Léim ar aghaidh chuig an bpríomhábhar

Dáil Éireann díospóireacht -
Wednesday, 11 Mar 2015

Vol. 871 No. 2

Topical Issue Debate

Heritage Sites

In 2010, Ireland submitted what is known as a tentative list to UNESCO, which is an inventory of properties we asked to be considered for nomination to the world heritage list. That list is as follows: the Burren; the Céide Fields and north west Mayo boglands; the monastic city of Clonmacnoise and its cultural landscape; the historic city of Dublin; early monastic sites, including Clonmacnoise, Durrow, Glendalough, Inis Cealtra - which lies in Lough Derg and is of particular interest to me - Kells and Monasterboice; the royal sites of Ireland, which comprise Cashel, Dún Ailinne, the Hill of Uisneach, the Tara complex, the Rathcroghan complex; and the western stone forts.

Ireland is spectacularly under-represented on the UNESCO world heritage site list. Italy has 50 sites on the list, while Germany has 39. Afghanistan, much of which has been war-torn since Ireland ratified the World Heritage Convention in 1979, has the same number of sites on the list as Ireland. We have had the unfortunate troubles in Northern Ireland, but they have not hindered the progress of this State to the same extent as Afghanistan has had its progress hindered.

There is little excuse for the lack of progress in getting Irish sites onto the tentative list. Much of that lack of progress occurred long before the current Minister's tenure, but I am not entirely convinced that there has been much of an improvement under this Government. I had a meeting off my own bat with UNESCO officials in Paris and they were surprised to see somebody from Ireland, given the lack of interaction from here. Very little progress has been made to advance the Irish tentative list since it was handed over in 2010.

I wrote to the Minister, Deputy Heather Humphreys, and I am grateful for her reply. It told me what I already knew with regard to a couple of those sites. The Burren, in particular, largely due to the activities of Clare County Council, is advancing, which is very welcome. Likewise, it looks like the historic city of Dublin may also advance, or what was left of it after the wanton destruction that took place under previous city managers. Again, that was long before the Minister's tenure in politics. Wood Quay was destroyed but it almost seemed to be a point of pride for certain city managers.

Now, however, the relevant local authority does not seem to want to advance Clonmacnoise. As a result, the early monastic sites cannot advance either since Clonmacnoise is one of them. Similarly, the local authority in Kerry does not seem to want to advance one of the western stone forts there, which means that they will all fail to advance.

Local authorities should recognise the benefits of advancing such sites. Most locations get a 30% increase in tourism numbers in the year following their designation as UNESCO world heritage sites. That increase in tourism would be hugely advantageous for any such locations here, although it is up to individual local authorities to adopt their own approach.

Clare County Council is advancing the Burren and is also proposing to purchase Inis Cealtra. I welcome the council's initiative in that regard, which is being done with its own funds. The State could and should play a role in seeking to get world heritage status for sites. It would be an important recognition of our heritage that we should be proud of and seek to promote. Such a designation also has a monetary value through the increase in tourism. What does the Minister's Department propose to do in this regard? If it does not propose to do very much, could it devolve some responsibilities and funding to local authorities that want to advance such sites? I appreciate, however, that some local authorities are not as interested in UNESCO designation, for whatever reason.

I thank the Deputy for raising this issue and for the opportunity to clarify the position.

Having a site progressed from being on a national tentative list to its inscription by UNESCO on the world heritage list is a long and involved process that requires comprehensive management plans for the site, full agreement with local interests, significant local authority actions and support and, finally, the production of highly detailed nomination documents that require significant financial investment.

Each stage of the process has to be quality controlled and checked by experts to ensure that the nomination documentation reaches the high standards laid down by UNESCO. We are working at all times to UNESCO standards and requirements and not to any local framework.

Ireland's current tentative world heritage list has come about from a very comprehensive, thorough and inclusive process undertaken by a panel of Irish and international heritage experts specifically appointed for that purpose. The process included full public consultation and an in-depth review of all proposed candidate sites. The tentative list, as the Deputy outlined, produced by the expert group contains the following sites: the Burren, the Céide Fields, the monastic city of Clonmacnoise, the historic city of Dublin, early medieval monastic sites, the royal sites of Ireland, and the western stone forts.

In September 2013 my Department held a seminar to explain the next steps in the process to the local authorities and local groups from the areas with proposals that had successfully made it on to the tentative list. The objective was to gauge the extent of the support that would be available to advance these proposals and also to set out the work that would be involved and the associated costs. After the seminar, the representatives that are now most actively engaged with my Department in pushing on with their proposals are those from the Burren and the royal sites of Ireland.

In both these cases, initial technical evaluation reports, financed by the local authorities, have been produced to ensure that all are aware of the strengths and weaknesses in their proposals. The fundamental requirement is that each site must be capable of demonstrating outstanding universal value to UNESCO. Technical evaluations have been produced for each of the six sites forming part of the royal sites serial nomination. The Burren representatives are working on their version. My Department has arranged for the royal sites technical evaluation to be examined by an acknowledged expert. This process, financed by my Department, will be repeated in the case of the Burren evaluation later this year.

The next steps will involve developing management plans for each site, which is a UNESCO requirement, and the designation of core and buffer zones in each case. At each stage local consultation is required. This process will also have to take into account the fact that some sites will be managed by the Office of Public Works, others by local authorities and two monuments on the royal sites list are privately owned. Another, Eamhain Macha in Armagh, is in another jurisdiction with different laws and heritage practices.

The culmination of these steps will be the creation of the full nomination documents for each site. These will also be evaluated by experts and a recommendation made as to whether the dossier, as it is called, is of sufficiently high standard to make it through the UNESCO evaluation process.

Our built and natural heritage legacy is a key component of our tourism offering in Ireland. It gives us a distinct comparative advantage that sets our tourist offering above and apart from those of other nations. Additional world Heritage sites would add further to that advantage and I am committed to supporting the current proposals in every way that I can.

The process is a lengthy one and we must remember that all of the work at every stage must be supported and developed from the local level up, with stakeholder buy-in and commitment at each stage. While this will add to the timescale, it is infinitely preferable than a top-down approach that fails to engage with local communities. It also ensures a far better chance of best care and support for the protection and preservation of these marvellous sites into the future.

I am pleased to be able report the progress that has been made to date in this area, and I will continue to help the process in every way I can.

It is clear from what the Minister has said that the road to getting UNESCO designation is long and difficult, but in the case of some of the sites on this list, it is simply a road to nowhere. The local authority in Kerry has said that it is not interested. In the Minister's letter to me, and I appreciate she might not have been adequately briefed by her officials, she states:

Kerry County Council informed the Department that it did not wish to be involved in progressing the potential Western Stone Forts nomination (which includes Cahercommaun in Co. Clare) ... This was also the case in Clonmacnoise, which had obvious implications both for the potential nomination of the site in its own right, as well as for its status as a crucial element of the potential serial nomination of the Early Medieval Monastic Sites, which of course includes Inis Cealtra.

If Kerry or Offaly County Councils, or whatever county councils, are not interested in this, that is their right. The Minister did say it should not be a top-down approach and should involve local communities and local authorities, but if they do not want to move forward, surely that should not affect every other site on the early monastic list, which includes Glendalough, Durrow and Inis Cealtra, which I am most concerned with because it is in my constituency. There was also a report into promoting Lough Derg and one of the findings was that it lacked an iconic site that could be used as the centrepiece of marketing it. That is clearly the beautiful early monastic site of Inis Cealtra, and Clare County Council is at an advanced stage in seeking to acquire it. Can we move forward with that without Clonmacnoise? Can studies be done on it? In my letter to the Minister I outlined that UNESCO had said there is an upstream process where rather than incurring all the expense of going through the nomination process only for it to be refused, experts can be engaged at an earlier stage to examine whether it is feasible to do this.

Can funding be devolved to our progressive county councils who want to move this forward both because they recognise the important heritage, which is a huge value in itself and also its tourist value?

Thank you, Deputy. I call the Minister, Deputy Humphreys, to answer.

Can funding be devolved to move this forward or are we going to allow, in effect, a power of veto on the part of some county councils which simply are not interested in their own heritage or in national heritage?

I listened carefully to the Deputy and I share his views on the importance and value of securing world heritage status for these sites as quickly as possible. I take on board what he said about the progressive county councils. When county councils work with us, it does make it much easier. When we have their assistance it is preferable, but my Department will continue to push for progress on the sites that are moving ahead while staying in touch with the others on the tentative list, with a view to getting them to move on should they wish to do so. We will engage with them, and we will try to move them along.

We are working closely with the local authorities and the local interest groups, as the Deputy knows, in regard to the Burren and the royal sites. I am also aware that the historic city of Dublin nomination is being actively followed up by Dublin City Council, and my Department is engaged with the council to help and guide them with the process. Once the nomination documentation has been sent to UNESCO, it usually takes about 18 months for it to be examined and for the related site visits and reports. It is only at that stage that the UNESCO World Heritage Committee is in a position to decide on whether to approve a nomination for inscription on the world heritage list.

That is not true.

Please do not interrupt the Minister, Deputy.

I hope I have clarified this but I take the Deputy's point that there are county councils that are not interested in getting involved in this process. I have taken on board what the Deputy said.

Will anything be done about it?

I understand Deputy Regina Doherty is deferring her Topical Issue matter.

I was going to wait until after I had taken my own Topical Issue to inform the House of this but I understand that the Minister of State, Deputy Humphreys, has dealt with the first matter. I am dealing with the second matter, and all other Topical Issue matters are to be deferred because the three Ministers at the Department of Transport, Tourism and Sport are unavailable. The Minister, Deputy Donohoe, will take these on 31 March.

Is Deputy Stanton also agreeable to that deferral?

Hospice Services Provision

I will address with the Minister of State the important issue of hospice services in the four midlands counties - Laois, Offaly, Longford and Westmeath. Hospice services are struggling in those four counties. We have excellent local hospice committees and local hospice groups. The problem is that those groups are carrying a significant proportion of the burden of trying to provide services.

At present, we do not have enough specialist support staff in the community, such as support nurses, social workers, occupational therapists and physiotherapists. We have no inpatient level 3 services. There is a small amount of inpatient level 2 services in the region. Despite being one of the top five areas prioritised by the HSE in 2009 for such a level 3 service, it still has not been provided and the only option is for beds in acute hospital care settings to be used. This option does not come cheap.

As the Minister of State, Deputy Kathleen Lynch, will be aware, this is causing problems in the system. It is costing a lot of money. No money is being saved by having patients remaining in acute hospitals who should not be in them. Not having the hospice inpatient unit is costing money. In the midlands regional hospitals in Mullingar, Tullamore and Portlaoise, an average of 6,411 bed days a year are being used for palliative care. The lack of a hospice level 3 unit in the region to take those persons is causing a significant problem. Home care nurses, social workers and staff are being funded by local hospice groups. There is no day care service. Such a service one day per week would be excellent, if we could have it. I ask the Minister of State to look at the Cuisle centre in Portlaoise as one venue that could be considered in that regard.

Our region has the lowest investment in palliative care of all the regions in the country. In the mid-west region and the north-west region, on average €30 per capita is being used to provide palliative care whereas in the midlands it is less than €9. The 2007 figures are the most recent ones available but I am told by those monitoring it that there has been little variation in it since. As a result, the region has the highest rate of cancer deaths in acute hospitals. Although it is a morbid subject to be talking about, those near the end of life wish to die at home.

A 2001 report from the national advisory committee on palliative care stated that each region should have comprehensive palliative care services, that is, home care, primary care, acute hospital and inpatient specialist services. Fourteen years later, we still do not have it. Two internal HSE reports, in 2007 and 2012, set out the need for palliative care services to be developed specifically in the midlands. There is a significant problem here. The population in the midland counties of Laois, Offaly, Westmeath and Longford is wondering why it is not being given the same priority and why these basic services are not there. For those reaching the end of life and their families, it is important that we provide these services at that crucial stage of life. I ask the Minister of State to address this issue.

I thank Deputy Stanley for raising this matter. He will be aware that I have a particular interest in palliative care and end-of-life treatment.

It is the intention of the Government that all people will be provided with the type of palliative care services they need regardless of their diagnosis, how old they are or whether they die in a hospice, an acute hospital, a nursing home or, as is the preference for most, at home. Specialist palliative care services in the midlands are provided through the community-based specialist palliative care team led by a consultant in palliative medicine and including a clinical nurse manager, specialist palliative care nurses, a senior social worker, senior physiotherapist and administrative support. The team provides input across the range of care settings and operates an open referral system, with referrals prioritised on the basis of need - there is no waiting list.

In 2013, funding to develop a model for the planning and delivery of specialist palliative care services in the midlands was provided by the Irish Hospice Foundation. A comprehensive plan was developed, integrating specialist home, acute and hospice care with generalist services, all working in collaboration to deliver a quality palliative care service. The most significant gaps identified were the need for a second consultant in palliative medicine, the absence of a specialist inpatient unit and associated day care services, the need for palliative care clinical nurse specialists in each acute hospital and the need for specialist occupational therapy services in the home care teams.

In 2015, the HSE will provide funding for a second consultant in palliative medicine for the midlands. The consultant will be based at the Midland Regional Hospital, Mullingar, covering the Longford-Westmeath area, and will work closely with the existing palliative care consultant. In addition, clinical nurse specialists for Portlaoise and Tullamore regional hospitals are currently being recruited.

Within the midlands, five local hospice groups currently provide funding on an annual basis for agreed core services and service development initiatives. The provision of a specialist palliative care inpatient unit remains a priority for the region. Recent research suggests that a 16-bed unit, with an option for an additional four to six beds, would meet the needs of the population in Laois, Offaly, Longford and Westmeath. The midlands palliative care consultative committee, chaired by the director of public health, has developed draft plans for the building of a hospice for the midlands. They are drawing on the experience of the Mayo and Waterford hospice movements regarding the overall size of the unit, architectural design and location. The site for the unit will be identified when the design brief has been completed. The Minister for Health, Deputy Varadkar, met a delegation from the Irish Hospice Foundation on 26 February and among the issues discussed was the need for a comprehensive service plan for palliative care in the midlands.

The Minister of State addressed some of the issues I raised in my opening remarks.

I was aware that there were plans for a second consultant post. The Minister of State confirmed that there is funding for it. When is that likely to happen? Is the recruitment under way or when will it begin? When can we expect to see that second consultant? While the consultant is to be based in the Longford-Westmeath part of the region, the appointment will improve matters in Laois and Offaly because one consultant will be able to dedicate himself or herself to palliative care for the counties of Laois and Offaly.

The Minister of State said research suggests we need a 16-bed unit. As far back as 2001, this was flagged in the report from the national advisory committee on palliative care. The report stated that we needed such a centre and also set out other matters that needed to be addressed. We need to provide this unit now. It is important to do so at a human level, but there are economic and management reasons for doing it also. Some 6,000 plus bed days are being taken up with patients who should be in palliative care. The unit would free up these beds. The Minister of State does not need me to tell her how bad things are in these acute hospitals, and that beds need to be freed up. That is not the primary concern here. The human need is the biggest concern but we must address this aspect also.

When can we expect recruitment of the second consultant and to see him or her in place? Why is there such a continuing low level of investment? I want the Minister of State to address why the spending on providing palliative care in the region is down at €9 per person when it is €30 per person in other areas. Why is each county not served by a full community multidisciplinary palliative service? It is recommended each county should have such a service. Why is there not even a firm plan in place at this stage?

The HSE has substantial land resources in all four counties. Why is there not a plan in place already to locate this proposed unit? Why are we not progressing with these plans? Around the country, the Minister of State knows that they are either in place or are being progressed.

To pin down when the consultant will be in the post - I imagine this is the Deputy's central question - is to ask how long is a piece of string.

Has recruitment started?

Once we have decided to do it, the request will go into the national recruitment service in Manorhamilton. It will then be put on an order of priority. There clearly are priority lists and lesser priorities. As soon as one becomes available and a suitable candidate identified, there should be no blockage other than whether the person can take up the post. There are all sorts of variables. The only thing we can control is whether there are sufficient funds available and I am told by the HSE that there are.

The other area relates to specialist nurses and physiotherapists within the community-based teams. These are hugely important because most people now get their palliative care or end-of-life care within a community setting. I take the Deputy's point on the expense of an acute hospital bed, but these are only used when looking to stabilise the person and to get the medication and the process right. Usually most people go on to live within their own communities. The situation is managed in that way.

Why is the midlands getting less than other areas? Who knows? Perhaps it is because the teams are not fully developed. Perhaps it is because there is no inpatient unit. There could be a multiplicity of reasons. I do not have the answer in front of me. If the Deputy, however, were to table a question, I am sure that if an answer is available we will do everything to get it to the Deputy.

Acting Chairman (Deputy Corcoran Kennedy)

The next two Topical Issues have been deferred because the three Ministers dealing with transport are unavailable. The Minister, Deputy Donohoe, will take them on 31 March. This has been agreed with Deputies Doherty and Stanton.