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Dáil Éireann díospóireacht -
Tuesday, 27 Jan 2015

Vol. 865 No. 1

Topical Issue Debate

Maternity Services Provision

I thank the Leas-Cheann Comhairle for giving me the opportunity to raise this important issue. I acknowledge the presence of the Minister for Health. I welcome the establishment of an independent investigation into the issues surrounding the care of seven babies at Portiuncula Hospital in Ballinasloe.

The least the parents deserve is to know the truth about what happened in the cases of each of the seven children. I reassure expectant mothers that Portiuncula Hospital has been audited on a number of occasions since the initial review began and has come through each one. Expectant mothers have nothing about which to be concerned with regard to their care in the hospital.

I wish to raise a specific issue of concern which needs to be included in this investigation. This is the fact that HSE management was made aware of the staffing, supervision and training concerns of staff and midwifery management as far back as July 2013. Midwives in Portiuncula Hospital have consistently highlighted the lack of inadequate staffing at the maternity unit. Instead of having one midwife to 28 births, last year Portiuncula Hospital operated on a ratio of one midwife to 54 births, which is almost half the number of midwives required.

In July 2013 the staffing situation was so serious the matter was brought directly to the attention of the group chief executive officer, Bill Maher, the group chief operating officer, Tony Canavan, and the group clinical director, Dr. Pat Nash. The correspondence informed all three that funding was needed to appoint midwifery trainers in all of the maternity hospitals in the group. The communication circulated to the three most senior managers of the hospital group stated these appointments were important to ensure recommendations and learning from recent reports were applied. This took place less than one month after the HSE report into the tragic death of Savita Halappanavar found the key factor in her death was inadequate assessment and monitoring. It was well before the spike in the number of babies transferred from Portiuncula Hospital to Dublin for therapeutic cooling in 2014.

I sympathise with all of the families who have suffered in this. I reiterate Deputy Naughten's comments that Portiuncula Hospital in Ballinasloe is a good hospital. Let expectant parents not be afraid. However, we need a proper and transparent investigation which is not biased in any way and the end game of which is not to try to close the hospital. We have seen enough of this through the years. We want to learn from mistakes. I urge the Minister to let this be completely independent. Do not involve in any way the people who have brought out reports. Do not use the people who want to do hatchet jobs on hospitals, particularly those in the west. Let those involved be open and transparent.

It is a sad day when media outlets, such as thejournal.ie, are those who inform parents, and someone from the health services cannot pick up a phone, drive to a house or write a letter to inform them. Will the Minister ensure this is done right? We should learn from mistakes. Staffing is a major problem, as Deputy Naughten stated. My children were born in the hospital in Ballinasloe and I cannot but give it the utmost praise. No Deputy wants what usually comes out of these investigations, which is a finding that a hospital may not be safe after which an attempt is made to close it. Portiuncula Hospital is needed for Roscommon and east Galway. It has had a credible reputation throughout the years so let us get it right.

I thank Deputies for raising the issue and affording me once again the opportunity to extend my sympathies to the families involved. I know this is a very difficult time for them, but I have been advised that the HSE is in contact with them and they will be offered the necessary supports.

While I am of course very concerned to learn of the events in Portiuncula Hospital, I take some reassurance from the fact that a quality and risk management process highlighted a potential problem and the Saolta University Health Care Group acted promptly to review the situation. Protective measures were very swiftly implemented to provide patient safety assurance and an intensive ongoing monitoring process has been put in place.

An external review of practices and processes will now be commissioned to ensure the ongoing safety of maternity services at Portiuncula Hospital. The review will incorporate a more detailed review of the individual cases.

I have no desire to add to the concerns of any woman who may be expecting a baby and I urge others not to do so. I thank the Deputies for their helpful comments in this respect. I believe it is very important to reassure women, and their families, that maternal and perinatal health statistics indicate that Ireland continues to be a safe country for a woman to give birth in, and our safety record compares favourably with other developed countries. The European health consumer index published this morning, which was critical of some aspects of our health service, pointed out that when it comes to perinatal deaths Ireland is in the best and safest group. I share the view of Deputies that we must seek to improve the services we provide, and in this regard a number of initiatives have recently been implemented or are being developed.

The Department, in conjunction with the HSE, is working on the development of a new maternity strategy. Developing the strategy will help us identify how we can improve the quality and safety of care provided to pregnant women and their babies. We want to ensure that women are provided with the right care, in the right setting, by the right staff, at the right time.

I note the launch last November of the Irish maternity early warning system, IMEWS. This national clinical guideline will assist in the early identification of deterioration and ongoing monitoring of a woman's condition. This development makes Ireland one of the first countries in the world to introduce a national maternity early warning system.

A sum of €2 million in additional funding has been provided in the national service plan for 2015 to address current pressures in maternity services through the recruitment of additional obstetricians, midwives and other front-line staff. In this context it is important to note that while of course we would like to have even more staff, we have more consultant obstetricians and substantially more midwives than ever before at a time when birthrates are decreasing. A new national maternity office will be established within the HSE acute hospitals division in 2015, and a national review and evaluation of maternity services will be undertaken.

I reassure women and their families that Ireland is and remains a safe place in which to give birth. While perinatal and maternal deaths in Ireland are few, I know this is of no consolation to those families who have suffered a loss. I assure them that we will seek to continue to increase the safety and quality of services provided to mothers and their babies in our national maternity service.

I am disappointed with the response that it will be purely focused on Portiuncula Hospital. I understand the management of the Saolta University Health Care Group was made aware by the hospital itself of the transfer of the babies from Portiuncula Hospital for therapeutic cooling after the first two babies were transferred and after the second two babies were transferred. Why did it fail to act on the concerns expressed by staff? We need clarity on the management of the care of each baby, which the parents deserve. They also deserve to know why they were not informed of the inquiry until they were told by the media. We also need to know why the resource concerns raised by the midwives in the hospital, and by local and group management, seem to have been ignored. This is the key question. If those concerns were addressed would there be a need for this inquiry? This needs to be answered.

It was the staff in Portiuncula Hospital who raised this issue. They are the people who pushed for a review to take place. Therefore they should not be scapegoated. We need a proper independent inquiry which not only examines what happened in Portiuncula Hospital but why senior management failed to act when these issues were brought to its attention.

Everything will be done to resolve this and an independent inquiry will take place, but the one thing the people, particularly those in Ballinasloe and its surrounding area, need to hear the Minister state is the hospital will continue to deliver babies. A sad reality in Ireland in recent years, before the Minister took over, was that when a hospital cried for help because of staff shortages and being under pressure the type of thinking in senior management in the HSE has been to try to close it. This must change.

The front-line staff in the accident and emergency department in Portiuncula Hospital were under horrendous pressure last Christmas. That must be addressed. People, regardless of where they live in Ireland, deserve a health service. As well as ensuring that the inquiry will be independent, I urge the Minister to confirm that this hospital will continue to provide services and that its staff need not be wary or wondering about its continued operation. The wondering that is prevalent about it at present is not helpful in the situation.

To the best of my knowledge the terms of reference have not been yet decided. I welcome the Deputy's suggestions as to what might be in them. The inquiry will be independent and will be led by people who are outside the Saolta hospital group and it will also include a patients' advocate.

The reason some of the families were informed through the media was due to the fact that it was leaked to the media. I do not know who was responsible for that leak but it is very regrettable because the hospital and the other authorities should have been given time to contact the families, but sometimes things are just too good a story for them to avoid publication. I know that at least one media outlet decided not to break the story in deference to the families' wishes but, unfortunately, others did not take that approach.

In regard to the therapeutic cooling, it is important to bear in mind that while the rate of therapeutic cooling was higher in Portiuncula than in Galway, it was not outside the international range of norms and it was not that in itself that created concerns. It was the subsequent review of the cases that threw up concerns.

On staff ratios, I do not know offhand what the midwife to birth ratios are in Portiuncula or whether they are very different from other hospitals or larger hospitals. However, one aspect needs to be pointed out. In medicine and in midwifery the more cases one sees, the better, and then one is more used to seeing a difficult case when it arises. If a centre, and I not speaking particularly about Portiuncula, has 1,500 or 2,000 births, which is probably five or six a day or two or three in each shift, one is less likely to know what to do when that one in 700 cases arises. Sometimes having more staff does not necessarily make services better. What we need are senior staff and we have a difficulty getting and retaining senior staff, particularly at registrar and senior house officer, SHO, level, in smaller centres. That is a reality we face across the country. We need to be honest with people about that and the difficulties that can arise from that. When one looks at inquest reports from maternal deaths and neonatal deaths, the deciding factor is not that the staff were too busy to do their jobs, it is that they made a mistake in reading a cardiotocography, CTG, or detecting a foetal heartbeat or something else. That can often be down to lack of experience and lack of case volume rather than there not being enough staff. Certainly, what I can say, and I will be straight about this, is that there are no plans to discontinue maternity services in Portiuncula. That is not part of this Government's agenda.

Medicinal Products Availability

I thank the Ceann Comhairle for accepting this issue and I thank the Minister for coming into the Chamber to take it.

I acknowledge the presence of Mr. John Duggan, his wife, Aileen, and his brother, Stephen, who are in the Gallery. John is a sufferer of paroxysmal nocturnal haemoglobinuria, PNH, the disorder that I am about to outline. I want to acknowledge they are here and that they have gone through a lot to get here.

PNH is an extremely sensitive and tough issue. I feel helpless in this respect as I do not have a medical background and while I am doing my job as a Deputy, we are talking about a life-threatening illness and a young man's life. PNH is an extremely rare and debilitating blood disorder. It is essentially characterised by the breakdown of red blood cells. Mr. John Duggan who is from Bellewstown in County Meath was diagnosed with this rare blood disorder in 2010. Since his diagnosis he, his wife, Aileen, and their family have probably been terrified every day and every night that John will have a blood clot, kidney failure, a heart attack or God knows what else. He is currently receiving blood transfusions every six weeks. I do not know how he does it but he has managed and continues to manage to work since his diagnosis in 2010. That is no way for somebody to live, especially when a treatment is available, has been diagnosed and is known to his doctors and himself.

The drug to which I am referring is Soliris. It is one of the most expensive drugs in the world. It costs more than €400,000 a year. While I acknowledge that is a great deal of money, we are talking about a man's life. I could perhaps acknowledge what has happened in this respect if we were talking about 400 or 500 people, but I am taking about two people, John being one of them. The Minister might clarify if there are many more people who are in need of this drug.

I understand that in 2008 the HSE entered into an interim agreement with Alexion Pharmaceuticals, the company that makes this drug, and St. James's Hospital to treat four people and after two years they decided to continue this treatment but also to include a further six people. At present ten people who are sufferers of PNH are availing of the drug, yet there are two people who are sufferers who cannot avail of it. That is extremely unfair and unethical.

There are three components involved. One is the Minister's Department and the HSE, which essentially work together. Another is the National Centre for Pharmacoeconomics, NCP, which essentially decides what drugs are or are not accepted. Another is Alexion Pharmaceuticals, the company that makes this drug. The Minister made his view on this known last week and I thank him for his comments in the Seanad, and I understand the job he has to do. The NCP has made its views well known by the fact that it will not accept Soliris into the community drugs schemes because it says it is too expensive. Alexion Pharmaceuticals has made its views very clear by the fact that up to now it has not been willing to engage and to lower the price of the drug, which seems to be the main problem. We need these three components to come and work together to find a solution now, not in six or ten months' time. For the company and the HSE, an issue that might continue for weeks might not seem to be a long time, but for John and his wife this is a lifetime. I am aware that in the last two days Alexion Pharmaceuticals has re-engaged with the HSE and other relevant bodies. That is good but while they are talking about it and I am talking about this issue now, John and Aileen will still go home tonight not knowing exactly what is happening or whether he will be able to avail of this drug.

I urge the Minister to help further facilitate these meetings and to try to find a solution, however it may be found, because we are talking about a young man's life.

I thank the Deputy for raising this important issue. The HSE has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drugs schemes in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013. This requires consideration of a range of statutory criteria prior to reimbursing any medicine. These include clinical need, cost-effectiveness and the resources available to the HSE. The decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds by the HSE and on the advice of the experts in the National Centre for Pharmacoeconomics. They are not political or ministerial decisions, nor should they be.

This drug eculizumab or Soliris, to give it its brand name, is indicated for the treatment of patients with paroxysmal nocturnal haemoglobinuria, or PNH. It is considered to be one of the most expensive drugs in the world.

I understand that in 2010 the HSE entered into an interim Access with Evidence Development Agreement between the company, Alexion Pharma, and St. James's Hospital to treat ten patients with this drug. The interim agreement was put in place with the expectation that further evidence would emerge which would assist the future decision-making on this drug.

The HSE received an application for the inclusion of Soliris in the general medical services, GMS, and community drugs schemes. In accordance with agreed procedures, the National Centre for Pharmacoeconomics conducted a pharmacoeconomic evaluation of eculizumab. The report of the centre in October 2013 concluded that the total cost per patient per year for this drug is €437,247 and would have a cumulative gross budget impact over five years estimated at €33 million. In addition, the manufacturer did not include an economic model as part of its submission and failed to demonstrate the cost-effectiveness of this therapy. Consequently, the National Centre for Pharmacoeconomics was unable to recommend reimbursement of the product under the community drugs schemes.

The HSE has been engaging with the company for some time to arrive at a price that would assist it in its desire to fund this medicine for as many patients as possible within available resources. The engagement with the company has now resumed and I hope that a positive outcome can be achieved to the benefit of all patients who avail of our health services and all the taxpayers who pay for them.

I want to assure the House that the HSE and I fully understand the concerns of patients regarding the availability of this medicine and that every effort is being made to achieve a satisfactory outcome.

While I appreciate that some may take the view that the taxpayer should reimburse every licensed medicine for whatever the price the drug company demands, the better interests of the health service require that we reimburse only the most effective medicines and only at a fair price.

I thank the Minister for his response, but I must stress that two people are involved. While I understand that we need to consider a cost-benefit analysis and the cost to the taxpayer, this does not involve a large number of people. The two people concerned, out of a possible 12, are not involved in a pilot scheme. I am aware that the company met HSE officials and other bodies this week and is engaging in talks, but we know from a number of different people that talks have been ongoing for years. This is something which should have been resolved a long time ago. I ask the Minister to facilitate these meetings and to find a solution.

I have brought this matter to the attention of the chairman of the Committee on Health and Children, Deputy Jerry Buttimer, who met John and his wife Aileen last week. He has promised to monitor the situation and if progress is not made it would possibly consider bringing the relevant bodies before the committee. We hope it does not get to that stage. I urge all bodies to come together to find a solution to this now, rather than after a number of weeks or months have passed.

I appreciate that the Deputy has referred to two people, and that is the perspective from which she is coming. It is fair to say that the HSE national drug committee has to take a slightly different perspective, and has to have regard to the tens of thousands of other patients also in need of services and the millions of taxpayers who fund them. In that context, a medicine which costs nearly €1 million for two people would be enough to provide a primary care service for an small town, which could improve the health of, and maybe even save the lives of, tens of people. As the Deputy knows, €1 million would hire two consultants and five midwives who, through their work on a daily basis, could improve and save thousands of lives. That is the reality of health care funding and it is true for very wealthy countries as well as those under financial pressure. Resources are limited and have to be used in the best interests of as many people as possible.

Garda Investigations

I thank the Acting Chairman for facilitating this Topical Issue debate and the Minister for Justice and Equality for coming into the House. I ask her to discuss the apparent failure by the Garda and HSE properly to investigate the appalling abuse of an individual, Anna Bubula.

The circumstances surrounding the case were covered comprehensively in yesterday's Irish Examiner, as the Minister may have read, in a report by Michael Clifford. The photographs alone are horrific and not for the faint-hearted, and reveal an appalling abuse and assault. The article itemises a series of apparent failures by the authorities in the case. There was an apparent failure by medical staff to report an allegation of rape to the gardaí. It was alleged that gardaí did not follow up on the case despite having attended at the scene when an ambulance was called. There was no record of an arrest of the suspect at the scene. No interpreter was present when the victim gave a statement to the gardaí. There was no effort to collect evidence about the alleged crime. No request for medical records was made for ten months after the assault, and only then at the direction of the Director of Public Prosecutions.

The assailant pleaded guilty to assault causing harm three years later and the issue of sexual assault was not adequately dealt with. The woman concerned was never examined in regard to sexual assault, which seems extraordinary because the notes on record at the time point to the fact she said she had been raped. The Garda Inspectorate report last year identified the fact that many rape or sexual assault cases were re-categorised as domestic violence or non-sexual assault cases, which is a worry.

The background to the case involved a Polish woman who had clear issues with articulating herself in the English language. It seems extraordinary that no interpreter was brought to bear on this case to facilitate the woman in communicating to the authorities the details of the appalling and dreadful attack. I recall, as Minister for Health, establishing ten years ago the first sexual assault unit in the South Infirmary Victoria University Hospital in Cork, and many more followed. The whole idea was that protocols would be established so that proper, professional, comprehensive examination and assessment of women or men who had been sexually assaulted would take place. For that not to have happened in this case is extremely worrying. I have come across one or two other case where it has not happened.

If the Rape Crisis Centre in Galway had not become involved, an interpreter would never have been made available to the woman concerned. It was during the court proceedings three years later, when she sought help from it, that one was made available to her.

There must be procedures and protocols to be followed by health services and the gardaí in cases where assertions and allegations of sexual and physical assault have been made. What steps are taken to ensure those protocols and procedures are fulfilled by the gardaí and other authorities? I ask the Minister to outline the nature of the investigation the Garda has now, I understand, initiated into how the case was dealt with.

I thank Deputy Martin for raising this matter. I share his concern about the shocking allegations of sexual assault in 2006 and that what has been reported in the media is properly addressed. I can only agree with what he said about the report and the photographs. Like him, I have a profound abhorrence for sexual and domestic violence in all its manifestations and I have worked in many fora over the years to tackle this type of crime.

The reports on this case are very serious and I am sure all in the House will agree they merit the most thorough investigation. Apart from the very brutal nature of the reported assault in this case, there are disturbing allegations, as the Deputy said and as reported yesterday, about a lack of response from State agencies, including An Garda Síochána and the health services. It is important that these matters are dealt with sensitively and are fully addressed, and I want to assure the House this will be done.

I can advise the House that the person in question wrote to me in late November. In view of the very serious nature of what she said in her letter to me, I asked for a full report on the matter from the Garda Commissioner and informed the person in question that I would be in contact with her again when I received it.

The Commissioner has now reported to me that she has asked the regional assistant commissioner to compile a report on the matter and has appointed an inspector to address the issues involved in this case. That obviously involves meeting the victim and I want to inform the Deputy that the first such meeting took place earlier this month. There is direct contact with the person in question, which is continuing with a view to obtaining full information on the case, and there will be a further meeting very shortly.

I can inform the House that the person in question also raised a second issue in her correspondence which is not in the public domain and on which it would not be appropriate to comment publicly. However, in light of this matter the Commissioner has now referred that aspect of the correspondence to the Garda Síochána Ombudsman Commission in respect of that specific issue. For the sake of completeness, as Deputy Martin alluded to, there have been court proceedings relating to an assault on the person concerned. I would like to await the full report so we can set out and establish all of the facts.

When I receive a final report from the Garda Commissioner, I will consider what further action may be necessary. I have powers to refer matters to the Garda Síochána Ombudsman Commission, GSOC, but I would like to get the full report before I decide what further action is necessary.

There are potentially criminal aspects involved and I do not want to do anything that might impede or have an impact on a criminal investigation. I will also contact the person directly once I have the full report. The person can make a report to GSOC as well, despite the time issues, as an issue related to An Garda Síochána can be investigated if it is in the public interest. However, the person may not feel able to do that, and I just mention it as a possible route.

I take the Deputy's point that the Garda Inspectorate raised a number of very serious issues relating to the treatment of victims of domestic and sexual violence. There was a series of recommendations, and we know that inter-agency support will be absolutely essential. There are currently a number of protocols in place, and the Garda Inspectorate was critical of the way in which victims of sexual and domestic violence were still dealt with. The protocols have been increasingly used, and it is clear that there has been progress within services generally, with inter-agency collaboration and local units dealing with victims of sexual abuse. It is essential that all agencies work together, and I will take up the points raised by the Deputy regarding the health service with my colleague the Minister for Health. It is obvious that the real needs of the victim were lost in this case, as she did not get some of the basic services of assessment and treatment, including the services of an interpreter. The question of how victims are dealt with is central to my work, including at a European level, given the need for us to implement the EU victims directive this year. I will await the full report and then decide what action to take.

I thank the Minister for her reply. Will she indicate what are the circumstances in which interpreters should be brought in? It seems to be a basic service for somebody from another country with very poor English. An interpreter should be a basic provision for somebody like this who is reporting a crime. We must thank the landlord and the friends of this person, who were in a different town, as without them we would never have known about this. It is frightening. Thanks be to God there were good people out there who would not let this rest and sought accountability. Apparently, 80% of survivors of sexual abuse do not report their cases to the Garda, and this kind of experience would frighten people away from such reporting. We need more people to report these issues so we can achieve satisfactory outcomes and reduce the number of sexual assaults.

There was almost an instinctive sense that this was a domestic violence issue, when it never was. Apparently, that was one of the initial flaws in the response of authorities to this case. I note the Minister's comments about GSOC being asked to examine a specific issue, and perhaps it could consider the entire case. A victim goes through trauma with a sexual assault and it is adequate reason for timelines not to be a factor when something is reported to GSOC. We have already waived the statute of limitations with regard to abuse in industrial schools and other institutions. On the basis that trauma induced by sexual assault is of such an enormous nature, allowances must be made for the capability of a person to report issues adequately and properly at the time they occur.

I would appreciate it if the Minister could keep an eye on this and ensure that the issue is comprehensively and properly followed through so that the victim can get justice and others may never have to go through what she did. One only needs to look at the photographs her friends took, which show the horrific consequences of this. Although I hate to repeat it, the landlord said he never saw a boxer come out of a ring with such damage to face and body. It was a vicious assault. We must improve our work in this area. We must ensure this never happens again.

I thank the Deputy again for raising this most important matter. The timeframe provisions can be waived by GSOC where it is a matter of particular public interest, and I can also refer a case to GSOC. I will bear that in mind when I get the full report. The Deputy has described the injuries and, unfortunately, victims of domestic and sexual violence suffer horrific injuries. That is the reason these crimes must be taken very seriously. That has been highlighted. Many of us in the House may have thought that the broader issue of the response to victims of sexual and domestic violence had improved greatly over the past ten years, but the Garda Inspectorate report highlights the need to keep this as a high priority, with an appropriate response from An Garda Síochána. I have discussed the issue with the Garda Commissioner and she has assured me that it will be a top priority for An Garda Síochána in the course of the coming year and into the future. With that in mind, we have a new process, with the establishment of victim liaison officers in every Garda division to improve the response to victims, which is an important initiative.

The Deputy asked about interpreters. There are very clear protocols in the courts, for example, when a person requires the services of an interpreter. This is also true of occasions when gardaí must question somebody and an interpreter is needed. I can arrange to get a note for the Deputy on precisely how interpreter services are dealt with in the health services and I will include details of how interpretation is provided when the police are dealing with people for whom English is not their first language.

Flood Relief Schemes Status

I acknowledge the decision of the Leas-Cheann Comhairle to allow me raise this issue, and I thank the Minister of State, Deputy Harris, for his attendance in the Chamber this evening. He has taken a very hands-on interest not just in this scheme but in other west Cork schemes in recent times. This is the second time such an issue has been raised in this forum. There are three schemes in west Cork, at Bandon, Clonakilty and Skibbereen, which the Minister of State has visited. He also met representatives at Skibbereen last week, so I acknowledge the hands-on role that he has taken on the issue, which is appreciated.

We are all well aware of the difficulties people face and the damage caused to property by flooding. The problem is not just damage to property; it is the inconvenience and horror experienced by people, along with subsequent problems such as an inability to obtain insurance and the real fear that it may happen again. That is particularly the case in Bandon. The €10 million Bandon flood relief scheme was first commissioned by the Office of Public Works, in partnership with Cork County Council, following a flood in 2009. The 2009 floods damaged or otherwise affected homes and 190 business properties in Bandon, resulting in approximately €140 million in insurance claims across County Cork. Construction of the scheme was scheduled to commence last spring, but it suffered a major setback last week with the news that it would not start this year due to the possibility of a legal challenge at the pre-qualifying stage from a contractor who has not been placed on the list of contractors from whom bids will be invited. The scheme has suffered serious setbacks, and the latest news has been met with dismay, frustration and even anger locally. The town's planned new sewerage scheme has also been hit with delays, as Uisce Éireann has signalled its decision to redesign the project. These two issues are difficult for people to accept, and the town has effectively been left in limbo, as both schemes have been plagued with delays.

I appreciate that in response to several parliamentary questions raised on the matter, the Minister of State indicated that the Government remained fully committed to the provision of this important scheme for the people of Bandon. As each month passes by, people are becoming increasingly frustrated. Each passing month, particularly at this time of the year, allows for more potential flooding and the possibility of consequent distress and expense for residents and businesses.

I am again making the case that the delay must be addressed. The community, the local residents, the local businesses, the ratepayers and so on should not have to wait this long for this particular scheme. I accept the recent legal aspect could not have been predicted. We have to take this review very seriously and respond appropriately.

Can the Minister of State indicate whether the OPW is in a position to deal with the legal matters separately in order to allow the project to proceed to construction phase? Is it possible to give a timeline for the delivery of that scheme? I am continually grateful to the Minister of State for his interest in advancing this particular project. Some of the delays inexcusable and they add to the frustration but I hope the Minister of State will give me some idea of where the scheme lies.

I thank Deputy McCarthy giving me the opportunity to address the House on this matter. I also thank him for his kind words. We have had an opportunity engage in a number of schemes in west Cork over the past number of months and I am pleased the Clonakilty scheme is progressing, as is the Skibbereen scheme. Along with Deputy McCarthy's Oireachtas colleagues, I was grateful to meet with the delegation from Skibbereen in recent weeks.

Since my appointment as Minister of State, I have had the opportunity to visit many areas of the country affected by flooding and have met many people who have suffered the consequences of these floods. I am very well aware of the situation in Bandon and of the fear of the people of the town of such events, in particular since the 2009 flood event, to which Deputy McCarthy alluded.

Since that particular flooding in 2009, the Office of Public Works has prioritised the development of a viable flood relief scheme for the town and has been working hard, along with Cork County Council, to achieve the completion of the final design of the scheme and the commencement of construction at the earliest possible date.

With this objective, a scheme has been designed which will benefit more than 360 properties, of which over 140 are residential properties, following significant consultation with all relevant stakeholders. The proposed works, which will be undertaken on the Bandon River, Bridewell River and Mill Stream, include dredging of approximately 3.6 km of the Bandon River, mainly downstream of the town; repair works and modifications to the Bandon Weir; replacement of the existing pedestrian bridge with a new three span pedestrian bridge; underpinning of Bandon Bridge; construction of new flood defence walls and improvement to others; construction of new earthen flood embankments; construction of new culverts; construction of new fish passes; and associated drainage works and services diversions.

The current procurement process to tender for a civil works contractor began in July 2014 when the contract was advertised on the e-tenders website and in the EU Journal. This is a two-stage process, as Deputy McCarthy will know, which involves an initial pre-qualifying stage to short-list suitable contractors to be invited to tender for the works at the second stage. The pre-qualifying stage involves the interested contractors completing a suitability assessment questionnaire to allow the contracting authority, in this case the OPW, to obtain information from applicants to enable it to assess their capabilities and competency to undertake the works. The questionnaire specifies the criteria that will be used to evaluate the applications, some of which are simple pass-fail criteria, for example, health and safety systems, and others involve additional qualitative assessment, for example, technical competence and experience. This is a standard procedure within the Government construction procurement framework.

The process has now been delayed, unfortunately, as a result of a legal challenge from a contractor who was not placed on the shortlist from which bids were to be invited. The OPW is currently taking legal advice on the matter and, because the matter is before the courts, I am sure Deputy McCarthy will understand that I cannot comment on issues or details surrounding the challenge.

What I can confirm is that I and the Government remain fully committed to the provision of a scheme for the people of Bandon. The OPW has made provision for the cost of implementing a scheme in Bandon in its financial profiles over the years 2015-17. I am confident the current legal issue will be resolved as quickly as possible and that the project can then progress towards the construction stage. The staff in the OPW and their legal advisers are working as hard as they possibly can to try to resolve this matter as quickly as they possibly can.

Once a contractor is appointed and the scheme is underway, it is expected that it will take approximately two years to complete. I understand the frustration people feel at these latest developments and the length of time it is taking to bring this scheme to construction. Both I and the Office of Public Works share this as a frustration given the significant work, engagement and consultation that has been undertaken with the community to get to this point. I also understand the real difficulties that this can cause in terms of the non-availability of flood insurance for households and businesses. I assure Deputy McCarthy and this House that the OPW and its partners, Cork County Council, remain committed to implementing the scheme for Bandon in the shortest possible timeframe.

I thank the Minister of State for his response. The case has been well made. I have pursued it through parliamentary questions and Topical Issues and I acknowledge the involvement of the Minister of State and the interest he has taken not only in the Bandon scheme but also in the Clonakilty scheme. He took time out of his very busy schedule to visit Clonakilty recently. He has also taken a Topical Issue I tabled and met the business group from Skibbereen in Leinster House recently, for which I am grateful.

Could we keep this scheme at the top of the agenda? I would appreciate if we could do whatever is required and is within the capability of the Department so that we can get around this current difficulty and see construction.

All of these schemes are very important, as are all the various stages, but the most important aspect of these works is when one sees the actual work being undertaken. That is when people realise the day of reckoning has come. I ask the Minister of State to keep this on top of the agenda and to give it as much priority as he can.

I am very happy to give Deputy McCarthy that assurance. This scheme is a priority for the OPW and for me. I genuinely feel the Bandon scheme, along with the Skibbereen and the Clonakilty schemes, will result in significant flood mitigation for the people of west Cork. They are three exciting projects and I want to see all three underway.

I can certainly understand the frustration. Sometimes when the solution is on a piece of paper or on a map on the wall and people can see it and if there is a delay, it can nearly be more frustrating than before the solution was even devised. However, I know Deputy McCarthy and the people of Bandon will appreciate that there is a legal case but I can assure them that the money is in the OPW budget to do this and my staff and our legal advisers are working as hard as they possibly can to resolve this as quickly as they possibly can.

Deputy McCarthy, his constituency colleagues and representatives of Cork County Council have sought to meet with me and the OPW officials. I would be delighted to facilitate that in February. I will certainly keep the Deputy and the House up-to-date as this progresses. I hope we can get over this legal issue as quickly as possible so we can move ahead with delivering what I think is a really exciting and beneficial scheme for the people of Bandon.

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