Leaders' Questions

As the Minister for Agriculture, Food and the Marine, Deputy Coveney, will realise, the Irish seafood industry is critical to rural coastal communities, providing 11,500 jobs in such peripheral areas. Some 2,100 fishing vessels throughout the country are dependent on the industry. That industry and those people are dependent on an effective Common Fisheries Policy to sustain their livelihoods and their communities.

Last week I met representatives of the Irish South and West Fish Producers Organisation and the Irish Fishermen's Organisation, IFO. I met both organisations together and was surprised that they were angry, annoyed, disillusioned and disappointed in the Minister in regard to the outcome of the Common Fisheries Policy review, in particular with regard to the lack of consultation between the Minister and them in the past while in the lead-up to the agreement which was ultimately reached. They felt they had not been consulted in any cohesive way on the current round of negotiations, the outcome of which has, in their words, "the potential to place the majority of our members out of business". That was a different kind of picture and perspective I received last Friday from the horse's mouth, from those who work in the industry. Afterwards, there was a presentation of press releases and a general media treatment of the deal. In particular, the representatives believe the discard compromise is unworkable from the point of view of the Irish whitefish industry, given the mixed nature of the fisheries in which the majority of whitefish vessels operate.

The implications for rural coastal communities would be adverse, particularly in places like Castletownbere, Union Hall and Baltimore. The Killybegs Fishermen's Organisation has also been highly critical of the proposal.

Why did the Minister fail to persuade his colleagues to directly enshrine the Hague preferences in the deal? I am aware that Pat the Cope Gallagher, MEP tabled an amendment at the trilogue to include the Hague preferences in the recitals, which means they are now subject to annual negotiations when it comes to the allocation of quotas. However, while due regard will now have to be paid to the preferences, they were not directly included in the deal itself.

Four young fishermen who accompanied the group told me that young Irish people will no longer go into fishing. They would prefer to emigrate than fish in Ireland. They pointed out that crews now comprise Filipinos, Egyptians and eastern Europeans. What does that say about the absence of an overall plan for the development of a sustainable fishing industry? I was left with that thought as I departed west Cork last Friday and I ask the Minister about the lack of consultation, the workability of discards - I know the policy is being phased in over ten years - the Hague preferences and the future for young people in fishing.

I thank Deputy Martin for raising this issue because I have spent considerable time during the Irish Presidency on brokering a deal with the European Parliament, the Commission and other member states which would radically reform the way in which Europe's fishing fleet fishes, link science in a real way with the calculation of quotas and total allowable catches each year and ensure we are fishing stocks as commercially as we can in terms of maximising catches while at the same time protecting stocks. I am a strong defender of the CFP reform we have agreed and so too is Deputy Martin's colleague from County Donegal, Pat the Cope Gallagher, MEP who voted this morning in favour of this reform at the PECH committee of the European Parliament. The vote was 20 to one in favour of the reform and the only MEP to vote against it was from the far left who was never going to vote for it in any event. For the first time ever the Spanish fishing industry, which has the largest commercial fleet in the European Union, the Spanish Government and the Green Party in the Parliament, which is the strongest advocate of NGO concerns about sustainability, are all in favour of a CFP reform that Deputy Martin suggests is a bad deal.

It is doomed then.

I suggest the Deputy should examine the detail of the reform.

I would always like more consultation with the fishing industry. It is true that it has been a while since I toured many of the fisheries harbours and I will do so again over the summer months. It is untrue to say that I do not have ongoing contact with fisheries organisations, whether from the south and west, Killybegs, the south and east or the Irish Sea. We meet regularly. We meet in Brussels, Luxembourg or Dublin in advance of almost every Council meeting dealing with fisheries issues. I cannot be accused of being a Minister who is not easy to contact.

On the substantive reform of CFP and ending the discarding of fish, we currently have an indefensible situation whereby between 400,000 tonnes and 500,000 tonnes of dead fish are dumped in Irish waters annually because fishing vessels do not have quotas to land them. We are ending that procedure by putting in place the flexibility to allow fishing fleets to operate in a way that makes commercial and practical sense. We have had significant input from the fishing industry. This is why, after political agreement was reached on CFP reform, Sean O'Donoghue and others came home and sold it. In the coming weeks we will put in place a stakeholders' group led by fishermen to draw up an implementation plan for the discards ban, or the obligation to land as it is known. Fishermen will be directly involved in the implementation of this radical reform. It makes sense for them because it will build up stocks and it makes sense for the stocks themselves that Irish waters remain fertile grounds for fishing.

The Minister accused me of being critical. I articulated what the fishermen said to me last Friday. There is no point in getting up on a high horse to attack me.

I think the Deputy heard the wrong answer.

Last week, I met a fisherman who employs 23 people in Castletownbere. That is the type person to whom I listen. The Minister acknowledged that he did not get around to meeting fishermen in advance of the talks.

I did not say that.

They were told that the horsemeat scandal and the fodder crisis were the reasons he could not meet them for a meaningful face-to-face discussion. I am only relaying what the Irish South and West Fish Producers Organisation and this man who employs 23 people have said to me. They said the Minister was a great disappointment. This is what is being said.

The Deputy's time is nearly up.

His time was up two years ago.

I am conscious of that. Fishermen do not feel positive at present. They have no sense of the practical workability and implications of the discard policy, particularly in regard to the whitefish industry. I spoke to Pat the Cope Gallagher, MEP who managed to table an amendment insisting that due regard be paid to the Hague preferences. He was very disappointed that the Hague preferences - he said this to me one hour ago - were not enshrined in the new agreement.

He voted for it this morning.

That is not the point. The Minister knows what has to happen in the European Parliament in terms of compromise proposals, particularly between the Council, the Commission and the Parliament. MEPs cannot have their own way on everything.

Say one thing at home and another in Brussels.

He has articulated his main criticism, namely, the absence of the Hague preferences from the treaty itself. That is a fair criticism and the Minister would acknowledge it in another forum. The key point is that many people in the fishing industry say it is time that we had a Minister dedicated to the marine, fisheries and natural resources. They feel the absence of such a figure.

That is what they are saying.

A question, please. The Deputy is one minute over time.

They have not received any explanation or meaningful communication. These are the people who go out fishing day after day. They feel neglected.

They believe they have not been consulted on this deal. That is what they are saying.

We have not had one in 15 years.

With respect, this Government reintroduced a Minister with responsibility for the marine to the Cabinet table. For 13 years, Deputy Martin's Government did not have such a Minister. As we now have a senior Minister in this area, this Government ensured a bigger quota last year than was the case for a decade. The quota for this year will again be bigger. The marine sector has been more active in the past two years than in the preceding two decades.

That is absolute rubbish.

It is absolutely true. The Deputy may not be aware of it.

The Minister is not talking to the fishermen.

I will not ask the Deputy again. Please stay quiet.

We now have an integrated maritime plan for Ireland. We have just concluded an Atlantic strategy under the Irish Presidency, which is a first. We now have a partnership with the United States and Canada. We have a Commissioner who has done a phenomenal job in generating interest in the potential for marine resources as an economic stimulus in the European Union and Ireland in particular. It is totally untrue to say that because I have been busy since January in my dual responsibilities of agriculture and fisheries and the marine, we have not delivered for either fishermen or the marine. Quite the opposite has been the case. I suggest that Deputy Martin should speak to more fishermen, many of whom are concerned about the radical nature of this reform but all of whom accept that it is not before time that we are doing something significant about ending discards in terms of EU policy. I recognise that we will face challenges in implementing the policy, but we will deal with it over the next five to ten years and as a result of it we will be able to catch more fish and have a stronger and growing industry.

That is not what they are saying.

That is what they are saying to me.

The Minister should meet them.

As the Minister is probably aware, Cork City Council last month became the first council to support a motion seeking the establishment of an all-Ireland national suicide authority. The impact of suicide across the island is dreadful. In 2011 alone, more than 1,000 citizens died as a consequence of suicide. Every town, village and community and virtually every family has been affected by this tragic crisis. The number of road deaths in 2011 stood at 245. Despite the major gap between the number of deaths caused by suicide and the number of road traffic fatalities, suicide prevention does not secure the same level of investment and resources as road safety. An island-wide national emergency is occurring in respect of suicide and it requires an island-wide emergency national response.

The Minister will agree that suicide prevention is under-resourced. Recently, in his home city of Cork, a minor who presented at Mercy University Hospital seeking assistance for mental health issues had to remain in the accident and emergency department as there was no bed available in the child and adolescent unit in Bessborough, Blackrock. The young girl had to stay in the accident and emergency department for four full days before being eventually transferred to the adult psychiatric services in St. Michael's unit where she remained for two weeks. Does the Minister agree that this is completely unacceptable, mental health services are under-resourced and the matter must be addressed immediately? Does he also agree that the national crisis requires a national, all-Ireland response?

I agree with almost all the points the Deputy raises. Mental health provision in the health service has been grossly underfunded in the past. I spent three years on the former Southern Health Board's mental services committee, as it was known at the time. Until recently, there was a significant deficit in terms of funding and expenditure in this area. The programme for Government included a commitment to a special additional allocation to mental health services of €35 million last year and this year, respectively, primarily to strengthen community health teams in adult and child mental health services and further develop suicide prevention initiatives. The majority of the recommendations of ReachOut, the national plan of action on suicide prevention, have been implemented. The Minister of State at the Department of Health, Deputy Alex White, will shortly bring proposals to Government on alcohol misuse which, as the Deputy will be aware, is frequently linked to mental health and suicide.

I agree with the Deputy that mental health services have been wrongly neglected in respect of funding and prioritisation. The position is changing under this Government, not before time, and we will continue to prioritise the mental health sector. For example, in January last, the Minister of State, Deputy Kathleen Lynch, launched guidance on mental health and suicide prevention for post-primary schools. The Deputy is correct to continue to raise this issue because it is one on which the Government needs to be pressed. I assure him, however, that we are more than aware that we must catch up in the area of mental health services. We are acting on this issue by increasing expenditure and launching new initiatives to try to address the matter.

On the question of whether an all-island approach is required, the honest answer is that I do not know whether conversations on this issue have taken place on a cross-Border basis. I will, however, ask the Minister to revert to the Deputy directly on the matter.

That the Minister agrees with me on the points I raised is welcome. I would also welcome any additional resources the Government were to invest, if that is the correct word, or spend in the field of suicide prevention. Last month, the 3Ts charity - Turn The Tide on Suicide - published a report entitled, Suicide in Ireland 2003-2008, which made for grim reading. Every Deputy should take the time to read this document, which revealed the startling fact that one child under 18 years dies by suicide every 18 days. Moreover, the State has the fourth highest youth suicide rate in Europe and the figure is increasing. Despite this, the appropriate services do not appear to be available when required, including in the case to which I referred.

The Minister agreed with me that the current position is unacceptable. Given that the current suicide strategy concludes in 2014, will the Minister ask his colleague, the Minister for Health, to accelerate the provision of a new strategy to ensure there is no gap in service provision or strategy in the coming years?

Absolutely. That is the reason the Government prioritised this area in contrast to the previous Government by introducing new initiatives and increasing expenditure on mental health services despite facing difficult budgetary challenges. We must continue to prioritise this area. Developments over the past four or five years have placed extreme pressure on many families and young people, especially young men, resulting in higher levels of stress and mental illness and an increase in the number of suicides. The Government has a significant responsibility, when many families are continuing to experience difficulty, to provide structures, support, staffing and finance in this area. We need modern initiatives to assist our understanding of suicide and suicide prevention and we must put anything learned from such initiatives into effect. We have competent Ministers to perform this task, in particular, the Ministers of State, Deputies Alex White and Kathleen Lynch. I am confident the Cabinet will continue to prioritise this area.

I would appreciate if the Deputy would forward details of the case to which he referred. While the circumstances he described appear to be unacceptable, I would like to have more background details to allow me to fully understand the position.

Nearly 3,000 men will be diagnosed with prostrate cancer this year. Ireland has the highest incidence of the disease in Europe. Diagnosis is primarily done by means of a PSA blood test, physical examination or biopsy. A major study published by the University of London last week indicates that as many of half of the men who develop prostate cancer in the United Kingdom may have been wrongly given the all-clear as a result of the inaccurate diagnosis of standard biopsies. The research recommends that patients suspected of having prostate cancer undergo an MRI scan prior to a biopsy being carried out. Health economists calculate that the use of an MRI scan would result in one quarter of men suspected of having prostate cancer being given the all-clear without having to undergo the invasive diagnostic procedure. Not only would the use of MRI technology, as recommended by the University of London, detect more cases of prostate cancer, but it would also lead to fewer false positive outcomes and spare hundreds of men unnecessary and painful surgery, which can have distressing side-effects, including incontinence and impotence.

Is the Government aware that there may be serious problems with the screening process for prostate cancer? Is it aware that prostate cancer receives approximately one sixth of the funding allocated to common female cancers? In the past six years, investment in research for prostate cancer diagnosis amounted to €62 per diagnosis as compared to €477 per ovarian cancer diagnosis, €453 per cervical cancer diagnosis and €288 for breast cancer diagnosis. I ask the Government to give a commitment to commission an investigation into this major imbalance? Will the Minister ask the Minister for Health, Deputy Reilly, to examine the possibility of introducing MRI screening for men suspected of having prostate cancer prior to a biopsy taking place?

I would be interested in the cost-benefit analysis based on the estimated amount of a biopsy deemed unnecessary as a result of an MRI scan.

The Minister might ask why I am asking this on Leaders' Questions.

We are over time.

This is a critical issue and the seriousness of the report released in England last week cannot be underestimated for the sake of the health of men who might be diagnosed with prostate cancer over the next couple of months or years and how we deal with diagnosing prostate cancer.

I thank the Deputy.

The report recommends discontinuing the biopsy and PSA blood test, and that we do MRI scanning. It has been proved beyond a shadow of doubt in England that this is the way forward.

I thank the Deputy.

We cannot allow this to drag on for weeks or months. I ask the Minister to make a clear statement on this or to ask the Minister for Health in the next couple of weeks to-----

I ask the Deputy to adhere to the Chair. He is way over time.

-----refute the study in England or to come back to us with his proposals.

This is a serious issue which deserves a serious and detailed response. I am limited in what I can say owing to my knowledge in this area. However, if the University of London has produced a report that exposes weaknesses in the screening system for prostate cancer in Ireland, that is a serious issue and of course we need to look into it. I give the Deputy a commitment that I will speak to the Minister for Health, Deputy Reilly, and ask him to give the Deputy a comprehensive response. To be fair to him and to many patients, we should not raise fears among people until the Department of Health has had an opportunity to respond comprehensively to the concerns the Deputy has raised.

Many men go through a screening process and unfortunately, as the Deputy has outlined, a significant number have prostate cancer that needs to be treated. If by using MRI scanning prior to a biopsy we can improve the accuracy and if that can be done in a way that is practical and makes sense, then obviously we should consider it. I should leave it to the Minister for Health to respond in a more comprehensive way to the Deputy's question.

I am not sure if the Minister is aware there is a high risk of sepsis from the biopsies that take place. I am somewhat taken aback that we have not up to now issued any statement on a comprehensive study undertaken by a hospital that is recognised across Europe as being to the forefront of dealing with prostate cancer. There are 141 male Deputies and based on statistics, 17 or 18 of us can expect to be told we have prostate cancer at some time in our lives. If the University of London report holds true, and outdated and inaccurate diagnosis techniques are responsible for many errors, surely we should deal with this immediately. I appeal to the Minister to look at this study by a renowned oncologist in that university, which categorically states that almost half of the diagnosis of cancer based on PSA scanning biopsies etc. have now proved inaccurate. I am not a medical man - maybe what they are suggesting is inaccurate but I do not believe it is. We cannot wait too long given that every day of the week a man in Ireland is diagnosed with prostate cancer.

I give the commitment to raise it this week with the Minister for Health, Deputy Reilly, and we will get a detailed response to the Deputy as quickly as is feasible.

I thank the Minister.