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Dáil Éireann díospóireacht -
Thursday, 29 Sep 2011

Vol. 742 No. 1

Topical Issue Debate

Portlaoise Hospital

I thank the Leas-Cheann Comhairle for taking the issue. I wish to raise the plans for the future of Portlaoise hospital, particularly with regard to the intensive care unit and the accident and emergency unit, the plans to proceed with the model 2 proposal, if any, and the implications for the maternity unit at the hospital. I am glad the Minister for Health is here and is taking time to deal with the matter. I note the HSE statement of 22 September states:

The HSE continues to work towards the full implementation of the HIQA report into Ennis Hospital and further recommendations arising from HIQA's Mallow report. Both reports will ultimately give rise to changes in the role of smaller hospitals, which include Portlaoise Regional Hospital and...Loughlinstown hospital.

In his statement the following day, 23 September, the Minister said:

In July of this year I attended the Oireachtas Joint Committee on Health and Children and made clear that Portlaoise is a Model Three hospital, and will remain a Model Three hospital. I stated to the committee that this is Government policy and will not change. I confirm that this remains the position.

We have two different positions, and that is why I am raising the issue. There is huge concern in the community, across County Laois and in south Kildare — the Acting Chairman will be aware of that — because many people from that area use the hospital. There is also huge concern in parts of Offaly. Staff, patients and users of the hospital are concerned.

When I and other Deputies for the constituency met the Minister in the summer, he outlined the same position. I have to report to him that, in the second part of the meeting with the officials, they were strong in pushing the model 2 position regarding Portlaoise. It was talked about at length. For my part, I believe Portlaoise must retain the vital services — the accident and emergency unit, the paediatric units, both of which are new, modern and well functioning, the intensive care unit and the maternity unit, which is busy and has a huge catchment area. Portlaoise is the second busiest hospital outside the Dublin region, with a huge throughput of patients, and it is also a very efficient hospital. The report shows that the cost per attendance is €149 whereas the next lowest figure is €195 and the figures for other hospitals are much higher.

I ask the Minister specifically to address maternity services. The hospital needs a new maternity unit. I recall a meeting with local councillors and Mr. John Bulfin in 2008, at which he stated that €8 million was being ring-fenced to provide a new maternity unit. There has been talk that Portlaoise will be reconfigured with the Coombe, Loughlinstown and Naas. Is there a plan in some people's heads in the HSE to transfer maternity services to the Coombe? I hope not. Perhaps the Minister will confirm that for me. I ask him to address the points I have raised.

I thank Deputy Stanley for the opportunity to clarify the situation. I do not believe there is any difference between the two statements, to be frank. There is an association because many of the hospitals mentioned in conjunction with Portlaoise are model 2, but I did not say that Portlaoise was going to be model 2. I have certainly never said that. Let us clear that up at the outset.

I want to place on record that the Midland Regional Hospital at Portlaoise will continue to deliver a quality-driven, people-centred service to the population of the region and the people of Laois in particular. There is no plan to reduce services at the hospital. Lest I forget to address the Deputy's question about what is in the heads of the myriad people working in the HSE, I think he will agree I could not possibly know what is in all their heads, but I know what is in my head and I put it on the record again today.

I remain committed to ensuring that acute hospital services at national, regional and local level are provided in a clinically appropriate and efficient manner. In particular, I want to ensure that as many services as possible can be provided safely in smaller, local hospitals. I have also made it clear that patient safety must be the overriding priority and I want patients to be treated at the lowest level of complexity that is safe, timely, efficient and as near to home as possible. Patients should only have to travel to larger hospitals for more complex services. I do not mind stating that the battles we have had on moving what it is not safe to provide in smaller hospitals will be superceded by the battles to get what should not be provided in the bigger hospitals out of them and back to the smaller hospitals. We will engage in these battles and win.

In the recent past there has been much speculation regarding the future of Portlaoise hospital. Certain reports have cited correspondence, as Deputy Stanley has done, and referred to the possibility of Portlaoise becoming a model 2 hospital, which would have implications, particularly for the emergency department. In July of this year, as Deputy Stanley pointed out, I attended the Oireachtas Joint Committee on Health and Children and made it clear that Portlaoise is a model 3 hospital and will remain a model 3 hospital. I said to the committee that this is Government policy and will not change. I confirm that this remains the case. I might mention that I intend to develop a framework for the development of smaller hospitals that secures their future and specifies the additional services it is safe for them to provide. The framework will underline the Government's commitment to the real development of smaller hospitals and not their closure, as some people would have us believe. It is important to point out that there are safety issues at Portlaoise and they are being addressed but addressing them does not mean it will become a model 2 hospital.

On the intensive care unit and critical care of patients at Portlaoise, there is currently a four bed ICU with the capacity to ventilate two patients should the requirement arise. As Portlaoise provides both obstetric and gynaecology and paediatric services 24 hours a day, seven days a week, anaesthetic and surgical cover is required 24 hours a day, seven days a week on site. In this regard, I am happy to confirm that it is envisaged the Midlands Regional Hospital at Portlaoise will maintain its current ICU service.

Furthermore, a proposition to appoint a clinical director for the midlands region is currently being considered by the HSE. A single clinical director would lead the provision of these services within the region and within the guidance of the national clinical care programmes. In advance of that process, I wish to re-iterate that the retention of Portlaoise Hospital as a model 3 facility remains Government policy. Accordingly, the recent speculation around the downgrading of Portlaoise hospital is not accurate and I am pleased to set the record straight. Portlaoise remains a model 3 hospital.

The Minister can understand where the confusion is coming from but I welcome the reply. In his statement he went into some detail. Can the Minister confirm there will be a new maternity unit in the hospital? What is the position with capital funding? I have tried to track the €8 million for the last three years, all the way from the council chamber in Portlaoise to the floor of this Chamber and I have not been able to get any answer.

I take the Minister's remarks in good faith. The budget for the hospital is €42 million for the year. The Minister as a medic knows that €42 million will not fund the operational costs of a busy regional hospital. While we might have the status, will we have the funding? I know these are difficult times financially but if we intend to retain those services, the capital costs are required for a new maternity unit and there is annual funding for the running of the hospital, which amounted to €51.5 million just a few years ago. There are decisions to be made on this so I would like to hear the Minister's opinion.

There is no provision in capital funding in the current year or next year for a maternity unit for Portlaoise that I am aware of. I will check that with my officials and would be happy to be proven wrong. We live in straitened times and we all know why, because of the previous Government's approach to our economic affairs. Equally, as a doctor, I do not know that €42 million is not enough to run this hospital.

It has 400 staff.

I do know, however, that many of our hospitals must change the way they deliver care. We must have far more day case surgery, we must have far more cases admitted on the day of surgery, rather than the night before and I know we need greater flexibility in our staffing and how we approach this problem. There is huge room for improvement within our hospitals. That is not to castigate those who work there; people must work within the system as it exists. The Government's commitment is to change that system so we can have greater results for patients and greater numbers of patients treated safely in an appropriate setting. We do not want to have patients being treated in Dublin who should be treated in Portlaoise and we do not want to have patients being treated in Portlaoise who should be treated by their GP.

The Deputy is right; there is no question of maternity services leaving Portlaoise. There is no capacity within the greater Dublin maternity hospitals to cater for people beyond the Dublin region, even though small numbers have come from outside the catchment areas. It is difficult, however, to assess how many but I encourage people who have uncomplicated pregnancies to go local, which is more convenient and the service is excellent.

Hospital Services

Over the last month, Mullingar, Portiuncula and Galway University hospitals have been taken off call for ambulances due to the chaotic situation in accident and emergency departments. At the same time, Roscommon accident and emergency operates as a minor injury clinic for 12 hours a day, seven days a week. I do not care what name is over the door of the emergency department, what goes on inside is what is important to me and the people I represent. The reopening of Roscommon is a simple and cost effective way to take pressure off the other accident and emergency departments and the overstretched ambulance service.

Within four weeks of the closure of the accident and emergency ward in Roscommon, the Department of Finance approved the roll-out of a new nationwide telestroke service, which allows the use of IT for specialists in regional centres to conduct video consultations and communicate with patients and staff. This is the sort of system hospital campaigners in Roscommon have always sought because of our unique geographical situation. Safety, however, was never the issue in Roscommon. Local GPs were told heart attack patients would be transferred directly to Galway University Hospital for access to the CAT lab. They now feel they have been lied to as patients are being transferred to Portiuncula hospital, a hospital with the same facilities as Roscommon; the only difference now is that in some instances patients are waiting in GPs' surgeries for up to an hour for the ambulance to arrive.

Even leaving these issues aside, at this point we have some of the most skilled staff in the country twiddling their thumbs while chaos reigns in other accident and emergency departments around the country. Where is the sense in that? There is a need to review the ambulance and hospital bypass protocols relating to Roscommon. Why does someone who needs two stitches who was picked up by an ambulance go past the front door of Roscommon Hospital on the way to an overcrowded accident and emergency department? Why have 300 children with minor injuries been forced, since the closure of the accident and emergency department, to travel in pain to other hospitals because staff in Roscommon have been instructed to turn them away even though Roscommon was well capable of treating them prior to July this year?

Before the election, the Minister for Health and his party promised us they would not close our accident and emergency department. After they closed it, they told us there would not be any problems with it being closed because we would get extra ambulances and super, souped-up paramedics. That has not happened either. Last weekend put the tin hat on it when people were told by the media not to go to the hospital we were told to go to in order to save lives. As someone who has dedicated his life to saving people's lives, I wonder how the Minister for Health can stand over this. It is not unreasonable for us to have some place to go when we are sick in this area.

I thank the Deputies for raising this important issue. The urgent care centre now in place in Roscommon operates from 8 a.m. to 8 p.m. seven days a week and is provided by non-consultant hospital doctors with clinical governance provided by the emergency medicine consultant in Galway. In addition, a medical assessment operates at the hospital and there is an out-of-hours GP service is in operation.

The changes at Roscommon were necessitated by the serious patient safety concerns of the HSE and HIQA. The accident and emergency service situation at Roscommon followed the publication of the authority's report on Mallow General Hospital in April 2011 and this was compounded by of NCHD recruitment difficulties. The Deputy knows how many meetings were held with the various medical, surgical and emergency department experts to see if there was any way around this. None could be found so my hand was forced, unhappily but without choice.

Data from the HSE indicate that since the change of Roscommon's emergency department to an urgent care centre, the number of patients referred each day to other hospitals has been very low. The most recent data for ambulance calls in the Roscommon catchment area show that less than two patients on average per day were brought to Galway and Portiuncula hospitals.

Even fewer patients were brought by ambulance to Mullingar, Sligo or Mayo hospitals.

While I do not accept that opening the urgent care centre at Roscommon on a 24 hour basis would address the difficulties experienced from time to time at Galway University Hospital emergency department, I am committed to ensuring that problems experienced at emergency departments in Galway and elsewhere are addressed.

In recent months I have established the special delivery unit, SDU, under the leadership of Dr. Martin Connor. The SDU is working to unblock access to acute services by improving the flow of patients through the system. It is focusing initially on emergency departments and will be working to support hospitals in addressing excessive waiting times for admission to hospital.

I am also committed to the future of Roscommon and to other smaller hospitals. There was a safety issue. I absolutely concur with the sentiment expressed in the Deputy's question. Why does someone needing two sutures need to go to Galway? I ask why someone needing two sutures needs to go to hospital in the first instance. Why is the GP not suturing? That is what I was trained to do as a GP.

With regard to media reports, it is my understanding that people were asked to stay away from Galway University Hospital unless they were acutely or seriously ill. This was because there was such overcrowding at the hospital. There were 32 people on trolleys on the Saturday morning. By mid-afternoon the number had reduced to the mid-teens, by 6 p.m. it was down to ten and by 8 p.m. it was down to five.

There are problems in Galway and Limerick and in other hospitals around the country. There are difficulties with work practices. Difficulties have arisen because people have not done what was asked of them. Day surgeries that should have moved from larger to smaller hospitals, such as Roscommon and Portiuncula, did not do so. That problem is being addressed.

I understand that a plastic surgery outpatient clinic began last week in Roscommon and that the first plastic surgery will take place next week, with a new plastic surgeon. I welcome her return to Roscommon. She is Ms Deirdre Jones and I believe she is from Roscommon originally.

I ask the Minister to address my questions regarding children and minor injuries which can be treated in Roscommon.

I bring the case of Mary to the attention of the Minister. Three weeks ago she had a mini-stroke at 10 p.m. The ambulance arrived within 15 minutes to bring her to the Midland Regional Hospital in Mullingar. When the ambulance was outside Edgeworthstown, the crew received a call to say that Mullingar was no longer accepting patients. The ambulance was turned around and the woman had to be transferred to Sligo General Hospital. She spent two hours in the ambulance and reached hospital three hours after the time of the stroke. This is contrary to all the publicity we see regarding fast action in relation to strokes. That ambulance was tied up for three hours and taken out of the area for which it should have been providing cover.

Before July, approximately 280 patients per week attended the accident and emergency department in Roscommon County Hospital. Currently, between 40 and 60 patients per week attend the department. Where are the other patients? I believe they are afraid to go to their GPs for fear they will be referred to other hospitals. Many of these people are elderly and vulnerable.

The Minister gave a commitment to the Joint Committee on Health and Children that he would have an independent evaluation of the medical evidence regarding the effect on a critically ill patient of an ambulance transfer in excess of two hours. Has that evaluation been completed and when will it be published?

The issue of children is of concern. Yesterday, at the request of Deputy Frank Feighan, I met a group from Roscommon hospital, including some of the surgical staff and management. This issue was raised and it will be addressed in the next week. There will be availability for staff to deal with minor injuries and lacerations. I received that undertaking from a senior clinician at the hospital.

That is a positive development.

That is only for children.

The Deputy also mentioned other matters.

I also mentioned minor injuries and ambulance transfers.

People should be able to go to the hospital. At yesterday's meeting, the senior staff member from Roscommon hospital said he is available to GPs at the end of a telephone. He will be letting them know that so that they can send people to the hospital. He is on call and will see people if needs be.

The Minister is missing the point.

I did not interrupt the Deputy. I ask him not to interrupt me. There will be an improved service in this regard and GPs will be informed of it.

The total number of paramedics in County Roscommon is 26 and the total number of advanced paramedics is seven. The paramedical service is working very well and has already had a positive effect on a number of individuals, at least one of whom believes their life was saved as a consequence of being able to access the paramedical service as rapidly as they were.

Our commitment to Roscommon remains. The hospital has a bright future. Several other developments are in hand and will be coming down the track. I will not make a habit of saying what will come but I will report regularly to the House as to what has come. The first new development is the new plastic surgery service. There will be other developments over the next number of months and I will be happy to bring them to the Deputy's notice.

Childhood Obesity

I acknowledge the presence of the Minister for Health and thank him for the responses I have been receiving on this issue, which I have been raising since I was elected. Having a background as a primary school teacher, the issue of childhood obesity is of great concern to me. The problem has developed to an alarming rate in Ireland and deserves more care and attention. Credit is due to the Minister for the establishment of a special action group to deal with this issue. Everything needs to be put on the table and examined with regard to this problem. The Irish Times recently reported the observation that childhood obesity is a ticking timebomb waiting to explode. Apart from its financial implications and the cost to the Exchequer, which is estimated at approximately €4 billion, the effect of obesity on the physical health and psychological wellbeing of the nation is being stored away for future generations and we can no longer ignore it.

In the United States, President Obama has given Mrs. Obama special responsibility for dealing with obesity. In recent years in Ireland the food we have been ingesting has been increasing while our movement rates have been decreasing. We are eating more and moving less, with the result that we are putting up weight at alarming rates. This is leading to cardiovascular problems, hypertension, type 2 diabetes and obesity related cancers. It also leads to people developing asthma at a much younger age. I have a special interest in this because I am an asthma sufferer. Endocrinologists say there is a strong link between obesity and type 2 diabetes which is now manifesting itself in the genetic make-up of society. We can no longer ignore this issue.

The problem was brought to my attention when I was training to be a primary teacher and a mother told me she could not find a first communion dress for her child, who was in second class, because the child was morbidly obese.

The problem must be tackled on a number of fronts. The most important is education. We must educate society as to the dangers of obesity. Many of us were fortunate to be brought up on boiled potatoes, meat and two vegetables, but some parents do not have the skills to produce a healthy lunch and give their children the start in life that other children are getting. I welcome recent media attention on this issue which is usually the focus of attention in January when people get involved in campaigns such as "Weigh the Nation", fitness regimes and so on. However, by mid-February the media has forgotten about it and many New Year's resolutions have gone out the window. I would like this issue to be tackled in the same manner as we tackled smoking, suicide and mental health awareness. We need to address this massive problem in our country.

I thank the Deputy for raising this hugely important issue. If we do not address it we may end up the first generation to bury the generation behind it, which is not the natural order of things or what any parent ever wants to be involved in.

The prevalence of overweight and obesity has increased with alarming speed over the past 30 or so years, so much so that the World Health Organisation calls it a "global epidemic". The problem has been exacerbated in recent years as a result of our changing social, economic and physical environment and by a dramatic reduction in physical activity and changing dietary patterns. It is projected that if current trends are maintained half the population of the United States will be obese by 2025. The disease is now a major public health problem throughout Europe. The situation in Ireland mirrors the global obesity epidemic, with 61% of Irish adults now overweight or obese. Most worrying of all is the fact that childhood obesity has reached epidemic proportions in Europe, with body overweight now the most prevalent childhood disease. Some 25% of Irish children aged 5-12 and 20% of teenagers are either overweight or obese.

Childhood obesity is of particular interest to me. Obesity is a condition in which weight gain has reached the point of seriously endangering health. Some people may exhibit a genetic predisposition to weight gain but in general overweight and obesity in individuals is an excess of energy intake over energy expended. Obesity in children is of major concern in that it causes a wide range of serious health and social consequences and increases the likelihood of adult morbidity. The health consequences of overweight children during childhood are less clear but a systematic review shows that childhood obesity is strongly associated with risk factors for cardiovascular disease, diabetes, orthopaedic problems and mental disorders. Moreover, childhood obesity is linked to lower self-esteem. More than 60% of children who are overweight before puberty will be overweight in early adulthood, reducing the average age at which non-communicable diseases become apparent and greatly increasing the burden on health services, which have to provide treatment during much of their adult life.

Earlier this year, a special action group on obesity was established, comprising key stakeholders to examine and progress a number of issues to address the problem of obesity. Alone no single initiative will reverse the trend but a combination of measures should make a difference. For this reason the group is concentrating on a range of measures, including actions such as calorie posting in restaurants, the introduction of a sugar tax on sugar-sweetened drinks, nutritional labelling, restrictions on the marketing of food and drink to children, the improved detection and treatment of obesity, revised healthy eating guidelines and the promotion of physical activity. The group will liaise with other Departments and organisations as required.

The Health Service Executive continues its work on many programmes and services to help prevent and treat obesity, including the provision of nutritional programmes, the roll out of national physical activity programmes, the community games and the all-Ireland media campaign "Little Steps". Equally the Department, in conjunction with other organisations and Departments, is involved in a number of programmes that encourage the adoption of healthy lifestyles.

The World Health Organisation recommends that no more than 10% of daily energy should come from added sugar. It has serious concerns over the high and increasing consumption of sugar-sweetened drinks by children in many countries. Sugar-sweetened carbonated drinks seem to be a contributory factor to the obesity epidemic. Research in the US shows that adolescents there now consume more calories from drink than do from the food they eat. The Irish Universities Nutrition Alliance conducted the national children's food survey in 2005,a survey of the diets of children in Ireland aged 5-12. Preliminary analysis shows a high intake of fat and sugar, a low intake of vitamins and minerals and high physical inactivity with 7-10 year olds spending three hours in front of a TV and-or computer screen every night. Looking specifically at foods from the top shelf of the food pyramid, every day children consumed 17 grams of chocolate, 11 grams of non-chocolate confectionery, 12 grams of savoury snacks and 26 grams of biscuits, cakes and pastries.

We take this problem seriously. The Government is basing its policy on evidenced based information. The Deputy may be aware that I recently visited the United Nations for the second ever meeting of the UN on a health matter, namely, non-communicable diseases. Each of the nations, developing and developed, are facing huge problems in relation to their health budgets and their ability to look after their people if we do not address this serious issue.

I thank the Minister for his reply. I do not believe this problem will be solved by the Department of Health alone. The Departments of Education and Skills; the Environment, Community and Local Government in terms of local authority housing location and infrastructure; and Transport, Tourism and Sport in terms of safe mobility, be it by foot or bicycle also have a role to play. Also, our national broadcaster has a role to play in regard to the times when advertisements for particular types of food are shown. Obviously it is in the advertiser's interest that these be shown when children are likely to be watching. The statistics on this are startling. It is estimated that 400,000 children in Ireland are currently obese. We cannot ignore that.

As a country that prides itself on being one of the world's finest food producers, I encourage the Minister and his Cabinet colleagues to engage, not alone with the food industry but with the games industry on this issue. The Minister referred earlier to the time children are spending in front of games consoles. While children will do this perhaps the games industry has an obligation to, through its games, encourage movement in children. There is one obvious game console on the market which encourages a lot of movement. There is an obligation on all of us to tackle this issue. If we bury our heads in the sand and pretend there is no problem, just as people did when they said smoking did not cause cancer, we will be only burying it for a future generation. We have an obligation to do more than we are currently doing.

I could not agree more with Deputy O'Donovan. This is a cross-departmental and cross-governmental issue, which is the reason the meeting was held by the United Nations. It is clear we can learn from one another. We all know there are vested interests involved here and that when it comes to advertising, high-sugar drinks and high-fat foods should not be shown when young children are watching television. We need to introduce regulations to deal with that issue. Equally, the display of calories on the contents of various foodstuffs is required. While there is some voluntary participation in this regard even that is skewed. There is a particular well known brand of snack which states on the package that the snack contains 130 calories. However, on reading the back of the package one finds it states in the small print that the package contains almost 500 calories, the first calorific count relating to a recommended portion. We are conducting research on this issue within the Department and are discussing with other Departments how it can be addressed.

Deputy O'Donovan is correct that the Departments of Education and Skills; Transport, Tourism and Sport; the Environment, Community and Local Government; Communications, Energy and Natural Resources; Health; Children and Youth Affairs; and Justice and Equality have a role to play in creating a safe environment for people. Part of the problem is that it is much easier for parents to have their child sitting at home playing a games console or watching telly where they can keep an eye on them than it is for them to allow them out on the street to play. However, that is not the healthy option.

We have been in touch with Mayor Bloomberg's office. The Deputy Mayor, Ms Linda Gibbs, is currently visiting Ireland and I hope to make contact with her tomorrow to discuss some of the initiatives they have taken in New York in relation to this issue. We have a long way to go in terms of calorie posting and letting people know what is contained in what they are eating and drinking.

Social Welfare Code

I wish to bring to the attention of the House anomaly in the social welfare code regarding the entitlement of retained firefighters to jobseeker's allowance which is affecting many of them across the country and in my constituency, Clare. Clare has 77 retained firefighters based at Ennis, Shannon, Scarriff, Ennistymon, Kilkee, Killaloe, and Kilrush fire stations. There is only one full-time firefighter in the whole of the county.

A retained firefighter will be paid €8,000 per year, a remuneration that everyone will accept could not support a family. The number of call-outs has also reduced significantly, so a supplementary amount the firefighters earned for call-outs is considerably down too.

In better times, most of the retained firefighters had other employment locally. In the current economic climate, however, unemployment is high and local jobs are not as easily available. One condition of jobseeker's allowance, or dole as it is commonly called, is that recipients are available for work. When firefighters are on call, they must be within 2 km of their fire station, however. Deciding officers from the Department of Social Protection have concluded these firefighters are placing unreasonable restrictions on their availability to work, therefore not entitling them to jobseeker's allowance. It is also somewhat unfair as there are not many jobs available in many of the surrounding areas in question.

Up to a quarter of retained firefighters in Clare were getting jobseeker's allowance. Some have been informed they are entitled to it; others, that they are not. As they may not be called out 19.5 hours a week, they do not qualify for family income supplement. If they leave the fire service, they will not be entitled to other social welfare payments because they voluntarily left work.

More importantly, if they left the fire service, where would that leave an essential community service? These men and women who put their lives on the line to provide a service to our communities are essentially being penalised by the social welfare code. This is an obvious anomaly and contrary to what the Government wants to achieve in making it attractive to work and provide a service to one's community. This anomaly needs to be addressed.

I am taking this matter on behalf of the Minister for Social Protection, Deputy Burton.

Social welfare legislation provides that a person must satisfy the conditions of being available for and genuinely seeking work to be entitled to a jobseeker's payment. Any person who fails to satisfy these conditions on an ongoing basis is not entitled to such payment. Unlike other jobseekers who must sign off the live register on any day on which they find work, part-time firefighters are paid a jobseeker's payment in respect of days that they are engaged in fire-fighting or training. They are, however, required to satisfy the statutory conditions for the receipt of a jobseekers payment, that is they must continue to be available for and genuinely seeking work. In this respect, departmental deciding officers do not treat them differently to any other jobseeker.

In applying the legislation, deciding officers have regard to the availability of job vacancies in the locality, the age and educational qualifications together with the family circumstances of the particular claimant. The legislation does not impose any restriction or limitation on the right of a person to the opportunity to engage in the employment of his or her choice. Where a person is seeking work in his or her usual employment and there is a reasonable prospect of securing work of that nature, he or she would normally satisfy the conditions for receipt of payment.

However, if there is no work available locally, the jobseeker must seek employment in the surrounding areas. It may be necessary also to extend their availability to different categories of employment rather than confine their availability to a particular type of work.

After a period of unemployment, a person must be prepared to accept any employment for which he or she is qualified. It is a principle of the availability for work condition that a person's unemployment must be involuntary. It is not possible for an unemployed person to hold herself or himself available exclusively for employment that is in a restricted distance from a fire station where he or she is employed as a part-time firefighter. Such action would be taken as placing an unreasonable restriction on his or her availability to secure full-time employment.

A person may be regarded as not being available for work if he or she imposes unreasonable restrictions on the nature of the employment, the hours of work, the rate of pay, the duration of the employment, the location of the employment and other conditions of employment which he or she is prepared to accept. A deciding officer may impose a disallowance in a case where a person refuses an offer of suitable employment or where he or she imposes unreasonable restrictions on the location of the employment he or she is prepared to accept.

Issues relating to the eligibility of firefighters for jobseeker's payments have been raised with the Department on several occasions over the years. Taking account of the unusual circumstances of these workers and general efforts to develop and standardise our jobseeker schemes, a group has been established in the Department to examine the position of firefighters. It will be reporting to the Minister over the coming period. She will keep relevant Deputies informed as this issue is progressed and would welcome any suggestions they may have.

Key to the Minister's considerations will be recognition of the valuable service which this group of workers provide to their local communities. However, it is also important that the integrity of the jobseeker schemes be maintained.

I welcome the announcement that the position of retained firefighters on jobseeker's allowance is being considered. If declining employment that is beyond a certain distance of a fire station is considered unreasonable, the whole rural fire service becomes untenable. It relies on men and women being available within 2 km of their fire station when on call. We have a choice of leaving the social welfare code as it is and abandoning essential rural fire services. To professionalise all rural services would be an expensive step for the State given the paucity of call-outs, however. Having a full-time fire service in every small town would be prohibitively expensive. Accordingly, the alternative would be a change to the social welfare code which is necessary in these circumstances.

I am pleased the Deputy welcomes the progress in this area through the establishment of a working group to resolve the matter. I want to put on record my appreciation of the brave men and women who perform this essential service for our rural communities and who often lay their lives on the line in doing so. It is in all our interests that this is examined closely for a resolution to be found to the satisfaction of all and one which does not compromise the jobseeker scheme or the fire service.

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