Adjournment Debate

Teaching Qualifications

I thank the Cathaoirleach for allowing me to raise this important issue. I recently met a very frustrated recently qualified primary school teacher who, after applying for more than 200 teaching jobs had received just eight letters in reply telling her that she would not even be called for interview. Her dream has always been to be a teacher and she is determined to get a job as soon as possible so that she can put her years of training into practice. Although she is providing substitute cover in schools for days here and there she believes she has little prospect of a teaching post in the short or medium term and she is now considering emigration. She sees this as preferable to collecting the dole. What a great pity and a waste it is to see young, eager, recently qualified teachers leave this country to teach elsewhere. I have heard of other fully qualified young teachers who regularly volunteer in schools or who have taken jobs as special needs assistants to further their skills and experience and I fully commend them for it.

The situation, unfortunately, is a far cry from the high esteem in which the teaching profession is held in Finland where teaching is a highly sought after career and where professional skills are not wasted. In recent years, Finland has consistently ranked at the top of the OECD education surveys. Many international reports have cited the importance of quality teacher training and how it has brought success for Finnish students. In Finland a long tradition of high-quality teacher training is regarded as an essential factor in the success of the Finnish public education system. Primary school teachers have been undergoing master's level university training since the 1970s. The success of the Finns in their studies is based on well-trained, university-educated teachers. The high-level academic teacher training has also made the teaching profession very attractive. University-level teacher education is based on solid pedagogic knowledge and proficiency in the subject areas to be taught. All primary school teacher trainees also engage in research, which supports them throughout their careers in terms of their pedagogical thinking and professional development. Since 1995, the training of kindergarten teachers working with children between the ages of one and six has also been based on university-level Bachelor of Education studies. The Finns are already looking at raising the education of pre-school teachers to master's degree level.

If we are to develop a smart economy, surely we need to lay firm foundations in schools and provide them with the brightest and the best. Newly qualified teachers are an investment in our children's futures which we cannot afford to waste. I accept that the economic situation in which we find ourselves means that our ability to employ extra teachers is limited. However, I also believe that paying fully qualified bright young teachers the dole is a poor investment. Allowing them to emigrate is as bad or worse. I welcome the new induction courses now in place for newly qualified teachers, NQTs, throughout the country as a significant step but other opportunities are required for newly qualified teachers who cannot find work.

Some time ago a plan was proposed by Professor Tom Collins, head of education at NUI, Maynooth in response to the jobs crisis facing student teachers after it was estimated that thousands of student teachers graduating each summer would struggle to find employment. Professor Collins's plan was that qualified second level teachers would join teaching staff on a studentship programme for up to two years. They would provide ten to 15 hours teaching and extra curricular provision per week and enrol for a master's degree. At the time Professor Collins suggested that the graduates would qualify for a jobseeker's allowance of €10,000, supplemented by €10,000 from sources such as the European Social Fund and FÁS. The obvious advantages of such an Exchequer-neutral scheme would include saving teachers from the dole queue while upgrading their qualification and providing extra resources for schools.

The plan was based on using existing funding mechanisms in a new way. The idea of the scheme was to allow newly qualified teachers to begin to practice their profession and continue their academic advancement while also mitigating the worst effects of the education cutbacks. Minority subjects and programmes currently threatened by the cutbacks could be retained, while other staff members in the school could potentially be freed up to pursue studies and other pursuits if they wished. Participants in the scheme would be supernumerary and it would not result in a reduction of the current teacher allocation to the host school.

While Professor Collins's proposal was based on second level education, it could also be of great relevance in other areas, especially in primary education. In hundreds of small primary schools teaching principals struggle to teach a class or more often several classes, while also double-jobbing as managers, school policy writers and God knows what else. It is interesting to note what is happening in Northern Ireland as well. A scheme, similar to that proposed by Professor Collins would elevate the standard of the teaching profession for the future, perhaps to equal or surpass that of the Finns and would be a sound foundation stone for the smart economy we seek to develop. I urge the Minister to consider seriously the proposal.

I am taking this Adjournment matter on behalf of my colleague, the Tánaiste and Minister for Education and Skills, Deputy Mary Coughlan.

The Department of Education and Skills and other Departments, in this current difficult economic environment, are open to looking creatively at options that provide benefits to the system and to individuals seeking to enhance their skills or to gain valuable work experience where they are not employed. As the House is aware, much has been done in this regard already, such as the FÁS work placement programme and the €32 million labour market activation fund.

The FÁS work placement programme provides unemployed individuals with up to nine months valuable work experience in an organisation in the public, private or the community and voluntary sectors. The programme is designed to keep participants close to the labour market while providing them with the opportunity to increase their employability. To date there have been 2,022 participants who have commenced their placement under the programme.

From an upskilling perspective, the Department is providing in excess of 160,000 training and employment places this year for the unemployed. The majority of this provision is delivered primarily through FÁS. However, the labour market activation fund will deliver approximately 12,000 places. This fund was launched to assist in the creation of training and education provision for specific priority groups among the unemployed, including the under 35s and those who are long term unemployed. The programmes delivered under the fund aim to provide participants with the skills to meet current and future skills requirements of the economy thereby improving their prospects of securing employment in the future.

In terms of graduate teachers, the significance of teacher quality is well supported by research which indicates that the most important factors in positively influencing student outcomes are the quality of teachers and the quality of their teaching. We are all aware of the rapid changes in Irish society in recent decades and the recent dramatic changes in our economic circumstances. These changes underline the need to provide our children and students with the education and skills to ensure that they have the flexibility to adapt to take on various roles during their adult life.

We are fortunate that initial teacher education programmes here continue to attract high achieving applicants at school leaving level, and entry to post-graduate courses is competitively contested, attracting candidates with a wide range of backgrounds, including some discovering a vocation for teaching having started their working lives in other professions. The teachers that graduate from initial teacher education programmes are recognised as being fully qualified to teach in our schools, and our teachers and education system generally are widely admired and lauded internationally.

That said, there is always room for improvement, and we cannot become complacent. The Department of Education and Skills therefore also operates a wide range of initiatives which link the initial stage of the continuum of teacher education with induction and continuing professional development. Of particular relevance to recently qualified teachers at primary and post-primary level are the national induction programmes freely available nationwide through the network of education centres. The Deputy may be interested to know that significant numbers of newly qualified teachers who have not obtained a post are currently taking part in this modular programme.

In tandem with this, teachers, those serving as well as those not currently in employment, are more and more identifying areas in which to pursue further studies, for example, in areas of education which hold a particular interest for them, or where they identify a need in themselves or related to their school environment. This is to be encouraged, and third-level institutes offer a range of programmes that are of relevance to qualified teachers at all stages of their career. In practical terms, the Deputy may be aware of the opportunities that are already in existence for graduate teachers, and for other disciplines too, to progress along the qualifications framework with financial assistance from the State. Financial assistance is available to students under the means tested maintenance grant schemes, which are administered by the local authorities and vocational education committees on behalf of the Department.

Students entering approved courses for the first time are eligible for grants where they satisfy the relevant conditions as to age, residence, means, nationality and previous academic attainment. However, financial assistance is also available to eligible candidates who already hold an undergraduate or postgraduate qualification and who wish to enter a further postgraduate course, at a higher level, which represents progression from the level at which the first qualification was attained. The progression route, for grant purposes, is primary degree to higher diploma or postgraduate diploma to masters degree to PhD.

We must all be committed to maintaining and improving the standard of teaching and education for all so that Ireland can work towards turning our economic fortunes around and placing ourselves at the front of the global knowledge economy. There are opportunities for new teachers to continue their professional development and this Government will continue to support this objective.

Health Service Executive Charges

This is a simple matter. The HSE has determined that an applicant for a medical card in certain situations must make a sworn statement in front of a commissioner for oaths instead of accepting a statement made in front of a peace commissioner. I cannot believe that in current circumstances a person seeking a medical card must pay €50 to a solicitor so he will sign a sworn affidavit. The peace commissioner's signature is accepted by the courts but the HSE refused point blank to accept an application I had signed in front of a peace commissioner for a man who has lost his job and whose wife is seriously ill. He was asked for a number of documents, such as a mortgage statement to confirm monthly repayments, income tax assessment forms for the past three years, the vehicle registration certificates for two vehicles, up to date payslips and GP reports and when he supplied those he was told he would need a statement sworn in front of a commissioner for oaths. We duly supplied such a statement sworn in front of a peace commissioner but it was not acceptable.

Our colleague, Councillor Mick Dollard, attended the health information committee that has been constituted by the HSE to seek to transfer information. He raised the issue at the meeting and no one knew a statement had to be sworn in front of a commissioner of oaths. The person there from the HSE said he would investigate but that as far as he knew, it was not the case. In a reply I got from the HSE, however, it was clear the commissioner for oaths would have to sign off on the affidavit.

In the present circumstances, someone looking for a medical card would not have the €50 the commissioner for oaths would charge for such a service. It is ridiculous that a peace commissioner, who has the confidence of the Garda, the courts and the Minister for Justice and Law Reform, is not acceptable to the HSE. I asked the Minister for Health and Children about this but, as usual, she referred it to the HSE for decision. I asked her to give a directive to the HSE on the issue but she chose to ignore that request and leave it for the HSE to answer.

I hope the HSE will have the confidence in the peace commissioner system that has been recognised since the foundation of the State and will accept the validity of the statement that has been made, so no one will be asked to pay a fee to obtain a medical card. It is unheard of in any other application for social welfare claims or anything else. I have been told by colleagues of sworn statements being required to be made before commissioners of oaths in similar cases. It is crazy. Deputy Connaughton is nodding his head, so the same must be happening in the west.

This is unique to the HSE, it wants to be different from every other State organisation and wants statements sworn in front of commissioners for oaths and will not accept what is accepted in every other facet of life, a statement made before a peace commissioner.

I am replying to this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. In assessing eligibility, the HSE uses guidelines based on people's means, which includes their income, certain allowable outgoings and the effect of other factors which may impact on people's ability to meet the cost of general practitioner, GP, services for themselves and their families. Notwithstanding the above, the HSE may issue a medical card on a discretionary basis if the applicant would otherwise be caused undue hardship in providing general medical and surgical services for himself or herself and any dependants. The executive takes all medical issues into account in determining whether undue hardship exists.

If a person is refused a medical card and is not satisfied with the decision, he or she may appeal the decision to the appeals office of the local HSE area. The office will conduct a reassessment of the application. This reassessment is conducted by HSE staff who were not involved in deciding on the original application. If the applicant is still not satisfied following the appeal, he or she may contact the Ombudsman's office.

The HSE has produced national medical card-GP visit card assessment guidelines for its staff. These are regularly updated to provide a clear framework for decision makers to assist them in making reasonable, consistent and equitable decisions when assessing people under the General Medical Services, GMS, scheme. As part of the HSE's ongoing programme to provide a more responsive and cost-effective service, the HSE is centralising the processing aspect of medical card applications to its facility at the Primary Care Reimbursement Service, PCRS, in Dublin. Under the centralisation plan, the HSE's local offices will continue to provide the public with assistance and information locally in respect of medical card eligibility and making an application. They will also provide information on the current status of their applications or reviews.

In June 2010, the HSE introduced a new website — — which enables people anywhere in the country to apply for a medical card through a simple and efficient application process. As the centralisation process continues, more initiatives will be introduced. The current initiatives will continue to be enhanced as the HSE receives feedback and continues to engage with advocacy groups, staff, public representatives and primary care contractors.

The HSE has advised the Department that there is no general policy in place that requires all applicants in the Kildare-west Wicklow area to provide sworn statements in support of medical card applications or appeals. In cases where an applicant cannot produce evidence of income, a sworn affidavit can be useful to progress the application more speedily because it can be difficult, in certain occupations, to establish the applicant's income. I understand the HSE has been advised by its legal advisers that it is difficult to apply legal recourse where a statement countersigned by a Peace Commissioner is subsequently found to be untrue. Therefore, an affidavit sworn before a Commissioner for Oaths is a more compelling document when produced in support of an application.

Special Educational Needs

It is with regret I must raise such a matter in the Dáil. I am referring to the review carried out earlier this year by the Department of Education and Skills of the allocation of special needs assistants, SNAs, to special units in primary and post-primary schools. As a result of the review, a primary school in my constituency, St. Senan's in Enniscorthy, has lost seven SNAs, five from its specialist autism unit and two assigned to children with autism in the mainstream classes. As such, the school believes it was hard done by.

Last Saturday week, I attended a protest march in Enniscorthy where more than 300 parents turned out in frustration at the cutbacks applied by the Department. When the autism unit opened in St. Senan's school in 2004, the Department recognised the special needs of the children and sanctioned SNAs for each child based in classes in the autism unit. Back-tracking and removing SNAs from those children several years later is sad. Parents with whom I spoke explained to me how much their children came on thanks to the SNAs.

As I stated in an earlier debate this evening, the Cabinet and Members opposite do not realise how important an SNA is to a child and how much his or her skills can develop with the help of one-to-one special needs assistance. I have no doubt that this is a cost saving exercise on the part of the Department of Education and Skills. Nor do I doubt that the Department, if it examined its budget and spending, would find other areas in which to apply cost saving measures without touching front line services. The SNAs based in St. Senan's school and many other schools across County Wexford form part of our front line services. They have been removed from children.

Parents and teachers alike would tell the Minister of State about the importance of having an SNA available. The children in question have special and autistic needs. It is sad to see a cost saving exercise being put in place at the expense of a child and that child's future. It is with total frustration and anger that parents took to the streets in Enniscorthy last Saturday week. The parent does his or her very best when his or her child returns from school in the evening. Parents expect a special level of education and a level of help for their children in the schools they attend.

I remember when the then Minister, Deputy Hanafin, visited the autistic unit in St. Senan's school and saw the great work the school was carrying out. I commend the principal, the teachers, the board of management and every parent on putting this excellent facility in place. They have fundraised to make it so. The work done by teachers and SNAs alike is special for the children who attend the school. They had the opportunity to access a proper education, one that recognises the importance of integrating the children in question into the mainstream setting, including its social aspect. These children were made to feel special by being able to attend a mainstream school like St. Senan's in Enniscorthy. With one fell swoop, the Department has saved money and removed SNAs from that school.

The Deputy's time has expired.

I will conclude on this point. When replying, the Minister of State will give the Government's standard reply. I know that cutbacks must be made, but I would rather that the Department of Education and Skills save money on costs in other areas and not hit the front line service provided by SNAs. Children should be given every opportunity to have a proper education.

I am taking this Adjournment matter on behalf of my colleague, the Tánaiste and Minister for Education and Skills, Deputy Mary Coughlan. I thank the Deputy for giving me this opportunity to outline the position in regard to the special needs assistant, SNA, scheme generally and, in particular, the allocation of SNA support to schools working with children with autism in specialised units.

The House is aware that the education of children with special educational needs has been and remains a key priority for Government. The Department of Education and Skills continues to invest huge resources into schools to enable them to meet the needs of children with special educational needs. This year alone, more than €1 billion of the Department's budget is being spent to provide supports to enable learners with special educational needs access an education appropriate to their needs. The SNA scheme, in particular, has been a major factor in both ensuring the successful integration of children with special educational needs into mainstream education and the provision of support to pupils enrolled in special schools and special classes.

I take this opportunity to assure the House that the National Council for Special Education, NCSE, is processing applications from schools for SNA support and sanctioning SNA posts to schools. Schools, which have enrolled children who qualify for support from an SNA continue to be allocated SNA support. The terms and criteria for the SNA scheme have not changed.

The Deputy will be aware that the NCSE, through its network of local special educational needs organisers, SENO, is responsible for allocating resource teachers and SNAs to schools to support children with special educational needs. The NCSE operates within the Department of Education and Skills criteria in allocating such support and is independent in the making and issuing of its decisions relating to the allocation of such supports.

It is important to understand in regard to the SNA allocation process that the allocation for any school, and any adjustments to that allocation, depend on a number of factors such as the number of pupils with care-medical needs leaving, the number of new pupils and the changing care needs of existing pupils in the school. SNA allocations are therefore not permanent but are increased or decreased as pupils who qualify for SNA support enrol or leave a school. They are also decreased where a child's care needs may have diminished over time. There has been no policy change in this regard.

The Deputy may be aware that one of the reasons for the allocation of SNAs is to assist children to develop greater levels of independent living skills. It is not generally in the interests of a child for the NCSE to leave an SNA in place where a child has achieved a greater level of independence. To do so has the potential to impact on a child's personal development in a negative way. I am sure the Deputy will agree that many children with disabilities develop independent living skills as they grow and mature. Where a child develops to such an extent that he or she no longer needs the support of a SNA, that is a positive development. Likewise, where children to whom SNA support was previously allocated have left a school, it would be inefficient to leave those resources in place.

The Deputy is fully aware that the Department has prioritised the provision of special education supports to schools. This remains a key Government policy. However, this does not mean that resources, allocated in response to various historical factors, are retained in schools ad infinitum. At a time of constrained resources, it is essential to ensure that public resources are deployed as effectively as possible. Resources left in an area that are not in accordance with criteria mean public resources are not available for another deserving area.

The Deputy may be aware that the NCSE has introduced an appeals procedure whereby schools and parents may appeal a decision in relation to the allocation of teaching and SNA resources. Where a school is unhappy regarding a decision in regard to its SNA resource allocation, it is open to the school and-or the parents concerned to appeal the decision of the SENO to the NCSE through this appeals mechanism.

I understand that a number of schools in the Wexford area have appealed the decision of the NCSE in relation to the allocation of supports. These appeals will be processed by the NCSE in line with that body's procedures in this regard.

I again thank the Deputy for raising this matter.

Hospital Services

I am thankful to be given this opportunity in Dáil Éireann to raise a very important matter concerning a patient in County Galway who was due to undergo an operation last week in St. Vincent's public hospital in Dublin for the insertion of a special implant known as a spinal pain block to try to lower the most intensive pain that emanates from his back. He was told hospital management at St. Vincent's had decided a few days earlier that it had established a new catchment area, consisting in the main of Dublin city and County Wicklow. For all other patients coming from outside this area the local HSE or the actual patients would have to bear the cost of the operation — in this case €26,000.

This is in spite of the fact that this operation cannot be performed in any other hospital in the country. St. Vincent's Hospital treated patients from all over Ireland until last week. Both the hospital and HSE west are funded from the same HSE purse nationally so this is no more than a tug of war match between two parts of the HSE. The only loser is an elderly patient in County Galway lying on the broad of his back with excruciating pain.

Whoever can knock heads together tomorrow morning, or however it may be done, it cannot be possible, in natural justice, that any person, in particular, any elderly person, should be subject to the treatment this poor man is receiving. I do not know the reason St. Vincent's Hospital has made this decision. I assume it has problems with its budget just as HSE west has problems but neither has the problems of the patient of whom I speak.

I hope the Minister of State will bring this matter to the notice of the Minister, Deputy Harney, tomorrow. Whatever may be done tomorrow, in the name of the Lord I ask that they try to get this man taken into hospital. Granted that even with this procedure the prognosis is not for 100% success, anything would be better than what he has been putting up with for the past ten years. I use whatever words I can to convey to the House that if ever there was an urgent matter regarding a sick patient I am speaking about it now. I have the medical evidence to prove it and all I ask is for the Minister of State to convey to the Minister for Health and Children that something must be done for this patient.

I am taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. The management of chronic pain is a highly complex and specialised area of medicine, requiring a multidisciplinary approach to treatment and care of patients. Traditionally within Ireland and the UK, pain medicine evolved from within the hospital discipline of anaesthesia and is a consultant-led service. The service has grown considerably in this country over the last two decades and departments of pain medicine now exist in most regions.

Patients requiring treatment for chronic pain can be seen in a number of different settings. Most patients are treated on an out-patient basis at major acute hospitals and return home after treatment. Where required, patients are also treated on a day-care or in-patient basis under a more intensive and structured treatment programme. The department of pain medicine at St. Vincent's University Hospital is the largest centre in Ireland providing treatment for chronic pain. The service was founded in the hospital in 1991 and has continued to develop its expertise in this area since then.

St. Vincent's University Hospital provides one of the comprehensive pain management services in Ireland. While it is not a national referral centre for pain management, the hospital has accepted on its waiting list patients from all over the country. These patients are referred to St. Vincent's by pain medicine consultants in other institutions. This is because of the need for particular expertise and a multidisciplinary approach.

Patients are prioritised and treated by the consultants based on clinical need. All patients at initial evaluation are assessed by a multi-disciplinary team comprising a pain specialist, a clinical psychologist and a physiotherapist. All patients complete a range of psychometric evaluation tools prior to assessment in order to help identify the psychological impact of pain on each individual. Following evaluation an individualised management plan is devised for each patient comprising medication optimisation, diagnostic procedures, psychological intervention, functional rehabilitation, including physiotherapy and occupational therapy and interventional therapies.

Approximately 150 major implants per year are performed in St. Vincent's Hospital including spinal cord stimulation. This accounted for over 80% of all such major interventions performed in Ireland in 2007. It would not be appropriate for me to comment on a particular case. However the HSE has assured the Minister that patients when referred to the service will continue to be prioritised on the basis of clinical need. This priority list is regularly updated.

Although HSE west provides certain treatments for chronic pain management it does not provide some of the more complex treatments available at St. Vincent's University Hospital. HSE west refers its more complex cases to St. Vincent's and sometimes to the Mater or Beaumont hospitals in Dublin. The HSE is exploring whether further treatments could safely and appropriately be provided in the western region. The Minister has been assured by the HSE that all patients already on the waiting list at St. Vincent's Hospital will be appropriately prioritised and treated on the basis of their clinical needs. It is important that a co-ordinated approach to the management of patients with severe and chronic pain is ensured in order that patients who require treatment can receive it as quickly as possible in the appropriate healthcare setting. The Minister has asked the HSE to address this issue as a matter of priority.

The Dáil adjourned at 9.35 p.m. until 10.30 a.m. on Thursday, 21 October 2010.