Over four years into this Government's term of office, we still have no proper roll-out of universal access to general practitioners, GPs. This was a stated Government policy. We learned as late as yesterday that a reported 50% of GPs have signed up for the under sixes contract. The figure is as low as 8% in County Tipperary. It stands at 32% in parts of Cork city and county. The figures for counties Clare and Louth are 29% and 22%, respectively. Large tracts of the country are to be left without access to GP services for under sixes under the new contract. While we did not oppose the Bill that made provision for the under sixes contract, we made the point from an early stage that primary care was simply being under-resourced and starved of funds and services. GP services are now beginning to fold across the country, which is an unsustainable position. At the same time, the Government is continuing to pretend that its stated primary care strategy, which involves investing in GP services, is the way forward in terms of maintaining people in the community and keeping them out of the acute hospital system. It may have escaped the notice of the Tánaiste that a couple of weeks ago, a 102 year old woman who had received a blood transfusion had to lie on a trolley in a corridor at the emergency department in Tallaght for over 24 hours.
Leaders' Questions
It was outrageous.
The same type of circumstance was repeated in Limerick in recent weeks. Given that we are talking about investing in primary care and keeping chronic illness and disease in the primary care setting, will the Tánaiste not accept that the Government's policy of rolling out universal access to GPs is in rag order?
It is shambolic.
It is certainly shambolic from the point of view that four years have passed since the Government started to roll out this programme, but less than half of the GPs in the country are getting involved in it and just half of the people of this country will have access to GP services in the next few weeks and months. There is huge uncertainty out there. Could we have some clarity? Will the Minister for Health and his colleagues re-engage with the doctors who are not signing these contracts? Will they engage with the National Association of General Practitioners, which represents many of the GPs who are not taking up these contracts? Will they give the parents of children under the age of six an assurance that this service will be available to them as stated by the end of next month?
Every hospital management has to be alerted to the issue of elderly patients being on trolleys for unacceptably long periods of time, which was mentioned by the Deputy. I know the Minister is absolutely determined to ensure such cases should not actually occur. I want to sympathise with those affected by the recent cases, including their families. As the Deputy knows, €5 million is being spent on finalising a new emergency department in Tallaght. As his party's health spokesperson, he will also be aware that the very successful urgent assessment units are now used quite widely. They have been in use in my local hospital in Blanchardstown for most of this year. Older people, particularly those over the age of 70 who often have chronic conditions, can go to those assessment units and be looked after extremely well. This takes them out of the emergency department situation very quickly. This system works very well. I understand that Tallaght is in the process of developing an urgent care approach to very elderly patients who come in. This is happening alongside the work in the emergency department. On the issue of GP cards and GP care for under sixes, I have to say I am very pleased at the level of response so far, which is just over 50% of the eligible doctors.
There are very few in County Tipperary.
These decisions are made for medical and business reasons by the doctors' practices and the many medical companies that are involved in this sector nowadays. Very good progress has been made with this initiative, which has been discussed in this country over a long period of time. The number of GPs signing up has actually been very good in my constituency and in most of the suburbs on the north and west sides of Dublin. That is important for the families of the children involved. As Deputy Kelleher is aware, parents will very shortly be able to apply online to register their under sixes to receive GP services from local medical practitioners. I understand there are specific problems in some areas of the country. While the figures have been extremely high in places like County Donegal and the west and north sides of Dublin, they are rather disappointingly lower at the moment in places like County Tipperary. The Deputy mentioned that there are problems in Cork. I believe all of these problems can be addressed over time. Obviously, medical practitioners have to make these decisions. I believe the under sixes GP card is good for the health of all children under the age of six. We will be rolling out the provisions for people over the age of 70 the following month. We have ambitions to extend this initiative further in line with the programme I agreed with the Taoiseach when I was appointed as Tánaiste. It is intended to roll it out to other primary school children and ultimately to all children under the age of 18.
If the 50% rate mentioned by the Tánaiste is in line with the Government's aspiration, it is a very poor effort. The provision of universal access to GPs for everybody is a stated policy in the programme for Government that was formulated in March 2011, which said that everybody in the country would have access to GP care free of charge. We were told there would be universality across the board. We are now over four years in and we have a situation where just half of GPs have signed up to the first effort to roll out this strategy. This means that large tranches of the population will be discommoded. These people will not have access to their family GPs. The Government had four years to negotiate this. We are now at the 11th hour and families are unsure of what services will be available to them in the coming weeks when they try to access their family doctors.
The broader issue is that it is simply not good enough to apologise to the 102 year old who had to lie on a trolley for 24 hours. Apologies will not change the policies being pursued by the Government. The under-resourcing of primary care, which is under huge pressure, is driving people into hospitals. GPs are referring people to hospitals because they cannot cope with chronic illness and disease. Even though the Government has a stated policy of keeping people out of hospitals, everything it is doing is facilitating the reverse. I hate to inform the Tánaiste that her constituency colleague, the Minister for Health, was doing his usual grand tour of radio stations this morning and waxing lyrical while making observations about health. He seems to forget he is the person who is ultimately in charge and responsible for the health service.
He is not a journalist.
He has been entrusted with making some effort to address the problems being faced in the health service on a daily basis.
It is getting progressively worse. Over 400,000 people are waiting to see a consultant. The Taoiseach promised in 2011 to reduce the number of trolleys but there is a crisis every day in the emergency departments. The Government accepts that to have 350 or 400 people lying on trolleys is fine. It is not the case that it is all fine.
The Minister for Health tells us that the budget presented to the Dáil last year was realistic but he can tell Shane Coleman today that he needs more beds, money and resources. At the heart of this is a lot of disingenuous talk, nonsense and spin. Our health services are now in rag order. Patients are suffering day in, day out. I should not have to raise it here. The Tánaiste should know that. She only has to look at the trolley figures for Beaumont, Tallaght and many other hospitals around the country. The Government’s stated policy was to reduce trolley numbers in our emergency departments and give free access to everybody by the end of this year, but none of that has been achieved. It is a shameful, sad indictment. In the context of general practitioner services, will the Government commit to giving additional resources to primary care to address the problems people face in having to go to acute hospitals because they cannot access treatment in their communities?
The task force on overcrowding and trolleys in hospitals and emergency departments has been allocated an additional €74 million to ease the difficulties. It is not acceptable to have somebody of an advanced age on a trolley for anything longer than a number of hours. This is something that hospital management must address. Anybody who has experience of waiting with an elderly person in the small hours knows that is a difficult and worrying place to be. The additional resources for and development of the urgent assessment units and special access for older people are working really well in several hospitals around the country. The ideal would be that somebody of an advanced age, with a complex medical history, should not have to go through the normal emergency section but should be able to go to the urgent assessment units.
I agree with the Deputy that primary care will be the best basis for the health service in this and every other country in years to come because it achieves the objective of helping to keep people out of hospitals. Very fine primary health care centres are being built around the country. In my constituency, one opened recently on the Navan Road. It is a fine three-storey building with diverse primary medical care facilities. In Corduff where, when Fianna Fáil was in government it had been promised for more than a decade during the best period of the boom, it was an empty site with grass growing on it.
The Tánaiste should not talk about promises. She is on weak ground.
I invite the Deputy as a health spokesperson to go and see the building, which is more than 50% complete.
Does the Government have staff for it? It is an empty shell.
That is what will deliver primary health care around the country.
There will be a primary health care centre in every Minister’s constituency.
The Tánaiste is looking after her own constituency.
The Tánaiste is rolling them out in her own constituency.
Does the money follow the patient or the Minister, Deputy Reilly?
Furthermore, for all those parents of the 270,000 children who are going to benefit from the general practitioner medical card, it will ensure that those children, from birth to six years of age, will have a very good primary health care service through GPs.
They cannot get a tablet in a chemist.
The Deputy has a difficulty because it has taken time. During his party’s period in charge of the Health Service Executive, which his party leader helped to create, notwithstanding the funding that was available-----
The Tánaiste’s Government promised to get rid of it but it is still there.
-----and throwing money at the problem, the outcomes were much less than those now being achieved.
That is not true.
If the Deputy goes back over the history of mother and child health care in this country, to the period of Dr. Noël Browne, it has always been necessary and appropriate to negotiate with GPs.
Go around the house and mind the dresser.
When will the Government abolish it?
My message to GPs around the country is to engage with the HSE and to give the 270,000 children-----
What about their patients?
-----and their parents who would benefit from a GP medical card the opportunity to improve their health not just from nought to six years, but because those years are so vital for the rest of their childhood and their adult life.
Will the Tánaiste arrange a visit for me to Balbriggan where I can see the health centre?
This morning, we learned the very distressing and alarming news that a 19 year old Dublin man has gone on hunger strike in an Egyptian jail. Ibrahim Halawa was born in the Coombe. He went to Holy Rosary national school in Firhouse and then to Rockbrook College in Rathfarnham. He finished his education in the Institute of Education on Leeson Street. He is a Dubliner.
Ibrahim has been detained for two years without trial. He was 17 when he was arrested so he never collected his leaving certificate results. His trial has been postponed on four separate occasions. He is held in an adult prison in an oppressive and cramped cell with 40 other people. Every morning when he wakes he hears the screams of people being tortured. He has been beaten. The Irish consul in Egypt has witnessed his injuries. He has been denied medical attention. If convicted, Ibrahim faces the very real prospect of life imprisonment.
Amnesty International has done considerable work on his case and has established beyond any doubt that Ibrahim Halawa is a prisoner of conscience. It firmly believes that he has been detained solely for peacefully exercising his right to freedom of expression and assembly.
What would the Tánaiste or any of us do if this was our child? I believe we would go to hell and back to secure his release. We would demand that the Taoiseach pick up the phone and tell the Egyptian Prime Minister to release this Irish citizen. That is what the Australian Prime Minister did to secure the release of journalist Peter Greste who shared a cell with Ibrahim. He did what any leader would do to protect the rights of a citizen. He intervened directly and decisively and secured the release of Peter Greste.
Will the Tánaiste join me today in calling on the Taoiseach to pick up the telephone to the Egyptian Prime Minister and call for the immediate release of Ibrahim? Will she also tell us whether she agrees with Amnesty International that Ibrahim is a prisoner of conscience and should be released immediately?
I thank the Deputy for raising this issue. Anybody who has read or heard about this issue through the media, or who has had an opportunity to meet people with a deep interest in this case, as I have, including members of his immediate family, whom I met briefly, would want to see Ibrahim Halawa at home in the bosom of his family in Ireland. We know that he went to Egypt to see his extended family when he was 17 and was there at the time of the Arab Spring, when there was a great deal of demonstration and unrest and associated events.
It is regrettable that the Egyptian authorities have not been in a position to process the various legal issues. The Minister for Foreign Affairs and Trade, with whom I have discussed the issue, other Ministers, and in particular, our ambassador and consular staff in Egypt, have maintained constant contact with Ibrahim and the Egyptian authorities to ensure that, notwithstanding the difficult circumstances he is in, the Egyptian authorities are aware of the deep level of concern about this case in Ireland, which remains a priority for the Department of Foreign Affairs and Trade.
Officials at the embassy in Cairo are monitoring and closely following the case. Mr. Halawa has received more than 40 consular visits since he was first detained, the most recent of which took place earlier this week. As with all hearings in his case, officials from the embassy were in attendance. I understand the case may come up again on 2 August. In the meantime, officials in the Department will remain in constant contact.
One of the approaches that may help to resolve this case would be if Mr. Halawa's bail application were accepted. The Government has been happy to support the bail application. I use the forum of the Dáil to urge the Egyptian authorities to consider the case of a teenager visiting Egypt with his extended family who became caught up in some of the events occurring in that country at the time and has since been languishing in prison under varying conditions that are of deep concern to everybody.
I commend Amnesty International on taking such a close interest in this case. It is a matter of concern to all of us that an Irish citizen should be in this position. I have spoken about the case with other members of the Government and I hope all of the work that is being done, particularly by our diplomatic officials and through a series of diplomatic channels, will result in Mr. Halawa being returned home safely to his family in Dublin.
The reason this young man's detention has been so drawn out and harrowing is precisely that the Government has not prioritised his safety, welfare and return. I have been speaking to members of the Halawa family and they are not convinced or satisfied that the Government has acted fully and appropriately to secure the safety and freedom of one of our citizens. To visit Mr. Halawa on 40 occasions may sound like an impressive statistic on the part of the Irish system but even if he received 140 visits, it would not be worth a candle to this young man if he continues to be detained in an Egyptian prison.
I asked the Tánaiste two specific questions, both of which she sidestepped. First, I asked her to join me in calling on the Taoiseach to make direct contact with the Egyptian Prime Minister and demand the release of Mr. Halawa. It seems that only this level of intervention will work in this case. In my second question, I did not ask the Tánaiste to commend Amnesty International but to accept, on the floor of the Dáil, the organisation's findings by acknowledging that Ibrahim Halawa is a prisoner of conscience. Unless we have this level of decisive thinking and action from the Government, this traumatic case will drag on and on.
Mr. Halawa's mother visits him every week, having moved to Egypt since he was detained to be close to her son. She does not have any contact with Ibrahim on these visits and sees him behind wire. She cannot comfort or console him or give him a hug. The family is distraught and concerned for Ibrahim's health, physical safety and mental health. The case has reached the point where this young man has undertaken a hunger strike and his life hangs in the balance. The Government has been at best tepid in its approach to securing his safety and freedom. What is needed is the direct intervention of the Taoiseach.
Deputies
Hear, hear.
I call on the Taoiseach to lift a telephone today, contact the Egyptian Prime Minister and state categorically that we demand the release of an Irish citizen, the Dublin man, Ibrahim Halawa. I want the Tánaiste to make the same call and I ask her not to equivocate or fudge the issue because the case is much too serious for that.
I thank Deputy McDonald for her concern about Mr. Halawa. If she wants him to be released, it does not help his case for her to disregard the work that has been done by Irish officials on a continuous basis. It is very easy for the Deputy to come into the House and scoff on almost any issue. She scoffs at the work of the officials in question and the idea that they have visited Mr. Halawa 40 times.
They do that in all international cases.
It is very easy to pick up a telephone.
It does not become her to do that.
That is an outrageous statement.
I do not know if she is familiar with how the legal and political systems work in Egypt but our officials have worked extremely hard. Last week, the Minister for Foreign Affairs and Trade and the Taoiseach met at length members of the Halawa family and went through the case with them in great detail.
Has the Taoiseach demanded a meeting with the Egyptian President whose name, incidentally, is el-Sisi?
From her comments, it is clear that members of the family also met Deputy McDonald either before or after that meeting. Everybody in Ireland is deeply concerned about the position in which this young man finds himself and wants to see him home in Dublin.
The Aussies got their man out.
We have a foreign affairs service so as to have a resolution to these types of extremely distressing cases. As I stated, I commend Amnesty International and want the Government to continue its detailed work to have this young man released. The Deputy wants me to enter into negotiations on the floor of the Dáil. I want to focus on what will see this young man released but she has other ideas. I do not know whether she accepts that Egypt is a country with a separate government and legal systems. As such, some respect must be shown for the legal processes of that country.
The Tánaiste should answer the question she was asked and the Taoiseach should pick up a phone.
It is a pity Sinn Féin did not pick up a phone over the past 40 years.
Given the gravity of this case, I insist that the Tánaiste answer the question. The reality is that what secured the release of an Australian citizen was direct contact, prime minister to prime minister. I ask the Tánaiste to answer my question.
I must call Deputy Maureen O'Sullivan.
I would like the Tánaiste to answer the question I put to her.
The Deputy must resume her seat when the Chair is on his feet. If she is not satisfied with the replies to her questions, she may raise the matter with the Office of the Ceann Comhairle.
Deputy Stagg should shut up.
You lot tried to shut me up before but you were not able to do it.
A boy of 19 years of age is on hunger strike and that is Deputy Stagg's response.
Sinn Féin is making a political football out of him. It has some neck.
The Government has some neck given that it will not pick up a phone.
Are you still torturing people in Northern Ireland?
Deputy Stagg should cop on and grow up.
Order, please. I have called Deputy Maureen O'Sullivan.
On 14 May last, I asked the Tánaiste a question about the devastating impact on some children of living in inappropriate accommodation as a result of the terrible effects of successive Governments' housing policies or lack thereof.
I was looking particularly at children in direct provision and children living in bed and breakfast and hotel accommodation. One week later, two reports came out that confirmed what I was saying. There was a HIQA report which showed that 14% of children of asylum seekers living in direct provision accommodation were not safe. They were subject and exposed to domestic violence, physical abuse and isolation. The report of the office of the Ombudsman for Children showed that in 2008, 6.8% of children were living in consistent poverty, while today it is 11.7%, which translates to 138,000 children. The quotes I take from the report are: "The Government is tolerating unacceptable levels of child poverty," and "B&B accommodation impacts negatively on family life and children's development." Last week, we had a report from the Irish Human Rights and Equality Commissioner, who asked in an article she wrote how the Government would explain and defend the increased poverty rates we see and why many groups already susceptible to poverty and inequality were disproportionately affected by the recession. Children are part of that group.
I cannot but be struck by what I have said here, given aspects of the debate on the commission of investigation over the last few days. One of these was the question of whether the write-down was €110 million or €119 million. The €9 million discrepancy was bandied about as if it were €9. There is no doubt that there has been preferential treatment for the privileged few, while the reality for those who suffered vicious cuts is very different. Housing is one of the casualties. In her reply on 14 May, the Tánaiste gave me various answers to the housing issue, but in the meantime all of the homeless charities have seen families living in unsuitable and risky places. There is also a fear that children will be joining the numbers of rough sleepers. We know the problems, and HAP was presented as one of the solutions. However, the homeless charities are saying there are areas in which HAP will not work, given that it was supposed to match market value. We had another answer around rent control and rent management, and I ask what is happening in that regard. The other aspect is that we have examples of international best practice. Holland is one country in which there are landlords who want to get into the private rented market. Has that been looked at? My general question is this: where is the urgency to address this crisis?
As I mentioned previously in the House, I met at length last week with a number of the organisations that are working very hard to address issues relating to homelessness. I use this opportunity to stress again that if there is anyone out there, particularly families with children but also anyone else, who has a difficulty around rents or tenancies and fears that he or she is at risk of homelessness, I ask him or her to contact the local Intreo social welfare office to seek an appointment with the community welfare service. At this point in time, we have a protocol we operate with organisations such as Threshold, Simon and Focus Ireland on a country-wide basis in co-operation with local authorities to provide an extensive one-to-one service to help people who are at risk of becoming homeless, who are homeless or who have difficulty renegotiating rent or a tenancy. The protocol is working extremely well and we have extended it right around the country and it is available nationally. It is working very well in Cork because of the dedication of the public servants operating the system and of the voluntary organisations, particularly Simon in Cork, in seeking to access accommodation for people. I use this opportunity to stress to all Members that the service is available and that it can respond extremely quickly. However, it means that people must actually go and utilise it. Where we have mobile phone numbers, which we do in many cases, we send out regular texts to remind people that if they have a difficulty with housing and they contact the community welfare service in their local Intreo office, they will receive help and advice. We have done that in a large number of cases.
On the overall issue of housing supply, the only way that will be addressed is by increasing the number of houses being built and the number of houses available to local authorities. Unfortunately, under the previous Government, the building of local authority accommodation came to a standstill because the policy of the Green Party and Fianna Fáil was to rely almost entirely on the private sector.
It has not restarted.
The Tánaiste is misleading the House again.
Deputy Alan Kelly's ministerial PR wrote that.
The Tánaiste is misleading the House.
We are now moving to put extensive capital sums into local authorities. In Dublin alone, we are making very good progress on reopening boarded-up void properties.
When? Where?
The Tánaiste's own party was in control of Dublin City Council for the past seven years.
We have already started them.
I am sure the Deputy is familiar with the fact that Dublin City Council is now producing far more opened accommodation which has been renewed and refurbished for families. The priority at the moment is for families with issues around homelessness to be dealt with as quickly as possible by the local authority. However, it is going to take us some time to come to terms with all of the different elements of the housing crisis. The Minister for the Environment, Community and Local Government, Deputy Alan Kelly, will be bringing proposals to Cabinet shortly on areas around rent certainty.
The Tánaiste had better watch out.
He will go to RTE first.
The Tánaiste had better watch him.
Can we have order, please?
AK-47. Watch him.
I would not praise him too much.
I provide statistics from some of the housing organisations. In quarter 1 of 2015, one homeless group worked with 116 homeless children in Dublin. That was an 87% increase on the 62 children they worked with in quarter 1 of 2014. Another organisation tells me that its view is that while it is waiting for the initiatives to make progress, 70-plus children will become homeless every month. I was outside with others yesterday, including Deputy Joan Collins, at the lone parent family protest. They make up 60% of the families in emergency accommodation. In July, a further 30,000 one-parent households will be affected by the last phase of the one-parent family payment reform. There are real concerns among housing organisations that the reform will push lone parents further from the workforce and expose them to a higher risk of homelessness. We know that social housing is a major part of the answer, but it is reckoned that the plan to build 1,700 social housing units by 2017 will provide 2% of the housing needed by those currently on the social housing list, which is being added to all the time.
Focus Ireland ran an e-mail campaign recently on foot of which approximately 4,000 e-mails were sent to the Taoiseach. The e-mails were on particular issues including rent certainty and increasing rent supplement to reflect market value, but there was also a call to provide that when a family is assessed by a local authority as being homeless, the local authority must then provide a place to stay until more suitable accommodation is available. The call was for local authorities to be resourced to do that. The Taoiseach did not reply. I am asking for the Tánaiste's response and I ask her to ensure that this becomes seen as the urgent matter it is. Some of us are in constituencies that are particularly affected by this, including the Tánaiste. Given that we can make other issues urgent, why not the housing issue?
I had an opportunity recently to meet with the various organisations. Unfortunately, because of the general disturbance in front of Deputy O'Sullivan and some of it behind me, I was unable to hear everything she said on the statistics. I understand, however, that some of the statistics were ones I discussed with the Focus Ireland delegation, including its new CEO, who came to see me.
I agree that those statistics are very worrying. What we need to do is to get all the different authorities to come together, particularly Dublin City Council, to open up the closed properties, of which there are more than 1,000. The council has been given the funds to refurbish them. I know that builders are anxious to do the work on them. The key is to make those properties available. As the Deputy said, those families will have a degree of priority with respect to the properties. All of these arrangements have been made with the local authorities, so the key thing is to see that families get those houses.
The Deputy referred to social welfare payments and to the UN committee hearings held earlier this week. I am sure the Deputy knows that because of social welfare transfers and social welfare payments to families we have the largest reduction in the at-risk-of-poverty grouping. Not only is our social welfare system strong, but it is my intention to make it stronger. Part of the strength of the social welfare system is that nowadays it helps families to get into work, whether those are one-parent families or families with two parents. That has been a passion of mine since I first became involved in politics. It is very good to have a strong social welfare system. My work as Minister for Social Protection has been to ensure strong social protection in this country. However, it is even better if a person can get a well-paid job that will give him or her greater financial independence. I refer to the changes currently under way.
One hundred and eight euro a week.
Very significant numbers of people will benefit by between €50 and €150 a week in additional earnings. That might not sound like a lot of money to people in here on a TD's salary, but for a family it is a very significant amount. As with the housing protocol, this policy has been ongoing in the Department for the past three years and already in the past two years 19,000 families have transited. It is a one-on-one interaction and if any of those families also have housing issues they can meet the community welfare service at the same time as the employment officer. It was the case in the past that when an individual went on lone parent benefit the expectation was often that he or she might stay on it for 20 to 30 years. What we want to do now is to offer a service to the families who have been coming in to see us. The outcomes have been extremely positive and perhaps when time permits we will arrange for some of the Deputies who are interested to actually visit and see the system in the social welfare offices, where people are involved in really positive engagements about how to provide a better future for themselves and for their children.