Dáil Éireann díospóireacht -
Wednesday, 14 May 2008

Vol. 654 No. 2

Adjournment Debate.

Cancer Screening Programme.

Deputy Kieran O’Donnell

I am delighted to have the opportunity to raise this issue on the Adjournment and I thank the Ceann Comhairle for allowing me to do so.

Over the next couple of weeks, Limerick will be the only city in Ireland without BreastCheck in place. Since 1 March 2008, the breast clinic in Limerick Regional Hospital no longer carries out screening mammography and only carries out symptomatic mammography. With screening mammography, women in the 50 to 64 year age group were screened for breast cancer. Due to the closure of the breast unit in Barringtons Hospital and the unit in Ennis, the Mid-West Regional Hospital finds itself under severe pressure in terms of resources to simply deal with symptomatic mammography.

Professor Tom Keane decided that the unit in Limerick would be designated for symptomatic cases and would no longer provide screening mammography. This decision was made on the understanding that screening mammographies would fall under the auspices of BreastCheck. However, there is no date for the roll-out of BreastCheck in Limerick. BreastCheck is already in place in Dublin, the east, the midlands, the north east and the south east. Since December it has been operating in Cork and Galway. The service will be available in Waterford in the next number of weeks but it is still not available in Limerick, even though the numbers of women aged between 50 and 64 are well in excess of those in Waterford and many other areas. The CSO population statistics for 2006 indicate that Limerick has a female population of 10,178 between the ages of 50 and 59. It is an absolute disgrace that BreastCheck has not been rolled out in Limerick.

I note that the Minister for Health and Children is not here tonight, which is not unusual. It merely demonstrates her lack of commitment to health in general and cancer treatment in particular. I wish to put some startling statistics on the record. Of every 1,000 mammograms carried out, 5.3 indicate the presence of breast cancer. There are 1,800 breast cancer cases per year in Ireland, of which 134 are in the mid-west. Perhaps the most horrifying figure is that one in 12 Irish women develops breast cancer. We have a death rate of 36%, which is the fourth highest out of 25 developed countries, according to the World Health Organisation. Breast cancer is the most common form of cancer after skin cancer.

Deputy Jan O'Sullivan, the Acting Chairman, knows the situation in Limerick well. There is no screening programme in place in the county. I have telephoned BreastCheck but cannot get a definite answer as to when the service will be rolled out in Limerick. The women of Limerick fall under the static BreastCheck service in Cork but are to be served by a mobile digital mammography unit which must be put in place as matter of urgency. The Minister for Health and Children stands indicted that this service has not been put in place before now.

Before the screening mammography service was discontinued in March of this year, there was a four month waiting list for screening mammographies for private patients and a one year waiting list for public patients. Now there are women aged between 50 and 64 in the Limerick area who — based on rumours we have heard that BreastCheck will not be rolled out for at least another 18 to 28 months — could be waiting over three years for a screening mammography test. This is completely unacceptable, particularly given the fact that BreastCheck recommends that a mammography be carried out every two years.

I want the Minister to indicate tonight when BreastCheck will be rolled out in Limerick and, until such time as the service is rolled out, the interim measures she will put in place to ensure that the women of Limerick and the mid-west are able to avail of screening mammography services. If such measures are not put in place, women's lives will be at risk, which is completely unacceptable. I await the Minister's response and hope we will be hearing news that BreastCheck will be rolled out in Limerick as a matter of urgency and that the women of Limerick and the mid-west will not be discriminated against any longer.

Minister of State at the Department of Education and Science (Deputy Seán Haughey)

I am taking this matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney. I welcome the opportunity to address the issues raised by the Deputy and to set out the current position regarding mammography services in Limerick Regional Hospital and the roll-out of BreastCheck. The HSE has designated Limerick Regional Hospital and University College Hospital Galway as the two cancer centres in the managed cancer control network for the HSE western region, which includes County Limerick.

The HSE has advised the Department that breast imaging services are available at the Mid-Western Regional Hospital, Limerick, through a breast clinic which provides rapid access for all women with breast disease symptoms. Mammography scheduling is based on clinical need and referrals to the breast clinic are assessed, prioritised and subsequently referred to the radiology department for imaging. Urgent referrals to the breast clinic for mammography are usually carried out within two weeks. Non-urgent cases are placed on a waiting list.

It is important that clear criteria are applied to distinguish between urgent and routine cases. Significant work has already been undertaken in the area of symptomatic breast disease services, supported by the Irish College of General Practitioners, regarding referral criteria and the development of appropriate referral forms to allow for appropriate triage of urgent and non-urgent cases.

The symptomatic breast service has traditionally provided 11 appointments per week to enable GPs to refer asymptomatic women, that is, women who do not have symptoms for screening mammograms. At present the waiting list associated with this service is up to 24 months. The service has recently been withdrawn in order to prioritise mammogram slots for the imaging of women presenting with symptoms. The HSE has advised the Department that this is the best use of the resources made available by the national cancer control programme.

The implementation of the national quality assurance standards for symptomatic breast disease will ensure that every woman in Ireland who develops breast cancer has an equal opportunity to be managed in a centre which is capable of delivering the best possible results.

The BreastCheck programme delivers screening to women in their local community through the use of static and mobile screening units. The 4% of women who need follow-on treatment receive it at one of the four BreastCheck static units located in the western, southern and eastern regions. The BreastCheck programme is designed to offer repeat screening to the eligible population, that is, women aged 50 to 64, within an interval of 21 to 27 months.

BreastCheck recently became the first national screening service provider worldwide to offer a fully digital mammography service and women in the mid-west will be screened from a mobile digital screening unit. The mobile unit will remain in an area until all women known to the programme have been offered a mammogram. This time period varies from county to county based on the numbers of women to be screened and uptake levels.

The roll-out to individual counties, including County Limerick, will be dictated by BreastCheck's management and operational considerations. The estimated total screening population in County Limerick is 12,976.

Undoubtedly, the development of the country's cancer services can provide the most effective testimony to how change driven by quality and safety can result in faster access to better services with best outcomes for the patient. We are now well into the initial stages of delivering a model of service for cancer care which will have all the characteristics of the modern and effective systems enjoyed by other developed countries, not least better outcomes for patients.

Deputy Kieran O’Donnell

That does not answer my question. The reply does not indicate when BreastCheck will be rolled out. It is a disgrace that the Minister for Health and Children is not in the House tonight.

Deputy Fergus O’Dowd

I thank the Ceann Comhairle for allowing me to raise this matter. I refer to the Le Chéile Educate Together school at Mornington, the official address of which is County Louth, although the school is actually in County Meath. On a technical point, it is in Drogheda, County Meath. It is a very successful national school. The enrolment next year is expected to be 366. The school is seven years old, multi-denominational and doing extremely well. It has the support of parents from far and near. However, the school has no fixed buildings and consists of all prefabs. Children who are now seven years old will be leaving a primary school which has only prefabricated buildings.

A site is available and the teaching staff are excellent. Currently, the waiting list for next autumn has 183 applicants for 56 places on a first come basis and 197 children are already on the waiting list for the following year. This is a school in great need. The teaching staff have been very supportive of all the children.

It is not acceptable that a decision has not been reached on a design team for the school. The advertisement has been published in the EU Journal with a closing date of 13 February, three months ago but no progress has been reported. Is it a fact that the submissions lie unopened on the desk of the Minister for Education and Science and that the design team may never be appointed unless those envelopes are opened and the quotations are examined? A 16-classroom school has been agreed. Everything is working well for this school but they have no building. Those of us who have been teachers know that prefabricated classrooms are too hot in summer and too cold in winter. This is a most inefficient and ineffective way of running a school. These prefabricated classrooms have been rented for almost seven years and this is a waste of money.

The parents, teachers, students and principal want to know the current position regarding the appointment of the design team which should have been announced on 1 May. The former Minister for Education and Science, Deputy Mary Hanafin, visited the school recently so before she left her desk to go to the Department of Social and Family Affairs she knew exactly what was the situation regarding the school. The parents, teachers and the students are demanding action from the Minister of State tonight.

Deputy Seán Haughey

I thank the Deputy for raising this matter as it provides me with the opportunity to outline to the House the Government's strategy for capital investment in education projects and also to outline the current position in relation to the building project proposed for Le Chéile Educate Together national school, Mornington Road, Drogheda.

The modernisation of facilities in approximately 3,200 primary and 730 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 to 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 back in 1997 to almost €600 million this year. Under the lifetime 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.

As the Deputy may be aware, a developing areas unit was set up recently in the Department to focus on the school accommodation needs of rapidly developing areas. The main emphasis in 2008 is on providing sufficient school places in these developing areas, as well as delivering improvements in the quality of existing primary and post-primary school accommodation throughout the country.

The Le Chéile Educate Together project has advanced to the stage where the Department has agreed the schedule of accommodation for a new 16-classroom school. The site required for the new school has now been acquired and the process of appointing a design team has commenced. The Department published the advertisement seeking qualified consultants on the public procurement website in January 2008. These pre-qualification questionnaires have been received in the Department for assessment and the Department will be in contact with the school authorities on this matter as soon as possible.

Deputy Fergus O’Dowd

When will that be?

Deputy Seán Haughey

As soon as possible. In the interim period, pending the provision of a new school building, the Department has approved the rental of one further temporary classroom for this school for September 2008 to cater for its immediate accommodation needs. In addition, the Department also funded grant aid of approximately €394,000 for the provision of adequate car-parking facilities for this school. I thank the Deputy for raising this matter.

Schools Recognition.

Deputy Joan Burton

I am delighted to have the opportunity to raise the urgent need for the new Minister for Education and Science to recognise the proposed Educate Together school in Dublin 15. This school is supported by hundreds of parents as the school of choice for their children in the Carpenterstown and Luttrellstown area of Dublin 15. Many of these parents have experienced great frustration in getting a place for their children in a local school. The previous Minister for Education and Science, in a change from long-standing education policy, refused recognition for this school. I urge the new Minister for Education and Science, Deputy Batt O'Keeffe, to review as a matter of urgency the intense demand from parents for the recognition of their school. The former Minister for Education and Science refused the application because of her wish to pilot a new VEC-sponsored primary school in the area. The Minister chose to ignore the advice of the new schools advisory committee which recommended recognition of this Educate Together school.

There is a legally binding agreement between the Department of Education and Science and Educate Together, dating back to 12 July 2000, that the Department would retain a further reserved school site for Educate Together in return for the Castleknock Educate Together school agreeing, at the time, to move to a Department-owned site at Beechpark Avenue. Educate Together accepted this arrangement in good faith but expected to proceed in time with a further school in the Carpenterstown area to serve the huge population of children in the area along with other schools, such as a further local primary school, St. Patrick's, which is now open and will have close to 1,000 pupils quite soon. The Department of Education has planning permission for a 16-classroom school in the area in Porterstown. This is on a site which could easily accommodate two schools during the start-up phase as happened in Adamstown.

According to the Constitution, the Department of Education and Science must respect parental choice in respect of schools where this is expressed. There is no doubt that a sufficient number of parents in the area have chosen a multi-denominational Educate Together school for their children.

I understand that the appeal for the recognition of Carpenterstown Educate Together school will be heard shortly. The new Minister has an opportunity to gain an immense amount of goodwill from parents in the area. I believe that if he reviews the case for recognising Carpenterstown Educate Together school, he will concur with the recommendation of the new schools advisory committee and recognise the school.

Educate Together has an established 30-year record of facilitating parents who want multi-denominational education for their children, from all backgrounds, Irish and international. Educate Together, as with all other schools in Dublin 15, Catholic and Church of Ireland and Gaelscoileanna, take children from all backgrounds and from all nationalities. I note the Minister of State with responsibility for integration policy is present in the Chamber. I believe it is important that we have integrated education at primary level of all the children who live in Dublin 15. We do not want schools that are for international children only, as was the disastrous policy of the previous Minister for Education and Science. With many others I welcomed the announcement by the previous Minister that the VEC might be involved in primary education and would be established as a patron of primary education but that should not come at the expense of the right of Educate Together to continue as a patron of new primary schools. The ball is in the Minister's court. The previous Minister for Education and Science got it wrong. The consequences are that in Balbriggan and in Scoil Choilm there are schools where there are only international children. Educate Together has a proven track record of educating children together of all faiths and none and of children from all backgrounds, whether Irish or international. All our local traditional parish primary schools in Dublin West do that as well and do it superbly. The former Minister for Education and Science chose not to know the situation. There is an opportunity for the new Minister for Education and Science to open out to the parents, who are desperate for a school for their children. I urge the new Minister for Education and Science to avail of the opportunity to revisit the issue and grant recognition to this important school project.

Deputy Seán Haughey

I thank the Deputy for raising this matter and for giving me the opportunity to outline to the House the actions being taken by the Department to address the school accommodation needs of the Porterstown, Carpenterstown, Clonsilla areas of Dublin 15. The Minister is conscious that the Dublin 15 area as a whole is one of the most rapidly developing areas in the country and, as a result, there has been a marked increase in the demand for primary school places. The Department is taking a number of measures to increase the capacity of existing schools in the area concerned along with the development of new schools to meet this growing demand. All building projects arising from these interventions are awarded a band 1 priority rating under the Department's prioritisation criteria for large scale building projects to ensure they are delivered as expeditiously as possible.

With particular reference to the Porterstown, Carpenterstown, Clonsilla areas a number of interventions have been made to ensure adequate school provision. There are currently three schools that serve the area. St. Patrick's national school moved into a new 24 classroom school last year. This school facilitates an annual three stream intake. St. Mochta's national school was expanded in 2006 to cater for an annual four stream intake. An extension to cater for this development has been progressed to architectural planning. School planning section liaised closely with the local authority and the two schools serving the area and determined that up to an additional 90 children would require junior places for September 2007. In that context a further school, Scoil Choilm, was opened in Diswellstown, Dublin 15 under the temporary patronage of the Catholic Church in September 2007 and enrolled three streams of junior infants. The school is temporarily accommodated in the Institute of Horology, VEC owned building, in Blanchardstown. Transport has been made available given the age of the children involved. The school will be relocated to an off-site constructed school on a temporary 2.5 acre site on the Porterstown Road from September 2008.

In relation to the Carpenterstown Educate Together parents group that has been established, an application for recognition of a new school in Carpenterstown in September 2008 was received by the new schools advisory committee. The new schools advisory committee is an independent advisory group established to process applications for the recognition of new primary schools and to make recommendations to the Minister. In the course of assessing the application from Carpenterstown Educate Together, the new schools advisory committee took cognisance of all of the factors and were of the view that the proposed new school met the normal criteria for the recognition of new schools and made their recommendation to the Minister in this regard.

In recognising a new school, cognisance needs to be given to the demand on resources so that the State can ensure efficiency and equity in the allocation of constrained resources. In that context, given the significant additional levels of primary school provision made in the area in the past two to three years, the Minister was satisfied that sufficient provision had been made to serve the current and future population of the area in the medium term, and that appropriate diversity of provision has also been provided. On that basis, recognition was not granted to Educate Together project on this occasion and this does not preclude recognition of this school in the future.

Educate Together lodged a number of other notifications of intention to apply for the recognition of new schools for next September with the new schools advisory committee and 11 new Educate Together schools across the country have been granted provisional recognition from September 2008 including four new Educate Together schools in Dublin. I assure the Deputy that all options were considered to ensure that there are sufficient school places in September 2008. Based on the pre-enrolment data to hand, there will be surplus school places in the area in September 2008.

Due to the anticipated continuing level of demand for school places in the Dublin 15 area, the need to make further provision at primary level in addition to that outlined is being kept under continuous review by my Department. Any proposed new school not granted recognition is entitled to appeal this decision if it considers that the criteria and procedures for the recognition of new primary schools have been improperly or inappropriately applied in its case. I understand that an appeal, in the case of the proposed Carpenterstown Educate Together school, has recently been lodged and this will be considered shortly.

I thank the Deputy for allowing me the opportunity to outline the Department's position on school provision in this area.

Asylum Support Services.

Deputy Jimmy Deenihan

Tralee Refugee Support Services has been working with asylum seekers and refugees since 2001 when the drop-in centre was first established. The need for the drop-in centre was identified through research into the needs of asylum seekers carried out by Partnership Tralee in early 2001.

There are three direct provision accommodation centres in Tralee which are home to almost 300 asylum seekers. One third of this number is made up of families, two thirds are men, often referred to in the system as "single males", whereas in fact the majority have spouses and children in their home countries.

Asylum seekers have been living in Tralee for the past eight years and inevitably some have secured refugee status. There are no official statistics of the number of refugees in Tralee as the Department of Justice, Equality and Law Reform does not track people once they secure refugee status. However, because Tralee Refugee Support services has worked continuously with asylum seekers for the past seven years, based on its knowledge it estimates that there are about 70 refugee families living in Tralee. The centre also supports and provides services to those previously in the asylum system who got residency under the Irish born child scheme in 2005. There are about 70 to 80 families with IBC residency in Tralee. As the only immigrant support organisation in Tralee, the centre also provides services and support to migrant workers from both EU and non-EU countries.

In addition to three part-time and one full-time paid staff members, the centre also has at any one time a core of about 15 volunteers who assist on an ongoing basis with different aspects of the work the centre carries out. This is in addition to the eight management committee members. The centre also has occasional volunteers who help with events or specific projects.

Among its daily activities the centre provides an integrated information, advocacy and support service to asylum seekers, refugees and immigrants primarily in the greater Tralee area, but with referrals also being received from west and north Kerry. In 2007 alone it provided almost 5,000 one-to-one supports for 1,000 asylum seekers, refugees and other immigrants. This number has increased every year since the centre opened in 2001. In 2007, it had 69 different nationalities accessing the centre representing countries throughout Africa, Asia, Europe and South America.

Tralee Refugee Support Services operates a drop-in centre as a resource for asylum seekers, refugees and immigrants in the greater Tralee area. Education and training, particularly in English language, literacy and computer skills is a key resource it offers asylum seekers and refugees. It does so in co-operation with the Kerry education service and the education officer of Partnership Tralee. In 2007, it provided training in English, literacy and computers for 150 asylum seekers and refugees. With funding from the HSE south region, the centre operates a family support service for up to 30 asylum seeker families in the Johnston Marina direct provision accommodation centre. It continues to support families when they secure refugee status and helps with the transition from the asylum system to residency in the local community.

Some of the local and regional agencies with which the centre works closely include the HSE south region fostering, community work and social work departments, the local GP practice nurses association, Tralee citizen information service and Tralee homeless information centre.

The Tralee refugee support services centre has submitted its applications to the European Refugee Fund, ERF, and European Fund for the Integration of Third Country Nationals, EIF, in partnership with the Garda Síochána in the town. It has developed a strong working relationship with the Garda, which has been of mutual benefit to the immigrant community and Garda. The centre had hoped funding under the ERF and EIF would have enabled it to develop this work as a unique and innovative project with potential to be replicated nationally.

The Tralee refugee support service supports more than 1,000 immigrants annually, including asylum seekers, refugees, Irish-born child residents and migrant workers. Given that these vulnerable immigrants and their needs will not disappear, how will their needs be met if the centre is forced to close? The service has more than proved its worth over the past seven years, both with client groups and other local and national voluntary and statutory organisations. It now faces closure from next week after seven years unless the Minister intervenes.

I understand EIF funding was not provided to any project in the south west region. Why is this the case? The total amount of grants made available under the ERF and EIF does not appear to add up to the total amount allocated. Are there moneys outstanding? Is more money available from Europe? I welcome the Minister of State and I am pleased he has come to the House to respond to the issue I raise.

Minister of State at the Department of Justice, Equality and Law Reform (Deputy Conor Lenihan)

I thank the Deputy for raising this issue.Tralee refugee support services was allocated funding of €160,420 from the European Refugee Fund, amounting to 50% of a total project cost of €320,840, which was programmed for payment over the years 2006 and 2007.

The purpose of the European Refugee Fund is to support and encourage the efforts made by member states in receiving and bearing the consequences of receiving refugees and displaced persons by providing financing for measures relating to the conditions for reception and asylum procedures and the integration of persons whose stay is of a lasting and-or stable nature. The fund is a co-funding instrument, that is, applicants may apply for funding of up to 50% maximum of the total cost required for completion of a project. Applicants must be able to secure the balance of funding from matching funders, that is, other sources.

Support under the European Refugee Fund is linked to the specific purposes of the fund and the purpose of grants awarded under it is not to fund the ongoing operation of an organisation but rather to provide a level of co-financing to that organisation to undertake specific actions particular to this fund. Moneys from the European Refugee Fund are issued each year in a series of payments, subject to the application of the various detailed and complex rules of eligibility of expenditure issued by the European Commission.

On examination of the financial returns submitted in respect of 2006, Tralee refugee support services was found to be entitled to a reduced overall allocation of €61,890.78, of which the final instalment of €6,083 was paid to the group at the end of April this year. Any discrepancy between the grant awarded and the payments made from the fund arise due to the verification process required by the fund. Tralee refugee support services has also been paid a total of €64,168 in respect of 2007 in two instalments of €40,105 and €24,063 in March and October 2007, respectively. A final payment may be due when all the necessary documentation has been forwarded to my Department.

These payments are subject to verification and may be amended when the financial returns for 2007 are examined. Such an amendment may occur if the expenditure concerned does not comply with the various rules of eligibility of expenditure issued by the European Commission. The group concerned has not yet submitted final documentation in respect of expenditure for 2007. It has been engaged in ongoing discussions with officials of my Department who have visited this group on a number of occasions to assist it in the preparation of the necessary documentation. My office also extended the deadline for receipt of such documents to the close of business on 9 May 2008. I understand Tralee refugee support services has been in touch by telephone with my officials and has undertaken to forward all outstanding documentation early this week.

I am supportive of the role of voluntary bodies in providing services to refugees and asylum seekers. The relevant European Commission rules concerning the administration of the European Refugee Fund are applied to the maximum possible benefit of such organisations.

With regard to future funding from the European Refugee Fund and the European Fund for the Integration of Third Country Nationals, known as the European Integration Fund for short, which commenced this year, the position is that Pobal, on behalf of my office, sought applications for proposals for funding from the voluntary-NGO sector and partnership companies under each of these funds. The closing date for receipt of applications for funding was 25 January 2008.

Pobal has recently notified the various applicant bodies as to whether they have been successful in their applications. I understand in this regard that Tralee refugee support services was not successful in its applications to either fund. It is open to the group to appeal these decisions to Pobal and its appeals will be dealt with independently by different officials within that organisation.

It is likely there will be further calls for proposals in respect of these funds, which will be advertised later this year. This will allow Tralee refugee support services and other unsuccessful groups an opportunity to re-evaluate their proposals before submitting new applications.

I draw the attention of this House to the recent statement on integration strategy and diversity management entitled "Migration Nation" published by my office recently. This statement sets out my policy strategy over the next number of years and my commitment to achieving the provision of adequate funding streams for integration projects. In this regard, the new integration policy focuses on the role of local communities, local authorities, sporting bodies, faith-based groups and political parties in building integrated communities from the ground up.

The Dáil adjourned at 9.30 p.m. until 10.30 a.m. on Thursday, 15 May 2008.