Adjournment Debate.

Health Services.

Deputy Joanna Tuffy

The senior speech and language therapist assigned to Rowlagh health centre resigned in November 2007. At the time, the HSE had in place what it referred to as a recruitment pause — in other words, there was an embargo on recruitment for positions that fell vacant — and it did not allow the vacant speech and language therapist position to be filled. This embargo was lifted on 31 December but the HSE determined that it would not fill any posts that became vacant while the embargo was in place. The post is still vacant and there are no plans by the HSE to fill it.

I received a reply from the HSE, when my question was referred to it recently, which stated that the only way it could fill the position was if another post became vacant and it suppressed that post. In other words, some other post would have to be deliberately left unfilled for this vacant speech and language therapist position to be filled.

With regard to the impact of this decision, the therapist provided therapy to children in the north Clondalkin area. Children from six primary schools in the area were on waiting lists to see her. Before she resigned, there was a waiting list of 18 months for the service but now there is no service. As the Minister of State, Deputy Hoctor, may know, there are Early Start programmes in the schools in this area because they are designated as disadvantaged. The children are from disadvantaged backgrounds. Their parents are not well off. The purpose of the Early Start programme introduced by the then Minister, Niamh Bhreathnach, was to provided targeted intervention to identify the needs of these children at an early stage in their education. They have been part of the Early Start programme but the speech therapy they have been identified as requiring will now not be provided to them. After all the investment in the Early Start programme and its success, the basic services are not being provided to these pupils. I have raised the issue previously.

One of the notions being peddled is that there are not enough speech therapists. I made inquiries today and thanks to a Government initiative there are now 100 graduates in speech therapy each year because the additional 75 places were being filled. Most of those people will not be able to get work in Ireland, however, because of the embargo on filling speech therapist positions in the health service and in the public service. After all the money invested in their education, they are now in the position where they cannot get jobs here and important speech therapist vacancies that are needed are not being filled. That is ridiculous.

I do not know what the Minister of State will say, on behalf of the Minister, in her reply but when I raised this matter previously I was told the matter was one for the HSE and that it is responsible for human resources and filling posts but the HSE is implementing these cutbacks in positions because of the Government's requirement to keep within budget. As is the case with the cuts in respite care services, it is the most vulnerable who are affected. On this occasion children in disadvantaged areas who have been identified as being in need of speech therapy are being affected.

It is not the HSE that has the ultimate responsibility to care for the vulnerable in terms of the delivery of our health services. It is the Minister for Health and Children and she should intervene to ensure the HSE does not leave these vital speech therapist positions unfilled. The HSE is opting for the easy targets in terms of its cutbacks but the Minister is turning a blind eye to what it is doing. The people affected are in her constituency and she should intervene and ensure the HSE fills this position as a matter of urgency.

Minister of State at the Department of Health and Children (Deputy Máire Hoctor)

I will take this matter on behalf of my colleague, Deputy Mary Harney, Minister for Health and Children.

I thank Deputy Tuffy for raising this issue and giving me the opportunity to outline the current situation regarding speech and language therapy services.

I wish to advise the House that the recruitment pause put in place in September 2007 was initiated as part of the HSE financial break-even plan. The purpose of that break-even plan was to facilitate the delivery of services on budget in accordance with the provisions of the HSE's 2007 national service plan. The pause did not involve random job cuts but did mean the recruitment of staff to approved positions was delayed. I understand the HSE put in place a derogation process to deal with the filling of essential posts to protect frontline services and that close to 900 posts were approved under this process.

This temporary pause in recruitment ended on 31 December 2007 and any posts falling vacant from 1 January 2008 can be filled subject to the provisions of the circular issued by the HSE in early January. That circular sets out the HSE employment control framework for 2008 and is aimed at ensuring that health services are delivered in accordance with the provisions of the 2008 national service plan and within the funding provided by Government.

My colleague, Deputy Harney, are I are conscious of the effect the non-filling of this post has on clients in the catchment area of the health centre in question, which I understand is called the Rowlagh Health Centre. As the House will be aware, however, operational responsibility for the management and delivery of health and personal social services was assigned to the Health Service Executive under the Health Act 2004. The filling of posts, therefore, is an issue for decision by local management having regard to service priorities and allocated budgets. The Health Service Executive has advised that it has a policy of prioritising the filling of frontline posts to enable the delivery of services to patients and clients. The HSE has also advised that the situation in Rowlagh Health Centre will continue to be kept under review.

The House may wish to note that arising from the budget day funding package approved by Government for 2008, an additional 1,050 new posts have been approved for the health services. It is anticipated that a number of these posts will be therapy professionals.

Deputy Alan Shatter

For many years Leopardstown Park Hospital has provided respite care to facilitate carers at home looking after elderly spouses or other relatives to have at least one week a year off for the sake of their own health and psychological well-being.

Leopardstown Park Hospital has a ward of 21 beds that, unexpectedly and arbitrarily, are to be closed from 5 May. A number of constituents in my constituency have been informed that the bookings they made for persons they are caring for who are to be admitted in the months of May, June or July, for whom respite care had been confirmed, have been cancelled. People looking forward to their one week holiday a year, who have already paid money for the holidays to which they have committed, have been left high and dry by a health service that lacks humanity and insight.

My office has been in contact with the HSE and Leopardstown Park Hospital. Leopardstown Park Hospital tells me that its budget allocation this year falls short by between €1 million and €1.5 million of what is required to maintain the hospital's current services. The HSE says it is surprised the respite beds have been closed without its authority. The hospital says the HSE was told all about the hospital's difficulties in March. At some stage the HSE was saying it knew nothing about this while at another stage it was saying it would get into negotiations with the hospital.

I have a simple view. We are seeking to encourage relations and spouses to care for their elderly relations and spouses who are unwell in the home. They are performing a service which saves huge resources to this State and leaves hospital and nursing home beds vacant to others. They are entitled to the basic recognition that respite care will be made available to them. No one should be treated in a manner in which respite care already booked and confirmed is cancelled less than three weeks before it was to be utilised.

I do not want to get the same reply as that given to my colleague. I am heartily sick of being told, and I quote from the previous reply, that "as the House will be aware, operational responsibility for the management and delivery of health and personal social services was assigned to the Health Service Executive under the Health Act 2004", and that the Minister has no dealings in the matter. It is the Government that sets policy. It is the Minister with responsibility for the elderly who has a political obligation and apparently a ministerial function to ensure the elderly in our community are treated in a decent and humane manner and have available to them the services to which they are entitled.

I call on the senior Minister, Deputy Harney, and the Minister of State who is present, Deputy Hoctor, to immediately intervene and ensure the respite care previously confirmed and made available to persons for the months of May, June and July or other months in the summer is restored. I ask that action be taken to ensure that ongoing respite care is provided in Leopardstown Park Hospital. It is an outrage and a scandal that people should be treated in this manner and that a crucial and important service, which for some people is their only lifeline to sanity and relaxation for one week in the 52 weeks of the year, should be withdrawn in the manner this service has been withdrawn.

I do not want to be told that the Minister has no function in the matter and that the HSE should deal with it. The HSE was created by the Fianna Fáil-Progressive Democrats Government. It is maintained in its current form by the current Minister and it is an unaccountable body spending over €15 billion of taxpayers' money. I do not accept that no matter how incompetent or poor the service or how inhumane the decision made that it should never be answerable. Ultimately and politically, the Minister and Department of Health and Children are answerable to this House.

I am hoping to be told this service will be restored. I have some optimism there is a possibility because of the two bodies — the hospital and the HSE — talking to each other, that some action will be taken to at least meet the commitments already in existence. I hope I will be told the service will be fully restored and this problem is being immediately addressed and will be resolved by the weekend.

Deputy Máire Hoctor

I reiterate that I am taking this Adjournment matter on behalf my colleague, Deputy Mary Harney, Minister for Health and Children. I thank Deputy Shatter for raising the issue as it provides me with the opportunity to reaffirm the Government's commitment to services for older people generally, and in particular to the important area of developing day and respite care.

Government policy is to support people to live in dignity and independence in their own homes and communities for as long as possible. Where this is not feasible, the health service supports access to quality long-term residential care where appropriate. This policy approach is renewed and developed in the latest partnership agreement, Towards 2016.

The Government's objective of continued development of community-based services for older persons is reflected in the funding given to the system in recent times. In the 2006 and 2007 budgets, more than €400 million was provided to enhance service developments across the sector, of which just over €190 million was for community-based services over the two years.

The 2008 budget provided an additional €135 million, bringing the total spend over the last three years to €540 million, including €22 million for the development of community services for older people. These measures have been designed to both enhance existing services put in place by the Government and also widen the range of services available to older people.

In this context, more than €16 million has been provided in the past three years for new day and respite care services. The recent budget will allow an additional 1,245 clients nationally to avail of new respite places and brings the total projected day-care provision to approximately 21,300 places by the end of this year.

As the Deputy is aware, the Health Act 2004 provides the HSE with responsibility for the management and delivery of health and personal social services.

Deputy Alan Shatter

It is a pity the Minister of State did not have the presence of mind to exclude that sentence.

Deputy Máire Hoctor

I have much time to give to it and I will read it again for the Deputy if he so wishes.

Deputy Alan Shatter

It is a farce that Ministers and Ministers of State come into this House to make statements of this nature rather than treat the matter seriously.

Deputy Máire Hoctor

As a statutory body, the provision of these services, including the delivery of services by agreement with voluntary and community organisations, is a matter for the HSE.

Leopardstown Park Hospital provides care for approximately 200 patients in south County Dublin. The majority of the beds are long-stay beds for older people and there are also respite beds and dedicated beds for patients of Alzheimer's disease and welfare-home type beds on the campus.

The hospital receives in excess of €12 million annually through the HSE to pay the costs of its services. As the Deputy is aware, the allocation of resources is a matter for the executive, in accordance with the overall priorities for particular services as set out in its service plan.

Discussions around the 2008 service level agreement are at an advanced stage with the Dublin south-east local health office of the HSE, which is the main link for the hospital into the HSE. In this context, the executive has advised it has been discussing with the CEO a deficit in the hospital budget which has accumulated over several years. The HSE has further advised it will be necessary for the hospital to break even financially in line with HSE plans. This is no different from any other agency funded through the HSE.

In the course of these discussions, the executive proposed a solution and plan to the CEO and board of Leopardstown to eliminate the deficit over a two-year period. The HSE advised that the focus of this plan was that the impact on services would be kept to the absolute minimum necessary to achieve break-even.

The board decided in a meeting on 6 March not to adopt the plan and to instead address budgetary issues by the closure of 11 respite and ten long-term beds with effect from 1 May 2008. It is important to note it was the hospital which made this decision rather than the Health Service Executive. When this decision was communicated to the executive, it sought an urgent meeting with the hospital board. It is understood this meeting will take place on Friday, 25 April 2008.

Deputy Alan Shatter

I have no idea why we have a Minister and Department for Health and Children as they obviously have no functions any more of any description.

Schools Building Projects.

Deputy Jimmy Deenihan

I raised this matter on 14 October 2003. At that time, St. Brendan's national school in Blennerville was closed because of rat infestation. In the course of my contribution I pointed out that the school was on the INTO list of schools in urgent need of replacement. Unfortunately, very little has happened since.

The school is now about 75 years old. In September 2007, the board of management of the school was informed that the file for the proposed new eight-classroom project had been referred to the schools building section of the Department from the schools planning section for the purpose of appointing a design team to the project and initiating architectural planning.

They were also advised that the advertisement seeking design team consultants for the proposed building project was entered that day, 26 September 2007, on the public procurement portal site, with a closing date for the pre-qualification stage of the completion of Friday, 26 October 2007 at noon. At that stage, the Department would conduct the selection competition and the process would continue to the second stage, award of the design contract.

There has been no communication with the school since. Despite a number of letters from the board of management, there has been no response from either the Minister or her Department. I understand school authorities were informed by telephone last January that there would be a substantial delay in advancing the project to the next stage.

I point out that the school will face a crisis in 2009 as it will have enrolment for the next appointment in September 2008. That will be more than 173 pupils. It had two new appointments in September 2007, one mainstream due to development school status, and one resource due to an increase in the number of special needs children.

The school will not have a classroom to accommodate the extra teacher and class in September 2009. Currently, the school has one main building with four classrooms. Two measure 17 ft. by 17 ft. and two measure 19 ft. by 19ft. The rest of the accommodation consists of two temporary buildings, which are mainstream classrooms. One is owned and the other is rented. There is one prefab of 20 ft. by 10 ft. for learning support and one 40 ft. by 12 ft., which is divided. One section serves as an office staff room a store room, the other section is a resource room. This is just unacceptable in this day and age.

The board of management cannot put in another temporary classroom as it would take away a precious play area, which is currently inadequate for the enrolment of 157. I know this yard very well and there is very little space to move.

The application for a new school began in 1996 and the board of management received a letter in April 2000 approving the new school. In 2008, the teachers and pupils are still working in cramped and unsuitable conditions. The teachers, parents and board of management of the school are very concerned and angry that the new school project seems to have been shelved. They feel betrayed by the Minister and her Department, as they were specifically told, before the last election, that the project was a top priority, and money and resources were available to complete it as a matter of urgency.

They were told this by the Minister when she visited the school in the company of the press and the Fianna Fáil candidates running in the last election. They need the new school to progress and they feel they have been strung along for far too long, with projects which started long after them now completed. They still have nothing and worse, no notification of when they can expect progress.

I appeal to the Minister of State present to take these views on board; it is unfortunate we do not have the Minister for Education and Science here or a Minister of State from that Department. I ask the Minister of State to convey to the Minister for Education and Science the message that the current position is not acceptable. Construction of a new school has been signalled for some time and the project should be one of the main priorities of the Department at this stage. I understand that this matter was referred to by three speakers during last night's Seanad debate on school buildings.

A major public meeting is due to be held in Tralee on Monday night next and the people attending will be very angry. I hope the Minister of State can provide good news which I can convey to them. I will give her full credit at the meeting to which I refer if she can provide such news.

Deputy Máire Hoctor

I thank Deputy Deenihan for raising this matter because it provides me with the opportunity to outline to the House the position regarding the provision of a new school building for the school to which he refers at Blennerville, Tralee, County Kerry.

The school in question is a co-educational facility with a current enrolment of 157 pupils, which represents a 26% increase in the past five years. It has a staffing level of a principal, five mainstream teachers and two learning support teachers. The school authority has applied for large-scale capital funding for a new building and the Department has acquired a site for the provision of an eight classroom generic repeat design building.

As outlined to the House on many occasions, all applications for large-scale capital funding are assessed against published prioritisation criteria by the planning and building unit of the Department of Education and Science. Under these criteria, each application is assigned a band rating that reflects the type and urgency of works required. A band 2 rating has been assigned to the Blennerville project. This is the second highest rating possible and reflects the fact that the school has existing accommodation but that this needs to be replaced. This approach ensures openness and transparency in respect of how capital funding is allocated to projects and that funding is targeted at the projects that are most in need. It also ensures that there is an orderly flow of projects through the school building and modernisation programme.

The next step for the project is the appointment of a design team. This will be considered on an ongoing basis consistent with the band rating assigned to the project in the context of competing priorities from higher band rated projects and the funding available.

I again thank the Deputy for raising this matter. I assure him that the Minister and her Department are committed to providing suitable high quality accommodation for Blennerville national school at the earliest possible date.

Deputy Jimmy Deenihan

Those who attend the public meeting on Monday night will not like that reply.

Local Authority Housing.

Deputy Chris Andrews

I welcome the opportunity to raise this important issue, namely, the introduction of a sale of flats scheme. Such a scheme must be introduced because it would be an extremely important social inclusion measure. When the sale of houses scheme for council tenants, there were huge improvements in estates throughout the country, particularly those in Dublin.

The difficulty is that many people live in substandard accommodation in Dublin City Council flat complexes. Fire safety in many of these complexes is not adequate. There was a fire recently in one of the top floor flats at the Beech Hill complex in Donnybrook in my constituency and firefighters could not gain access from the rear of the building. That is not acceptable. The fire regulations must be changed so that people can raise their children in an atmosphere of security and safety.

The standard of electric wiring in many flats is not acceptable and needs to be upgraded as a matter of urgency. The position in respect of drainage is similar, with sewerage pipes running through people's flats and, in many cases, their kitchens. Flats are regularly flooded as a result of old and rusting pipes.

Those who live on the top floor of flat complexes experience continual problems with leaks because many of their roofs need repair. These roofs are often repaired but within months the problem returns and there is a need for further repair. This is an expensive process.

Bedrooms in flats are often tiny and this accentuates the difficulty that arises in the context of overcrowding. Even if a sale of flats scheme is introduced, most of those who live in council flats in Dublin will not be able to avail of it because their homes are in such a substandard condition. It would be wrong for the council to sell substandard flats to tenants who are eager to buy.

Many people have stated that there is a need for a sale of flats scheme and that it must be introduced as quickly as possible. However, we must get it right and ensure that we do not sell second-hand goods to tenants. It will be possible for those flats that are refurbished to be sold under the scheme when it is finally introduced. However, those which are not refurbished will not be sold.

The redevelopment of flat complexes is ongoing. I refer here to the complexes at Charlemont Street and York Street. Other redevelopment projects are already in the pipeline. However, this is not sufficient. We need a redevelopment scheme in respect of which a clear timeframe for commencing and completing works will be set down. The flat complexes at Beech Hill, Mercer House, located a stone's throw from the Dáil, Glover's Court, Bishop Street, Ringsend, Irishtown, Rathmines and Pearse Street are in a substandard condition and should be redeveloped.

Tenants deserve to live in modern and safe accommodation. The Government must ensure that flat complexes are redeveloped to such a degree that their tenants will be able to avail of a sale of flats scheme, were it to be introduced. The residents of most of the flat complexes to which I refer would not be in a position to avail of such a scheme. People have invested a great deal of money in their flats and, like those who own the houses in which they live, they want to pass them on to their family members. They should be entitled to do so and I ask the Minister of State to ensure the scheme to which I refer is introduced as a matter of urgency.

Deputy Máire Hoctor

I thank Deputy Chris Andrews for raising this matter which I am taking on behalf of my colleague, the Minister of State with responsibility for housing, urban renewal and developing areas, Deputy Batt O'Keeffe. I am happy to set out for the information of the House, the work being undertaken to extend the opportunity for home ownership to more social housing tenants in a way that protects the interests of tenant purchasers, continuing tenants and local authorities alike.

The Government announced its intention of introducing a scheme for the sale of local authority apartments under certain conditions in Housing Policy Framework — Building Sustainable Communities, published in December 2005. This commitment was reiterated in Delivering Homes. Sustaining Communities, a statement on housing policy published in February 2007. Furthermore, the Agreed Programme for Government published in June 2007 indicated that the Government will "expand the paths to home ownership to assist the maximum number of people in gaining a stake in their own home".

Proposals for a tenant purchase scheme for apartments were included in the General Scheme of the Social Housing (Miscellaneous Provisions) Bill, prepared by the Department of the Environment, Heritage and Local Government and approved by Government for drafting in December 2006. These proposals take account of the difficulties experienced with previous attempts to introduce such a scheme in areas such as the management of apartment complexes, insurance, the cost of maintenance and the transfer of legal title. They also reflect consideration of proposals submitted by Dublin City Council in 2004 for selling its apartments to tenants.

The proposals are based on the long-standing arrangements in the private sector for the ownership and management of multi-unit residential developments. The transition from a rented social housing apartment complex to a mixed tenure of privately-owned and social-rented accommodation adds an extra dimension to the legal and practical problems that can arise in private apartment complexes. In conjunction with the Attorney General's office, progress is being made in identifying and dealing with the complex issues involved.

The tenant purchase of apartments is one of a range of reform measures included in the Bill, which is scheduled for publication in the current parliamentary session. The new legislation will give effect to the programme of social housing reforms outlined in Delivering Homes. Sustaining Communities, which is aimed at improving services and their delivery. The reform programme includes new provisions on the assessment of social housing needs, updating local authority powers to deal with anti-social behaviour, expanding and providing a more developed legislative basis for the rental accommodation scheme and a statutory basis for housing action plans. As well as updating and expanding the existing tenant purchase path to home ownership for social housing tenants, the Bill will provide for a new incremental purchase scheme whereby households can start acquiring, by degrees, ownership of certain new local authority houses from their first day of occupation.

The Minister of State, Deputy Batt O'Keeffe, is looking forward to a thorough examination in this House of all the proposals in the Bill, which will be recognised as a major contribution to reform of the social housing sector.

The Dáil adjourned at 5.20 p.m. until 2.30 p.m. on Tuesday, 29 April 2008.

Dáil Éireann díospóireacht - Thursday, 24 Apr 2008