Léim ar aghaidh chuig an bpríomhábhar

Dáil Éireann díospóireacht -
Thursday, 20 Feb 2014

Vol. 831 No. 3

Topical Issue Debate

Disease Awareness

I thank the office of the Ceann Comhairle for facilitating me in raising this matter and the Minister for Health for responding.

Lyme disease, known as borreliosis, is a bacterial infection transmitted by the bite of hard-bodied ticks. Not all ticks are infected but vigilance is recommended where ticks are present to reduce the risk of transmission to humans and pets. Lyme disease can cause a variety of symptoms, ranging from mild to severe. Known as the great imitator, Lyme disease can mimic other diseases such as Parkinson's disease, multiple sclerosis and chronic fatigue syndrome. Early treatment is vital so as to prevent serious consequences.

There are three stages to the development of the disease. Within days to weeks of a bite from an infected tick, an expanding rash may occur. This is the first stage. Sometimes the rash will appear as multiple concentric rings forming a bull's eye. It is important to note that the rash may not develop or be noticed in some patients. A flu-like illness may also occur in the early stages of the disease.

Stage two, otherwise known as disseminated disease, has symptoms that may include migratory joint pain, head and neck pain, sore throat, swollen glands, Bell's palsy and severe fatigue. Cardiac problems may occur also, in addition to bladder irritation in the form of interstitial cystitis. Some patients may miss stage one of the illness and develop disseminated disease within months to years of the initial bite.

The stage-three symptoms for late stage Lyme disease may include neurological changes such as tingling, numbness and tremors.

Nerve pain, poor temperature control, brain fog and disturbed sleep patterns are common. Complications may include optic neuritis, depression, panic attacks, muscle weakness, tissue damage, meningitis and chronic arthritis. Lyme disease was named after the town of Lyme in Connecticut. Studies by the University of Bath, however, have identified that Lyme disease has been present since the ice age in Europe.

The length of treatment with antibiotics depends on the severity and stage of the disease and existing co-infections. Intravenous antibiotics may be required for treatment of late stage, disseminated disease.

What does one do if one is bitten by a tick? The ticks embed themselves into the skin for feeding. They use cement-like material in their saliva to latch on. It is important when removing the tick not to leave the mouth parts behind as this could cause a secondary infection. It should be removed gently with a tick twister or fine tipped tweezers, ensuring one pulls upwards very close to the skin. One should wipe the area clean with an antiseptic wipe. One should not smother, burn or squash the tick as it may regurgitate its stomach contents if placed under stress, which could increase the chance of infection. Place the tick safely in a sealed plastic bag and write the date it was removed.

There is debate among some medical people about the disease. Some people cast doubt on whether there is such a disease, but the medical profession in general has now accepted that it is a disease that requires treatment. I welcome the opportunity to raise awareness of Lyme disease. One of the most important things we must do is raise awareness of how it occurs and of the treatment for it.

I thank the Deputy for raising this Topical Issue as it provides me with an opportunity to update the House on the matter.

Lyme disease, also known as Lyme borelliosis, is an infection caused by a bacterium called Borrelia burgdorferi. It is transmitted to humans by bites from ticks infected with the bacteria. Lyme borelliosis was made statutorily notifiable in Ireland by the Infectious Diseases (Amendment Regulations) Regulations 2011.

Three cases of Lyme borelliosis have been notified up to 25 January 2014. There were 20 cases of Lyme borelliosis notified in 2013 and eight cases notified in 2012, the first year in which notification was compulsory. However, due to the diverse and unspecific nature of the symptoms a number of the less serious cases may not be diagnosed, leading to an under-reporting of cases. Recent estimates suggest that there may be up to 50 to 100 cases in Ireland per year. The increase in reported cases since 2012 is likely to reflect the fact that Lyme disease is now a notifiable disease and there is increased public awareness of the condition, rather than an increase in incidence of the disease. I agree with the Deputy that the purpose of this debate is to make people aware of this. Often, as the initial infection might not manifest itself strongly and there is a time delay, people might forget that they were bitten by a tick by the time they present to their doctor with various symptoms.

The infection is generally mild affecting only the skin, but can occasionally be more severe and highly debilitating. Many infected people have no symptoms at all. The most common noticeable evidence of infection is a rash called erythema migrans, commonly called a bulls-eye rash. That is seen in 80% to 90% of patients. People can also complain of influenza-like symptoms such as headache, sore throat, neck stiffness, fever, muscle aches and general fatigue. One can see how it would be very easy to miss the cause of such symptoms if one forgets to tell one's doctor that one was bitten by a tick. Occasionally, there may be more serious symptoms involving the nervous system, joints, the heart or other tissues.

Common antibiotics such as doxycycline or amoxicillin are effective at clearing the rash and helping to prevent the development of complications. They are generally given for up to three weeks. If complications develop, intravenous antibiotics might have to be used.

Both the health protection surveillance centre, HPSC, and Tick Talk Ireland provide guidance on protection against contracting Lyme disease. The best protection is to prevent tick bites when walking in grassy, bushy or woodland areas, particularly between May and October. Arms and legs should be covered - wearing long trousers tucked into socks or boots and long-sleeved shirts with cuffs fastened is advised. Shoes or boots should be worn rather than open-toed sandals. The use of insect repellent on clothes is recommended or on limbs if it is not practicable to cover up. Skin and clothing should be inspected for ticks every three to four hours and children's skin and clothes checked frequently. Ticks should be removed as soon as they are seen. Further advice on tick removal can be obtained from the HPSC website. However, the Deputy has given us an in-depth description of what to do.

It is not recommended that antibiotics are given to prevent the transmission of Lyme disease following a tick bite. People should see their doctors if they develop a rash or become unwell with other symptoms, letting the doctor know of exposure to ticks. Further advice can be obtained from the HPSC website and the HPSC has produced a leaflet, "Protecting Yourself Against Tick Bites and Lyme Disease", which is available online to download.

I again thank the Deputy for raising this important issue.

I thank the Minister for his comprehensive response. He has highlighted that prevention is better than cure. It can be an issue for people who travel abroad, particularly those who participate in mountaineering and outdoor activities. They can return, feel ill and sometimes it is difficult to identify that Lyme disease is the cause.

Does the Minister agree that many in the medical profession are not aware of or fully appreciate the fact that one of these symptoms could be due to Lyme disease? Is the medical profession advised to identify Lyme disease if one of these symptoms is presented? Is there a programme to advise and update the medical profession on the developments surrounding Lyme disease? When representatives of the association appeared before the Oireachtas Joint Committee on Health and Children there was some concern about awareness of the disease among the medical profession and even a level of denial, on occasion, regarding the identification and treatment of the disease. I accept that the Department of Health has identified it as a notifiable disease, which means it is a very serious disease in that context. That is very helpful, but what is required is the dissemination of information, understanding by the medical profession, the awareness of the general population to look out for the symptoms and ensuring that the protections the Minister mentioned, which are very important, are used by the general public when they travel into areas where there is a high chance of contracting the disease.

This is an important issue and the purpose of the House in discussing it today is to raise awareness among the public and among general practitioners. Lyme disease is not very common in this country and given the general nature of its symptoms such as headache, fatigue, sore throat and so forth, we must heighten awareness of it. It is a matter for the Irish College of General Practitioners to highlight it with its members. We are pleased to have made funding available in 2012 to Tick Talk Ireland to help highlight the issue also.

Health Services

We will wait a minute for Deputy Robert Dowds to speak on the next Topical Issue.

Gabh mo leithscéal, bhí mé ag feitheamh taobh amuigh agus ní raibh a fhios agam go raibh tús curtha leis an díospóireacht.

Táimid an-efficient anseo, nach bhfuil?

Toisc go bhfuil an tAire anseo, sin an fáth.

The topic I raise relates to the need to ensure the boards of section 38 health organisations are representative of all stakeholders. It is an obvious one because of some of the cases that have come to light. As a member of the Committee of Public Accounts, I heard representatives of the Central Remedial Clinic, CRC, and the board of St. Vincent’s University Hospital explain themselves. While issues definitely arise in terms of pay, one of the things that struck me was the way the boards had been constituted. I worked in a school that was under the patronage of the CRC; therefore, I have some personal experience of it. These organisations have boards which do not in any way represent their clients and staff. The Government should use its clout to ensure all section 38 bodies have boards which represent the organisation effectively and which are fit for purpose. I have no doubt that if one trawls through all section 38 organisations, some of them will have good, effective boards, but we must put down a marker to ensure best practice is followed. The fact that most of the money the organisations receive comes from the State puts us in a good position to ensure this happens in the sense that he who pays the piper calls the tune. We have an opportunity to improve the position.

The first board that comes to mind is that of the CRC because it and the board of the Friends and Supporters of the CRC have now resigned and something must be done about the situation. I understand the HSE has been talking to an organisation called Boardmatch Ireland which is working on constituting a new board for the CRC. How that pans out might be instructive on how the situation will develop. The problem arises because many of the organisations – the CRC is a good example, while Enable Ireland is another – started off as charitable organisations with the very best of motives on behalf of those who worked for them. Many of those involved were working voluntarily. The position changed fundamentally when the State began to fund these organisations. Therefore, the old model under which they had operated was no longer appropriate. The issue should have been tackled previously, but the revelations about the CRC, St. Vincent’s University Hospital and, I suspect, other organisations give us an opportunity to make a new start. I am interested in hearing the response of the Minister.

I thank the Deputy for raising this important and current issue. The HSE provides funding of approximately €3 billion for almost 3,000 agencies for the delivery of a range of services, of which €2.44 billion is provided for section 38 organisations, of which there are approximately 38.

They are primarily in the acute hospital and disability sectors. Since 2009 they have been required to enter into a formal service arrangement with the HSE. The service arrangement is the contract between the HSE and each individual agency. Under this arrangement, they are obliged to give certain undertakings in relation to compliance with a range of standards and statutory requirements.

A compliance statement process came into effect for agencies from January 2014 and applies to their 2013 financial accounts. Submission of an annual compliance statement will form part of the consideration of ongoing funding for each agency. In agencies established under legislation the membership of the board is often prescribed in the legislation. In general, legislation prescribing the membership of boards provides for the inclusion of relevant stakeholders particular to the organisation. Where membership is not prescribed, boards must examine their functions to ensure the appropriate competency and skills mix is provided by board members in order to carry out their functions effectively, ethically and in keeping with best governance practice.

In line with Government decisions in 2011, my Department advertises for board vacancies as they arise where I, as Minister for Health, have nominating rights. Competencies are developed and agreed in conjunction with relevant boards, depending on their requirements. The suitability of applicants is assessed against these criteria and a short list is compiled, from which I may make appointments. Full cognisance is taken in all appointments made by me of relevant competencies or gaps identified by individual organisations. The code of practice for the governance of State bodies provides a framework for the application of best practice in corporate governance by both commercial and non-commercial State bodies. While a list is provided, sometimes people who have not applied, who are deemed by the Department to have suitable qualifications, can be appointed also.

The chairperson performs a key role in ensuring appropriate standards of corporate governance are adhered to in all aspects of the activities of the board. Boards are required to constantly review their operations and seek to identify ways to improve their effectiveness. This will include the identification of gaps in competencies and ways they could be addressed. Where a board chairperson is of the view that specific skills are required on the board, he or she should advise me of this view for consideration sufficiently in advance of the time when board vacancies are due to arise in order that I may take his or her views into consideration when making appointments.

I have recently established a governance forum for the health sector, including section 38 agencies, to support and help chairpersons, board members and CEOs to fulfil their accountability and governance roles. I will insist on structured induction programmes for all new board members and a system of independent regular governance audits. All efforts are made, in conjunction with relevant agencies, by my Department and the Health Service Executive to ensure the composition of each board and relevant competencies required to facilitate the effective and efficient conduct of each organisation, including relevant stakeholder inclusion, are in place.

I thank the Minister for his response. It is welcome that there will be pressure on the agencies to have appropriate boards in place. I am interested in hearing what the timescale is and whether any effort will be made to create an appropriate template for the various organisations. Primary schools have a particular template for how boards are appointed which specifies the inclusion of representatives of parents, teachers and the community, the principal and the chairperson of the board of management. Does the Minister consider that it would be valuable to do some work along these lines? Will he comment on two things, first, whether staff or clients of an organisation should be able to elect people to boards and, second, the length of time for which one should serve on a board? It is important that there be rotation. I do not wish to be entirely prescriptive, but, for example, a person might serve for a period of three years, after which another election should be held. In total, nobody should serve on a board for more than nine years. One of the problems with the CRC was that it was a self-perpetuating board and the staff and clients of the organisation had no influence on it whatsoever.

I am interested in hearing the Minister's response on whether a template should be put in place, whether clients and members of staff should be able to elect people to the board and how long people should serve.

The Deputy is absolutely right; there are 43 section 38 agencies. All of this arose out of the HIQA report into Tallaght hospital, during the course of which we discovered alternative streams of payment which led us to a broader audit of the entire sector. This took some time, as the Deputy knows. With regard to the formulation of boards, strong recommendations came out of the inquiry following the appointment of Sir Keith Pearson to the board of Tallaght hospital. He is an expert in the NHS on governance. While I have great sympathy with the view that a member of the clientele or community should be on the board, he was absolutely clear, and I fully agree, that no member of staff should be on it. A member of staff can be on a board of governors but not on the board that supports the management of a hospital. In the past this has led to difficulties. This is the new template we use. We look at the various competencies required and we have a grid. If somebody does not meet the competencies on the grid, or the grid shows a deficit in competencies on the board, such as no one on the board having legal or financial competency, these must be addressed.

As is the Deputy, I am strongly in favour of the idea that a member of the clientele of a body such as the CRC should definitely be on the board, as should members of the community. These can be represented through the competencies but not necessarily exclusively so. We have made a huge leap forward in transparency and competencies on boards, and our health service will be the better for it. With regard to section 38 and section 39 agencies, we will have a better service for the people as a consequence.

Foreign Conflicts

I thank the Ceann Comhairle for selecting this important Topical Issue. I welcome the Minister of State, Deputy Joe Costello, to the House. I understand the mission in which the Tánaiste is engaged and I am glad the Minister of State can be with us.

On 23 January my colleague and Fianna Fáil spokesperson on foreign affairs and trade, Deputy Brendan Smith, raised this very serious matter in the House, condemning in the strongest possible terms the use of state violence to prohibit any type of demonstration against the government in Ukraine. The fatalities on the streets of Kiev in January shocked Europe and the world, and at the time Fianna Fáil called on the Tánaiste and Minister for Affairs and Trade to drive the call at European level for sanctions against those responsible for the fatalities. We also called for intense European engagement to prevent further violence in Ukraine. Unfortunately, what we have seen since then is a dismal and inadequate response from our Government and, more significantly, from the European Union.

Events in Ukraine have taken another fatal and tragic turn, with the deaths of more protesters. The situation is becoming increasingly dangerous and has begun to teeter on the point of civil war. A tentative agreement between the government and the opposition broke down and lives are being lost in the streets of Kiev as we speak. I contend that the European Union must stand for peace, stability and safety throughout the continent. The prospect of a civil war at the gates of Europe in 2014 is extremely serious. There must be clear, determined action arising from today's meeting of the EU foreign Ministers.

Last month Fianna Fáil pointed out that the increasingly authoritarian style exhibited by the Ukrainian Government was of great concern and huge questions were being raised about human rights in the country, but our Government remained silent. It folded its hands and stated it could do nothing. It appears the Minister fails to recognise that Ireland, as a neutral country outside NATO, has an important role to play in acting as an honest broker in this crisis at European level. Our voice must be raised in support of those who seek democratic reform and a peaceful resolution to this awful crisis.

The European Union has failed to grasp the gravity of the situation in Ukraine. It is still debating the possibility of sanctions against those responsible for the violence. These sanctions have been debated for weeks and the crisis continues to escalate. The crisis is on our doorstep. It ignited following the failure of EU trade talks with Ukraine, and we understand the history between Ukraine, Europe and Russia. This is critical for the European Union. The bloodshed witnessed on the streets of Kiev is totally unacceptable. A failure to act to support democracy, put pressure on President Yanukovych and stand against the abuse of power in Ukraine would seriously damage the position of the European Union on the world stage. Fianna Fáil believes there is a clear case for sanctions to be imposed on Ukraine and the European Union must act quickly and decisively. The Government should reiterate its call for the release of Yulia Tymoshenko, the former Ukrainian prime minister, imprisoned in the country.

The European Union must wake up to the reality of what is happening in Ukraine. Words are not enough. They must be accompanied by action.

I thank the Deputy for raising this Topical Issue and agree entirely with him. This is an extraordinarily serious crisis. As the Deputy may be aware, the Tánaiste issued a statement yesterday outlining his views on the developing crisis in Ukraine, which the Government has followed with growing concern. He indicated that he was appalled at the most recent outbreak of violence this week, which has reportedly left many people dead and many more injured.

Today the Tánaiste is attending an extraordinary Foreign Affairs Council in Brussels to discuss the crisis. The European Union has identified the formation of a new and inclusive government, progress on constitutional reform, and the preparation for transparent and democratic presidential elections as the key elements needed to restore peace.

Since 18 February, the deadliest clashes to date between anti-government protestors and security forces have taken place in Kiev. The proximate cause of the recent violence may have been the decision by protestors in Independence Square, known as the Maidan, to march to parliament buildings, situated a mile away, on the morning of 18 February. News agencies report that 20,000 protestors were involved in the march, which was timed to coincide with a scheduled discussion in parliament on possible constitutional change. When they were met with large numbers of security forces in the vicinity of the Parliament, violent clashes ensued. Regrettably, later that night emergency talks between President Yanukovych and two opposition leaders, Arseniy Yatsenyuk and Vitali Klitschko, ended in stalemate.

Yesterday morning, riot police using tear gas tried to clear protestors encamped in Independence Square, and a number of casualties, including fatalities, resulted. Despite the agreement of a truce between President Yanukovych and opposition leaders, fresh fighting has taken place in central Kiev today, and there are media reports of further casualties.

The Ukrainian health ministry has today confirmed the deaths of 35 people, including security personnel, and the toll is expected to increase. Hundreds more have been seriously wounded. The authorities have closed Kiev's underground transport system, announced that traffic into the capital will be restricted and called on businesses not to open. Protests have taken place in several other cities, including Lviv in western Ukraine, where demonstrators have reportedly seized government buildings.

There has been international condemnation of the latest outbreak of violence. The UN Secretary-General, Ban Ki-moon, expressed his shock at reports of violence in Ukraine and has urged the immediate renewal of genuine dialogue between all sides. The High Representative of the European Union for Foreign Affairs and Security Policy, Catherine Ashton, issued a statement on 18 February condemning all use of violence, including against public or party buildings. The Secretary General of the Council of Europe has called upon all political forces in Ukraine to act responsibly and refrain from further violent actions.

I recall that from the outset, the European Union has been actively involved in facilitating the search for a peaceful and negotiated solution to the crisis. It has stressed the obligations of the authorities to respect and protect the fundamental rights of the Ukrainian people and has stated that a democratic solution must be sought through inclusive dialogue. This is a message that High Representative Ashton has conveyed repeatedly in her recent visits to Kiev.

It is clear that the use of force, from whichever quarter, cannot resolve the political crisis in Ukraine. Immediate steps must be taken to calm the rising tension. Both sides have a shared responsibility to build trust and to create the conditions necessary to chart a way forward through dialogue in the parliament, rather than confrontation in the streets. Further bloodshed will deepen divisions and make it even more difficult to reach a political solution to which all sides state they are committed. President Yanukovych and his Government have a particular responsibility to act to enable a meaningful dialogue with opposition leaders. They should take the necessary steps without delay.

While I acknowledge the Minister of State's response, I wish to put a couple of questions to him. Does he accept the European Union - and he as a Minister - must be somewhat embarrassed that, for example, the Obama Administration has moved already to apply sanctions to more than 20 Ukrainian officials, while here in Europe we continue to fail to move? Second, what has been done by either the Tánaiste and Minister for Foreign Affairs and Trade or the European Union to secure the release of the former prime minister, Ms Tymonshenko? Is it the belief of the Government that her release would be helpful in finding a resolution to the situation? Has the Tánaiste discussed this situation with his counterpart in Russia, Sergey Lavrov? Finally, has this crisis been discussed in a Cabinet meeting? Has there been a united Cabinet decision on how this crisis should be addressed, recognising the status Ireland has in being outside NATO and having a recognised history in peacekeeping, as well as much to offer, based on our recent history, in respect of contributing to the building of peace in situations in which conflict exists?

I thank the Deputy for his supplementary questions. The European Union has been very much engaged from the outset in the Ukrainian crisis. From the outset, Catherine Ashton has travelled to Kiev quite a number of times to represent the European Union through the European External Action Service. She has reported back and the issue has been discussed on a regular basis at the Council of Ministers. The extraordinary meeting that was called for today is considering carefully what further action will be taken. All possible options will be explored at the Foreign Affairs Council in Brussels today, including restrictive measures against those responsible for human rights violations, violence and the use of excessive force. The Foreign Ministers of France, Germany and Poland were in Kiev this morning, where they met President Yanukovych and opposition leaders and they will report on their visit to the Council. As the Deputy is aware, the Tánaiste is at that Council at present and will take the opportunity to speak strongly on the matter. The international community must send Ukraine the clear message that the images seen on the streets of a European capital city in recent days are not acceptable. Ireland believes the use of force cannot be as a means of resolving the political stalemate in Ukraine. The only sustainable way forward is a genuine political engagement in an inclusive dialogue to meet the legitimate democratic aspirations of the Ukrainian people. International organisations such as the European Union, the Council of Europe, the OSCE and the United Nations potentially could play a constructive role in facilitating a resolution to the current crisis that respects the rights of all Ukrainians. However, there is a particular responsibility on President Yanukovych and his Government to take urgent steps to enable such a dialogue and to help de-escalate the situation. Consequently, the Government urges him today to take the necessary steps to put an end to bloodshed and the tragic loss of life on the Ukrainian streets.

This is the context in which the Tánaiste will be lending his voice to the debate, which no doubt will be very robust. In respect of the former prime minister, Yulia Tymonshenko, Ireland has called consistently for human rights and the proper procedure of law to be adhered to for her release. This position always has been put strongly on the record over a period. The Tánaiste also has engaged with the Russian Foreign Minister, Mr. Lavrov, in respect of these matters. It is something in which Ireland has taken a regular interest over a period of time before the present crisis. I do not know whether there has been a discussion in Cabinet on the matter as that is something of which I have no direct knowledge. However, I am sure I can supply that information to the Deputy.

Corporation Tax Regime

I thank the Ceann Comhairle for selecting this issue for debate. I also appreciate that the Minister has come into the Chamber to participate. Between the Garda Síochána Ombudsman Commission, GSOC, and the Garda whistleblowers, this week may well go down in history as one in which attempts to cover up scandals were exposed. I certainly believe that what has been going on regarding the issue of Ireland's corporate tax rate and the real amount of tax that large corporations are paying amounts to a cover-up. This has been reinforced by the paper produced by Professor James Stewart of Trinity College within the past week, which suggested the real corporate tax rate being paid by large and hugely profitable firms is nowhere near the 12.5% headline rate or any of the rates the Minister, the Taoiseach and others regularly have claimed such companies are paying but it is a tiny fraction thereof. An astonishing figure of 2.2% is being suggested. When one recalls what Mr. Nyberg said about the banking crisis, groupthink and the lack of contrarians willing to question the consensus, nowhere has this been more apparent than in the Government's attitude to questions raised about the real corporate tax rate. Essentially, a tiny number of people, including myself, who have raised this matter over the past two years have been largely ridiculed and accused of cloud-cuckoo economics and so on, because we questioned the assertions that corporations were paying the 12.5% rate and suggested the entire issue of corporation tax should be questioned and examined thoroughly. However, an eminent professor of economics has now stated the situation is actually worse than even we had thought. I tabled a parliamentary question to the Minister and received a reply based on Revenue statistics which showed that multinationals earned €70 billion in pre-tax profits, according to the last available figures, and paid only €4 billion. This revealed an effective rate of 6.8%, rather than the aforementioned 12.5%. I thought that was bad enough, because at stake there is approximately €4 billion of potential revenue to the State. When one considers what that would do to alleviate cuts imposed on vulnerable sectors of society or what it could be used for to develop infrastructure, invest in job creation and so on, it constitutes a great deal of money. However, there appears to be an absolute dismissal of even a serious attempt to investigate and examine this issue, given the huge divergence in figures being bandied around for corporate tax. This also has been confirmed by the academic whose surname has escaped me but who is the consultant to the finance sub-committee on global corporate taxation. He has acknowledged there is a real issue in this regard and provided five different figures on what the corporate tax rate could be, including rates of 11.9%, 12.3%, 6.9% and 14.4%, to which one can add Professor Jim Stewart's figure of 2.2%. Whatever the Minister and I might think, given the billions that are at stake, does this issue not require serious investigation?

The Minister needs to give serious consideration to having a minimum effective corporation tax rate in order to clarify this matter and ensure we get a proper take from these hugely profitable corporations.

I have had detailed public discussions with the Deputy on this issue on a number of occasions, most recently at the Joint Committee on Finance, Public Expenditure and Reform on Thursday of last week. He will also recall that the issue of effective tax rates was discussed at length on Committee Stage of the Finance Bill last November. In view of the significant confusion around the issue, it was agreed at the time that my Department would prepare a report on the matter to be submitted to the Oireachtas finance committee by the end of the first quarter this year. This report is being prepared and will likely be published on completion.

It is important to clarify that there are two separate scenarios that are often confused in discussions on the effective rate of corporation tax. The first is the global rate of tax paid by multinational companies which operate across a number of jurisdictions. This is a blended rate which takes into account the amount of tax charged not only in Ireland but across all of the countries in which a company trades. The extremely low effective rate figures that have been quoted in the past week and attributed to Ireland are based on a flawed premise. They are estimated by dividing the amount of Irish tax paid by a total profit figure that includes substantial profits made by companies not tax resident in Ireland. They are running together the profits earned by group companies in Ireland and other jurisdictions and incorrectly suggesting Irish tax does or should apply to both. Ireland cannot tax profits properly attributable to other jurisdictions. The ability of some multinationals to lower their worldwide rate of tax using international structures reflects the global context in which Ireland and all countries operate. The best way to effectively address this issue is for countries to work together at the international level. Appropriate action is being considered in this regard by the OECD as part of its project on base erosion and profit shifting, in which Ireland is participating.

The second issue is the effective rate of tax applying in individual countries. Clearly, the domestic rate of tax paid in Ireland is within the control of the Irish tax system and Ireland is responsible for the amount of Irish corporation tax charged here. I re-emphasise that all companies operating in Ireland, domestic businesses and multinationals, are liable to corporation tax at the 12.5% rate on the profits generated from their trading activities here. A higher rate of 25% applies in respect of investment, rental and other non-trading profits, as well as certain petroleum, mining and land-dealing activities, and chargeable capital gains are taxable at the capital gains tax rate of 33%. Some other countries have a high headline rate of corporation tax which is then supplemented by a high number of tax reliefs which reduce the overall rate of tax paid. By contrast, the approach in Ireland is transparent in that we have a competitive headline rate of corporation tax which is applied to a broad base. We, therefore, have only a small number of corporation tax incentives in Ireland and ensure these are specifically targeted at and focused on the creation of employment and areas of innovation.

There are different ways of measuring the effective rate of corporation tax once account is taken of such reliefs and there is no single internationally agreed comparative measure in this regard. As the quality of debate on the issue shows, it could really be characterised as more of an art rather than a science. There are a range of independent studies on this issue and the Deputy will shortly have a comprehensive report that will set out an analysis of the different figures in the public domain. In the meantime, I see no benefit in repeating the same debate we have had, quoting different figures at each other. However, in response to the growing interest in the subject the Revenue Commissioners now publish an additional explanatory note with their annual statistical report. The 2012 revenue statistical report which refers to 2011 data indicates that aggregate net taxable profits, taking account of various deductions, allowances, charges and reliefs, amounted to €40.1 billion, while the total amount of corporation tax payable on these profits was €4.2 billion. This means that total corporation tax payable as a percentage of taxable profits was approximately 10.5% for 2011. While this percentage is lower than the 12.5% rate, this can be attributed to the availability of certain reliefs such as the research and development credit which was the subject of a comprehensive review last year and which was found to give value for money for the taxpayer.

The one aspect on which I agree with the Minister is that assessing corporation tax rates is more of an art than a science. There is plenty of artistry when it comes to covering up the reality of what firms are or are not paying in tax. I agree with the Minister that there are two separate issues involved. The first relates to the global profits of the multinational companies that are bestriding the globe. I do not accept that it is a false premise that we should assess their global profits. It seems that the problem lies in the unacceptable distinction between companies that are incorporated and taxable here and companies that are incorporated but not taxable here, despite the fact that they are all based here.

The Minister may have heard on radio today Professor Jim Stewart, to whom I spoke in the debate with the PwC spokesperson who tried to claim that these companies had real operations in countries such as Bermuda. Professor Stewart pointed out that they did not and that despite the fact that their address was Clarendon Street, Bermuda, they had no employees there and that all of their accounts were and the administration of their profits, sales and so on was being done in Dublin. However, because of a loophole in our system, they are not tax liable here and are managing to use Ireland as a place in which to avoid tax and we are allowing them to do so. This issue must be addressed.

Another issue concerns how the tax payable on profits of €70 billion, which becomes €40 billion following allowances and so on, amounts to only €4 billion. This raises concerns about the generous allowances which permit companies to write off huge amounts of tax. The EUROSTAT figures indicate that the implicit rates are far lower here than in any other country. I know that they all have different tax systems, but when one looks at the implicit rates, our implicit rates are far lower than anywhere else in Europe, however they are calculated. This issue needs to be addressed.

I do not think the Deputy and I are going to solve this conundrum this evening because we have had this debate several times before. I acknowledge that there are different estimates of what the effective tax rate is in Ireland. We have gone through them on a number of occasions. The most fruitful way to advance this debate is to revert to the Committee Stage debate on the Finance Bill in November 2013, during which the Minister of State, Deputy Brian Hayes, agreed that officials of the Department of Finance would prepare a note for the committee. Among those in attendance at the meeting were Deputies Richard Boyd Barrett, Pearse Doherty and Michael McGrath. The purpose of the note is to clarify the issues around the calculation of the effective rate for Ireland, which is exactly the issue we are now debating. Confusion around this topic has led to a number of unhelpful statements being made publicly. The note will include a description of the complications in the calculation of an effective rate of tax for Ireland and explain the bases for calculating the numerous figures quoted internationally and attributed to Ireland, often on an incorrect basis. They will include the 2.2% rate quoted last week by Professor Jim Stewart and the 6.8% rate implicit in the EUROSTAT figures. The note will also explain the 10.5% rate indicated in the data published by the Revenue Commissioners and the 14.4% rate quoted by the European Commission for Ireland. Work in this regard is ongoing and the note is due to be presented to the committee by the end of March and likely to be published. We will talk about this issue further in committee when we will have a properly researched basis for our discussion.

The Dáil adjourned at 5.40 p.m. until 10 a.m. on Friday, 21 February 2014.