Dáil Éireann díospóireacht -
Thursday, 20 Jan 2011

Vol. 727 No. 2

Adjournment Debate (Resumed)

Health Services

Deputy Pearse Doherty

The matter I wish to raise relates to the north west radiotherapy centre that was due to be built in Altnagelvin. Construction was due to be completed in 2015. The people of the north west, namely, those in Donegal and Derry, are very concerned with regard to the unilateral decision taken by the Minister for Health, Social Services and Public Safety, Mr. Michael McGimpsey, MLA, last week to the effect that construction on the centre will not now proceed. This has given rise to fears among cancer sufferers in the north west, their families and those who campaigned long and hard to bring us to the point were a centre such as that proposed for Altnagelvin was to be built on a cross-Border basis.

Under the agreement that was reached, the authorities in this State were supposed to purchase services from the Assembly in the Six Counties for the people of Donegal. This is a central plank of the State's cancer strategy. In light of Minister McGimpsey's decision, I am seeking that the Tánaiste and Minister for Health and Children intervene. I am not sure whether any discussions took place between the previous Minister for Health and Children and her counterpart in the North. I welcome the fact that responsibility for health and children now lies with the Tánaiste, Deputy Coughlan, who, in view of the area in which she lives, will have a clear understanding of this matter.

There is a need for both dialogue and an element of straight talking with the North's Minister for Health, Social Services and Public Safety in respect of this matter. The Minister of State, Deputy Moloney, will be aware of the unique governance arrangements that exist in respect of the Assembly in the Six Counties. Unlike their counterparts in the South, each Minister in the Six Counties has executive authority. While the Executive in the Six Counties agrees the overall budget and the allocations for each Department, it is the responsibility of the relevant Ministers to decide how money is spent. They do not require the approval of the Executive in this regard. Those arrangements came about under the British-Irish Agreement. They were drafted in the context of our past and were designed to ensure that no section of the community or party could interfere with the budget of a Minister from another party.

Even though €25 million has been ring-fenced in the draft budget of the Executive in the Six Counties for the Minister for Health, Social Services and Public Safety to proceed with the project, the latter has taken a unilateral decision to the effect that the centre will not be built because he cannot guarantee that, post-2015, he will have the money required to cover the running costs of the facility. Of course, this presumes that Mr. McGimpsey will be Minister for Health, Social Services and Public Safety following the Assembly elections which are due to take place in May. In addition, the budget in the North is a four-year budget and it runs from 2011 to 2015. There is again, therefore, a presumption that in 2015 the money relating to the facility will still not be forthcoming in 2015.

The Department of Health, Social Services and Public Safety is the only Department in the North not to have its budget cut. This is due to the existence of what is termed the "block grant". The position in the Six Counties is different to that which obtains here. The Assembly does not have tax-raising powers and must rely instead on the block grant provided by the British Exchequer. The money allocated under this grant is disbursed among the various Departments. As already stated, the budget of the Department of Health, Social Services and Public Safety was not reduced.

The refusal to build the centre at Altnagelvin, even though the money relating to the project has been ring-fenced, is playing on the fears of cancer sufferers in the north west. I am of the view that the North's Minister for Health, Social Services and Public Safety is posturing and is trying, perhaps, to strengthen his hand as he enters negotiations with the Minister for Finance and Personnel on the need for additional funding. This is despite the fact that the entire block grant for the North is allocated to the Department of Health, Social Services and Public Safety.

It would be easy to take the view that this is a matter with which the northern Executive should deal. I am of the view that it is not an issue for the Executive because, in light of the unique governance arrangements that exist, the Minister for Health, Social Services and Public Safety is in a position to decide how his Department's budget should be spent. If he decides that it will not be spent in particular areas, the northern Executive has no control over his actions. There is, however, a role for the southern Government. The need for the centre has long been recognised by the health Departments, North and South. This matter has been discussed by the North-South Ministerial Council on many occasions. I commend the Government in this State on its commitment to provide Exchequer funding to build the centre in the north west and to cover some of the operating costs. It is central for the people of Donegal and for the cancer strategy. I ask that the new Minister for Health and Children, who has this responsibility, would engage with her ministerial counterpart in the North to discuss and try to find a resolution to this issue as soon as possible.

Minister of State at the Department of Health and Children (Deputy John Moloney)

I apologise to Deputy Doherty for the absence of the Tánaiste. I welcome the opportunity to set out the current position in regard to the proposed radiotherapy centre at Altnagelvin and radiotherapy services nationally. On average, approximately 24,000 new cases of invasive cancer, including non-melanoma skin cancer, are diagnosed each year. Current trends indicate that the number of cancers diagnosed each year is likely to double in the next 20 years.

It is against this background that the HSE's national cancer control programme is being implemented. Its goals are better cancer prevention, detection and survival through a national service based on evidence and best practice. Part of the programme is the implementation of the national plan for radiation oncology, which was originally agreed by Government in July 2005. The plan is designed to provide the national infrastructure for radiation oncology for the next 25 years.

Phase 1 of the plan involves the construction of new facilities at Beaumont and St. James's hospitals, with four linear accelerators in each. These new centres were completed at the end of last year. The two facilities, together with St. Luke's Hospital in Rathgar, now form the St. Luke's radiation oncology network for Dublin-mid-Leinster and Dublin north-east. This will provide sufficient capacity to deal with patient needs until at least 2015. Phase 2 of the national plan for radiation oncology will provide additional radiation oncology capacity at St. James's and Beaumont hospitals, Cork University Hospital and Galway University Hospital, with satellite centres at Limerick regional and Waterford regional hospitals.

To deal with the specifics raised by Deputy Doherty, there are particular geographic concerns that need to be addressed for patients in the north west. For that reason, the Government also decided in July 2005 that the best option for improving geographic access to radiation oncology services for patients in the north west was through North-South co-operation. It was therefore decided to facilitate access to Belfast City Hospital for patients needing radiation oncology treatment. A service level agreement has been in place with Belfast City Hospital for the provision of radiation oncology services to patients from Donegal since 2006.

The Government also decided it would consider a joint venture between North and South for the provision of services from a satellite centre in the north west, linked to Belfast City Hospital. In 2008, Mr. Michael McGimpsey, Minister at the Department of Health, Social Services and Public Safety in Northern Ireland announced that a new satellite radiotherapy centre would be established at Altnagelvin Hospital in Derry, linked to Belfast City Hospital, as part of Northern Ireland's plans for the provision of radiotherapy services beyond 2015. At that time, the former Minister, Deputy Harney, agreed to fully explore the opportunity presented for further collaboration in the delivery of those services.

The business case for the development at Altnagelvin has now been finalised and is under consideration by the Minister, Mr. McGimpsey. I am pleased to confirm that the Irish Government has committed to providing a significant capital contribution to the project. This contribution recognises the fact that approximately one third of the patients who will attend the Altnagelvin centre will be from Donegal and the surrounding areas. In addition, the national cancer control programme will contribute on an agreed basis to the operating costs in respect of patients from the Republic of Ireland who attend this service.

The Government is committed to working in partnership with colleagues in Northern Ireland on the development at Altnagelvin. The Department of Health and Children and the HSE have nominated representatives to the various sub-groups overseeing the development of this project. The discussion of patient pathways will include input from clinicians at Letterkenny General Hospital and St. Luke's Hospital who are currently involved in the delivery of radiotherapy services to patients in Letterkenny. The Government's financial contribution to the project was confirmed to the Minister, Mr. McGimpsey, in the past few weeks.

The Government is committed both to the radiotherapy centre at Altnagelvin and to the development of radiotherapy services nationally. Approximately half of cancer patients will require radiotherapy at some point in their illness and the aim is to ensure best outcomes for these patients regardless of location.

EU Habitats Directive

Deputy Paul Connaughton

It is ironic that I rise possibly for the last time on the Adjournment on a matter I have probably raised more often in this House than any other Deputy, namely, the effect of the EU habitats directive on the 32 raised bogs. I have a personal interest in the matter which I always declare in the House.

Just before last December, I and thousands of people throughout the country received a letter from the wildlife section of the Department of the Environment, Heritage and Local Government stating that as and from 1 January this year I would be prohibited from cutting a domestic supply of turf on our bogs, as we have done for generations. In that letter, the Minister stated that negotiations would take place about price and alternative local arrangements that may come to pass between the stakeholders and the Department with a view to ascertaining whether there is any middle ground. To my knowledge, nothing has happened in that regard, as nothing happened in the previous two years.

I want to put on the record that this was a daft decision — I must put it that strongly. I accept that Ireland must implement the EU habitats directive, and Fine Gael has no difficulty with that. However, the method in which this directive has been handled in recent years is outrageous. This is at a time when the cost of home heating oil is at a high and is rising by the day, and when the Departments of State have not a penny to pay to anyone and will not have for some years. How will they find compensation for people who cannot cut turf on their bogs when there is not a penny in the Exchequer? I emphasise that this concerns people's domestic rather than commercial supply of turf. The freedom to cut this turf would ensure that the cost of importing oil was reduced somewhat.

Nothing in this affair makes sense. A halt should be called at this stage. An independent chairperson should be put in charge of an overall board where all the stakeholders, including the Department, are involved. The independence of such a board is crucial. The turf cutters should be allowed to cut for this cutting season and a management plan should be drawn up for every one of the 32 complexes of bog throughout the country. If the issue was approached in this manner, I have no doubt the Department and the Government of the day, whoever that is, would find the bog cutters would be helpful and flexible in coming to an accommodation.

My grandfather got this bog from the Land Commission in the 1930s, he transferred it to my father, I got it in due course and I am in the process of transferring it to my son. I am lucky enough to have a grandson and I hope his day will come. I do not want to be the link that broke in a generational chain or that I was in some way the cause of a situation where people could not cut their own supply of turf for domestic use in the middle of rural Ireland. Irrespective of what the culture of the day was, that would not make sense. I ask the Minister of State to do what he can. This is an issue that must be dealt with in his constituency as well.

Deputy John Moloney

I have heard Deputy Connaughton speak about this issue, which is clearly of great interest to him, on many occasions. I have been associated with turf-cutting in my own constituency of Laois-Offaly over the years. I may have plenty of time to cut turf in the future.

The State has a legal obligation under the habitats directive and under the Wildlife Acts to protect sites it has designated for conservation purposes. A number of sites have been designated for the protection of raised bog habitat within special areas of conservation, SACs, or natural heritage areas, NHAs. These make up just over 4% of bogland in the State where turf extraction is feasible.

Ireland's raised bogs are important and unique habitats hosting ecosystems that are extremely rare. In recent history almost all of western Europe's peatlands have disappeared or been severely damaged. While Ireland has approximately 60% of the remaining uncut areas, less than 1% remains of our active raised bog, that is, raised bog on which the indigenous flora are still growing and where peat is forming.

Scientific evidence has shown that turf-cutting and associated drainage, including cutting for domestic supply only, is incompatible with the preservation or restoration of raised bogs. For this reason, in May 2010, the Government confirmed the ending of the derogation which allowed a ten-year continuation of turf-cutting for domestic purposes on raised bog SACs and NHAs. Cutting is no longer permitted on the first 31 of these sites without the express consent of the Minister for the Environment, Heritage and Local Government. The Government has also decided that cutting will cease on a further 24 raised bog SACs from the end of this year and on 75 raised bog NHAs in 2013. The Government decision related to domestic cutting applies on selected raised bog protected sites — not blanket bogs, which are much more extensive in area. However, restrictions introduced in 1999 relating to turf-cutting on designated blanket bogs continue to apply.

It is not possible to reconsider this matter. Ireland has a clear legal obligation to protect these sites. To fail to do so would inevitably render the State liable to significant financial sanctions imposed by the European Court of Justice. The Government accepts there is a need to compensate those who have a legal right to cut turf in these designated sites and who will suffer a loss due to the restrictions arising from the protection of such sites. An interim compensation scheme was established to compensate those who have been cutting turf on the 31 raised bog sites on which cutting was no longer permitted from 2010. Just under €200,000 was paid out in 2010 to ensure those affected by that cessation had the means to provide alternative winter fuel.

The Department of the Environment, Heritage and Local Government and the Office of the Attorney General are examining how the interests of affected parties can be addressed in the longer term. The Minister, Deputy John Gormley, intends to revert to Government shortly regarding the arrangements for those affected by the requirement to cease turf-cutting on protected raised bogs, including putting in place appropriate compensation arrangements.

The Dáil adjourned at 5.20 p.m. until 2.30 p.m. on Tuesday, 25 January 2011.