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Dáil Éireann díospóireacht -
Thursday, 5 Jun 2008

Vol. 656 No. 3

Adjournment Debate.

Health Services.

I thank the Leas-Cheann Comhairle for selecting this matter for the Adjournment debate. I want the record of the House to show that the Minister for Health and Children, who was present for Question Time, has left the House. I thought she might at least show me the courtesy of staying to hear what I have to say.

In August 2006 the Health Service Executive, HSE, announced its plans to transfer inpatient surgery from Roscommon County Hospital to Portiuncula Hospital in Ballinasloe as an interim measure before its transfer to University College Hospital, Galway. In September that year the now Minister of State at the Department of the Environment, Heritage and Local Government, Deputy Michael Finneran, had the plan postponed until after the general election. On the eve of the general election the then Minister for Finance, Deputy Brian Cowen, told RTE on the steps of Roscommon County Hospital that the hospital would not be downgraded. The plan was shelved until February this year when it was resubmitted to the hospital network manager of the HSE and on 28 April the green light was given by Ms Ann Doherty of the National Hospitals Office. The decision was made to implement the transfer of inpatient surgery from Roscommon County Hospital to Portiuncula Hospital in Ballinasloe.

In April the HSE advertised for a consultant surgeon to fill Mr. Flynn's position in Portiuncula Hospital and three more posts for consultant surgeons will be advertised shortly. The appointments will be made between now and the end of the year and, if they are lucky, they hope to make all the appointments for the posts already advertised. Appointments will be made of five general surgeons with no particular speciality. The only appointment that needs to be made prior to the transfer of sources from Roscommon to Portiuncula is to fill Mr. Flynn's position. Once that is done the HSE insists it can implement the transfer of surgery from Roscommon County Hospital to Portiuncula Hospital within 12 months. The HSE was to give an outline of its plan to Roscommon County Council on 26 May but that meeting finished after less than an hour because the Government was to meet the National Hospitals Office on 28 May.

I do not understand why the second option, put forward by local consultants, has been rejected and why the HSE and the Government have not been prepared to outline their plans regarding the hospital. The Government has not issued a statement on the future of the hospital because if the news were positive local representatives of the Government would trip over each other to claim credit. It is important that the Government issues a statement as we do not want another agreement made behind closed doors. The Minister of State, Deputy Finneran, knows well what happened the last time. We want a clear statement on the floor of this House regarding the plans for inpatient surgery at Roscommon County Hospital. It is important that the Government and the HSE stop hiding behind closed doors. If the HSE and the Government are so confident that the downgrading plans are in the best interests of Roscommon County Hospital and the people who rely on it, why are they not prepared to talk to the media or engage in public debate either here in the House or at a meeting of Roscommon County Council? The HSE claims it is not a cost-cutting exercise but the reality is different. Not one additional bed will be provided in Portiuncula Hospital, Ballinasloe, which will see a doubling of inpatient surgery. In fact, there will be a reduction in capacity of two beds at Portiuncula Hospital. No additional day surgery will be carried out at Roscommon County Hospital and there will be no additional investment in the ambulance service in County Roscommon. The next stage is the removal of the accident and emergency department, initially to Portiuncula Hospital and subsequently to University College Hospital, Galway, in line with the Government's policy as stated in the Hanly report. This is already happening in Louth County Hospital; inpatient surgery was moved to Drogheda and now the accident and emergency department is to be transferred by the end of the year. That is being used as the blueprint for the downgrading of services at Roscommon County Hospital, as categorically stated by the hospital network manager for the western region.

It is vital that we are given a clear and unambiguous statement on the future of inpatient surgery at Roscommon County Hospital, the retention of acute medical services and the accident and emergency department. I ask the Minister of State to tell us whether the green light has now been given to the HSE to proceed with the transfer of inpatient surgery services from Roscommon to Portiuncula and when that decision was made. Has the Government taken any action on this to date? Why have no additional resources been put in place for emergency acute medical services in Roscommon?

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

The Government is committed to ensuring the delivery of the best quality health services possible and to doing so effectively and efficiently. Ensuring patient safety is of paramount importance so that people can have confidence in the service and the best possible patient outcomes can be achieved.

The Health Information and Quality Authority was established on a statutory basis in 2007 and is responsible for driving quality and safety in the health and social care services. In 2007 a new Medical Practitioners Act — the first major overhaul in 30 years of the law regulating the medical profession — was enacted. Also in 2007, the Minister for Health and Children established the Commission on Patient Safety and Quality Assurance to develop proposals for a service-wide system of governance based on corporate accountability for the quality and safety of all health services. In this context it is essential that every health care provider and facility is fully cognisant of patient safety and quality issues and takes account of these in the organisation, management and delivery of services. The priority is to provide safe services as close as possible to where people live.

The HSE has conducted a review of surgical and anaesthetic services at Roscommon County Hospital and Portiuncula Hospital, Ballinasloe. The difficulties faced by Roscommon and Portiuncula in maintaining surgical services independently, and the need for closer co-operation between them, was highlighted by the former Comhairle na nOspidéal in March 2006. The best way of retaining and developing services at Roscommon and Portiuncula hospitals is for both hospitals to work together. In the past, these two hospitals operated independently, with two consultant general surgeons in each hospital. Advances in clinical care and ever-increasing levels of specialisation mean this model of care is no longer sustainable. Small stand-alone hospital services will not be able to offer their doctors the opportunity to treat a sufficient volume and variety of patients to maintain their skills. Nor will they be able to provide the range of experience required for training new doctors. As a result, it will prove increasingly difficult, and perhaps impossible, to fill consultant posts on a permanent basis.

The development of joint departments of surgery and anaesthesia will provide a better service for patients of both hospitals. The plan is to combine the staffing and workload of the existing small service units in Roscommon County Hospital and Portiuncula Hospital into joint departments of surgery and anaesthesia serving both hospitals. This will involve joint consultant surgical and anaesthetic posts. While the more complex surgical cases will be treated in Portiuncula, this represents only about three cases per week on average. Roscommon Hospital will continue to provide surgical services for the rest of its patients. It is likely that more Roscommon patients than heretofore will be able to have surgery performed at the hospital because most surgery can be carried out on a day basis, which is also more convenient for patients.

Does that mean in-patient surgery is gone?

The HSE has advised that there is no proposal arising from this review to close the accident and emergency department at Roscommon County Hospital.

I have endeavoured during my reply to stress the terms "patient safety" and "quality of care". The Deputy did not address that in his speech, but it is important that he take this into account——

The Minister of State obviously did not listen to what I said.

I was listening to the Deputy.

A second option was put on the table.

I did not hear much from the Deputy about quality and safety, which are important issues.

The Minister for Health and Children did not think it worth her while to stay and listen to what I had to say.

Private Transport Operators.

I want to talk today about the Patton Flyer, which is the magic bus of the 21st century. The Minister may be old enough to remember the song of that name released by The Who back in 1968. It is an excellent bus service that carries passengers from Dalkey, Glasthule, Dún Laoghaire and Monkstown to and from Dublin Airport. The people of these areas want to see the service retained. I put this in the context of the Department of Transport's development of a sustainable transport and travel action plan, one of the purposes of which is to encourage people to use buses more. This bus serves areas that have no alternative bus or rail links to the airport. It is a punctual, well operated service that is invaluable to residents. I used the service on the one occasion I went to Dublin Airport in the past year, but many of my constituents use it on a regular basis, not just to catch flights but because they work at Dublin Airport and want to get there without driving.

The bus uses the port tunnel and serves the county town of Dún Laoghaire, which has no other service to the airport. There is the Aircoach service that goes from Greystones to the airport via Bray, Shankill, Blackrock, Booterstown and Sandymount, but the Patton Flyer is the only service that connects Dalkey, Glasthule, Dún Laoghaire and Monkstown with Dublin Airport. Dublin Bus runs the 4A service, but this starts at Blackrock and goes to Harristown bus depot, which is adjacent to the main runway at the airport but is miles from the departure building.

Dún Laoghaire has a population of 26,000, which is not far off the population of Leitrim at 29,000. Imagine if we were to cut Leitrim off from all bus services. The lack of services to Dún Laoghaire has the same effect of making it difficult for people to travel. The problem here is the licensing procedure. Operators must wait months for a licence to be issued and if it is refused they are in contravention of the legislation. I note that the Department of Transport has referred the matter to the Garda for non-compliance with the legislation, and the matter now rests with the Garda. It is a strange that a bus operator who provides a much-needed service is deemed to be operating illegally. This is at a time when we are trying to encourage more people to use buses and public transport to achieve sustainable travel. We are making it extremely difficult for people to provide these services even though they have taken a considerable business risk.

I note that there is another private bus operator in the north Dublin area who had to wait two and a half years for a decision on a licence application. The root cause of this is the outdated 1932 Road Transport Act under which licences are issued. Under that Act, which dates from more than three quarters of a century ago, an operator can be fined the heady sum of £50 for running an unlicensed service, plus £5 per day for repeat offences. This equates to €7.50 per day. This legislation must be modernised.

I carry no brief for Dublin Bus, Aircoach or the Patton Flyer. Today is not the time to argue about the merits of public and private bus services. However, I do carry a mandate from the people of Dún Laoghaire. They want a service to the airport that is efficient and reliable and that does the job. Dublin Bus does a good job and has risen to the challenge of providing new routes in certain areas, but the private sector has provided some excellent new services and deserves support where it is innovative and responds to travellers' needs. Let us modernise the legislation, speed up the processing of applications and have a clear and transparent system. Let us reform the antiquated legislation and continue to provide a necessary service via the Patton Flyer to the people of Dalkey, Glasthule, Dún Laoghaire and Monkstown.

I thank the Deputy for proposing this Adjournment matter, which I take on behalf of my colleague, the Minister for Transport, Deputy Dempsey.

The Road Transport Act 1932, as amended, provides the statutory basis for regulating the provision of public bus services by private bus operators. In accordance with the legislation, private bus operators apply to the Department of Transport for licences to operate scheduled bus passenger services within the State. Section 11 of the Act establishes specific criteria for the determination of applications, which provide that the service is required in the public interest having regard to the passenger road services and other forms of passenger transport available to the public on or in the neighbourhood of the route of the proposed service, whether the service is sufficient in terms of frequency and duration to meet the requirements of the public and whether the applicant has the organisation and equipment necessary to carry out the service.

There are no undue delays with the processing of either licence applications from private operators or notifications from State companies. The Department turns around straightforward applications within a matter of weeks. However, where there are prior applications for licences from other private operators or notifications from State companies, a decision on an application must be deferred until such time as the prior applications have been decided. In these cases, while the preliminary work may have been completed on a particular application, a final decision cannot be made until other relevant applications or notifications received prior to it have been finalised. In other cases, the application process can be delayed where relevant information is not provided by an applicant, such as an updated road passenger transport operator's licence, current public service vehicle licences and approvals from the Garda under the Road Traffic Acts for pick-up and-or set-down points. All applications and notifications are assessed by the Department on receipt and decisions made as to whether they can be issued promptly or deferred for the reasons mentioned above. Applicants are advised accordingly.

On 20 February 2007, the Department received an application from the operator concerned for a licence to operate bus passenger services between Dalkey and Dublin Airport. At that time, the Department advised the applicant that the application was being held until such time as a decision on a prior application for services on a similar route from another private operator had been determined. The prior application has been finalised and the licence issued to Aircoach for the provision of bus passenger services between Greystones and Dublin Airport. The licensed service also caters for passengers travelling from the areas of Bray and Blackrock and is meeting the needs of passengers by providing an express service via the port tunnel to Dublin Airport.

It does not meet the needs of the people of Dún Laoghaire, Dalkey or Monkstown.

I will bring that matter to the attention of the Minister.

Go raibh maith agat.

The Department understands from the licence holder that the service has been introduced and the frequency shall be increased in the coming months.

On 16 July 2007, the Department was made aware that the operator concerned had commenced the operation of an unlicensed bus passenger service between Dalkey and Dublin Airport. The Department immediately contacted the company and advised that failure to cease the operation of a service in respect of which a licence had not been issued under the Road Transport Act 1932 is an offence under section 7 of that Act. It is also a prerequisite to the issuing of a licence that, in accordance with road traffic legislation and safety, the applicant provides the Department with Garda approvals for all proposed bus stops along the route. No bus stop approvals have been received by the Department for any of the stops being utilised on the service in question. As the unauthorised service continued to operate, the Department advised the company that the matter was being passed to the Garda Síochána for its investigation. This matter is currently the subject of an ongoing Garda investigation. I assure the Deputy that I will raise the matter of transport in Dún Laoghaire with the Minister.

I am much obliged.

Water Pollution.

This matter relates to an April 2007 incident of phenol-contaminated drinking water in five group schemes in counties Cavan and Monaghan. It was discovered following complaints by consumers of private water supply schemes about a bad taste and odour. The water was contaminated with phenol by an aluminium chloride product that, according to a HSE report, "was not recommended for use in the treatment of drinking water and was suitable only for waste water treatment". Of the nine group schemes to which such a product was supplied, five were found to have been contaminated.

I welcome the HSE's findings. As phenol is unpalatable at low levels, the HSE found that consumption of water in harmful quantities was unlikely. I commend the work of the HSE and Cavan and Monaghan county councils in response to the incident and in drafting their reports. Cavan County Council pointed out that, had it not been for the unpalatable nature of the phenol, "the health of a large number of consumers could have been compromised". The HSE and the councils found that the water was unfit for human consumption.

This type of incident could recur, although the contaminant might not be as unpalatable as phenol — even phenol carries health risks. There could be a detrimental impact on human health. According to the HSE, greater priority must be given to protection of the consumer. We must ensure that we avoid such incidents in future and that the local authorities and the HSE are empowered and armed to deal with them as efficiently as possible. Much work has been done in respect of private group water schemes under the design, build and operation programme, but safeguards must be put in place. The schemes are private and, while they are monitored by local authorities, there is no Government oversight.

Much work has been invested in the reports, a number of the recommendations in which require Government action, particularly by the Minister for the Environment, Heritage and Local Government. Legislation must be introduced and the councils and the HSE must be properly staffed and resourced if we are to ensure good quality drinking water. The HSE recommends that a national agency, such as the Environmental Protection Agency, should be empowered to actively oversee the management of chemical incidents, particularly where more than one local authority is involved. This would require Government action. Monaghan County Council recommends that the EU drinking water regulations be amended to require the immediate notification of the supervising authorities and-or the HSE by contractors or operators of water schemes in the event of a water quality incident that could affect human health. Both councils identified a problem in assessing suitably accredited laboratories in Ireland and the UK to appropriately test samples. Cavan County Council recommends that there be a central laboratory. All the reports identify and highlight the need for stronger standards regarding the procurement and use of chemicals intended for use in the treatment of drinking water. There are also the difficulties presented by the staff recruitment embargo imposed by the Government. That was highlighted in the Monaghan County Council report which recommended a review of staffing levels to determine what additional resources are needed by local authority water services departments to deal with their day to day duties as well as with this type of incident. All reports identify the need for stronger powers to seize and retain evidence.

The report from Monaghan County Council pointed out that the exact nature and cause of the coagulant contamination remain to be established. The Government must monitor this. It is important that the report's recommendations are acted upon by the Minister and his Department. There are lessons to be learned from the work carried out by the three authorities concerned.

Will the Minister for the Environment, Heritage and Local Government, or the Minister of State meet the HSE and the two county councils? Will action be taken to bring in the necessary legislation? Will the water services departments gain more staff?

I thank Deputy Tuffy for raising this on the Adjournment. I am pleased to be able to update the House regarding developments in this case.

Separate investigations into this incident, which involved five group water scheme supplies, serving about 1,700 households in Cavan and Monaghan, have been carried out by the respective county councils and by the Health Service Executive. The reports have just become available and were published by all three bodies last Friday. These reports are comprehensive and outline the background to the incident and the actions taken by each of the parties thereafter. They highlight issues identified by the investigations and include a number of recommendations.

The contamination of these supplies came to light over the period 30 March to 5 April 2007 when consumers registered complaints about taste and odour in their drinking water. The schemes were part of a collection of ten treatment plants in Cavan and Monaghan that serve 3,500 households. The source of the problem has been identified as a contaminated batch of poly aluminium chloride, a coagulant used in the water treatment process, which was supplied to the contractor operating the affected treatment plants.

When the problem was identified, the coagulant was immediately replaced by the contractor through a new supplier, and, as a precautionary measure, was replaced across all ten schemes in the project bundle. A "Do Not Use" notice, under Section 9 of the Drinking Water Regulations 2007, was issued on 19 April 2007 to all affected group water scheme users by Cavan and Monaghan County Councils, in consultation with the Health Service Executive.

An incident management team which included representatives of all interested parties was set up immediately and remained in place until the warning notice was withdrawn. During this period arrangements were made to provide householders in all the affected schemes with an alternative supply of drinking water.

This was a regrettable incident that caused great worry and inconvenience to all consumers concerned. On a positive note, it is clear that the public authorities responsible quickly took charge of the situation and, with the co-operation of the contractor, identified the problem, made alternative arrangements to get drinking water to consumers and ensured that the treatment plants were brought back into operation as quickly as possible. I note also that the HSE report has confirmed that the threat to human health was minimised by the low odour and the taste threshold of the phenol contaminant. The expert advice is that the water would have been too unpalatable for consumption to have reached harmful levels.

The HSE has also confirmed that no symptoms or illnesses relating to drinking water were reported and that media reports of mouth irritation and nausea were not noted by or presented to HSE staff. Neither were unusual patterns of illness or symptoms reported by general practitioners in any of the affected areas.

In Ireland there are more than 6,500 public and group water scheme supplies and incidents of this kind are very rare. Nevertheless, all possible measures must be taken to prevent a recurrence. The local authority and HSE reports are being examined in my Department and the recommendations will be given early and careful consideration to ensure that all steps required will be taken to guarantee safe and secure water supplies.

Construction Industry Regulations.

I thank Deputy Finneran for taking the Adjournment debate. I would obviously prefer to have the Minister for the Environment, Heritage and Local Government, Deputy Gormley, in the House to address the matter.

For almost a year, I have been asking the Minister, Deputy Gormley, to take command of a major investigation and process of remediation and compensation for residential and infrastructural projects which have been badly damaged by defective infill materials with too high a concentration of the mineral pyrite. A few weeks after the Government came to office, I first learned of the distress of householders in the Drynam Hall estate in Kinsealy where floors, walls and ceilings were cracking. A circular on the problem had been sent around by the Drynam Hall developers, Mennolly Homes.

A few months later I was informed that the problem also existed in The Coast and Clongriffin developments in the huge new north-fringe urban region in my constituency. Other reports located the pyrite problem in the vast Castlecurragh estate in west Dublin and indicated that a significant number of developers had contacted the suppliers, Homebond, regarding their fears about the matter. Lately, I have heard allegations from the construction industry that at least 60,000 residential units built during 2001-2002 may be infected by the disastrous pyrite infill. Equally alarmingly, there are continuing allegations that a number of large infrastructural developments, including urban regeneration projects, are contaminated by pyrites.

Pyrites is an iron sulphide popularly known as "fool's gold". It reacts with oxygen and water to form sulphuric acid and expands with devastating consequences for buildings if exposed to air or water.

This unfolding crisis is exacerbated by the serious downturn in the construction industry. In the middle of it all stands the Minister, Deputy John Gormley, who has washed his hands of any responsibility for the disaster. It was his Department, however, that permitted complete self-regulation of building standards in the construction industry. In earlier replies the Minister has referred me to a pathetic circular on building standards which he sent out to the local authorities last autumn. It requests them to implement the Building Control Act 1990 and consult the National Standards Authority of Ireland amendment to SR 21 on building aggregates. The Minister, Deputy Gormley, has shirked his responsibility to thousands of householders, perhaps tens of thousands, who have entered negative equity by his failure to act. In more general terms, he has failed the State because of possible damage to very costly infrastructural developments.

Why has the Minister not yet ordered a full traceability audit of the 2 million tonnes or so of infill from the affected quarry owned by the Irish Asphalt division of the Lagan Group? Only 100,000 tonnes, or 5%, of this aggregate has been accounted for so far, in terms of location. Is the Minister terrified of the possible results of a thorough investigation of the Lagan Group's operations at this quarry? Can he confirm if the quarry is still open? Why has he not directed Fingal County Manager, Mr. David O'Connor, to close the facility immediately? Why has the Minister not ordered a thorough investigation of the other quarries in Leinster that are also allegedly damaged by high pyrite concentrations? Why has he not examined the wider operations of the Lagan Group and similar suppliers of quarry concentrates?

Young householders were left to fend for themselves while a company called Killoe Developments failed to respond to their desperate anxieties about their mortgage investments. Why did the Minister stand helplessly on the sidelines?

The pyrites infill disaster is not the first infill calamity of its kind in the world. The Minister might have followed the example of the Mennolly Homes developers and looked to the experience of the Canadian provinces of Ontario and Quebec with regard to this problem. Yet the Minister, Deputy Gormley, has consistently refused to establish a national pyrite investigation and monitoring agency along the lines of the Quebecois example or even to issue an information document for the benefit of homeowners and consumers such as the Canadian document "Pyrite and Your Home".

Why will the Minister, Deputy Gormley, not immediately implement a protocol for compulsory chemical analysis of all construction infill? Why has the Minister not asked the Taoiseach and the Cabinet to consider appropriate compensation mechanisms for affected householders and public bodies? Even at this late stage, will the Minister call on the Dublin City Manager, Mr. John Tierney, and Fingal County Manager, Mr. David O'Connor, and establish a task force to investigate and address all aspects of this appalling affair? Is the Minister, Deputy Gormley, aware that UK media outlets are inquiring if the Lagan Group is considering off-loading and selling quarries in the State and in the North? The Irish media is running scared of this important story.

The Minister, Deputy Gormley's response to this shocking development during the construction boom of the Celtic tiger is completely unacceptable and must change immediately. I am deeply disappointed that a Green Party colleague from the first rainbow coalition on Dublin City Council, which I led, should be so lethargic and uncaring to perhaps tens of thousands of our fellow citizens unwittingly caught up in this disaster. If the full dimensions of the pyrites infill problem turn out to be as feared and alleged by sources in the construction sector, the Minister, Deputy Gormley's days in the Department are surely numbered and the local authorities and the State will be left with a possible liability of tens of billions of euro.

I take this matter, which was discussed on several previous occasions, on behalf of my colleague, the Minister for the Environment, Heritage and Local Government, Deputy John Gormley.

The difficulties being experienced by homeowners whose homes have been affected by the use of pyrite in certain developments in and around County Dublin are fully recognised. However, the resolution of problems arising between building owners, including owners of public buildings, as well as home owners and the builders are matters for resolution between the parties concerned, namely, the building owner, the relevant developer and the builder's insurer. Where the construction of a building is the subject of a contract between the client and the builder, enforcement is a civil matter.

I wish to report on certain developments and actions since the matter of pyrite was first raised. As a first step, Fingal County Council, the building control authority for the area, made direct contact with the developers and the quarry concerned regarding problems encountered following the use of pyrite as an under-floor infill material in certain developments.

Having consulted the statutory Building Regulations Advisory Body, the Department issued a circular letter, BC 6/2007, to each county manager and local building control authority on 16 August 2007 to bring the issue of pyrite to their notice and to request co-operation in the enforcement of the relevant requirements set out therein. The circular also brought to their attention a notice issued by Fingal County Council on 26 July 2007 on this matter.

The certification of products is the responsibility of the National Standards Authority of Ireland, NSAI. When the issue of pyrite arose and following an intervention from the Department, the National Standards Authority of Ireland moved to reconvene its aggregates panel to give urgent consideration to the matter. The Department is represented on this panel, together with representatives and stakeholders of the construction industry.

Following a public consultation process, the NSAI has now published a new amended standard recommendation on the use of aggregates as infill for civil engineering and road construction work. The new standard recommendation came into effect on 7 December 2007 and the intention is that it will address the quality standards of new homes and buildings in so far as problems relating to pyrite are concerned. My Department will adopt this NSAI standard recommendation in the relevant technical guidance document associated with the building regulations. The NSAI has notified the EU Commission of this intention in accordance with statutory requirements and EU approval is currently awaited to the proposal. I am satisfied that the measures outlined represent the appropriate response to the issues raised.

The Dáil adjourned at 3.05 p.m. until 2.30 p.m. on Tuesday, 17 June 2008.
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