Dáil Éireann díospóireacht -
Thursday, 6 Feb 2014

Vol. 829 No. 3

Leaders' Questions

Deputy Éamon Ó Cuív

This morning, INMO representative Mr. Derek Reilly claimed that Tallaght hospital is unsafe and dangerous. He said that while he had great confidence in the staff, he would not like to be admitted to the accident and emergency unit. He said the unit is unfit for purpose owing to overcrowding and that the staffing level is lower than in 2012. As the Tánaiste knows, that is the same year in which HIQA produced a report on the unnecessary death of a patient at the hospital. In that report, HIQA stated front-line staff concerns about staffing had to be addressed. The chief executive officer of the hospital has denied the claims but at the same time he has agreed that there were 36 patients on trolleys in the accident and emergency unit yesterday. This number has decreased to 20 now but that is by cancelling all elective and day-case surgeries.

What is happening now, not only in Tallaght hospital but also in many others, is that elective surgery and day care are being postponed further and further. Is the Government satisfied that patient safety is not being jeopardised in Tallaght hospital? Is the Tánaiste confident that the 2014 service plan is sufficient to meet the growing demands on the accident and emergency departments across the country?

The Tánaiste

I am informed that the chief executive officer of Tallaght hospital, Mr. David Slevin, has stated it is not the case that the health of patients is under threat at the hospital. I understand he has provided assurances that the situation is being managed and that the hospital is providing adequate patient care.

Tallaght hospital is experiencing an unprecedented surge in the number of people attending its emergency department. However, circumstances continue to improve. I am told there are currently 19 people in total on trolleys. The hospital is implementing a response plan to manage actively the current pressures with a focus on regular ward rounds to increase the number of patients discharged. Thirty day-case procedures have been cancelled for today and tomorrow, and the patients have been notified. A meeting is to take place with hospital management tomorrow to discuss staff concerns.

With regard to staffing issues, the hospital is actively seeking to fill a number of nursing vacancies, particularly three nursing posts in the emergency department. The Department of Health, the HSE special delivery unit and the INMO all agree that waiting on trolleys is an unacceptable feature of the health care system that must be addressed. However, to date this year nationally, we are 3.3% ahead of the figure for 2013 and 34% ahead of the baseline trolley count for 2011. These percentages are the equivalent of 225 and 3,365 fewer patients on trolleys, respectively.

Deputy Éamon Ó Cuív

The Tánaiste seems to be dismissing out of hand the concerns of front-line staff. It appears that the Government does not listen to the people at the coalface. We know this problem is not confined to Tallaght hospital because there is a crisis in the hospitals in Galway, Limerick and Castlebar and many others.

Deputy Finian McGrath

Beaumont.

Deputy Mattie McGrath

Clonmel.

Deputy Éamon Ó Cuív

There are 286 patients on trolleys across the country. Despite all the massaging of the figures, the fact is that there was a 2% increase in the number of patients on trolleys last year. The way this problem is being solved by the HSE is that it is sending people messages asking them not to turn up for their elective or day surgery. Time and again, people are ringing every constituency office in the country saying they were called for elective surgery two, three or four times only to have it postponed continually. Is that a way to run the hospitals? What will be done to deal with this issue, as opposed to putting extra beds in the wards? At present, the HSE is just putting extra beds into the wards and stating the patients are not on trolleys anymore. That is not dealing with the issue. One cannot keep postponing elective surgery forever.

The Tánaiste

The Government is listening to staff at the front line and to patients and their families. The problem is not being ignored by the Government but addressed by it, the HSE and hospital management. I remind the Deputy that the number on trolleys is significantly lower than when Deputy Éamon Ó Cuív and his colleagues had responsibility for the health service. That said, the number is still not low enough. No patient should have to remain on a trolley overnight. The objective should be to reduce the waiting time.

A problem that has arisen in Tallaght hospital is that there is a spike in the number of people presenting at the accident and emergency department. This may be due to the time of year. The issue is being addressed on a ward-round basis. Some elective procedures are being cancelled to deal with the beds issue. Staff are being met and I understand hospital management is to meet tomorrow to discuss staff concerns. Issues arise over the number of nursing staff, in particular, in the emergency department at the hospital. Additional staff are being recruited and the issue is being addressed.

Deputy Sandra McLellan

People throughout the State have since Christmas been experiencing an unprecedented weather crisis. This has now become a state of emergency in many areas, including Cork, and it should be declared as such. Local communities and local authorities are not in a position to respond to the daily devastation and they require Government support urgently. This support has not been forthcoming. I find it incredible that, to date, the Minister for the Environment, Community and Local Government, Deputy Phil Hogan, has failed to appear before this House to inform Members of the action and interventions being taken by the Government to alleviate the terrible impact on families and communities. This is unacceptable. People are being bled by the same Minister, and the rest of the Government, for the local property tax and water charges. Is it too much to ask that the Government should take action and provide leadership to assist the people in this time of great need? In the immediate term, homeowners, businesses and service providers need urgent practical and financial aid from the Government beyond the terms of their private insurance, if they have any. This would alleviate the impact, including on cooking and washing, and on utilities and bedding that need to be replaced. The Government should quantify quickly the broader impact of the devastation on local communities and key infrastructure.

We heard yesterday from the Taoiseach how much has been invested in flood defences since 1996 and how much will be spent in the coming five years. I am aware that the EU floods directive compels the Government to publish what are termed detailed flood hazard and flood maps. There should be no delay in their publication to inform the Government on how best to allocate resources for the future. Can the Tánaiste tell the House whether he, in his capacity as Minister for Foreign Affairs and Trade, has been in direct contact with the European Commission and the Directorate-General for Regional and Urban Policy through the Government's permanent representative in Brussels, Mr. Declan Kelleher, or by any other means to request financial aid through the EU solidarity fund?

We know the solidarity fund can be mobilised in the event of an extraordinary regional disaster such as that experienced across this State in recent weeks.

The Tánaiste

Our hearts go out to the people who have been affected by flooding over the past number of weeks. In some cases, people have been affected more than once. It is a devastating experience for people to have their homes flooded and I have enormous sympathy for their plight. I want to pay tribute to the workers and volunteers on the ground whose efforts in these awful weather conditions have helped to mitigate the impact of the flooding.

The Government has acted on this issue. We discussed it at Cabinet on Tuesday and are taking action on a number of fronts. Indeed, the Minister of State at the Department of Finance, Deputy Hayes, is in Cork today as part of that exercise. In the first instance, the Department of Social Protection assists households in the aftermath of emergency events such as flooding with urgent needs payments to cover clothing, food and emergency accommodation costs. The Department of Social Protection has funding available now in the form of a humanitarian assistance scheme to assist people whose homes were damaged by flooding and who are not in a position to meet the costs of essential needs. Local Department of Social Protection officials are engaging with the local authorities and a protocol has been established whereby they will carry out an assessment of the level of assistance required on a house-by-house basis.

The national co-ordination group on severe weather met on Tuesday, Wednesday and again this morning to review the situation to date and to consider the ongoing threats from storms, tidal conditions and river flooding. The Government decided on Tuesday to make an immediate initial allocation of €15 million for emergency purposes, pending a fuller assessment of the situation over the coming days and weeks. The Defence Forces and the Civil Defence have been deployed to give practical assistance as necessary.

A total of €320 million has been spent on flood defences up to 2013. Of this figure, €25 million relates to the minor flood works and coastal protection scheme introduced in 2009. An additional amount of approximately €50 million has been spent on other programmes, mainly the catchment flood risk assessment and management studies. A total of €45 million has been allocated to the OPW for flood risk management in 2014. This will enable construction to continue on four capital schemes, a further six projects to begin construction and 22 other projects to continue to be advanced towards implementation, subject to satisfactory progression through planning and design stages. The OPW will also continue to operate the minor flood works and coastal protection scheme, which provides funding to local authorities to allow them to carry out smaller-scale flood mitigation and coastal protection projects in their areas. Approximately €250 million is planned to be spent on flood defences over the next five years. Together with the local authorities, we will have to assess whether that will be sufficient to meet future needs.

The local authorities are also now required, as an integral part of their development planning process, to consider climate adaptation measures, including the risk of flooding. At the request of the Government, the Department of the Environment, Community and Local Government is currently collating more detailed reports from local authorities on the clean-up response, repair and restoration costs. This report will be submitted to the Government next Tuesday and will include measures relating to the funding and co-ordination of clean-up, repair and remedial works.

Deputy Sandra McLellan

This is a state of emergency and must be declared as such. The Minister of State, Deputy Hayes will be in Cork and Kerry today and tomorrow. He will be visiting my home town of Youghal tomorrow morning and I intend to meet him there. Youghal has been flooded three times already this year. While we welcome his visit, we need more than just photo opportunities and words of comfort. We need to hear about the Government's action plan and we need to see the immediate benefits of that plan.

Does the Tánaiste accept that the Government's response to what is now an emergency has been at best lethargic, if not completely hands-off? It has taken the Minister for the Environment, Community and Local Government, Deputy Hogan, weeks to make a statement before the House and the lack of coherent leadership from him and other senior Ministers has been nothing short of appalling.

Have community welfare officers been instructed to give immediate financial aid to families whose belongings have been destroyed?

The Tánaiste

First, the Government has acted on this issue and has acted quickly. In a flood situation, the first thing people need is immediate assistance, which is being provided through the Department of Social Protection. A sum of €15 million was provided by the Government this week to address people's immediate needs. Officials of the local authorities and the Department of Social Protection have been asked to go house to house and talk to people about their immediate needs. Some people cannot cook while others have had their living spaces destroyed and they need immediate help. The Department of Social Protection, together with the local authorities, have been asked to address that on an immediate basis, and that is why the €15 million was provided.

The second issue that must be addressed is the longer-term situation, particularly for homes that have been affected. In some cases, insurance issues may arise which will have to be addressed. The third issue is how to prevent the flooding from happening in the first place. That is where the investment in flood protection schemes comes into play. I have given details of the very significant sums of money that have been provided and the various schemes that are in preparation to prevent flooding or at least mitigate it.

Deputy McLellan also asked about an application for European Union assistance. There is a fund available but there is a very high threshold or bar for applications to it in terms of what will actually qualify for funding. That will form part of the consideration of the report that the Minister for the Environment, Community and Local Government will bring to Cabinet next week. At the moment he is getting an assessment from all of the local authorities of the scale and cost of the damage. That will form part of the report that the Government will consider on Tuesday.

Deputy Joan Collins

I wish to raise the issue of apprentices being forced to pay college fees. These fees can range from €833 to €1,433 per year, depending on the particular apprenticeship and how much time is required in college. The Minister for Education and Skills insists on treating apprentices as students, but they are not students. They cannot avail of student grants or other financial assistance available to students. They are full-time workers and very low-paid workers at that. Apprentices in their first year will be paid the minimum wage and their pay does not rise much after that. They pay income tax, the universal social charge, PRSI and so forth. The apprentices of today are very different from apprentices in the past. The latter often left school at 15 or 16 and were finished their apprenticeships by the time they were 21 or 22. Many of today's apprentices are young adults with family responsibilities. A total of 1,500 out of the 7,500 apprentices in Ireland are currently unemployed. They have been made redundant and may have to wait a number of years to gain employment and continue their apprenticeships.

In 2004 there was an attempt to make apprentices pay college fees but it was defeated by mass protests and the threat of a legal challenge in the High Court. This Government reintroduced college fees for apprentices in the October budget. The Technical, Electrical and Engineering Union, TEEU, and the Union of Students in Ireland, USI, have launched a campaign to axe the tax on learning. They have quite correctly pointed out that it makes a mockery of the promise to provide young people with a job, work experience, an apprenticeship or training under the youth guarantee. I am glad to see the Minister for Education and Skills is in the House today. To date, he has refused to meet the TEEU or the USI. Will the Tánaiste, as leader of the Labour Party, give an absolute commitment to arrange such a meeting and address the concerns of these young workers? I urge him to find the resources to reinstate the payment of college fees for this small group of workers. It was with FÁS but did not transfer over to SOLAS.

The Tánaiste

I understand the Minister for Education and Skills is planning to meet the USI about this issue. He is making arrangements for a date for the meeting. My understanding of the issue is that a student registration fee applies throughout the education system and what is applied in the case of apprentices is on a pro rata basis.

The Government is looking at the apprenticeship system very closely. The Minister for Education and Skills, Deputy Quinn, has received a report from a review carried out by Mr. Kevin Duffy on apprenticeships. The role of apprenticeships in the modern economy is part of what we need to do in order to get people back to work and ensure that the economy fully recovers. Apprenticeships are used in a much wider way in other countries than in this country. We have tended to have an apprenticeship system for a fairly limited range of trades. There is a much wider definition and concept of apprenticeships in other European countries. There are a number of things we can probably learn from that.

We must also ensure that employers are open to taking on apprentices. That must be part of the recovery story as we move forward. Even in good times we saw a reluctance on the part of some employers to take on apprentices. There are two parts to the apprenticeship process; there is the on-the-job training and experience that the apprentice gets, and there is also the formal education part, which is in a school or college. The issue to which Deputy Collins’s question relates in particular is the pro rata student registration charge which applies to the formal education element of an apprenticeship. In respect of that issue, the Minister for Education and Skills, Deputy Quinn, has indicated his willingness to meet the USI about it.

Deputy Joan Collins

I thank the Tánaiste, but he did not really answer my question. What I asked was for an immediate meeting with the TEEU and the USI. We spoke to both organisations yesterday afternoon and they had received no indication that a meeting would be organised. Perhaps the situation could be clarified as soon as possible.

The institutions were not even approached before the October budget to say that another possible way of funding students through their apprenticeships was being considered. According to the TEEU and the USI, the scheme was axed with no discussion or debate.

I could make a political play on the issue but I will not because it is too serious. A campaign is being set up that is also backed by the Labour Party candidate for the Leinster region in the European Parliament elections. The matter must be dealt with and resources found immediately. FÁS was supplying the money and SOLAS should supply it now. The matter should be sorted out and the scheme should be reinstated immediately.

The Tánaiste

One of the points we must bear in mind is that apprentices continue to be paid while they are in the education part of their apprenticeship.

Deputy Joan Collins

They are low-paid.

The Tánaiste

The estimate I have is that the levels of pay can range from €300 a week to €700 a week, depending on the particular apprenticeship. It is not unreasonable that where there is a student charge, those who are part of the education system and are getting paid would contribute to the student charge. In some cases, students who do not get paid have to contribute to the charge.

Deputy Collins’s question was whether the Minister for Education and Skills would meet with USI to discuss the issue.

Deputy Joan Collins

And whether he will provide resources.

The Tánaiste

I indicated that he is willing to do that and he intends to do that. The Minister for Education and Skills is examining the apprenticeship system in a much wider way because we can use apprenticeships in a much more creative and broader way in the economy to get people back into employment, to get appropriate training and to ensure that people are equipped for work. We have had a system of apprenticeship in this country that has been far too confined and limited and, in some cases, for periods that were too long. The issue is now being addressed by the Minister for Education and Skills.