Dáil Éireann díospóireacht -
Tuesday, 4 Apr 2006

Vol. 617 No. 4

Adjournment Debate.

Hospital Staff.

Ms O’Sullivan

I welcome the opportunity to raise the need for the Minister for Health and Children to appoint a neurologist with support staff to the mid-western regional hospital. This is a matter of urgency because the visiting neurologist no longer accepts new patients. I also welcome the fact that the Minister of State at the Department of Health and Children, Deputy Tim O'Malley, is in the House tonight because he will share my concern about this matter. We both served on the former Mid-Western Health Board when this issue was raised many times over the years.

This issue is vital to thousands of people in the mid-west region who suffer from neurological conditions such as multiple sclerosis, Parkinson's disease and many other conditions. The situation is woefully inadequate and very distressing for patients. General practitioners have been instructed to refer new patients to Dublin, Cork or Galway. A circular is sent around when GPs attempt to refer patients to the limited service that exists in the mid west. It states:

The following is the current position regarding the neurology services at the Mid-Western Regional Hospital, Dooradoyle, Limerick. At present the Mid-Western Regional Hospital has the services of a visiting consultant neurologist for two days per month. This consultant provides an outpatient service for review return patients and an inpatient consultation service only. The waiting list for neurological assessment has grown substantially and waiting times for routine appointments of several years are not uncommon. Due to pressure on the existing service, I regret to inform you that the hospital cannot accept further new patient referrals. The neurologist will continue to see review patients and draw patients from the review waiting list as it stands, but I would advise that new patient referrals should be forwarded to the GPs' neurological services at Cork, Galway and Dublin.

Please note that any patient seen within the last two years will be seen as a return patient. However, if the interval is greater than two years the patient will be regarded as a new referral. It is with great regret that this action continues to be taken but the current volume of work is not sustainable within the existing consultant staffing levels.

That circular has been in place for at least two years but the hospital continues to send it out whenever a GP tries to refer a patient to the services.

The Minister of State and I were members of the then Mid-Western Health Board when it made recommendations on this matter in 1999 and 2003. The Comhairle na nOspidéal report on neurology and neurophysiology of April 2003 recommended that a post be developed in Limerick. The national task force on medical staffing recommended further neurological posts in the country.

I have raised this issue by way of parliamentary question at least three times and we are still waiting for a most essential service in the mid-western region. It is not a question of wanting a specialty in every hospital but it has been recommended by national bodies set up to make such recommendations. It is not acceptable that we have waited so long for this important appointment. The experience of patients, many of whom have chronic illnesses, is distressing because they expect to be treated in their own region but instead must travel for treatment.

On a separate issue, people in the mid west are deeply concerned that they no longer seem to have the same priority as neighbouring regions in regard to the siting of major health specialties and services. For example, breast screening will be run from Cork and Galway and radiotherapy services were provided only after local fund-raising for them, otherwise people would have had to go to other regions for the services. The region is no longer autonomous in respect of health services. The health centre for the mid west is in Galway, and all meetings are held there rather than in Limerick. The area is losing out on many health services. I wish to ensure the area does not lose out further but gets a neurologist and neurological team without delay.

Minister of State at the Department of Health and Children (Mr. T. O’Malley)

I am taking this matter on behalf of my colleague, the Tánaiste and Minister for Health and Children, Deputy Harney. As Deputy O'Sullivan stated, she and I lobbied for years while we were on the former Mid-Western Health Board for the provision of neurology services in the mid west.

As part of the Estimates for the health services in 2006, additional funding of €3 million was allocated to the Health Service Executive specifically for the further development of neurology and neurophysiology services nationally. This funding was provided to allow the Health Service Executive to further progress the implementation of the recommendations made by the former Comhairle na nOspidéal in respect of these services. The Comhairle report of the committee to review neurology and neurophysiology services recommended significant enhancement of services, including the appointment of additional consultants. While reaching the full complement of consultant posts as recommended will take some time, major improvements in patient care can be achieved in the short term through a combination of additional consultant posts and the appointment of a number of clinical nurse specialists and allied health professionals.

A priority objective for the National Hospitals Office is to progress the implementation of the Comhairle report to address immediate service needs and to improve equity of access in the regions. This Department has been advised by the Health Service Executive that the development of three new neurology units will commence during 2006, one in the mid west, one in the north west and one in the south east, with the appointment of multidisciplinary teams comprising consultant neurologists and support staff.

The mid-western regional hospital has the services of a visiting consultant neurologist two days per month. The consultant provides an out-patient service for review or return patients and an inpatient consultation service. Due to pressure on the existing service, new patient referrals are forwarded to the neurological services at Cork, Galway or Dublin. ln view of the pressures, the development of neurology services at the mid-western regional hospital is an urgent priority for the Health Service Executive in 2006.

This Government is committed to the continued development of neurology services nationally. Resources have been made available to commence neurology services in Limerick and I am confident that the Health Service Executive will succeed in its objective to deliver these important services in 2006.

Missing Persons.

Ms C. Murphy

Last Friday the missing persons helpline was out of action for one year. When this service was introduced in 2002 the Minister for Justice, Equality and Law Reform, Deputy McDowell said, "For too long the crime victim was marginalised and treated as a mere spectator to the criminal justice process." He admitted that Ireland lagged behind other countries in terms of such services and said that although we were learning it was strange that we had not reached this stage previously. He described the service as a positive step and said, "This service will provide invaluable advice and psychological support for families of missing persons". This was quoted in the Irish Examiner on 25 October 2002.

In response to parliamentary questions tabled by several Deputies last January, the Minister quoted selectively from a report evaluating the helpline he had commissioned. Stating that there had been only 100 calls to the helpline between 2002 and 2003, he failed to provide the justification for its continued use in the same report and the reasons given for the number of calls. This gave the impression that the helpline was of limited value.

The Minister recently criticised the selective use of statistics yet is himself guilty on this charge in respect of this issue.

The report, An evaluation of the National Missing Persons Helpline, written in 2003 by Kevin Lalor and Kalis Pope, two social scientists in the Dublin Institute of Technology, made 12 recommendations. These were that funding for the helpline be continued, that the operation of the helpline under the auspices of Victim Support be continued and that a concerted effort be made to increase public awareness of the helpline through, for example, making the brochure available at citizens information centres, railway stations, airports, ferry bus terminals, public libraries, student unions and local newspapers at times when articles are being written about missing persons.

Other recommendations in the report were that an advertising budget be identified, that the range of services for families of the missing be extended and that volunteers be recruited. According to the report, the missing persons helpline should be regarded as a first step. The report also refers to the importance of providing a professional counselling service to families of missing persons. It recommends the development of formaI service agreements between the Department of Justice, Equality and Law Reform and Victim Support and quarterly meetings between the helpline operator, the Missing Persons Bureau and the Department.

Another recommendation is the expansion of the remit of the helpline as "a link between family and friends of missing persons". The report argued that while both the Missing Persons Association and the embryonic Missing in Ireland Support Service sprang up spontaneously in response to the lack of services for families and loved ones of missing persons, the greatest benefit would accrue from a single national voluntary body with close links to the missing persons helpline. According to the report, this would facilitate the creation of a critical mass which could evolve into a larger service.

The report recommended exploring the possibility of integrating the missing persons website with the helpline; inducting a small number of specialist volunteers into the helpline; offering the helpline as a free call service, as opposed to a lo-call service; and making regular and prolonged efforts to ensure that members of the Garda Síochána are aware of the helpline. A total of 700 Garda stations were surveyed in November 2003, of which only 65% had a brochure on display. The report's final recommendation was that call records be computerised in anticipation of an increased number of calls to the helpline.

Just over a month prior to its abandonment, the Minister communicated with my constituency colleague, Deputy Durkan, about the helpline. He stated:

The Deputy will be aware of the missing persons helpline, which has been operating since October 2002. This is a dedicated helpline which is operated by Victim Support as a counselling and referral service and serves as a primary point of contact for the families of missing persons. The helpline provides advice and psychological support for families of missing persons as well as structured liaison with the Garda Síochána.

The Minister has catalogued problems with the Victim Support Organisation, which has now closed down. However, he cannot talk about the need for a service like the missing persons helpline and decide on a course of action, at a time when we are awash with money, that terminates the helpline. The Minister informed me that the number of people who remained untraced out of the 1,848 people who were reported missing in 1997 was three. However, this figure starkly contrasts with the 72 people who remained untraced at the end of 2005. These people were part of a group of 4,319 people who were reported missing during this year. A problem clearly exists, which is not the fault of Victim Support but is the result of the decision by the Minister to withdraw a service which needs to be restored, irrespective of whether it is an independent helpline or a service attached to a service organisation.

Mr. T. O’Malley

I thank the Deputy for raising this matter. I am speaking on behalf of the Minister for Justice, Equality and Law Reform who, unfortunately, is unable to attend this debate. I assure the Deputy that the Minister and I share her concern and that of many members of the public with regard to missing persons.

The national missing persons helpline was established in October 2002. Initially, funding of €65,000, which included set-up costs, was provided by the Department of Justice, Equality and Law Reform to establish a dedicated national missing persons helpline to be operated and administered by Victim Support. Further funding of €45,000 was provided to the helpline in 2003. The Deputy should bear in mind that this funding was subject to the conditions that no funding beyond the year 2003 should be implied and that audited accounts should be provided to the Department of Justice, Equality and Law Reform. I understand that, to date, no audited accounts have been received in the Department.

The conditions under which the Department provided funding did not include any requirements concerning the operational activities of the helpline, such as advertising and strategy, as referred to by the Deputy. Any decisions relating to the operation of the helpline were made by Victim Support, an independent, non-governmental organisation with charitable status, which managed the operation of the helpline, in conjunction with the helpline itself.

In March 2005, following an independent review, the Minister decided that continued funding of Victim Support could no longer be justified due to serious concerns in respect of governance, accountability for public funds and poor service levels, following a lengthy period of instability within the organisation. I understand that Victim Support Limited closed down its headquarters during 2005 and that a number of staff were made redundant, including the person employed to operate the missing persons helpline. The Department had no role in the decision of Victim Support Limited to make a number of its staff redundant, other than to insist that statutory requirements, such as notice, holiday pay etc., were met and the interests of the staff protected.

In March 2005, the Minister established a new commission for the support of victims of crime to devise an appropriate support framework for victims of crime into the future and to disburse funding for victim support measures. The commission is entirely independent in its decision making and examines each application on its merits. Its members are Mr. Jim McHugh, retired assistant commissioner in the Garda Síochána, who is the chairman; Ms Nora Owen, former Minister for Justice, Equality and Law Reform; Mr. Sean Lowry, former head of the Probation and Welfare Service; Mr. Michael Whelan, Gemini Consulting; and Ms Marian Finucane, who is a broadcaster.

The commission received an application from the Missing ln Ireland Support Service for €71,600 to establish, staff and operate a helpline for missing persons. After careful consideration of the application, the commission decided to offer funding of €25,000. However, this offer was rejected by the Missing in Ireland Support Service on the basis that it would accept only the full amount sought. In this context, it should be borne in mind that the commission is charged with funding support services for victims of crime and that while some persons who are missing are crime victims, most missing persons are not. Other than the request to the independent commission for funding, no request for funding has been made by the helpline to the Department. It remains open to the Missing In Ireland Support Service to make an application to the Department for assistance if it so wishes. Any such application will be carefully considered on its merits.

The missing persons bureau in Garda headquarters is responsible for maintaining data relating to missing persons. All cases of a person reported missing in suspicious circumstances remain open and under ongoing review and investigation until the person is located or, in the case of a missing person who is presumed drowned, a verdict to that effect is made by a coroner.

At present, local Garda management take direct responsibility for missing person cases and special investigation teams are appointed as necessary. All missing persons are recorded on the PULSE system. When a person is reported missing, the local Garda superintendent takes direct responsibility for the investigation and appoints an investigation team to include any specialised unit deemed necessary — for example, the national bureau of criminal investigation or the technical bureau. The systems put in place by the Garda Síochána to manage and deal with reports of missing persons are in line with the best international police practice and Garda management is satisfied and has assured the Minister that the systems in place are adequate to deal with any reported case of a missing person.

The Garda Síochána interacts fully and as appropriate with all media outlets — print, radio and TV — in highlighting cases involving missing persons. The services of other external agencies such as Interpol and Europol are also available to assist in the investigation. In addition, every Garda district has a specially trained search team that is familiar with the locality. The investigation of missing persons is a dedicated subject on the curriculum at the Garda College, Templemore, and is covered during in-service training.

Rail Services.

Mr. Ring

I wish to raise the issue of rail freight services in Ireland. The Irish freight market was opened by the Government on 1 January 2006 to allow the private sector to become involved in it. However, there is little evidence that the market has been opened by Government measures. Iarnród Éireann held a contract from Diageo to transport Guinness to the west. Three trains brought Guinness to the west each week. That contract has been lost and 19 or 20 articulated trucks will bring Guinness into the west.

In recent weeks we have listened to the Government preaching about road safety and the volume of traffic on our roads, yet our rail service is being underused. Iarnród Éireann has been given the job of running the country's rail freight services but has failed. If the Government does not step in soon, there will be no rail freight business left because Iarnród Éireann will have lost the contracts. Freight services and staff will be lost and more vehicles will be on the roads. If Guinness can be carried by road more cheaply, it is daft of the Government to allow this to happen when Iarnród Éireann should be able to compete. For many years it has had the contract to deliver Guinness all over Connacht but 25 jobs will be lost and more transporters will be on our roads.

What efforts has the Government made to get people in the private sector involved now that the rail freight market has been opened? Has anyone taken up the offer? What has the Government done to take more trucks off of the roads to improve road safety?

We should be using the rail freight service. I do not want to see more rail lines closed down, such as the western rail corridor, and people seeking in 20 years to have these services re-opened. The infrastructure is in place and it is time for the Government to take the necessary action, including the introduction of legislation to this House. If Iarnród Éireann is not prepared to deal with the rail freight service, it should be handed to the private sector, which would be glad to run it at a profit. I cannot understand why the company could not compete for the contract, having had it for so many years. I believe Iarnród Éireann does not want anything more to do with freight. It wants only the passenger services.

The Government cannot preach to the people, bring in penalty points, tell us that there are too many cars on the roads or ask why people do not use public services when a company is not able to look for new businesss and has lost its existing business. I hope the Government will step in and do something about this matter.

Minister of State at the Department of Transport (Mr. Gallagher)

I thank Deputy Ring for raising this issue and giving me an opportunity to outline what the Department is doing. The strategic rail review commissioned by my Department contained a comprehensive examination of the rail freight business and its realistic potential to support economic development and contribute to sustainable development.

Iarnród Éireann, in responding to the challenges contained in the review, developed a business plan with regard to freight. The company's goal is to return the rail freight business to profitability. To help achieve this turnaround, Iarnród Éireann recently withdrew from loss making groupage, palletised and single container rail transport. It continues to pursue a policy of growing its rail freight business where opportunities present.

Since 1999, larnród Éireann has invested more than €1.5 billion in rebuilding the railways with Government and EU support for the investment programme. This has delivered improvements in new trains, upgraded infrastructure and customer facilities. While such investment has primarily focused on improving passenger services, the investment in improving rail infrastructure also has a direct beneficial impact on freight activities.

Against this background, two recent developments — the closure of the sugar beet factory in Mallow and the loss of the Diageo contract — represent a setback to recent Iarnród Éireann's efforts to develop its freight business. Following the closure of the sugar factory last year, Iarnród Éireann increased its annual transport of sugar beet from approximately 150,000 tonnes to 313,000 tonnes in 2005. The demise of the sugar beet transport marks the regrettable end of a long and successful association.

Regarding the Diageo contract, larnród Éireann has informed me that Diageo carried out a tendering process last year for all of its logistics business and has decided that it will not be renewing the Iarnród Éireann contract for this business as it received an offer that is significantly lower than current rail freight rates by alternative road-based suppliers. Improvements in road infrastructure as well as a decline in the sale of draught beer have made the distribution of kegs by rail uncompetitive with road haulage.

Despite these setbacks, larnród Éireann will continue to pursue viable trainload traffic. The company has made progress in growing the rail freight business in areas where it holds a competitive advantage over road haulage, including mineral ore and pulpwood. For example, Iarnród Éireann has increased the trainload pulpwood business by modifying surplus wagons and providing additional services for Coillte between the west and the south east. It has recently altered rail schedules and is currently providing three additional trains per week for Tara Mines, with a potential to carry an extra 85,000 tonnes of lead and zinc between Navan and Dublin Port per annum. It has modified surplus platform wagons to provide a trainload service for containers between Ballina and Waterford Port. This new service, initially two trains per week, is due to commence on 21 April.

The position regarding competition in the rail freight market is that the Minister for Transporter, Deputy Cullen, introduced the European Communities (Access to Railway Infrastructure) (Amendment) Regulations 2005 (S.I. No. 780 of 2005), implementing EU Directive 2004/51 on the development of the Community's railways. These regulations allow for the opening of the rail freight market to competition from 1 January 2006 in the case of international freight, and from 1 January 2007 in the case of domestic freight operations. Under the regulations, the market is open to foreign operators. My Department has received a communication from a UK operator stating its intention to establish itself as a freight operator. The Department has been in touch with the operator but a formal application has not been received to date.

larnród Éireann has undertaken extensive engagement with industry and transporters around the country to try to identify long-term sustainable business opportunities. It has had genuine difficulty in identifying business opportunities that offer reasonable volumes of business on a regular basis. It is not feasible to run trains with one or two containers and larnród Éireann has not identified sufficient business to group a number of separate activities together to form a viable trainload. Most Irish industry is focused on "just in time" transport and as our road network continues to expand and improve across the country, the role of rail freight becomes more problematic because all rail journeys involve road movements at each end of the logistics chain. Furthermore, distances in Ireland are short. The experience across Europe is no different. Rail freight activities are most economic where distances are long, where there are large volumes to be transported and where the freight to be carried is not time sensitive.

The Minister is open to any views on how we can expand rail freight but the business environment is such that he has not seen any real opportunities identified. The market for rail freight will be fully liberalised in a matter of months and if there were opportunities, expressions of interest would be welcomed. The possibility of providing capital funding for sidings is often mentioned as a stimulus to rail freight but no firm proposals have been received.

Decentralisation Programme.

Mr. D. Moynihan

Ba mhaith liom mo bhuíochas a gabháil leat, a Leas-Cheann Comhairle, de bharr cead a thabhairt dom cúpla focal a rá anseo mar gheall ar decentralisation. The Government decided on a major decentralisation programme in the first week of December 2003. My concern is that, since that time, little has happened in various locations in practical terms, particularly in Macroom where I live and which I represent. However, there have been a number of reports in the meantime from decentralisation and communication groups, from which it appears that very little has happened in practical terms in Macroom.

Macroom did not come to the fore in the previous report and it was a matter of great disappointment to me and the people of the town that it was down the list regarding progress in decentralisation. Macroom was not included in the first 15 projects to be relocated and it is of the utmost importance that it is included in the next report. I thank the Minister for Agriculture and Food, Deputy Coughlan, for keeping me updated regarding the accommodation brief in respect of the new laboratories which has been finalised within her Department.

The Office of Public Works was given prime responsibility for delivering the property aspects of the decentralisation programme. This matter is urgent because the site on which the present laboratories stand on Model Farm Road has been earmarked for housing. Therefore, the laboratories which have been earmarked for Macroom must be relocated urgently. The relocation of the laboratories from Model Farm Road provides the Department with an ideal opportunity to consolidate its laboratory operations in the southern region. This will involve the three laboratories in Cork, as well as two in Limerick, and I am pleased that Macroom will be recognised as the regional veterinary headquarters for Munster.

I ask the Minister to outline the progress made by the Office of Public Works in acquiring a suitable site or property. If such a suitable site or property has been earmarked, when can we expect accommodation to be made available for those departmental staff who volunteer to decentralise to the Macroom area? When will work commence on the programme to provide those facilities?

Minister for Agriculture and Food (Mary Coughlan)

Gabhaim mo bhuíochas dhuit, a Leas-Cheann Comhairle, as deis a thabhairt dom a chur in iúl don Dáil agus an Teachta Donal Moynihan cad atá ag dul ar aghaidh ag an mbomaite i Maigh Chromtha.

The construction of a laboratory complex in Macroom is part of the Government's decentralisation programme. It involves the rationalisation of the laboratories currently located in the Munster region into one new laboratory complex in Macroom. These laboratories consist of a dairy science laboratory, a regional veterinary laboratory and a brucellosis laboratory on Model Farm Road, Cork, a dairy science laboratory on Killeely Road, Limerick and a regional veterinary laboratory in Knockalisheen, Limerick.

Although these laboratory facilities were adequate for their time, the technology, regulatory and testing requirements etc. have changed significantly since they were built. The Department considers that building a new state-of-the-art facility on a greenfield site will allow it to amalgamate the two existing laboratories in Limerick and the three in Cork into a single efficient and modern complex which will allow the Department to continue to meet its commitments to food safety into the future, allow the laboratories to achieve accreditation status which is essential if they are to continue to carry out their work, facilitate compliance with EU regulation, allow the achievement of efficiencies and align the Department's facilities to the changing structure of the agriculture and food sector.

Many factors favour the new proposals, such as the fact that little investment has been made in the Munster laboratories in the past decade. Moreover, the laboratories are not accredited and updating them to achieve accreditation status would be expensive. In addition, the Department's laboratory operations are subject to many EU regulations and accreditation requirements and it is necessary for them to have the appropriate accreditation status to be allowed to continue their work.

A Government decision taken on 28 December 2003 agreed to allocate the Model Farm Road site to the affordable housing initiative. The Government's decentralisation programme committed the Department of Agriculture and Food to relocate 70 staff members to Macroom.

The decentralisation implementation group, DIG, report of June 2005 provided for an indicative construction start of the end of 2007 for Macroom, with an indicative completion time of early 2009. The Department of Agriculture and Food has forwarded an accommodation brief for the Macroom laboratory to the Office of Public Works. The brief outlines the requirements for office staff, laboratories, visitor areas and general service areas for the new laboratory complex. Given the complexities of the facility, that brief is preliminary and will be adjusted as specific requirements are finalised. Communication between my Department and the Office of Public Works regarding the brief is ongoing. This preliminary brief will, however, allow the Office of Public Works to source a site for the facility. The selection of the site or property and the completion of the development will be a matter for the Office of Public Works, which will submit an application for planning permission in duecourse.

As with decentralisation generally, the relocation of staff from their current location to the new complex in Macroom is voluntary. Human resource and industrial relations issues relating to decentralisation are dealt with centrally by the Department of Finance. It has recently begun discussions with the staff associations of professional and technical civil servants. My Department has indicated to the Department of Finance that as well as dealing with the issue of specialised staff who wish to remain in Dublin after decentralisation, any staff who do not want to move from the existing laboratories in Cork and Limerick must be considered.

I will keep the Deputy updated and will apprise him of progress in the matter.

The Dáil adjourned at 9.05 p.m. until 10.30 a.m. on Wednesday, 5 April 2006.