Adjournment Debate.

Medical Cards.

Deputy Joe Costello

I am delighted to have the opportunity to raise this very important issue. I am asking the Minister for Health and Children to establish an all-party Oireachtas committee to review the background to the decision to centralise medical card applications and renewals. I do not call for that lightly; I do so because the system is simply not working. That is the experience I have had with my constituents and I hear anecdotally that most of my colleagues have the same experience.

We need to review carefully how and why the decision was made, how the system is operating and what we can do to resolve the matter. Since the system has been centralised there seems to have been a sharp increase in the length of time it is taking for people applying for medical cards to have their applications processed. The centralisation has also caused confusion and unnecessary hardship to many who are applying. Nearly a year ago a unilateral decision was made to centralise all medical card applications and renewals. All medical card applications and renewals are now being processed by the primary care reimbursement service, PCRS. The PCRS was not designed for this purpose and has been forced to try to cope with the extra and unfamiliar workload. The medical card system was previously based around the local health care providers who made decisions on a case-by-case basis. This system was effective because those who were making decisions had a personal knowledge of the applicants and their needs. The new centralised system does not have this advantage and this could mean that people who are in need of medical cards may not receive them or may receive them only after a long waiting period.

Centralisation has caused chaos to the medical cards applications and renewals process. The PCRS was not set up to deal with medical cards and has struggled to cope with the influx of applications. Some 10,000 people have had to reapply for medical cards since centralisation. The PCRS was not consulted on the plan to centralise the medical system and place it under its control. Now the Minister for Health and Children has had to provide it with extra resources and personnel. Even with these extra resources the PCRS is struggling to cope. The public is finding it extremely difficult to contact the medical card section and when they do finally manage to talk to someone that person is often not the one in charge of that particular case. This situation is made worse by the fact that there is no way to meet a representative of PCRS in person. There is no public office, no reception and anyone who calls to PCRS is turned away by security personnel. It is like the Dark Ages.

My office has been inundated with calls inquiring about medical card applications and renewals. One constituent who contacted me applied for a medical card in February 2009 in her local HSE office. When she subsequently changed her address and contacted the PCRS, it did not have her file so could not amend her address. Neither was the file in local office, so it had disappeared into thin air. On 22 January 2010 I contacted the PCRS about her situation. She still has not received a medical card.

A second constituent who applied to renew her medical card in August 2009 by registered post is still awaiting a response. I tabled a parliamentary question to the Minister for Health and Children on 8 December and it was passed on to the HSE. I am still awaiting a reply, almost two months later. These are just two of many cases that have been brought to my attention and they seem to be commonplace, as may be gleaned, anecdotally from the experience of colleagues in the House. It is the sick, elderly and the vulnerable who are suffering.

There is a need for an all-party Oireachtas committee to investigate the situation. It needs to look at the preparation and planning that went into making the decision to centralise the medical card process, examine the problems the system is now facing and decide how best to deal with them. Also, the committee needs to investigate the affects of the delays and numerous lost or mishandled applications.

The Minister for Health and Children told the House on 24 November 2009 that the turnaround time for applications was 15 working days.

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

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

Following the change in medical card eligibility for persons aged 70 and over in the Health Act 2008, the HSE through its service plan for 2009, advised the Department of Health and Children of plans to introduce a centralised national processing centre for medical cards and community drugs schemes as part of its value for money programme. The centralising of the medical card application and review process is facilitating a number of enhancements to the level of customer service associated with these applications

The HSE has informed the Department that its decision to centralise the processing of all medical card and GP visit card applications and renewals to the primary care reimbursement service, PCRS, in Dublin was in the context of its requirement to make efficiencies in business practices that could realise savings in a very challenging economic environment and provide a modern service to the public within sustainable levels of expenditure. The initial phase of the centralisation process commenced in January 2009 with the PCRS processing all medical card applications for persons aged 70 or over. The second phase commenced in September 2009 with the transfer of the case load from two local health offices in Dublin city to the PCRS.

The phased implementation will allow the situation to be continuously monitored and, if required, modified to address any issues arising. In 2009 the PCRS processed over 72,000 medical card applications which included nearly 42,000 reviews. With regard to these reviews, 85% of cases where the required information was supplied were completed within 20 working days and 95% within 30 days.

The HSE has recently put in place a national online system to allow local health offices track the current status of applications in the PCRS. The HSE has also advised that it has recently launched a facility, where a person who has applied through the PCRS can view the status of their medical card application or review online, using a unique reference number that is provided on the acknowledgement sent to him or her. In addition if a mobile telephone number is supplied with an application, updates by text message will be delivered to the applicant's phone. The PCRS is also finalising the development of a facility which will allow people to apply online if they wish.

The Minister for Health and Children in her letter to all members of the Oireachtas on 19 January 2010 stated that she fully supports the decision by the HSE to centralise the medical card and GP visit card application and review process to one location. The HSE has advised that when fully implemented, this measure will ensure improved turnaround times for processing of applications — under the new arrangements the HSE will be aiming for a turnaround time of 15 working days or less, with provision for emergency applications to be dealt with immediately; consistent and equitable application of eligibility and service provision; clearer governance and accountability, as well as improved management information; and a reduction in the overall number of staff required to process medical or GP visit card applications, thus freeing up staff for other service needs.

The decision to centralise the medical card application and review process will, when fully implemented, enhance the delivery of services provided to the public and realise overall savings through the greater usage of shared services. This decision is in line with the Government's Transforming Public Services' Programme announced by the Taoiseach in November 2008. Therefore, it is not envisaged that the establishment of an all-party Oireachtas committee is required to review this initiative.

Waste Management.

Deputy Chris Andrews

I thank the Ceann Comhairle for giving me the opportunity to speak on this matter. In 2003, Ireland came close to introducing a chewing gum levy. However, ultimately this move did not go ahead and I believe now is an opportune time for the issue to be revisited.

Chewing gum residue is unsightly and very difficult and costly to remove. In an ideal world, people who chew gum would dispose of it properly in litter bins but unfortunately, this does not happen, and like cigarettes, the residue ends up on the streets. Reports indicate that chewing gum accounts for a quarter of all food litter dropped on streets, and last year Dublin City Council spent some €37 million cleaning up the streets. In the current economic climate much-needed funds should not have to be spent on cleaning up chewing gum and other litter.

An article in one of the Sunday newspapers last week indicated an unexpected side effect of the bad weather was that all the grit spread on the city's streets to combat the ice had the duel effect of lifting away much of the chewing gum. However, I believe the Minister of State would agree that this is not a solution to the problem. Earlier this month a survey carried out by An Taisce pointed to the fact that although many towns around the country have done a great job in reducing litter, our cities are not particularly clean. Dublin ranked 51 out of 60 towns and cities surveyed, and was found to be "littered" by European standards. Dublin, and Ireland generally, rely heavily on tourism and having clean, litter-free streets is crucial to ensuring overseas visitors are attracted here. Businesses in the city centre pay a host of rates and levies including BID fees. Dublin City Council relies on these moneys to provide essential services. Chewing gum is an enormous problem on our city streets, and a levy could be directly used towards cleaning this product from our pavements, allowing council finance to be diverted to other areas.

The Minister for the Environment, Heritage and Local Government indicated to me in reply to a parliamentary question that negotiations with the chewing gum industry are currently underway following the expiration of an agreed three-year awareness campaign. I believe that while the gum litter taskforce has done great work in raising awareness of this problem and educating people about disposing of their litter, a levy is the only way forward and I would ask that the Minister to strongly consider this.

While I welcome the raising of on-the-spot fines for littering from €25 to €150, it is critical that these are processed in order to be effective in deterring people from littering. Reports in June of this year pointed to the fact that more than half of litter fines imposed by local authorities remain unpaid, which is unacceptable and I believe this matter must also be addressed to deter people from littering.

Deputy Seán Haughey

I am taking this Adjournment matter on behalf of my colleague, the Minister for the Environment, Heritage and Local Government, Deputy John Gormley.

In 2006 that Minister's Department entered into a three-year negotiated agreement with the chewing gum industry to address the problem of chewing gum litter on our streets. The agreement constituted a commitment by industry to a €6 million, three-year education and awareness programme aimed at tackling the gum litter problem.

A gum litter task force, GLT, was established as part of the agreement and a full-time executive was appointed to co-ordinate gum litter awareness and education programmes. The GLT organised three nationwide gum litter action campaigns in 2007, 2008 and 2009. These campaigns included extensive outdoor advertising, an educational secondary schools programme entitled "Bin It", the development of a dedicated GLT website, local radio, in-store and around store advertising, and the distribution of point of sale and promotional materials.

This campaign has achieved much success. For example, monitoring of gum litter levels in the five main cities has demonstrated a 37% overall reduction in gum litter over the course of the 2009 campaign, with all five cities recording significant reductions. Monitoring results in 2008 demonstrated a 36% reduction over the course of the campaign. This shows that the campaign is gathering momentum over time and is having a positive effect on gum litter levels nationwide. In addition, consumer research demonstrates that the campaign has been successful in increasing awareness of the gum litter problem with significantly greater numbers of respondents since 2006 agreeing with the propositions that "it is wrong to drop gum", "spitting gum is disgusting" and "I would feel guilty dropping gum". Overall the researchers concluded that there has been an overwhelming positive trend in attitudes and claimed behaviour in respect of gum disposal since 2006.

It must be recognised that a levy would not address directly the actual cause of the problem, that is, the incorrect disposal of chewing gum. The value of the chewing gum market in Ireland is estimated at €30 million. Therefore a levy pitched at 10% of the retail price would raise approximately €3 million.

The removal of chewing gum is more problematic than other litter items. The prohibitive cost of cleaning chewing gum from our streets means that many local authorities do not engage in this activity. Therefore the funds raised from the imposition of a levy would not provide anything close to the amount that would be required to fully cleanse the country's streets. There would also be substantial administrative costs involved, leaving aside any potential legal challenges which might arise. Furthermore the levy would have to be paid by all consumers of chewing gum, not simply those who dispose of their gum incorrectly, thus punishing all for the behaviour of a few.

It is clear that the imposition of a levy alone will not change the behaviour of those who dispose of their gum irresponsibly. This is the reason the Minister for the Environment, Heritage and Local Government believes that even were a levy to be introduced, it would remain crucial to continue to educate and raise awareness of the damaging environmental consequences of dropping gum on the streets. Short-term cleansing solutions do not tackle the root cause of the problem and are unlikely to improve the position in the long term unless one can influence the behaviour of those who continue to dispose of their gum irresponsibly.

The Minister is actively considering what steps to take in the future regarding the gum litter problem, including the possible imposition of a chewing gum levy. All options are being considered and he is currently engaged with industry to establish whether a re-energised education and awareness campaign, funded entirely by the industry and building on the success of the previous agreement, is a viable option.

Special Educational Needs.

Deputy Brian O’Shea

I thank the Ceann Comhairle for giving me the opportunity to raise this most important issue on the Adjournment. My request can be simply stated, namely, that funding be provided for sign language interpreters for five deaf people who wish to participate in a course at Waterford Institute of Technology.

The Unite trade union has been working with Waterford Institute of Technology on the development of education courses for workers who lost their jobs when Waterford Crystal closed. An information evening was held at Waterford Institute of Technology on 23 September 2009 and there have been subsequent meetings between the college and the Unite trade union. Waterford Institute of Technology has developed a programme to address the educational needs expressed by the group from Waterford Crystal who attended on the information night. There are three main areas in the programme, namely the recognition of prior learning from life and work, personal development in study skills and the opportunity to taste higher education programmes. This pilot initiative, which has been developed by Waterford Institute of Technology, is funded by FÁS. It is to be run on a part-time basis from the end of this month until May. The target group are those who wish to up-skill and return to education and this constitutes an innovative approach to life-long learning.

It aims to inform participants about new opportunities and developments in the education system. It provides the opportunity for individuals to map and evaluate their life and work experience to date. This facilitates educational progression and will involve the exploration of relevant educational pathways. It will allow participants to sample a range of the programmes provided by Waterford Institute of Technology in order that they can identify programmes of interest to them. There will be individual guidance and support sessions while learning will be provided within a group context.

The college states that the aims of the programme are to enable learners to review their perceptions of themselves as learners, to increase participants' levels of confidence in their learning abilities and to enhance skills and identify progression routes appropriate to the individual learner and to assist in developing in participants the confidence to undertake further study at an appropriate level. I greatly welcome this pilot project and see great potential in it as an example to be implemented widely in the interests of those who have lost their jobs and who wish to enhance their prospects of re-entering the workforce as the economy recovers and employment opportunities come on-stream.

Given the kinds of employment that are likely to emerge in the future, the whole area of enhanced qualifications is a major factor. Both the Unite trade union and Waterford Institute of Technology perceive this pilot project as being vital in the context of the participants taking up full-time courses in the new academic year, starting in September next. This course is fully accredited and will allow participants to build additional credits to further their education options. As for the five people who are deaf, I consider having the opportunity to participate in this course to be their absolute right. I call on the Minister to provide the funding for the sign language interpreters and ask him to make an urgent positive decision in this matter in order that the course can go ahead and the five people who need the services of sign language interpreters are facilitated.

Deputy Seán Haughey

I am taking this Adjournment matter on behalf of my colleague, the Minister for Education and Science, Deputy Batt O'Keeffe. I wish to thank the Deputy for giving me this opportunity to outline the Department of Education and Science's position on the provision of supports to students with disabilities who wish to attend higher education.

A fund for students with disabilities is administered on behalf of the Department by the national office for equity of access to higher education, which is a unit of the Higher Education Authority. The purpose of the fund is to provide required assistance and equipment to students who have a disability to enable them to access, participate and complete their course of study. Support under this fund is available to any student who has specific support needs arising from a disability. It is available to students who are enrolled on a full-time course in a further or higher education institution.

I am pleased to report that approvals under this fund have increased significantly in recent years. For example, in 2003-04 a total of 1,499 students were approved for support from a total allocation of €5.8 million. In 2008-09 the number of students approved for support increased to 3,844 with the total allocation increasing to €11.7 million. In 2008-09, 179 deaf or hard of hearing students in further and higher education benefited from the fund for students with disabilities. The total amount of the benefits to these students amounted to approximately €2 million. Among the students to benefit were eight deaf or hard of hearing students in Waterford Institute of Technology. The number of students with a disability enrolled in higher education continues to increase. In 1998 it was estimated that slightly more than 1% of all undergraduates were students with disabilities. Recent data available from the Higher Education Authority indicated that 4.2% of first-time enrolments in higher education in 2007-08 were students with a disability.

Applications for support from the fund for students with disabilities are made to the National Office for Equity of Access by the institution on behalf of the student. Students must supply appropriate documentation relating to their disability for approval. Funding is made available to the institution, which in turn puts in place the various supports required by the student. Common supports required by students who are deaf or hard of hearing include Irish sign language, note-taking and academic learning support. As an initial course of action, it would be advised that any third level students requiring support of this nature should contact the access or disability officer in the institution in question.

I understand that decisions on some applications made to the fund for students with disabilities for 2009-2010 are still being processed. Information on the fund for students with disabilities and on all other State supports available to students at third level is available from the HEA website, www.studentfinance.ie. I thank the Deputy once again for raising this matter.

School Accommodation.

Deputy James Reilly

I thank the Minister of State for his attendance. It is appropriate that he is here as he has children who attended and some of whom still attend this august institution. I am sure he will agree the parents of children at this school have been extraordinarily patient. They have sought an extension to the school since 1988. They were promised the extension and it was approved in 1998 and they were told the building would start in the year 2000. Now, as we enter the second decade of the third millennium, they are still without their school. Their patience has rightly snapped.

St. Oliver Plunkett national school is the third largest national school in the country with more than 900 students. It depends on ten portakabins for classes for approximately 300 of its children and a further three portakabins for learning support. The problem is these portakabins are old and poorly sealed. They are very draughty and the badly hung doors cannot be shut properly. The portakabins are poorly insulated and are too cold in the winter and too hot in the summer. If the doors and windows are left open, the noise from the road and surroundings is too great and interferes with pupils' ability to concentrate and learn. Children in the portakabins have an increased number of complaints of aches and pains as a result of sitting in draughts. Owing to the fact the portakabins are poorly ventilated, air becomes stagnant very quickly and children find it difficult to focus and concentrate. Low ceilings do not help the situation. There is no sound-proofing in the portakabins which means that noise levels from neighbouring classes are distracting and frustrating. There is poor lighting due to the position of some portakabins and fluorescent lights are on all day all year around and cause headaches and eyestrain for some. Windows have no blinds or covers and children are easily distracted by outside activity, especially when pupils are moving from classes for PE and other activities.

Basic services for the portakabins, such as water, light and heat, are unreliable. In winter it is a common occurrence to suffer a power failure due to over-reliance on electrical heaters in portakabins. Valuable time is lost from the timetable each day at junior yard time or when PE classes take place. At infant dismissal time, noise levels make it impossible for those in classrooms near the road to work as parents gathering at the gate for the 2.30 p.m. early dismissal cause distraction for children. Time is also lost when going to PE, the library or computer room as the portakabins are a good distance from the rest of the building. In inclement weather the children get wet when moving and suffer health problems as a result. The health and safety of children and teachers are compromised every day, and because of tight space and poor ventilation, sickness spreads quickly from one child to another. It has also been asserted that children in portakabins have a higher absentee rate than those in proper classrooms.

Portakabins are a poor environment for children who suffer from asthma, bronchitis or compromised immune systems. Their health is not being helped by an environment where mould and fungus grow on the walls and ceilings. There is a lack of space for hanging coats and in inclement weather wet coats must hang on the backs of children's chairs, causing their health to suffer. Dust and condensation increase in such conditions and this has obvious health implications. Special needs children cannot be accommodated owing to steps, limited space in bathrooms and insufficient room for special needs assistants. The list goes on. To cut to the quick, on account of the appalling toilet facilities, many children will not use them, leading to urinary and faecal retention. There have been many admissions to Temple Street Hospital for non-specific abdominal pain and increased attendance at local general practitioners who say there is a much higher incidence of respiratory tract infections and medical problems among these children. One child was admitted to Temple Street Hospital recently with pneumonia.

The Minister of State cannot be happy with this situation. These people have waited patiently. We are supposed to be a modern society. When we had very little in the 1950s, we could afford stone and brick to house and educate our children. Today we are stuck with portakabins. I urge the Minister of State to expedite the building of this school and to alleviate the shock it has suffered in finding it has slipped back to band 2.2 when it should be in the 1.1 band, having waited so long. The parents cannot take much more of this. I expect there will be serious disruption in the area. I must offer them 100% support because their children's welfare is at stake, from the point of view of both health and education. I appeal to the Minister of State to use his undoubted influence to progress this matter.

Deputy Seán Haughey

I declare a vested interest in this matter. Two of my children attended this school and two are still being educated there. Therefore, I am familiar with the issue. I am taking this debate on behalf of my colleague, the Minister for Education and Science, Deputy Batt O'Keeffe. I thank Deputy Reilly for raising this matter as it provides me with the opportunity to outline to the Dáil the Government's strategy for capital investment in education projects and the current position regarding St. Oliver Plunkett national school, Malahide, County Dublin, roll No. 17914S.

Modernising facilities in the existing building stock and responding to emerging needs in areas of rapid population growth present significant challenges. The Government has shown a consistent determination to improve the condition of school buildings and to ensure the appropriate facilities are in place to enable implementation of a broad and balanced curriculum. All applications for capital funding are assessed in the planning and building unit of the Department. The assessment process determines the extent and type of need based on the demographics of an area, proposed housing developments, condition of buildings and site capacity. As part of this process, a project is assigned a band rating under published prioritisation criteria for large-scale building projects which were devised following consultation with the education partners. The original criteria were revised and refined in 2004. Projects are selected for inclusion in the schools building and modernisation programme on the basis of priority of need, as reflected in the band rating assigned to a project. In other words, a proposed building project moves through the system commensurate with the band rating assigned to it. The building project for St. Oliver Plunkett national school has been assigned a band 2.2 rating. The project is at an early stage of architectural planning.

With regard to the Deputy's concerns regarding the temporary accommodation units at the school, these have been reviewed recently as part of a strategy adopted by the Department to achieve best value for money and to reduce overall rental costs for schools in general. One aspect of the review involves negotiations with prefab suppliers to buy out existing rental contracts or to negotiate reductions in annual rent, as appropriate. An initial group of 46 schools with rented prefabricated accommodation has been identified for priority negotiations with suppliers to buy out existing rental contracts. A number of these prefabs have now been bought out, including the prefabs at St. Oliver Plunkett's, and negotiations are ongoing with a view to ending rental contracts for as many schools as possible in 2010. The chartered surveyors engaged by the Department to assist in this process carried out a site visit at St. Oliver Plunkett's on 26 June 2009 and provided the Department with a report confirming that the units are in good condition and well maintained.

Deputy James Reilly

That is a disgraceful allegation.

Deputy Seán Haughey

On 9 December 2009, the school authorities were informed that the Department had decided to purchase the 13 temporary accommodation units at the school and that this initiative was undertaken to achieve better value for money.

The school authority was advised that this change in the funding arrangement for its temporary accommodation would not affect any application the school may have for permanent accommodation under the schools building and modernisation programme. The brief for the current project is to provide accommodation on the current school site for long-term projected staffing of a principal, 32 mainstream teachers plus ancillary staff. Representatives from the board of management have been invited to meet Department officials to discuss the current school building project and their current proposals in this regard. That meeting will take place next week.

The progression of all large-scale building projects, including this project, from initial design stage through to construction is dependent on the prioritisation of competing demands on the funding available under the Department's capital budget. The proposed building project will be considered in the context of the Department's multi-annual school building and modernisation programme for 2010 and subsequent years. However, in light of current competing demands on the capital budget of the Department, it is not possible to give an indicative timeframe for the delivery of the project at this time.

I thank the Deputy for giving me the opportunity to outline to the House the current position on the school building project for St. Oliver Plunkett national school, Malahide, County Dublin.

Deputy James Reilly

I thank the Minister for his response. I sympathise with him on his discomfiture over the nature of the replies he must give.

The Dáil adjourned at 5.25 p.m. until 2.30 p.m. on Tuesday, 2 February 2010.

Dáil Éireann díospóireacht - Thursday, 28 Jan 2010