Dáil Éireann díospóireacht -
Wednesday, 13 Oct 2004

Vol. 590 No. 2

Adjournment Debate.

School Accommodation.

Mr. Sargent

Ba mhaith liom buíochas a ghabháil leis an gCeann Comhairle as seans a thabhairt dom an cheist thábhachtach seo a ardú ar an Athló anocht. I wish the Minister well in her new position. I have not had the opportunity to do so in the House although I have done so outside it.

The Minister will be aware of the pressures on schools in an area with a growing population. Balbriggan, a designated growth town in terms of the national spatial strategy and Fingal County Council's development plan, is bursting at the seams, as Deputy Glennon will acknowledge. This issue arises from that phenomenon more than any other.

St. Molaga's national school, a senior primary school on the north side of that town, with 300 pupils — the number is growing — is particularly noteworthy as it has a number of special learning need classes. The Department has recognised the school's proficiency in that area and asked it to take on another such special needs class. It is close to Mosney where a number of non-nationals live. The children of families living there attending St. Molaga's national school bring an additional element of need in terms of language diversity. This school has considerable challenges and demands on its resources and expertise. To have the crisis of a lack of accommodation on top of that is asking it to bear the unbearable.

In September 2003 the school authority applied for three prefabs. It was granted one and is seeking the balance. There is a considerable background to its accommodation needs, into which I could go but I must be brief given the time available. Day in and day out the school is turning away pupils. At least 15 pupils seeking places at the school have been turned away this year alone. These are young people living nearby, often within sight of the school. The appalling situation that needs to be recognised is that many children living in Balbriggan within walking distance and sometimes within sight of the school have to be transported by car or some other means to schools in Artane, Clontarf or Raheny where they can find a place. Not to mention the traffic such journeys add to our already congested roads, there is the trauma families experience in their children having to make such journeys. A direct and immediate response is needed.

I find it strange and contradictory that general purpose rooms and PE halls must suffice for accommodation while primary schools are at the same time being asked to become excited and full of anticipation over the new PE and music subjects on the revised curriculum. It is contradictory on the part of the Department. PE halls are not suitable for teaching the revised curriculum, as the Minister recognises having been a teacher.

The Department has recognised the proficiency of the school and asked it to take on additional responsibilities in terms of special needs education, including the facilitation of a proportion of non-nationals greater than that in other schools. The school's staff room has to be used for a non-national class that is grappling with the challenges of the English language. With these points in mind, will the Minister, if she if is ever in the vicinity of the school, call in to recognise its work and see for herself the challenges it faces? The application in question is serious and cannot be turned down.

Minister for Education and Science (Ms Hanafin)

I thank Deputy Sargent for raising this issue. As he quite rightly said, the north Dublin area, Balbriggan in particular, has grown exponentially. The Deputy is not the only one to have raised this with me as Deputy Glennon took up a good part of my morning to explain to me the difficulties of provision in this area. We recognise that this issue needs to be addressed, especially given the population growth and the fact that so many young families are moving into the area.

St. Molaga's national school is one of the schools that must be considered in the context of our schools building programme. It is interesting to examine the figures for the growth of the school in recent years. From the 1999-2000 school year to date, enrolment has increased from 253 to 312.

The Deputy quite rightly referred to the special needs class. It is to the credit of the school that it has such a class and I commend it on providing that facility. It is for this reason that it has seven specialist teachers — this is higher than the average — along with a principal and 11 mainstream teachers. It obviously puts increased demands on its space.

The school was grant-aided for two extra temporary classrooms in May 2004. It then lodged an application for two further classrooms to cater for September 2005. The applications for temporary accommodation are being accepted and the closing date is 5 November. We will obviously consider them after that date. We should have definite word on the school's application by the end of January to allow it to make provision for the installation of whatever temporary accommodation it receives. The permanent extension is an issue of real concern and is being examined actively along with the prioritisation criteria established with the education partners, as the Deputy will be well aware.

This is an interesting area, as the Deputy stated, because the north Dublin-east Meath-south Louth region is being included in a pilot scheme regarding a new school planning model. This is to ensure that in areas with burgeoning populations, the future provision of school infrastructure can be arranged in consultation with all the partners, including the parents, trustees, sponsors and prospective new schools. It is important that they all have their voices heard in the process. Arising from this, an individual plan will set out the blueprint for all the schools of an area. This will be the mark by which capital investment will be decided over the next ten years. This is the way to go for areas such as that represented by Deputies Sargent and Glennon. It should help us in our understanding of when the permanent extension in question will progress. I will certainly examine the issue in the context of the needs of new areas. The issue of temporary accommodation will be considered soon.

Mr. Sargent

What about the parents whose children are refused every day?

Hospital Services.

Ms McManus

This Monday two young children were sent home from Our Lady's Hospital for Sick Children in Crumlin. Both had heart conditions that required surgery. Their experience mirrors in a deeply disturbing way that of the tragic child, Roisin Ruddle, who was sent home because of a staffing shortage at the hospital and who died subsequently. The investigative reports on that event have still to be published. The Minister for Health and Children should publish them immediately. It is incomprehensible that lessons have not been learned from that terrible event. We need to know exactly what those lessons are.

In one of the cases to which I refer, the child had been gowned and was ready for surgery. A team of experts was ready to assist in the procedure and in the child's care. An operating theatre was available but the child was sent home instead of to the theatre. He was first due to have his operation last June but it is now October and he is still waiting. It must be remembered that this has a knock-on effect on other children waiting for operations. It is not just two children who are affected. Who knows how many are waiting in the queue?

The spokesperson for the hospital has stated the problem clearly. There are 20 nurse vacancies in Our Lady's hospital. In the country as a whole there are more than 700 such vacancies, yet the Minister for Health and Children boasts that we have the highest ratio of nurses to population in the EU. We may have in theory but the reality is that Irish nurses are leaving the profession because there are more attractive options elsewhere.

The work of an intensive care paediatric nurse is demanding, difficult and pressurised. Such nurses are not afforded sufficient recognition for the work they do. As a consequence, there is a shortage. We are training enough nurses but our problem is that we are not holding on to enough of them. Greater efforts must be made and practical measures introduced to deal with that reality.

I have argued for the introduction of a special weighting system for Dublin and other cities. The Irish Nursing Organisation, INO, has made the same argument but the Minister for Health and Children has turned a deaf ear. Instead, the Government policy is to trawl the world for intensive care, IC, nurses and when one is found, she or he is required to pass a language test in Ireland which, apparently, is more difficult than that in the UK, which is competing with us to attract nurses into the national health service, NHS.

I urge the Minister for Health and Children to introduce immediately and announce publicly measures to address the pay and conditions of intensive care paediatric nurses. I also urge her to commit publicly to the construction of a new hospital on the site of Our Lady's Hospital in Crumlin. This is long overdue as the existing buildings are not appropriate in this day and age. They have already been the subject of a damning critique published by an expert on hospitals. If a new hospital is built on-site, it will prove to be a much more attractive environment for nurses and others in which to work and would be part of the solution to the problem in question. In the meantime, the Minister can introduce immediate measures and I urge her to do so in the interest of children and their parents.

Tánaiste and Minister for Health and Children (Ms Harney)

I thank Deputy McManus for raising this issue which we dealt with on the Order of Business. I and the hospital regret very much that it was felt necessary to defer surgery on two patients due to a lack of staffed ICU beds. The beds to be occupied by the patients in question were used instead to accommodate two emergency cardiac surgery cases that had to be carried out that day. Extensive efforts were made to make ICU beds available. However, it did not prove possible to accommodate the two elective cases and their surgery was accordingly deferred. In both cases the parents were given an alternative date for surgery before they left the hospital.

The hospital seeks to prioritise elective cardiac surgery and minimise the number of deferrals. However, priority is always given to emergency cases which are, by their nature, unpredictable, and unfortunately this may necessitate the deferral of less urgent cases.

There are 16 fully equipped and funded intensive care beds at the hospital, and five high dependency beds. These are divided into two units, the main ICU and St. Patrick's ICU. The main unit consists of eight beds and caters for all post-operative open heart surgery cases in addition to other intensive care patients. Complex cardiac cases are concentrated in the main unit to maintain the specialised nursing skills required for these patients. St. Patrick's ICU consists of 13 beds, five of which function as high dependency beds. St. Patrick's ICU does not admit post-operative open heart cardiac surgery patients as the nursing skill mix to care for these patients is located in the main unit.

The approved funded complement of nurses for the ICU at Our Lady's hospital is 124. Currently, the ICU has a staff of 107 nurses. Because of the nursing shortage, which is not unique to Ireland but global, the ICU is staffed for between 14 and 17 beds, depending on the case mix between intensive care and high dependency patients. Patients requiring intensive care are nursed on the basis of one nurse per patient, whereas patients requiring high dependency care are nursed on the basis of one nurse per two patients.

On the morning of 11 October, 15 ICU beds were occupied. The hospital made two ICU beds in the course of the day but these were used to accommodate the two emergency cases.

The hospital has been involved in an extensive campaign globally to recruit nurses, in the Middle East, Asia, the United Kingdom and Poland. I share the view expressed by Deputy McManus relating to the English language competency requirements here and in Britain. The reality is that nurses can now come from any EU country and practice here, even with a minimum amount of English. We must be practical in the manner in which we apply standards of that kind. I hope to have some discussions with An Bord Altranais concerning that matter in particular.

I am informed that since 2000, 12 nurses from Our Lady's hospital have completed the paediatric intensive care nursing course. A further ten are undertaking the programme. Five are due to complete the course in 2005 and the remainder in 2006.

All possible measures need to be taken to reduce the possibility of a deferral of elective surgery at Our Lady's hospital. I spoke with the hospital authorities today and they have expressed their regret, as I also wish to do now, that this had to happen. However, given the unpredictable nature of emergency cases, the hospital cannot always guarantee that elective cases will not, on occasion, be required to be deferred.

Health Board Funding.

Mr. Crawford

I thank the Ceann Comhairle for giving me the opportunity to raise this important issue. I wish the Tánaiste well in her new post as Minister for Health and Children. Her portfolio is possibly one of the most important in Government. We certainly need a great deal of assistance in the North Eastern Health Board area and I hope the Minister will see to it that we receive that assistance.

I have raised this issue following a number of cases that have come to light recently. Yesterday, I received a phone call from a man whose mother must avail of nursing care. She is already in temporary accommodation in Cavan. He applied for subvention in the normal way and suddenly found that because the farmhouse is in his mother's name, it must be taken into account and all that can be given is €114 per week. He does not have the finance to meet the difference in paying for a nursing home. The man in question is the only son of the household and is not dependent on his mother. Having gone through the issue with the subvention officials, it appears that this anomaly needs to be examined seriously. There is no doubt that this lady needs full-time care.

A few days ago I came across another case in which a lady from County Monaghan had to move into a home in Sligo. She has family in Sligo which is part of the reason for her move. There was also a problem in obtaining the subvention since she had to move into the home in a hurry before the subvention forms could be sorted out. I do not blame the local authorities for that but there is an anomaly there as well. The Northern Eastern Health Board area cannot pay such subventions retrospectively owing to a lack of funds. The homeowner in Enniscrone has made it clear that he never had such a problem with any other health board area in his life. Hitherto, if somebody needed care, the subvention was made available on time.

I bring these two cases to the Minister's notice because of the serious overall situation in the north east. A few years ago, we had about 250 subvented beds, but that figure has been cut back dramatically. When I raised this matter with the chief executive of the health board, Mr. Paul Robertson, he made it clear that it was simply because the board does not have the funds available.

I could cite a litany of case histories involving lack of home help. One lady in Cavan was obtaining ten hours home help per week, yet that was cut to two and a quarter, which is 45 minutes for three days per week. If she needed home help, surely she required it for at least five days per week. A couple in their 80s in south Monaghan had their home help removed, even though the lady has poor sight. An aged brother and sister living in the Cootehill area received three to four hours of home help per week, whereas they required three or four hours per day. The man has since died. I have already raised in the House the case of a lady in a wheelchair who receives one hour's home help per week. We cannot be serious about providing home help to try to keep people out of nursing homes if that is the sort of service available.

One person informed me that when she was looking after her mother, she was so badly pressed that she had to pay somebody to let her attend a special commemoration in her place of worship. She had to pay €20 for a few hours. The home help issue needs to be examined. The Tánaiste and Minister should give the North Eastern Health Board the extra money it requires. The board's chief executive made it clear to me that he has put the relevant figures to the Department. The figures show there is a shortfall of €42.5 million using the historical basis criteria. Even though the area has had the single largest increase in population in recent years, the shortfall is €130 million.

I do not apologise for having been critical of the health board's chief executive officer, CEO, in the past, but one cannot expect him to work miracles. This area needs to be examined as it comprises an ageing population, including a higher ratio of people over 85 than anywhere else in the country. I urge the Tánaiste to re-evaluate funding to the North Eastern Health Board to provide what is necessary.

Ms Harney

I thank the Deputy for raising this matter. The issue of care for the elderly is one of concern to everybody in this House. Given the demographics of our population, with an additional 6,000 people each year moving into the over-65 category, care of the elderly will continue to be a major issue for us in future. In the context of resources that may become available, whether from the special savings investment account scheme or elsewhere, we will have to examine seriously a range of initiatives in this area. Most elderly people wish to remain in their own homes, stay with their families and be as independent as possible. Since 1997, the Government has substantially increased funding for services for older people, from £10 million in 1997 to €277 million in 2003. A further €10 million was allocated this year.

Funding for the nursing home subvention scheme in 2004 will amount to approximately €115 million, helping 10,000 clients receiving a subvention payment, and more than 50% of these clients receive an enhanced subvention payment. I am conscious that, given the huge increase in the cost of nursing home care, very often it falls far short of what is required, particularly in the greater Dublin area, but not exclusively.

I am pleased that the home help service has been extended. Since 1999, with the introduction of the national minimum wage, home helps are now appropriately remunerated. They were one of the groups that were a driving force for the introduction of a statutory national minimum wage. In 2003, expenditure on the home help service was more than €110 million and this year in excess of €113 million has been allocated to the service. It greatly helps many older people, who would otherwise require institutional care, to remain in their own homes, in many cases either living alone or living with members of their family.

I thank Deputy Crawford for raising this issue. Since my appointment to the Department of Health and Children, the whole issue of care of the elderly is a priority for me, as it is for the Government. In the context of solving accident and emergency problems in the acute hospital services, I hope to bring forward appropriate step-down facilities for patients who do not require to be in an acute hospital bed. Because there is no alternative, this issue needs to be addressed. This is an area about which we will hear much more, not just in the Dublin area but in the entire country.

I hope that from next year, with the establishment of the health services executive, a central agency to administer health care nationally, the kind of discrepancies to which the Deputy referred as between one part of the country and the other, will be eliminated as quickly as possible. It is not satisfactory that services are available to people living on one side of a road from a health board while on the other side, something far short of that is available to citizens who live in a different health board area. This is not desirable, fair or equitable.

Social and Affordable Housing.

Mr. Walsh

I thank you, a Cheann Comhairle, for allowing this important question on the Adjournment and I thank the Minister of State, Deputy Ahern, for coming to the House to take the question.

Last year in my position as Minister for Agriculture and Food, I encouraged Teagasc to make 15 hectares of land available at the agricultural college in Clonakilty. Clonakilty is a growth town. There is a long housing list and an acute need for affordable houses. Housing stock is particularly expensive in west Cork. Sites are making a couple of hundred thousand euro and houses typically cost between €350,000 and €550,000. Obviously young people cannot afford that burden, even with two good jobs. It is crucially important that this project is expedited. I know the Minister of State strongly supports the affordable housing initiative. This is an inspired and laudable initiative that has the total support of the Government and the social partners. However, it is disappointing that in the Clonakilty region a number of members of the Fine Gael Party are opposed to the scheme for their own middle-class reasons. They can be critical of such an initiative in the comfort of their nice suburban houses.

I encourage the Minister of State to keep the urgency of the project to the fore. In carrying out the project, I would like particular attention to be paid to planning and design. There is no need for high density and it is important to create a rural village. There is already a school and church in the village, therefore, it lends itself to a great deal of creativity, with plenty of green area and supporting structures. It could be twinned with the local village of Ring.

I ask the Minister of State to continue with the initiative and perhaps he will give me an up-date and time scale for the commencement of the work.

Minister of State at the Department of the Environment, Heritage and Local Government (Mr. N. Ahern)

I thank Deputy Walsh for raising this matter. The affordable housing initiative was included as one of the ten special initiatives negotiated with the parties to the pay agreement in Sustaining Progress. The initiative is aimed at those who in the past would have expected to purchase a house from their own resources but find that they are unable to do so in the current housing market.

Good progress is being made on the initiative. Part V affordable units are an important contribution to the initiative. More than 50 projects on State or local authority lands are planned. It is projected that these projects, together with more than 2,100 affordable units coming from Part V, will deliver a total of approximately 8,900 units to the initiative. My Department is currently engaged with a number of other Departments and State agencies with a view to securing further land to reach the agreed target of 10,000.

In December 2003, Deputy Walsh as Minister for Agriculture and Food proposed a site at Darrara Agricultural College in Clonakilty which was agreed by Government for inclusion in the initiative. As Minister with responsibility for housing, I acknowledge this and the other sites put forward by Deputy Walsh, which are sizeable and have greatly helped to boost the initiative. The number of housing units to be provided on this site, which is approximately 15 hectares, will depend on feasibility and other studies and the planning process.

The State lands made available for the initiative are transferred to the relevant local authority responsible for developing and progressing the projects. In this case, it is up to Cork County Council to plan and develop this project in a sustainable manner. The council has established an in-house technical group to progress the project. There is a keen interest locally in this project and I understand the council has already started local consultations. I heard what Deputy Walsh said about some objections and I hope they will not be too loud.

Cork County Council advertised for consultants to undertake a thorough feasibility assessment in terms of strategic land use planning, financial viability, affordability and suitable infrastructural solutions on 7 August this year. There were six submissions and short-listing interviews took place on 21 September. Two candidates have been invited back for interview to take place during the second week in November, after which it is expected the contract to undertake the study will be awarded. The intention is to complete the feasibility study by the end of December 2004 or January 2005.

The study will result in a range of conceptual design options with a number of suitable settlement models being brought forward for discussion. Following the selection of a suitable model, detailed design and planning will be necessary. As with all projects under the initiative, all activities are being progressed as a priority with some being paralleled as necessary with a view to early delivery of units. Ownership of the site is in the process of being transferred to Cork County Council following approval by the board of Teagasc of the transfer at its May 2004 meeting.

When I was in Cork in early September, in nearby Inchydoney, I visited the site and discussed progress and options with officials of Cork County Council. I promise to continue to monitor progress on this site and other sites under the initiative and will try to ensure that the Department pushes matters forward and does everything possible to secure the earliest possible delivery of units. It is a nice location, adjacent to the church. When Deputy Walsh was Minister for Agriculture and Food, he was helpful in giving this and other sites, and it is my intention to push forward and get the work done as quickly as possible. I hope the objections which Deputy Walsh mentioned will not prove a barrier because everybody's co-operation is required and we do not want delays when it comes to the planning process.

The Dáil adjourned at 9.20 p.m. until 10.30 a.m. on Thursday, 14 October 2004.