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Dáil Éireann díospóireacht -
Tuesday, 19 May 2009

Vol. 682 No. 5

Adjournment Debate.

Hospital Services.

I welcome the opportunity to speak on the closure of wards at Our Lady's Hospital for Sick Children, Crumlin. The decision to close the wards is totally misguided. The only outcome of the decision will be unnecessary pain and suffering for children, who will be put on the waiting list, and incredible stress for their parents. I am sure the Minister of State, like all other Members, has received the e-mails on this issue. If these e-mails are anything by which to judge, there is a huge level of anger and frustration. In my experience it is matched only by the reaction to the removal of the medical card from people over 70. There is huge annoyance at this decision on the part of parents not just in Dublin — as Our Lady's Hospital for Sick Children is in my constituency I have a particular interest in it — but throughout the country, as the e-mails have made clear.

Closing the wards and reducing front line services make no sense. Over the past few years significant amounts of money have been invested in the hospital and various aspects of its service have been upgraded. What sense or logic is there in closing wards after recently investing substantially in the hospital? The consequence of closing the wards is that the sick children will either be forced into overcrowded wards or put on an extended waiting list, each of which is extremely unsatisfactory and most unfair.

The decision is yet another example of the right hand of the HSE not knowing what the left hand is doing. The HSE will probably argue that critically ill children will get the service and treatment they require. That is most welcome and one would hope nothing other than that would happen. However, it is not good enough for the small children and patients who suffer from illnesses such as scoliosis. I am sure all Members will have received e-mails on that issue as well. It is heart-rending to hear of the impact on and consequences for children if treatment is not put in place in a timely manner. Saying that critically ill children will get the treatment they need is another way of saying that many children who are ill will not get the treatment they require.

Everybody accepts that the HSE is facing serious budgetary problems but it is most inappropriate that the front line services being challenged are the ones that affect children. This should really be the last resort and not the first option, as it appears to be. The revelation today that the HSE spent almost €17 million on spin doctors and management consultants last year indicates that maintaining front line services falls well down on the list of priorities when allocating resources. The spend on public relations is totally unacceptable, particularly in the current climate and against a background of the closure of wards for the provision of services for sick children.

The details supplied by parents about the effects of the closure on their children are graphic and, in many cases, are clearly causing them huge distress. The fear factor alone is enough to prompt them to contact every Deputy to have the decision reversed. The loss of the service to the children is clearly the priority but there is also concern in my constituency about the secondary effect of job losses. This is also important, and people are very concerned about that risk. I urge the Minister for Health and Children to engage with Professor Drumm and the management of Our Lady's Hospital for Sick Children, Crumlin, to reverse the decision. I will not list the possible areas where savings could be made, as there are many and it is not important now that these are identified. What is important is that the decision to close the wards is reversed straight away. The hospital must be given the go-ahead to reopen these wards and to provide for the sick children of this country.

I am replying on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. Hospital care for children is provided in Dublin at three hospitals: Our Lady's Hospital for Sick Children, Crumlin; Temple Street Children's University Hospital and the National Children's Hospital, Tallaght. Between the three, funding of over €250 million is provided for a national service for sick children.

The way to provide the best possible tertiary care most cost effectively involves the creation of one single national paediatric hospital, alongside a major teaching hospital, bringing together all the medical and nursing expertise for complex conditions. The concept of bringing together all three existing services is widely accepted. It is, therefore, entirely appropriate that we should now move towards that model of care in terms of closer integration and co-operation in the medical areas and in the most cost-effective use of resources. The Minister understands that significant cost savings are achievable if services and practices are more closely integrated, even before the building of a new paediatric hospital has been completed. For these reasons, to focus on each of these three hospitals providing paediatric services one by one, in isolation from the other two, will miss the full picture of paediatric services and the full potential for the level of services that could be provided within the resources being made available by taxpayers.

The facts relating to the budget for Our Lady's Hospital for Sick Children are as follows. The 2009 allocation to the hospital is €139.6 million. The allocation has increased by over €38 million or 39% since 2004. In line with budgetary constraints across the system, the 2009 allocation is 3% below the 2008 allocation of €143.8 million. The employment ceiling at the hospital is 1,550. At the end of March the HSE reports that the hospital employed 1,650 whole time equivalents, WTEs, which is 100 above its employment ceiling, and therefore contributing to the current financial difficulties.

In terms of activity, in the first three months of this year there were 2,745 treatments for children as inpatients and 3,841 treatments as day cases at the hospital. This represents an increase of 244 over the same period in 2008. There were also 21,252 attendances in the outpatients' department, an increase of 1,041 over the same period last year. The HSE has advised that, based on the financial performance for the first quarter of 2009, the hospital should achieve a break even position at year end. This assessment takes account of cost saving measures totalling €6.5 million which have been agreed with the hospital and which are to be implemented over the remainder of the year. Much of the focus of the discussions between hospital management and the HSE has been on ensuring that all areas of non-pay expenditure are critically examined and that costs are reduced where possible.

It has proven necessary for Our Lady's Hospital for Sick Children, Crumlin, to take measures to stay within budget, including the closure of a theatre and a ward from this month. However, the hospital has confirmed that it is committed to delivering on the full level of its service plan commitments for 2009.

The funding and provision of the best standard of complex hospital care for children will continue to be a priority for the Government. Hospitals can work more effectively together, and hospitals will deliver a sustainable and constantly improving service for children by managing costs so that they stay within budget. Our strategic plan to integrate services at one new hospital is most important to achieve best outcomes for children.

Sports Capital Programme.

I thank the Ceann Comhairle for affording me time to discuss this important matter, namely, the need for the Minister for Arts, Sport and Tourism to explain why application forms for funding under the national lottery sports grants programme for 2009 have not yet been made available to clubs and when he envisages grants being paid. I am asking not only when the grants will be paid, but if it will be in the foreseeable future. There is major concern throughout the country about the delay in issuing application forms and awarding funding.

I first submitted this matter for debate on 23 March and have submitted it each week since then. It has finally been selected for debate two months later. I wonder why it has been sidelined for so long. I am from a strong sporting family and many members of my family have been associated with the GAA and, indeed, other sports over the years. Like county groups throughout the country, Longford-Westmeath sporting organisations have made numerous representations to me about sports grants for 2009.

Although we are faced with tight budgetary constraints, national lottery funding is separate from budgetary allocation and, as such, should not be radically affected. While spending on lottery tickets may be reduced as a consequence of the economic downturn, considerable moneys will nevertheless continue to be generated. If some of this fund is not allocated to sport, will the Minister explain how it is being allocated? If the national lottery money previously earmarked for sporting organisations is not to be disbursed to those groups, we can only assume it will be lost in another bottomless pit by a Government that has failed the people.

The apparent complete abandonment of sports capital funding represents a major blow to the sporting clubs and associations that play a valuable role in their communities. This is a crying shame. Sport is the bedrock of every community in every country. It binds together local groups and provides an outlet for young people who might otherwise be drawn into drugs, crime and associated activities. An issue of particular concern is the uncertainty regarding the continuation of Government funding for GAA inter-county players. The Gaelic Players Association has indicated its members are prepared to take a cut in funding in line with other sports as a consequence of the current economic crisis. The protection of this funding is critical to the future of the GAA as it affords parity with other elite athletics. This is extremely important for those engaged in our national games.

Numerous parliamentary questions have been tabled to the Minister recently on the question of funding for sports. Sports clubs and organisations are falling victim to a passing of the ball between the Department of Arts, Sport and Tourism and the Department of Finance. In these times of economic recession and job losses, it is more important than ever that public morale is lifted by sporting endeavours. I take this opportunity to congratulate Shane Lowry on his fine achievement in winning the Irish Open at Baltray last weekend. I am familiar with that golf course and the area in which it is located because I knew the former manager well.

I hope the Minister of State, Deputy Áine Brady, will have good news for us today. I received a telephone call only today from my own parish club, which is in great need of funding. At least 23 clubs throughout County Longford are awaiting an allocation from the national lottery fund. A similar number in County Westmeath are crying out for support. Will the Minister of State indicate when this funding will be delivered?

I thank the Deputy for raising this issue, which I am taking on behalf of my colleague, the Minister for Arts, Sport and Tourism, Deputy Cullen. Given the benefits associated with sporting activities, the Government regards expenditure on sport as important for the social and economic development of the State. These benefits arise in a broad range of areas, including health and well-being, social and cultural development, education, personal development, tourism and the economy. Irish sporting successes lift the spirits of the nation and improve our image on the international stage.

The sports capital programme, which is part funded from the proceeds of the national lottery, is the primary means of granting Government support for the provision of sports facilities at national, regional and local level. It is, however, a common misunderstanding that the proceeds of the lottery come directly to the Department. Rather, they are delivered to the Exchequer. Under the sports capital programme, the Department provides funding to voluntary, sporting and community organisations for the provision of sports and recreational facilities. More than 7,400 projects have benefited from such funding since 1998, bringing the total allocation in that time to more than €725 million. In 2008, more than €50 million was allocated to 685 separate sports facility and equipment projects. The programme has, in the past ten years, transformed the sporting landscape of the State, with improvements in the quality and quantity of sporting facilities in virtually every village, town and city. The facilities funded range from the smallest clubs to national centres of sporting excellence.

The aims and objectives of the programme are to foster an integrated and planned approach to the development of sports and physical recreation facilities throughout the State; to assist voluntary and community organisations to develop high-quality, safe, well-designed, accessible and sustainable facilities in appropriate locations in order to maximise participation in sport and physical recreation; to prioritise the needs of disadvantaged areas in the provision of sports facilities; and to encourage the multi-purpose use of local, regional and national sports facilities by clubs, community organisations and national governing bodies of sport.

The programme has supported the provision or improvement of landmark national and regional stadia such as Thomond Park, home to twice European rugby champions, Munster, and Semple Stadium, the home of hurling for many. Such facilities provide a platform for our most talented athletes to perform, which in turn inspires new generations of young people to aspire to match the sporting prowess of their heroes. They are also an important support to our tourism industry as they draw visitors from Britain, Europe and further afield who come to Ireland to see their teams in action.

All Members are aware of the many benefits that derive from the programme in their localities. They have no doubt witnessed the value of the programme in assisting local clubs in meeting the sporting needs of their areas. In recent years, the programme has targeted clubs in areas of social disadvantage. In this way, the Government is supporting the provision of facilities where there may be little prospect of such facilities being provided by the communities acting alone. These facilities provide an opportunity for participation in sport which leads to healthier lifestyles and a reduced likelihood of younger people drifting into anti-social behaviour.

It is prudent, however, to pause and take stock on occasion, regardless of the merits of any programme. It is essential to review areas of expenditure to determine whether particular schemes represent the optimal use of the resources available. Accordingly, no decision has yet been made about the timing of further rounds of the sports capital programme. My Department is currently finalising a five-year strategic plan to inform the future development of necessary sporting facilities throughout the State. The aim of the strategy is to provide high-level policy direction for future investment and grant assistance at national, regional and local level. It is intended to identify the requirement for sports facilities in order that participation at reasonable cost is feasible for those who wish to engage in sport, at either amateur or elite level. It aims to prioritise areas for future investment and to ensure continued improvements in the relevant areas.

In the interim, it is business as usual for those that were allocated grants under previous rounds of the programme. There is no question of rowing back on allocations already made. The current position remains that €56 million has been provided in the Department's Vote in the 2009 Estimates to cover payments to be made from the Cl subhead, out of which grants are paid for the provision of sports and recreation facilities. While we are in difficult times, we must also recognise that more than 1,000 payments will be made to projects being undertaken this year throughout the State. These projects will allow clubs to drain pitches, erect flood lighting, build changing rooms and sports halls and generally increase the opportunities for people to engage in sports at all levels.

As I have said, no decision has been taken on the timing of the next round of the programme. I am taking this opportunity to ensure sporting facilities are fairly balanced in each region of the State. A national audit of sports facilities is currently being finalised. The results of this audit will inform a more strategic approach over the next five years, as we decide how to use the sports capital programme to continue to benefit all areas. As more than 7,400 projects have been already funded under the programme, it is fair to say it has been a great success. Now we must take a step back and consider the recommendations of the national sports facilities strategy and the results of the audit. We must refocus and ensure we continue to invest our scarce resources as effectively as possible in order to meet the dual objectives of increasing participation and improving performance.

With respect to the Minister of State, the Minister, Deputy Cullen, has given us nothing but a load of fudge.

The Deputy should allow Deputy Sheahan to speak.

The Minister has squandered public moneys once again, as he did with the e-voting machines.

I ask Deputy Bannon to give way to Deputy Sheahan.

There must be funding for these vital projects throughout the State.

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