Topical Issues Debate

Periodic Payment Orders

Deputy Willie Penrose

I thank the Ceann Comhairle for selecting this matter for debate on the floor of the House this evening and I thank the Minister, Deputy Shatter, for attending personally in the House to address this important issue which has significant implications for many people.

As the House will be aware, where a person is injured in an accident, which event arose as a result of an accident as an employee, as a result of a road traffic accident or under the auspices of the occupier's liability principles, and the injured party establishes liability against a particular person or company, then that injured party is entitled to recover compensation by way of damages. In deciding the amount of compensation in a civil claim, the courts resort to two headings of damages - general damages and special damages.

General damages is that part of the award which compensates a person for the injury up to the date of the court hearing and also as to the future, which is at best a guesstimate since the effects of the injury can be borne by the injured party right through until he or she dies. This is, therefore, encompassed by a lump sum award which, despite public perception to the contrary, is not unlimited as there is a court defined cap on general damages in civil claims.

The second heading of an award is special damages which encompasses various items which can be calculated with reasonable accuracy with the aid of expert evidence provided by an actuary. Such items include the loss of earnings, both past and in the future, and can be based on the likely future earnings and the possibility of not always being in employment as is currently the position, and this must also be factored in to this estimate. Special damages also include future medical expenses and in the case of very serious physical injuries, the cost of equipment, the modification of a dwelling house, the requirement for an automatic car, the requirement for home care help, and the cost of specific medical assistance and aids.

Under the system as currently constituted in the Irish jurisdiction, it means that awards in these types of serious cases consist of a lump sum which is a once-off amount of money paid. In so far as the amount awarded in respect of special damages, this is especially problematic as the amount for special damages is intended as a capital sum which, if invested wisely, would yield enough annual income for the person so injured to pay his or her medical and other expenses and live comfortably in the context of his or her injury.

The Judiciary has been active and vocal in this area for the past three years or so. Mr. Justice Kearns, President of the High Court, established a working group on medical negligence and periodic payments under the chairmanship of Mr. Justice John Quirke, who is now retired. Indeed, the first module of this report concerning periodic payment orders was presented in October 2010. This has been available for the past two years. Notwithstanding the urgings of the members of the Judiciary in recent months, most notably Ms Justice Mary Irvine, who has taken a number of these cases for ruling, to bring forward appropriate legislation to implement the recommendations of this report, nothing appears to have happened today, and I hope the Minister will change that this evening.

The House will be aware that since 2005, in England and Wales, personal injury awards in catastrophic injury claims may be based on structured settlements or periodic payments. A structured settlement is, in effect, an annual payment or annuity purchased from an insurance company to meet the obligations in an agreement to provide periodic payments. Periodic payments are the payments made as a result of a personal injury claim which are made by way of a future stream of payments.

The executive summary of the working group makes 13 specific recommendations. The group was unequivocally clear that a single lump sum award is inadequate and inappropriate in such cases where a plaintiff has been catastrophically injured in the long term or, indeed, permanently, a where this person will require ongoing care and medical treatment in the future. Therefore, I urge that legislation be enacted to empower the courts, as an alternative to lump sum awards of damages, to make consensual and non-consensual periodic payment orders to compensate injured victims in cases of catastrophic injury where long-term permanent care will be required, for the cost of future treatment and future care and the future provision of medical and assistive aids and appliances.

The order should apply to the whole or part of an award in any case where, having regard to the nature of the injuries in respect of which the award is being made and the circumstances of the person to whom the award is being made, the court considers it appropriate in the best interests of that person that such order should be made, provided that the parties have been given an opportunity by the court to make submissions and be heard in full on the relevant issues. The court should be empowered to make periodic payments orders to compensate for future loss of earnings only with the consent of all of the parties to the relevant claim.

I look forward to the Minister's reply. This is an innovative area in which I expect the Minister will bring forward legislation as quickly as possible.

Minister for Justice and Equality (Deputy Alan Shatter)

I thank Deputy Penrose for raising this important matter. As Deputies may know, the programme for Government has a commitment to legislative reform in this area. The commitment is to empower courts to make provision for structured settlements in circumstances where lump sums are currently awarded as a consequence of individuals suffering catastrophic injury because of the negligence of another.

In our legal system an award for damages, in other words monetary compensation, in personal injury cases is restitutory in purpose. It is the most common form of redress pursued in civil claims. The bedrock principle underlying the awarding of damages in our legal system is that the amount of compensation should restore the injured person, in so far as money can do so, to the position he or she would have been in if he or she had not sustained the wrongful injury.

In general, damages awards are paid by way of a single lump sum. Damages are awarded under two headings - special damages and general damages. Special damages are damages specifically claimed and proven to have been sustained in the circumstances of the particular wrong to the plaintiff. They cover pecuniary losses like medical expenses or loss of earnings, including loss of future earnings. General damages cover non-pecuniary loss that the law presumes follow from the type of wrong complained of. This loss includes pain and suffering, loss of amenities and loss of the expectation of life.

A one-and-for-all lump-sum award has a number of advantages. It is final, simple and allows the plaintiff to be flexible in deciding for himself or herself the order of priority in relation to his or her different needs and wants. This straightforward approach, however, often results in over-compensation or under-compensation. The calculation in court by reference to average life expectancy may bear little relation to the real life expectancy of the individual plaintiff involved. A claimant may die long before his or her expected time. In that event, the defendant cannot take back the excess of damages paid, and the excess becomes a windfall for the plaintiff's family.

The converse is that a plaintiff may live longer than expected. In that event, his or her damages may simply not be sufficient to meet his or her needs during the last phases of his or her life. This is likely to happen later in life when the effects of having insufficient resources will be particularly hard to handle. Out of excessive prudence, a plaintiff may become so concerned about exhausting the lump sum that he or she does not spend the required amount of money on their needs.

There are other variables we must keep in mind. Investment returns will depend on the person's investment strategy and the prevailing financial and economic climate. A plaintiff's needs may change from those assessed at the time of trial or settlement. The costs relating to care that were assessed at rates or values operative at the time of the trial date may increase substantially later on.

Judges do their best to ensure that a catastrophically injured plaintiff is adequately provided for, whatever the future holds for him or her. However, the pressure on judges in many cases to turn to what is in effect guessing what the future holds for the plaintiff is unreasonable. In this area, accuracy and legal certainty are important values. It is desirable to have a system of compensation that is better able to meet future needs as and when they arise.

To meet some of the difficulties of the current system and, in particular, to ensure that plaintiffs are safeguarded against the danger that at some time in the future their damages might be depleted, a new means of paying damages by way of periodic payments orders needs to be developed. This would allow the courts to structure awards or settlements in a more realistic way. It would provide a guarantee for a plaintiff that he or she will continue to receive regular annual payments for the duration of his or her life so his or her damages will never be exhausted.

The Deputy specifically referred to the work undertaken by the working group on medical negligence and periodic payments, under the chairmanship of Mr. Justice John Quirke. I welcome that work and acknowledge its importance.

On periodic payments, the working group recommended that legislation be enacted to empower the courts, as an alternative to lump sum awards, to make consensual and non-consensual periodic payments to compensate injured victims in cases of catastrophic injury where long-term permanent care and treatment will be required. The working group also recommended that periodic payment orders should only be made where the court is satisfied that continuity of payment under the periodic payments order is reasonably secure.

The viability of a statutory scheme for periodic payments requires the establishment of a financial infrastructure to ensure that continuity of payment is secure. In this regard the working group recommended that the State, through the agency of the National Treasury Management Agency, be empowered to provide injured victims with the necessary security for periodic payments, either by the provision of annuities to insurers and others or in such other manner as may be appropriate. Alternatively, it was recommended that consideration be given to the introduction of a statutory scheme whereby payments made under periodic payment orders will be statutorily protected and guaranteed.

The NTMA has recently concluded an actuarial review on the feasibility and cost-effectiveness of the State acting as an annuity provider to insurers and indemnity providers in personal injury actions to enable compliance with the security-of-payment principle. The NTMA report is currently being considered by my Department in consultation with the Department of Finance with a view to the development of legislative proposals by my Department. Subject to the outcome of these consultations, which I expect will conclude shortly, I intend to bring to Government for its approval in the coming weeks concrete proposals for the preparation of the scheme of a Bill to amend the Civil Liability Act to give courts the power to make periodic payment orders in appropriate cases.

I regard the enactment of such legislation as of particular importance. I very much appreciate the comments made by members of the Judiciary underlining the need for this matter to be adequately and fully dealt with by this House. I hope we will see the legislation enacted during 2013.

Deputy Willie Penrose

I thank the Minister for his comprehensive reply and for taking this matter on board. I am concerned about cases where plaintiffs live for longer than expected and the imposition that would create where an award would be insufficient to meet their needs. That can put a lot of pressure on parents and others concerned.

In any such legislation, provision should be made for the appropriate indexation of periodic payments. The working group recommended that this should include the introduction of earnings and cost-related indices which would allow periodic payments to be index-linked to the level of earnings of treatment and care personnel and to changes in the cost of medical and assistive aids and appliances. That would ensure plaintiffs were able to afford the cost of treatment and care into the future.

The working group also recommended that the Central Statistics Office is uniquely qualified to compile and maintain the indices required in this regard. It is important that these matters should be taken on board. I thank for Minister for his reply. I look forward to this legislation whose passage, hopefully, will be facilitated by all parties in the House. The Judiciary has been active in this regard but quite restrained and eager that the Legislature would act in an area where long-standing recommendations have already been made. When this legislation is brought forward, it will enhance the Minister's standing by ensuring an issue of such import is accelerated through the Oireachtas.

Deputy Alan Shatter

I regard this legislation as a priority matter of great importance. It is evident that a statutory scheme is required if periodic payments orders are to become a reality. This is clear from the work done by the working group. Further additional work was required in the context of how we ensure necessary security for the long-term viability of periodic payments, which has to be a key element of any legislative proposals. There is little point in putting in place a structure which facilitates the making of such payments unless it is ensured that those payments are secured into the future. This is one of the issues, among others, which is being examined. The reality is that there is no financial product available to insurers in this area at present. A new financial infrastructure will be necessary to make the legislation workable. This is quite a complex area involving a whole range of issues that need to be addressed. Very careful work is required to ensure that any legislation enacted meets the required objectives.

I want to assure the Deputy, and members of the Judiciary who quite properly raised the importance of this issue, that this is a matter the Government intends to address. It is my objective to ensure the legislation is enacted during 2013.

Gas Exploration Licences

Deputy Brendan Griffin

I appreciate the opportunity to speak on this matter. I call on the Government to consider establishing a State body to co-ordinate and develop the oil industry. I am anxious to see a proactive State effort to ensure the Irish people will derive the greatest possible benefit from our oil reserves.

Recent significant oil-related developments off the Cork and Kerry coasts signal major potential and Members must ensure the most is made of it. Significant opportunities now present themselves before any oil is actually extracted and preparation and exploration could prove to be significant money spinners and employers for both regions and the State as a whole and Members must be alert to this. They should not wait any longer as the opportunities are there now. This is coming in the midst of the greatest economic crisis the State has ever known and oil and its associated benefits offer great hope. This must be harnessed and put to tangible good use for the people of the country and this is the reason I call on the Government to consider the establishment of this State body to co-ordinate and maximise the potential of the oil industry.

Historically, State bodies such as Bord Iascaigh Mhara and Bord na Móna have delivered major benefits for the State by making the most of the natural resources available to their respective sectors. I envisage this also would be the case in this regard. Oil now offers a massive wealth opportunity to the people and the State must step in and make the most of it for this and for future generations, who will benefit therefrom. This agency should comprise professional expertise brought from the oil industry and it would act as a one-stop shop on oil-related matters. Among other tasks, such an agency would liaise with oil companies to provide access to Irish companies, services and trained personnel. It also would advise the Government.

Acting Chairman (Deputy Olivia Mitchell)

I must come back to the Deputy as Deputy Ferris's time now is being taken.

Deputy Brendan Griffin

I had almost finished and was saying the agency would advise the Government on policy areas.

Acting Chairman (Deputy Olivia Mitchell)

I will revert to the Deputy for a moment later.

Deputy Martin Ferris

Earlier this year, the Oireachtas Joint Committee on Communications, Natural Resources and Agriculture produced a report, which had the unanimous support and backing of its members, on offshore exploration by the oil and gas industries. In preparing this report, the joint committee sought advice from the Norwegian oil ministry and the Norwegian ambassador and other interest groups also appeared before it. The report is available and I understand it is probably in the Minister's office. It should be considered in respect of exploiting this potential for the benefit of all the people and not for the oil companies or for a golden circle. The potential of two discoveries off Dunquin and off the South Porcupine Basin offers quite substantial hope for the economy if they are used properly for the common good. The tax regime that forms part of that potential should be consistent with the proposals in the aforementioned joint committee's report.

I also wish to bring to the Minister of State's attention that Fenit Port, County Kerry, has a history and a great track record of servicing oil rigs off the west and south-western coasts from the 1970s and 1980s in particular. It also has available skilled personnel who worked as roustabouts or roughnecks or who worked in galleys or as derrick men and so forth. Many people there still have such experience and some people continued to work right up until the late 1990s by travelling to Aberdeen and so on. County Kerry has almost twice the national average rate of unemployment. Moreover, it received no visits from the IDA this year and nothing has come into the county in recent years. Consequently, from the perspective of the local economy, it would be essential for Fenit to be considered as a port for supplying the oil rigs off the coast.

Acting Chairman (Deputy Olivia Mitchell)

While I must ask the Minister of State to respond, I will revert to the Deputy.

Minister of State at the Department of Communications, Energy and Natural Resources (Deputy Fergus O'Dowd)

I thank both Deputies for putting this matter before the House for debate. It is an important and current debate and I wish to refer to some of the facts. The first fact obviously is that were oil to be discovered off the Kerry coast or off any other part of the coast, it would indeed be good news. I can confirm for Members that there has not, as yet, been a discovery of oil off the Kerry coast and the last time an exploration well was drilled in this area was more than a decade ago in 2001. Unfortunately, that well was dry. On a more positive note, I can inform Members that planning for an exploration well in 2013 on the Dunquin prospect is being advanced. There has been quite a deal of media coverage on the topic of oil and gas exploration in recent months, including some articles about potential major fields. In some instances, these articles have related to exploration authorisations where the holders have yet to commit to exploration drilling or even to acquiring new seismic data. Forecasts made in such circumstances must be put into perspective. In order for a discovery to be made, there must first be exploration drilling and such drilling in the Atlantic is expensive and involves a high financial risk.

Over the past decade, there has only been an average of a single exploration well per year. In recent years, however, there has been an increase in the number of exploration authorisations granted in the Irish offshore area. In the coming years, this should result in an increase in exploration activity and in exploration drilling in particular. As a consequence of the current low level of drilling activity, there are no offshore drilling rigs permanently based in Ireland. While the current level of exploration activity provides some employment opportunities in ancillary supply and support services, along with specialist port services, there is unlikely to be a substantial oil industry based in Ireland until there is a much higher level of exploration drilling in Ireland's offshore areas. Not alone has drilling activity been low, but it does not all occur in one area and this has implications in terms of anticipating where support services should be located. Clearly, a drilling rig off the coast of County Donegal is likely to be supported from a different port to a drilling rig off the County Kerry coast.

Ireland has a clear policy of actively encouraging investment in oil and gas in order that we can enjoy both economic and energy security. A reasonable increase in exploration activity levels resulting in further commercial discoveries of oil and gas certainly would result in increased employment and economic activity generally. It also would result in significant financial benefits to the State from the higher rate of corporation tax that applies to profits from production of oil or gas. For the present, however, one must remain realistic regarding both the pace and nature of the exploration effort.

Deputy Brendan Griffin

One does not need to wait for oil to start flowing for the money to start flowing as in itself, exploration is a major industry that offers a massive spin-off to local communities. For example, airports, seaports - as were mentioned - and local hotels could benefit greatly from such exploration. Now is the time to be proactive in this regard and to put in place a one-stop shop for the industry to co-ordinate this effort. There is a need to be proactive in this respect and I am very hopeful that there will be major reserves that can be brought to the surface at some point. However, the very fact of finding it will cost a great deal of money. As the Minister of State indicated, there will be massive expenditure involved and Members must ensure that before any oil is brought to the surface, the people of the country will benefit from such expenditure. This is the reason the particular conduit I have proposed should be put in place for the industry. I again ask the Minister of State to reconsider the matter and to give serious consideration to this proposal.

Acting Chairman (Deputy Olivia Mitchell)

I interrupted Deputy Ferris earlier. Did he want to come back in?

Deputy Martin Ferris

The Porcupine Basin was explored in 1978, 1979, 1980 and 1981. A number of exploration wells were drilled there and oil was discovered. However, because of the depth of water at which the oil was discovered - I believe it was approximately 1,700 ft. - modern technology was not then available to deliver the oil to the surface and to the shore and the find was capped and left there. I assume the Petrel Resources company has returned to those areas on the south Porcupine Basin, where it is due to start drilling in the new year. Based on its findings as a result of the two licences it purchased last year, Petrel Resources has stated it believes the area in which it intends to drill has the potential to deliver 1 billion barrels of oil. If that is true, one would be talking about a monetary value of between €85 billion and €100 billion, which would be a significant start. In addition, Providence Resources also has claimed to have made a big discovery off Dunquin.

Both of those will probably start next year and work together.

It would be remiss of us as elected representatives not to make the point that the resources which exist should be for the common good and the greater good of our people; they should not just be for the people who exploit resources for their own good. People may stand to make much money from this but there should be a proper taxation system consistent with what the committee delivered earlier this year. That report would have guaranteed that resources would go back for the use of this country's people.

Deputy Fergus O'Dowd

I thank both Deputies for their comments. So far, Ireland has had approximately 146 wells drilled. That compares with over 4,000 wells drilled in Britain and over 1,200 in Norway. The reason people have not been coming here until now is that a chance of a find is much greater elsewhere. We have resources in the Department, and the petroleum affairs decision is very much involved in the issue. The Department has sponsored, along with the Canadian Government in the Labrador area, a study of geological backgrounds and the possibility of new exploration based on reversing plate changes. In an Atlantic margin round, 12 new companies have taken up options to examine seismic data. I announced recently that the Department is in discussions about a major new seismic analysis taking in thousands of kilometres off the Atlantic coast to determine what may be under the sea.

We must be realistic and remain factual. We want these companies to find oil and attract them to the country. That is why we have our current level of consent and co-operation. There is also our tax regime, which is often attacked by people. That is comparable with that of Spain and Portugal. We must encourage companies to explore here and we hope they will make oil finds. Nevertheless, they must drill to find oil, and that is up to them. There will be more drilling next year than there has been in previous years, which is good.

Hospice Services

Deputy Simon Harris

I am thankful for the time to raise in the Dáil today the need for the provision of a hospice in County Wicklow and to seek an update on where plans for such a provision are currently within the Department of Health and the HSE. I thank the Minister of State, Deputy Kathleen Lynch, for her attendance for this topical issue.

The people of County Wicklow, relative to other parts of the country, have been poorly served by the level of palliative care available. In counties such as Limerick, Clare, Tipperary, Donegal and Sligo, the health spend on specialist palliative care services in 2011 was roughly €30 per head of population; in my county of Wicklow, the figure is a paltry €3. Currently, Wicklow does not have the resources to provide a service seven days a week and it cannot provide a weekend on-call service. Whereas the standard of care provided by home care teams of nurses is exceptional and very much appreciated by families in need of such a service, we have experienced weeks in Wicklow where services have been suspended in parts of the county due to staff leave and vacant nursing posts.

Despite this, an amazing group of dedicated and committed people have come together in Wicklow to set up what is known as the Wicklow Hospice Foundation. They have worked day and night and, to date, they have raised in excess of €2.5 million to provide a hospice in Wicklow. They have even obtained a site for the hospice, very kindly donated by nuns, in Magheramore. They now expect to be able to meet all the capital costs of building a hospice through fund-raising, an incredible achievement, particularly in the current economic climate. That makes me very proud to represent such a community in this House.

The people in the Wicklow Hospice Foundation, the residents of Wicklow and I must know where is the provision of the hospice in the view of the HSE and the Department of Health. What consideration has been given to the possible funding streams to staff, equip and maintain such a Wicklow hospice? If the community can build the hospice and has raised funding voluntarily, as well as finding a site for the hospice, where can the Department of Health and HSE meet the community in progressing the work?

I wish to emphasise a few points and seek answers. In 2009, the HSE carried out a major consultation process on palliative care and produced a five-year implementation plan. The list emanating from the plan was based on population, need and clinical opinion on where the hospice facilities should be built, as we cannot build a hospice facility in every town. County Wicklow was included as a location, so the need has already been recognised by the HSE as far back as 2009. Will the Minister of State indicate where the implementation of the five-year plan stands?

The Government's health document, Future Health, has just been published and it has a strong commitment to develop potential funding channels for palliative care. Will the Minister of State elaborate on the issue and will the funding mechanism be based on the model of money following the patient? It is clearly enshrined in the programme for Government and I know both of our political parties campaigned heavily on it in the last general election.

The provision of a Wicklow hospice is clearly right morally and from a societal perspective. It is also right from an economic view. We all know the cost of acute hospital care is far more than the cost of palliative and community care. Will the Minister of State address that point? The provision of a Wicklow hospice is a perfect example of a partnership approach to the delivery of important community health services. The community has played a leadership role and there is significant buy-in and pride in the project. Residents in County Wicklow have put their money where their mouth is and raised more than €2 million. The nuns in the county have played their part and contributed a site, which has been approved as being suitable by the HSE. We now need to advance the issue with the support of the HSE.

Minister of State at the Department of Health (Deputy Kathleen Lynch)

I thank the Deputy for raising the issue as it provides me with the opportunity to outline the position to the House. As somebody from a city that has always been extremely well served with palliative care, I understand the value of such a service.

Our policy is to continue to develop and improve palliative care health services in all regions of the country, thus meeting the objective of providing modern, high-quality palliative and end-of-life care services for those who need them. The development of such services is informed by various sources including, for example, the Report of the National Advisory Committee on Palliative Care 2001 mentioned by the Deputy, the ongoing wider reforms for the health service generally and service priorities and resource availability generally, as indicated in the agreed HSE annual service plans. The Deputy will be appreciate, therefore, that the executive has operational responsibility for the delivery of health and social services, including considering in the first instance proposals relating to developing hospice facilities in Wicklow.

Despite existing resource pressures overall on the health care system, the HSE national service plan for 2012 indicates funding of some €78 million for palliative care. Approximately 75% to 80% of this is being provided to the main voluntary organisations. Palliative care is also additionally funded through both acute and community services. The HSE service plan for 2012 specifically identifies the following deliverable outputs which are of relevance to the Wicklow area. These are the development of a national standardised admission, discharge and referral criteria which will improve uniformity of care; development of a systematic process of assessment of need which will result in improved care plans; development of a benchmark which will ensure improvements from referral to first point of contact; development of integrated care pathways to improve access; development of guidelines and pathways to improve out-of-hours services; and production of readily available information on palliative care and bereavement services which will be provided to individuals and organisations to enable them better access to local services.

The HSE palliative care services five year or medium term development framework for 2009 to 2013 identified the need for an inpatient hospice unit for Wicklow, together with associated staffing and revenue. The HSE is keenly aware that the current level of service available is less than optimal. The local Wicklow Hospice Foundation has been engaged in extensive fund-raising for capital to build a hospice. However, in order to staff and operate such a service, it would be necessary to secure substantial revenue funding and staff. The Deputy is aware of the budgetary pressures currently facing this Government and the HSE and all new developments have to be considered against the current budgetary and fiscal constraints. The executive must also to take account of other palliative care issues, such as capital projects approved in the national framework for all areas which face similar service and resource pressures. Nonetheless, the executive is continuing to engage with the hospice to see if it is possible to address funding issues in the context of any flexibility for this from 2013 onwards. In these circumstances the Department and the HSE will continue to keep the matter under review.

Deputy Simon Harris

This is an issue of equity for people in County Wicklow. As I indicated, spending on palliative care in the county is €3 per head of population as opposed to €30 per head of population in counties Donegal, Sligo and Limerick. While we do not begrudge people in these counties such expenditure, some degree of equity is required. The lack of equity was evident when palliative services in north County Wicklow where I live were suspended during the summer owing to staff leave. Moreover, the Health Service Executive, having carried out interviews for vacant nursing posts, decided not to proceed to fill the positions. While I am aware of the current budgetary difficulties, I ask the Minister of State to convey to the HSE my concerns regarding its failure to fill the relevant nursing posts. Addressing this matter in the first instance is important. However, it is also important to address the issue of equity.

One of the Minister's key commitments is to move to a funding model under which money follows the patient. If we are serious about shifting to such a model, money should leave some of our hospitals with patients and go to hospices. In 2011, the percentage of patients in hospice home care programmes who died in hospital was 6% in Limerick and 40% in Wicklow. As Deputies are aware, it is more expensive to care for patients in hospitals than hospices. If we were to introduce a funding model whereby money follows the patient, some financial resources should follow patients being discharged from acute hospitals into hospices.

Politicians are always asked whether Departments have lists of projects. Does the Department have a list setting out where the next hospices will be built? If so, where does County Wicklow feature in the ranking? I would be grateful if the Minister of State would raise these matters with the Health Service Executive.

Deputy Kathleen Lynch

I accept that an issue of equity always arises in the development and delivery of services. The Deputy provided stark figures on the percentage of hospice home care patients in Limerick and Wicklow who died in hospital care. All the research suggests people wish to spend their final days at home and in their communities. I am not certain if the list the Deputy seeks exists but I will convey his request to the Health Service Executive. If information is available on this matter, I will ensure he receives it.

Hospital Services

Deputy John McGuinness

In raising this matter, I express my sympathy to the family of the late Niall Comerford, his parents, Walter and Joan, brothers, Damien and Shane, and sister, Linda. Niall Comerford was a young man who had a routine operation lasting for 15 minutes in Kilcreene Hospital on 24 September 2012. His parents complain that he was not given pre-operative advice and information on his after-care was not provided on discharge. He was simply asked to return to the hospital within ten days and visit his consultant six weeks later. On 1 November 2012, Niall died as a result of pulmonary embolism and deep vein thrombosis. Professor Beverley Hunt, who has written many papers on deep vein thrombosis, states that the condition can be avoided or addressed by following appropriate advice.

The death of Niall Comerford has been shocking for his family who decided to wait until after the autopsy last Friday before raising the case publicly. I listened carefully to Walter Comerford speak on my local radio station in recent days. Despite his loss, Mr. Comerford is dealing constructively with his son's death and has asked publicly for an independent inquiry. When I met him before the autopsy more than a week ago he was thinking along the lines of seeking an inquiry but chose to await the outcome of the autopsy. He has since issued a public statement requesting an independent inquiry.

It is difficult to believe the Health Service Executive did not contact the Comerford family until after the autopsy. I believe it was for this reason that the family concluded it did not have confidence in the HSE. Put simply, I support the family's request and urge the Minister of State to support the family during this very difficult time by immediately establishing an independent inquiry to ascertain precisely what occurred. Such an inquiry could be carried out by the Health Information and Quality Authority.

Deputy Kathleen Lynch

Before referring to the notes provided to me, which are, by necessity, very short, I extend my deepest sympathy and that of the Department to the family of Mr. Comerford. The loss of a child is unimaginable for most people.

Approximately one week following discharge after routine knee orthopaedic surgery undertaken at Kilcreene Orthopaedic Hospital, Kilkenny, a young man was admitted to Waterford Regional Hospital in a collapsed state and pronounced dead shortly afterwards. The Health Service Executive expresses its deepest sympathy to the family on the death of this young man. On 30 November 2012, the Waterford city coroner recorded a death of acute cardiac failure secondary to pulmonary failure, which was caused by deep vein thrombosis originating in the left calf. The orthopaedic consultant involved in the case met with the family separately approximately one week before the inquest. Following the verdict of the inquest, HSE representatives contacted the family and offered to meet them. The family are to refer back with a decision as to whether they will attend a meeting. The family have expressed their dissatisfaction and requested an independent review of the case. The HSE has confirmed that this case is being escalated to the national incident management team for completion of a review. The family will be consulted as part of this process. I am sure the Deputy will understand that further comment at this time would be inappropriate. I will convey the sentiments he expressed to the Minister for Health when we meet later.

Deputy John McGuinness

I respect the role the Minister of State must play in this matter and note the information she provided, none of which is inaccurate or disputed. She indicated that further comment would be inappropriate. The family of Niall Comerford has requested an independent inquiry and is not interested in discussing the matter further with the HSE, as they made perfectly clear to me today. They are shocked that the HSE did not make contact with them prior to last Saturday. I am not making a big issue of this but asking the Minister of State to consider a reasonable request from the family.

The Minister of State's reply did not address the question I asked. I ask her to reconsider her response and consider, with the HSE and Department, the family's request, bearing in mind the constructive approach they have taken to this matter at a shocking and sad time. At a minimum, the Health Service Executive must change its normal tack, stop being defensive and come to the assistance of a family by acceding to its request, which was made in a public, quiet and constructive manner, for an independent inquiry.

The Minister of State will fully understand why such a family can lose its faith in the health system and the HSE. Given the poor contact between the family and the HSE, rebuilding confidence in the system, the HSE and the Department requires that similar situations be dealt with in a more sympathetic way. I do not expect a reply now, but please reconsider the family's simple request.

Deputy Kathleen Lynch

I will be brief. We all understand the grief that the family must be going through. A healthy young man, a son, was lost. That this situation has been escalated to the national incident management team for the completion of a review is important. As Deputy McGuinness rightly stated and as we all accept, though, I cannot give a commitment now. However, I will bring the family's request to the Minister for Health. Understandably, the family has been deeply traumatised by these events. I will not walk out of the Chamber and leave this issue behind me - I will bring it with me and discuss it with the Minister.

Dáil Éireann díospóireacht - Tuesday, 4 Dec 2012