Adjournment Debate.

Health Services.

Deputy Jimmy Deenihan

The annual report of the HSE south orthodontic service for Cork and Kerry in 2007 makes very depressing reading. It reflects the totally inadequate service in respect of orthodontic treatment in the region. The report refers to serious structural and equipment deficiencies in HSE south and the lack of apparent will to do anything about it.

As of last December, 1,049 young people in Kerry are on the waiting list for orthodontic treatment, 42 of whom have been waiting since 2002. A total of 126 people have been waiting since 2003 and 224 people have been waiting since 2007. There are 2,299 people on the waiting list in Cork-North Lee and Cork-South Lee, while in west Cork 2,002 are on the waiting list. In respect of those looked after by St. Finbarr's Hospital, a total of 3,555 people are involved. This is not the whole story because north Cork is now looked after by Cork University Hospital.

Overall, the waiting list for orthodontic treatment in the southern area has increased by 246 patients from December 2006 to December 2007. The waiting list for orthodontic assessment — an assessment to determine a child's eligibility for orthodontic treatment — was 3,071. However, owing to the fact that patients aged 12 years and over are the only patients officially placed on the waiting list, approximately 3,000 children have been referred for orthodontic assessment but have been excluded from the assessment waiting list by the protocols laid down by management.

In October 2006, two senior dental surgeons left the orthodontic service to further their education in orthodontics at the dental school and hospital in Cork. The decision by management to suppress these posts has led to a significant increase in the number of patients awaiting orthodontic treatment. It is reasonable to assume that the 246 patients, most of whom have been waiting since 2002 and 2003, failed to receive orthodontic treatment in 2007 as a direct result of the decision by management to suppress the two posts for senior orthodontists. Those waiting in Kerry since 2002 and 2003 would be treated at this stage.

In December 2006, the number of patients under orthodontic treatment was 3,400. However, this figure has not changed in the returns to the Department of Health and Children since 2003. This indicates that this figure was an arbitrary one. It is clear that the number of patients under orthodontic treatment has significantly diminished. The loss of the two senior dental surgeons has not only affected the number of patients under treatment but has seriously affected morale within the orthodontic unit. For example, the clinics in Tralee had to be reduced from three days to two days per week at the request of line management. In January 2007, the HSE directed that there should be no further treatment for any new patients in Kerry. It is clear that the decision of management to suppress the two senior dental posts and to interfere with access to the dental surgery in Tralee has had a devastating effect on the orthodontic unit's ability to reduce the number of patients currently awaiting orthodontic treatment in Kerry.

It is anticipated that the Cork and Kerry region will apply for the appointment of a second consultant and it is proposed that this consultant be placed in the new centre proposed for Cork-North Lee and Kerry. This new consultant should be housed in the new dental service that will be provided at St. Finian's Hospital in Killarney. This individual could cater for the needs of patients in Kerry and west Cork. If a second consultant orthodontist is appointed, which should happen, the appointment should be for the Kerry region. That consultant orthodontist should be assigned to the new unit at St. Finian's Hospital in Killarney.

Minister of State at the Department of Health and Children (Deputy Pat The Cope Gallagher)

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

As the House will be aware, the Health Act 2004 provided for the Health Service Executive, which was established on 1 January 2005. Under the Act, the executive has the responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. This includes the delivery of orthodontic services. The prioritising and resourcing of the development of orthodontic services is now a matter for the Health Service Executive.

It is important that I explain that the report referred to by Deputy Deenihan is an unofficial one, not an official Health Service Executive document. This report was not commissioned or requested by the HSE nor is it a requirement, operationally or legally, of any area of the public orthodontic service to produce such a publication. Furthermore, the author of this report did not make local HSE management aware of its existence or forward them a copy. They became aware of the existence of this unofficial report only when contacted by the local media.

The majority of the issues outlined in respect of the management and future development of the orthodontic services in Cork and Kerry in this unofficial document are under ongoing consideration. The HSE plan regarding the future model of orthodontic service delivery is clearly outlined in the strategy for the provision of orthodontic services in the HSE South, which has been produced by management in the HSE.

Most of the issues outlined in this unofficial report relating to the infrastructural deficits of the orthodontic unit in St. Finbarr's Hospital are documented in a health and safety audit commissioned by management and completed by the orthodontic department in late 2007. Local HSE management have noted that a small number of the issues relating to the infrastructure of the orthodontic unit were not previously brought to the attention of management at South Lee Local Health Office. These issues are now being examined.

The progress of local HSE management in dealing with these issues highlights the necessity and fundamental importance of staff, especially those at a consultant level, engaging openly and in a positive and constructive way with their local management to overcome difficulties and problems and achieve outcomes. Only through this process will we achieve high quality, reliable and sustainable services for patients.

I remind the House that the Joint Oireachtas Committee on Health and Children carried out a review of orthodontic services in Ireland and published two reports — one in 2002 and 2005. On foot of this, the HSE established an orthodontics review group in 2006. The group was chaired by Hugh Kane of the HSE and was made up of consultant orthodontists, a specialist orthodontist working in the HSE, representatives from the two dental schools, Trinity College Dublin and University College Cork, and the Department of Health and Children.

The terms of reference for the group were to review the recommendations contained in the joint Oireachtas committee reports on the orthodontic service in Ireland — February 2002 and June 2005; to examine the recommendations within the operational remit of the HSE and establish their status; to conduct an analysis of the HSE's existing orthodontic delivery structure and capacity; and, based on that analysis, to make recommendations in that regard, the recommendations thus made to be costed and a timeframe for their implementation proposed.

The group made recommendations in four broad areas. These are guidelines and revised eligibility criteria, training, manpower planning and service provision. These recommendations reflect many of the issues raised in the joint Oireachtas committee report of June 2005. A range of measures to improve the orthodontic services on foot of the report of the joint Oireachtas committee and the Kane report is already under way.

In addition, my ministerial colleague, Deputy Mary Harney, announced in October 2007 the research and development of a new national oral health policy. This new oral health strategy, the first such strategy in 13 years, will be undertaken by the Department of Health and Children in conjunction with the HSE. The development of this new national strategy will allow a critical examination of the many challenges and issues currently facing the dental sector in Ireland. Some of the issues which will be examined include service delivery issues such as orthodontic services. Other issues which impact on orthodontic services such as specialisation and skills-mix, including the recognition and future expansion of the role of auxiliary dental professions and the identification of appropriate training needs, will also be examined.

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. This undoubtedly presents challenges for services delivery and will continue to do so. Our aim is to continue to make progress and to develop a high quality, reliable and sustainable service in HSE South and all other areas of the executive for children and their parents.

Physical Education Facilities.

Deputy Tom Hayes

I thank the Ceann Comhairle for allowing me to raise this important matter.

I refer to the Abbey School in Tipperary town, an excellent school with a great history. It is a great sporting school which has won many cups throughout its long history and contributed a great deal to the well-being of many pupils in the entire Tipperary area.

The school applied for funding for a physical education hall in 1989. Nineteen years later it is still waiting for that funding. I would like clarification on the band rating, which I understand was changed. In May 2007 the school had a band 4 rating but I understand in April of that year it had a band 2 rating. I would like clarification on that.

I welcome the recent announcement of the many school projects throughout the country, but there was no mention of any funding for PE halls. In 2001 the then Minister for Education and Science told us that the Department was preparing PE hall templates that would standardise the construction of PE halls at second level, that those templates were being piloted in four schools initially and that it was anticipated that the templates would be available for generic use later in the year. In May 2005, the current Minister stated that those designs will speed up the delivery of PE halls and significantly reduce design costs.

It emerged less than 12 months ago that Irish schools are ranked close to the bottom of a European Union league table for the provision of physical education classes. Senior cycle students often go without PE classes. Some schools must split PE classes, which is largely a waste of time. As we all are aware, the cost of that neglect on our health system is huge. The level of obesity in Ireland has doubled in the past decade. One in eight Irish people has been identified as being obese.

PE halls are needed throughout the country. My aim in raising this matter is to establish the current position regarding the Abbey School in Tipperary town. I hope the Minister of State will have good news.

Deputy Pat The Cope Gallagher

I thank Deputy Tom Hayes for raising this matter as it provides me with an opportunity to outline to the House, on behalf of the Minister for Education and Science, the Government's strategy for capital investment in education projects and the current position regarding the Abbey School, Tipperary town.

Modernising facilities in our 3,200 primary and 731 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 needs in areas of rapid population growth. Nonetheless, the Government has shown a consistent determination to improve the condition of our school buildings and ensure that the appropriate facilities are in place to enable the implementation of a broad and balanced curriculum.

The Government has dramatically increased investment in the school building programme from just over €90 million in 1997 to approximately €600 million this year. Within the timespan of the national development plan almost €4.5 billion will be invested in schools. This is an unprecedented level of capital investment which reflects the commitment of the Government to continue its programme of sustained investment in primary and post-primary schools.

At second level, it is the policy of the Department of Education and Science to provide a PE hall to a school that does not already have such a facility. This is considered as part of the design brief for new schools, and major renovation of existing schools, within available resources and overall published criteria for prioritising projects. The physical education curricula at primary and second level have been developed on the understanding that facilities available to schools vary. Consequently, they offer a level of flexibility that allows each school to tailor its programme to the facilities available. The number of schools with general purpose rooms and PE halls is increasing all the time, while practically all schools have outside exercise space. In addition, many schools use adjacent local facilities, including public parks, playing fields and swimming pools. The facilities schools have on site is just part of the picture as schools may also have access to excellent local sports facilities which have been greatly expanded and improved through funding from the Government's sports capital programme in recent years.

Turning to the specific matter of interest to Deputy Tom Hayes, Abbey School is a co-educational voluntary secondary school located in Tipperary town. The school had an enrolment of 439 students in September 2006 and enrolments in the school generally have been stable over the past five years.

The school originally submitted an application for major capital funding in 1998 for a PE hall and refurbishment of existing accommodation. Tenders for the refurbishment project were approved in 2002 totalling approximately €850,000 while the PE hall application was put on hold pending the delivery of the Department's template design for PE halls. The school looked to have the PE hall application re-activated in 2002, but the project did not proceed at that time owing to competing priorities within the capital programme. The school submitted a revised application in April of 2007 for a PE hall only. The application has been assigned a band 4 rating according to the published prioritisation criteria and will be considered in the context of the multi-annual school building and modernisation programme.

I thank the Deputy for affording me the opportunity to outline the current position on the provision of a PE hall at Abbey School, Tipperary town.

School Accommodation.

Deputy Michael McGrath

I thank the Ceann Comhairle as this is an issue close to my heart. Star of the Sea primary school resulted from an amalgamation of Scoil Colmcille and St. Mary's national school some years ago. I am a past pupil of the school, with many happy memories of my years there.

In 1999 the then Minister for Education and Science sanctioned, in good faith, a new school building for Star of the Sea. At the time, provision of a new school building was central to securing the agreement of both schools to amalgamate and become Star of the Sea. Since 1999 the project has been bogged down in delays. Difficulties in securing a suitable site delayed the project for a number of years and it was not until 2005 that the Department of Education and Science purchased a greenfield site from Cork County Council with the agreement of Passage West soccer club, which had the use of the lands at the time. In November 2006 the school was included on the Department's building programme for the first time and was approved to proceed to the architectural planning stage. At that stage, we hoped the battle for a new school was coming to an end.

The following month, in December 2006, representatives of the school met officials from the planning and building unit of the Department and were advised that the generic design method would be used and that the architectural planning and design team would be in place by April 2007. For the following nine months nothing happened. The project went out to tender for a design team in autumn 2007 with a closing date for submission of tenders of 15 October.

For the past number of months I, and people at the school, have been trying to establish the position regarding the appointment of the design team. Every inquiry elicits the same response — that the appointment is at an advanced stage. It is now the middle of February 2008 and the design team has not been appointed. I cannot understand how it takes more than 14 months to appoint a design team for a straightforward project where a generic design is being used. Along with everyone associated with the project, I am frustrated by the lack of progress.

The school has 311 pupils enrolled, to increase to 450 in the next few years. Two junior infant classes are now being taken in every year and, within a few years, the school will expand to a 16-classroom school. The Department accepts these figures as correct.

The current site, comprising the residual building from the old St. Colmcille boys' school and a prefab complex, is woefully inadequate for the needs of Star of the Sea in 2008. The former playground is now a car park, the assembly area is now a classroom and the green area where we played football when I attended the school is now taken up by the prefab complex. At least three more prefabs are required in the next year. A learning support teacher is using a makeshift computer room to teach children with special needs. The classrooms and prefabs are cramped and overcrowded and do not have in-class toilet facilities. All children must leave the classroom for the toilet and many must leave the building, depending on the part of the site their class is in.

The Department of Education and Science is prioritising rapidly expanding areas where there are issues with school capacity. Passage West is one of those. It is experiencing major residential development and the current school site does not have the capacity to cater for the numbers coming through. For example, a single development now under way in Passage West will deliver more than 600 residential units in the coming years and planning has been secured from Cork County Council for a further 400 units. People want to come and live in Passage West and it is our duty to ensure there is a place available at a school where their children can learn in a safe, modern educational environment.

I plead with the Minister to appoint the design team without further delay and to ensure Star of the Sea is included in the next announcement of projects approved to go to construction. I acknowledge the immense efforts of the school principal, Mr. Brendan McCormack, the staff, the parents association, the board of management and the local parish as patron organisation. All of these have worked tirelessly to get the new school the children deserve and which was promised nine years ago. They have my continued support and I look forward to the reply of the Minister of State.

Deputy Pat The Cope Gallagher

I thank the Deputy for giving me the opportunity to outline the Department's position regarding the provision of a new primary school building for Passage West. It is proposed to build a new 16-classroom generic repeat design school, including a general purpose hall and ancillary accommodation, on a greenfield site. The process of appointing a design team to the school building project referred to by the Deputy is at an advanced stage. I note the Deputy's desire to have the team appointed as quickly as possible.

Under the national development plan, €4.5 billion is assigned to the capital requirements of the primary and post-primary schools. Approximately €600 million will be spent this year on school buildings. The progression of all large-scale building projects from initial design stage through to construction phase is considered on an ongoing basis in the context of the Department's multi-annual school building and modernisation programme in which the main focus is to deliver school places within rapidly developing areas.

I note the Deputy's comments about Passage West being a rapidly developing area and his reference to the number of residential units to be built there. The progression of a new primary school at Passage West, as with all large-scale projects, will be considered in this context. I assure Deputy McGrath that the Minister and the Department are committed to providing suitable high quality accommodation for the school in Passage West at the earliest possible date. I assure him I will bring his strong views to the attention of the Minister for Education and Science, Deputy Hanafin. I note Deputy McGrath's comments about the additional residential units, which will have a direct relationship with the enrolment projections.

Road Safety.

Deputy Thomas P. Broughan

It was with amazement that I read media reports that the Government is considering abandoning plans for the roll-out of speed cameras because of the higher than anticipated cost of the programme. The road safety strategy is in a shambles and will be critically undermined by the Ministers for Justice, Equality and Law Reform and Transport if the roll-out of speed cameras does not proceed. The core excuse of excessive cost seems ludicrous, given that the administrative and monitoring cost of the 600 locations is approximately €25 million per year, well below the expected €70 million that would be generated in revenue. Given the significant speed factor in car collisions, fatalities and serious injuries, it must be asked how this cost of €25 million per annum can be regarded as more important than the approximately €700 million cost of tragic crash fatalities in 2007.

There are still just three fixed speed cameras on Irish roads, rotating between 20 locations, although the rollout of speed cameras has been part of national road safety strategies for the past ten years. The new road safety strategy of 2007 to 2012 had a commitment for the provision of 6,000 hours of speed camera detection per month by the second quarter of 2008, in other words, next month or the following month. The Minister of State, Deputy Gallagher, will remember that was action No. 26 of the Road Safety Authority programme. It would be astonishing if the Government were now to drop this key target altogether less than five months into the lifetime of the new road safety strategy.

Speed cameras are the norm in most of our European Union partner states, which have a much better traffic collision record than ours. Government-commissioned research has established that a five-fold increase in cameras could reduce serious crashes by more than 20%. The Government-commissioned report in 2002, The Use of Speed Cameras in Ireland, by researchers at Monash University in Melbourne stated, "The social and community benefits of a successful speed camera programme are high, with between 30% and 50% reduction in the costs of road trauma being saved by the implementation of a successful road safety strategy." I believe that could amount to perhaps €500 million over five years. The experience in the Australian state of Victoria has found that to develop the societal attitude that if one speeds, one will be caught and prosecuted, some 60% of the jurisdictional fleet must have their speed checked statistically every month. The programme we intended to embark on would have enabled speed to be checked every two months.

Ten years ago, in 1998, the Taoiseach promised the rollout of a network of speed cameras in the road safety strategy, Road To Safety. The 2004 to 2006 road safety strategy again proposed this as a key objective and again failed to deliver it. On 1 August 2005, following a Cabinet decision of 25 July 2005 at which the Ceann Comhairle was present, the then Minister for Justice, Equality and Law Reform, Deputy McDowell, and the then Minister for Transport, Deputy Brennan, again agreed to proceed with approximately 500 to 600 speed camera locations nationwide. I understand that a competitive tendering process was undertaken and that six bidders were shortlisted to provide speed camera detection services at 600 locations around the country.

The Department of Justice, Equality and Law Reform was often quoted in recent years, including prior to the general election, as stating the award of the speed camera contract was "imminent". Yet, in December 2007, we were still waiting for the decision, and now we are being told that due to "cost issues" the decision taken in 2005 will not proceed.

Just last week the chairman of the Road Safety Authority, Mr. Gay Byrne, strongly criticised the ongoing Government failure on speed cameras, saying it was disgraceful. Today's reports on the possible abandonment of the speed camera programme are very demoralising for the chairman of the Road Safety Authority, Mr. Gay Byrne, its chief executive, Mr. Noel Brett, and the hardworking and dedicated Road Safety Authority workforce. The speed camera rollout must remain a key component of the overall road safety strategy. Information gained from research in the United Kingdom clearly shows a major reduction in casualties from collisions. We should allow Mr. Gay Byrne, Mr. Noel Brett and all their staff to do the job they were charged with by this House and by the Minister, by providing the proper funding for the long-promised and critical road safety programme and, in particular, for the rollout of speed cameras.

We accept we need a mix of measures to cut back on the savage casualty rate on Irish roads. These include the introduction of random breath testing, the new penalty points system, the new learner driver system and, above all, the new traffic corps. The Minister of State, Deputy Gallagher, may refer to that as I read an earlier press release from the Department on the traffic corps. I accept we need the promised 1,200 gardaí in the traffic corps but the information I have from the Road Safety Authority and from road safety bodies elsewhere, including the UK, where there is a vicious campaign against cameras by people who want to continue speeding rampantly on British roads, is that we need speed cameras. We should proceed with them without delay. They were promised for the second quarter of 2008. I urge the Minister to carry out the road safety strategy.

Deputy Pat The Cope Gallagher

I thank Deputy Broughan for raising this matter and for giving me an opportunity to respond on behalf of the Minister for Justice, Equality and Law Reform, who unfortunately is unable to be present.

I assure the Deputy that the Minister and I share his concern and that of the public in general about the unacceptable level of fatalities and serious injuries on our roads. At the same time, we should not lose sight of the fact that significant progress is being made. I believe that has been acknowledged. The Road Safety Authority recently published the Road Collision Factbook 2006. It notes that over the last decade the death rate, as measured against the number of vehicles on the road, has more than halved. In 1996, the fatality rate per million registered vehicles was 338. By 2006, the rate had fallen to 159 per million registered vehicles. Road users are twice as safe now compared to ten years ago. I spent time in the Department of Transport. I accept one life is too many to lose and this reduction is no solace for the many families who have lost their loved ones in accidents.

Looking at the overall figures, the trend in fatal traffic collisions has been favourable for the past three years. The number has decreased from 396 in 2005 to 365 in 2006 and 338 last year. These figures represent a reduction of 8%, followed by a reduction of 7%, year-on-year. The figure for last year is the second lowest in the past ten years. When the level of road deaths is measured against our overall population, Ireland's rate in 2006, the latest year for which international comparative information is available, moved us up to 12th out of the then EU 25. We cannot and will not become complacent over these statistics, as even one death or injury on our roads is too much.

The Departments and agencies responsible for road safety are tackling rigorously driver behaviour such as speeding in the context of the Road Safety Strategy 2007-2012. In particular, the Garda Síochána continues to focus its enforcement activity on the main causes of death and serious injury on our roads, which include speeding, along with drink driving and non-wearing of seatbelts. The Garda policing plan for 2008 aims to increase by 10% in the course of the year detection of speeding, driving while intoxicated and also road transport offences. In 2007, there were approximately 200,000 speeding detections, giving an average detection rate per month of approximately 16,500.

At the request of the then Minister for Justice, Equality and Law Reform the Garda established the Garda traffic corps in 2004, with a supporting command structure, equipment and resources. The traffic corps ensures the necessary enforcement capacity to achieve increased compliance with road traffic law. The increase in the personnel strength of the traffic corps, which will reach its planned level of 1,200 by the end of this year, is enabling this continuing increase in enforcement activity to take place. The Deputy referred to this matter.

Detailed analysis by the Garda Síochána of collision data is under way to identify locations and times where the greatest tendency for speed-related collisions occur. Speed enforcement will be prioritised on a risk assessment basis on such locations and at such times. The public will continue to be made aware of roads which have been identified as having a propensity for speed-related collisions, including through the Garda website. Enforcement will, therefore, be on the basis of preventing death and serious injury, and drivers will be given the opportunity to modify their driving behaviour by being informed of where blackspots, and consequently Garda enforcement activity, are located.

A number of projects are under way to replace and upgrade equipment available to the Garda. The current GATSO speed detection equipment will soon be replaced by modern equipment with increased capacity. In addition, arrangements are being made to make available to the Garda state-of-the-art automated number plate recognition technology. This will give the force the ability to detect vehicles which are stolen, untaxed or otherwise brought to the attention of the Garda, in addition to being able to detect speeding drivers. The Garda will therefore not only gain improved intelligence on persons known to them, be able to deny the use of the roads to criminals and detect drivers who do not pay their motor tax, but they will also have enhanced traffic law enforcement capabilities, including the detection of speeding.

With regard to outsourcing the provision and operation of safety cameras to a service provider, following the drawing up of a shortlist and the issue of a request for tender to the market, tenders were received and evaluated. As a result of this process issues have arisen because, as the Minister informed the House recently, costs involved would be substantially higher than had been estimated when the matter was considered previously by Government. In light of these issues, the Minister intends to bring proposals before his colleagues in Government shortly taking into account issues of value for money and the commitment to reduce speeding on our roads in the context of the road safety strategy. Obviously, the Minister cannot pre-empt the outcome of the Government's consideration of these proposals. Equally, it is unwise for anyone to jump to speculative conclusions about decisions that remain to be taken. What there can be no doubt about is that saving lives through making our roads safer, including through taking effective, efficient and targeted measures to reduce speeding, will remain an absolute Government priority.

The Dáil adjourned at 9.40 p.m. until 10.30 a.m. on Thursday, 14 February 2008.

Dáil Éireann díospóireacht - Wednesday, 13 Feb 2008