Topical Issue Debate

Energy Conservation

Deputy David Stanton

I am grateful to the Office of the Ceann Comhairle for allowing me to raise this matter. I am also glad that the Minister of State at the Department of Health, Deputy Alex White, is here to take the debate.

There are two lovely hotels in east Cork, which the Minister and Leas-Cheann Comhairle may visit at some stage. One is Garryvoe Hotel, which has invested €325,000 in energy savings. The hotel has told me it has data showing savings running to €130,000 per annum since it made the change. Rochestown Park Hotel did something similar. It looked at energy and has seen that it has also made huge savings of approximately €115,000 per annum following an investment of €240,000. In two years, they will have made the money back. I was approached a number of years ago by a contractor who was very concerned about what he saw as an opportunity being wasted to save energy in our hospitals. I put down a series of parliamentary questions and received a great deal of information back. The information demonstrates that if combined heat and power - or CHP - was used in our hospitals, massive savings would be possible.

I have some figures that we have worked out. The 2012 energy bill at Cork University Hospital was €3.258 million. By making a number of changes, including moving to CHP or from oil to gas, and taking into account other efficiencies, some contractors say annual savings at that hospital could be of the order of €1.7 million. We have done the analysis for a lot of hospitals, including Merlin Park, Portiuncula, Mayo and Roscommon hospitals, and the savings come to approximately €5.5 million per annum. That is excluding the large hospitals in Dublin. That is a minimum saving. A great deal more is possible.

Why is this not happening? I have been asking the question for quite a while. I have been told that all kinds of expensive consultants must be brought in and all kinds of reports produced. Yet, two hotels in Cork have been able to do it very easily. They brought in Bord Gáis and said "Tell us what we can do". I am told that there is a plant in Cork University Hospital which is not being used and needs to be upgraded. Why is that not happening? It is simply a matter of plugging one out and the other one in. We have just had a debate on expensive medical cards.

This is money that could be saved very easily by switching over to gas. Many contracting firms have told me they are willing to do this for free and to share the savings over a number of years so there would be no capital outlay upfront.

I cannot understand why a much greater effort is not being made to try to save this amount of money. Perhaps it is a relatively small amount but €10 million would go a long way to help the budgets of these hospitals. If the Minister of State had €1.7 million extra per annum for Cork University Hospital it would go a long way to provide services for patients. Will the Minister of State have this matter investigated and come back to me and the House soon to tell us whether I am right or wrong with these figures? Can this be achieved and if it can be achieved why is it not happening? Why are we not making it happen? We have many consultants and experts in every area but this could be done immediately. I am sure there are many more areas like this throughout the public sector where it could be achieved. I await the response of the Minister of State with interest.

Minister of State at the Department of Health (Deputy Alex White)

I thank Deputy Stanton for raising this important and interesting issue. The national energy efficiency action plan sets a public sector energy efficient target of a 33% reduction of energy usage to be achieved by 2020. The HSE is working to comply with the Government's green procurement guidelines, which require public bodies to ensure that a minimum building energy rating of B3 is achieved in all newly built and leased buildings from January 2012 and a minimum rating of A3 from January 2015.

A national programme for installing a combined heat and power, CHP, plant was initiated in the mid-1990s. Given the advances in technology a number of these older plants have been removed. However, a number of CHP evaluation processes are under way. These include University Hospital Galway, St. Luke's General Hospital in Kilkenny and Cork University Hospital.

The HSE policy on energy saving is guided by a number of programmes. In conjunction with the Sustainable Energy Authority of Ireland, SEAI, the HSE runs the energy management action plan and has rolled it out on its larger campuses. It is also working with some of the major acute voluntary hospitals. The first stage of this programme is now completed.

In conjunction with the OPW, the HSE is also implementing a monitoring and reporting programme. Three large administration campuses have been identified as pilot sites. The installation of monitoring equipment on these three campuses is now completed and the energy awareness programme is scheduled to commence in mid-June 2014. Discussions are also under way with a large acute hospital. These pilot programmes will identify energy saving projects which may include combined heat and power installations.

The HSE is also participating in the national energy services framework which was published in December 2013 by the Minister for Communications, Energy and Natural Resources. It provides for public sector and commercial organisations, a standard and structured approach to support the efficient procurement and delivery of energy efficiency projects on the ground. In June 2013, the Minister with responsibility for energy announced the first tranche of exemplar energy efficiency projects to be supported by the SEAI under the Action Plan for Jobs.

The HSE is committed to increasing its energy savings and is planning to deliver savings in future years and I have set out the broad context in which the HSE is approaching this important area. I note the specific issues raised by Deputy Stanton in respect of converting to combined heat and power plants. I bow to his superior knowledge which he clearly elaborated for the House this afternoon. Any innovative ideas a Deputy brings to the House deserve to be considered and examined. If there is further detail the Deputy wishes me or the Minister to look at in respect of this we will certainly do so.

Deputy David Stanton

I thank the Minister of State for his response and ask him to look at some of the replies to parliamentary questions I have received over the past six months on this issue and the figures therein which are quite instructive. Perhaps the Minister of State could call the two hotels I mentioned and speak to the management there. I spoke to them today and they are delighted with it.

With all due respect, the response I have received is exactly the same as the response I received last December, almost word for word. That was six months ago. If this had been acted on then the Minister of State would have €5 million more to spend. I have very little faith in this. I have come to the House as a last resort because I have been pushing this at various levels with the HSE and hospital management and getting no response whatsoever. I challenge the Minister of State to personally telephone the hospitals, find out what is going on, visit them and make it happen because we are wasting public money which could be saved and the Minister of State is responsible for this to the House.

The speech the Minister of State read out was all very fine but it is fancy verbiage and does not mean much because nothing is happening. I have been raising this issue for quite a while at various levels and I am frustrated. The amount I mentioned as a potential saving is a minimum and a lot more could be achieved by making simple changes and bringing in serious contractors. Forget the fancy consultants; bring in serious contractors who are practical people and they will identify and make the changes in approximately one month. They have done it already in the private sector hotels I mentioned. I cannot see why it cannot be done in hospitals.

There would also be huge savings in carbon emissions. The Rochestown Park Hotel has had a reduction of 33% in emissions which has resulted in a decrease of 77 tonnes of carbon and 278 fewer tonnes of carbon dioxide being emitted to the atmosphere, which is equivalent to removing 150 cars from the nation's roads each year. There are other benefits and it is not just about financial savings. I challenge the Minister of State, the Department and the HSE to get working on this. I want to see serious results soon.

Deputy Alex White

I am not sure if I can add too much to what I said already other than to see if we can at least obtain for the Deputy some more detail and specific answers to the issues he raised. If he has received the same response today as he did in December it is unfortunate. Let us see if there is any more detail we can get. I never have any difficulty in either telephoning or calling to hotels in any part of the country, particularly in east Cork, but I am not sure if it is necessarily the way we need to proceed although I would not exclude it. I will certainly speak to the director general of the HSE to see where we are on this issue.

Acting Chairman (Deputy Terence Flanagan)

I wish to call Deputy Mick Wallace who has a Topical Issue on the ongoing crisis in Libya.

Deputy Mick Wallace

No one from the Department of Foreign Affairs and Trade was available today so the Minister of State, Deputy Paschal Donohoe, will take it on Wednesday.

Acting Chairman (Deputy Terence Flanagan)

It will be deferred to Wednesday's Topical Issue debate.

Mental Health Services Provision

Deputy Colm Keaveney

Last week I felt compelled to write to the Mental Health Commission and the Inspectorate of Mental Health Services asking them to carry out an urgent inspection of the psychiatric unit at University Hospital Galway. I was prompted to do so after being contacted by staff and families of patients in the unit. That week the local press in Galway described the unit as being like a war zone. Last week a person in the Health and Safety Authority provided me with a copy of a letter sent to it on behalf of the staff in the unit. It makes for alarming reading and states the ongoing dangerously low staffing levels at the unit continue on a daily basis and on more than one occasion there has been no clinical nurse managers to manage the ward. One clinical nurse manager was recently assigned elsewhere in the community.

Last week, there was a tragic situation when the absence of any security meant a patient was able to abscond from the ward and commit suicide. There was also a very near miss last week when a highly suicidal patient absconded from the ward and was found in the community inflicting self harm. The activities area in the unit was closed last week and remains so. This denies patients access to an area which is part of their holistic recovery plan. Risk assessments submitted to management appear to be ignored. Disclaimers submitted by staff outlining unacceptably short staffing levels also appear to be ignored.

There appears to be no agreement on minimum staffing levels. Morale among the staff appears to be at an all-time low and there is an exceptionally high level of sick leave owing to stress in that location.

The staff to whom I have spoken believe the above factors have been identified since the closure of St. Brigid's Hospital in Ballinasloe. They have been warning about this arrangement and pointed out that this has been an accident waiting to happen. I compliment the staff who have spoken out. Like the Garda whistleblowers, in the face of incredible pressure from senior management and the HSE, they have done a wonderful job in highlighting the consequences of the reconfiguration of the service.

This has happened as a direct result of the closure of the St. Brigid's psychiatric unit and the failure to fill key front-line posts in the region. Since last year some 40% of the posts provided for under A Vision for Change have not been filled under the HSE service plan. Without adequate mental health staff levels in University Hospital Galway and across the community, the unit is simply not fit for purpose. However, in this House earlier this year the Minister of State with responsibility for mental health services made a robust defence of the provision of that service. Is the Minister of State aware of the consequences of these cuts to mental health services in Galway? Is he aware that the House has been warned about them? We were unequivocally advised, however, that this would not happen. Is the Minister of State aware that there is a €3.2 million brand new, ligature-free facility lying idle in Ballinasloe? Despite this, service users in the psychiatric unit have no access to a recreational area, which inhibits them from securing better outcomes in their own recovery.

I appeal to the Minister of State to urgently reconsider reinstating temporarily services at St. Brigid's Hospital in Ballinasloe which would allow us to deal with the overflow. Before I came to the House, staff informed me that they were gravely concerned about the prospect of an intake over the course of a bank holiday weekend in the light of the chronic staffing levels. I appeal to the Minister of State to consider positively the temporary opening of the brand new facility that lies idle in St. Brigid's Hospital in Ballinasloe to deal with the overflow of patients at University Hospital Galway.

Deputy Alex White

I am taking this important matter on behalf of the Minister of State, Deputy Kathleen Lynch. I thank the Deputy for raising it.

The HSE is proceeding to modernise and reform mental health services across HSE West, including the Galway and Roscommon areas. A key factor in this reform was the recognition that the previous overall stock of 79 psychiatric beds across Galway and Roscommon was too high, based on the recommendations in A Vision for Change, allied with a corresponding underdevelopment of community-based mental health services. In this context, an implementation plan to reconfigure mental health services across the Galway and Roscommon administrative area was put in place, culminating in the closure of the psychiatric ward in St. Brigid's Hospital, Ballinasloe, and the transfer of beds from Ballinasloe on a phased basis to the existing acute psychiatric unit in University Hospital Galway. Since February, a bed capacity level of 45 psychiatric beds has been operational in University Hospital Galway. I have been informed by the HSE that at no time since February has this bed occupancy level been exceeded. The latest information from it is that there were ten vacant beds in the unit this morning. Therefore, there is no pressure on physical bed occupancy in University Hospital Galway.

With the increase in bed capacity, the local HSE has also improved clinical governance, putting in place two assistant directors of nursing and two additional senior nurse managers. This is in addition to a range of new staff and services, including the redeployment of nurses from Ballinasloe. The HSE points out that the clinical director, together with the nurse managers, conduct daily assessments of staffing requirements to ensure a safe service at all times. Representatives of the Mental Health Commission also regularly visit the service. Staff in the acute unit at University Hospital Galway are confident that they can meet the needs of current inpatients and the needs of those referred for assessments.

The HSE acknowledges the tragic death of a service user recently. This has been reported to the Mental Health Commission and internally in line with HSE protocols. An internal review is under way.

My Department and the HSE are committed to quality in mental health services and patient safety and will continue to strive to ensure patients receive the best care possible when they need to access health and social care services. Improving the safety and quality of that care, be it mental health, acute care, services for older people and other areas, should be and will be our highest priority.

Deputy Colm Keaveney

This issue is not about bed capacity, despite the fact that 30% of the beds in the administrative area of Galway and Roscommon have been removed. The infrastructure has not been put in place for community-led multidisciplinary teams. Some 40% of posts in the community are unfilled. It is not, therefore, an issue of bed capacity but of not having the staff to deal with whatever capacity is available in the system today. It is an unsafe unit. A brand new €3.2 million facility in Ballinasloe has never even been opened and the appeal was to consider opening it temporarily.

I do not know why the HSE is advising the Minister of State that there is no issue with bed capacity. We have previously received these guarantees from the Minister of State with responsibility for mental health services and they are not being honoured. In Galway in the past 12 days there have been 11 deaths by suicide. I do not know what the unit's discharge policy is, but the staffing levels are inconsistent with the HSE's advice. The Minister of State is not listening to those on the front line who are clearly stating there is an ongoing dangerously low staffing level in the unit. I have advised the Minister of State with responsibility for mental health services that she fails to listen to front-line staff. I am, therefore, asking the Minister of State to listen to front-line staff, not to some corporate individual in a pinstripe suit based in the HSE in Merlin Park who is talking to the Department about bed capacity. This is not an issue about bed capacity but about outcomes for patient-centred delivery of an acceptable mental health service.

This location is inappropriate and absolutely unacceptable. I ask the Minister of State to consider opening temporarily a modern public service, not some 1960s or 1970s decrepit unit. The HSE cannot even open up an amenities area that is central to the recovery of vulnerable patients. Staff have clearly stated the patients detained in the unit are not being detained by legal means because the detention does not meet the requirements of the Mental Treatment Act. The HSE has closed a holistic environment where there is supposed to be socialisation and engagement with other service users. The unit is inappropriate and I am asking the Minister of State to open temporarily the facility in Ballinasloe that lies idle.

Deputy Alex White

I do not propose to add very much to what I said in my initial response. From what I have been told, I understand there was a visit last Thursday by the Health and Safety Authority of relevance to this issue. A meeting between the HSA and senior management took place on Friday and some immediate issues were addressed, including updating certain policies. It was agreed that the HSE would submit a full action plan to address outstanding issues and that there would be intensive consultation between staff and management. There has been and will continue to be intensive consultation between staff and management, which has been ongoing since last week, to complete the action plan. It was anticipated that the completed action plan would issue to the HSA today. I understand it includes the recruitment of additional nursing staff to eliminate the requirement for agency staff. I will certainly communicate the issues the Deputy has raised to the Minister of State, Deputy Kathleen Lynch, who is aware of the issues he has raised and has dealt with them in the House previously.

College Closures

Deputy Clare Daly

I appreciate that this issue does not relate to the Department of the Minister of State, Deputy Alex White, but I decided it was important to highlight it, even without a Minister from the Department of Education and Skills being present because of the urgency attached to it.

As people know, the wind-down of All Hallows College started last week and the 30 day consultation period has commenced. There was a meeting of the students in the college last night. As of now, there are no answers forthcoming and they have been informed that they will not be getting any from the board of trustees until Friday at the earliest, which is a major cause for concern.

All Hallows is a unique educational facility. Many of my former colleagues at the airport who worked for SR Technics pursued courses there when that company closed and European funding was made available. The college is a centre of excellence for mature students and its ethos is one of liberation through education. All Hallows looks at things differently and develops different types of programmes. Its closure would represent a tragic loss to the education system.

There are two problems which arise. At present, there are approximately 460 students studying at All Hallows and some 150 of them are pursuing the adult learning BA, ALBA, for personal and professional development. A number are due to graduate imminently and are, as a result, fairly much in the clear. The college will not be enrolling any further students but it estimates that it would take three to four years for existing students to complete their studies. Given that it is a private college, All Hallows does not fall under the terms of the relevant legislation but the authorities there have stated that they will assist students in completing their studies. As yet, there has been no indication of how this might be achieved.

All Hallows is connected to DCU, St. Patrick's College of Education and the Mater Dei Institute under a linkage agreement, a copy of which I would like, if possible, to see. There are students at the college who want to continue their studies and who, in many instances, have paid thousands of euro towards their education. A large number of them are mature students. Their tutors and mentors at the college want to continue to facilitate the provision of adult education. What they need is another institutional setting in which to do so and for the Department of Education and Skills to do what it can to assist the process in this regard. Many of the college's degree and other programmes are facilitated by DCU, St. Patrick's College of Education and the Mater Dei Institute. We must be creative in terms of how we deal with that fact.

The ALBA programme is extremely important for mature students. I know someone who is studying at All Hallows and who had wanted to apply to pursue a masters degree in community development and voluntary work. The college offers some excellent programmes in that regard. Aontas has recommended that the ALBA programme, which is only available at All Hallows, should be rolled out across all third level institutions nationally. Prior learning is recognised under ALBA and the strands relating to it include adult education, human development and arts and ideas. It also includes a professional focus strand which emphasises areas such as community development, etc. If the Department does not intervene to save the programme, it will be lost forever. Students were informed last night that they cannot transfer anywhere else as a result of the uniqueness of the ALBA programme.

The Department of Education and Skills must address this matter. Has it given any consideration to what it might do to help students who are currently studying at All Hallows? Has it considered how it might protect the type of educational programmes to which I refer and which have a great deal to offer both our economy and society?

Deputy Alex White

I am taking this matter on behalf of my colleague, the Minister for Education and Skills, Deputy Quinn, and I thank Deputy Clare Daly for raising it.

The Department of Education and Skills was informed by All Hallows College of its intention to wind down its operations. The President of the college indicated to the Department that its closure will be handled in an orderly manner. As the Deputy will be aware, All Hallows is a private college that specialises, inter alia, in the teaching of theology, philosophy, psychology and English literature. A linkage agreement has, as the Deputy noted, been in place between DCU and All Hallows since 2008. As a result of this agreement, All Hallows College became a college of DCU and all degrees are validated and accredited by the latter. The college is not an approved institution under the Higher Education Authority and it does not receive core funding from the Department. However, three full-time undergraduate courses in the college are approved under the Department's free fees initiative. Under the latter, the Exchequer meets the cost of tuition fees in respect of eligible students on approved full-time courses. In the case of All Hallows, the Department refunds the cost of tuition fees up to a limit of 130 students on the three approved courses. The college was paid some €440,000 for the 2013-14 academic year in respect of 119 eligible students who attended the courses to which I refer for the full year.

A wide-ranging reform programme of the higher education system is being implemented. This arises on foot of the modernisation framework contained in the national strategy for higher education to the year 2030. The latter recommends that continuing funding support for institutions such as All Hallows, which receive limited public funding for specific programmes, should be a matter for the Higher Education Authority and subject to ongoing review in the context of quality outcomes, overall demand and available provision within relevant regional clusters. In May 2013 the Minister set out his response to the Higher Education Authority's advice on future system configuration and confirmed the approach recommended. In its consideration of the limited free fees funding allocated to All Hallows, the Higher Education Authority concluded that existing provision should be continued.

Deputy Clare Daly

A couple of issues arise. The college has developed and moved on from the theological base on which it was founded. Its current ethos is very much based on social justice and community. As already stated, it has a particular focus on mature students who want a second chance at education. On foot of its ethos, it has certainly inspired people to undertake voluntary and community work. It is quite important, therefore, that it should be saved. As the Minister of State indicated, the problem which arises in this regard relates to money. All Hallows is a private college but, as he also indicated, the State pays it some money on the basis of the number of students pursuing particular courses. However, this money is capped. If the cap were lifted, that might assist in alleviating the situation.

One of the solutions being discussed relates to the fact that DCU has decided to accept a different combination of subjects in respect of the relevant courses and this would help in attracting more students. I do not wish to be disrespectful but dropping many of the theology combinations and focusing more on the other programmes might be the way forward. DCU has agreed that this would, in fact, attract more students. The difficulty is that the Department must lift the cap to which I refer. It must be accepted that All Hallows is a fine educational facility on the northside of Dublin. The premises in which it is located is extremely impressive and it would be tragic if it was lost to the education sector. The college has relied on philanthropy to survive and is existing on the basis of endowment funds, which are being depleted, and some fees. It sold some land a number of years ago in order to fund its operations.

Could the State not intervene and negotiate with the authorities at the college in order to try to preserve it as an educational facility? We know, on the basis of population projections, that we are going to require more such facilities in the future. I accept that this matter is not relevant to the Minister of State's Department but I request that he impress on the Minister for Education and Skills the need for an intervention in respect of it. A further meeting of the ALBA students is due to take place tonight. Most of the latter are mature students and they are extremely concerned. The Government could, without breaking the bank, secure what is a fine educational establishment. If it lifted the cap in respect of the courses to which I referred earlier, the number of students would increase and this would be enough to keep All Hallows going. The college estimates that it would require €2 million in order to get through the next academic year. That is not a huge amount and most of the students who attend the college pay fees. As stated earlier, many of them are former colleagues of mine at Dublin airport. All Hallows provides a fine service. I appeal to the Minister for Education and Skills to link up with the authorities there in order to discover what might be done in the context of securing its future for both current and prospective students.

Deputy Alex White

As the Deputy acknowledged, All Hallows is a private college. It is a fine institution and the Deputy did a great job describing it. I know All Hallows and its history very well because I grew up just a stone's throw from it. Everything the Deputy said about it, its history and its contribution to education is absolutely correct.

As I noted earlier, the Department provides the college with specific funding under the free fees initiative in respect of a small cohort of the student population. I am not sure whether I fully grasp the point the Deputy made in the context of the relationship with DCU and the cap in respect of All Hallows. I understand the point about the cap but I must point out that it was not reached in any of the past three years.

The cap on numbers in respect of which the free fees would be reimbursed was 130 in 2013-14 and 119 students availed of it. The cap has been 130 for the past three years and the numbers who availed of the scheme were 119 in 2013-14, 121 in 2012-13 and 103 in 2011-12 while the number was 112 in 2010-11 when the cap was 136. The Deputy may have been making a point in respect of a possible connection with DCU.

Deputy Clare Daly

It is a case of whether the college could change the mix of courses. DCU has agreed this might make it more attractive.

Deputy Alex White

I understand that point now, I did not grasp it earlier. Certainly, I will communicate that to the Minister for Education and Skills. The Deputy raises what is absolutely a fair point in that respect.

I have no wish to speak directly on behalf of the Minister for Education and Skills but the Minister must operate in respect of the future planning and configuration of higher education on the basis of a rational plan from the Higher Education Authority that covers the configuration of need and course mix throughout the third level sector. He received this advice last year and he is proceeding on that basis. It is difficult for any individual college or an individual request to depart from the overall global plan the Minister must observe. I will certainly communicate what the Deputy has said to the Minister, Deputy Quinn.

It is clearly a difficult time for the staff and students involved in the college. In the first instance everyone's thoughts are with them. It is a very human situation. These people are facing the closure of an institution. The same would apply to any third level institution. I hope and expect that the interests of students are kept to the fore of the arrangements being undertaken by the college. The Department has welcomed the fact that the college intends to wind down on a phased basis to facilitate, as far as possible, the completion of students' studies. Meanwhile, I undertake to communicate to the Minister the issues the Deputy has raised in this context.

The Dáil adjourned at 5 p.m. until 2.30 p.m. on Wednesday, 4 June 2014.

Dáil Éireann díospóireacht - Thursday, 29 May 2014