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Dáil Éireann díospóireacht -
Tuesday, 10 Oct 2006

Vol. 625 No. 1

Adjournment Debate.

Health Services.

I thank the Leas-Cheann Comhairle for choosing this matter. I raise it to ask the Minister for Health and Children if she is aware that the orthodontic services in the Cork-Kerry region have been severely curtailed by the departure of two dentists from the service; if she is concerned that the delay in replacing those dentists has led to the closure of the five year waiting list in this region for children to see an orthodontist; and if she will make a statement on the matter.

That the Minister for Health and Children has not come into the House to hear the debate, despite receiving almost 24 hours notice, is not just disappointing but a reflection of how seriously she takes this issue. I appreciate that the Minister of State at the Department, Deputy Tim O'Malley, is here to respond but it is not his responsibility. The Minister, Deputy Harney, should hear this debate.

Children who are waiting over four years for specialist dental treatment in the Cork-Kerry area will face further backlogs because of the delay in replacing two dentists who have left the service. Those dentists did not leave the service of their own volition. They were removed from their posts for further training and now train at the dental school. Those dentists were in their positions for ten years. There was no reason they could not have received on-the-job training but the dental service, and particularly the orthodontic service, is organised in such a way that it does not benefit the clients of the public dental service.

The current situation in Cork and Kerry is intolerable. The Minister should take note of what I am about to tell him but he is probably already aware of it, although he will not admit it. A total of 4,201 people are awaiting assessment. I am talking about children aged 12 to 16 years. A total of 3,524 are in Cork and 677 are in Kerry. A total of 3,558 patients are awaiting treatment. A total of 7,759 children are waiting to have their teeth examined. That is appalling. Of those, 72 patients in Cork and 171 patients in Kerry have been waiting more than four years for treatment. Those children are approaching their 16th birthday and will very soon be out of the scope of that service.

On the treatment waiting list, in the Cork region 767 people are waiting one to two years; 820 are waiting two to three years; 412 are waiting three to four years; and 72 are waiting four years and more. That is a total for Cork of 2,642. In Kerry, 173 people have been waiting one year, 262 have been waiting one to two years, 129 have been waiting two to three years, 181 have been waiting three to four years and 171 have been waiting four years and more. That is a total of 916. In total, 3,558 people are on a waiting list of between one and four years.

Patients are divided into three categories — A, B and C. Urgent cases — patients with cleft palate — are in category A. Patients with a large overbite are in category B and patients with severe overcrowding are in category C. Incidentally, overcrowding can often be as detrimental to one's dental health as an overbite, sometimes it can be worse. The patients in category A begin treatment immediately but the less urgent categories — B and C — are placed on the waiting list to which I have just referred. The children with what are considered less serious complaints such as overcrowding must wait a lengthy period.

Failure to deal with this waiting list means that increasing numbers of patients are forced to seek private treatment at enormous cost. Parents are taking out loans to avoid their children suffering from low self-esteem because of dental problems. Also, according to orthodontists in the Cork-Kerry region, the Department has been urging them to narrow the criteria so that it is more difficult for people to be eligible for treatment. The problem in Cork has been further compounded by the block on the Cork Dental School training programme, which is forbidden from training dentists to orthodontic level until a professor of orthodontics is appointed. The delay in that regard is scandalous. We were talking about that ten years ago but the problem persists.

In recent years progress has been made in reducing the waiting time. That was only as a result of the total dedication of a number of dentists but the waiting list has been closed and any improvements made have been set aside and will be set aside even further as a result of the delay in producing two more dentists to fit into the dental scheme. I understand no children are being assessed currently. The Minister must outline the way the Department will deal with this crisis.

I would point out to the Minister of State that a similar situation as this one occurred in Dublin five years ago. At that time the waiting list had been reduced from approximately 18,000 to 6,000 but because of the lack of urgency in replacing the two dentists involved at that time, 1,000 children whose braces were left on for too long a period without further examination ended up with severely damaged teeth as a result of the Department's inaction. I hope the Minister of State will have some good news for the children of Cork and Kerry tonight.

On behalf of the Minister for Health and Children, Deputy Harney, I am happy to have the opportunity to address the issue raised by Deputy Lynch.

The provision of orthodontic treatment to eligible persons in the southern area of the Health Service Executive is the statutory responsibility of the Health Service Executive in accordance with the Health Act 2004. The Minister and I are aware of the waiting list for orthodontic treatment in HSE south. We are pleased to note that in the period June 2002 to June 2006, there has been a decrease of 2,326 in the assessment waiting list in this area. At the end of March 2006 there were almost 25,000 patients receiving orthodontic treatment in the public orthodontic service nationally. Over twice as many patients are getting orthodontic treatment as there are waiting to be treated. Nearly 7,000 extra patients are getting treatment now compared to four years ago. This tangible improvement will be further enhanced as the HSE develops the orthodontic services.

Developing the quality, standards, treatment capacity and outcomes of our orthodontic services in a sustainable way are objectives shared by the Department and the HSE. To ensure the best use of resources and develop treatment capacity in a sustainable manner, guidelines were introduced by the Department to enable the HSE to prioritise resources for those with the severest orthodontic condition.

The Joint Oireachtas Committee on Health and Children carried out a review of orthodontic services in Ireland which culminated in the publication of its report, The Orthodontic Service in Ireland, in 2002. The joint Oireachtas committee has also published a follow up to its 2002 report in June 2005.

The HSE has established a national orthodontic review group to draw together an agreed national approach under four principal headings: guidelines, training, service provision and manpower planning. The group consists of representatives from the Department, the dental schools in Cork and Dublin and consultant orthodontists and management from the HSE. The Minister and I are advised that this review group will conclude its report in the coming months and that will guide the implementation of service improvements in the coming year in line with the recommendations contained in the joint Oireachtas committee reports.

Training more orthodontists will make a significant impact on the increasing demand for orthodontic treatment. Until recently there was only one centre in this country offering a postgraduate course in orthodontics, the Dublin Dental School. The HSE is now funding the post of Professor of Orthodontics at the University Dental School and Hospital in Cork to the tune of €1 million. This has enabled the establishment of a postgraduate training programme in orthodontics in Cork, which has commenced with the first intake of four postgraduate students this month. This training programme will provide services for an agreed cohort of patients on the north Cork waiting list, which will help to reduce the waiting times for orthodontic assessment and treatment in the area.

The HSE will recruit a specialist orthodontist to replace the dentists who have been successful in securing specialist training places. The HSE south is also developing proposals on a waiting list initiative to reduce waiting times and ensure that treatment programmes commenced by the two dentists leaving the service will be completed in a timely fashion. Orthodontics is unique in that the treatment period for a child is between 18 and 24 months and each year thousands of children, with varying degrees of need, are placed on assessment waiting lists. Our aim is to continue to make progress and to develop a high quality, reliable, sustainable service in HSE south and all other areas of the executive for children and their parents.

Cancer Screening Programme.

I am grateful for the opportunity to raise the delay of BreastCheck for the women of Mayo, a matter I raised on my first occasion speaking in Dáil Éireann. It is scandalous and unforgivable that hundreds of women have died and at least 300 more will die before BreastCheck is available to women in Mayo. The former Minister, Deputy Martin, stated that BreastCheck would be available throughout the country by 2001 or 2002 at the latest. Many deadlines have passed since then and last month the Minister for Health and Children, Deputy Harney, stated that BreastCheck would be available at the start of 2007. This would be eight years after it was in place for almost half the population of Ireland. Today, we read in the newspaper that BreastCheck will not be available until the end of 2007.

These deadlines are more examples of broken promises by the Government, which does not give a damn about the women of Mayo. I have seen these people as patients, and women could have availed of three screenings if the service had been available. I know women who have died. There are hundreds of them in the south and west and at least 300 more will die before this negligent Government sets up BreastCheck. In 2003 I brought the board and executive of BreastCheck before the Joint Committee on Health and Children, of which I was a member. Dr. Sheelagh Ryan, chairperson of the BreastCheck board and the former Western Health Board, stated that no one should question the Government's commitment and that the service would be in place by 2005. So much for the commitments of the Government, which are worth nothing.

There is no reason that this service should not have been extended to the entire country in 2000. I have spearheaded the campaign for the extension of BreastCheck but I have not made much progress. If we could find a drug that would save the lives of hundreds of women, would we not want to make it available? That drug is the extension of BreastCheck and it has not been provided. This is scandalous and negligent and I hope someone sues every Minister in this Government for everything they have. People need and deserve this service.

The Government would pay lip service to the abolition of apartheid in South Africa but what about apartheid in Ireland, apartheid in Mayo and apartheid for the women in the south and west of Ireland? Some 700 women die of breast cancer each year, yet 20 years of evidence proves that screenings can reduce the mortality rate of breast cancer cases by 20% to 30%. This was achieved in Northern Ireland by 1998, where the mortality rate for the disease was reduced by 20%, and in Scotland, where it was reduced by 30%.

The Government stated that it was better to provide the service properly than not to do it at all, but I disagree with that strongly. BreastCheck was made available to only half the population of Ireland and predictably it was the half on the east coast. There is no excuse for this because research from the USA and Europe demonstrated that mortality rates can be reduced. The service was not extended because of money, filthy lucre.

We will not tolerate any more delays. When we held a march, an extension to BreastCheck was announced within 48 hours. Of course, it never happened, but I can guarantee another march on the Dáil. I want to hear when the people of Mayo will be able to avail of this service and how many more must die before it is provided.

I welcome the opportunity this evening to address the issues raised by the Deputy and to set out the current position on the roll-out of the national breast screening programme. The Minister for Health and Children, Deputy Harney, met representatives of BreastCheck and they are fully aware of her wish to have a quality assured programme provided for the remaining regions in the country as quickly as possible. Essential elements of the roll-out must be in place, including adequate staffing, effective training and quality assurance programmes. At a meeting with Department officials this morning, BreastCheck reported that significant progress has been made in preparation for the roll-out. Additional revenue funding of €2.3 million has been made available to BreastCheck to meet additional costs of roll-out and an additional 69 posts have been approved. BreastCheck has appointed clinical directors for the southern and western regions and both will take up their positions in November of this year. The clinical directors are currently undergoing additional training. The recruitment of consultants and other staff, including radiographers, is under way.

BreastCheck requires considerable capital investment in the construction of two new clinical units and in the provision of five additional mobile units and state-of-the-art digital equipment. An additional €21 million in capital funding has been made available to BreastCheck for this purpose. BreastCheck reported this morning that it has appointed construction contractors for the static units at the South Infirmary Victoria University Hospital, Cork, and University College Hospital Galway. The BreastCheck clinical unit in the western area at University College Hospital Galway will have two associated mobile units. Almost 58,000 women are in the target population for invitation to screening.

A breast screening programme is a complex, multidisciplinary undertaking that requires considerable expertise and management involving population registers, call and recall systems, mammography, pathology and appropriate treatment and follow-up. A programme must be quality assured and acceptable to women who attend for screening. The first phase of the programme is of a high quality, and a similar quality in the south and the west is essential. BreastCheck is confident that the target of next year for the commencement of roll-out to the southern and western regions will be met. However, it has advised the Department that it is not possible to issue timelines for individual counties at this stage.

Of course it is not. We will have to wait another nine or ten years.

Schools Building Projects.

Gabhaim buíochas as an seans a bheith agam an t-ábhar seo a phlé. Tá mé ag caint faoin ghéarghá le freagra dearfach ar iarratas an chomhairle bainistíochta Gaelscoil Dara, An Rinn Mhór, cathair na Gaillimhe. An rud atá fíor-phráinneach anois ná buan-chóiríocht a chur ar fáil don scoil. Tá an scoil ann le 21 bliain agus ag an phointe seo, fiú go bhfuil a lán litreacha curtha go dtí an Roinn, níl sé soiléir an bhfuil suíomh aimsithe aici, cá bhfuil an suíomh aimsithe, cé mhéid acra atá ag baint leis agus cén toradh a bhí ar na cainteanna idir an Roinn agus na Bráithre Carthanachta.

Tá mé ag cur na gceisteanna seo toisc go bhfuil na tuismitheoirí, múinteoirí agus na daltaí ag cur suas le caighdeán scolaíochta nach bhfuil ceart le níos mó ná 20 bliain. Tá freagra dearfach ag teastáil ón bhord bainistíochta, ón phríomhoide, ó na múinteoirí agus ó na tuismitheoirí ar na nithe a luaigh mé. Cathain a bheidh an suíomh aimsithe? Cé mhéad acra atá ag baint leis? An bhfuil sé aimsithe ag an Roinn go bhfuil le suíomh trí acra a oireann do 16 múinteoir nó an bhfuil suíomh níos lú ná sin i gceist?

I raise this matter because it concerns Gaelscoil Dara. Its pupils have put up with temporary accommodation for 22 years. The parents, teachers, children and board of management should not have to wait any longer for an answer to definite questions. What potential sites in Galway were examined by the Department of Education and Science? What conclusions did it draw, what decisions did it arrive at, what decisions remain to be taken and what is the size of the site under discussion? Is it three acres and is it suitable for 16 teachers? Is it less than three acres? Where is it located? Can the board of management have access to the maps and details of the site under discussion? When will the final decision be taken in respect of this necessary school?

What will happen if, for example, more than one site has been examined? Mention has been made of the site held by the Brothers of Charity. If another site is being examined, such as the site owned by the Galway Institute of Technology, what is the position in respect of both sites, their scale and the timescale for delivery? If there are any further technical difficulties, as has been mentioned in correspondence about this school, what are they? When can we look forward to their resolution? This matter is of the utmost urgency. It has dragged on for almost all of my years as a Deputy representing Galway West. It concerns the provision of a proper and permanent home for this gaelscoil, which makes such an outstanding contribution to language, culture and basic education in Galway city.

Ar dtús, is mian liom buíochas a ghabháil leis an Teachta as an ábhar seo a ardú mar go dtugann sé deis dom míniú a thabhairt ar straitéis an Rialtais maidir le hinfheistiú caipitiúil i dtionscadail oideachais agus, ina theannta sin, achoimre a dhéanamh ar an staid reatha i ndáil le cóiríocht bhuan a sholáthar do Ghaelscoil Dara, Co. na Gaillimhe.

Mar gheall ar an easpa maoinithe atá déanta sa réimse seo le tamall fada de bhlianta, agus freisin ar an ngá le freastal ar riachtanais nua i limistéir ina bhfuil ráta ard fáis i dtaca leis an daonra de, níl sé furasta athchóiriú a dhéanamh ar na saoráidí sna 3,300 bunscoil agus 750 scoil iar-bhunoideachais atá ann. Dá ainneoin sin, tá sé léirithe ag an Rialtas ó chuaigh sé i mbun oifige go bhfuil rún daingean acu feabhas a chur ar bhail ár gcuid foirgneamh scoile agus a chinntiú go bhfuil na saoráidí cuí ann chun gur féidir curaclam leathan cothrom a chur i ngníomh.

Mar fhianaise ar an rún daingean sin, beidh tuairim is 1,300 tionscadal foirgníochta agus athchóirithe ar siúl inár gcuid bunscoileanna agus scoileanna iar-bhunoideachais le linn na bliana 2006. I mbliana, tá thart ar €500 milliún á chaitheamh ar na tionscadail bhunoideachais agus iar-bhunoideachais ar fud na tíre i gcomparáid le tuairim is €90 milliún sa bhliain 1997.

Tá mé cinnte go n-aontóidh an Teachta gurb ionann an leibhéal seo infheistíochta, nach raibh a leithéid ann roimhe seo, agus comhartha dearfach ar an ardtosaíocht a thugann an Rialtas don earnáil seo. Chun laghdú a dhéanamh ar mhaorlathas agus chun gur féidir tionscadail a chur i gcrích ar shlí níos tapúla, tá an fhreagracht as tionscadail bheaga tugtha do scoileanna. Tá dearthaí caighdeánacha forbartha freisin le haghaidh scoileanna ina bhfuil ocht gcinn, agus 16, de sheomraí ranga ionas gurb éasca tionscadail a chur i gcrích ar shlí níos tapúla agus chun coigilteas a dhéanamh i dtaca le táillí dearthóireachta.

Maidir leis an ábhar sonrach lena mbaineann an cheist, is bunscoil chomhoideachais í Gaelscoil Dara agus 269 ndalta ar an rolla inti faoi láthair. Is é atá i líon na foirne san fhadtéarma, faoi mar atá cinnte ag an Roinn Oideachais agus Eolaíochta ná Príomhoide móide 16 chúntóir príomhshraithe móide foireann chuí fhoghabhálach.

Tá an Roinn ar bhonn gníomhach ag iarraidh láithreán a aimsiú don scoil. Rinneadh pléití leis an Roinn maidir leis na féidearthachtaí a bhaineann le láithreán atá ar an gcampas láithreach a cheannach — ar láithreán é a úsáideann na Bráithre Carthanachta faoi lathair.

Chun dul chun cinn a dhéanamh maidir le láithreán a áirithiú do Ghaelscoil Dara, rinne an Roinn Oideachais agus Eolaíochta iniúchadh teicniúil ar láithreáin ionchasacha i mí Iúil i mbliana. Tá pléití leanúnacha ar siúl ag an Roinn leis na Bráithre Carthanachta i ndáil leis an láithreán atá acusan ach níl an measúnú ar an láithreán sin críochnaithe fós. Ag féachaint don éileamh ar sholáthar oideachais sa limistéar seo, samhláitear go gcríochnófar an próiseas measúnaithe a luaithe is féidir.

Is féidir leis an Teachta a bheith cinnte go bhfuiltear ag déileáil le riachtanais bhuanchóiríochta Ghaelscoil Dara chomh tapaidh agus is féidir agus go ndéanfar soláthar foirgnimh bhuain don scoil a chur ar aghaidh i gcomhthéacs an Chláir um Athchóiriú agus Foirgníochta Scoileanna 2006-2010, tar éis an láithreán a bheith faighte. Ba mhaith liom buíochas a ghabháil leis an Teachta arís as an ábhar seo a ardú.

I thank the Leas-Chean Comhairle for allowing me to raise this matter. I previously raised this issue on the Adjournment on 28 April 2005 and have raised it with the Minister during Question Time on a number of occasions since then, but to no avail. Despite welcoming the Minister of State, I am disappointed the Minister for Education and Science is not here this evening. It reflects the interest in this subject. At least a Minister of State from the Department should be here.

The present enrolment at Scoil Eoin, Balloonagh, is 614 students. Of those students, 54% are accommodated in prefabricated buildings which are 20 years old. That amounts to 331 students. A further 24% of the students, more than 147 children, are accommodated in a building built 46 years ago which has never been modernised. A further 22% of the students, or 135 children, are accommodated in a building between 86 and 116 years old. That building has never been modernised either.

In 2000, it was agreed the long-term accommodation needs for Scoil Eoin would be to provide accommodation for a staffing of principal plus 22 mainstream teachers and ancillary staff. In 2001, the Department commissioned a feasibility study, which was carried out by Healy & Partners, Limerick. Five options for a rebuild were proposed. A meeting was held in Tullamore on 26 September 2002 between Department officials and the board of management to discuss the options. Unfortunately, despite the urgency of the situation, no further development of the project has taken place.

One of the main reasons for a rebuild is to accommodate all students in one permanent modern building. The Tuairisc Scoile report of 1999 concluded:

The school has been carefully maintained and looked after and is indeed a credit to all who have had responsibility for its upkeep. However, there is need here for a major improvement in accommodation. It is anticipated that the adjacent post-primary school will move to new premises within a few years. This would facilitate a re-development of this important educational centre to provide modern classroom facilities, better entrance and parking arrangements, and overall refurbishment of the existing accommodation.

In 2000, a report on the mechanical and electrical services in Scoil Eoin, commissioned by the Department of Education and Science, reached the following conclusion. I want to emphasise this because it is a major health and safety issue and an argument for the provision of a new school at Scoil Eoin:

We believe it is of paramount importance to install a completely new electrical system in the entire school complex. The present electrical system falls very much short of the requirements of current electrical regulations. A new electrical system is the most satisfactory way in which the safety and integrity of the electrical services at the school can be guaranteed and in which the school will have an electrical system which complies with current stringent ETCI, RECI and ESB regulations.

Department of Education and Science planning guidelines for primary schools recommend a minimum area of 76 sq. m, made up of 70 sq. m for teaching and wet play area and 6 sq. m for two toilet cubicles. None of the permanent classrooms in the school meets these criteria in area or en-suite facilities.

The energy rating of the school does not reach minimum standards. ESB and heating bills at Scoil Eoin are exorbitant. Evidence of this is available from the principal on request. Maintenance costs are also mounting due to the ageing structure. The ESB bill, which does not include oil, is approximately €3,500 every month. The building has no insulation and is completely outdated.

The issue of parking provision and set-down areas at the school must be addressed urgently as the volume of traffic outside Scoil Eoin has increased dramatically in recent times. Due to the fact the school is divided into five different buildings, it is difficult to keep cohesion between staff and students. In winter months the buildings are cold. Conditions are particularly miserable in wet weather because the school has so many external doors and students and staff must travel between buildings throughout the day.

I hope the Minister of State will state more than the information I was given in April 2005. I want definite news for the principal, the board of management, the parents, the teachers and particularly for the children. This will be a case for the Ombudsman and the courts unless the Department of Education and Science is prepared to act.

I thank Deputy Deenihan for raising this matter as it affords me the opportunity to outline the Government's strategy for capital investment in education projects and also to outline the position regarding Scoil Eoin, Tralee.

Modernising facilities in our 3,200 primary and 750 post-primary schools is not an easy task given the legacy of decades of under-investment in this area as well as the need to respond to emerging requirements in areas of rapid population growth. Nonetheless, since taking office the Government has shown focused determination to improve the condition of our school buildings and ensure the appropriate facilities are in place to enable the implementation of a broad and balanced curriculum.

As evidence of this commitment approximately 1,300 building and modernisation projects will be active in our primary and post-primary schools during 2006. This year alone, approximately €500 million will be spent on primary and post-primary projects throughout the country, compared to approximately €90 million in 1997. I am sure the Deputy will agree this record level of investment is a positive testament to the high priority the Government attaches to this sector.

Turning to the specific matter in hand, Scoil Eoin, Balloonagh is designated an all-girls' primary school which caters for infant boys to first class. The school had a September 2005 enrolment of 608 pupils. The September 2006 enrolment has yet to be confirmed in the October returns to the Department of Education and Science. However, I understand enrolments are stable at this school.

The school authority applied to the Department of Education and Science to relocate to the adjacent secondary school campus which became vacant with the opening of the new secondary school at Mounthawk. When the application was initially assessed in the Department it was agreed the long-term accommodation needs for Scoil Eoin would be to provide——

With all due respect, this is the same reply I received in 2005. It is exactly the same. I know it is not the Minister of State's fault.

Allow the Minister of State to reply without interruption.

It is the same reply I received in April 2005. It is almost the exact same wording.

When the application was initially assessed in the Department it was agreed the long-term accommodation needs for Scoil Eoin would be to provide accommodation for a staffing of principal plus 22 mainstream teachers plus ancillary staff. A feasibility study was received which outlines a number of options for the future development of Scoil Eoin. To ensure the appropriate level of accommodation is provided, the Department is re-assessing the long-term projected staffing figure on which accommodation needs will be based. Once the long-term projected staffing figure is agreed, a technical visit of the site and buildings will be carried out by Department officials with a view to determining how best to deliver the required accommodation. As soon as a decision is taken on the best solution to meet the school's current and future accommodation needs, the project will be progressed in the context of the school building and modernisation programme 2006-10.

I thank the Deputy for providing me with the opportunity to outline the position on this particular school project and to highlight the enormous work undertaken by the Department of Education and Science in implementing the school building and modernisation programme to ensure infrastructure of the highest standard is available for all our schoolgoing population.

The Dáil adjourned at 9.10 p.m. until 10.30 a.m. on Wednesday, 11 October 2006.
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