Dáil Éireann díospóireacht -
Thursday, 28 Oct 2004

Vol. 591 No. 2

Adjournment Debate.

Hospital Services.

Mr. P. Breen

A Cheann Comhairle, I thank you for giving Deputy James Breen and me the opportunity to raise the important issue of why the Mid-Western Health Board has not installed a CAT scanner in Ennis General Hospital, given that the money is ring-fenced for the unit.

There had been much talk of overcrowding in Dublin accident and emergency units and rural hospitals are often forgotten about. Ennis General Hospital is one such hospital. We have a continuous overcrowding problem with patients been kept in day wards all the time.

Every hospital needs to provide a safe service and the lack of such a service in a county will eventually lead to someone's death. We saw what happened in Monaghan earlier this week when an ambulance carrying a man with a suspected heart attack had to pass Monaghan hospital and make its way to Cavan General Hospital 30 miles away where the man died on arrival, despite frantic efforts by ambulance crews to save him.

Ennis Regional Hospital has a proven record in patient care, working within the budget of the Mid-Western Health Board, unlike some of the bigger hospitals, with a dedicated staff who unfortunately work in an outdated building and lack some very modern diagnostic equipment.

A CAT scanner is not a luxury in medical terms today. It is a necessary piece of equipment for any acute hospital whether local or general. It gives an instant accurate 3D X-ray reading on a patient, which is vital. Not only will it save lives, it will save money and, unfortunately, this is all about money.

A CAT scanner will save lives. Given an instant reading, the consultant can make his decision on the welfare of the patient without further delay. It will save money because at least three patients per day have to be transported from Ennis by ambulance to Limerick Regional Hospital for CAT scans and these have to be accompanied by a nurse. It will also free up the overcrowding in Limerick hospital and there will no need for appointments or delays.

We cannot afford to wait any longer for this necessary equipment. We need a consultant radiology service based in Ennis with a minimum of two postings. We are waiting for the development plan that is said to be with the building unit of the Department of Health and Children since the end of September. We are still waiting. This project needs to be fast tracked and not just built on a phased basis. Even if the €20 million development commenced tomorrow morning it would take years to complete.

The best people to ask about the genuine fear for patients in Ennis are the consultants and I am disappointed to learn today from an answer to a parliamentary question that the Tánaiste has refused to meet a group from the hospital. They will tell the real picture, the difficulties and the problems they encounter working with patients every day with limited diagnostic equipment. They want to give better, efficient and safe health care to the people of County Clare but are being prohibited by the snail's pace approach to the development control plan investment, the lack of additional consultants and physicians and the fact that a basic equipment like a CAT scanner, which in today's modern technology is the bread and butter for any acute hospital, is not available.

I ask the Minister to see that the health board installs this equipment without further delay.

Mr. J. Breen

I want the Minister to tell the people of Clare when the upgrade of Ennis General Hospital will take place. When the previous Minister for Health and Children came to the county four years ago he promised that Ennis General Hospital would be upgraded. He put a price on the project of £15 million. During the previous general election campaign members of the Government parties rushed to the media to spread the good news about the upgrading of Ennis General Hospital. Earlier this year, during the campaign for the European Parliament and local elections, local Fianna Fáil councillors and prospective MEPs again announced the upgrading of Ennis General Hospital. However, at a meeting in Ennis on 18 October, consultants informed local Members of the Oireachtas that the upgrading will not work. A CT scanner is needed in Ennis but such an item is of no use without the appointment of two radiologists. An additional consultant surgeon is also required. Two surgeons are working a 1.2 rota, which cannot continue. For the safety of patients in Ennis, an extra surgeon is required. We also need two additional consultant physicians, one for geriatric care and the other for respiratory medicine. To assure the continuity of an acute hospital service in Ennis, the development plan originally presented in 2000 needs to be expedited. The development plan needs to go ahead in its entirety. We cannot have it introduced in three phases because it will not contribute to patient care.

The Minister of State should tell us when we will see bricks and mortar going into Ennis General Hospital to ensure its upgrade. We want no more empty promises because we are sick of them. The Minister of State should tell us clearly when this upgrading will occur. It is badly needed for the care of patients.

Hospital treatment in Limerick is far superior to that in Ennis General Hospital but that should not be the case. Ennis should be entitled to the same benefits that are available in any other hospital. I congratulate the Minister of State on his appointment but he should indicate clearly when this upgrading will happen.

Minister of State at the Department of Health and Children (Mr. S. Power)

I thank Deputy James Breen and Deputy Pat Breen for raising this matter. It is nice to see colleagues from the same constituency working in harmony. Long may it last.

The provision of services at Ennis General Hospital is the responsibility of the Mid-Western Health Board. The Department of Health and Children approved the appointment of a project team and the appointment of a design team to plan for the development of facilities at Ennis General Hospital. The proposed priority areas for development include the accident and emergency department, outpatients department, radiology, and inpatient ward areas. I understand that the preparation of an outline development control plan is nearing completion. It will help to define the scope and content of the first phase of redevelopment for Ennis General Hospital and to confirm final decisions on the sequence of construction work in due course. The plan will be submitted to the Mid-Western Health Board for consideration.

I understand that the provision of CT scanner facilities at the hospital is acknowledged in the outline development control plan. The development of facilities at Ennis General Hospital, including CT scanning, will be considered in the usual way during the course of planning and designing of the major project. I understand that the Mid-Western Health Board has been advised that the capital cost of a CT scanner for Ennis General Hospital will be made available by way of donation from the mid-western regional hospitals development trust. However, the necessary infrastructure to provide for the installation of a CT scanner must be planned and prioritised as part of the overall project at Ennis General Hospital.

Mr. P. Breen

The Minister of State has given us no answer. He has not told us when the scanner will come.

Child Care Services.

Mr. Gogarty

I have raised this matter on the Adjournment to find out why proper procedures were not followed in providing personal details under the Freedom of Information Act to Mr. Michael Bowler of Lourdes House, Gloucester Place Upper, Dublin. I want to know what action the Government will be taking to address the matter. I am also asking that the case involving allegations of abuse during his time at Errigal House, St. Kieran's, Rathdrum, County Wicklow, during the period 1980 to 1984 be re-opened.

This is not an issue for the redress board or the courts. It is an issue concerning the State, knowingly or unknowingly, placing obstacles in the way of one man's search for the truth. I have met Mr. Bowler on several occasions. He is a man of sound mind who only seeks the full facts regarding personal details about him which are held by the State, as well as seeking justice regarding his experiences in Rathdrum.

Under the Freedom of Information Acts 1997 and 2003, Mr. Bowler applied to the Eastern Health Board and subsequently to the East Coast Area Health Board for personal information held by the boards relating to him and his family. He later applied to the Department of Health and Children for similar information under the same Act. In all cases he was not provided with the full information to which he is entitled under the law. Despite a huge personal effort, he has not yet received access to anywhere near all the records held by the board.

Some information was eventually made available but not enough and certainly not quickly enough. For example, information was provided to Mr. Bowler regarding the existence and whereabouts of his sister who he had not seen since she was placed in care at the age of six months. This information came too late for Mr. Bowler to re-establish a close and trusting relationship with his sister. Its delayed release has been the cause of much personal trauma. Other information held by the board has also yet to be released. I suspect that it is not being released because the State does not want to admit it was complicit in the abuse Mr. Bowler suffered and in the events that led to his brother's untimely death.

I am eager to be proved wrong and I would be grateful for any information the Minister of State can provide that would suggest I am wrong. I do not expect the Minister of State or his colleagues to work miracles, but Mr. Bowler should be given full access to all of his files so he can get the full truth of what happened during his childhood, take action for legal redress, if appropriate, and, most importantly, get on with his life, as everyone wants to do.

I ask the Minister of State to re-open another case concerning an investigation that was being carried out by Sergeant George Kyne from Harcourt Terrace Garda station. He originally contacted Mr. Bowler in November 1995 regarding a Garda investigation into abuse in Rathdrum. No subsequent charges in this investigation were pursued by the Director of Public Prosecutions. The Garda Síochána has confirmed and newspapers have reported that no specific investigation into the abuse alleged by Mr. Bowler was ever undertaken. I am talking about the general abuse and also the specific abuse to which Mr. Bowler refers.

To put the story of Rathdrum in context, Mr. Bowler's brother Jason ran away from that institution and lived on the streets of Dublin rather than put up with the abuse he suffered. He died at the age of 22 from a heart condition exacerbated by his years spent living rough. I am referring to Mr. Michael Bowler, rather than his brother Jason but there are numerous clippings about how Mr. Jason Bowler — who was named as Tom in the newspapers — spent his years living rough under the care of Fr. Peter McVerry. The Minister for Health and Children at the time was complicit, acknowledging there was a duty of care to Jason, yet allowing him to roam freely. That matter will have to be dealt with at a later stage but I am now discussing the question of some form of justice for Mr. Michael Bowler.

Will the State admit that it was complicit in letting Mr. Bowler suffer in the way he did? After all his troubles and the way in which he was treated by various State organs, the least we owe Mr. Michael Bowler is to re-open the investigation into the abuse at St. Kieran's in Rathdrum. The investigation should involve all persons who are alleged to have committed abuse, including the individual named by Mr. Bowler during his 1995 interview. I respectfully ask that the case be re-opened and closely investigated with the full vigour it deserves. Will the Minister of State give a commitment that Mr. Bowler will receive some satisfaction from the State and that justice will be seen to be done in his case regarding the information he has sought? Will the Minister of State follow up this case or will he, as the State's figurehead on this occasion, let Mr. Bowler down again?

Mr. S. Power

I thank the Deputy for raising this matter on the Adjournment this evening. The Deputy will appreciate that it would not be appropriate for me to comment on an individual case. However, I will outline the current legislation and standards, which underpin the child care system. The Child Care Act 1991 obliges health boards to provide a wide range of services which include the promotion of the welfare of children, the protection of children at risk, the taking of children into care, the provision of child care and family support services and the supervision and inspection of care services.

The emphasis of the Child Care Act 1991 is on supporting children and families in their own communities having regard to the principle that it is generally in the best interests of the child to be brought up in his or her own family. However, children are taken into the care of health boards or placed voluntarily in care due to a range of family circumstances and health boards have a statutory responsibility to provide appropriate services for these children either in foster care or residential care.

Regulations have been made under the Child Care Act 1991 to provide for the placement of children in foster care or residential care and the requirements must be complied with by the boards. The regulations cover the operation of residential centres, care planning, supervision, visiting and review of all cases of children placed in care. Provision is also made for the inspection of residential centres. Health board operated residential centres are inspected by the social services inspectorate and centres operated by the non-statutory sector are inspected by the registration and inspection units of health boards. In addition to the inspection process monitoring officers are employed by health boards to ensure that standards are met or progressed on an ongoing basis.

Based on the legislation and recognised good practices national standards for children's residential centres have been developed against which inspections are made. Each standard is inspected against a number of criteria. As I mentioned, health boards have a statutory requirement to prepare and keep under review the care plan for each child in care. The health board is also obliged to satisfy itself that appropriate arrangements are in place to facilitate reasonable access and contact between children in care and their parents, relatives, friends and any other person whom the board considers has a bona fide interest in the child.

The national standards for children's residential centres, which were developed in 2001, include a standard on planning for children and young people. Among the criteria against which this standard is inspected is contact with families. This includes actively seeking to re-establish contact between a child and his or her family or significant others where contact has been lost. The criteria state that staff should be sensitive to the child's wishes on the matter of contact with family. They also state that the wishes of siblings to be placed together where possible should also be respected and if this is not possible arrangements should be made for them to have high levels of contact. When a young person does not have contact with family the reasons should be explained clearly to the young person and documented by the relevant health board or residential centre staff as part of the care plan.

A children and a young persons version of national standards for children's residential centres was published and distributed in 2004. National standards for foster care were drawn up in 2003 and a young persons version of these standards has been developed and distributed.

The information provided by the Deputy is insufficient to enable the health board to identify with certainty the individuals referred to. While the Deputy has supplied some additional information this evening, if he wishes to provide further details such as date of birth, name and address of residential centre and care history including years in care together with details of his sister I will pass the details to the relevant health board and ask the chief executive officer to reply directly to him. Any further details on the issue of the Garda Síochána investigation of alleged abuse should be forwarded to my colleague, the Minister for Justice, Equality and Law Reform, Deputy McDowell.

Genetically Modified Organisms.

Mr. Mulcahy

I raise this matter to highlight the need for the Minister for Agriculture and Food to consult the Food Safety Authority of Ireland about the proposed introduction in Ireland of an oilseed rape product, Brassica Napus L GT73, which is genetically modified, given that the Oireachtas Joint Committee on Health and Children, at its meeting on 13 May 2004, unanimously decided to reject an earlier modified sweet corn, BT11, for placing on the market.

There appears to be a difference in approach by the two Departments. In the case of the first GM food introduced in May, the lead Department was the Department of Health and Children. While Ireland voted in favour of BT11, it failed to get sufficient votes at the Council and ultimately on 19 May the European Commission under the commitology rules decided to allow BT11 to be placed on the market. The lead Department for this GM product, Brassica Napus L GT73, is the Department of Agriculture and Food, not the Department of Health and Children. There seems to be an inconsistency in approach.

Although the European Food Safety Authority and, I believe, the Food Safety Authority of Ireland, if it was consulted, cleared this new GM food, Ireland abstained in the vote on 16 June. On the one hand on an earlier occasion when the Food Safety Authority of Ireland cleared the food, Ireland voted in favour, the second time the authority cleared the food, Ireland abstained. I have raised this matter at the Sub-Committee on European Scrutiny and at the Oireachtas Joint Committee for Health and Children, which unanimously rejected the introduction of a GM food in Ireland. We need an interdepartmental approach by the Departments of Agriculture and Food, the Environment, Heritage and Local Government, and Health and Children to analyse all these GM foods to determine whether Ireland wants them.

Allowing GM foods into this country will seriously erode Ireland's reputation as a producer of prime natural food. We have nothing to gain and everything to lose by allowing GM food into the country. We need a consistent approach. Why did Ireland abstain at the meeting of the regulatory committee on 16 June? Does the Government have a consistent policy on these GM foods? Will it establish an interdepartmental committee to monitor all these foods? I know the Minister of State has good contacts in this regard. As he is aware, the public are considerably concerned about generically modified food and this requires concerted Government action.

Minister of State at the Department of Agriculture and Food (Mr. Browne)

I thank the Deputy for raising this matter. I assure him that very effective and efficient lines of communication operate between officials of my Department and those of the Departments most actively involved in the whole GMO crops, food and feed issues, the Department of the Environment, Heritage and Local Government and the Department of Health and Children, and by extension the EPA and the FSAI. All five bodies are represented in some form or other on the various groupings addressing GM matters in this country.

I would like to set the background to the approval system for GM products. Prior to the coming into force last April of EU Regulation 1829/2003 on GM Food and Feed, which covered, inter alia, the approval and authorisation of new GM food and feed products, approvals were dealt with under two separate items of legislation. EU Regulation 258/97 on Novel Foods, administered by the Department of Health and Children and the FSAI, covered GM foods while EU Directive 2001/18 and it’s forerunner EU Directive 90/220/EEC, administered by the Department of the Environment, Heritage and Local Government and the EPA, covered GM feed. Since the coming into force of the new GM food and feed directive last April my Department has assumed responsibility for approval of GM feed applications.

Application for approval of the GM product referred to by the Deputy was made by Monsanto in summer 1998 under EU Directive 90/220/EEC, the forerunner of EU Directive 2001/18. Following the entering into force of Directive 2001/18 and the recommencement by the European Commission of the process of examining such notifications, the application was considered under the strengthened framework afforded by Directive 2001/18. The product is a genetically modified oilseed rape, referred to as GT73, with the modification allowing the crop to be tolerant to glyphosate herbicide thereby facilitating improved weed control during cultivation. This GM crop is cultivated extensively in the USA. Monsanto, which already received approval in November 1997 under the novel foods directive to market refined oil from this GM crop as a food use, is now seeking approval to market the product for animal feed. The issue of cultivation of the crop within the EU does not come into question.

The EU assessment process for any GM approval application is the most comprehensive in the world and is extremely stringent. This product has been subjected to its full rigours. The application was initially submitted to the Dutch competent authority, which raised no objection to the placing of the product on the market. The Irish competent authority, the EPA, following consultation with my Department, the Department of Health and Children, Teagasc and the GMO and novel foods sub-committee under the Food Safety Authority of Ireland's scientific committee, indicated that it had no objection to the Dutch view. Neither did the competent authorities of Sweden and Finland.

However, concerns were raised by some other member states which referred mainly to such issues as the need to ensure a more robust post-release monitoring plan and to identify and deal with unintended spillage and dispersal of seed during transportation. In the light of these objections, the Commission requested the opinion of the European Food Safety Authority, EFSA, and its opinion was that the oilseed rape in question was as safe for humans and animals as its conventional counterparts.

In accordance with the procedures laid down in Directive 2001/18/EC, the Commission sent a proposal for approval of the application to the regulatory committee for the purposes of that directive for consideration. The regulatory committee is representative of all member states and the Department of Environment, Heritage and Local Government attends on Ireland's behalf.

On 16 June, that committee failed to reach a qualified majority decision and the matter has now been referred to the environment council for a decision. Ireland abstained in the vote at the regulatory committee to enable further consideration of proposals that were made by that committee to strengthen procedures for the monitoring of accidental spillage and dispersal of seed. The strengthened procedures proposed by the regulatory committee have not, however, been carried through in the proposal that the Commission intends to bring before the Council. This is something that the Minster for the Environment, Heritage and Local Government will be aware of in determining our national position at Council on the product.

The Deputy is probably aware that the BT11 sweetcorn to which he refers, and which was appropriately administered by the Department of Health and the FSAI because it is a food item, was approved for marketing within the EU last July.

Tribunals of Inquiry.

Mr. Costello

I welcome the Minister of State. This question is a matter for the Minister for Justice, Equality and Law Reform and I wish he was here to answer it. It concerns a long-running sore in the legal process that should be addressed, namely, the need for the Minister to provide paid legal representation to the McBrearty family before the Morris tribunal.

Mr. Justice Morris published an excellent interim report on the findings of the first module examined by his tribunal into the behaviour of Donegal gardaí earlier this year. The tribunal has now moved on to dealing with a new module at the heart of which are the McBrearty and McConnell families. A bizarre situation now exists in terms of legal representation. The Garda Commissioner is represented by two senior counsel, two junior counsel and two solicitors. The Garda Representative Association has separate and similar legal representation, as have the Association of Garda Sergeants and Inspectors and the Minister for Justice, Equality and Law Reform.

Incredibly, there are four separate high-powered teams representing the Minister and the Garda. Already, €2 million has been paid to these legal worthies from the Garda overtime fund at a time when the Minister is cutting back on Garda overtime and has not delivered on the 2,000 gardaí promised two and a half years ago by this Government. The Minister, in his inimitable fashion, has managed to do the unthinkable. He has put together a legal team to represent him at the tribunal and has to date paid each of the two senior counsel €150,000 not to be present and not to attend the tribunal. Why has it not been possible for the Minister to put together one single legal team representing the interests of all those people wearing the jersey of the Department of Justice, Equality and Law Reform? What is the purpose of burdening the taxpayer with separate legal teams each doing basically the same job? The Minister has spoken about reducing the exorbitant legal fees at tribunals. He can now set the good example himself by dispensing with his own legal team and by combining the other three into one.

This is also the opportunity for the Minister to review his refusal of paid legal representation for the McBrearty family. There is an anomaly at the Morris tribunal at present. There are five full heavyweight legal teams, including the tribunal's own team, holding a watching brief, making submissions, questioning and cross-examining on a daily basis. On the other side, Frank McBrearty jnr. and Mark McConnell have to spend five days a week representing their families without the benefit of legal advice or legal representation. This is because they and their families are at the heart of the tribunal's deliberations and the Minister has refused them paid legal representation. They cannot afford to pay for legal representation themselves.

The best the Minister could offer was to give the chairman of the tribunal and the chairman of the Bar Council the imprimatur to trawl through the Bar Council's barristers seeking volunteers to represent the McBreartys without informing the McBrearty family or their long-suffering, unpaid legal advisers of seven years' standing.

The McBrearty family cannot get justice in the Morris tribunal without legal representation. They now face the unhappy choice of staying in the tribunal without effective means to participate in it or leaving it in despair and under protest. The Minister for Justice, Equality and Law Reform should now know that there was something rotten in Donegal in the 1990s and that the McBreartys were victims of the wrongdoing. The State owes them paid legal representation to vindicate their good names properly. I call on the Minister for Justice, Equality and Law Reform to provide that paid legal representation.

Mr. Browne

I apologise on behalf of the Minister for Justice, Equality and Law Reform and thank Deputy Costello for raising this issue. The position with regard to the family in question has been raised previously in this House. I accept that Deputy Costello has raised questions about the Minister's legal team and the combining of those teams and I will ask the Minister to respond directly to him on that matter.

The facts of this matter, however, are quite clear. The family concerned applied for, and were granted, a right to legal representation at the outset of the tribunal's business in the summer of 2002. They chose to exercise that right and were fully represented by counsel during the opening of the Barron investigation module for six weeks in Donegal during the summer of 2003. Work on that module resumed for a week in September 2003 and was discontinued until May of this year while the tribunal completed and reported on the explosives module. The tribunal resumed hearings on the Barron module in June 2004 but the family have chosen not to be represented by counsel.

Since September, during the course of the hearings members of the family have attended the hearings and have been permitted to conduct cross-examination of the various witnesses as they have seen fit and have been quite vigorous in their questioning. At various times since September they complained to the chairman of their inability to get legal representation for financial reasons.

The chairman, Mr. Justice Frederick Morris, recently made efforts to resolve the issue. I understand from a statement made by the chairman at the tribunal that some progress was made by him in trying to secure the services of counsel who would act on behalf of the family without remuneration. This was not acceptable to the family and the chairman decided not to continue with his efforts in this regard.

The matter of costs has always been clear. Under the terms of the Tribunals of Inquiry (Evidence) Acts 1921 to 2002, the question of costs is solely a matter for the tribunal. This is not only the legal position, it also has important practical implications for tribunals in their search for the truth. The Acts allow a tribunal which, having regard to its findings and all other relevant matters, is of opinion that there are sufficient reasons rendering it equitable to do so to order the whole or part of the costs of representation of a person appearing before it to be paid. A tribunal, when determining whether costs should be paid, may take into account failure to co-operate with, provide assistance to or knowingly giving false or misleading information to the tribunal.

It is worth noting from the chairman's judgment on the costs associated with the first module that he regards co-operation with the tribunal and truthfulness in giving evidence as matters of paramount importance. In deciding on costs, he made deductions in some cases and rejected other applications where he was of the opinion that persons deliberately lied or otherwise hindered him in his efforts to get to the truth. It is crucial that this power is available to tribunals and we should be very slow to consider any changes which would blunt the effectiveness of tribunals in uncovering the truth, as could be the case if the State were effectively to guarantee in advance the payment of legal costs for parties before tribunals. I appreciate we are discussing one family but there must be a clear and consistent principle behind the policy on the payment of costs which is applicable generally, not just in relation to any individual. I know, for example, that the Minister for Justice, Equality and Law Reform has consistently maintained the present position in the face of High Court challenges from a number of parties to the Morris tribunal.

I fully acknowledge that the establishment of the tribunal was to a significant degree brought about by the continued campaigning of this family and representatives on its behalf. Its fight for justice is to be commended. The forum now exists for it to achieve this. The chairman and his legal team are pursuing the truth with vigour and they will not leave any stone unturned in the search for the whole truth about the unfortunate events in Donegal. The Government will act promptly on its findings, and this has already been demonstrated.

Coming back specifically to the question of legal representation for the family, I hope it is reassuring to the family and its legal representatives of choice to note that Mr. Justice Morris has acted promptly and has addressed the issue of costs arising out of the first module, on which he reported during the summer. By any standards, this is remarkably quick. It is clear that the chairman is cognisant of the difficulties of the various parties with regard to their legal costs and is acting to ameliorate the situation as best he can. I understand the tribunal is making significant progress on the current module and on this basis I encourage this family and its legal representatives to participate fully and co-operate with the tribunal to the greatest possible extent. I have no doubt that Mr. Justice Morris will endeavour to bring matters to a conclusion in the shortest possible time.