Dáil Éireann díospóireacht -
Thursday, 4 Nov 2004

Vol. 591 No. 5

Adjournment Debate.

Hospital Services.

Ms McManus

On Thursday, 21 October family doctors in County Wicklow and other areas received a letter from the master of the National Maternity Hospital, Holles Street. The doctors were informed that:

Obstetric activity levels in the National Maternity Hospital peak in the months of May through to September on an annual basis. The increase in activity is often coupled with a reduced staff complement. In order to address this, it has been decided to limit the number of obstetric patients booking for delivery in their peak months to ensure continuing prioritisation of patient care.

The letter advised a new booking system would be put in place applying to all mothers. It went on to state that once the quota is reached the patient would be informed the hospital is booked out and that a cap would be placed on the months of June, July, August and September 2005. The letter went on to warn that "Unbooked emergency obstetric patients who present to the hospital will be seen, however, this does not guarantee a booking." It is clear that Government neglect, coupled with a shortage of staff, has led to this unprecedented and unacceptable decision to cap the number of births at Holles Street, a hospital that has prided itself on having an open door policy.

We have reached a new low in health care when we are being faced with what is an impossibility, that is, a waiting list for the delivery of babies. It is vital that the Government addresses the issue immediately to ensure the care and safety of mothers-to-be and their babies are not put at risk as they will be if this directive is implemented. The need to provide sufficient midwives must be met and we need to hear from the Minister that it will be. Time and resources are available having regard to the timeframe given by the hospital and the extraordinary Exchequer returns published this week. The Government introduced a constitutional amendment on Irish citizenship at the last local elections, which, according to the Minister for Justice, Equality and Law Reform was intended to relieve pressure on the maternity hospitals. The people voted accordingly, the Government got its way yet the pressure on this maternity hospital is worse rather than better. As far as my constituents in County Wicklow are concerned they were given an undertaking that when the maternity unit in St. Columkille's Hospital in Loughlinstown was closed down there would be there would be guaranteed access to Holles Street maternity hospital. Women from Ringsend down to south Wicklow rightly expect to be able to access this hospital. There is no other maternity hospital in the East Coast Area Health Board area. It is disgraceful that they should lose such security in this new arrangement. Surely, at the very least, women in the catchment area must be given priority as they have nowhere else to go.

The Hanly report gives similar assurances with regard to accident and emergency services but unless the crisis at Holles Street hospital is resolved we will know for certain that such promises are worthless. I urge the Minister to address the issues raised by the hospital and to ensure the safety of pregnant women and their babies. Generations of women in County Wicklow have enjoyed the protection of the National Maternity Hospital at Holles Street. It is unconscionable that women in the 21st century should be denied it.

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

I welcome this opportunity on behalf of the Minister for Health and Children to clarify the background to and present position of the National Maternity Hospital, Holles Street. On 22 July last, the then Minister for Health and Children, Deputy Martin, and officials of the Department met representatives of the board and management of the hospital and of the Eastern Regional Health Authority to discuss proposals for several developments aimed at relieving infrastructural deficits at the National Maternity Hospital.

The Minister approved the proposals, which are intended to be put in place in the short term, and are designed to increase capacity in delivery rooms, theatres and neo-natal intensive care units, as well as providing improved post-natal facilities for mothers and babies. The Department has approved the appointment of staff to oversee and manage the project, and the process of selection of a design team is under way. At that meeting, hospital representatives gave an assurance that there were no plans to cap the booking numbers and the hospital would ensure it would meet patient demand over the course of the capital works. The Eastern Regional Health Authority further advises the Department that it was not consulted by the hospital on the recent decision to issue letters to general practitioners placing limits on obstetric bookings for the months of May through to September next year.

In addition to the interim capital works to which I have referred, considerable work has been done in preparing plans for the long-term redevelopment of the hospital. The project team charged with overseeing this work has completed a development plan that recommends a significant increase in the accommodation.

The National Maternity Hospital manages approximately 8,300 deliveries each year, an average of just under 700 per month. The number of births tends to peak during the summer months when it averages 720 per month and can be higher in some months. The hospital has stated that during the summer months factors such as staff holidays, education leave and retention difficulties place additional pressure on services. The Department of Health and Children is advised that the National Maternity Hospital will continue to manage 700 deliveries per month. If demand exceeds this number a few women may have to attend another maternity hospital.

The authority acknowledges the continuing challenges facing the maternity services in the region. It has been working with the three maternity hospitals jointly to address the issue of how best to manage the provision of maternity services over the summer months and to ensure the continuity of care. The Eastern Regional Health Authority has also been working with the three maternity hospitals to consider ways to address the increase in numbers and to introduce initiatives that would alleviate some of the pressures. These initiatives include the further development of community-based midwifery led services such as the Domino home birth scheme and early transfer home programme.

Staffing levels at the three Dublin maternity hospitals have risen significantly in recent years. While the number of births has risen by 8% from 1998 to 2003, staffing levels have risen as follows in the same period: medical staffing has increased by 25% in the three Dublin maternity hospitals, with a 24% increase in Holles Street; nursing staff has increased by 15% in the three hospitals and by 28% in Holles Street. There has also been a significant increase in health and social care professionals of 36% in the three hospitals and 25% in Holles Street.

The Minister for Health and Children assures the House that the Eastern Regional Health Authority is working closely with the three Dublin maternity hospitals to ensure that all patient demand for maternity services in the Eastern region will be met without causing difficulties to expectant mothers. I will report the Deputy's comments on Loughlinstown hospital to the Minister.

Mr. Gilmore

We were promised that facility. We remember that.

Mr. N. Ahern

I hope matters are not as bad as might appear from recent media reports.

Decentralisation Programme.

Mr. Gilmore

In his budget speech of 3 December 2003, the then Minister for Finance, Deputy McCreevy, announced that the Government had decided to transfer Bord Iascaigh Mhara from Dún Laoghaire to Clonakilty as part of the grand decentralisation plan. I call on the Government to reverse that decision. The decision was clearly made without any real examination or forethought. The Minister announced that 150 Bord Iascaigh Mhara jobs were to be relocated to Clonakilty. He did this presumably by checking out how many people Bord Iascaigh Mhara employed, assumed they were all based in Dublin or Dún Laoghaire and that they were to be moved to Clonakilty. It would be impossible to do that because 60 of those jobs are not located at Bord Iascaigh Mhara's headquarters at all. They are located in fishing ports around the coast, where their jobs relate to fishing activity, fish processing and marketing. Surely it is not intended to bring them back from Killybegs and all the other fishing ports around the coast so they can fill an office building in Clonakilty.

That leaves 94 staff located in Dún Laoghaire. These staff have been surveyed and only 16 wish to be relocated to Clonakilty. The Government's theory on decentralisation is that the remaining staff could be transferred to other Dublin-based Departments or agencies and that civil servants from any other Department who might wish to relocate to west Cork could work for Bord Iascaigh Mhara in Clonakilty. The problem, however, is that Bord Iascaigh Mhara's activity is very specialised. It employs a range of scientists, marine engineers, marine technicians and so on, many of whom would be out of place if they were to be transferred to another Department. It is difficult to see, for example, what a marine biologist would have to offer let us say, the immigration division of the Department of Justice, Equality and Law Reform. In turn, they cannot be replaced by general service employees of other Departments or agencies.

If Bord Iascaigh Mhara is to be relocated to Clonakilty, most of the existing staff will have to be accommodated in Dublin-based jobs which are not related to their qualifications, and Bord Iascaigh Mhara will have to recruit an entirely new staff of scientists and specialists to work in Clonakilty. None of that makes sense. It is unfair to the existing staff; will seriously disrupt the important work and services being provided by Bord Iascaigh Mhara and add unnecessary costs to the taxpayer.

Moreover, it is unfair to Dún Laoghaire. I and other public representatives from all parties attended a recent meeting with the Dún Laoghaire Business Association and there is very strong and understandable opposition from traders and business people in Dún Laoghaire to Bord Iascaigh Mhara being moved out. They see it as the town losing almost 100 jobs with all the economic and social consequences which such job losses entail. Whatever the rationale for decentralisation from Dublin city centre, there is none for decentralisation from Dún Laoghaire. Bord Iascaigh Mhara was decentralised from a city location to Dún Laoghaire almost two decades ago and it should not now be moved again.

The decentralisation proposal for Bord Iascaigh Mhara makes no sense in terms of cost, operation, staff or even traffic. It was a hastily conceived notion and should be dropped.

Mr. N. Ahern

I thank the Deputy for raising this matter and I propose to respond on behalf of my colleague the Minister for Communications, Marine and Natural Resources. The Government's decentralisation programme, announced on 3 December 2003, provided for the relocation of the headquarters and functions of the Department of Communications, Marine and Natural Resources to Cavan and Bord Iascaigh Mhara to Clonakilty. It was subsequently decided that the Department's seafood and coastal zone functions are also to be located in Clonakilty.

Since the Government announcement, a senior level committee has been established and an executive appointed within BIM, to liaise with the Department, the Office of Public Works, the Department of Finance and the decentralisation implementation group, the Flynn group. In addition, the management committee of the Department has established a structure to manage and co-ordinate the decentralisation project involving a steering group chaired by the deputy Secretary General, and appointed a decentralisation programme manager. The co-location of the range of State services for the seafood and coastal zone sectors, operated by the Department and by BIM, offers opportunities to further develop the existing synergy in service delivery. It will also facilitate the creation of a one-stop shop concept for the extensive common client base and help to build improvements in customer service.

The co-location of services may also present possibilities in terms of sharing elements of accommodation. The Department and BIM are therefore working in close partnership in all aspects of the proposed relocation to Clonakilty and particularly in liaison with the Office of Public Works on accommodation issues. The preferred option of both parties, which has been discussed with the OPW, is for campus style accommodation involving a significant element of shared facilities, but maintaining the distinct corporate identity of both organisations. Regular consultations with OPW have included a number of joint visits to Clonakilty to assist consideration of the various site options. Since the decision was made to locate services in Clonakilty, the focus of both the Department and BIM has been on widespread consultation with stakeholders both internal and external. In particular, consultation with staff interests is being progressed via the established fora. In addition, there has been regular liaison with the Department of Finance and the Flynn group.

The Flynn group has indicated its intention to report shortly on sequencing of moves based on both CAF results to date, and the progress made by OPW in property and accommodation acquisition at the various locations. Developments will have a critical bearing on arrangements for relocation of both the Department's seafood and coastal zone functions and BIM to Clonakilty. The latest information from the Public Appointments Service, formerly the Civil Service Commission, indicates that as of 7 September 2004, 140 expressions of interest had been received for the 91 CAF posts in the Department's seafood and coastal zone functions in Clonakilty. Staff within the Department make up 23 of those applications. In the case of an Bord Iascaigh Mhara, expressions of interest via CAF to date are lower, with 36 applications for the 93 BIM posts in Clonakilty and no applications from within BIM.

Mr. Gilmore

It is worse than I thought.

Mr. N. Ahern

However, a survey carried out earlier this year showed that 16 BIM staff out of 92 polled expressed an interest in relocating to Clonakilty, while a further ten staff were undecided. Public service unions have advised their members in State agencies such as BIM not to engage in the CAF process. To date BIM staff have not participated in the CAF process. It should also be borne in mind that central developments will have a bearing on trends and developments at agency level over the coming months. The decentralisation implementation plans of both the Department and BIM have signalled the potential for significant staff turnover and loss of corporate memory and expertise, as well as business continuity and business efficiency requirements for technical, professional and expert functions.

Mr. Gilmore

How is the Government going to solve that?

Mr. N. Ahern

Both plans contain preliminary risk analysis and plans for risk mitigation, which take into consideration the impact of these and other aspects of the decentralisation process. The mitigation plans include knowledge management and transfer to underpin business continuity. These plans will continue to evolve in line with developments. The Department continues to work very closely with BIM on the decentralisation process and particularly in relation to project management, risk and opportunity assessment and business continuity strategies including knowledge management. The overall objective for the Department and BIM in implementing decentralisation is to maintain and enhance standards of service delivery and to realise opportunities for modernisation and business efficiency and effectiveness as part of the process. I will report back to the Minister for Communications, Marine and Natural Resources, but it is more difficult with professional staff than with administrative staff.

Mr. Gilmore

It would be better to drop the idea altogether.

Coastal Erosion.

Mr. Stanton

I thank the Minister for coming to debate the issue of coastal erosion in the Ballymacoda area of east Cork. I have been raising this issue ever since I was elected here in 1997. The situation has got worse and the most recent storms caused terrible damage. I am worried about its future. There is much low lying land in the Ballymacoda area near Youghal. There was some coastal protection there over the years. Farmers did their best to keep the sea out but they are losing the battle and they need the Minister's help at this stage.

Four reports have been commissioned on that area, in 1995, 1998, 2000 and in 2001. The report in 2000 cost £21,000 to produce, but very little has happened there. The soft earthen banks there have been washed away by the sea. There is low lying land and the sea is now encroaching. Once the salt water hits agricultural land, it is very hard to grow crops until the salt is washed out again. I know of one farmer who spent a considerable amount of his own money in building up banks to keep the sea out. The recent storm destroyed that, so we can only imagine later in the year if more serious storms occur. We could have situations where roadways could be damaged, houses could be cut off and where land could be put under seawater irretrievably. At this stage, it does need an emergency measure for that part of east Cork.

I have been told before that responsibility rests with the property owner and with the local authority, but I urge the Minister to examine this. It has gone beyond that. We have to take pro-active measures in these areas to stop the sea encroaching. Once the land is lost, it will not be possible to bring it back.

During the recent storms, the island of Cobh was cut for some time. The Minister should also look at the access to Cobh. It is a large town and a large island and people could not get off. If they had to deal with emergency services, there was no way of getting on or off the island. The bridge there needs to be seriously upgraded. I look forward to the Minister's response. There was a geographical information system survey carried out on the east Cork area and I am not sure whether the Minister can tell us anything about that. Youghal was also flooded by seawater. In many towns, river water, flood water from plains and run-off caused the floods. However, when seawater comes in it is far more serious, especially where agricultural land is concerned. I implore the Minister to examine the policy of the State in this area. If they can do it in Holland, then why can we not do it here? The amount of coastal area involved is relatively small, but it does need urgent attention. Otherwise, quite an amount of land will end up under seawater and I am serious about that.

I am worried about the future of the area if action is not taken very soon. We do not need more reports because the Department and the county council have received many reports. We need a meeting of minds. My impression is that the Department has been saying it is a matter for the county council, which has been saying it is a matter for the Department and never the twain shall meet. We need a meeting of minds to bring about a national coastal protection policy. I would appreciate if the policy concentrated initially on east Cork.

Mr. N. Ahern

I thank the Deputy for raising this matter, to which I will respond on behalf of the Minister for Communications, Marine and Natural Resources, Deputy Noel Dempsey.

Responsibility for coastal protection rests with property owners, including local authorities and private individuals. In July 2002, the Department of Communications, Marine and Natural Resources asked coastal local authorities to submit proposals for coastal protection works in the period between 2003 and 2006. Some 195 proposals, with an estimated cost of over €120 million, were submitted from the relevant local authorities.

As coastal protection works are costly undertakings, projects must be selected on the basis of a clear cost benefit justification. The priority should be to safeguard human life and to protect public property, including roads and other public infrastructure and amenities. The Department does not have funding available for the protection of privately owned property.

Over €52 million has been identified for expenditure under the coastal protection measure of the national development plan. Expenditure under the measure was €2.9 million last year and an allocation of €2.7 million has been made available to the Department for the coastal protection programme this year.

All coastal protection proposals are carefully examined in the Department of Communications, Marine and Natural Resources in accordance with the priority criteria, which are to protect public safety, public property or infrastructure; to protect areas of socio-economic, tourism or recreational importance; to support the economic development or increase the economic potential of coastal regions; to provide essential protection for areas or features of environmental or heritage significance; and to avert the need for costly remedial works at a later stage.

Mr. Stanton

That is the one.

Mr. N. Ahern

Some €500 million has been allocated this year to a major coastal protection strategy study, which commenced in 2002.

Mr. Stanton

Is that figure correct?

Mr. N. Ahern

It cannot be correct. There is something strange about it. I assume the correct figure is €0.5 million.

Mr. Stanton

It cannot be €500 million.

Mr. N. Ahern

It is obviously wrong, given that I said that €2.9 million was spent last year. The correct figure must be €0.5 million.

Mr. Stanton

Even that is too small.

Mr. N. Ahern

I will get back to the Deputy with the correct figure.

Mr. Neville

Perhaps €500 million is the right figure.

Mr. N. Ahern

I do not think it is, sadly. If €500 million were available, the problems in east Cork would be solved.

Mr. Stanton

Yes, and many other problems.

Mr. N. Ahern

I assume that €0.5 million was allocated this year for the coastal protection strategy study, which commenced in 2002. The study will address the nature and extent of erosion at various locations and different types of coastline. It will seek to identify the most effective technical, financial and environmental means of responding to particular instances and types of erosion.

An aerial survey of the coastline using oblique digital video photography has been completed as part of the first phase of the study. The survey was commissioned to obtain a comprehensive and up-to-date record of the extent of coastal erosion around Ireland's coastline and to facilitate the identification of priority areas for future expenditure. The completed survey provides a useful baseline for the preparation and commissioning of future surveys. The filming, which commenced in September 2003, was undertaken from a helicopter using a high quality digital camera system. The coastline was overflown in an anti-clockwise direction, beginning at Lough Foyle and ending at Carlingford Lough. The results of the survey are presented as a series of overlapping digital images linked to interactive maps, which enable the digital images of particular sections of coastline to be examined. It is expected that a more targeted approach to programme delivery will result when the study has been completed. It will enable a greater level of efficiency in responding to instances of coastal erosion.

I confirm that Cork County Council submitted 24 proposals to the Department for consideration in the period between 2003 and 2006. Youghal Town Council submitted a proposal for a coastal protection scheme at Youghal. The county council did not submit any proposals in respect of Ballymacoda. The local authorities rank the Youghal coastal protection scheme as the priority in the county. The total cost of the proposed scheme is estimated at €6 million. The Department has allocated funding to two projects in Cork this year. It has contributed €375,000, or 75% of the cost, for the first phase of the Youghal coastal protection scheme.

Mr. Stanton

It is peanuts.

Mr. N. Ahern

The Department has contributed €187,500, or 75% of the cost, for coastal protection works at Rosscarbery. The provision of funding for coastal protection works after 2004 will depend on the outcome of the coastal protection strategy study, the amount of Exchequer funding available for such works and overall national priorities. I promise to speak to the Minister, Deputy Noel Dempsey, probably next Tuesday, about the area in east Cork which is under severe threat. I will also discuss the issue of flooding with him, particularly as it relates to the bridge into Cobh which was discussed by the Cabinet the other day. Perhaps the issues of coastal erosion and flooding will be considered with greater urgency in that light. I will speak to the Minister about the matters raised by the Deputy.

Mr. Stanton

I thank the Minister of State.

School Staffing.

Mr. Neville

I welcome the opportunity to discuss this matter on the Adjournment. Martinstown national school in County Limerick was a two-teacher school until last September, but it is now a one-teacher school. The quality of the school's implementation of its child-centred curriculum has been seriously affected by the loss of 50% of its staff and its pupils are now faced with a disadvantage. I pay tribute to the remaining teacher because the school's problems have been ameliorated as a result of her efforts and commitment, as well as that of the teacher who was obliged to leave the school.

A previous Minister decided some years ago that the number of teachers in a school should not be reduced to one. That made sense because schools need to have a minimum of two teachers, for very good reasons. Teachers in one-teacher schools face enormous difficulties because they need to be aware of the full range of the curriculum for all primary school classes. It can happen that infants do not achieve their potential because they are denied an even break in one-teacher schools. Senior pupils making the transition from primary to secondary school may also be denied an even break, which could be detrimental to their future careers, although I accept that is not happening at present.

I ask the Department to examine carefully the number of pupils currently in Martinstown national school because it will increase in September 2005. I ask for an early commitment to the restoration of the school to a two-teacher school. It is fine to say the school's problems could have deteriorated further, but it should be borne in mind that it has been affected by the loss of a teacher. The commitment I have mentioned should be made at an early stage so that the confidence in the school which may have been lost can be restored, thereby maximising the school's ability to attract additional pupils. It is difficult for the school community to participate in inter-school games and sports because the presence of a teacher is rightly required by sporting authorities when schoolchildren are participating in sports during school hours.

It is obvious that the reduction of teacher numbers in the school has health and safety implications. If the only teacher in the school leaves the classroom for any reason, it is obvious that there will be nobody to fill in for her. It is clear that teachers have to absent themselves from schools from time to time. If the teacher cannot be with her pupils for teaching or supervisory purposes, it is a cause of great concern for the teacher and the board of management. Anything can happen causing a teacher to leave in the short or medium term, and the Minister will understand my point. Regarding health and safety, if a child needs any attention, all other pupils must be ignored to allow the teacher to concentrate on the difficulties being experienced, which might be in the school yard or elsewhere.

The school is part of the local community and has been there for 150 years. It is an extremely important aspect of community life, and any suggestion that the school should be discontinued, as has been made by the Department, is totally unacceptable since that community is surviving and we can see it expanding in future, and it is situated in a parish where the population will grow. If anything were to happen to the school, within ten years people might demand it back. It is vitally important that the school continue as part of the community. The school will survive if the second teacher is restored. We ask the Department for a commitment to do that during this school year.

Mr. N. Ahern

I am glad to have the opportunity to outline to the House the position of the Department of Education and Science regarding staffing at Martinstown national school, Kilmallock.

The mainstream staffing of a primary school is determined by reference to the enrolment of the school on 30 September of the previous year. The number of mainstream posts is determined by reference to a staffing schedule which is finalised for a particular school year following discussions between Department officials and the education partners. The staffing schedule is set out in a circular which issues from the Department to the board of management of all primary schools. Accordingly, all boards are aware of the staffing position for their school in any school year. The staffing schedule for the 2004-05 school year is outlined in the Department's primary Circular 03/04, which issued to all primary schools in April 2004 and is available on the Department's website.

Under new arrangements introduced in August 2002, all appeals on the mainstream staffing of primary schools are considered by an independent staffing appeal board. The criteria for appeal are set out in Department of Education and Science primary Circular 19/02. The appeal board allows for equitable and transparent treatment of all primary schools, and its decision is final. It is not open to the Minister for Education and Science or her Department to interfere in this process. The school referred to by the Deputy, Martinstown national school, had an enrolment on the 30 September 2003 of seven pupils, which warranted staffing for the current school year, 2004-05, of a principal teacher. I understand that the enrolment at the school on 30 September 2004 was 12 pupils, which under the present staffing schedule will warrant the appointment of a mainstream class teacher in addition to the principal teacher for the 2005-06 school year.

The staffing appeal board considered an appeal from the school in question having regard to the criteria outlined the Department primary Circular 19/02 and was satisfied that a departure from the staffing schedule was not warranted in this case. The board of management of the school was notified of the decision of the staffing appeal board on 5 June. The decision of the appeal board is final. I am sure that the Deputy will appreciate that it would not be appropriate for the Minister for Education and Science to intervene in the operation of the independent appeal board.

Once the discussions on the staffing schedule for the school year 2005-06 have been concluded, the schedule will be set out in a circular to be issued to all primary school boards of management in 2005. I would like to thank the Deputy once again for raising this matter in the House. There may be no short-term solution to his difficulty, but it should come right next September. However, I am not aware of any other way around the problem as outlined. I will report back to the Minister for Education and Science, Deputy Hanafin.

Mr. Neville

I appreciate the Minister's reply, but in principle a one-teacher school should not be acceptable. Two teachers should be the minimum.

Mr. N. Ahern

I understand the Deputy's point of view.

The Dáil adjourned at 5.25 p.m. until 2.30 p.m. on Tuesday, 9 November 2004.