in the House.
I am conscious of the concerns to ensure that there is adequate governance of the new structures in a radically restructured health system together with appropriate representation. This is a matter that will continue to receive consideration. I am satisfied that the new arrangements, combined with the introduction of system-wide best practice governance and accountability systems, will ensure a stronger more effective health system and an improved heath service for patients and clients.
It is intended that the Health Service Executive will be established on a full statutory basis by January 2005. Work on the preparation of the necessary primary legislation is well under way. Meanwhile the board of the Interim Health Service Executive, established last November, held its first meeting in January. The interim HSE is being assigned responsibility for ensuring that all necessary measures are in place to ensure an orderly transfer from existing statutory agencies of authority, responsibility and accountability for the management and delivery of publicly funded health services. In particular, the interim board will have responsibility for: recommending the senior management structure for the new executive; recommending regional boundaries and location of regional headquarters for primary, community and continuing care services and appropriate management structures for consideration by the Government; and within approved parameters, selection and appointment of a chief executive officer to the HSE and subsequent appointments at senior management level.
Irish Blood Transfusion Service.
Enda Kenny
Ceist:123 Mr. Kenny asked the Minister for Health and Children if PCR testing is available in both Dublin and Cork; if the Progesa integrated computer system is operational and compatible between the two sites; if operational standards are being kept under systematic review to ensure that they comply with good manufacturing practice and with the new blood directive which has to be implemented before the end of February 2005; and if he will make a statement on the matter. [6917/04]
Dan Neville
Ceist:147 Mr. Neville asked the Minister for Health and Children if there will be or have been capital costs associated with the decision to have a second blood testing site in Cork; and if he will make a statement on the matter. [6913/04]
I propose to answer Questions Nos. 123 and 147 together.
The board of the Irish Blood Transfusion Service decided that nucleic acid amplification technology — NAT — testing, otherwise known as PCR testing, should be carried out at its centres in Dublin and Cork.
Development of the NAT laboratory began at the National Blood Centre in Dublin last summer and was completed before Christmas. Parallel NAT testing with the Scottish National Blood Transfusion Service commenced on 4 February 2004. Parallel testing will remain in place for 12 weeks. When the parallel testing period concludes, NAT testing for both centres will be carried out at the National Blood Centre.
It is intended to implement NAT in Cork in 2005. The timeframe has been determined by the need to enhance accommodation in the current facility and the implementation of other technologies to maintain current services. An interim buildings solution is currently in progress and it is expected that this will be completed by the end of August 2004. This will provide accommodation suitable for the performance of NAT.
The IBTS proposes to replace the current facility in Cork with a new blood centre at an estimated capital cost of €28 million.
The Irish Medicines Board, as the regulatory authority, inspects the IBTS centres in Dublin and Cork twice yearly to ensure compliance with good manufacturing practice. It is proposed to extend the remit of the IMB to include ensuring compliance with the terms of the EU blood directive which will come into force in February 2005.
The Progesa computer system went live in Cork on 18 March 2003 and in Dublin on 6 May 2003. Progesa is an integrated system which is compatible between all IBTS sites.
Cancer Screening Programme.
Joan Burton
Ceist:124 Ms Burton asked the Minister for Health and Children if his attention has been drawn to the fact that some women are still waiting up to four months for the results of cervical smear tears; the steps he intends to take to reduce this waiting time and ensure that women receive the results promptly; and if he will make a statement on the matter. [7007/04]
Having made inquiries of the Eastern Regional Health Authority and those health boards in which there are laboratories undertaking the analysis of cervical smears, I am advised that the position with regard to turnaround times is as follows:
|
Board |
Routine |
Urgent |
|
ERHA |
4-16 weeks |
1-3 weeks |
|
NEHB |
8-9 weeks |
Under 1 week |
|
NWHB |
16 weeks |
4 weeks |
|
SHB |
3 weeks —29 days |
2 days —1 week |
|
WHB |
5 weeks |
Under 3 weeks |
I should point out that phase one of the national cervical screening programme has been up and running in the Mid-Western Health Board since October 2000. Under the programme, cervical screening is being offered at five year intervals to approximately 74,000 women in the 25-60 age group, free of charge.
The national health strategy includes a commitment to extend the programme to the rest of the country. The Health Boards Executive, HeBE, has initiated an examination of the feasibility and implications of a roll out of the national programme which is a major undertaking with significant logistical and resource implications. The work currently being undertaken as part of the roll out includes an evaluation of phase one, policy development and the establishment of national governance arrangements. This work has regard to both the experiences gained from the phase one programme and other international programmes as well as current best practice.
The evaluation of phase one is a key element in informing the development of a high quality cervical screening model for Ireland. The evaluation is currently under way and it is anticipated that it will be completed within the next few months. Once completed, HeBE has advised that it will be in a position to prepare a draft roll out plan.
With regard to the issue of resourcing of cervical cytology laboratories, it is the case that over the past number of years my Department has allocated additional funding to support the ongoing development and enhancement of cervical cytology services including the achievement of a reduction in waiting times for smear test results. The funding has facilitated the employment of staff, provision of training, introduction of new technologies such as liquid-based cytology, investment in new equipment and upgrading of facilities. Further additional funding amounting to €500,000 was allocated in 2004 as part of a programme of continued investment in cervical cytology and colposcopy services.
Health Reform Programme.
Liam Twomey
Ceist:125 Dr. Twomey asked the Minister for Health and Children his views on the fact that the Hanly report did not specifically deal with industrial relation issues; and if he has information on the way in which the workload in general practice and the qualifications of ambulance personnel will affect the reforms proposed in the Hanly report. [6830/04]
The National Task Force on Medical Staffing agreed from the outset of its work that it would not deal with industrial relations matters, and that any of its proposals which had implications for industrial relations would be referred to the appropriate forum for those issues.
The implications of the Hanly report's recommendations for general practice and the ambulance service will be fully taken into account as we move towards implementation. There will be close liaison with general practice and with the primary care task force. The implementation groups in the two regions examined in detail by the Hanly group, the east coast and mid-western areas, include representation from general practice. There is also representation from general practice on the acute hospitals review group, the membership of which I announced recently.
The training of ambulance personnel to emergency medical technician, advanced EMT-A standard, is a key element of the Hanly report. I formally launched the EMT-A programme for the ambulance service in March 2003. Arising from this, the pre-hospital emergency care council, PHECC, has developed proposals on the introduction of the programme. The legislative changes necessary to facilitate this initiative are being progressed as a priority by my Department.
Nursing Home Subventions.
Pat Rabbitte
Ceist:126 Mr. Rabbitte asked the Minister for Health and Children if terms of reference of the group established by his Department to undertake a review of the nursing home subvention scheme have been formulated; when he expects the report to be completed; and if he will make a statement on the matter. [7063/04]
I wish to advise the Deputy that the inaugural meeting of the working group took place in early December 2003. One of the items for discussion by the working group was the terms of reference for the review. The terms of reference as now agreed by the group are:
That the review will take into account issues arising from the interpretation of certain aspects of the 1990 Act and the Subvention Regulations which have arisen over the years, the Ombudsman's comments on the operation of the Nursing Home Subvention Scheme, the recommendations in the O'Shea and Mercer reports, and the views of clients and service providers on the operation of the Nursing Home Subvention Scheme.
The aims and objectives of the review will be: to recommend any changes necessary in the light of Prof. O'Shea's recommendations; to make recommendations on an equitable means assessment test for subvention; to make recommendations on the development of a standardised dependency test; to examine alternative care settings such as home care and to make recommendations for the funding of such care settings as an alternative to long-term residential care; to make recommendations on the development and implementation of quality care standards in institutional settings; and to make recommendations on such other matters as the group considers appropriate within the broad parameters of its mandate.
The ultimate aim of the review will be the development of a system which will be transparent, provide equity, be less discretionary, be financially sustainable and ensure a high standard of care is on offer to clients.
At this stage it is not possible to state exactly when the review will be finalised but it is expected to take at least 18 months to complete.
Classification of Drugs.
Dan Boyle
Ceist:127 Mr. Boyle asked the Minister for Health and Children the consideration which is being given to reclassifying the drug cannabis as has happened in the United Kingdom. [3160/04]
The recent reclassification of cannabis from a class B to a class C drug in the UK means that the maximum criminal penalties for possession of cannabis would be reduced and that the possession of cannabis would become a "non-arrestable offence". Possession would remain a criminal offence punishable by the criminal courts. The police would then have the option to "report for summons".
In Ireland, drugs are not classified for penalty purposes in the manner in which they are classified in the UK. While the various controlled drugs have been placed in various schedules, this classification in Ireland is exclusively for the purpose for the controls that are applicable to the classes concerned and have no consequences for the penalties that the courts may apply.
Possession of any controlled drug, without due authorisation, is an offence under section 3 of the Misuse of Drugs Act 1977. The legislation makes a distinction between possession for personal use and possession for sale or supply. Penalties for possession depend on the type of the substance, for example cannabis or other drugs, and on the penal proceeding, that is whether a summary conviction or a conviction on indictment is obtained. Penalties for unlawful possession for the purpose of sale or supply range from imprisonment for up to one year and-or a fine on summary conviction up to imprisonment for life and-or an unlimited fine if convicted on indictment.
Possession of cannabis and cannabis resin is considered in a different way to other drugs. Possession of cannabis or cannabis resin for personal use is punishable only by a fine on the first and second offences. In the case of a third and subsequent offence, possession for personal use would incur a fine and-or a term of imprisonment at the discretion of the courts. This would be for up to one year on summary conviction and if convicted on indictment imprisonment for up to three years and-or a fine. Possession in any other case would incur a penalty of imprisonment for up to one year and-or a fine on summary conviction and-or up to seven years imprisonment if convicted on indictment. Following the reclassification of cannabis to a class C drug in the UK, the equivalent penalties continue to be higher than those currently in force in this country.
The recent events in the United Kingdom, therefore, do not create a justification for any change in our laws or in our approach to the possession for personal use of cannabis or cannabis resin.
Nursing Staff.
Joe Sherlock
Ceist:128 Mr. Sherlock asked the Minister for Health and Children the steps being taken to address the continuing serious shortage of nurses; the steps being taken to ensure that qualified nurses remain in the hospital service; and if he will make a statement on the matter. [7066/04]
Denis Naughten
Ceist:134 Mr. Naughten asked the Minister for Health and Children the efforts he has made to attract and retain nurses within the health service; and if he will make a statement on the matter. [6904/04]
Bernard J. Durkan
Ceist:163 Mr. Durkan asked the Minister for Health and Children the steps he has taken or proposes to take to ensure that adequate medical, surgical and nursing staff are available to meet current and future requirements having particular regard to overseas agencies recruiting here; and if he will make a statement on the matter. [6998/04]
Bernard J. Durkan
Ceist:236 Mr. Durkan asked the Minister for Health and Children the current requirements in terms of medical, nursing and surgical staff to ensure the operation of all hospitals and health institutions throughout the country; the degree to which this requirement is currently being met; his plans to address the shortfall in the foreseeable future; and if he will make a statement on the matter. [7262/04]
Bernard J. Durkan
Ceist:238 Mr. Durkan asked the Minister for Health and Children the plans he has to ensure the provision of the required levels of nursing staff at all hospitals and health boards throughout the country; and if he will make a statement on the matter. [7264/04]
I propose to take Questions Nos. 128, 134, 163, 236 and 238 together.
The chief executive officer of each individual health board has responsibility for the management of the workforce, including the appropriate staffing mix and the precise grades of staff employed within that board, in line with service plan priorities, subject to overall employment levels remaining within the authorised ceiling. Hence, the recruitment of health service staff in 2004 will take place in the context of the implementation of each health board's service plan. The Deputy may wish to note the increase in the approved employment level from 1997 to end 2003 was 27,985, 41%, bringing the approved employment ceiling to 95,800 in whole-time equivalent terms, excluding home helps. In the context of this extension, the implementation of some important initiatives are making an important contribution to strengthening the capacity of the health services to recruit and retain the high calibre professionals required in all disciplines to fill challenging and demanding roles central to the delivery of quality health and social care services to the public.
The Deputy will be aware of developments such as pay increases, improvements in career structure and enhanced opportunities for professional and career development, which have all played a part in increasing staffing levels. The implementation of the pay recommendations of the public service benchmarking body will make a further contribution to recruitment and improved retention. Overseas recruitment by health agencies has, over recent years, also contributed significantly to meeting the workforce needs of the health services, particularly in professions where qualified staff are scarce. The implementation of these, and similar, developments will make an important contribution to strengthening the capacity of the health services to recruit and retain the high calibre professionals required in all disciplines to fill challenging and demanding roles central to the delivery of quality health and social care services to the public. It is, however, important to emphasise that staffing requirements overall must be viewed in the context of the very substantial increases in employment levels achieved in the health services over the past several years.
With regard to overseas agencies recruiting in Ireland, it must be acknowledged that freedom of movement of workers is protected and encouraged under existing EU policies to which Ireland fully subscribes. I would also point out that the number of overseas health professionals employed in the Irish health service is ample evidence of our ability to recruit from abroad and that overseas staff find Ireland an attractive location in which to pursue their careers. For many years, the Irish health service has benefited hugely from the international mobility of health professionals, and our educational and regulatory regimes are well adapted to ensuring the portability of professional qualifications.
I would also point out that comparing the latest available employment levels, September 2003, to those in 1997, there are 32.5%, an extra 8,200, more nurses, 36.8% more medical and dental personnel, an extra 1,832, and over double,112%, the number of health and social care professionals, an extra 6,971, employed in the health services. This is a considerable achievement which reflects the success of the steps taken to increase the attractiveness of employment in the health services and also the ongoing measures being taken in areas experiencing shortages of fully trained and qualified staff.
The Health Service Employers Agency, HSEA, undertakes quarterly surveys of nursing vacancies, the latest of which is for the year ending 31 December 2003. The main points of the survey are: there were 994 extra nurses employed in the health service in the year ending 31 December 2003; 788 nurses were recruited from abroad in the year ending 31 December 2003; 329 nurses work every day in the hospitals as agency nurses; and the vacancy rate now stands at 1.73% nationally.
While all sectors reported that recruitment was well ahead of resignations and retirements, employers reported that 675 vacancies existed at 31 December 2003, a decrease from 1,021 vacancies in December 2002. However, the combination of utilising agency nurses and overtime adequately compensates for this shortfall.
Since the surveys began, the number of vacancies as at 31 December 2003 is the lowest recorded. The highest number was at the end of September 2000, when employers reported 1,388 vacancies. The latest figure represents a reduction of 51% on September 2000.
The current vacancy rate of 1.73% has been declining steadily in recent years, and could be considered to be a normal frictional rate, given that there will always be some level of movement due to resignations, retirements and nurses availing of opportunities to change employment and locations.
I introduced a scheme of flexible working arrangements for nurses and midwives in February 2001. Under the scheme, individual nurses and midwives may apply to work between eight and 39 hours per week on a permanent part-time basis. The figure 33,442 whole-time equivalent nurses working in the health service translates into 39,119 individual nurses. Of these, some 28,366 work full-time, and 10,753 work job-sharing or other atypical patterns. Thus, over one quarter of the nursing workforce avails of family-friendly work patterns.
There have been substantial improvements in nursing pay since 1997. For example, a staff nurse on the maximum point of the scale has seen a 51% increase in basic pay up to 1 January 2004. Since 1998 nurses have been paid for overtime. Previously they had been given time off in lieu and the introduction of payment represents a further significant financial incentive for nurses.
Last year, 1,640 nursing training places were available, and this is 70% higher than the number available in 1998. In addition, there are now in excess of 800 places available on specialist postgraduate courses including accident and emergency, coronary care and oncology. A comprehensive package of incentives, including payment of fees and other financial supports, are available to nurses undertaking these courses.
The latest survey of numbers from the Health Services Employers Agency, HSEA, shows that, out of a total complement of 3,973 filled non-consultant hospital doctor posts as at 28 September 2004, there are 33 vacancies, giving a vacancy rate of just 0.83%. These statistics clearly show that we have a very low vacancy rate among the NCHD cohort this year. Comhairle na nOspidéal is the statutory body set up under the Health Act 1970 to regulate the number and type of appointments of hospital consultants in the Irish public health service. According to the recently published Comhairle na nOspidéal consultant staffing report, during 2003, 93 additional consultant posts, a 5.4% increase on last year, were approved by the body. In the past five years 436 additional consultant posts have been approved by Comhairle na nOspidéal. This compares with 202 in the previous five years. The current consultant establishment at 1 January 2004 in the public sector was 1,824 which constitutes an average distribution of 2,148 of population per consultant throughout the country.
I am also conscious that, in view of the large numbers of staff employed and the unique nature of the services being delivered, it is imperative that a coherent, strategic approach to workforce and human resource planning be developed further and aligned closely with strategic objectives and the service planning process. Planning for the development of new and existing services in the future must be soundly based on a robust and realistic assessment of the skill and human resource needs to deliver these services. The issue of skill mix is also of paramount importance in meeting human resource needs. Enhanced skills, by matching skills to service needs, benefit patients and empower health personnel to reach their full potential and optimise their contribution to quality care.
I am, however, well aware that, in addition to effective planning to ensure the continued availability of a qualified, competent workforce, it is also necessary for the health service to become an employer of choice to further improve potential for recruitment and retention. While the record number of staff recruited into the health service in the past number of years shows the progress that has been made in this regard, even more can be achieved. Having recruited and developed such a large number of staff over recent years, it is a priority to retain them by offering a challenging and rewarding career path. In the human capital and skills intensive health sector, retention has been identified as a key issue in better people management. The continuing implementation of the Action Plan for People Management plays a crucial role in improving retention and reducing turnover of skilled staff, while providing the opportunity for each member of the workforce in the health sector, to maximise their contribution to the creation of a quality and patient-centred health service in line with the objectives of the health strategy.
Water Fluoridation.
Eamon Ryan
Ceist:129 Mr. Eamon Ryan asked the Minister for Health and Children the reason a person (details supplied) who attended the fluoridation forum has not yet received answers to the questions he raised there; and if he will make a statement on the matter. [7088/04]
The use of fluoride technology is known to manifest a positive oral health outcome. Local and national surveys and studies conducted since the introduction of fluoridation in this country attest to the reduced dental decay levels of children and teenagers in fluoridated areas compared to those residing in non-fluoridated areas. The safety and effectiveness of water fluoridation has been endorsed by a number of international and reputable bodies such as the World Health Organisation, the Centre for Disease Control and Prevention, the United States Public Health Service and the United States Surgeon General.
As the Deputy is aware, I established the forum on fluoridation to review the fluoridation of public piped water supplies in Ireland. The forum's report was launched on 10 September 2002 and its main conclusion was that the fluoridation of public piped water supplies should continue as a public health measure.
The forum also concluded that: water fluoridation has been effective in improving the oral health of the Irish population, especially of children, but also of adults and the elderly; the best available and most reliable scientific evidence indicates that at the maximum permitted level of fluoride in drinking water at one part per million, human health is not adversely affected; and that dental fluorosis, a form of discoloration of the tooth enamel, is a well-recognised condition and an indicator of overall fluoride absorption, whether from natural sources, fluoridated water or from the inappropriate use of fluoride toothpaste at a young age. There is evidence that the prevalence of dental fluorosis is increasing in Ireland.
The forum consisted of people with expert knowledge spanning the areas of public health, biochemistry, dental health, bone health, food safety, environmental protection, ethics, water quality, health promotion and representatives from the consumer and environmental areas. This diversity of professional backgrounds and representation was reflected in the comprehensive way the forum conducted its work and research. Ultimately, the forum took an evidence based approach to its examination of water fluoridation.
The forum's report emerged from 14 plenary meetings, several meetings of subgroups and oral presentations of material from both proponents and opponents of fluoridation. It invited the public to forward their views and examined more than 1,000 submissions. In adopting a participatory and evidence-based approach, it strove to ensure balance between participants from both sides of the debate on water fluoridation.
Following the publication of the forum report, members of the forum made presentations country-wide to various civic groups and bodies including the Irish Society of Toxicology and the Institute of Engineers. Many issues raised by the person concerned were covered in the forum report. It was not considered appropriate to respond comprehensively in the report to all of the questions from the person concerned; a more comprehensive response to them will be published in the coming months.
Health Service Remuneration.
Brian O'Shea
Ceist:130 Mr. O’Shea asked the Minister for Health and Children the value of the remuneration package being awarded to the part time chairman of the Interim Health Service Executive; the remuneration package it proposed to award the chief executive of the HSE; and if he will make a statement on the matter. [7022/04]
The executive chairman of the Interim Health Service Executive, HSE, is in receipt of a remuneration package totalling €100,000 per annum. This sum is commensurate with the considerable time commitment involved, the nature of the role to be performed and the experience and track record of the person appointed.
The value of the remuneration package applicable to the position of chief executive of the HSE has yet to be determined. This is currently the subject of discussions between my Department and the Department of Finance. The position will be advertised shortly.
Question No. 131 answered with Question No. 116.
Care of the Elderly.
Caoimhghín Ó Caoláin
Ceist:132 Caoimhghín Ó Caoláin asked the Minister for Health and Children the steps he has taken and proposes to take to ensure the earliest possible resourcing of the senior citizens day care facility at the Cootehill health care centre; the staffing and transport arrangements he envisages and by what date he expects same to be in place; and if he will make a statement on the matter. [6879/04]
As the Deputy will be aware, the provision of health services in Cavan is, in the first instance, the responsibility of the North Eastern Health Board.
The board has informed my Department that it has attempted over many years to support the voluntary sector in the provision of day care services to older people through section 65 grant aid. The board has stated that it has had many successes across the region in this regard, none more so than in the Cavan and Monaghan region. In this regard, an offer of significant financial support was made to representatives of the Cootehill day care centre committee prior to Christmas, which was not acceptable to the committee. In light of this development, the board now proposes that an out-reach day service will commence at the Cootehill day care centre before the end of April. This will entail the redeployment of resources from services in Cavan to Cootehill to support the delivery of a service there, initially on one day per fortnight. Again, this approach has been successful in developing services in other locations. The board is hopeful of receiving as much support as possible from local voluntary groups for its endeavours in this regard and local health board management will meet with voluntary groups from the area to consider available options.
I am hopeful that the interventions to be put in place by the North Eastern Health Board during 2004 will result in a measurably improved service for the people of Cootehill and surrounding areas.
Water Fluoridation.
Eamon Ryan
Ceist:133 Mr. Eamon Ryan asked the Minister for Health and Children the precise costs to date of the fluoridation forum; and if he will make a statement on the matter. [7087/04]
The use of fluoride technology is known to manifest a positive oral health outcome. Local and national surveys and studies conducted since the introduction of fluoridation in this country attest to the reduced dental decay levels of children and teenagers in fluoridated areas compared to those residing in non-fluoridated areas. The safety and effectiveness of water fluoridation has been endorsed by a number of international and reputable bodies such as the World Health Organisation, the Centre for Disease Control and Prevention, the United States Public Health Service and the United States Surgeon General.
As the Deputy is aware, I established the forum on fluoridation to review the fluoridation of public piped water supplies in Ireland. The forum's report was launched on 10 September 2002 and its main conclusion was that the fluoridation of public piped water supplies should continue as a public health measure.
The forum also concluded that: water fluoridation has been effective in improving the oral health of the Irish population, especially of children, but also of adults and the elderly; the best available and most reliable scientific evidence indicates that at the maximum permitted level of fluoride in drinking water at one part per million, human health is not adversely affected; and dental fluorosis, a form of discoloration of the tooth enamel, is a well-recognised condition and an indicator of overall fluoride absorption, whether from natural sources, fluoridated water or from the inappropriate use of fluoride toothpaste at a young age. There is evidence that the prevalence of dental fluorosis is increasing in Ireland.
The forum consisted of people with expert knowledge spanning the areas of public health, biochemistry, dental health, bone health, food safety, environmental protection, ethics, water quality, health promotion and representatives from the consumer and environmental areas. This diversity of professional backgrounds and representation was reflected in the comprehensive way the forum conducted its work and research. Ultimately, the forum took an evidence based approach to its examination of water fluoridation.
The report of the fluoridation forum made 33 recommendations covering a broad range of topics such as research, public awareness, and policy and technical aspects of fluoridation. The cost of the fluoridation forum to date is €335,796.77.
Question No. 134 answered with QuestionNo. 128.
Michael Ring
Ceist:135 Mr. Ring asked the Minister for Health and Children if raw water is now checked for fluoride levels before fluoridation takes place in compliance with current regulations and as reiterated by the forum on fluoridation. [6897/04]
The use of fluoride technology is known to manifest a positive oral health outcome. Local and national surveys and studies conducted since the introduction of fluoridation in this country attest to the reduced dental decay levels of children and teenagers in fluoridated areas compared to those residing in non-fluoridated areas. The safety and effectiveness of water fluoridation has been endorsed by a number of international and reputable bodies such as the World Health Organisation, the Centre for Disease Control and Prevention, the United States Public Health Service and the United States Surgeon General.
As the Deputy is aware, I established the forum on fluoridation to review the fluoridation of public piped water supplies in Ireland. The forum's report was launched on 10 September 2002 and its main conclusion was that the fluoridation of public piped water supplies should continue as a public health measure.
The forum also concluded that: water fluoridation has been very effective in improving the oral health of the Irish population, especially of children, but also of adults and the elderly; the best available and most reliable scientific evidence indicates that at the maximum permitted level of fluoride in drinking water at one part per million, human health is not adversely affected; and dental fluorosis, a form of discoloration of the tooth enamel, is a well-recognised condition and an indicator of overall fluoride absorption, whether from natural sources, fluoridated water or from the inappropriate use of fluoride toothpaste at a young age. There is evidence that the prevalence of dental fluorosis is increasing in Ireland.
The forum consisted of people with expert knowledge spanning the areas of public health, biochemistry, dental health, bone health, food safety, environmental protection, ethics, water quality, health promotion and representatives from the consumer and environmental areas. This diversity of professional backgrounds and representation was reflected in the comprehensive way the forum conducted its work and research. Ultimately, the forum took an evidence based approach to its examination of water fluoridation.
The report of the fluoridation forum made 33 recommendations covering a broad range of topics such as research, public awareness, and policy and technical aspects of fluoridation. The establishment of the expert body recommended by the forum is now well under way.
The terms of reference of the expert body are: to oversee the recommendations of the forum on fluoridation; to advise the Minister and evaluate ongoing research, including new and emerging issues on all aspects of fluoride, its delivery methods as an established health technology and as required; and to report to the Minister on matters of concern, either at his or her request or on its own initiative.
The expert body will have broad representation, including from the areas of dentistry, public health medicine, toxicology, engineering, management, environment and the public identified within the forum on fluoridation report. Letters of invitation have been issued to prospective members of the body. I am pleased to say that, based on the acceptances which have been received, the body will have a strong consumer input in terms of members of the public and representatives of consumer interests, in addition to the necessary scientific, managerial and public health inputs. My Department is in discussion on the chairmanship of the expert body, and I expect to be able to announce a decision in respect of that matter in the very near future.
I am pleased that the secretariat of the body will be provided by the Irish Dental Health Foundation, an independent charitable trust which has been very much to the fore in securing co-operation between private and public dentistry and the oral health care industry in regard to joint oral heath promotion initiatives. The foundation's stature and expertise place it in an excellent position to support the work of the forum in its initial stage. As the House is aware, the forum's report envisages that the work of the expert body may be subsumed into the health information quality authority in due course. The support of the foundation allows us to press ahead now with the establishment of the expert body in advance of the establishment of HIQA. I understand that the intention is to have an inaugural meeting of the expert body in early April.
The Health Fluoridation of Water Supplies Act 1960 stipulates that an analysis of the quantities of fluorine in public piped water supplies be undertaken before fluoridation. More than 660 public piped water supplies were sampled pursuant to this provision of the Act for naturally occurring fluoride — only five were found to have levels greater than 0.3 parts per million of naturally occurring fluoride. The forum on fluoridation recommended that the sampling of raw water for levels of fluorine should continue. It recognised that the expert body being established may have a key role in monitoring the recommendations of the forum on technical aspects of fluoridation, including this recommendation.
Question No. 136 answered with QuestionNo. 103.
General Medical Services Scheme.
Róisín Shortall
Ceist:137 Ms Shortall asked the Minister for Health and Children when he intends to publish the report commissioned from a company (details supplied) on the general medical service, given that it is over a year since a draft was submitted to him; if the report has been brought to Government; if it is intended to implement the recommendations of the report; and if he will make a statement on the matter. [7058/04]
A draft copy of the Deloitte and Touche consultancy review of governance and accountability mechanisms in the GMS schemes was received by my Department in February 2003. While the review was being considered by officials in my Department, both the Commission on Financial Management and Control Systems in the Health Service — Brennan — the Audit of Structures and Functions in the Health System — Prospectus — reports were published. Since the contents and recommendations of both of these reports are relevant to the subject matter of the GMS review, my Department requested Deloitte and Touche to update the draft in this light, and also having regard to the latest financial data from the General Medical Services (Payments) Board. The final draft of this review has been received by my Department. It is my intention to bring this review to Government as soon as possible, at which time its publication and implementation will be discussed.
Hospital Services.
Thomas P. Broughan
Ceist:138 Mr. Broughan asked the Minister for Health and Children the steps he intends to take to ensure that hospitals comply with the requirement to have a mix of 20% private and 80% public in regard to elective admissions in view of the reports that some hospitals have not complied with these guidelines; and if he will make a statement on the matter. [7008/04]
As indicated in the Government's health strategy, Quality and Fairness, measures being taken in regard to addressing equity and mix between public and private care include: setting targets for waiting times for public patients and facilitating treatment for those patients waiting longest under the national treatment purchase fund; providing that additional bed capacity should be for public patients; ensuring greater equity for public patients as part of any revised contract for hospital consultants; and reviewing current arrangements regarding access of patients to public beds.
I am committed to ensuring that private practice within public hospitals will not be at the expense of fair access for public patients and I assure the Deputy that in the context of the ongoing health reform programme every opportunity will be taken to reinforce the application of this principle in the health system.
Health Board Services.
Jim O'Keeffe
Ceist:139 Mr. J. O’Keeffe asked the Minister for Health and Children the reason the average waiting time for children seeking orthodontic treatment in the Southern Health Board area at 42 months is over three times the average waiting time in any other health board area. [6828/04]
Jim O'Keeffe
Ceist:148 Mr. J. O’Keeffe asked the Minister for Health and Children the numbers of children on the assessment waiting list for orthodontic treatment for the entire country, and for the Southern Health Board area; and the reason for the high proportion of the total in the Southern Health Board area. [6827/04]
I propose to take Questions Nos. 139 and 148 together.
I am pleased to advise the Deputy that I have taken a number of measures to improve orthodontic services in the Southern Health Board area and on a national basis.
The grade of specialist in orthodontics has been created in the health board orthodontic service. In 2003, my Department and the health boards funded 13 dentists from various health boards for specialist in orthodontics qualifications at training programmes in Ireland and at three separate universities in the United Kingdom. These 13 trainees for the public orthodontic service are additional to the six dentists who commenced their training in 2001. Thus, there is an aggregate of 19 dentists in specialist training for orthodontics. These measures will complement the other structural changes being introduced into the orthodontic service, including the creation of an auxiliary grade of orthodontic therapist to work in the orthodontic area.
Furthermore, the commitment of the Department to training development is manifested in the funding provided to both the training of specialist clinical staff and the recruitment of a professor in orthodontics for the Cork Dental School. This appointment at the school will facilitate the development of an approved training programme leading to specialist qualification in orthodontics. The chief executive officer of the Southern Health Board has reported that the professor commenced duty on 1 December 2003. In recognition of the importance of this post at Cork Dental School my Department has given approval in principle to a proposal from the school to further substantially improve the training facilities there for orthodontics. This project should see the construction of a large orthodontic unit and support facilities which will ultimately support an enhanced teaching and treatment service to the wider region under the leadership of the professor of orthodontics.
In June 2002, my Department provided additional funding of €5 million from the treatment purchase fund to health boards specifically for the purchase of orthodontic treatment. This funding is enabling boards to provide both additional sessions for existing staff and purchase treatment from private specialist orthodontic practitioners. The Southern Health Board was allocated an additional €0.720 million from this fund for the treatment of cases in this way.
The chief executive officers of the health boards-authority have informed my Department of the following information on their assessment waiting lists for December 2003:
|
Health Board/Authority |
Assessment Waiting List |
Average waiting time (months) |
|
SWAHB |
291 |
3 —6 |
|
ECAHB |
100 |
1 —3 |
|
NAHB |
179 |
3 —6 |
|
MHB |
287 |
4 |
|
MWHB |
2,432 |
24 —36 |
|
NEHB |
Nil |
No waiting time |
|
NWHB |
990 |
5 |
|
SEHB |
283 |
3 —3.5 |
|
SHB |
4,034 (12 years or older) |
According to date of birth(currently 1990) |
|
WHB |
654 |
10 |
As the Deputy is aware, the provision of orthodontic services, including the management of waiting lists, in the Southern Health Board area is a matter for the chief executive officer of that board in the first instance; therefore, my Department has asked him to respond directly to the Deputy's questions on the board's waiting list.
Finally, the chief executive officers of the health boards-authority have informed my Department that at the end of the December quarter 2003, there were 21,295 children receiving orthodontic treatment in the public orthodontic service. This means that there are over twice as many children getting orthodontic treatment as there are children waiting to be treated and 4,000 extra children are getting treatment from health boards since the end of 2001.
Question No. 140 answered with QuestionNo. 97.
Hospital Services.
Caoimhghín Ó Caoláin
Ceist:141 Caoimhghín Ó Caoláin asked the Minister for Health and Children the current status of the recommendations contained in the Kinder report on maternity services in the north east; the progress, if any, that has been made towards their implementation; and when he envisages the return of childbirth services at Monaghan General Hospital. [6880/04]
Responsibility for the provision of maternity services in the north-eastern region rests with the North Eastern Health Board. My Department has, therefore, asked the chief executive officer of the board to examine the matters raised by the Deputy and to reply to him directly.
Care of the Elderly.
Willie Penrose
Ceist:142 Mr. Penrose asked the Minister for Health and Children his views on recent suggestions that too many families are leaving the responsibility for minding elderly family members to the State and that families should contribute to the cost of keeping their older relatives in retirement homes; and if he will make a statement on the matter. [4104/04]
John Gormley
Ceist:169 Mr. Gormley asked the Minister for Health and Children the plans his Department has to ask family members of elderly people in need of care, to contribute to the cost of such care services. [4028/04]
I propose to take Questions Nos. 142 and 169 together.
As the Deputies will be aware, the practice whereby the capacity of adult sons and/or daughters to contribute to the cost of their parents' care in private nursing homes was taken into account by the health boards ceased with effect from 1 January 1999. The current situation is, therefore, that families are not legally required to contribute towards the cost of elderly relatives' maintenance costs in extended care.
It is clear from population projections that, as a society, we will have to address the issue of how we will meet the cost of long-term care in the future. The Mercer report published by my colleague, the Minister for Social and Family Affairs, considers the options available in this regard. I understand the Minister proposes to engage in widespread consultations in regard to the Mercer report prior to the establishment of a working group, involving all stakeholders, which will have the task of producing proposals for the funding of long-term care. The question of whether family members should be required to contribute to the cost of relatives' care is one which should be considered as part of that consultation process.
Consultancy Contracts.
Breeda Moynihan-Cronin
Ceist:143 Ms B. Moynihan-Cronin asked the Minister for Health and Children if consultants have been appointed to run a public relations and information campaign in connection with the Hanly report; the identity of the company appointed; the value of the contract; and if he will make a statement on the matter. [7021/04]
Following a tendering process conducted in accordance with public procurement guidelines, my Department will shortly appoint a firm to arrange an information campaign relating to the report of the national task force on medical staffing.
Hospital Procedures.
Eamon Gilmore
Ceist:144 Mr. Gilmore asked the Minister for Health and Children the details of the inquiry being held into the death of a person at a hospital (details supplied); when the committee appointed to inquire into complaints made against two consultants at the hospital will report; and if he will make a statement on the matter. [7011/04]
Responsibility for the provision of services at Cavan General Hospital rests with the North Eastern Health Board, NEHB.
An expert group was established by the board on the 2 February 2004 to undertake a review of all factors involved in this case. The review will cover the period from the child's first contact with Cavan General Hospital on the 7 January 2004 to her untimely death on the 1 February 2004. The expert group is comprised of senior clinical, nursing and risk management personnel and was asked by the board to report as a matter of urgency.
With regard to the suspension of the two consultants in Cavan General Hospital, I formed the committee of inquiry on the 30 January, 2004 and it held its first meeting on the 10 February, 2004. At the outset of this case, the chairman indicated that the work of the committee would take approximately eight weeks. It is probable, therefore, that the committee will finish its work in April. A report will then be produced by the chairman.
Pharmacy Regulations.
Michael D. Higgins
Ceist:145 Mr. M. Higgins asked the Minister for Health and Children when the Mortell report will be published; his views on the future regulation of pharmacy services here; and if he will make a statement on the matter. [7015/04]
Bernard J. Durkan
Ceist:241 Mr. Durkan asked the Minister for Health and Children if his attention has been drawn to the fact that deregulation in other countries has led to a take-over by monopolies in the pharmaceutical industry; if he can ensure that this does not happen here; and if he will make a statement on the matter. [7267/04]
Michael Ring
Ceist:242 Mr. Ring asked the Minister for Health and Children the reason for the delay in the publication of the Mortell report; and if he will make a statement on the matter. [7281/04]
I propose to take Questions Nos. 145, 241 and 242 together.
I assume the Deputy is referring to the pharmacy review group report. I established that body in November 2001 to examine the pharmacy issues raised in the OECD report on regulatory reform in Ireland. The group submitted its report on 31 January 2003. I have been examining the complex legal and other issues surrounding the group's recommendations. Deputies will appreciate that it would not be appropriate for me to comment on the report's recommendations before completion of this examination. I have made the report available on my Department's website.
Registration of Medical Practitioners.
Joe Costello
Ceist:146 Mr. Costello asked the Minister for Health and Children the steps he intends to take arising from the recent Supreme Court decision in a case (details supplied) that could result in doctors struck off in other jurisdictions being free to practise here; and if he will make a statement on the matter. [7009/04]
Under the Medical Practitioners Act 1978, the Medical Council was established as the body with the statutory responsibility for the registration of medical practitioners and the regulation of their activities in Ireland.
In the particular case referred to by the Deputy, the Supreme Court confirmed an earlier decision of the High Court in respect of a case where a doctor had been struck off in another jurisdiction. The Medical Council, due to the unavailability of the original witnesses, had proposed to use the transcript of the proceedings from the foreign jurisdiction in a fitness to practice inquiry to be undertaken by the Medical Council. The Supreme Court ruled that the use of the transcript, with no opportunity for the defendant to cross-examine his accusers, would deprive the doctor concerned of his right to fair procedures.
The doctor in question had been registered with the Medical Council before any accusations were made in the other jurisdiction. As the witnesses who gave evidence in the foreign jurisdiction were not prepared to attend hearings in Ireland, the council, not being in a position to proceed with an inquiry into the matter, had no cause or right to remove the doctor's name from the general register of medical practitioners.
A major review of the Medical Practitioners Act is taking place in my Department and draft heads of a Bill for significant amendments to the Act have been prepared and will shortly be brought to Cabinet for approval. The implications of the ruling in this case have been fully considered in that context.
Question No. 147 answered with QuestionNo. 123.
Question No. 148 answered with QuestionNo. 139.
Hospital Death Inquiry.
Seán Ryan
Ceist:149 Mr. S. Ryan asked the Minister for Health and Children when he expects to receive the report of the independent review into the circumstances of the death of a person (details supplied); and if he will make a statement on the matter. [7057/04]
On 23 July last, I announced that I had convened a review panel to conduct an independent review of the events surrounding the tragic death of the person concerned. The members of the panel are: Mr. David Hanly, management consultant; Ms Kay O'Sullivan, director of nursing at Cork University Hospital; and Dr. Shakeel A. Qureshi, paediatric cardiologist at Guy's and Thomas's Hospital, London.
The terms of reference of the panel are: to consider the report of the ERHA on the events of 30 June 2003 at Our Lady's Hospital for Sick Children, Dublin, and to make such further inquiries and conduct such interviews as the panel considers necessary; to address the questions raised by the family; to examine protocols and procedures relevant to this incident having regard to prevailing standards of best practice, and to examine their application in this case; and to report to the Minister and to make such recommendations as it sees fit. Following the review, both reports will be made available.
The work of the review panel is ongoing and I am not in a position to say, at this stage, when the report will become available.
Health Reform Programme.
Liz McManus
Ceist:150 Ms McManus asked the Minister for Health and Children the matters discussed and conclusions reached at the first meeting of the National Steering Committee held on 16 February 2004; if concerns were expressed at the meeting regarding the high cost of the Government proposals; if concern was also expressed regarding the confusion evident in the work of the action groups regarding the policy-executive split; and if he will make a statement on the matter. [7006/04
Liz McManus
Ceist:215 Ms McManus asked the Minister for Health and Children the matters discussed and conclusions reached at the first meeting of the National Steering Committee held on 16 February 2004; if concerns were expressed at the meeting regarding the high cost of the Government proposals; if concern was expressed regarding the confusion evident in the work of the action groups regarding the policy-executive split; and if he will make a statement on the matter. [7165/04]
I propose to take Questions Nos. 150 and 215 together.
The first meeting of the National Steering Committee for the health service reform programme took place on 16 of February last.
The role of the National Steering Committee is to oversee the different strands of the health reform programme, confirming direction and ensuring that objectives are delivered. It provides a co-ordinating forum for actions being led by the Hanly group and the Interim Health Service Executive and the Department, respectively. It will provide guidance on programme planning and ensure that direction and progress are in line with the Government's decisions. It will report to me and the Cabinet committee on a regular basis. Reports will comment on progress achieved and should surface, in particular, any issues which require a response at Government level. It will liaise with the health reform project office in the Department of Health and Children and the board of the Interim Health Service Executive in the implementation process.
This initial meeting provided an opportunity for the committee to be briefed on progress to date in the first phase of implementation of the programme; updated on the development of a project plan for the next phases, including the identification of key milestones in 2004; and to discuss the most appropriate focus for the committee in guiding and overseeing progress.
The Deputy may wish to note that concerns were not expressed regarding the high cost of the Government proposals and confusion regarding the policy-executive split as these matters were not discussed by the committee. A short presentation was given which highlighted a number of issues which have emerged during phase I and which will be dealt with in the next phase of the programme. These include fully clarifying the description of the roles and responsibilities of the three main structures in the new system — my Department, the Health Service Executive and the Health Information and Quality Authority — to the level of detail required to make the necessary statutory provisions in legislation.
Health Board Services.
Michael D. Higgins
Ceist:151 Mr. M. Higgins asked the Minister for Health and Children if his attention has been drawn to the claims made by persons (details supplied) at a recent meeting of the Oireachtas Committee on Health and Children that his Department was allowing consultants to abuse their positions by refusing treatment to children in an effort to artificially reduce waiting lists; the steps he is taking to investigate these claims; and if he will make a statement on the matter. [7013/04]
The provision of orthodontic services is the statutory responsibility of the health boards-authority in the first instance. The aim of my Department is to develop the treatment capacity of orthodontics in a sustainable way over the longer term. Given the potential level of demand for orthodontic services, the provision of those services will continue to be based on prioritisation of cases based on treatment need, as happens under the existing guidelines. Under the Health Act 1970, a child is eligible for orthodontic treatment on the basis of defects noted at a school health examination carried out while the child is attending national school. Entitlement to orthodontic treatment is determined by reference to orthodontic guidelines, a set of objective clinical criteria applied by health board orthodontists when assessing children's priority of need for treatment. The orthodontic guidelines were issued by my Department in 1985 and are still in use. The guidelines are used to ensure that orthodontic resources are prioritised for and applied equitably to the most severe cases; therefore, the question of refusing treatment to children to artificially reduce waiting lists, as alleged, does not arise. When a health board orthodontist decides that a child is in clinical need of orthodontic treatment in accordance with the criteria, he or she is then placed on a treatment waiting list. The guidelines are intended to enable health boards to identify in a consistent way those in greatest need and to commence timely treatment for them. The number of cases treated is dependent on the level of resources available, in terms of qualified staff, in the area and this is reflected in the treatment waiting list. The provision of orthodontic services is currently severely restricted due to the limited availability of trained specialist clinical staff to assess and treat patients. However, I am pleased to advise the Deputy that I have taken a number of measures to address this shortage of specialist clinical staff.
The grade of specialist in orthodontics has been created in the health board orthodontic service. In 2003, my Department and the health boards funded 13 dentists from various health boards for specialist in orthodontics qualifications at training programmes in Ireland and at three separate universities in the United Kingdom. These 13 trainees for the public orthodontic service are additional to the six dentists who commenced their training in 2001. Thus, there is an aggregate of 19 dentists in specialist training for orthodontics. These measures will complement the other structural changes being introduced into the orthodontic service, including the creation of an auxiliary grade of orthodontic therapist to work in the orthodontic area.
Furthermore, the commitment of the Department to training development is manifested in the funding provided to both the training of specialist clinical staff and the recruitment of a professor in orthodontics for the Cork Dental School. This appointment at the school will facilitate the development of an approved training programme leading to specialist qualification in orthodontics. The chief executive officer of the Southern Health Board has reported that the professor commenced duty on 1 December 2003. In recognition of the importance of this post at Cork Dental School my Department has given approval in principle to a proposal from the school to further substantially improve the training facilities there for orthodontics. This project should see the construction of a large orthodontic unit and support facilities; it will ultimately support an enhanced teaching and treatment service to the wider region under the leadership of the professor of orthodontics.
Orthodontic initiative funding of €4.698 million was provided to the health boards-authority in 2001 and this has enabled them to recruit additional staff, engage the services of private specialist orthodontic practitioners to treat patients and build additional orthodontic facilities.
In June 2002, my Department provided additional funding of €5 million from the treatment purchase fund to health boards specifically for the purchase of orthodontic treatment. This funding is enabling boards to provide both additional sessions for existing staff and purchase treatment from private specialist orthodontic practitioners.
The chief executive officers of the health boards-authority have informed me that at the end of the December quarter 2003, there were 21,295 children receiving orthodontic treatment from the health boards-authority. This means that there are over twice as many children getting orthodontic treatment as there are children waiting to be treated and 4,000 extra children are getting treatment from health boards since the end of 2001.
Survivors of Symphisiotomy.
Trevor Sargent
Ceist:152 Mr. Sargent asked the Minister for Health and Children the progress he has made is assisting the survivors of symphysiotomy; and if he will make a statement on the matter. [7089/04]
As the Deputy is aware, I met the Survivors of Symphysiotomy — SOS —group, and I agreed that a range of measures would be put in place by the Eastern Regional Health Authority, ERHA, and the health boards to support the group. Since then, the ERHA and the health boards have been liaising on a regular basis with the SOS group on the implementation of these measures, and I am advised that the current position is as follows: each health board-authority has appointed a liaison officer within the organisation to liaise with patients who have undergone symphysiotomy; the ERHA and the health boards have initiated steps to ascertain the number of symphysiotomies carried out in hospitals in their regions — it may take some time to complete this process as procedures may have been carried out in maternity units or in hospitals that no longer exist; an exercise is under way to profile patients to assist in formulating a needs assessment for each individual — the SOS group is helping to contact its members in this regard; arrangements are being finalised with regard to the provision of independent counselling services; an information leaflet has been prepared in consultation with the SOS group and this leaflet will issue from the ERHA-health boards to general practitioners and patients shortly; arrangements are being made to provide independent clinical advice to patients who have undergone symphysiotomy — this has already been availed of by a number of members of the SOS group, and the ERHA-health boards have indicated that they will be submitting details of a health care package for patients to the Department shortly; and discussions have taken place with SOS regarding the setting-up of an information line which would be staffed by appropriate health care personnel.
In addition, my Department has been in discussion with the ERHA-health boards and the Department of Social and Family Affairs on a range of eligibility issues in respect of the provision of services and assistance to the patients.
The ERHA and the health boards will continue to liaise with the group on the implementation of the above measures. The chief medical officer has contacted an international expert, with a view to undertaking an external review of the practice of symphysiotomy in Ireland and he is awaiting his reply.
Health Reports.
Ciarán Cuffe
Ceist:153 Mr. Cuffe asked the Minister for Health and Children his views on recent studies from Britain which show a link between social class and ill health; if he will undertake a similar comprehensive study here; and if he will make a statement on the matter. [7084/04]
I am aware of the reports to which the Deputy refers that show a link between social class and ill health. I understand the Deputy is referring to a number of studies but with particular reference to the Wanless report recently published. This report provides general policy on broad population health issues including health determinants, reducing health inequalities and on the public health delivery plans to underpin these.
The Deputy will be aware that both the national health strategy, Quality and Fairness: A Health System for You, and various reports of the chief medical officer, in particular the Annual Report of the Chief Medical Officer 1999 and Better Health For Everyone: A Population Health Approach for Ireland, the Annual Report of the Chief Medical Officer 2001, have pointed out the links between poverty and ill health in an Irish context.
On research studies, a number of initiatives have been undertaken already and others are currently under way on the issue of health status or mortality which disaggregate data by socio-economic group or occupational class.
In 2001, I launched Inequalities in Mortality 1989-1998: A Report on All-Ireland Mortality Data, jointly with my counterpart in Northern Ireland. This study was carried out by the Institute of Public Health in Ireland, which is an all-Ireland body. This report has shown that the all-cause mortality rate in the lowest occupational groups was 100 to 200% higher than the rate in the highest occupational group. These occupational class gradients in mortality were present for all major causes of mortality: cancers, circulatory diseases, respiratory diseases, injuries and poisonings.
The consultation process for the all-Ireland study on traveller health status and health needs has been concluded. An all-Ireland feedback event on this took place in December of last year. A proposal from the Institute of Public Health on the design, management and funding of the study is currently under consideration in my Department. A pilot study on the inclusion of an ethnic identifier in a number of data sources is also being supported.
Last year my Department commissioned the Institute of Public Health to progress work on data and monitoring requirements for the National anti-poverty strategy, NAPS, health targets. This work includes working with the Central Statistics Office to strengthen the quality of the reporting of socio-economic group information in mortality records, and specifying the data and analyses required to monitor progress towards the NAPS target on mortality from cardiovascular disease. Another relevant report is the Institute of Public Health North/South study on social capital which is due to be launched in spring of this year. To address a recognised shortage of representative health and lifestyle data available to health service planners the health promotion unit of my Department commissioned in 1998 the National health and lifestyle surveys to be carried out at four-yearly intervals. The first report was published in 1999 and the second on 16 April 2003. These surveys aim to produce reliable baseline data on key health related lifestyle behaviours including smoking, alcohol consumption and exercise for a representative cross-section of the Irish population.
I have no plans at present to undertake a study for Ireland similar to the Wanless report to which the Deputy refers for the reason that many of the issues and recommendations in Wanless have already been taken on board in recent strategies, in particular in the national health strategy, Quality and Fairness: A Health System for You. The four goals of the national health strategy are better health for everyone, fair access, responsive and appropriate care delivery and high performance. The four objectives of the first goal, better health for everyone, clearly address issues covered in Wanless. These four objectives are: the health of the population is at the centre of public policy; the promotion of health and well-being is intensified; health inequalities are reduced; specific quality of life issues are targeted.
The targets to reduce health inequalities set out in the Government's review of the NAPS, Building an Inclusive Society: Review of the National Anti-Poverty Strategy under the Programme for Prosperity and Fairness, have been integrated into the national health strategy. These targets were developed in the course of an extensive consultation process with poor and excluded groups. Key health targets are to reduce the gap in premature mortality and low birth weight between the highest and lowest socio-economic groups by 10% by 2007, and to reduce differences in life expectancy between Travellers and the rest of the population.
Many of the actions set out in the action plan accompanying the national health strategy are already under way. For example, the Department of Health and Children, in partnership with the Institute of Public Health, is developing a programme of health impact assessment, HIA. An introductory policy seminar for senior managers and the launch of HIA methodology guidelines and a screening tool for HIA took place in July 2003. Reforms currently under way acknowledge quality and fairness —with its targets —and will put in place structures to underpin this in the Department of Health and Children and the Health Service Executive. The Institute of Public Health has been commissioned to work with the Health Board Executive, the Office for Social Inclusion and the Combat Poverty Agency to support health boards in implementing actions to achieve NAPS targets.
The existing National Health Promotion Strategy 2000-2005 is also central to population health, as are the cardiovascular strategy, the new cancer strategy currently being developed and the mental health policy, which is also in development. My priority now is implementation of actions in the context of the above strategies and of the Government's health reform programme generally.
Health Board Services.
Dinny McGinley
Ceist:154 Mr. McGinley asked the Minister for Health and Children the number of patients awaiting orthodontic treatment in County Donegal; and the efforts that are being made to improve the situation. [6829/04]
The provision of orthodontic services is a matter for the health boards in the first instance.
I am pleased to advise the Deputy that I have taken a number of measures to improve orthodontic services in the North Western Health Board, NWHB, area and on a national basis. The grade of specialist in orthodontics has been created in the health board orthodontic service. In 2003, my Department and the health boards funded 13 dentists from various health boards — including one from the NWHB — for specialist in orthodontics qualifications at training programmes in Ireland and at three separate universities in the United Kingdom. These 13 trainees for the public orthodontic service are additional to the six dentists who commenced their training in 2001. Thus, there is an aggregate of 19 dentists in specialist training for orthodontics. These measures will complement the other structural changes being introduced into the orthodontic service, including the creation of an auxiliary grade of orthodontic therapist to work in the orthodontic area.
Furthermore, the commitment of the Department to training development is manifested in the funding provided to both the training of specialist clinical staff and the recruitment of a professor in orthodontics for the Cork Dental School. This appointment at the school will facilitate the development of an approved training programme leading to specialist qualification in orthodontics. The chief executive officer of the Southern Health Board has reported that the professor commenced duty on 1 of December 2003. In recognition of the importance of this post at Cork Dental School my Department has given approval in principle to a proposal from the school to further substantially improve the training facilities there for orthodontics. This project should see the construction of a large orthodontic unit and support facilities; it will ultimately support an enhanced teaching and treatment service to the wider region under the leadership of the professor of orthodontics.
Orthodontic initiative funding of €4.698 million was provided to the health boards-authority in 2001 and this has enabled health boards to recruit additional staff, engage the services of private specialist orthodontic practitioners to treat patients and build additional orthodontic facilities. The NWHB was allocated an additional €0.273 million in 2001 for orthodontic services of which €0.178 million was for the orthodontic initiative.
In June 2002, my Department provided additional funding of €5 million from the treatment purchase fund to health boards specifically for the purchase of orthodontic treatment. This funding is enabling boards to provide both additional sessions for existing staff and purchase treatment from private specialist orthodontic practitioners. The NWHB was allocated an additional €0.285 million from this fund for the treatment of cases in this way.
The waiting times for orthodontic treatment by county are not routinely collected by my Department. Therefore, the chief executive officer of the NWHB has been requested to provide the information requested directly to the Deputy.
The chief executive officer of the NWHB has informed my Department that at the end of the December 2003 quarter, the average waiting times for category A and category B orthodontic treatment were seven months and 2.3 years, respectively. The chief executive officer of the NWHB also informed my Department that at the end of the December 2003 quarter, there were 2,532 patients receiving orthodontic treatment in the board's area.
Social Services Inspectorate.
David Stanton
Ceist:155 Mr. Stanton asked the Minister for Health and Children his plans to expand the role of the Social Services Inspectorate; and if he will make a statement on the matter. [7004/04]
The Social Services Inspectorate, SSI, was established in April 1999, initially on administrative basis, but it is proposed to establish it on a statutory basis. The main function of the inspectorate is to support the child care services by promoting and ensuring the development of quality standards. The SSI will monitor all personal social services operated by the health boards, in the longer term, but initially it is concentrating on the child care area and in particular on the inspection of health board operated residential child care facilities.
The health strategy, Quality and Fairness —A Health System for You, states that the SSI will be established on a statutory basis and its remit will be extended to cover residential services for people with disabilities and older people. Establishing the SSI on a statutory basis will strengthen its role and will provide it with the necessary independence in the performance of its functions. It will also serve to increase public confidence in state and voluntary social services. Consultation with the Department of Finance on the statutory instrument to enable the SSI to be established on a statutory footing is in progress.
Assisted Human Reproduction.
Brendan Howlin
Ceist:156 Mr. Howlin asked the Minister for Health and Children the progress made to date by the Commission on Assisted Human reproduction which was established in March 2000; when he expects to receive the report of the commission; and if he will make a statement on the matter. [7065/04]
The Commission on Assisted Human Reproduction was established in March 2000 with the following terms of reference: to prepare a report on the possible approaches to the regulation of all areas of assisted human reproduction and the social, ethical and legal factors to be taken into account in determining public policy in this area.
The first commission meeting was held on 26 July 2000 and the most recent on 5 February 2004. I understand that the commission has adopted an interdisciplinary approach to its work. Initially, each discipline, medical, legal scientific and social, prepared a report outlining the current position within that discipline on assisted human reproduction. Work groups were then formed to examine specific topics and issues that needed to be addressed. The work groups meet on a regular basis to discuss their tasks and to progress the work of the commission.
The work group structure facilitates close attention to a relatively limited range of topics by a highly specialised group. It also facilitates the detailed exploration of a range of ethical and social implications that arise from assisted human reproduction.
The commission organised a one-day conference in Dublin Castle in September 2001. The conference dealt with the social, ethical and legal factors inherent in assisted human reproduction. It provided an opportunity for an exchange of views between experts in the various fields from Ireland, the UK, France and Germany.
When the commission was set up, I indicated that it would be required to seek submissions from the public and to consult appropriate interests. In order to inform itself on the current state of public opinion in Ireland on assisted human reproduction, the commission placed an advertisement in the newspapers inviting interested members of the public, professional or voluntary organisations and other parties who wished to do so to make written submissions before Wednesday, 31 October 2001. Over 1,600 of these were received and examined.
I understand that the commission has engaged in a number of information gathering exercises that include: survey of assisted human reproduction services provided in specialised clinics — a survey instrument was drafted by the commission with a view to establishing the extent of the provision of assisted human reproduction services in Ireland; a survey of GPs — the commission issued a survey instrument to a random sample to 50% of GPs in all health board areas and I understand that a high proportion of those surveyed responded; a survey of obstetricians and gynaecologists — the commission also issued a survey instrument to obstetricians and gynaecologists to elicit information on their level of involvement in assisted human reproduction services; and a survey of public attitudes and opinions — the commission has also surveyed public attitudes and opinions on a range of questions related to assisted human reproduction.
I understand that the commission is nearing completion of its work, but given the complex ethical, social and legal implications which arise, it is not possible to say when it will be in a position to finalise a report.
Contaminated Blood Products.
Emmet Stagg
Ceist:157 Mr. Stagg asked the Minister for Health and Children the position in regard to his commitment that there would be an inquiry into the role of multi-national drug companies in the contamination of blood products; and if he will make a statement on the matter. [7061/04]
As the House is aware, I appointed Mr. Paul Gardiner, Senior Counsel, to produce a situation report about the position in Ireland and in the United States in respect of a possible investigation into the actions of the multinational pharmaceutical companies whose products are implicated in the HIV and hepatitis C infection of persons with haemophilia.
As part of his investigations, Mr. Gardiner liaised with solicitors acting for the Irish Haemophilia Society. He travelled to the United States and spoke to a number of relevant experts, including the lead counsel in the HIV haemophiliac litigation in the United States. Mr. Gardiner also received legal advice from a major New York law firm on the matters relevant to his investigations.
Mr. Gardiner furnished a report to me which consisted of a 60 page opinion and a number of appendices, one of which comprised over 50 pages of legal advice from the US lawyers. The report drew attention to the fact that there is no guarantee that the US authorities would provide judicial assistance to an Irish tribunal, either on enforcing the discovery of documents or compelling the attendance of witnesses. I briefed my Cabinet colleagues on the content of the report and I provided the Irish Haemophilia Society with a copy of it.
Notwithstanding the difficulties that have been identified, I believe it would be possible to mount a useful investigation which would access publicly available material and seek the assistance of persons and bodies willing to co-operate with such investigation. The committees of investigation Bill may provide an appropriate mechanism for this inquiry. Other legal avenues are also being explored in consultation with the Attorney General and the legal representatives of the Irish Haemophilia Society. I intend to maintain contact with the Irish Haemophilia Society regarding this issue.
Medical Cards.
Willie Penrose
Ceist:158 Mr. Penrose asked the Minister for Health and Children the number of persons holding medical cards, at the latest date for which figures are available, who exceed the income levels specified in the guidelines, but who have received cards as a result of discretionary powers of chief executive offices of health boards; and if he will make a statement on the matter. [7026/04]
The latest information available on medical card coverage is that for 1 February 2004. There were 759,654 cards, covering 1,149,081 persons, or 29.33% of the population, in existence at that time.
Information on the numbers of discretionary medical cards, that is, cards for persons whose income exceeds the guidelines but who have been granted medical cards, is not routinely kept by my Department. The matter will be referred to the area boards and the authority for investigation and direct reply to the Deputy.
Smoking Ban.
Ciarán Cuffe
Ceist:159 Mr. Cuffe asked the Minister for Health and Children if outdoor areas designated under the Public Health (Tobacco) (Amendment) Bill 2003 will have no smoking as well as smoking areas; and if he will make a statement on the matter. [7075/04]
The new smoke-free workplaces measures will apply, with limited exceptions, to all enclosed places of work. These measures will not apply to outdoor areas. The provision of no smoking sections in outdoor areas, such as beer gardens, would be a matter for the occupier, manager or person in charge of the workplace concerned.
Hospital Accommodation.
Jack Wall
Ceist:160 Mr. Wall asked the Minister for Health and Children the steps being taken to deal with bed closures and the ensure that optimum use is made of all hospital beds, in view of the fact that more than 50,000 bed days were lost in the first six months of 2003; and if he will make a statement on the matter. [7067/04]
It is a feature of all acute hospital systems that some beds are out of use for short periods. Bed closures fluctuate over time and may arise for a variety of reasons, such as ward refurbishment, essential ward maintenance, staff leave, seasonal closures and infection control measures. The figure mentioned by the Deputy represents just over 2% of the overall capacity for the first six months of 2003.
Some hospitals, particularly in the Dublin region, temporarily closed some beds during 2003 due to budgetary difficulties. These closures were in addition to the normal seasonal closures that take place in hospitals during holiday periods.
I have requested the Eastern Regional Health Authority to recruit the staff necessary to ensure all beds are reopened as soon as possible.
Question No. 161 answered with QuestionNo. 104.
Hospital Services.
Bernard J. Durkan
Ceist:162 Mr. Durkan asked the Minister for Health and Children his alternative proposals to those set out in the Hanly report with particular reference to the implications for the various general hospitals throughout the country; if his attention has been drawn to the likely negative impact of the Hanly proposals; and if he will make a statement on the matter. [6997/04]
I believe the Hanly report will have a very positive impact for hospitals and for the patients that they serve. The proposals involve much better access to senior clinical decision-making, a substantial increase in consultant numbers, shorter working hours for junior doctors and a better organised service for patients in acute hospitals throughout the country. For these reasons, I have no plans to put forward alternative proposals, nor have I seen any viable alternative proposals from others.
Question No. 163 answered with QuestionNo. 128.
Questions Nos. 164 and 165 answered with Question No. 122.
Paudge Connolly
Ceist:166 Mr. Connolly asked the Minister for Health and Children the steps he proposes to take to ensure the continued provision of full services at Cavan General Hospital; and if he will make a statement on the matter. [6826/04]
Responsibility for the provision of services at Cavan General Hospital rests with the North Eastern Health Board. My Department has, therefore, asked the chief executive officer of the board to examine the matter raised by the Deputy and to reply to him directly. I met with representatives of the hospital's medical board, at their request, on 5 February 2004 to discuss the position with regard to the provision of acute hospital services within the Cavan-Monaghan hospital group. The medical board representatives tabled several proposals at this meeting which are the subject of discussion with the North Eastern Health Board.
Question No. 167 answered with QuestionNo. 108.
Question No. 168 answered with QuestionNo. 99.
Question No. 169 answered with QuestionNo. 142.
Question No. 170 answered with QuestionNo. 97.
Community Care.
Mary Upton
Ceist:171 Dr. Upton asked the Minister for Health and Children in regard to his announcement of July 2002, the number of the promised 850 community nursing units that are now available; the hospitals in which they are available; the number in each case; and if he will make a statement on the matter. [7069/04]
The 850 additional beds which I announced in July 2002 were for community nursing units to be provided under two pilot public private partnership projects in 17 locations throughout the Eastern Regional Health Authority and Southern Health Board areas. These additional beds are not available, as the process of providing services under a PPP arrangement requires the health board or authority to comply with the EU procurement legislation and national guidelines on PPPs.
A public sector benchmark has been prepared and finalised by the ERHA. This is a comprehensive and detailed risk adjusted costing of the project elements using conventional procurement over the whole life of the project. My Department is in consultation with the Department of Finance about this. The Southern Health Board is finalising its public sector benchmark. On approval contract notices will be advertised in the Official Journal of the European Union. It is expected that the community nursing units will begin to come on stream in 2006.
Hospitals Building Programme.
Joan Burton
Ceist:172 Ms Burton asked the Minister for Health and Children when it is expected that the new five storey facility at James Connolly Memorial Hospital, Blanchardstown, which cost more than €96 million to construct and equip, will be brought into service; the steps being taken to ensure that the facility is commissioned without further delay; and if he will make a statement on the matter. [7059/04]
Responsibility for the provision of services at James Connolly Memorial Hospital rests with the Eastern Regional Health Authority. This major development is being funded jointly by the Northern Area Health Board, through the sale of surplus lands, and my Department. The projected full cost is €101.4 million. This includes an amount of €5 million approved last year to facilitate refurbishment works at the hospital which are necessary as part of the transition process to the new hospital and to facilitate a land transfer in line with the project development arrangements.
My Department is advised that the first phase of the transition to the new development at James Connolly Memorial Hospital, Blanchardstown has been completed. The coronary care and cardiac unit, the therapeutic psychiatry of old age unit, day hospital and the rheumatology service transferred to the new building in September 2003. The further commissioning of this development is being examined by the ERHA and my Department.
Smoking Ban.
Tom Hayes
Ceist:173 Mr. Hayes asked the Minister for Health and Children his views on whether the manner in which the smoking ban has been effected has adversely influenced its legal certainty; and if he will make a statement on the matter. [6932/04]
When drafting the necessary legislation required for the introduction of the smoke-free workplaces measure, legal advice was received from the Attorney General. I am satisfied that I am taking all the necessary precautions to ensure the legislation is sound. It is not possible to guarantee that any legislation is immune to a legal challenge.
Work Permits.
Ned O'Keeffe
Ceist:174 Mr. N. O’Keeffe asked the Tánaiste and Minister for Enterprise, Trade and Employment the position regarding an application for a non-EEA work permit in respect of a person (details supplied) who is working under a work permit at present. [7187/04]
A work permit application was received on 24 February 2004. Assuming the application is complete and is otherwise in order, work permits take approximately four weeks to process.
Ned O'Keeffe
Ceist:175 Mr. N. O’Keeffe asked the Tánaiste and Minister for Enterprise, Trade and Employment if a work permit was obtained in respect of a person (details supplied) in 2003. [7188/04]
The work permit was not issued as the employer in this case wrote to the work permit section of my Department in September 2003 requesting the work permit application to be cancelled on the basis that the employee withdrew her intention to work for this employer.
Enda Kenny
Ceist:176 Mr. Kenny asked the Tánaiste and Minister for Enterprise, Trade and Employment the conditions under which a person from Bali may obtain a work permit for employment here; and if she will make a statement on the matter. [7244/04]
Enda Kenny
Ceist:177 Mr. Kenny asked the Tánaiste and Minister for Enterprise, Trade and Employment the conditions under which a US national may obtain a work permit for employment here; and if she will make a statement on the matter. [7245/04]
I propose to take Questions Nos. 176 and 177 together.
An employer who wishes to employ a non-EEA national must apply to my Department for a work permit. In considering such applications cognisance is taken of the status of the prospective employee, the skill requirements of the job and whether the employer has sought an Irish or EU person for this work. My Department gives preference to accession state nationals particularly in respect of low-skilled jobs.
After EU enlargement, in May 2004, it is anticipated that new work permits will be granted only for high skilled, high paid employment, the balance of our overseas personnel needs being met from within the enlarged EU labour market.
Company Closures.
Billy Timmins
Ceist:178 Mr. Timmins asked the Tánaiste and Minister for Enterprise, Trade and Employment if her attention has been drawn to the closure of a company (details supplied) in County Wicklow; if representations were made to her seeking assistance to keep the Nigerian market available for the export of soap; and if she will make a statement on the matter. [7246/04]
I regret very much the job losses as a result of the company's decision to close. FÁS is offering its full range of services to the workers affected. I am advised by IDA Ireland that on 7 January 2004, the federal executive council of Nigeria's Government, as part of a protective trade policy, announced a list of banned import goods into Nigeria. In total, 41 items were placed on the list, including soap.
I understand that, as most of the output of the Arklow facility was destined for the Nigerian market, the owners felt they had no option but to announce the closure of the facility. No representations were made to me seeking assistance to keep the Nigerian market available for the export of soap.
Defence Forces Staff.
Jack Wall
Ceist:179 Mr. Wall asked the Minister for Defence if he will investigate the transfer of a person (details supplied) to an army facility for family reasons; and if he will make a statement on the matter. [7176/04]
The military authorities have advised that the individual in question applied for a transfer from 2 Infantry Battalion to 1 Air Defence Regiment Curragh Camp on 14 November 2003. The application was not recommended by his commanding officer or by the general officer commanding of the Defence Forces Training Centre, as there were no vacancies in the proposed unit.
The individual in question submitted another application to 1 Armoured Cavalry Squadron, Curragh Camp on 1 March 2004. This application is being considered by his commanding officer. Following his commanding officer's recommendation the application will be forwarded to the general officer commanding 2 Eastern Brigade and to the proposed unit for their consideration. It is not possible at this stage to indicate what the outcome of the individual's current application for transfer may be.
The transfer from one service or unit to another of a member of the Permanent Defence Force is entirely a matter for the military authorities in the light of operational requirements. Applications for transfers must be made through the normal military channels in the prescribed manner. The outcome of any such application is notified to the individual through the normal military channels. Every effort is made to facilitate transfer applications where circumstances permit. Applications are considered having regard to factors such as the manpower level of the unit in which the applicant is serving, the number of transfer applications already on hand, the seniority of the applicant within the unit and the existence of a suitable vacancy in the unit to which the applicant wishes to transfer.
Defence Forces Property.
Ned O'Keeffe
Ceist:180 Mr. N. O’Keeffe asked the Minister for Defence the position regarding the disposal of a small section of property owned by his Department in County Cork to a person (details supplied) in County Cork. [7178/04]
My Department holds a small area of ground, which was part of the former military barracks in the locality in question. The matter of the possible disposal of that land remains under consideration in my Department and related mapping and title matters are being examined prior to a final decision being taken on the matter. I intend that the matter will be brought to a conclusion at an early date.
Enda Kenny
Ceist:181 Mr. Kenny asked the Minister for Defence if he will report on the deplorable condition in respect of some of the housing conditions for soldiers and their families at the military quarters in the Curragh, County Kildare; his proposals to deal with this situation; the moneys allocated for this purpose in 2004; the works expected to be carried out; and if he will make a statement on the matter. [7241/04]
Married quarters for members of the Defence Forces have for some time been considered an anachronism and it is the policy of the Department to discontinue them in a managed and orderly manner save in exceptional circumstances. The provision of housing is primarily a matter for the local authorities and married military personnel have an equal claim on such housing as other members of the community in the same income category. Inspections of married quarters are carried out by the military authorities from time to time and it is the policy not to re-allocate quarters, which are considered sub-standard.
For the past number of years it has been the practice to only carry out emergency repairs to married quarters and this policy will continue in the future. The military authorities estimate that about €100,000 was expended over the past five years in carrying out such repairs. Rents for married quarters are considerably less than the market value rental valuation for the properties and in this regard negotiations with the representative associations on increases in charges are currently at an advanced stage. However, any revised rates that might be agreed will reflect the present condition of the quarters and those rates would have to be adjusted to reflect any future investment in married quarters.
Defence Forces Recruitment.
Enda Kenny
Ceist:182 Mr. Kenny asked the Minister for Defence the expected recruitment to the Defence Forces for 2004 and 2005; the Defence Forces’ strength by rank that are deployed; and if he will make a statement on the matter. [7242/04]
The White Paper on Defence of February 2000 sets out a figure of 10,500 personnel for the Defence Forces, comprising 930 for the Air Corps, 1,144 for the Naval Service and 8,426 for the Army.
On 31 January 2004, the most recent date for which figures are available, the total strength of the Permanent Defence Force was 10,443. The breakdown of this figure by rank for the Army, Air Corps and Naval Service is shown on the tabular statement set out below.
It is envisaged that approximately 330 personnel will be recruited to the Permanent Defence Force in 2004 comprising general service recruits, cadets, air corps apprentices and direct entry personnel. At this time it is not possible to estimate what the recruitment requirements will be for 2005. It is my intention to maintain the established Government policy of ongoing recruitment to the Defence Forces to fill vacancies as required.
|
Strength of the Defence Forces |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|
|
31 January 2004 |
||||||||||
|
Lt Gen |
Maj Gen |
Brig Gen |
Col |
Lt Col |
Comdt |
Capt |
Lt |
Total Officers |
SM |
|
|
Army |
1 |
3 |
6 |
38 |
125 |
348 |
270 |
233 |
1,024 |
34 |
|
Naval Service |
0 |
0 |
1 |
2 |
13 |
39 |
22 |
61 |
138 |
7 |
|
Air Corps |
0 |
0 |
1 |
2 |
13 |
33 |
23 |
67 |
139 |
8 |
|
BQMs |
Cs |
CQMs |
Sgts |
Cpls |
Total NCOs |
Ptes |
Rec |
Cadets |
Total Other Ranks |
Total All Ranks |
|
|
Army |
41 |
138 |
249 |
1,063 |
1,556 |
3,081 |
4,126 |
142 |
97 |
7,446 |
8,470 |
|
Naval Service |
7 |
76 |
16 |
200 |
161 |
467 |
415 |
25 |
28 |
935 |
1,073 |
|
Air Corps |
4 |
52 |
15 |
128 |
206 |
413 |
337 |
11 |
761 |
900 |
Pension Provisions.
Enda Kenny
Ceist:183 Mr. Kenny asked the Minister for Defence if arrangements can be made to allow for payment of compensation bounty to families of military personnel serving abroad who lose their lives; if such payment is only payable in respect of UN sanctioned missions and in view of the numbers serving or other such missions; and if he will make a statement on the matter. [7243/04]
Where a member of the Permanent Defence Force, PDF, is killed in the course of duty or dies from a wound received in the course of duty, whether on duty at home or overseas, enhanced spouse's and children's allowances are payable under the Army Pensions Acts. The spouse's allowance is 50% of the deceased member's pay and an additional amount of up to 40% of the deceased's pay may be payable in respect of dependent children. Thus the maximum combined payment would be 90% of the deceased's pay. These benefits would be in place of the standard combined benefits of up to 50% of pay payable where a member of the PDF spouses' and children's contributory pension schemes dies in service or while on pension.
In addition to the benefits mentioned, a death gratuity of one year's pay is payable under the Defence Forces pensions schemes in all cases of death in service regardless of the circumstances.
Furthermore, my Department administers a special extra-statutory compensation scheme under which a lump sum payment of almost €87,000 may be paid to the spouse or other dependent immediate relative of a member of the PDF who was killed in the course of duty while serving overseas with an international United Nations force established by the Security Council or the General Assembly. This scheme covers the main missions in which PDF contingents are currently participating including UNMIL, United Nations Mission in Liberia, and KFOR, International Security Presence in Kosovo. It does not apply to UN observer missions or to other non-UN missions abroad.
Additional lump sum death benefits may also be payable under special insurance schemes organised by the Defence Forces. Most PDF personnel are members of such schemes and I understand that death benefits range from about €130,000 upwards.
Members of the PDF are insured for widows' or widowers' contributory pension under the Social Welfare Acts and such pensions would be paid in addition to any benefits payable by my Department.
Live Exports.
Johnny Brady
Ceist:184 Mr. J. Brady asked the Minister for Agriculture and Food the number of live cattle exports in 2003; the destination countries for these exports; and if he will make a statement on the matter. [7095/04]
The information requested by the Deputy is set out in the table below.
|
Destination |
Calves |
Adult Cattle |
Total |
|
Northern Ireland |
33 |
38,022 |
38,055 |
|
United Kingdom |
0 |
1,786 |
1,786 |
|
France |
0 |
84 |
84 |
|
Italy |
1,313 |
18,131 |
19,444 |
|
Belgium |
1,453 |
810 |
2,263 |
|
Netherlands |
32,749 |
1,743 |
34,492 |
|
Germany |
0 |
63 |
63 |
|
Spain |
26,426 |
60,909 |
87,335 |
|
Other EU |
0 |
649 |
649 |
|
Lebanon |
0 |
36,922 |
36,922 |
|
Total |
61,974 |
159,119 |
221,093 |
The overall figure for live exports in 2003 shows a 50% increase on 2002 exports.
Grant Payments.
Ned O'Keeffe
Ceist:185 Mr. N. O’Keeffe asked the Minister for Agriculture and Food if payment will be recommence to a person (details supplied) in County Cork under the scheme of early retirement from farming in view of the fact that a suitable transferee has now been put in place. [7166/04]
The early retirement pension for the person named was suspended with effect from 31 October 2003 because documentation on the substitution of a transferee had not been submitted. As soon as this documentation is received, my Department will consider restoring payment of the pension.
Ned O'Keeffe
Ceist:186 Mr. N. O’Keeffe asked the Minister for Agriculture and Food if a decision has been taken on an appeal by a person (details supplied) in County Cork held recently, on an application for the installation aid scheme. [7167/04]
A decision has been taken in this case and the appellant was notified in writing on 2 March 2004.
Official Travel.
Michael Ring
Ceist:187 Mr. Ring asked the Minister for Agriculture and Food the persons officials from his Department met concerning the visit with farmers affected by the landslide in Pollathomas, County Mayo; the names of the officials who attended on that day; the cost of the expenditure for the officials on that day; the amount each official was paid in expenses; and the outcome of this visit. [7168/04]
Officials from my Department met representatives of the Pollathomas Landslide Committee on 23 January 2004. The officials concerned are mainly based in the west of Ireland and would have been entitled to claim the appropriate travel and subsistence allowance.
Live Exports.
Billy Timmins
Ceist:188 Mr. Timmins asked the Minister for Agriculture and Food the position on the export of live horses for slaughter; and if he will make a statement on the matter. [7169/04]
Trade in horses between member states and from member states to third countries is governed by European law and specific commission decisions which establish the health conditions and certification to be applied to such animals for trade purposes. All export licences issued by my Department are in respect of animals for breeding, racing, jumping and sport use. My Department has not issued export licences for horses for slaughter.
Common Agricultural Policy.
Billy Timmins
Ceist:189 Mr. Timmins asked the Minister for Agriculture and Food the position on the impact CAP reforms which benefit farmers here will have on other countries, especially in Africa, and Caribbean and Pacific countries; and if he will make a statement on the matter. [7170/04]
The recent reform of the CAP, which provides for the replacement of production-related supports with decoupled payments, will be of benefit to developing countries since the potential distortion effect of these measures will be reduced.
The Agriculture and Fisheries Council and the European Union generally are acutely aware of the needs of developing countries and of the implications for them of policy decisions taken at EU level. The EU has provided over many years for preferential access to EU markets for exports from developing countries through the EU-ACP Agreement, the Generalised System of Preferences and other preferential trade agreements. More recently, the EU has offered duty-free and quota-free access to all imports except arms from the least developed countries. In the context of the current WTO round of trade negotiations, the EU has offered generous arrangements under the heading of special and differential treatment for developing countries.
Motor Vehicle Registration.
Denis Naughten
Ceist:190 Mr. Naughten asked the Minister for Finance the reason the year of manufacture is no longer present on car registration certificates; and if he will make a statement on the matter. [7277/04]
The Revenue Commissioners are the motor vehicle registration authority in the State. I am advised by them that prior to the introduction of their on-line vehicle registration facility in November 2002, they reviewed the data requirements for all vehicle registration declarations and certificates.
They concluded that because there is no statutory requirement for the date of manufacture of a vehicle to be declared to them or to be indicated on the registration certificate and because the date of manufacture has no bearing on the amount of vehicle registration tax to be paid, they could dispense with the requirement that the date of manufacture be declared and shown on the registration certificate. This change was supported by the motor trade. If the Deputy has a particular concern he should contact Mr. John O'Shea, Indirect Tax Policy and Legislation Division, Stamping Building, Dublin Castle.
Benchmarking Awards.
Bernard J. Durkan
Ceist:191 Mr. Durkan asked the Minister for Finance if he has examined the extent to which pay awards including benchmarking have been eroded by income tax, particularly in some pay categories; and if he will make a statement on the matter. [7103/04]
I have made no such examination nor do I see a reason to do so. Benchmarking pay increases, like all other pay increases or other increases in income, are subject to the normal tax rules that apply generally to income earners in the State.
Pension Provisions.
Mary Upton
Ceist:192 Dr. Upton asked the Minister for Finance if he will expand the Civil Service compulsory spouses’ and children’s contributory pension scheme to include non-marital partners in order that they may avail of the scheme on the death of their partner; if this expansion will include same sex couples; and if he will make a statement on the matter. [7115/04]
In respect of surviving partners, spouses' and children's pension schemes in the public service provide for pensions for the surviving legal spouse of a member. The Commission on Public Service Pensions, which took account of the views of unions, management and independent pensions experts, recommended that the existing provisions of public service spouses' and children's schemes be modified to allow payment of a survivor's pension to a financially dependent partner in circumstances where there is no legal spouse and where a valid nomination has been made. A working group was set up under the PPF to advise on the implementation of the commission's recommendations. That group reported in October 2003.
As I announced in my budget 2004 speech, the Government has decided to implement the bulk of commission's recommendations. I announced that I would examine the feasibility of implementing the recommendation for payment of survivor's pensions to non-spousal partners. In view of likely developments in equality law, the term "non-spousal partner" in the context of the examination will be taken as including same-sex couples.
An examination of the feasibility of modifying public service spouses' and children's pension schemes to allow for the payment of survivor's pensions to non-spousal partners has now commenced and the item has been tabled on the agenda of the newly formed joint working group on pensions. This is a joint union and management group, which has been established as a forum within which practical aspects of the implementation of the commission's recommendations can be discussed. There are important legal and financial aspects to be considered in detail and in consultation with other Departments, such as the interaction between the "pension splitting" provisions of the Family Law Acts and the rules of the schemes.
Tax Code.
Mary Upton
Ceist:193 Dr. Upton asked the Minister for Finance further to Parliamentary Question No. 240 of 4 February 2004, the criteria by which one spouse is deemed to be the assessable spouse; and the position regarding his contacts with the Revenue Commissioners further to this parliamentary question. [7116/04]
The concept of "assessable spouse" was introduced with effect from 6 April 1993. Prior to that date, the husband was assessed on both his own income and his wife's income. Since 6 April 1993, the legal position distinguishes couples married prior to 6 April 1993 from couples married after that date. These changes were introduced in Finance Act 1993 and responded to recommendations made by the Second Commission on the Status of Women.
For couples married prior to 6 April 1993, the position as at 6 April 1993 prevails, that is, the husband remains the person responsible for fulfilling the couples tax obligations unless the couple subsequently elect jointly for the other spouse to be the assessable spouse. For couples married on or after 6 April 1993, unless there is a claim for separate assessment or separate treatment, the couple is deemed to have elected for joint assessment, and the spouse with the greater income will be the assessable spouse. The key criterion, therefore, for deeming one spouse to be the assessable spouse is the amount of income, that is, the spouse with the greater income will be the assessable spouse. However, the couple may jointly elect for either one of them to be the assessable spouse.
Notwithstanding the foregoing, in practice, where one spouse is a PAYE taxpayer and the other spouse is a self-assessment taxpayer, the self-assessment taxpayer is usually considered to be the assessable spouse. The main reason for this is that the self assessment taxpayer is likely to have more onerous responsibilities as regards tax matters e.g. record keeping, returns, preliminary tax etc., than the PAYE taxpayer.
I am informed by the Revenue Commissioners that they have not completed their consideration of the feasibility of the administrative arrangements referred to in my reply to Parliamentary Question No. 240 of 4 February 2004, and, given the range of issues to be considered, it may be some time before their deliberations are completed.
Tax Reliefs.
Ned O'Keeffe
Ceist:194 Mr. N. O’Keeffe asked the Minister for Finance if a Med 1 application form will issue to a person (details supplied) in County Cork. [7193/04]
I am advised by Revenue that the relevant claim form Med 1 has issued to the person concerned. The return address for the completed form is the Office of the Revenue Commissioners, Cork East District, Government Offices, Sullivan's Quay, Cork. If the person concerned has any queries on completing the form, he or she should contact the Revenue Commissioners' PAYE inquiries line 1890 22 24 25. When the completed form is received by the Revenue Commissioners the matter will be progressed by them.
The explanatory leaflet on Health Expenses Relief — IT6 and the forms for Med 1 and Med 2 may be downloaded from the Revenue Commissioners' website, www.revenue.ie.
Tax Incentive Scheme.
Richard Bruton
Ceist:195 Mr. R. Bruton asked the Minister for Finance the number of applicants who have availed of the specific tax break brought into being by him some years ago, concerning the need to develop park and ride facilities in and around Dublin city and county; and if he will make a statement on the matter. [7194/04]
In order to promote the provision of park and ride facilities, in the Finance Act 1999 I introduced accelerated capital allowances of up to 100% for capital expenditure on the construction or refurbishment of park and ride developments in or near designated urban areas which provide parking facilities for commuters using public transport. Relief is also available for expenditure on the construction or refurbishment of related residential developments which are located at park and ride facilities. Guidelines on the operation of the scheme were issued by the Minister for the Environment and Local Government in August 1999. The guidelines set out various criteria which a park and ride development and residential developments located at park and ride facilities must meet to qualify under the scheme. Certification of a development for the purposes of obtaining relief under the scheme is carried out by certain local authorities.
The Finance Act 1999 also provided for capital allowances for commercial developments located at these park and ride facilities. Guidelines in regard to the commercial development element of these park and ride facilities were issued in July 2001 after discussions with EU Commission officials on State aid rules.
In my recent budget I extended the qualifying period from 31 December 2004 to 31 July 2006, provided a planning application has been received by a planning authority by 31 December 2004. Based on the latest information received from the Department of Transport, one application for certification to avail of the capital allowances has been made.
Decentralisation Programme.
Enda Kenny
Ceist:196 Mr. Kenny asked the Minister for Finance if he will consider proposals from military personnel to decentralise the Department of Defence, military and Civil Service personnel to a single location at McKee Barracks, Kildare; and if he will make a statement on the matter. [7251/04]
The Government decided on 1 July 2003 last that Magee Barracks, Kildare would be among the State lands released to the Department of the Environment, Heritage and Local Government for inclusion in the affordable housing initiative under Sustaining Progress. The future development of that site is a matter for that Department and Kildare County Council.
Subsequently on 3 December 2003 the Government decided that the Defence Forces headquarters would move to the Curragh and the headquarters of the Department of Defence would be located in nearby Newbridge. The background to this decision is set out at pages B.25 and B.26 of the budget book 2004.
Northern Ireland Issues.
Caoimhghín Ó Caoláin
Ceist:197 Caoimhghín Ó Caoláin asked the Minister for Foreign Affairs if his attention has been drawn to the continuing refusal of the Ulster Unionist Party and Democratic Unionist Party representatives on Lisburn City Council to accommodate any measure of power-sharing on that authority, their continuing exclusion of the Sinn Féin, SDLP and Alliance Party representatives from all positions on that body and on external bodies; if the Government has raised this corrosive practice with the British Prime Minister or the Northern Secretary of State; and if he will make a statement on the matter. [7111/04]
In recent years, power-sharing arrangements have increasingly become the norm across local authorities in Northern Ireland. The current practices within Lisburn City Council are a regrettable departure from this encouraging trend.
Partnership politics represents the way forward in Northern Ireland, both in regard to the operation of the devolved institutions and local government. In its contacts with the British Government and with the political parties in Northern Ireland, the Government has availed of all opportunities to advocate the principle and practice of partnership politics and we will continue to do so.
Furthermore, I have asked officials to continue to closely monitor the situation in Lisburn City Council and to keep me informed of all relevant developments, particularly in the context of the annual general meeting of the council, due to take place in the summer. I hope the outcome of that meeting will represent progress towards a power-sharing dispensation on Lisburn City Council.
Rockall Island.
Finian McGrath
Ceist:198 Mr. F. McGrath asked the Minister for Foreign Affairs the position regarding the ownership of Rockall Island off the Irish coast; and if he will make a statement on the matter. [7283/04]
Concern in regard to the issue of Rockall arose in the past from then unresolved fears that jurisdiction over Rockall and similar rocks and Skerries was thought to be central to the mineral rights in the adjacent sea bed and to fishing rights in the surrounding seas. However, during the course of the Third United Nations Conference on the Law of the Sea, the Irish delegation worked hard to establish a satisfactory legal regime applicable to islands. The United Nations Convention on the Law of the Sea, which was adopted at Montego Bay at the conclusion of the conference on 10 December 1982, provides at Article 121 paragraph 3 that, "Rocks which cannot sustain human habitation or economic life of their own shall have no exclusive economic zone or continental shelf".
Article 121(3) applies to Rockall. Ireland ratified the convention on 21 June 1996. The United Kingdom acceded to the convention on 25 July 1997. It is accordingly accepted by both States that Rockall cannot be used as a basis for delimiting their respective continental shelves or fisheries zones. While the United Kingdom continues to claim jurisdiction over Rockall, this claim is not accepted by Ireland. Each country remains aware of the position of the other.
Port Security Procedures.
Caoimhghín Ó Caoláin
Ceist:199 Caoimhghín Ó Caoláin asked the Minister for Foreign Affairs if his attention has been drawn to the practice by the Scottish police at the Stranraer ferry port of demanding that Irish nationals write their names in English on their embarkation cards; if this practice is being applied to all passengers with non-English names; if the Irish are being singled out; and if he will seek an immediate end to the practice. [7104/04]
My Department has not received any recent complaints about a practice requiring that Irish nationals write their name in English on their embarkation cards at Stranraer ferry port. We have, in the past, consistently raised our concerns with the British authorities that the provisions of the British Terrorism Act 2000 be applied sensitively to ensure they do not cause embarrassment to travellers, nor discriminate against persons travelling between the two islands.
I would be concerned if Irish nationals travelling via Stranraer ferry port were being discriminated against on linguistic grounds. I have asked the Embassy of Ireland, London, to raise the Deputy's concerns with the British Foreign and Commonwealth Office. In addition, I have also asked our Consul General in Edinburgh to look into this matter. I will respond directly to the Deputy when in receipt of a reply from the British authorities.
Visa Applications.
Ned O'Keeffe
Ceist:200 Mr. N. O’Keeffe asked the Minister for Foreign Affairs the position regarding an application for an entry visa to Ireland in respect of two persons (details supplied). [7196/04]
Decisions on visa applications such as the ones referred to are made by the Department of Justice, Equality and Law Reform, which has responsibility for all immigration matters. The applications which were submitted to the Honorary Consulate in Kenya were recently forwarded to the Department of Justice, Equality and Law Reform for consideration. It is expected that the Department of Justice, Equality and Law Reform will make a decision on these applications in the very near future. Once the Department of Justice, Equality and Law Reform has made its decision it will inform the visa office. The applicants in turn will be informed of this decision through the Honorary Consulate.
Diplomatic Representation.
Gay Mitchell
Ceist:201 Mr. G. Mitchell asked the Minister for Foreign Affairs the reasons Ireland has established diplomatic relations with Burma-Myanmar as of 10 February 2004; and if he will make a statement on the matter. [7232/04]
Gay Mitchell
Ceist:203 Mr. G. Mitchell asked the Minister for Foreign Affairs his views on the way in which the establishment of diplomatic relations with Burma-Myanmar as of 10 February 2004 can contribute more directly to promoting the process of democratisation and national reconciliation there; and if he will make a statement on the matter. [7235/04]
I propose to take Questions Nos. 201 and 203 together.
The decision to establish diplomatic relations with Burma-Myanmar was taken in the context of Ireland's current Presidency of the European Union and the need for Ireland, as EU Presidency, to be in a position to deal directly with the Burmese authorities. Of the other EU member states, only Luxembourg does not have diplomatic relations with Burma.
Our previous unwillingness to appoint an ambassador to Burma, however satisfying it may have been as a gesture of disapproval, had no effect on the behaviour of the Burmese authorities. As Presidency of the EU, we have both the opportunity and the responsibility to speak to the Burmese authorities on behalf of the EU. We will in particular demand the release of Daw Aung San Suu Kyi, and other political prisoners, the participation of the National League for Democracy in the forthcoming national convention, a timetable for progress towards democracy, and an improvement in the human rights situation in Burma.
Our ambassador designate visited Burma from 23 to 25 February. The ambassador used this opportunity to convey our views to the Burmese Deputy Minister for Foreign Affairs, who he met along with other EU Heads of Mission. He also met with five members of the central executive committee of the National League for Democracy and with representatives of Burma's ethnic nationalities. This visit, and the access the ambassador gained, confirmed the practical value of the Government's decision to establish diplomatic relations.
Both Ireland and the EU are strongly critical of serious and persistent human rights abuses, the lack of fundamental freedoms, and the absence of political progress in Burma. The EU Common Position on Burma, which provides for a visa ban on members of the regime and a freeze on all their financial assets in the European Union, is due to expire on 29 April 2004. Ireland, together with our EU partners, will discuss in due course what revisions in the common position, if any, may be necessary in view of developments in Burma.
Ireland continues to work with Burma's Asian neighbours to encourage them to bring their influence to bear on Rangoon. For example, the question of Burma was on the agenda for the EU Ministerial Troika to India, 16 February, and was discussed during the troikas at political director level with China, 26 February, and Japan, 27 February. These concerns will feature in discussions at the ASEM Foreign Ministers' Meeting, which I will host in Kildare in April 2004.
Our goals continue to be the return of democracy to Burma, an end to human rights violations, and the realisation of peace and prosperity for the long suffering people of Burma. It is our belief that the appointment of an ambassador to Burma increases our influence and credibility in the efforts to promote these goals by the EU and international community.
Human Rights Issues.
Michael D. Higgins
Ceist:202 Mr. M. Higgins asked the Minister for Foreign Affairs if his attention has been drawn to the fact that, as of January 2004, there were 145 Tibetan political prisoners being held, including nine women; the Government’s position on this issue; and if the Government plans to take any action. [7234/04]
The Government continues to have concerns regarding the protection of the human rights of the Tibetan people, including political prisoners, and takes this issue very seriously. Officials in my Department continue to monitor the situation and are in regular contact with NGOs and other interested groups, who bring particular cases to our attention. These human rights concerns are raised with the Chinese authorities both bilaterally and through European Union channels, including through the framework of the EU-China Human Rights Dialogue.
Last week, on 25 February 2004, my colleague, the Minister of State with responsibility for overseas development and human rights, Deputy Tom Kitt, held a meeting in Dublin with representatives of Tibet Action Ireland, the Tibetan Community in the UK and the Free Tibet Campaign, at which the general situation in Tibet, and human rights concerns in particular, were discussed.
The issue of human rights in Tibet was raised with the Chinese Government most recently at the EU-China Human Rights Dialogue meeting, which took place in Dublin on 26 and 27 February 2004. At this meeting the EU raised its concerns at the human rights situation in Tibet, highlighting in particular the imprisonment of Buddhist monks. The EU urged the Chinese authorities to address the human rights situation in Tibet, investigate the reports of imprisonment of Buddhist monks and renew its contacts with the representatives of the Dalai Lama. In response, the Chinese authorities indicated a willingness, in principle, to continue to meet representatives of the Dalai Lama, though no date for a future meeting was given.
The Government has consistently called on the Chinese authorities to respect fully the rights of the Tibetan people, including prisoners. We will continue to address our ongoing concerns regarding the protection of human rights in Tibet, along with the general human rights situation in China, both bilaterally and within the framework of the EU-China Human Rights Dialogue. We will also continue to encourage and support direct talks between the representatives of the Dalai Lama and the Chinese authorities.
Question No. 203 answered with QuestionNo. 201.
Foreign Conflicts.
Finian McGrath
Ceist:204 Mr. F. McGrath asked the Minister for Foreign Affairs if he will raise the issue of civilian casualties (details supplied) during the US-UK invasion of Iraq with the US President Bush at the proposed EU summit. [7236/04]
The Government does not have any information on casualty figures other than those readily available in the public domain. These usually vary between 8,000 and 15,000. My officials have been in contact with relevant multilateral organisations on this matter but none of the organisations involved was in a position to give us such figures, as they either did not compile them or could not guarantee their reliability.
The Government has from the outset called on all parties in the conflict in Iraq to respect their obligations under international law. This policy is in keeping with the public pronouncements of UN Secretary General Annan and had been established long before the adoption of Security Council Resolution 1483. This resolution calls upon all concerned to comply fully with their obligations under international law, including, in particular, the Geneva Conventions of 1949 and the Hague Regulations of 1907. The protection of civilians in time of war is specifically covered by the Fourth Geneva Convention. The US and UK have publicly committed themselves to doing so.
The Government will continue to stress the importance of adhering to international law in appropriate contacts with the US. As for the summit meeting that will take place with the United States in June, the Taoiseach will represent all the member states of the European Union and, accordingly, will convey to President Bush positions which will have been agreed by the Union as a whole.
Special Educational Needs.
Seán Ardagh
Ceist:205 Mr. Ardagh asked the Minister for Education and Science if he will resource the allocation of a full-term learning support teacher as requested by the parents association of a school (details supplied) in Dublin 12. [7097/04]
The school in question currently has the services of a shared learning support teacher. My Department is currently reviewing existing arrangements for the allocation of special educational supports to primary schools. In that context, my officials have initiated discussions on the matter with representative interests. At this stage, it would be premature to anticipate the outcome. I can confirm, however, that the basic purpose of that review is to ensure that each school has the level of resources required to cater for its pupils with special educational needs.
Seán Ardagh
Ceist:206 Mr. Ardagh asked the Minister for Education and Science if he will report on the application, already submitted for additional resource teacher hours for a school (details supplied) in Dublin 12. [7098/04]
I can confirm that my Department has received applications for special educational resource, SER, from the school referred to by the Deputy. The school in question has the services of two full-time resource teachers and one part-time resource teacher.
SER applications received between 15 February and 31 August 2003 are being considered at present. In all, more than 5,000 such applications were received. Priority was given to cases involving children starting school last September and all these cases were responded to at or before the commencement of the current school year.
The balance of more than 4,000 applications has been reviewed by a dedicated team comprising members of my Department's inspectorate and the National Educational Psychological Service, NEPS. These applications are being further considered in the context of the outcome of surveys of SER provision conducted over the past year or so. Account is also being taken of the data submitted by schools as part of the recent nationwide census of SER provision.
The processing of the applications is a complex and time-consuming operation. However, my Department is endeavouring to have this completed as quickly as possible and my officials will then respond to all applicant schools. Pending a response, schools are advised to refer to Circular 24/03, which issued in September 2003. This circular contains practical advice on how to achieve the most effective deployment of resource already allocated for special educational needs within the school.
Seán Crowe
Ceist:207 Mr. Crowe asked the Minister for Education and Science if he will report on the progress of the school for autism in Middletown, County Armagh. [7099/04]
It is intended that the facility in question will be purchased, funded and operated on a joint North-South basis to serve the needs of children and young persons with autism in both jurisdictions.
The purchase cost involved is £3 million sterling. Precise details of the annual operating costs will not be available until final decisions have been taken on the required level of specialist inputs involved in the various elements of the centre's activities. However, current estimates suggest an overall annual operating cost of approximately €2 million. No funding has been expended to date on the project.
Proposals for the centre envisage the following: an educational assessment service for children and young people referred to the centre with a suspected or confirmed autistic spectrum disorder; a training and advisory service for teachers, other professionals and parents; an individual learning centre; an autism research, dissemination and information service; and residential accommodation with care staff.
The proposed centre at Middleton will not replace any existing service provision for children with autism. Rather, it will complement existing services by providing specialist back-up support, advice and guidance on best practice to service providers North and South. The final terms of the purchase contract are currently under discussion with the owners of the facility.
Residential Centres.
Róisín Shortall
Ceist:208 Ms Shortall asked the Minister for Education and Science if he will provide, in respect of the Finglas children centre for the period 1 August 2003 to 31 January 2004, the number of times the gardaí had to be called to the centre to deal with out of control behaviour; the number of abscondances which occurred; the cost of the damage done to those recently refurbished premises by residents; the number and nature of crimes committed by residents while at large; the number of incidents in which staff were subjected to violent threats; the number of staff sick-leave days taken in this period; and if he will make a statement on the operation of this centre. [7181/04]
In the light of the concerns which have been raised about the operation of the Finglas Child and Adolescent Centre by key stakeholders both internal and external to the centre, my Department has commissioned a review of the operation of the centre. The terms of reference for this review are to identify the issues and problems which are affecting the efficient and effective operation of the centre and adversely impacting on the task of caring for troubled children and to make recommendations to address the shortcomings identified. The review is being undertaken by Mr. Michael Donnellan, director of Trinity House School. It is expected that the report and recommendations will be completed within six weeks from its commencement next week. I understand that the various stakeholders at the centre are supportive of this review and I urge all involved to participate fully with the reviewer. I am most concerned that the current difficulties facing the centre are addressed as quickly as possible.
In regard to the specific queries raised by the Deputy, my Department has consulted with the centre and I understand that during the period 1 August 2003 to 31 January 2004: the gardaí were not called to the centre to deal with any incidents of out of control behaviour; there were 85 incidents when boys absconded, 51 of which incidents occurred at the centre; there was no significant damage done to the premises; and three boys who were not in the centre, having either absconded or being on home leave, were convicted of offences, which included the unlawful taking of a motor vehicle, criminal damage, trespass with intent and larceny, criminal damage and trespass, and criminal damage trespass with intent and larceny. One boy was involved in two incidents which resulted in convictions. One other boy has been charged with the theft of a mobile phone and failure to appear in court; there were 15 incidents where staff were subjected to violent threats; and a total of 2,118 days sick leave was taken by staff, other than teaching staff and the director-deputy directors, at the centre.
Teachers’ Retirement.
Finian McGrath
Ceist:209 Mr. F. McGrath asked the Minister for Education and Science if he will make issues (details supplied) a matter of priority. [7183/04]
The principal issue raised by the Deputy is the question of the age at which teachers should retire. This issue, including the age at which public servants generally should retire, has been the subject of a Government decision which was announced in the budget and has been explained to the public service unions. The decision reached, with which I am in full agreement, is that the generality of new entrants to the public service from 1 April 2004, including teachers, should retire at age 65.
Teachers already in service may continue to avail of the existing provisions for early retirement, including the scheme of early retirement introduced under the PCW agreement. The latter scheme was introduced some years ago on a pilot basis pending review in the light of the Report of the Commission on Public Service Pensions. The commission, in its report of 2001, recommended that the pilot scheme be continued for a further five years and be further reviewed at that time.
The commission also recommended the introduction of cost neutral early retirement. The Minister for Finance in his Budget Statement indicated that he will examine the possibility of providing for some form of optional early retirement with payment of actuarially reduced benefits which would have a cost neutral effect, as recommended by the commission.
The Minister for Finance also announced in his Budget Statement that the Government has decided to implement the bulk of the commission's recommendations. A joint management-union group has been established as a forum within which practical aspects of the implementation of the commission's recommendations can be discussed. Both my Department and the teachers' unions will have an opportunity at this forum to put forward their views on the various matters raised by the Deputy.
Schools Refurbishment.
Jack Wall
Ceist:210 Mr. Wall asked the Minister for Education and Science if his Department will investigate the urgent need for funding in regard to very necessary central heating repairs for a school (details supplied) in County Kildare in which, due to such heating problems, the children have had to be sent home; and if he will make a statement on the matter. [7184/04]
My Department has not been notified of any problems with the heating system in the school to which the Deputy refers.
The school authority made an application for funding under the summer works scheme, SWS. In the application form, the school was required to state the highest priority works required at the school. No application was made for repairs to the heating system.
A list of successful applicants under the SWS will be published on my Department's website at www.education.ie no later than 5 March next.
Higher Education Grants.
Michael Moynihan
Ceist:211 Mr. M. Moynihan asked the Minister for Education and Science if a PLC College can, by definition, offer a postgraduate course; if so, if a graduate student on such a postgraduate course is eligible to apply for a higher education grant; if the postgraduate teacher’s diploma in commercial skills at the Cork College of Commerce is the equivalent of a higher diploma in education in terms of qualification; the rate of remuneration paid to persons who hold each qualification; and the eligibility of such persons to apply for and obtain permanent positions in second level schools. [7185/04]
The circumstances surrounding the case on which the Deputy based his question are under review in my Department at present. A response will be furnished directly to the Deputy in due course.
School Transport.
Jack Wall
Ceist:212 Mr. Wall asked the Minister for Education and Science if his Department will investigate the application for school transport for a person (details supplied) in County Kildare; and if he will make a statement on the matter. [7186/04]
The person referred to by the Deputy in the details supplied lives more than two miles from the local school, and is fully eligible for transport to that school only.
My Department understands that the pupil is attending the next nearest school in the town. The bus service to this school passes 2.1 miles from the pupil's home. Concessionary fare-paying transport on the existing service to that school may be allowed subject to there being room available on the bus after all fully eligible pupils have been accommodated and provided no extra cost is involved by way of extending or altering the bus route. The current charge for concessionary tickets is €26 per pupil per term. The local Bus Éireann office will advise on the position regarding concessionary fare-paying transport.
Harbours and Piers.
Pat Breen
Ceist:213 Mr. P. Breen asked the Minister for Communications, Marine and Natural Resources if the application for funding by Ballyvaughan Harbour in County Clare can be considered in order to construct a slipway and parking area at the new pier, Ballyvaughan; and if he will make a statement on the matter. [7096/04]
Ballyvaughan Pier is owned by Clare County Council and responsibility for its maintenance and development is a matter for the local authority in the first instance. Clare County Council has not submitted a proposal to my Department for the development of Ballyvaughan Pier. I would therefore recommend that the Deputy contact Clare County Council to determine what proposals, if any, the local authority has for the development of Ballyvaughan Pier. Any proposal that the local authority submits under my Department's fishery harbours development programme in respect of Ballyvaughan in the period 2004 to 2006 will be considered in the context of the funding available for works at fishery harbours generally and overall national priorities.
Arts Funding.
Jack Wall
Ceist:214 Mr. Wall asked the Minister for Arts, Sport and Tourism if he has had representations for Ballet Ireland in regard to its financial difficulties; the reply to such inquiries and the concerns he has in respect of possible loss of tourist revenue due to the group’s difficulties; his views on documentation (details supplied); and if he will make a statement on the matter. [7172/04]
In 2003, I received a number of representations on behalf of Ballet Ireland. In my reply to these representations, I advised that support of arts organisations, including Ballet Ireland, is a matter for the Arts Council, and my Department is not in a position to provide any direct financial support. The Arts Council is independent in the context of its funding decisions, and I could not therefore become involved in any intermediary role between the council and any organisation seeking funding.
Question No. 215 answered with QuestionNo. 150.
Food Irradiation.
Mary Upton
Ceist:216 Dr. Upton asked the Minister for Health and Children the action he intends taking following the results of a survey carried out by the FSAI which showed that more than 50% of herbal supplements and herbal substances were irradiated but not labelled as such; and if he will make a statement on the matter. [4937/04]
While irradiation is not suitable for all foods, the process is generally considered safe when carried out under controlled conditions and in suitable facilities.
European Community legislation, transposed into Irish law by S.I. No. 297 of 2000, covers general and technical aspects for carrying out the irradiation process, conditions for authorising food irradiation, exemptions, and labelling requirements of irradiated foods. The legislation sets out a list of foods and food ingredients that are authorised across the EU for treatment with ionising radiation. Currently, only dried aromatic herbs, spices and vegetable seasonings, with a permitted maximum overall average absorbed dose of 10 kGy, are listed, though, for the time being, in some member states a number of other food types may be irradiated under national authorisations.
In November 2002, the Food Safety Authority of Ireland, FSAI, conducted a survey of herbal supplements available in central Dublin retail outlets. Of the 24 samples taken, ten — 42% — tested positive, six samples were wholly irradiated while four others contained irradiated components. None was labelled to indicate exposure to ionising radiation. The second phase of this survey was carried out in 2003 and found that 50% of the herbal supplements tested had been wholly or partially irradiated. Again the labelling failed to indicate exposure to ionising radiation.
In its report on the 2003 survey, published in February 2004, the FSAI stated that there were no immediate food safety concerns arising from the survey. However, in view of the inadequate labelling of some of the products surveyed, and following a meeting with the authority, the health food industry agreed to remove the irradiated product batches from the Irish market and provide action plans on how to address the problem long term. The authority is planning to hold further meetings with the industry in the near future to review progress on the industry action plans after which the authority will carry out further sampling and analysis to ensure the problem is being resolved.
Health Board Services.
Jackie Healy-Rae
Ceist:217 Mr. Healy-Rae asked the Minister for Health and Children if he will reconsider the cut in home help hours in view of the fact that they are having a detrimental effect on the people for whom they are providing the service; and if he will make a statement on the matter. [7105/04]
I wish to inform the Deputy that the aim of the home help service is to enable people to remain living at home, where appropriate, who would otherwise need to be cared for in long-stay residential care and that this service is an essential support to families and informal carers. The home help service by its nature is a flexible service which is designed to respond to clients' needs. The service is targeted at high and medium dependency clients in accordance with their assessed needs. As a result, therefore, the level of service required in individual cases will fluctuate from time to time. To ensure effective prioritisation of the service, assessments are undertaken at local sector level and are carried out by the public health nursing services.
There are a number of reasons demand for home help service has been increasing, such as demographic factors. Approximately 6,000 additional people come into the over 65 age bracket every year and there has been a proportionately higher percentage increase in the more dependant over 80 age category. These factors may necessitate some minor adjustments in the provision of the home help service. Basically, what this means is that, although a small percentage of clients may have had their hours reduced, this has been counter-balanced by others receiving the service for the first time. I have been assured by all health boards that the provision of the home help service is organised on the basis that the most vulnerable clients are given priority. The following table illustrates funding allocated to the home help service by health board area in 2003 and the percentage increase in funding for this service as compared with 2000.
|
Authority/Health Board |
Expenditure in 2003 on Home Help Service |
Percentage Increase in Expenditure since 2000 |
|
€ |
% |
|
|
Eastern Regional Health Authority |
21,650,641 |
45.74 |
|
Midland Health Board |
8,671,000 |
147.81 |
|
Mid-Western Health Board |
9,574,315 |
136.62 |
|
North Eastern Health Board |
8,165,391 |
107.05 |
|
North Western Health Board |
8,347,268 |
131.62 |
|
South Eastern Health Board |
9,196,719 |
155.07 |
|
Southern Health Board |
31,300,000 |
154.47 |
|
Western Health Board |
13,513,791 |
122.98 |
|
Total |
110,419,125 |
The total increase in expenditure on the home help service across all health board areas since 2000 is 113.59%. The Deputy might also wish to note that an additional €3.748 million has been allocated by my Department to this service in 2004.
Since my appointment as Minister of State I have been encouraging the Eastern Regional Health Authority and the health boards to introduce home care packages including home based subvention for clients applying for nursing home subvention as an alternative to long-stay residential care. The criteria that apply for home based subvention are the same as apply for nursing home subvention. I am pleased to advise that a number of health boards are developing personal care packages that are more focused on individual care needs, for example, public health nurse service, attendance at day care, day hospital and rehabilitation, and the provision of respite care, home help and care assistance.
Hospital Services.
Michael Ring
Ceist:218 Mr. Ring asked the Minister for Health and Children the reason a person (details supplied) in County Mayo was not admitted to Galway Regional Hospital on the date given to them. [7107/04]
The provision of hospital services for people living in County Mayo is a matter for the Western Health Board. My Department has, therefore, asked the chief executive officer of the board to reply directly to the Deputy in regard to the matter raised.
Eating Disorders.
Mary Upton
Ceist:219 Dr. Upton asked the Minister for Health and Children the number of public beds specifically available for the care of persons suffering eating disorders; and the plans he has to improve the medical care on offer to persons suffering from these disorders. [7114/04]
Persons presenting with eating disorders are generally treated through the psychiatric services of their local health board. Outpatient psychiatric services are provided from a network of hospitals, health centres, day hospitals and day centres. Where in-patient treatment is deemed necessary, it is provided in the local acute psychiatric unit or hospital, beds being allocated on the basis of patient need at any particular time. A tertiary referral service for eating disorders is available to public patients in St. Vincent's Hospital, Elm Park, Dublin where three in-patient beds are designated for this purpose. A similar service is available privately at St. Patrick's Hospital, James's Street, Dublin and at St. John of God Hospital, Stillorgan, County Dublin.
The Working Group on Child and Adolescent Psychiatry will this year commence the preparation of a report on services for people with eating disorders and how they can best be developed in the short, medium and long term.
Health Board Services.
Ned O'Keeffe
Ceist:220 Mr. N. O’Keeffe asked the Minister for Health and Children if he will assist in having domicilary allowance awarded to a person (details supplied). [7197/04]
The assessment of entitlement to and payment of the domiciliary care allowance in any individual case is a matter for the relevant health board. Accordingly, a copy of the Deputy's question has been forwarded to the chief executive officer, Southern Health Board, with a request that he examine the case and reply directly to the Deputy as a matter of urgency.
Hospital Waiting Lists.
Finian McGrath
Ceist:221 Mr. F. McGrath asked the Minister for Health and Children if there are results on practical measures to reduce waiting lists for patients on trolleys at Beaumont Hospital, Dublin 9; and if he will make a statement on the matter. [7198/04]
Services at Beaumont Hospital are provided under an arrangement with the Eastern Regional Health Authority and my Department has, therefore, asked the regional chief executive of the authority to examine this issue and to reply to the Deputy directly.
Health Board Services.
Mary Upton
Ceist:222 Dr. Upton asked the Minister for Health and Children if he will investigate the cutback in budgetary allocation to an organisation (details supplied) which has received a reduction of 5% for 2004 and has not had an increase since 2001; and if he will make a statement on the matter. [7199/04]
As the Deputy will be aware, the provision of health services in Dublin 6W is, in the first instance, the responsibility of the South Western Area Health Board acting under the aegis of the Eastern Regional Health Authority. The SWAHB is obliged by legislation to organise its activity in line with the available funding and as a result to adjust that activity where necessary to reach a level that can be sustained.
It should be noted that the number of home help hours provided in Dublin south city in 2003 was 91,803 which was higher than the previous year. The board recognised the difficulties that the organisation involved was experiencing in 2003 and as a result did not reduce the grant allocated to this organisation.
The authority has received an additional allocation from my Department in 2004 amounting to €1.172 million for home help services and will allocate this funding to the three area boards for distribution to the various home help services. The level of funding to be made available to the organisation will be determined as part of this process.
Hospital Services.
Paddy McHugh
Ceist:223 Mr. McHugh asked the Minister for Health and Children if he will request an interim report from Comhairle na nOspidéal on its review of neurosurgical services here in regard to capacity and geographical location. [7229/04]
Paddy McHugh
Ceist:224 Mr. McHugh asked the Minister for Health and Children when Comhairle na nOspidéal is expected to have completed its report on the neurosurgical services here in regard to capacity and geographical location. [7230/04]
Paddy McHugh
Ceist:225 Mr. McHugh asked the Minister for Health and Children if Comhairle na nOspidéal will be encouraged to visit other neurosurgical models with similar geographics, transportation and demographics as Ireland in the course of its review here of neurosurgical services here in regard to capacity and geographical location. [7231/04]
I propose to take Questions Nos. 223 to 225, inclusive, together.
As the Deputy is aware, I asked Comhairle na nOspidéal to carry out a review of neurosurgical services and to prepare a report for my consideration. Comhairle was asked to focus, in particular, on the provision of adequate capacity and consideration of equity of access to neurosurgical services having regard to best practice in the provision of quality health care. Comhairle established a committee to review neurosurgical services.
The work of the committee on neurosurgical services is ongoing and I understand it is endeavouring to have a report prepared for consideration of Comhairle na nOspidéal before the end of the year. I do not intend to request an interim report. I also understand that the committee is considering the most appropriate way in which it can gather the information it requires regarding the organisation of neurosurgical services in other countries.
Health Board Staff.
Liz McManus
Ceist:226 Ms McManus asked the Minister for Health and Children the number of employees who have been employed on contract by the Western Health Board in 2002, 2003 and 2004; the number taken on through an agency; and if he will make a statement on the matter. [7233/04]
The chief executive officer of each health board-authority is responsible for the management of the workforce in his-her region, including the employment of staff on a contract or agency basis. My Department has therefore asked the chief executive officer of the Western Health Board to investigate the matters raised by the Deputy and reply to her directly.
National Treatment Purchase Fund.
Bernard J. Durkan
Ceist:227 Mr. Durkan asked the Minister for Health and Children the specialty areas which have necessitated treatment for patients outside the jurisdiction; his plans to provide for such services here; and if he will make a statement on the matter. [7252/04]
Bernard J. Durkan
Ceist:228 Mr. Durkan asked the Minister for Health and Children the extent to which specialty services are available throughout the country; the areas in respect of which it is proposed to extend such services; and if he will make a statement on the matter. [7253/04]
I propose to take Question No. 227 and 228 together.
Circular 21/85, which was issued by my Department, sets out the criteria that must be applied when considering applications for authorisation to receive medical treatment outside the State. The responsibility for applying these criteria to the specific circumstances of each case rests with the health boards and the ERHA. Information in regard to the type of procedures funded under the terms of this circular is not routinely collected by my Department. Therefore, my Department has asked the chief executive officers of the health boards and the ERHA to communicate directly with the Deputy in regard to the specialty areas which have necessitated treatment for patients outside the jurisdiction.
The recently published Comhairle na nOspidéal Report on Consultant Staffing provides details on the distribution of consultant staffing and related specialties nationally. In the past five years there has been an increase of 31% in the number of consultant posts. These new posts are providing additional and new services to the population all over the country.
The National Task Force on Medical Staffing recommended a substantial increase in the total number of consultants from some 1,800 at present to 3,000 by 2009 and 3,600 by 2013. This will greatly improve the availability of consultant-provided services throughout the country.
I recently announced the composition of the Acute Hospitals Review Group which will be chaired by Mr. David Hanly. The Acute Hospitals Review Group will prepare a plan for the Interim Health Services Executive for the configuration of acute hospital services, taking account of the recommendations of the National Task Force on Medical Staffing.
Hospitals Building Programme.
Bernard J. Durkan
Ceist:229 Mr. Durkan asked the Minister for Health and Children the remaining proposals to be implemented in the Naas Hospital Development Plan; when he expects these proposals to become operational; and if he will make a statement on the matter. [7255/04]
Responsibility for the provision of services at Naas General Hospital rests with the Eastern Regional Health Authority. A major development programme in two phases, phases 2 and 3A, at the hospital commenced on site in November 1999. Phase 3A, which includes additional accommodation and enabling works for future phases, phases 3B and 3C, commenced on site as a variation to the phase 2 contract in April 2002. Phases 2 and 3A were completed in September 2003 and have been equipped and commissioned.
It is anticipated that the remainder of the development, phases 3B and 3C, will be procured on a phased basis with construction planned for commencement in late 2004 and completion in 2005-07. Equipping and commissioning of phases 3B and 3C are planned for 2008.
Hospital Services.
Bernard J. Durkan
Ceist:230 Mr. Durkan asked the Minister for Health and Children the impact he expects in respect of Naas Hospital arising from the proposals contained in the Hanly Report; and if he will make a statement on the matter. [7256/04]
The Report of the National Task Force on Medical Staffing, the Hanly Report, deals with the reorganisation of acute hospital services in two regions, the East Coast Area Health Board and the Mid-Western Health Board and sets out a series of principles regarding the development of acute hospital services nationally.
I recently announced the composition of a group to prepare a national plan for acute hospital services. The group, to be chaired by Mr. David Hanly, will prepare a plan for the Interim Health Services Executive for the reorganisation of acute hospital services, taking account of the recommendations of the National Task Force on Medical Staffing including spatial, demographic and geographic factors. I anticipate that the future role of Naas Hospital will be examined in this context.
Hospital Staff.
Bernard J. Durkan
Ceist:231 Mr. Durkan asked the Minister for Health and Children the number of staff in all disciplines required at Naas General Hospital; the numbers currently available; when he expects to be in a position to ensure the availability of adequate staff in all categories to be appointed; and if he will make a statement on the matter. [7257/04]
Responsibility for the provision of services at Naas General Hospital rests with the Eastern Regional Health Authority. My Department has, therefore, asked the regional chief executive of the authority to examine the matters raised by the Deputy and to reply to him directly.
Question No. 232 answered with QuestionNo. 121.
Hospital Waiting Lists.
Bernard J. Durkan
Ceist:233 Mr. Durkan asked the Minister for Health and Children the current waiting period for heart or hip replacement surgery; and if he will make a statement on the matter. [7259/04]
Bernard J. Durkan
Ceist:234 Mr. Durkan asked the Minister for Health and Children the current number of patients awaiting heart or hip surgery; the number of such patients treated under the treatment purchase scheme since the scheme’s inception; and if he will make a statement on the matter. [7260/04]
Bernard J. Durkan
Ceist:235 Mr. Durkan asked the Minister for Health and Children the cost to date of the treatment purchase scheme; the extent to which the treatments involved are available here; and if he will make a statement on the matter. [7261/04]
I propose to take Questions Nos. 233 to 235, inclusive, together.
The total number of people on public hospital in-patient waiting lists for cardiac surgery as at 30 September 2003, the latest date for which figures are available, was 228. This includes 78 adults waiting over 12 months for cardiac surgery.
The total number of adults waiting for orthopaedic procedures, either as an in-patient or as a day case, was 3,023. The total number of adults waiting more than 12 months for in-patient treatment in the specialty of orthopaedics was 794, which represents a decrease of 42% between September 2002 and September 2003.
The cost of the national treatment purchase fund to date is as follows: 2002, €5.012m; 2003, €30.057m Provisional Outturn; 2004, €44.00m Allocation.
The NTPF purchases procedures from private and public hospitals in Ireland. Where it is not possible to treat patients within a reasonable period in Ireland, either in public or private hospitals, arrangements can be made to refer the public patients for treatment abroad, having regard to quality, availability and cost. If patients are prepared to exercise choice by travelling to where there is capacity, they can be treated much quicker in many instances. To date the fund has arranged treatments for more than 11,000 patients.
My Department has asked the chief executive officer of the NTPF to reply directly to the Deputy in regard to the number of patients who have undergone heart or hip surgery under the NTPF since its inception.
Question No. 236 answered with QuestionNo. 128.
Hospital Staff.
Bernard J. Durkan
Ceist:237 Mr. Durkan asked the Minister for Health and Children his views on the ever increasing influence of agency nursing staff; and if he will make a statement on the matter. [7263/04]
The Health Services Employers Agency carries out quarterly national surveys of the nursing resource, including use of agency nurses. The numbers of agency nurses used in the public health service for the months mentioned are as follows:
|
Month |
Average Number of Agency Nurses used per Day |
|
September 2000 |
414 |
|
January 2001 |
423 |
|
April 2001 |
499 |
|
July 2001 |
417 |
|
October 2001 |
397 |
|
January 2002 |
459 |
|
April 2002 |
384 |
|
September 2002 |
416 |
|
December 2002 |
346 |
|
March 2003 |
307 |
|
June 2003 |
294 |
|
September 2003 |
317 |
|
December 2003 |
329 |
|
Average 2001 |
434 |
|
Average 2002 |
401 |
|
Average 2003 |
312 |
The above figures demonstrate significant fluctuations. However, a comparison of the averages for 2001 to 2003, inclusive, clearly shows a continuous and substantial downward trend. The average number of agency nurses used per day during 2003 was 122 fewer than in 2001. It was also 187 fewer than the number used during April 2001, the highest monthly number recorded since the surveys began.
Agency nurses are used for operational reasons. For example, to cover unexpected absences or to deal with temporary fluctuations in workflows.
Question No. 238 answered with QuestionNo. 128.
Hospital Services.
Bernard J. Durkan
Ceist:239 Mr. Durkan asked the Minister for Health and Children the degree of consultation entered into by his Department, or agents thereof, with management, staff or patients at Peamount Hospital, Newcastle, County Dublin prior to entering into proposals that will culminate in the closure of the tuberculosis or respiratory unit at the hospital; and if he will make a statement on the matter. [7265/04]
Bernard J. Durkan
Ceist:240 Mr. Durkan asked the Minister for Health and Children how a service will be provided to the catchment area previously served by the chest and respiratory unit at Peamount Hospital, Newcastle, County Dublin; if his attention has been drawn to the legitimate concerns of patients regarding the availability of a service to meet their condition in the future in view of the seriously competing demands within the general hospital services throughout the greater Dublin area and the country and the likelihood, after the proposed closure of the facility, that such patients will be left without a service; and if he will make a statement on the matter. [7266/04]
I propose to take Questions Nos. 239 and 240 together.
Responsibility for the provision of services at the hospital rests with the Eastern Regional Health Authority. My Department has asked its CEO to examine the matters raised and to reply to the Deputy directly.
Questions Nos. 241 and 242 answered with Question No. 145.
Motor Insurance Claims.
John Bruton
Ceist:243 Mr. J. Bruton asked the Minister for Transport his plans to implement legislation in the immediate future to assist drivers of insured vehicles who are hit by cars that are neither taxed nor insured because the insured driver must bear the brunt of all car repair costs when he or she cannot make an insurance claim against another insurance company; and if he will make a statement on the matter. [7202/04]
I have no such plans.
In 1988 there was an agreement between the then Minister for the Environment and the Motor Insurers' Bureau of Ireland. As a result the bureau undertakes liability to pay compensation to innocent victims of motor vehicle accidents involving uninsured drivers and untraced vehicles. The compensation covers personal injuries and injury to property, in the case of accidents caused by uninsured drivers, and personal injury in the case of accidents caused by hit and run accidents.
The position accords with the current requirements of the EU motor insurance directives. There is a European Commission proposal under discussion for a further motor insurance directive that would, inter alia, make some provision for property damage in hit and run accidents in certain circumstances. Ireland is supportive of the proposal in principle provided adequate safeguards are included in order to exclude fraudulent claims.
Taxi Regulations.
Michael D. Higgins
Ceist:244 Mr. M. Higgins asked the Minister for Transport the response he proposes to make to a specific report in April 2003 by the European Parliament to the serious plight of a small number of Irish pre-deregulation taxi families; his views on the report, if it is his intention to implement it; and if so, the sections of same and the timescale involved. [7113/04]
Pat Carey
Ceist:246 Mr. Carey asked the Minister for Transport if he intends implementing the recommendations of the European Parliament report on the deregulation of the taxi industry; and if he will make a statement on the matter. [7214/04]
Finian McGrath
Ceist:248 Mr. F. McGrath asked the Minister for Transport the position regarding the serious plight of a small number of pre deregulation taxi families; if he will implement the recommendations of the impartial European Report; and if he will make a statement on the matter. [7270/04]
I propose to take Questions Nos. 244, 246 and 248 together.
The Government approved the implementation on a phased basis of the recommendations of the taxi hardship panel. The independent three person panel was established to report, in general terms, on the nature and extent of extreme personal financial hardship that may have been experienced by taxi licence holders arising from loss of income as a direct result of the liberalisation of the taxi licensing regime. The panel recommended the establishment of a scheme to provide payments to taxi licence holders who fall into one of six categories that it assessed as having suffered extreme personal financial hardship arising from taxi liberalisation.
I am aware of the report of the EU Committee on Petitions and their fact finding mission to Ireland on the effects of taxi liberalisation. As I have explained previously in the House and to the committee, based on legal precedent there can be no legal duty on the State to compensate taxi licence holders for open market licence values that may have existed prior to liberalisation. The position remains unchanged and I have no proposals to reopen either the terms of the taxi hardship panel report or the Government's decision on it.
The process of implementing the panel's recommendations through the taxi hardship payments scheme is well under way with Area Development Management Limited administering and managing it. Payments to qualifying persons commenced in December 2003.
With regard to the third recommendation of the EU Committee report concerning regulation and standards, the Taxi Regulation Act 2003, enacted in July 2003, provides a legislative basis for the establishment of the commission for taxi regulation. A commissioner must also be selected by open recruitment competition held by the Civil Service and Local Appointments Commission.
Following a competition for the post of taxi commissioner in 2003, the Civil Service and Local Appointments Commission was unable to recommend a candidate for appointment. A further recruitment competition is being progressed with an enhanced salary and the closing date for receipt of applications is 4 March 2004.
The taxi commission will be an independent public body. Its principal function will be the development and maintenance of a new regulatory framework for the control and operation of small public service vehicles and their drivers. It will pursue a range of objectives that will be focused on the promotion of quality oriented services by all small public service vehicle operators and drivers. This will be based primarily on the deployment of new qualitative standards, to be applied to the licensing and ongoing operation of small public service vehicles and their drivers, that will be focused on the enhancement of customer services.
Dublin Bus Refunds.
Charlie O'Connor
Ceist:245 Mr. O’Connor asked the Minister for Transport how much moneys Dublin Bus accrued for the past five years from the public who pay more than is required for bus journeys and change is not given on buses and is then not claimed; the good use it is proposed for the moneys; and if he will make a statement on the matter. [7213/04]
The issue of uncollected change accruing to Dublin Bus is an operational matter for the company. An exact fare and no change system was introduced in response to a situation where a number of drivers were assaulted for cash. Under the company's arrangements, Dublin Bus offers customers a change receipt in lieu of change. It can be cashed at a later date and it has no expiry date. In other cities with an exact fare system no refund facility is offered.
Over the past five years the value of unreclaimed change tickets averaged €1.9 million per annum and is equivalent to less than 1% of turnover. All of the unclaimed amounts are reinvested by Dublin Bus for the purposes of: discounting prepaid fares by in excess of €6 million per annum; minimising price increases for the cash customer; and maintaining and developing service levels across the network.
Question No. 246 answered with QuestionNo. 244.
Public Transport.
Richard Bruton
Ceist:247 Mr. R. Bruton asked the Minister for Transport the discussion he has had with Dublin Bus concerning the need to provide a feeder bus service for outlying communities on to the new Luas line from Tallaght to the city centre; his views on the need for the service to maximise use of the new Luas line when it opens; and if he will make a statement on the matter. [7215/04]
My Department and Dublin Bus are discussing changes to its services to integrate the Luas project. The company will advise the public in good time before any changes are made to the network.
Question No. 248 answered with QuestionNo. 244.
Road Traffic Offences.
Tony Gregory
Ceist:249 Mr. Gregory asked the Minister for Justice, Equality and Law Reform the statistical breakdown of persons detected driving at excessive speeds in different speed limit zones. [7112/04]
I am informed by the Garda authorities that no such breakdown is available. The compilation of such information would involve a disproportionate amount of Garda time and resources that cannot be justified.
Drug Abuse.
Seán Crowe
Ceist:250 Mr. Crowe asked the Minister for Justice, Equality and Law Reform if his attention has been drawn to the increase in drug users brewing crack cocaine; and the steps his Department and related organisations intend to take to respond to the problem. [7279/04]
The Garda authorities have informed me that for many years the Garda national drugs unit, in co-operation with the Forensic Science Laboratory, has been proactive in monitoring the incidents of crack cocaine use here. In 2003 less than 2.5% of the total number of cases forensically screened showed crack cocaine to be present. Reports indicate an increased level of cocaine use in Ireland but offences involving cocaine still remain a small proportion of the overall number of drug offences annually.
In accordance with a commitment in the annual policing plan for 2003, the Garda research unit in conjunction with the Garda NDU are researching cocaine usage and criminal activity and will make policing recommendations accordingly. The research will provide a better insight into the links between cocaine usage and criminal activities and will inform police management about appropriate policing strategies.
The Government's overall policy to tackle the drug problem is set out in the National Drugs Strategy 2001-2008 entitled Building on Experience. Responsibility for co-ordinating its implementation lies with my colleague, the Minister of State at the Department of Community, Rural and Gaeltacht Affairs, Deputy Noel Ahern. He has already stressed that the matter of cocaine use will be kept under close review. As a result of the reports indicating increased levels of cocaine use in Ireland, the national advisory committee on drugs recently presented him with an overview study on cocaine use here for his consideration.
Road Traffic Offences.
John Bruton
Ceist:251 Mr. J. Bruton asked the Minister for Justice, Equality and Law Reform the breakdown of data regarding the 15 offences for speeding that had taken place on the Drumree Road, Dunshaughlin, County Meath, west of a public house (details supplied) in Dunshaughlin, that were outlined in the reply to Question No. 1186 of 30 September 2003; when the speeding offences occurred; and if he will make a statement on the matter. [7108/04]
It has not been possible to compile the information requested within the time allowed. I will convey it to the Deputy as soon as it becomes available.
Garda Investigations.
Joe Costello
Ceist:252 Mr. Costello asked the Minister for Justice, Equality and Law Reform the progress of the Garda investigation into the case of a person (details supplied) in Dublin 7; and if he will make a statement on the matter. [7200/04]
A Garda superintendent was appointed to investigate the matter and a file is being prepared for the Director of Public Prosecutions.
I have no role in the investigation or prosecution of cases. Therefore, it would be inappropriate for me to comment further on the matter at this time.
Registration of Title.
John Ellis
Ceist:253 Mr. Ellis asked the Minister for Justice, Equality and Law Reform if his Department will complete a dealing for a person (details supplied) in County Leitrim that has been lodged for some time. [7201/04]
I am informed by the Registrar of Titles that an application for registration by way of a Land Commission schedule was lodged on 12 February 2001. Schedule No. 93587 refers.
Land Commission schedule applications are deemed to be registered as of the date of vesting that is prior to the date of lodgement of the documents in the Land Registry. Accordingly, registration in the Land Registry of Land Commission cases is afforded a lower priority than the registration of other dealings.
A query was issued on 11 November 2003 and a reply was received. The application is receiving attention in the Land Registry and will be completed as soon as possible.
Motor Regulations.
John Bruton
Ceist:254 Mr. J. Bruton asked the Minister for Justice, Equality and Law Reform if he has initiated an investigation into the number of car crashes in which the vehicle driver has no insurance and no tax; and if he will make a statement on the matter. [7202/04]
A survey of motor tax, motor insurance and national car test compliance was carried out in 2001. It was jointly published by the Department of the Environment, Heritage and Local Government, the National Roads Authority and the Garda Síochána. It examined the number of car crashes in which the vehicle driver had no tax or insurance.
The survey examined a five year period from January 1996 and showed that motor tax details were available for approximately 65,000 vehicles involved in crashes. Of these approximately 5% were recorded as being untaxed by the investigating officer.
Insurance details were available for approximately 60,000 vehicles and 2.5% were found to be non-compliant with respect to insurance.
Departmental Files.
Joe Higgins
Ceist:255 Mr. J. Higgins asked the Minister for Justice, Equality and Law Reform if he will give a full report on the discovery of his Department’s files in an illegal dump in County Tyrone. [7203/04]
My Department received a report from a journalist that some of its documents were allegedly found in an illegal dump site in County Tyrone. The Garda Síochána is investigating the matter. Therefore, it would not be appropriate for me to comment at this stage.
Joe Higgins
Ceist:256 Mr. J. Higgins asked the Minister for Justice, Equality and Law Reform if his Department requested the PSNI to visit and question a journalist who found files from his Department in an illegal dump in County Tyrone. [7204/04]
My Department did not contact the PSNI or request it to do anything about the matter.
Travel Documents.
Gay Mitchell
Ceist:257 Mr. G. Mitchell asked the Minister for Justice, Equality and Law Reform when documents presented by a person (details supplied) in Dublin 8 in August 2002 will be returned or replaced; and if he will make a statement on the matter. [7237/04]
My Department's records show that the travel document of the person was retained as there were indications that it had been interfered with. This is the normal practice of the Department in such circumstances.
Recently the person concerned contacted my Department's immigration division about a new travel document. She was advised to make a fresh application for consideration. A form was issued to her but to date no application has been received.
There is no record that the person's "green book" was retained by my Department. If it is no longer in her possession then she should contact the immigration division who will address the matter.
Decommissioning of Arms.
Finian McGrath
Ceist:258 Mr. F. McGrath asked the Minister for Justice, Equality and Law Reform if Sinn Féin and the Worker’s Party were ever involved in a process of decommissioning or facilitated it. [7238/04]
I refer the Deputy to the various reports made by the Independent International Commission on Decommissioning.
Prison Committals.
Finian McGrath
Ceist:259 Mr. F. McGrath asked the Minister for Justice, Equality and Law Reform the position with regard to a person (details supplied) in Limerick Prison; and if he will make a statement on the matter. [7239/04]
I refer the Deputy to my reply to Question No. 373 of 2 March, 2004.
Northern Ireland Issues.
Fergus O'Dowd
Ceist:260 Mr. O’Dowd asked the Minister for Justice, Equality and Law Reform further to the decision of the Louth County Coroner, that the recovery of the remains of a person (details supplied) did not fall within the Criminal Justice (Location of Victims’ Remains) Act 1999, if there will be a full Garda investigation into the person’s murder; and if he will make a statement on the matter. [7240/04]
I am informed by the Garda authorities that, as the discovery of the remains of the person in question was adjudged not to fall within the terms of the Criminal Justice (Location of Victims' Remains) Act 1999, the Garda Síochána conducted a thorough forensic examination of the scene and the remains. I am further informed that the Garda Síochána has conducted inquiries to gather evidence and has also been in contact with the Police Service of Northern Ireland to advance the investigation.
Political Party Funding.
Enda Kenny
Ceist:261 Mr. Kenny asked the Minister for Justice, Equality and Law Reform if he has evidence of organised crime funding parties involved in politics here; if so the nature of such activity; and if he will make a statement on the matter. [7268/04]
The Deputy will appreciate that the collection of evidence in regard to criminal activity in particular cases is a matter for the Garda Síochána. However, in so far as the Deputy's question may arise in the context of public comments which I have made relating to the funding of a particular party in this House, I can tell him on the basis of the briefings available to me that I stand by those comments and that will remain my position until such time as it is clear that all criminal activity carried out by or to the benefit of a particular paramilitary organisation, with links to that party, has ceased completely.
Deportation Orders.
Fergus O'Dowd
Ceist:262 Mr. O’Dowd asked the Minister for Justice, Equality and Law Reform if he will reconsider the decision to deport persons (details supplied). [7291/04]
Deportation orders were signed on 5 January 2004 in respect of the persons concerned. The orders were signed following consideration of their cases taking account of the criteria set out in section 3 of the Immigration Act 1999 and having regard to section 5 of the Refugee Act 1996 (Prohibition of Refoulement). Each case was considered in the light of all relevant information available at the time of the decision to deport. The safety of returning —refoulement —was not found to be an issue in these cases.
It now transpires that the birth of a child in the State to one of the applicants, which would have been a factor in considering whether or not to deport, had not been made known by the applicant to my Department at the time the deportation order was made. In fact, this information was not provided until four months after the birth by which time the deportation orders had been made and served. The applicants will now be asked to make further representations as to why they should not be deported. In the light of any new information received, I will reconsider the cases taking account, inter alia, of the Supreme Court decision of 23 January 2003 in the L. v. O case. In the meantime, the Garda National Immigration Bureau has been requested not to enforce the deportation orders in respect of the persons concerned.
Local Authority Housing.
Tony Gregory
Ceist:263 Mr. Gregory asked the Minister for the Environment, Heritage and Local Government if he will detail the arrangements made with the Cúid Housing Association for the management of the Clarion Quay social housing scheme; if provision was made for management charges in addition to rent; the level of rent provided for, and if income related, as are local authority rents; and the way it is intended to fund increasing management charges in social housing apartment schemes. [7100/04]
Minister of State at the Department of the Environment, Heritage and Local Government (Mr. N. Ahern)
Management and maintenance arrangements for projects, such as the Cúid project at Clarion Quay, which was provided under my Department's capital loan and subsidy scheme for voluntary housing projects, is a matter for the relevant approved housing body.
Management and maintenance costs are met from the rental income generated by the project as well as an annual management and maintenance subsidy allowance which is paid to approved housing bodies in respect of each dwelling funded under the scheme. For the year 1 July 2003 to 30 June 2004, this allowance is €607 per dwelling in the administrative areas of all city councils including Dublin. This amount is adjusted each year in line with movements in the consumer price index. Housing authorities pay this allowance to the approved housing bodies and recoup their expenditure from my Department.
Under the terms of the capital and subsidy scheme, the rent payable to an approved housing body, by a tenant, is based on household and subsidiary income in the previous tax year. There is no maximum on the rent payable on the principal household income. However, the contribution to the rent by each subsidiary earner is subject to a maximum of €25.39 per week.
Where a tenant of a capital loan and subsidy scheme project produces satisfactory evidence of a fall in income to an approved body and of the likelihood of such a fall being sustained for at least four weeks, the weekly rent may be adjusted to the level appropriate to the reduced rate of income for the full duration of the reduction in income.
Hunting on State Lands.
Tony Gregory
Ceist:264 Mr. Gregory asked the Minister for the Environment, Heritage and Local Government the recommendation of the Heritage Council regarding the introduction of hunting on State lands; if this recommendation conforms to best practise and official policy for the past 30 years; if it is his intention to reject the Heritage Council recommendation; if so, the reasons for doing so and the locations involved; and if he will make a statement on the matter. [7101/04]
Emmet Stagg
Ceist:272 Mr. Stagg asked the Minister for the Environment, Heritage and Local Government if his attention has been drawn to the unanimous report of the independent scientific group dated 18 June 2002 and which concluded that a blanket ban on hunting on State owned lands was without justification, and that if this ban were lifted or modified that no international agreements would be breached; and if in view of this report he will reconsider the blanket ban on hunting on State lands and the way in which it might be modified. [7247/04]
Emmet Stagg
Ceist:273 Mr. Stagg asked the Minister for the Environment, Heritage and Local Government the international agreements or obligations which the Government would be in breach of if it were to allow hunting on State lands. [7248/04]
I propose to take Questions Nos. 264, 272 and 273 together.
In 1999, my predecessor requested the Heritage Council to review the existing policy of no hunting on national parks and wildlife lands, taking into account the implications for wildlife conservation, sustainability, the interests of recreational users, potential impacts on the amenity value of the land, European and international policies and relevant issues of public safety. The council recommended that the current policy of not allowing hunting on State lands acquired for nature conservation purposes and managed by the National Parks and Wildlife Service should be maintained.
Following the advice issued by the Heritage Council and at the request of the National Association of Regional Game Councils, NARGC, my predecessor agreed, without prejudice, to a joint examination by a scientific group, comprising officials of my Department and nominees of NARGC, of the question of permitting hunting on State lands, from a scientific perspective only.
I have recently given careful consideration to all aspects of this matter, including the conclusions of the scientific group. While the group considered that scientific reasons would not obtain for an automatic ban where hunting is sustainable, its report did not advance specific advice on how populations and sustainability should be assessed.
While the group's report did propose a methodology for considering this matter further, the implementation of this would require significant national parks and wildlife personnel resources which would have to be diverted from other priority work. Furthermore, other considerations, for example public safety and the purpose for which the properties were acquired, have also to be taken into account.
Following a review of all of the issues I have concluded, therefore, that the established policy should continue to apply. This is a matter of national policy, rather than being mandated by international agreements.
Local Authority Funding.
Fergus O'Dowd
Ceist:265 Mr. O’Dowd asked the Minister for the Environment, Heritage and Local Government if he will make funds available to provide funding for a new bridge at Narrow Water linking Carlingford in County Louth with Warrenpoint in County Down; and if he will make a statement on the matter. [7102/04]
The initial selection and prioritisation of projects to be funded from non-national road grants in County Louth is a matter for Louth County Council. No application has been received in my Department from Louth County Council for funding in 2004 for a new bridge at Narrow Water linking Carlingford in County Louth with Warrenpoint in County Down. It is, however, open to the council to prioritise this project for funding under the EU co-financed specific improvement grant scheme in 2005, when applications are sought later this year by my Department.
As this would be a cross-Border project, an agreement with the roads service in Northern Ireland would be necessary regarding their contribution towards the project. I understand that no such agreement has yet been concluded.
Planning Issues.
Richard Bruton
Ceist:266 Mr. R. Bruton asked the Minister for the Environment, Heritage and Local Government if his attention has been drawn to the very high number of planning applications being deemed invalid since the new planning regulations have come into force; and if he has satisfied himself that the high rejection rate is genuinely in the public interest and does not represent excessive regulation in the contest of the principles of regulation set out by the recent Government strategy paper on regulation. [7189/04]
The system of invalidating incomplete applications was introduced in the Planning and Development Regulations 2001 in response to complaints that a high proportion of applications for planning permission could not be processed by planning authorities because they did not comply with the requirements of the planning code. My Department is currently reviewing the regulations to ensure that they achieve the aim of streamlining the planning system without imposing unnecessary burdens on persons applying for planning permission. Arising from this review, it may be appropriate to consider some amendment of the regulations later this year.
Local Authority Pensions.
John McGuinness
Ceist:267 Mr. McGuinness asked the Minister for the Environment, Heritage and Local Government his plans to regrade the small number of retired town clerks for pension purposes; if he will review the three cases and make the appropriate changes; and if he will make a statement on the matter. [7190/04]
Complaints and disputes in regard to individual pension issues affecting retired local authority staff may be appropriately addressed to the relevant local authority. Should any issue remain unresolved following internal review by the local authority, the matter may be referred to the pensions ombudsman for determination.
Without prejudice to any such complaint or dispute, it is a generally established principle that pensions of retired public sector — including local authority — staff may not be increased to take account of any pay increases which are applied to the pensioners' former posts as a result of regrading, restructuring or changes in duties or conditions of service that take place after they retire.
Housing Grants.
John Ellis
Ceist:268 Mr. Ellis asked the Minister for the Environment, Heritage and Local Government if his Department will award a new house grant to a person (details supplied) in County Leitrim. [7191/04]
Minister of State at the Department of the Environment, Heritage and Local Government (Mr. N. Ahern)
An inspection with a view to payment of the grant, if in order, has been arranged by appointment.
Motor Taxation.
John Bruton
Ceist:269 Mr. J. Bruton asked the Minister for the Environment, Heritage and Local Government if the on-line payment facility for car tax will be enhanced and amended to ensure that verification must be received of the car owner having a verifiable traceable car insurance when logging on to pay their car tax through the Internet system recently established by him; and if he will make a statement on the matter. [7192/04]
Motorists taxing cars on-line are required to provide details of insurance company, policy number and expiry date and to give a declaration as to the veracity of this information. This information is maintained on the national vehicle and driver file and is transmitted to the gardaí as part of the regular update of PULSE. False declarations are subject to penalties of up to €1,270.
I understand that the Minister for Transport is in discussion with the insurance industry in relation to the establishment of a comprehensive database of motor insurance details. Such a database would facilitate on-line insurance verification.
Hunt Licences.
Trevor Sargent
Ceist:270 Mr. Sargent asked the Minister for the Environment, Heritage and Local Government if the licensing of stag hunting will cease in view of the fact that the quarry in this activity is in fact domesticated. [5062/04]
As stated in reply to Questions Nos. 971, 972, 973, 974, 975 and 976 of 27 January 2004, the legal advice to the Government is that the Minister for the Environment, Heritage and Local Government may grant to the master or other person in charge of a pack of stag hounds a licence authorising the hunting of deer by that pack during such period or periods as is or are specified in the licence. Licence applications from the Ward Union Hunt Club continue to be determined on their merits in accordance with this legal advice.
Animal Welfare.
Trevor Sargent
Ceist:271 Mr. Sargent asked the Minister for the Environment, Heritage and Local Government if he will report on the number of dog pounds and their location here; if his attention has been drawn to the need in County Clare for a properly resourced dog pound; and if he will make a statement on the matter. [5056/04]
There are 36 dog shelters/pounds operated by local authorities and the ISPCA in this country, one in each city council and county council area other than Carlow and Kilkenny who share a facility; Galway County where there are three dog shelters/pounds; and Wexford County where there are two. These shelters/pounds are resourced from the receipts of dog licence fees. I have received no representations regarding the provision of an additional dog pound in County Clare.
Questions Nos. 272 and 273 answered with Question No. 264.
Postal Votes.
Enda Kenny
Ceist:274 Mr. Kenny asked the Minister for the Environment, Heritage and Local Government if arrangements can be made to allow for spouses of Army personnel serving abroad to have a postal vote in the same manner as do spouses of diplomats; the numbers estimated to be in this category; and if he will make a statement on the matter. [7249/04]
No proposals in this regard have been made to my Department by the Department of Defence or by interested persons. If such a case is made, I will ensure that it is carefully considered.
Waste Disposal.
Joe Higgins
Ceist:275 Mr. J. Higgins asked the Minister for the Environment, Heritage and Local Government the Government policy relating to the disposal of waste by Government Departments. [7250/04]
Government policy in relation to waste is set out in the policy statements Waste Management: Changing Our Ways (1998) and Preventing and Recycling Waste: Delivering Change (2002) and the Waste Management Acts 1996 to 2003 place a general duty of care on holders of waste to ensure that waste is managed in a manner that does not cause environmental pollution. In so far as my own Department is concerned, the Deputy may wish to note that the Department's offices at the Custom House were certified last September to ISO 14001:1996, the international standard for environmental management systems. This certification followed an audit of the Department's environmental management systems, including those relating to waste management, by an accredited body, the National Standards Authority of Ireland.
While it would be a matter for other Departments to ensure that their waste management practices comply with the policy requirements outlined above, my Department has provided support in the form of a green Government guide which issued to all Departments. In addition, building on my own Department's success in achieving ISO 14001 certification, consideration is currently being given to mechanisms through which the initiative might be extended to other Departments.
Ministerial Travel.
Denis Naughten
Ceist:276 Mr. Naughten asked the Minister for Community, Rural and Gaeltacht Affairs the locations in County Roscommon which he has visited over the past six months; the groups or organisations with which he held meetings; the purpose of such meetings; and if he will make a statement on the matter. [7276/04]
I presume the question relates to visits by me on official ministerial business. In answer to the Deputy's question, I wish to advise him of the following: I travelled to Roscommon on Thursday, 15 January 2004 and the following is a timetable of my official day there. At 4.00 p.m. a meeting with Clontuskert Development Committee to discuss the development of community facilities took place; at 5.00 p.m. a meeting with St. John's Hall Committee, Lecarrow, Roscommon, to discuss development of community facilities took place; at 6.00 p.m. a meeting with Ballyforan Hall Committee in Ballyforan, to discuss development of community facilities took place; and at 8.00 p.m. I addressed the south Roscommon Community Forum and also attended the AGM with Mr. Michael Kelly at the community centre, Four Roads.
National Drugs Strategy.
Seán Crowe
Ceist:277 Mr. Crowe asked the Minister for Community, Rural and Gaeltacht Affairs if his attention has been drawn to the growing concern among addiction services at the use of cocaine and the significant usage of crack cocaine; and the extra resources he has allocated to research or pilot programmes designed to address this growing problem. [7278/04]
Seán Crowe
Ceist:278 Mr. Crowe asked the Minister for Community, Rural and Gaeltacht Affairs if his attention has been drawn to the increase in injecting cocaine; and his Department’s intended response to this growing phenomenon particularly in the Dublin area. [7280/04]
I propose to take Questions Nos. 277 and 278 together.
My Department has overall responsibility for co-ordinating the implementation of the National Drugs Strategy 2001-2008 as well as funding the work of the local drugs task forces, LDTF, and the Young People's Facilities and Services Fund, YPFSF. As I have outlined to this House on a number of occasions recently, I am confident that through the implementation of the 100 actions in the strategy and through projects and initiatives operated through the LDTFs and the YPFSF, the problem of cocaine use can be addressed. As the Deputy is aware, these initiatives are concentrated in the Dublin region in the areas of highest drug misuse.
In this context, a range of projects are being supported under the LDTF plans and these focus on prevention, treatment and rehabilitation as well as curbing local supply for a range of drugs, including cocaine. As the Deputy will be aware, most drug abusers engage in poly-drug use and, therefore, projects should be able to address this pattern of usage, rather than concentrating on one drug to the exclusion of others.
In terms of resources, to date, the Government has allocated or spent almost €145 million on LDTF initiatives and projects supported under the YPFSF. In regard to the prevalence of cocaine use, the National Population Survey of Drug Use published by the National Advisory Committee on Drugs, NACD last October 2003 shows that 3.1% of the population have ever used the drug, 1.1% used it in the last 12 months and 0.3% used in the last month. Compared with similar surveys undertaken in other European countries, these figures suggest that Ireland is roughly average in terms of use.
While there is evidence that suggests that cocaine use has increased, the Deputy should be aware the numbers presenting for treatment are still very low and, in total, make up approximately 1% of those in treatment. Similarly, cocaine related offences remain relatively small compared to other drugs and account for approximately 3% of all such offences. In regard to treatment modalities, the Deputy will be aware that there is no substitution treatment drug for cocaine and I am advised that existing services such as counselling and behavioural therapy are the best options available. In this context, it is worth noting that the three area health boards of the Eastern Region Health Authority have recruited additional counsellors and outreach workers in the last number of years.
In addition, I should point out that regional drugs task forces have been established and are currently mapping out (i) the patterns of drug misuse in their areas and (ii) the level and range of existing services. Where cocaine use is found to be a problem, this can reflected in the measures proposed in their future action plans. I can assure the Deputy that I am keeping the matter of cocaine use under review. Furthermore, it should be noted that the strategy provides for an independent evaluation of the effectiveness of the overall framework by end 2004. This will examine the progress being made in achieving the overall key strategic goals set out in the strategy and will enable priorities for further action to be identified and a re-focusing of the strategy, if necessary. The need to amend the strategy to reflect changing patterns of drug use will be considered in that context. Finally, the Deputy should note that primary responsibility for drug addiction services lies with my colleague, the Minister for Health and Children, Deputy Martin.
Anti-Poverty Strategy.
Finian McGrath
Ceist:279 Mr. F. McGrath asked the Minister for Social and Family Affairs the strategies that are in place to tackle poverty in the 71,000 poorest households in the State; and if she will make a statement on the matter. [7272/04]
Based on the results of the 2001 Living in Ireland Survey undertaken by the Economic and Social Research Institute, ESRI, it is estimated that some 5.5% of households are experiencing consistent poverty. This equates to approximately 71,000 households.
The national anti-poverty strategy, NAPS, together with the national action plan against poverty and social exclusion, NAPS/inclusion, provide the framework for the strategic response by Government to the issues of poverty and exclusion. The reduction and eventual elimination of consistent poverty has been a priority goal of the NAPS since its inception. Latterly, the NAPS/inclusion, covering the period from 2003 to 2005, incorporates the commitments made in the NAPS and in the current social partnership agreement, Sustaining Progress. The NAPS/inclusion sets out the ambitious targets across the range of policy areas, including employment, income support, health, education, health and housing and accommodation, which impact on poverty and social exclusion. It also addresses the needs of certain groups within society who are particularly vulnerable to poverty and social exclusion. These groups include women, children and young people, older people, people with disabilities, travellers, prisoners and ex-prisoners.
Under the partnership agreement, Sustaining Progress, a range of special initiatives are being undertaken, most of which are of direct relevance to combating poverty, including in particular the initiatives on ending child poverty, tackling educational disadvantage, supports for the long-term unemployed and other vulnerable workers, supports for carers, housing and accommodation initiatives and migration and inter-culturalism.
Institutional structures have been established to monitor and evaluate progress in all areas of the NAPS and NAPS/inclusion. These structures are facilitated and supported by the Office for Social Inclusion, OSI in my Department. OSI is also involved in co-ordinating the process across Departments and agencies and in implementing key support functions related to the strategy. The challenge now is to sustain and build on the progress we have made to date so that we can achieve our overarching objective of building a fairer and more inclusive society.
Social Insurance.
Michael Ring
Ceist:280 Mr. Ring asked the Minister for Social and Family Affairs the steps she intends to take to improve qualifying conditions on optical and dental benefits for persons paying PRSI contributions (details supplied). [7274/04]
The treatment benefit scheme provides a range of benefits in the areas of dental, optical and aural treatment for qualified PRSI contributors and their dependent spouses. The PRSI contribution conditions relating to entitlement to these benefits vary depending on the age of the insured person. Persons aged under 21 must have at least 39 contributions paid since first starting work in order to qualify. Persons aged from 21 to 24 must have at least 39 contributions paid since first starting work and have at least 39 weeks contributions paid or credited in the relevant tax year. In the case of persons aged over 25 the requirement is that they have at least 260 PRSI contributions paid since first starting work and 39 paid or credited in the relevant tax year.
These qualifying conditions are necessary to ensure a realistic relationship between entitlement to benefit and a continuing or recent attachment to the workforce through an active PRSI contribution record. I have no plans, at present, to change the current qualifying conditions of the treatment benefit scheme. Any changes in this scheme would have financial implications and would be a matter for consideration within the constraints of budgetary policy and the best targeting of available resources.