Dáil Éireann díospóireacht -
Thursday, 30 Mar 2006

Vol. 617 No. 3

Adjournment Debate.

Hospitals Building Programme.

Ms Shortall

I thank the Leas-Cheann Comhairle for allowing me and my colleagues, Deputies Broughan and Costello, to raise on the Adjournment this important matter concerning the future of Temple Street children's hospital.

Temple Street children's hospital has a special place in the hearts of a great number of families throughout Ireland and especially on the north side of Dublin. Many parents are deeply grateful to Temple Street hospital for the role it has played in the health and the lives of their children. The medical, nursing and ancillary staff are outstanding and have coped extremely well in what are deplorable physical conditions.

After many years of promises a development plan was eventually finalised last year. This provided for a co-located child and adult hospital on the Mater hospital campus. To date, €50 million of public money has been spent on this development. Planning permission has been secured and much of the preparatory work has been completed. Funding of €400 million has even been allocated but, incredibly, the Minister has pulled the rug from the development at the last minute and has put the entire future of the hospital in jeopardy. All the carefully worked out plans have now been put on hold pending the major review. If the outcome of the review recommends a location other than the Mater site it will mean the effective closure of Temple Street children's hospital forever. It would be unthinkable for the north side of Dublin to lose the children's hospital.

The Mater campus is the ideal site, given its accessibility for private cars and its many public transport connections. This is essential to parents who need to bring a child to hospital in an emergency but also to the parents of many children with chronic illnesses who must attend hospital frequently and on an ongoing basis. The Mater campus can deliver the children's hospital speedily because of all the work that has already been undertaken. Most importantly, it is the optimum location because of the huge range of expertise that exists both in Temple Street and the Mater, and the fact that 30 of the 31 specialties are already provided from there.

Much party politics is involved in this matter, as well as medical politics. The goalposts have been changed to the disadvantage of Temple Street and decisions seem to be taken behind closed doors. The implications of a decision to recommend a location other than Temple Street, meaning the hospital will be lost, is beginning to dawn on people. Those on the north side of Dublin, the many families who are indebted to Temple Street and we as their public representatives will not tolerate that under any circumstances and we urge the Minister to give approval to the proposal from the Mater and Temple Street children's hospital.

Mr. Costello

Like Deputy Shortall, I am extremely concerned at the threat to the future of Temple Street children's hospital and I am committed to ensuring the hospital be retained and redeveloped on the Mater campus site that had been identified for it 20 years ago. Temple Street hospital has served the people of Dublin, not just on the north side, and the entire country very well for many generations. A brand new children's hospital was to be built on the grounds of the Mater hospital to replace the present old buildings. All the planning, design, tendering and funding arrangements were in place for the project to begin early in 2006. However, the project was put on hold by the Tánaiste and Minister and Health and Children at the 11th hour on 29 December 2005. Temple Street was forbidden to open the tenders and consultants McKinsey and Company were appointed to produce a report on best practice for a world class paediatric facility. At the end of January 2006 McKinsey and Company produced the report and a task force was set up under the aegis of the HSE and the Department of Health and Children to recommend the best location for the new paediatric hospital. A final decision will be made in a few weeks. My concern is that the decision has already been taken by the Minister for Health and Children and the HSE. The appointment of consultants and the task force is merely a smokescreen to give justification to a recommendation to locate the new children's hospital on the southside of Dublin, in or adjacent to the Tánaiste's constituency.

We cannot stand idly by while the northside is deprived of a world class facility in the best and most suitable location. Waiting lists are already five or six times what they are on the southside. Last night the Labour Party held a public meeting in the Teachers' Club to support the Temple Street project. The response was enthusiastic. This is the first step in a campaign to save Temple Street from the internal politics of the HSE and the Minister for Health and Children. Temple Street is the optimum location for the new hospital and its tradition must not be lost.

Mr. Broughan

The most disturbing aspect of this is that the redevelopment of Temple Street was put on hold for so long. It looked like it was making progress until the HSE report recommended that all paediatric surgery converge on one location. Some €46 million has been spent on redevelopment, planning and preparation for construction. My colleagues have referred to the Machiavellian manoeuvring between the Department of Health and Children, the Taoiseach and the Tánaiste, resulting in work on Temple Street grinding to a halt.

A few weeks ago the Minister issued a list of possible fines for incompetence and inefficiency in Irish hospitals. When can we fine the Minister for her performance in the Department? This also applies to the Taoiseach, in whose constituency Temple Street lies.

I heard the Minister on "The Late Late Show" proposing a single specialist utility for the entire country. A city of the magnitude of Dublin and the Leinster region would be best served by two facilities, one on the northside, one on the southside. Beaumont Hospital also proposed a plan for a northside children's hospital. All Dublin northside constituencies wish to retain the children's hospital at Temple Street, with access to top paediatric facilities at that location. We agree that a similar facility should be maintained for the southside.

I have heard that a decision is imminent. At last night's meeting I heard mothers from the northside who were highly agitated at the prospect of having to dash across the M50 through the infamous toll bridge. If a child suffers a seizure or an asthma attack, the key is getting the child to specialist assistance as soon as possible. Introducing problems of distance in the Dublin region is not the way forward. I appeal to the Minister of State, on behalf of the united Labour Party northside Deputies, that the decision regarding Temple Street be honoured.

I refer to the strategy published in 2001. Michael Kelly was involved in this, as was the former Minister for Health and Children, Deputy Martin. We expected an enhanced specialist site for the northside region, with high quality paediatric care.

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

I reply on behalf of my colleague, the Tánaiste and Minister for Health and Children, Deputy Harney.

The Mater and children's hospital development project was planned some years ago with a view to significantly improving the facilities for patients and staff at both hospitals. It was envisaged at that time that paediatric secondary and tertiary services could appropriately be provided at more than one location. However, it is clear from the recent McKinsey report that current best practice indicates that best outcomes for children should be provided by one national tertiary paediatric centre.

The McKinsey report was produced on foot of a request by the Tánaiste that the Health Service Executive undertake a review of tertiary paediatric services to ensure they are provided in the most efficient and effective manner. This request was made in the context of the decision to be taken on the possible relocation of the facilities at Our Lady's Hospital for Sick Children, Crumlin. Following the Tánaiste's request, the HSE engaged a team of management consultants, McKinsey and Company, to provide a report on the strategy organisation of tertiary paediatric services.

The HSE published the McKinsey report on 3 February 2006. The report recommends that best outcomes for children should be provided by one national tertiary paediatric centre, which would also provide all secondary paediatric services for the greater Dublin area. The report recommended that these secondary services would be supported by strategically located accident and emergency facilities. The report also recommended that ideally the new facility should be located on the site of, or adjacent to, a major adult teaching hospital in order to achieve the maximum service benefit for children.

Arising from the report's recommendations, a joint HSE and Department of Health and Children task group was established to progress matters and to advise on the optimal location for the new facility. The group has received proposals from all of the major Dublin teaching hospitals to accommodate the new children's hospital. It has also received proposals from a number of private sector interest groups and the report is expected in early April.

When a decision has been taken on the new tertiary paediatric facility, the HSE will examine the organisational arrangements necessary to progress the development, including arrangements for the provision of paediatric accident and emergency services. The work and recommendations of the task group clearly have implications for all three Dublin children's hospitals, including the Children's University Hospital, Temple Street. The Tánaiste's primary concern is to ensure the solution arrived at is in the best interests of children.

Tax Code.

Ms F. O’Malley

I am grateful for the opportunity to speak on this matter. I am aware the Finance Bill was passed yesterday. Considering what measures can be taken for the next budget is good planning.

The Chancellor of the Exchequer in Britain reduced the rate of VAT on condoms to 5%. Given the incidence and growth of sexually transmitted infections we must consider preventative measures. Condoms prevent sexually transmitted infections as well as acting as contraceptives. They are also an important weapon in the fight against HIV and AIDS. With VAT rates of21%, Ireland has the most expensive condoms in Europe. Given the nature of sexual activity, we must remember that young people may not be able to afford condoms.

We should also reflect on prevention of pregnancies as we all deal with the results of pregnancies, particularly those that are unwanted. It is always better to invest in prevention rather than cure. The tax that would be foregone by zero rating condoms would not be considerable given the impact it could have on the health of the nation. The statistics for sexually transmitted infection have been rising at an alarming rate in recent years. We must take strong action on preventative measures and making condoms much cheaper by reducing VAT on them would be one way of doing this. We have much to learn from the British example on this and as we look forward to the next budget I hope the Minister will consider zero rating condoms given the important place they have in the prevention and control of sexually transmitted diseases and unwanted pregnancies.

Mr. S. Power

I thank the Deputy for raising this important issue. The use of condoms is one of the simplest and most effective ways to guard against both unplanned pregnancy and the transmission of infection. I encourage sexually active people to continue to act responsibly in this regard. I am aware also of the decision announced recently by the British Chancellor of the Exchequer to reduce the rate of VAT on condoms and other contraceptives from 17.5% to 5% and that this has been welcomed by groups working in the field of sexual health.

The Government established the Crisis Pregnancy Agency in 2001 to address the issue of crisis pregnancy. Its remit includes the objective of seeking to reduce the number of crisis pregnancies by the provision of education, advice and contraceptive services. I am aware that the agency wrote to the Minister for Finance in August 2003 proposing a reduction in the VAT rate on condoms from 21% to 13%. The agency noted that consistent and proper use of contraceptives can help prevent crisis pregnancy, and condoms also afford protection against sexually transmitted infections. It also indicated that clinical trials have shown that correct and consistent use of condoms can lead to 95% to 98% contraceptive efficacy rates. Condoms are widely available from a variety of outlets nationwide without prescription. The Deputy will appreciate that the question of reducing the rate of VAT on condoms is one for the Minister for Finance in the first place and the Minister for Health and Children has no direct role in the matter.

School Accommodation.

Mr. McEntee

I am grateful for the opportunity to raise the important matter of the lack of facilities at Ashbourne community school. Ashbourne is one of the fastest growing communities not only in Meath but in Ireland. Within living memory it was a small, rural village. The local community school lies at the heart and well-being of Ashbourne and the surrounding area. I visited Ashbourne community school last week with the Fine Gael Party spokesperson on education and science, Deputy Enright. We wanted to see at first hand the situation at this well established community school in County Meath. We met the principal Ms Áine O'Sullivan and some of her teaching colleagues.

Ashbourne community school has an outstanding reputation across a wide area of Meath and parishes in north Dublin. The school like almost nothing else has bound the people of Ashbourne and the neighbouring parishes together as a community. I got to know the community school, its staff and pupils well since I was elected a Deputy last year. One of my first public events was to address the transition year students. The obvious lack of facilities for young people in Ashbourne generally, and more particularly in the community school, struck me very forcefully. Ashbourne community school has primitive facilities for physical education for its 918 pupils. The existing PE facilities were built for a much smaller school population. They must also be used for other general school subjects. This is unfair to the pupils and their dedicated teachers when trying to encourage physical activity among young people.

The most startling and shocking aspect of our recent visit to Ashbourne community school for both Deputy Enright and me was the lack of a proper, modern canteen for the students. Most students sat along the corridors of the school eating their lunch. ln the era of the Celtic tiger that must be addressed urgently. A solution to this appalling situation can no longer be long fingered by the Minister for Education and Science.

Ashbourne has grown in leaps and bounds since the community school first opened its doors. The student population has significantly outgrown the existing facilities in the school. This has placed significant additional pressures on the excellent teaching staff and pupils of the school. The lack of a proper canteen and proper PE facilities are only two of the obvious limitations of the existing building. The teachers, pupils and the parents of Ashbourne community school deserve better. The school is involved in ongoing fund-raising to provide the basic facilities that should be an integral part of any second-level school. That is not as it should be. The Department of Education and Science must accept its responsibilities to provide basic facilities such as a canteen area. The Minister for Education and Science's response must give a clear indication of the funding being made available for this project and a realistic timeframe for the work to be completed in Ashbourne community school. The current situation for the staff, students and their parents is intolerable and cannot be allowed to continue.

Mr. S. Power

I will take this adjournment on behalf of my colleague the Minister for Education and Science, Deputy Hanafin. I thank the Deputy for raising this matter as it affords me an opportunity to outline to the House the current position of the Department of Education and Science regarding the application for additional accommodation at Ashbourne community school, County Meath.

Meeting the modernisation needs of our 3,200 primary and 750 post primary schools and responding to emerging needs in areas of rapid population growth is a major priority for the Government. Since taking office, this Government has shown a sincere determination to improve and modernise conditions of our school buildings and to ensure that the appropriate facilities are in place to enable the implementation of a broad and balanced curriculum. This Government has invested in the largest school building programme in the history of the State. Between 1998 and the end of 2004, almost €2 billion was invested in school buildings and approximately 7,500 large and small projects were completed in schools including 130 new schools and 510 large scale refurbishments or extensions. Funding for school building and renovation projects increased five-fold since 1997. In 2006, €491 million will be spent on school building projects, compared to just €92 million in 1997. The 2006 allocation is, in its own right, an increase of more than 9% in real terms on the 2005 allocation. As the Deputy will be aware, at the end of last year the Minister for Education and Science outlined the spending plans for primary and post-primary schools for 2006. With €491 million to be spent on school buildings, more than 1,300 projects will be active in schools all over the country. This significant investment will allow the Minister for Education and Science to continue to progress the major programme of school building and modernisation which includes improving equipment needed for new technologies and ICT.

With regard to Ashbourne community school itself, this is a co-educational post-primary school. It has a current enrolment of 917 pupils. The Department recently completed a major extension project at the school at a cost in excess of €2.5 million to cater for the school's long-term accommodation needs which was projected at 1,000 pupil places.

The school authority currently has an application with the Department of Education and Science for a PE hall. This application will be considered in line with the overall criteria for the selection of capital projects as revised last year following consultation with the education partners. These criteria are structured to ensure, as a matter of top priority, that no child is left without a place to attend school, special needs provision is made to allow access for all and problems are resolved as quickly as possible where the day-to-day functionality of a school is threatened. No application has been received for the provision of additional classroom accommodation at Ashbourne community school. The Department has been given no indication that there is a deficit of mainstream classrooms at the school. The accommodation capacity requirements associated with the school's current enrolment of 917 pupils has been addressed through the recent extension project. ln the circumstances the Department of Education and Science would not anticipate any application from the school for extra classrooms. If dining facilities are required by the school, it should make immediate contact with officials in school planning section of the Department of Education and Science for assistance with regard to submitting a revised capital funding application form. If circumstances have changed in relation to the school's overall capital funding requirements, immediate contact should be made with the school planning section of the Department of Education and Science so that the position with regard to the school's application for capital funding can be regularised and the process of re-assessing the application can be commenced.

I thank the Deputy once again for raising this matter.

The Dáil adjourned at 5.10 p.m. until 2.30 p.m. on Tuesday, 4 April 2006.