Dáil Éireann díospóireacht -
Wednesday, 4 Feb 2015

Vol. 866 No. 2

Leaders' Questions

Deputy Micheál Martin

Last week I raised the issue of patients with paroxysmal nocturnal haemoglobinuria, PNH, a life-threatening blood disease, being denied access to Soliris, a life-saving medicine. Some 35% of people with the condition die within five years, which is the life expectancy without treatment. It is a serious situation. In 2010, ten patients were put on treatment at St James's Hospital by the then Government and HSE. Since then, new patients have been denied the therapy and treatment used in the United Kingdom and across Europe. I have met some of those involved, having spoken to Ms Mary Gorman and Mr. John Duggan. Mary Gorman's letter and testimony is heartrending. I contrast it with the case of a young woman who had to emigrate to get treatment. Mary Gorman talks about slowly dying with this disease and how her daily life involves another dreadful night of disturbed sleep and distress and the daily onslaught on her body. It is a two-year battle she has had with the authorities and has written to the Taoiseach over the past 12 months. She had a job and was energetic but she now has no job. She says she is slowly but surely dying without treatment. She hopes the Government, the Minister for Health and the people responsible in the HSE are fully aware of the distress and utter devastation they are causing.

We can contrast that with a young woman to whom I have spoken. At a young age, in her 30s, she developed this particular condition and was diagnosed with it. She was denied treatment St. James's Hospital but she was not told why. She was given no timeframe for when she might expect to get medication. In 2013, the young woman went to another EU country and before she was resident in the country she was able to talk to the haematologist, who reassured her she would get the treatment. Within five days of going to the country, she was under treatment. The contrast in her life is as follows. She says that she is now very fortunate that she can work in an extremely high pressure environment, with very long working hours, without the worry of treatment and PNH over her. Poignantly, she says that she will never be in a position to return to Ireland so long as Soliris is unavailable to her. She is permanently in exile.

Then we have the case of Maeve McGill, Ardara, County Donegal. She is a 15-year-old who was denied treatment. Her family has been farming in the area since the 1800s and are now planning to sell the small firm to go to the United Kingdom so that she can get access to treatment. Do the Taoiseach and the Government have any shame that a situation like this is carrying on for the past two years when the drug has been available in United Kingdom? It is an orphan drug with a limited market and from what I can read, the Taoiseach also knows there has been little proper engagement by the authorities in terms of offers. Mary Gorman was denied all freedom of information requests in terms of times, venues and meetings between the company and the HSE. Why? What is the big secret? It is a disgrace and I ask the Taoiseach to urgently intervene to make sure patients get access to the drug therapy.

The Taoiseach

This is a very personal issue and I take fully on board what the Deputy has said in respect of the person involved and the letters written. I am dealing with a case that came to my attention where someone has gone to the United States for a particular form of treatment. I do not accept that the Minister, the HSE or the Government are not aware of the importance or sensitivity of this. The cost is €400,000 per annum but we cannot put a price on a life. The HSE has been engaged with Alexion Pharmaceuticals, the company that produces the drug here. I am disappointed that it has not been able to reach a conclusion that the company will make the drug available at a cheaper cost and a lower price for people who need it in Ireland. That is regrettable and I am sorry that this is causing distress to this patient and others, who are small in number but very sensitive and must put up with this scale of challenge. It is important to stress that the engagement of the HSE with Alexion Pharmaceuticals is designed to bring about a situation where the drug can be available at a more reasonable cost and therefore be able to treat more people. Deputy Martin is well aware of the scale of the challenge facing the health services.

The HSE will continue to engage with a pharmaceutical company, urging it to provide the drug at a more reasonable cost. I do not know the country to which the Deputy referred or whether the same drug is required. This is an indication of why we must move towards universal health insurance, where access to medicine and the attention required can be available to people as they need it.

Deputy Micheál Martin

We gave them medicine.

The Taoiseach

The Deputy may shake his head but he went through this himself with sensitive cases. I understand what he is pointing out about the person involved and he can be as righteously indignant as he wants from the point of view of his party-----

Deputy Finian McGrath

These are real people.

The Taoiseach

------but this is about an engagement between the HSE, the Department of Health and Alexion Pharmaceuticals, which is charging €400,000 per year for the drug. Some ten people are on a pilot scheme and I wish the company would be more reasonable in its response to an engagement when it knows there are small numbers of people with this challenging condition. We will continue to engage directly with the company. I do not know the number of meetings that took place but I can find out for Deputy Martin.

Deputy Micheál Martin

The Taoiseach knows more than he is saying. Some nine months ago, he wrote to Mary Gorman enclosing an e-mail from Laverne McGuinness of the HSE. The offer nine months ago was €125,000, a 65% discount on the current price. There has been nothing since. That offer is not realistic. We are playing hardball with people's lives and there is a UK precedent. The National Institute for Health and Care Excellence, NICE, is not known for being particularly generous in approving new drug therapies. Over 200 patients in the UK are receiving this. I cannot name the country because I must protect the identity of the person who spoke to me. That is understandable but it is an EU country similar to our own.

This matter has nothing to do with universal health insurance but is about willpower and the desire to get to the bottom of something and get it sorted. In 2010, ten patients were in the clinician-led high-tech drug programme in St. James's Hospital, which is led by Dr. Paul Brown, and it was identified as the national centre to deal with this. In the agreement, which I have read, it was specified that it should not be administered under the community drug pharmacy scheme. There is a long history in the country of providing access to high-tech drug therapies, particularly those that are new and emerging pioneering drugs where they can significantly improve quality of life and allow people to live a normal life.

The Taoiseach said in his response that no one can put a price on life. The Taoiseach has done so. I have spoken to Mary Gorman this morning and she is in deep distress due to her medical condition.

Time is running out. Last week I spoke to John Duggan, a young married man. Does that 15 year old girl and her family have to uproot themselves from County Donegal to go to the United Kingdom where they will get it? Five days after leaving the country the woman referred to received access to it under the public system.

The Taoiseach

I want to see Mary Gorman, John Duggan and the others involved being treated with this drug. The position is that Alexion Pharmaceuticals is charging €400,000 per annum for it. The engagement is aimed at seeing whether that price can be reduced. The Deputy previously made a point about the e-mail. We have invested €10 million to enable a number of people to be put on a programme where one can plot the progress and benefits of treatment with the drug for this category. I am disappointed that Alexion Pharmaceuticals has not reached a decision that would allow for the treatment of these patients more quickly and at a more reasonable cost. We will continue to engage and, if the Deputy gives me the telephone number of the good lady involved, I will call her myself.

Deputy Sean Fleming

Why do we not sort it out now in this Chamber? The Taoiseach is abdicating responsibility.

Deputy Ray Butler

The party opposite had 14 years in which to sort out a lot of things.

An Ceann Comhairle

The matter can be dealt with outside the Chamber.

Deputy Gerry Adams

I return to the Taoiseach's handling of the events leading to the establishment of the commission of investigation into certain matters relevant to the Cavan-Monaghan division of An Garda Síochána, matters of extreme gravity. I want to focus on the Taoiseach's relationship with the former Minister for Justice and Equality, Deputy Alan Shatter, and his correspondence with him. It is a matter of public record that Deputy Alan Shatter was embroiled in a series of controversies brought to the attention of the Taoiseach and others by the Garda whistleblowers John Wilson and Maurice McCabe. Many of the claims made by these two courageous public servants have since been vindicated. However, the response of the Government and the then Garda Commissioner was to stonewall until the Garda confidential recipient resigned, followed by the Garda Commissioner and the then Minister, Deputy Alan Shatter. During this entire period the Taoiseach remained totally loyal to Deputy Alan Shatter who resigned not as an act of contrition but to save Fine Gael and the Labour Party.

Last week I asked the Taoiseach whether Deputy Alan Shatter, or anyone acting on his behalf, had been in touch with him, the Ceann Comhairle or anyone else in the Oireachtas about the Guerin report. He failed to answer my questions. When I pressed the issue, he eventually gave limited information to the Dáil, but even this small amount had to be dragged out of him. He did not divulge to the Dáil the content or extent of the correspondence with Deputy Alan Shatter, as he was obliged to do, including the fact that Deputy Alan Shatter had written to him as far back as last September. Yesterday, again under questioning, the Taoiseach revealed to the Dáil the extent of the voluminous correspondence between his office and Deputy Alan Shatter. He also had to correct the record of the Dáil. Is it not clear that he engaged in a series of evasions and diversions to avoid giving a full, accurate and timely account to the Dáil of ongoing and extensive correspondence between him and Deputy Alan Shatter?

The Taoiseach

I reject the Deputy's story. The position is that very serious matters were brought to the attention of the public and the Government following the revelations by the whistleblowers. The Guerin report was commissioned, following whcih the Government decided to set up a commission of investigation. The correspondence to which the Deputy referred has been very clear and consistent. The material published by my Department yesterday indicated all of the correspondence from the former Minister for Justice and Equality and the replies. These replies were clear and consistent in stating the matter was of sufficient serious public concern that the commission of investigation, in accepting the recommendations made by Mr. Guerin on its terms of reference, should be able to investigate how the matters brought to the attention of the public by the whistleblowers had been handled by the Department of Justice and Equality, the Garda and the former Minister. The Government agreed to these terms of reference and brought forward proposals for the establishment of the commission of investigation. I signed the order setting up the commission of investigation, to be conducted under Mr. Justice O'Higgins, after yesterday's Cabinet meeting. In answer to the Deputy's question, I have published all of the documentation, including the letters sent to the Department of the Taoiseach and the replies to the legal firm involved.

Deputy Gerry Adams

Did the Taoiseach at any time discuss these matters with Deputy Alan Shatter? I acknowledge that he eventually published the correspondence, but he did not come forward in a straight and clear way to tell the Dáil what he knew about the contacts between his office and Deputy Alan Shatter. We are entitled to this information. The correspondence raises further questions. A letter to Deputy Alan Shatter which was sent on behalf of the Taoiseach on 21 November included a copy of the draft order with the terms of reference for the commission of investigation. This was done before the draft order was presented to the Houses of the Oireachtas. Is this normal? Is it appropriate that a Fine Gael backbencher who played a central role in the issues under investigation should be given the draft terms of reference which, as it transpired, the Dáil was subsequently unable to debate? Another letter to Deputy Alan Shatter, dated 17 December, stated Mr. Justice Kevin O'Higgins would be the sole member of the commission of investigation. Once again, this information was provided for Deputy Alan Shatter before it was presented to the Dáil or made public. Is this normal practice? Does it not offer confirmation of the dismissive and disdainful approach the Taoiseach and his Government take to the Dáil?

The Taoiseach

On the contrary, it is clear what the Government had in mind. It decided to set up a commission of investigation and on the terms of reference for it. Subsequent to the Government making its decisions, it sent the terms of reference to the former Minister for Justice and Equality for his information only in order that he would be in no doubt that the Government was going to press ahead with establishing the commission of investigation with the terms of reference as decided and agreed to by the Government before they were sent to the Deputy for his information because he was involved in litigation.

Deputy Gerry Adams

The Taoiseach did not answer my questions.

Deputy Tom Fleming

I welcome the Taoiseach's intervention in the house repossession crisis. The number of court proceedings for house repossessions is rising at an alarming rate. In 2014 approximately 10,000 new applications for repossession were made to the courts. Between 1 and 10 January 2015, more than 1,400 court applications were made. According to all of the indications, there will an avalanche of similar cases in the coming period. It is speculated by reliable sources that up to 30,000 repossessions will be carried out between now and 2016. This is ironic, given that we are approaching the centenary of the 1916 Rising because the Proclamation of Independence stated all of the children of the nation would be treated as equals.

This is certainly not in keeping with that aspiration. In court proceedings so far, an alarming 46% of cases have resulted in an order for the repossession or sale of a property. In the Munster counties alone, there were 676 court proceedings in being in January. In my own county, there were 84 cases while there were 115 in the Taoiseach's county, Mayo. These figures have been compiled from the registrars of courts and the legal diary. The figures for people who have been in arrears for two years or more is consistently high. The latest statistic is that more than 37,500 people are in this category. The figures I am relating for our counties are mirrored across the board and consistently in proportion to population size. With a huge population in County Cork, there are 174 repossession proceedings in being.

An Ceann Comhairle

I ask the Deputy for a question.

Deputy Tom Fleming

To compound matters, borrowers in many cases lost their jobs in the recession and remain unemployed. It is unsustainable for these people to meet the huge arrears and to live in their homes. I ask the Taoiseach to act diligently in the work he has been doing since last week and will continue over the next number of months. I ask him personally to give this matter his full time and attention.

The Taoiseach

I thank Deputy Tom Fleming for his comments. This is a matter of great concern to thousands of people all over the country. Over 110,000 problem mortgages have been restructured over the last period. The changes the Government has made in this context have been the most radical in many years in regard to bankruptcy, the establishment of the insolvency service, and the creation of the targets set by the Central Banks for banks to deal with the issue. There is a solution to the vast majority of these problems. Many people have not engaged at all with the lender in the first instance, but an issue cannot be sorted out if that does not happen.

There is a requirement on the banks to do their job and there is a requirement on the Central Bank in terms of the targets it has set. Work is being done by the Minister for Justice and Equality and the engagement of personal insolvency practitioners has been under way for quite some time. Since the law was changed to reduce the bankruptcy period from 12 years to three, there has been a dramatic shift by the banks in wanting to arrive at solutions for people with particular problems with their mortgages. It is not enough and we must do more. It is not right that so many people should have the stress and mental anguish of being afraid to get involved in sorting out the problem and just leaving it lie there. It is not for me to say that all of these can be sorted immediately, but there is a solution to the vast majority of them. The suite of options that has been put in place by Government has resulted in 110,000 mortgages being restructured.

Headway is being made as underlined by the Central Bank figures. The numbers show that mortgages that are in arrears for more than 90 days have fallen by 15,500 when compared with the start of 2004. In August 2013, there were 2,500 split mortgages put in place by the six main banks, whereas the figure is now 19,500. That shows how it is progressing. During the same period, the six main banks found permanent restructuring solutions for family homes, with an increase from 41,000 to just over 90,000. Nobody wants to see a family lose its home. The options and solutions that are there must be worked on by the different elements including the Department of Justice and Equality, the insolvency service, the banks and the other parties.

I am not happy with the progress being made on the very difficult cases. I stress that in some of these cases, people have not engaged with the lender at all. That is not going to resolve matters either. We have been working with the banks. The Tánaiste and I met with a number of insolvency practitioners last week and I expect to talk to the banks and work with the Central Bank on the targets that have been set. While the Insolvency Service of Ireland has not dealt with a great number of cases in its first year of operation, the number of applications for assistance is now rising dramatically because of the word of those who have gone through the system and had a permanent solution put in place for their mortgages.

Deputy Tom Fleming

The number of debt deals being processed through the new insolvency agency has been dismal up to now to say the least. In the first half of 2014, fewer than 30 cases were being processed. I hope there will be a positive outcome from the Taoiseach's engagement last week on the new agency. All the evidence is that the banks do not want to deal with the majority of people in debt distress. They are cherry-picking those who have short-term arrears of one year while those who have been in arrears for two years or more are being ignored. The banks are making no effort to engage with these people. That is why we have a figure of 37,500. It is outlandish how it has been allowed to slide to that level. The regulator and the Department of Finance have absolutely no powers in respect of the banks. It is really a case of the tail wagging the dog. This will have to end and our State bodies and the Minister for Finance will have to row in and assist the Taoiseach in his efforts. The banks will have to face up to the catastrophe they played a major role in creating. They are now reneging on their obligations and failing to carry out their responsibilities. In many cases, the banks are dragging their heels and treating people in a very unfair manner.

I ask the Taoiseach to provide assistance to MABS and New Beginnings, which are carrying out Trojan work on the ground. They are short of staff and resources but they have been playing a very effective role. They could do more over the next 12 months if they received the proper assistance. There are a number of volunteers out there who are specialising in this area also. I can give the Taoiseach a number of names. Perhaps they could also be given some assistance.

The Taoiseach

I agree with Deputy Tom Fleming that MABS has done great work over the years and evolved to a point where it has taken on some very difficult cases for clients dealing with the banks. No case will be sorted out if there is no co-operation or agreement to engage in the first instance. Help is available for people who do not read the letters or who dump them because they are afraid to read them. There is a solution to the vast majority of these problems, whether it be through MABS or the Insolvency Service of Ireland, the banks, the Department of Justice and Equality and the other agencies and organisations referred to by Deputy Tom Fleming. When the issue is put on the table, it can then be decided which of the solutions or options is best. There are various elements to that, including split mortgages and parking elements of the mortgage itself. There are a variety of things that can be done, but nothing will happen if people are not prepared to engage. The assistance put in place by the Government is available to them and we hope they will avail of it.

The last resort is for somebody to lose his or her house, and we do not want it to happen. Repossession is not inevitable for a person who has received a legal letter. The Central Bank has set down a code of conduct for mortgage holders and when a mortgage holder or borrower engages in the process, the code of conduct must be observed and this provides protection for the borrower. Last week, along with the Tánaiste and other Members, I met some of the personal insolvency practitioners to see first hand the progress being made. I want the increasing numbers of applications to the Insolvency Agency to be followed through so that the Department of Justice and Equality, Central Bank, the banks and MABS do their jobs and work with the borrowers. Without engagement, it will not work.

An Ceann Comhairle

Could we have the microphone switched on?

Deputy Micheál Martin

We have been silenced.