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Dáil Éireann díospóireacht -
Thursday, 23 Mar 2006

Vol. 616 No. 6

Adjournment Debate.

Accident and Emergency Services.

I welcome to the House the Minister of State at the Department of Health and Children with responsibility for children, Deputy Brian Lenihan. I would have liked to see the Tánaiste and Minister for Health and Children here because this is such a serious issue.

Next month, I will have been three years protesting outside the accident and emergency unit at the Mater Hospital. I have been there every Saturday between 1 p.m. and 2 p.m. I did not do that for the exercise but because three years ago next month a lady aged 89 years entered the accident and emergency unit in the Mater Hospital. She had a slight heart attack on a Monday and the following Thursday a member of her family contacted me asking if it was possible to get a bed for her because she would have her 90th birthday on the following Saturday, and wanted to be in a bed to receive her grandchildren. She did not want to be sitting on a chair or on a trolley in the accident and emergency unit.

I contacted the bed management section in the hospital which said it would do its best, it could not do anything that day but would get a bed on the Friday. I checked on the Friday and it had given the lady a bed. I visited her on the Thursday night. She was a fabulous, sprightly little old lady, full of life. I telephoned the hospital on the following Monday and the management told me the lady was fine, had been treated and had gone home. A week later a member of the family telephoned me to say that in fact the lady had never gone home but had died that day in the hospital.

It was atrocious that a lady of that age should be kept on a trolley for virtually a week, and that I should have been told a lie about what had happened. I subsequently raised this matter with the hospital management which said it would look into it but I never received a satisfactory response. I was determined that, arising out of that incident, I would leave no stone unturned until the waiting lists in the Mater Hospital had been eliminated.

Unfortunately it has not been eliminated although three years have passed, and for half of that time there has been a new Minister for Health and Children, who, on taking office in September 2004 said her priority was to sort out the problems in accident and emergency units and that she and the Government in which she served would be judged on her success in this matter. In January 2005 she said that people judge our health service by their experience of accident and emergency units. The Tánaiste went on to provide her ten-point plan to deal with it. That plan was supposed to bear fruit within six months. Much more than 18 months have now gone by and the situation is worse than it was when the Tánaiste took up office. Last week we saw a record 455 people on chairs and trolleys in accident and emergency units. The stage has now been reached whereby there is no room for the normal chair, an armchair. We have had the trolleys, the armchairs, soft plastic chairs and now hard chairs because there is no room for the normal chairs. It is scandalous.

A Minister arrived to deal with the matter and the situation has worsened rather than improved. I do not know where we can go from here unless we can deal with the situation of an 89 year old lady who has never cost the State a penny, and there are many similar people now in need of State assistance. They are in their hour of need and are let down by the State and the services. We must deal with that and I hope the Minister of State has some answers for me.

I am responding to this matter on behalf of my colleague, the Tánaiste and Minister for Health and Children, Deputy Harney. Deputy Costello is aware, as he indicated in his contribution, that there have been particular pressures on accident and emergency services in recent weeks. A number of factors have contributed to these pressures, including increases in the number of attendances and the rate of admission at accident and emergency departments, an increased incidence of influenza and the winter vomiting virus and an increase in the number of patients awaiting discharge from acute hospitals. The winter vomiting virus has had the added complication of closing acute beds to new admissions and slowing the discharge of patients to a number of sub-acute facilities.

Particular difficulties were experienced over the recent bank holiday weekend when 27 patients were in the accident and emergency department of the Mater Hospital awaiting admission. Latest available figures for the hospital show that 14 patients were awaiting admission at 2 p.m. yesterday.

Prior to the more recent difficulties experienced in accident and emergency, the Mater Hospital had shown a reduction of over 20% in the numbers waiting in accident and emergency at 2 p.m. when comparing January 2005 and 2006 figures. This reduction in numbers waiting in the Mater Hospital accident and emergency department was achieved through the opening of the 33-bedded transit ward in December 2005 and the sustained focus on tackling delayed discharges. A total of 45 patients were discharged under this initiative in late 2005, 92 patients benefited in 2005 under home care packages and a further 153 patients were discharged to intermediate care.

The Health Service Executive and the Mater Hospital are working closely together to alleviate further pressures in the accident and emergency department and in this regard, the HSE has announced an initiative to contract 250 long-stay beds in the private sector to facilitate discharges from the acute hospitals. This initiative is to free up capacity in acute hospitals, including the Mater Hospital. It is expected that patients will begin to move from acute hospitals in the coming weeks.

In the broader context of accident and emergency services, the Taoiseach, the Tánaiste and Deputies on all sides of the House agree it is unacceptable that elderly people in particular should have to wait for long periods at accident and emergency units or sleep overnight on trolleys rather than in beds. Every available action that can be taken will be taken to improve patients' experience of care. These include a continuation of the steps in the ten-point plan. For example, the HSE will continue to provide many more long-term beds, step-down places and home care packages. These actions are recognised as essential by all concerned. In particular, the HSE's management actions are focused on attendances and admissions, delayed discharges and improving efficiency and throughput.

In terms of implementation, the following approach is being taken: tackling the issue hospital by hospital, developing hospital-specific time-based targets for accident and emergency and delayed discharges, development of financial incentives linked to performance in these areas and development of targeted initiatives aimed at delivering immediate and sustained impact in the areas of attendances, delayed discharges and efficiency. A dedicated team has been established by the HSE to drive the implementation of this framework.

In terms of immediate action it is critical that all hospitals take appropriate steps to ensure that patient privacy, dignity and comfort is preserved. In this context, funding is being made available within the capital programme to develop admissions lounges or transit units to ensure that patients are treated in an acceptable environment. Discussions are already under way with hospitals in this regard and detailed proposals will be agreed within the coming weeks.

The HSE has been asked to undertake a bed capacity review in light of changing demographics and proposals for the development of community services. This work will be conducted as a matter of priority and reported on at the earliest possible time. The HSE will undertake, as a matter of priority, an assessment of the future requirements for long-term care residential capacity.

Disadvantaged Status.

I thank the Minister of State with special responsibility for children for attending to respond to this debate. While I have the utmost respect for him, I am very disappointed that the Minister for Education and Science, Deputy Hanafin, is not in the House to respond to this issue of major concern in Waterford city.

De La Salle Stephen's Street national school is an excellent school that has provided education in inner city Waterford over many years. It is located in a RAPID area. The removal of its disadvantaged status and its concessionary post would be an act of educational vandalism and an attack on the futures of the boys attending the school. Any Minister who would wilfully dramatically worsen the educational provision in such a school must consider his or her position. I sincerely hope the Minister will immediately resolve this situation and allow a highly effective principal and staff continue with their most important work unhindered by a Department which should be doing everything possible to support and encourage their work.

The Minister should visit the school and meet the parents and staff to see at first hand the damage done to the morale of the staff and parents alike. They are proud of their school and its achievements. There is an extended school community which contributes much to the sporting, cultural and social life of Waterford city. To harm seriously the kernel of such an important component of the community life of Waterford would be unforgivable.

Brother Martin, principal of De La Salle Stephen Street, has stated:

We have been told that we have lost our disadvantaged status. This will mean that the school will be crippled. Two teachers will be let go this summer and grants for vital materials and other resources will be withdrawn.

Brother Martin has further stated the school is unlikely to survive the next four to five years without disadvantaged status.

Is the Minister aware that in 46% of the households that provide pupils for this school, the main income earner is unemployed and that 45% of parents were early school leavers? Is the Minister aware that in recent years the De La Salle Order has donated €18,500 of its own funds to provide a part-time teacher in mathematics and English four days a week for those pupils who require such provision?

The school also received funding from the Waterford area partnership which helped provide music lessons for all pupils from first to sixth standard. That such a school could lose the major prop of disadvantaged status beggars belief. Is it the education policy of this Fianna Fáil-Progressive Democrats Government to punish those schools which successfully confront the ongoing education problems facing them?

There are specific questions which must be answered to clarify what exactly is happening with the disadvantaged status of De La Salle Stephen's Street national school. What is the present position regarding the designated disadvantaged status awarded to the school under the disadvantaged areas scheme in 1994? Will the Minister of State confirm that the additional permanent concessionary post allocated to the school and to which the first appointment was made in 1995 will continue to exist? Is the Minister's decision regarding disadvantaged status for the school based on a genuine mistake in the course of completing an application form relating to disadvantaged status? Will the Minister of State give a categorical assurance that at least St. Stephen's De La Salle national school will be no worse off in the coming year than in the current year in meeting the many problems the De La Salle order, the principal, staff and parents have been so successful in addressing to date.

Ba mhaith liom mo bhuíochas a ghabháil leis an Teachta as ucht an cheist seo a phlé. The position of the Department of Education and Science in regard to the school support programme and St. Stephen's De La Salle national school, Waterford, will be outlined in this reply which I make on behalf of the Minister for Education and Science, Deputy Hanafin.

The school support programme under DEIS, delivering equality of opportunity in schools, is the new action plan for educational inclusion. It will bring together and build upon a number of existing interventions in schools with a concentrated level of disadvantage. The new action plan is being introduced on a phased basis, starting during the current school year. It will involve an additional annual investment of €40 million on full implementation. In addition, supports will continue to be provided for schools where the level of disadvantage is more dispersed.

The process of identifying primary and second level schools for participation in the new school support programme has been completed. This process was managed by the Educational Research Centre on behalf of the Department of Education and Science and supported by quality assurance work co-ordinated through the Department's regional offices and the inspectorate. In the primary sector, the identification process was based on a survey of all mainstream primary schools. An excellent response rate of more than 97% was achieved from this survey.

Deputy O'Shea outlined the particular difficulties facing St. Stephen's De La Salle in Waterford. That it was not assessed as qualifying for the programme suggests the standard of teaching and the achievement of students in the school are at a very good level. As a result of the identification process, 840 schools have been invited to participate in the new school support programme. These comprise 640 primary schools — 320 urban-town and 320 rural — and 200 second level schools. Letters of invitation were issued to all 840 schools in late February with a request to complete and return an acceptance form by 10 March 2006.

The school to which the Deputy refers is not among the primary schools selected for participation in this programme. However, this school is among the schools receiving additional resources under pre-existing schemes and programmes for addressing concentrated disadvantage and will retain these supports for 2006-07. The efficacy of these supports will be kept under review.

As well as the provision being made under the new school support programme for schools with a concentrated level of disadvantage, financial support will also continue to be provided for other primary schools where the level of disadvantage is more dispersed. This support will be based on the results of the new identification process, and the arrangements which will apply in this regard will be notified to schools early in the autumn.

A review mechanism has been put in place to address the concerns of schools that did not qualify for inclusion in the school support programme but regard themselves as having a level of disadvantage which is of a scale sufficient to warrant their inclusion in the programme. The mechanism will operate under the direction of an independent person, charged with ensuring that all relevant identification processes and procedures were properly followed in the case of schools applying for a review. The school to which the Deputy refers has requested a review, and a review form issued to the school on 7 March 2006. The closing date for receipt of review applications is Friday, 31 March 2006. The position at St. Stephen's De La Salle national school, Waterford, will be reviewed. I thank Deputy O'Shea for his interest in this question and I hope the reply has clarified the position.

School Closures.

This is the third time in the past two years the Ceann Comhairle has facilitated a debate on the future of Greendale community school and I thank him on behalf of the Kilbarrack community. Two years ago I rose in the House to plead with then Minister for Education and Science, Deputy Noel Dempsey, that Greendale community school should remain open. The people of Foxfield, St. John's parish, and St. Benedict's parish in Kilbarrack were devastated and distraught, as a sixth year pupil told us in late March 2004, when the Greendale community school's trustees, the Jesuit and Holy Faith orders and the VEC, announced the closure of Greendale community school by June 2007. Disgracefully, there was no consultation process whatsoever with the staff, students and parents, or with representatives of the local Kilbarrack parishes, such as Councillor Anne Carter or me. This was the second body-blow to my constituency in a matter of months since it followed the appalling decision by the Oblate Order to sell the historic Belcamp College in Belcamp parish to a developer for €105 million, thereby depriving a huge area of north Coolock and Ayrfield of its long-standing historic secondary school.

Two years ago the then Minister for Education and Science, Deputy Noel Dempsey, said he had no objection to Greendale's closure and when I raised the matter with the Minister, Deputy Hanafin, in February 2005 I received a similarly unhelpful reply. I hope that reply referring to enrolments in the mid-1970s and 1980s will not be recycled here again this evening.

During the past six months especially, Kilbarrack parents and local residents in the Greendale Road district of Foxfield, St. John's parish, are increasingly anxious as to the future of the impressive Greendale community school campus following the Government sanctioned closure next summer. Because massive high rise and high density developments are being approved across the constituency of Dublin North-East and particularly in the north fringe, local residents are deeply fearful that the site will be sold to developers and turned into a massive apartment and commercial complex. I ask the Minister of State to address and remove these fears in this short debate this evening.

My Kilbarrack constituents are rightly adamant that Greendale community school campus must continue as an educational and community resource for the whole of the Kilbarrack, Raheny and mid-Sutton area. Greendale community school was founded in 1975 and had a peak enrolment of 950 students in the early 1980s. An impressive teaching team led by the inspiring principal, Mr. Anton Carroll, including teachers such as the distinguished novelist, Roddy Doyle, the famous playwright, Paul Mercier, the iconic Dublin star, Brian Mullins, and dozens of other wonderful teachers have made an enormous contribution to several generations of Kilbarrack children and their families.

While second level numbers had fallen to 220 students two years ago with the maturing of the Kilbarrack area, the Greendale campus had more than 1,000 adult students and provided an important second chance gateway to third level through Greendale's key association with Trinity College, Dublin. It is this crucial work for adult and second chance education which local residents believe should be the core role of Greendale community school campus following the closure of the second level school next June.

The large campus and its fine gym should also be permitted to continue the school's deeply appreciated role as a readily available and pleasant facility for all the community and residents' groups, sports and youth bodies of Kilbarrack. Over the years those bodies have included Kilbarrack and District Residents Association and our two great local soccer and Gaelic clubs, Kilbarrack United and Naomh Barróg.

I call on the Minister for Education and Science, Deputy Hanafin, and her colleague, the Minister of State, Deputy Brian Lenihan, and the Department to liaise with me and my two Dáil Fianna Fáil colleagues in the constituency, all the local community and sporting bodies, local councillors, the Northside Partnership led by chairperson Padraic White, Dublin City North Central Area Management team led by Mr. Declan Wallace and Ms Elaine Mulvenny and the city and county VECs, Trinity College Dublin, UCD, DCU and all the other educational stakeholders. The objective must be to keep Greendale community school in educational and community use as a continuing focal point for the two parishes of Kilbarrack and the surrounding districts of my constituency.

I thank Deputy Broughan for raising this matter on the Adjournment. I am replying on behalf of the Minister for Education and Science, Deputy Hanafin. The reply deals with the planned closure of Greendale community school in Kilbarrack.

Greendale community school was built in 1975 to accommodate 800 pupils. The school expanded quickly to exceed its enrolment capacity. An extension to increase the school's capacity to 900 pupil places was provided in the early 1980s. In line with demographic changes in the area, the school has experienced a steady decline in enrolments in recent years. Since 1996-97, enrolment has declined by more than 50%, from 449 students to 215 students in the 2003-04 school year. Current enrolments in primary schools in the area indicate that this decline will continue.

The school applied to the Department of Education and Science for major capital funding in 1999. A feasibility study commissioned by the Department estimated that an investment of €2.4 million was required to address the remedial works necessary.

Greendale community school is located in the Howth Deanery of the Dublin archdiocese. The general decline in enrolments in this area has resulted in spare capacity of an estimated 2,300 places at post-primary level. In the circumstances, the Department did not consider that the level of capital investment required was a viable option. However, grant aid was made available to ensure immediate health and safety issues at the school were addressed.

Subsequent to that, officials from the Department of Education and Science held meetings with the trustees to discuss the future of the school because there did not appear to be adequate pupil numbers in the locality to enable it to regenerate. The Department was concerned about the ability of the school to offer a broad and balanced curriculum given the relatively small number of pupils enrolled.

The trustees advised officials in the Department of Education and Science in March 2004 that a decision had been taken to close the school in June 2007 and that there should be no intake of pupils in September 2005. The Department concurred with this decision.

Ownership of the school property is currently vested in the trustees. This will revert to the Department when the school closes. I assure Deputy Broughan that the Department of Education and Science is open to considering any proposals made to it with regard to the future use of the building. Furthermore, in common with all educational facilities, any need for the retention of the building for alternative educational provision will be explored before any decision is taken on its disposal. I thank the Deputy again for raising the matter.

Fire Service.

This year marks the 25th anniversary of the tragic Stardust disaster and it is perhaps fitting that we have a much-needed debate on reform and improvement of the fire service. On the Stardust issue, I reiterate Sinn Féin's absolute support for the campaign of the families of those killed and injured.

In 2004, Dublin Fire Brigade responded to more than 200 incidents per day on average. That single statistic is a testament to the skill, courage and determination of the men and women of the fire brigade but without substantial changes, a disaster is waiting to happen. Our overstretched fire service is unable to respond adequately. There is an urgent need to focus attention on reform and investment in the fire service. Dublin Fire Brigade delivers a range of services and it is unacceptable that the last fire risk assessment was carried out more than 20 years ago.

I ask the Minister of State to indicate in his response if the Government would be prepared to pursue the issue of putting such an assessment in place with the various local authorities. Blanchardstown fire station, whose area includes Connolly hospital as well as a major chemical storage facility, has just one fire appliance. Fingal has some of the largest chemical sites in the State but to date has no equipment for mass decontamination. In addition, the two high-reach turntables for buildings over three storeys are based in Tara Street and would require a lengthy period of time to reach areas like Fingal or my area in Tallaght, where 12 storey apartments are currently being built.

There has been a short-sighted approach taken and criminal disregard for the non-involvement of the fire service in planning matters in Dublin. Since it is not represented on many of the major planning forums in the city and county, due consideration is now given to the way good planning can impact on, for example, access to fires and other emergencies and a faster reaction time, in allowing multiple units to congregate at a serious incident and enabling sustainable traffic diversions to be put in place. Dublin Fire Brigade is not represented on the Northern Fringe Forum and the forums overseeing developments in Adamstown, Poolbeg, Rathmichael, Cherrywood and Cherry Orchard.

In addition to the issue of assessment, I ask the Department of the Environment, Heritage and Local Government to take steps to address the lack of representation of the fire brigade as of right on planning forums such as those I mentioned. Concern has also been expressed about the fact that there are no plans to purchase fire tenders with a reach longer than seven storeys, despite the increasing number of taller buildings. The two turntables for three storey and higher buildings are located in Tara Street, which prolongs the response time to some areas. A review of equipment in terms of what is available and needed and where it is deployed is essential.

Another indictment of the parties that have been in power relates to the fact that the number of fire brigade ambulances has not increased since 1986. The number of emergency calls received annually has increased from 26,000 to more than 80,000 yet there are still only 11 ambulances. The fatal accident on Dublin's south quays in 2004 that left five people dead stretched the fire and ambulance units. Eight ambulances were deployed to Wellington Quay, leaving just three for the rest of the county. Two major accidents occurring at the same time, therefore, would cause a major problem and would inevitably lead to injury and possible loss of life. I urge the Government to carry out urgent reform and invest in the State's fire service, which is currently under-resourced and under-structured.

I am giving this reply on behalf of the Minister for the Environment, Heritage and Local Government, Deputy Roche. I thank Deputy Crowe for raising the matter on the Adjournment.

The Minister is anxious to record the commitment of the Government to the fire service and the way that commitment has been backed up by positive action both in terms of change and financial investment. He also wants to express his appreciation for the very significant contribution the fire service has made, and continues to make each day, in safeguarding our communities. I join the Minister in that tribute.

The environment in which the fire service operates has changed dramatically in recent years. With that in mind, the Minister, Deputy Noel Dempsey, appointed consultants Farrell Grant Sparks to carry out a review of the fire service and make recommendations. The outcome of that review was the report, Review of Fire Safety and Fire Services in Ireland. That is the template for the development of the service.

Many of the recommendations of the Farrell Grant Sparks report have been implemented already. These include, in particular, the enactment of the Licensing of Indoor Events Act 2003, which addressed a number of legislative changes called for in the review. In February 2005, the Minister for the Environment, Heritage and Local Government, Deputy Roche, announced the fire services change programme to implement the key fire services and fire safety recommendations of the report.

The fire services change programme sets out the strategy for the future development of the fire service and includes measures addressing the development of community fire safety programmes; the development of a risk based approach to the determination of fire cover standards; the introduction of a competency-based approach to recruitment, retention and career progression in the fire service; and the enhancement of health, safety and welfare programmes within the fire service.

Work on the fire services change programme is being carried out by a project team of dedicated fire service professionals and is progressing satisfactorily. All of the key stakeholder groups in the fire service are participating positively in the change programme. The Minister is confident this approach can take us forward and achieve real progress in modernising the fire service. The outputs from the change programme will significantly reshape the delivery of fire and rescue services in the years ahead. The Minister has made it clear on many occasions that his priority under the fire services change programme is not to pursue further institutional change at this time but to use the available resources to bring about direct and real improvements in the key fire services and the fire safety area.

The fire service can never have enough resources but we must achieve a balance. There have been massive improvements affecting all areas of the service — more investment in infrastructure and equipment, more staff, better training, improved communications and legislation has been stepped up. We have 3,400 persons employed in the fire service. There are more than 1,000 full-time firefighters in our major cities and more than 2,000 retained staff who respond to protect their own communities when needed. We have 170 senior personnel who lead the service, including professional staff members who examine all building plans for fire safety and carry out inspections of premises.

Our training in the fire service is to international standards. The Fire Services Council assists fire authorities through the provision of training courses and seminars to supplement the training provided by the authorities. The council runs an annual programme of training courses and seminars for senior and junior fire officers and for the instructors who train the firefighters at local level. Since 2001, the Department of the Environment, Heritage and Local Government has provided more than €2.3 million to the Fire Services Council for this purpose.

In tandem with implementing the fire services change programme, we are continuing to maintain a very high level of capital investment in the fire service. Over the past 25 years, almost €240 million has been provided to local fire authorities under the fire services capital programme for the provision of new and refurbished fire stations and the purchase of fire appliances and other equipment. At this stage, more than two thirds of our fire stations, including almost all of the busiest stations, have been replaced, we have a modem fleet of front-line fire appliances and a modem emergency response communications system and our equipment is world class.

The Dáil adjourned at 5.20 p.m. until 2.30 p.m. on Tuesday, 28 March 2006.
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