Dáil Éireann díospóireacht -
Tuesday, 14 Jul 2015

Vol. 887 No. 1

Topical Issue Debate

Dublin Bus Services

Deputy Mary Mitchell O'Connor

Last week, on Monday, 6 July, Dublin Bus met with councillors from Dún Laoghaire-Rathdown County Council to propose changes to the current network of services in the south-east area of Dún Laoghaire-Rathdown. What has ensued since is a case of misinformation, speculation and conjecture because of the lack of hard concrete information. This has caused much upset and anxiety in the area. The routes under consideration include the Nos. 7A, 7B, 8, 45A, 59, 63 and 111 which serve many local communities throughout the Dún Laoghaire constituency. Constituents rely on these vital services and it is crucial any changes made are decided on after a fair and inclusive consultation with the public.

I am calling on the Minister for Transport, Tourism and Sport to ensure Dublin Bus runs an inclusive public consultation and informs the wider public when, where and how long such a process will take place. As far as I am aware, the consultation details have not yet been decided and the review is not available online. These steps should be taken as a matter of priority. It is unfair constituents have to learn from hearsay that their bus route may no longer exist or will be amended. Several constituents have contacted me already on the proposals, including local colleges which have firmly stated the potential adverse effects of any such change cannot be overestimated. We cannot forget the large elderly community in the constituency. These bus routes serve and act almost as a lifeline to elderly people, ensuring their daily mobility and independence.

I have been in touch with Dublin Bus to arrange a meeting with its new chief executive, Ray Coyne. I will be recommending to him that the consultation uses all means possible, including open days in shopping centres similar to those for Dublin Bus’s Network Direct service and stands where Dublin Bus reps can take on board both positive and negative feedback. The public need to be heard on this.

Deputy Richard Boyd Barrett

I am involved in organising a public meeting in Sallynoggin tonight where I expect large numbers of local residents to come and express their absolute fury and disbelief at a decision of two public bodies, Dublin Bus and the National Transport Authority, NTA. These bodies, which are the Government’s responsibility, have made proposals to slash bus services in the greater Dún Laoghaire area, affecting bus routes Nos. 7, 59, 63, 8, 111 and 45A.

In particular, Sallynoggin will be devastated with the proposal to take the No. 7 out of the area altogether. Killiney Village and Mackintosh Park off Pottery Road are to lose the No. 59 bus service. The frequency of buses to Loughlinstown Park is to be substantially reduced. Blackrock Village will no longer have the No. 7 going through it. Significant numbers of residents in large community areas, particularly the elderly, the young, students and the disabled, are going to suffer severely as a result of these proposals if they are implemented.

I do not want the Government to fob this of, claiming it is the NTA or Dublin Bus’s responsibility. These are bodies owned by the public and of which the Government is in charge. The NTA cannot be an excuse, like the Health Service Executive, for the Government to abdicate its responsibility. It is the Government’s cuts in subsidies to Dublin Bus that are forcing this agenda of privatisation of these services. Will the Government tell Dublin Bus and the NTA to get their hands off our local bus services? We need more, not fewer, buses through these areas.

Minister of State at the Department of Transport, Tourism and Sport (Deputy Ann Phelan)

I am taking this important matter on behalf of the Minister for Transport, Tourism and Sport, Deputy Paschal Donohoe.

I understand the stress that can be caused in areas where there is talk about changes to bus routes. Under the Dublin Transport Authority Act 2008, as amended by the Public Transport Regulation Act 2009, the NTA is responsible for the provision of bus services. The Minister has no role in decisions regarding bus routes.

Subsidised bus services in Dublin are provided by Dublin Bus in accordance with the terms of its contract with the NTA. No changes to services can be made without the approval of the NTA. The Minister, however, has been informed by the NTA that subsidised bus services are constantly changing and evolving to better meet the needs of the travelling public and ensure best use of public funding. The NTA regularly meets with Dublin Bus to review the operation of the subsidised bus network.

Dublin Bus is developing proposals to revise the current network of services in the south-east area of Dún Laoghaire-Rathdown. The purpose of the proposals is to improve the public transport network in the area, providing dedicated access to Loughlinstown Hospital, helping combat traffic congestion and increasing service levels to key destinations such as Cherrywood. Routes under consideration include Nos. 7A, 7B, 8, 45A, 59, 63, and 111.

Dublin Bus presented the emerging proposals to local councillors in the Dún Laoghaire-Rathdown area on 6 July last. Dublin Bus will also be consulting with customers and other interested parties prior to finalising the proposals for consideration and decision by the NTA.

Deputy Mary Mitchell O'Connor

I thank the Minister of State for her reply. I am glad to hear Dublin Bus will be consulting customers and other interested parties. However, I want this to be a genuine conversation, not a one-way street. I am perturbed the details of the proposals are not up on the Dublin Bus website, even though a public meeting will be held tonight on them. It is difficult for people to know what exactly is the truth concerning these proposals. I want people, particularly older people, to be helped in this process. While Deputy Boyd Barrett has referred to some groups complaining, others are glad that some of the routes will change. At the same time, the concerns of older people and those with disabilities must be listened to.

Deputy Richard Boyd Barrett

Dublin Bus is making €11 million in profits, carrying 4 million extra passengers and these numbers continue to rise. That means we need more, not fewer, buses. This is about profit, nothing more. For the Government, as the Minister of State has just done, to pass this off, claiming it has to do with the NTA and Dublin Bus, is nonsense. The NTA was set up by Fianna Fáil and continued by this Government. Owen Keegan, a Dublin city manager, and John Fitzgerald, a former city manager, are on the NTA board and are the Government’s appointees. We want them called to heel. It is this and the previous Governments’ decisions to cut subsidies to public transport in Dublin city from €85 million down to €60 million that has generated an artificial crisis in Dublin Bus services. This then has become the excuse for Owen Keegan, John Fitzgerald and other bodies to demand the reconfiguration of bus routes, meaning cuts. We lost the No. 46A through Monkstown Farm as a result of this process.

Now we will lose the No. 7 services through Sallynoggin from Loughlinstown. Killiney village will be devastated without the No. 59, Mackintosh Park etc. Of course, several of these routes are also earmarked for privatisation. It is a set-up what is going on here. There will be fury about this, and it will not be only as it was in one isolated area in Monkstown Farm on the last occasion. This is across the whole of Dún Laoghaire.

I ask the Minister to not fob this off. The Minister should intervene stating this is not acceptable. Dublin Bus is making profits. We have more passengers. We need more, not fewer, buses through those areas. The Minister should say, "No way", to these cuts.

Deputy Ann Phelan

I draw the Deputies' attention to the fact that Dublin Bus is committed to meeting customers and interested parties - I will assume Deputy Boyd Barrett is an interested party - in regard to the proposed changes and will do so prior to finalising the proposals which, in turn, will require approval by the NTA. If I was to give advice to both Deputies and to the public meeting, they should try to work with the NTA and Dublin Bus and see can they come up with a working solution that will suit most of the service users who are on the route. The Deputies will find that the agencies will not be wanting. The Deputies should make their feelings known to the NTA and Dublin Bus, but try to find a solution that is workable for all interested parties.

Building Regulations Compliance

Deputy Pádraig Mac Lochlainn

The Minister of State, Deputy Coffey, is familiar with this issue. He would have seen for himself the impact of mica in terms of defective blocks in homes in Donegal.

The scale of this, in terms of the amount of homes affected, is not fully known at this stage but the impact is clear. There are families this evening in my county who are literally living in terror that their ceiling or gable wall would collapse on top of them such is the seriousness of this issue. There are also families in Donegal this evening who cannot insure their homes because of this problem.

My colleague, Councillor Albert Doherty, has relentlessly pushed Donegal County Council to carry out testing on some of the housing stock in the county and a preliminary engineer's report has unfortunately found that mica is impacting on the homes that were tested. There is a lot more work to be done, but it is a serious development and confirms the worst fears of many within the county.

I understand that preliminary engineer's report has been sent on to the Department and I welcome the news that the Minister has established an independent panel of experts, but here is my concern. Earlier I looked through the 200-page report and 20 recommendations of the panel of experts which dealt with the pyrite issue. Is the Minister reinventing the wheel? Have they not set a strong template? How long will this independent panel of experts take to report back?

I have met the families of which I speak in their homes. I attended a public meeting where they told their story. They are literally living in terror that the ceiling above them or the gable wall beside them will collapse on top of them. Their homes are not insured. The banks are not taking responsibility. Such is the seriousness of this issue. They cannot wait, perhaps for years, for an independent panel to report. We need urgent action.

I repeat the call of my party on the Minister to introduce a mica muscovite redress Bill as soon as possible over the summer recess, to bring that Bill before the Houses in the autumn and to implement a mica redress scheme, as this Government has done rightly for those families affected by the issue of pyrite. The impact is similar. Of course, these are separate deficiencies that affect the structure of the home but, if one looks at the 20 recommendations of the panel established on pyrite, I imagine they would almost all apply to this issue of mica.

The Department had submitted blocks for testing. What was the outcome of those tests? Did they confirm the presence of mica in the blocks that were tested?

In terms of this panel of experts that the Minister will establish, is it reinventing the wheel? Is there a danger that it would drag on for far too long? What was the outcome of the tests on the blocks that the Department has done? Finally, what can the Minister do about the insurance companies which will not insure families in Donegal as we speak?

Minister of State at the Department of the Environment, Community and Local Government (Deputy Paudie Coffey)

I thank the Deputy for raising this important issue. At the outset, I wish to acknowledge the extremely distressing and difficult situations that certain homeowners in Donegal are facing on account of damage to the structural integrity of their homes. I also add that I firmly believe that the parties responsible for poor workmanship and-or the supply of defective materials should face up to their responsibilities and take appropriate actions to provide remedies for the affected homeowners.

It was against this background that my Department met a number of private homeowners in early December 2014. At that meeting, my Department requested the affected homeowners to make available copies of any technical reports that they may have commissioned from test laboratories on the affected concrete blocks in their homes. The provision of this information would provide my Department with an invaluable and scientific insight into the problems that have emerged in north Donegal.

In addition, as Deputy Mac Lochlainn stated, on the invite of my colleague, the Minister of State for Arts, Heritage and the Gaeltacht, Deputy Joe McHugh, I visited a number of the affected homes in late February of this year to witness first-hand the damage to the homes and the real difficulties the homeowners and their families have to live with on a daily basis. Following that visit, copies of the requested test reports were provided to my Department and have now been reviewed.

From the test reports and information provided from other sources, the Department understands that problems mostly affect buildings constructed during the period 1999 - 2008, although at least one dwelling pre-dated this timeframe. There would appear to be a number of causes suggested for the alleged problems in the blocks such as low cement content, high moisture-low cement ratio, an abundance of mica, low density, low compressive strength and porosity.

My Department understands that over 170 houses have been surveyed by homeowners and are confirmed as having problems in the block work. The Mica Action Group, which represents many of the affected homeowners, is of the view that there may be other housing schemes which have not yet discovered or reported problems with the block work in these homes.

Furthermore, and as the Deputy has referred to, I understand that Donegal County Council commissioned consulting engineers to carry out sample investigations into cracking to external walls in a sample of local authority dwellings in a number of separate locations across the county. The results of these investigations will inform what further research and-or remedial works are required to the local authority dwellings.

In general, building defects are matters for resolution between the relevant contracting parties, that is, the homeowner, the builder, the materials provider and-or their respective insurers. In the event that the parties cannot reach a settlement by negotiation, the option of seeking redress in the courts can be considered.

My Department understands that legal proceedings may have been instigated in some of the cases relating to this problem. This is the appropriate course of action in the event that the responsible parties, that is, the builder, the supplier and-or their insurers, do not face up to their responsibilities and provide a solution for the affected homeowners.

Notwithstanding the general position, a technical report has been prepared for me on my instruction and that is something I am currently considering. I also understand that the local authority will work closely with the tenants and elected members in terms of implementing any remedial works that may be required to its social housing stock.

We are not reinventing the wheel. The establishment of an independent panel is being considered. However, Sinn Féin is surely not suggesting that every building defect around the country should be resolved by the taxpayer. We need to be careful. The pyrite scheme to which the Deputy refers is a scheme of last resort.

This is a matter of concern to me and something I will consider very closely with a view to making a decision shortly.

Deputy Pádraig Mac Lochlainn

As the Minister of State will know, families in the council areas of Dún Laoghaire-Rathdown, Fingal, Kildare, Meath, Offaly, south Dublin and Dublin city have rightly benefited from the pyrite redress scheme and that is the template under which he should move forward. He confirms that the tests carried out by his Department, like the tests carried out on behalf of Donegal County Council, have established that there are homes affected by mica within the county. The impact is devastating and terrifying. Can the Minister of State imagine a family who know that the gable of their house is affected by seriously defective blocks which could, according to engineers, collapse? The concrete ceiling over their heads is being held up by these blocks and it, too, could collapse. This is the terror families face. There are also families who cannot have their homes insured.

The problem in taking the legal route is the same as that in dealing with the pyrite issue - the Statute of Limitations comes into play. Will the Minister of State, please, not abandon these families to legal recourse? It is clear that they purchased their homes and the blocks to build them in good faith and now they are left in this situation because of poor regulation, as was also demonstrated in the pyrite issue. The 20 recommendations made in the pyrite report stress the issues around regulation, poor standards and the need for change. The families in question are caught up in a similar debacle. I appeal to the Minister of State to put in place a mica redress scheme Bill, along the lines of what was brought forward to deal with the pyrite issue. Will he, please, not abandon the hundreds of families across the county of Donegal to the terrible dilemma in which they find themselves?

Deputy Paudie Coffey

As I said, I am extremely aware of the difficult and distressing circumstances in which the homeowners and families in question find themselves. I have visited their homes and spoken to them. I reiterate, however, that building defects are generally matters for resolution between the relevant contracting partners, namely, the homeowner, the builder and the materials provider and-or their respective insurers. I urge the responsible parties in the cases the Deputy mentions to take all appropriate actions to provide remedies for the affected homeowners. Similarly, if any of the affected homes is covered by a structural guarantee or structural insurance, the homeowner may wish to pursue this avenue to seek redress.

The Deputy keeps mentioning the pyrite redress scheme. That was a scheme of last resort where builders or suppliers who should have been accountable could not be legally pursued by the people involved. I do not want to see any family abandoned who have been left in the lurch, but the State cannot intervene when responsible people or entities can still be pursued. That has to happen as we cannot expect the State to remedy every building defect in the country when there are people who should be held to account for the very substandard buildings they have put up for innocent families.

I am sympathetic to those involved, which is why I visited them and commissioned a report on the matter. I am considering taking it a step further, but I urge the Deputy and other Deputies such as my colleague, the Minister of State, Deputy Joe McHugh, who is closely involved in assisting the people in question, to pursue those involved to the end to ensure there is accountability. I am considering the report and will make further decisions in due course.

Hospital Facilities

Deputy Timmy Dooley

The Minister may be aware that two day care facilities in County Clare, namely, in Raheen and Kilrush, are to be closed from Monday for a period of two weeks and possibly more. This is creating significant stress among the population who use these facilities on a daily basis. They collectively cater for some 200 elderly individuals in the community on a weekly basis. I do not need to remind the Minister of the importance of day care centres, not just to the residents but also to the entire health system. They can act as an early warning device in recognising illness in residents, ensure any minor illness is picked up at an early stage to prevent from it developing and sometimes avert the necessity for long-stay care. The facilities in question do an immense amount of good work and are a great basis on which to provide an adequate health care system for the people in question..

It appears that the Government has not done enough in advance planning. We have been given excuses by the Department of Health, through the HSE at local level, that they do not have an adequate supply of nurses and that there is no supply of agency nurses. I have to believe this reflects negatively on the Department and the Minister for Health. It was the then Minister, Deputy James Reilly, who abolished the HSE and took full responsibility back within the control of the Minister for Health and the Department. Therefore, the blame lies at their door, not at that of the HSE or local management. We are led to believe this is not about financial resources but about the deployment of personnel. It is incumbent, therefore, on the Government to ensure there is enough advance planning. Everybody recognises that this is the holiday period and that people get sick. Therefore, there should be capacity to put in place a proper HR management system that will identify requirements and ensure staff will be available to meet the need.

Deputy Michael McNamara

I will not reiterate what my constituency colleague has said, except to say there is significant distress because of this issue, caused not just by the announcement but also by its nature. This is not the first time we have had such an announcement. In this forum I raised the issue of the closure of a ward in St. Joseph's Hospital in Ennis, a facility which also treats elderly people. The ward was closed without notice and people were moved throughout the evening and early the next day. Thankfully, it was reopened after two weeks.

I do not think it can come as a surprise that people take holidays. In any work environment or management setting it is something managers have to deal with. Even those who manage one or two people have to take account of the fact that they will take holidays. The date on which tenders were received for the first phase of work to bring Raheen Hospital into compliance with HIQA standards was 10 July, which was good news. It was a statement of intent that Raheen Hospital would continue into the future, but then the news came, on what was otherwise a good news day, that the day care centre would not be open on Monday. If there are shortages, surely the very least that should happen is that people should be told a couple of weeks before in order that those patients reliant on the service and their family members can make plans. It is not just the announcement that is worrying but its timing. It does not cover the HSE in glory in the way it has been managed. I appreciate the reasons, namely, that it is based on sick leave, because people do get sick, but we also know that there is an increased tendency for nurses and medical personnel to get sick because they deal with people who are sick. That is inevitable in managing a health service.

Deputy Joe Carey

I join colleagues in raising genuine concerns about the discontinuation of vital day services at the Raheen and Regina House community nursing home units. Yesterday I received a response from the chief executive officer of the mid-west community health care team which confirmed that the temporary closure of these units had not been influenced by the availability of financial resources but by the unavailability of nursing staff in the next few weeks.

Factors such as annual leave, sick leave and the unavailability of agency staff were cited.

The day care centres at Raheen and Regina House community nursing units provide wonderful services to older people in both east and west Clare. Not enough credit or priority is given to day care centres in terms of their role in delivering our national health service. The provision and development of community-friendly day care services offers a real and significant win-win situation to the client and the State as keeping people at home for longer avoids clogging up residential care settings.

It is highly regrettable that staff and clients at Raheen and Regina House community nursing units were informed at 2.30 p.m. last Friday that their respective day care centres would not open the following Monday. This action poses questions in terms of the staffing roster. Surely the roster for these day care centres are put together monthly. Why could the clients and staff not be told earlier? What efforts are being made to recruit new nursing staff? The bottom line is when these units will be reopened. Will the Minister of State assure the House today that these temporary closures will not happen again?

Minister of State at the Department of Health (Deputy Kathleen Lynch)

The overarching policy of the Government is to support older people to live in dignity and independence in their own homes and communities for as long as possible. It is clear this is what older people want and only those in genuine need of residential care should go down that route, which is why services such as day care, meals on wheels and the availability of respite facilities are so important. I agree with each of the Deputies who have spoken on this issue in that regard.

The Health Service Executive is responsible for the delivery of health and personal social services, including those at facilities such as Raheen community nursing unit and Regina House community nursing unit. Both centres are registered with the Health Information and Quality Authority. The services provided at these units are a vital part of the supports for older people that allow them to maintain their independence and quality of life in a way that meets their own wishes. Raheen community nursing unit, which was originally a private house, has been used since 1973 to provide services for older people in south-east Clare. The centre can accommodate up to 25 residents, including 15 long-stay places and ten short-stay beds comprising respite, palliative care and rehabilitation beds. There are supported living units in the grounds of the building. Raheen community nursing unit also provides day care for up to 20 people on weekdays. Regina House community nursing unit, which opened in 1972 as a welfare house, is now a residential centre for older people and is also registered with HIQA for up to 30 residents. There is a separate day care service for older people in the adjoining building which caters for up to 25 people from the local community on weekdays.

On the temporary closures, and people need to realise it is a temporary closure, of the day centres at Raheen and Regina House community nursing units, the Health Service Executive has confirmed that these are not influenced by the availability of financial resources. The decision to close the facilities temporarily was because of the unavailability of nursing staff over the next number of weeks. The contributory factors are annual leave, sick leave and the unavailability of agency staff. I stress this is a short-term measure for a couple of weeks only. I recognise the primary responsibility is to provide safe care to the residents of the units and to ensure the availability of access to respite residential services for the elderly population in the area. The HSE is committed to restoring the day care services at both centres as soon as possible. Every effort will be made to minimise disruption to service users. If any person using the services has particular difficulties, I urge them to contact Raheen or Regina House community nursing units directly and the HSE will do everything in its power to support him or her.

It is worthy of explanation to note that the difficulty in respect of nursing staff and the unavailability of nurses is not just in this area. We have considerable difficulties in other areas. As both centres are registered with HIQA, it is incumbent on us to stay within the guidelines set down by it. We have a difficulty recruiting a range of nursing staff, particularly nurses who work in psychiatric services and in the area of care for the elderly. They are not seen as the most attractive areas in which to nurse, although I often find it can be the most rewarding. Services such as this one provide, as the Deputies have already said, an invaluable service.

The reason for the late notice is the HSE was, until the last minute, trying desperately to recruit agency nurses. Even they are not available. I think it has something to do with the time of the year. Along with everything else, nurses within the agency sector are usually young and are off doing different things at this time of the year. It is not something we are letting rest. We will endeavour to put the service back as quickly as possible. I appeal to people to have a little patience but I understand fully the difficulties in which it places families.

Deputy Timmy Dooley

A couple of hundred people are being disenfranchised for the want of two nurses, which highlights the massive problem that is the shortage of nurses. If two nurses out of the system can have that big an impact, what happens if four or five nurses are sick tonight because of an outbreak of a bug in the mid-west? Could it lead to the closure of a number of wards at University Hospital Limerick? Is the line that fine at the moment? Is that what has been achieved? Is she telling me that, having dispensed with the HSE and its board and having taken control of the delivery of health services in this State for the past four years, the Department is still relying on excuses grounded in not knowing or expecting a couple of people would be off sick? Is that any way to run a health service? I am not directing this at the Minister of State personally but towards the Government and the senior Minister who hoodwinked the people. The Government lay the blame for the difficulties on the heads of the HSE when in truth it was a ruse to win an election. Taking control back into the Department of Health has made things worse. The Minister of State is saying it is not a financial resources issue. It is a result of massively poor planning, responsibility for which lies firmly and squarely at the feet of the Minister for Health and the Government.

Deputy Michael McNamara

I welcome the Minister's commitment to ensuring these services at Raheen and Regina House community nursing units open as soon as possible. There is a further problem, however, for people who receive these services. Some of these people would also hope to receive home help at some point. There is an incredible disparity in the distribution of home help hours in the mid-west. The population aged over 65 in Limerick is 21,032. In Clare, it is 13,292 and in the north Tipperary-east Limerick area it is slightly less, at just under 13,000. Despite this, when one looks at the number of people in receipt of home help hours per month in 2015, in Limerick, it is 1,437, in Clare, it is 961, and in north Tipperary-east Limerick, it is 1,241. When one looks at the actual hours allocated, there is a similar discrepancy, which is inexplicable. Why does the population in north Tipperary-east Limerick receive one and a half times the number of home help hours received by the population in Clare? It is an appalling inequality and one that needs to be addressed. Progress has been made in the lifetime of this Dáil in this regard but not enough progress. A lot more needs to be done.

Deputy Joe Carey

I also welcome the commitment given by the Minister of State to work to restore the services as quickly as possible. She noted that there is a difficulty in recruiting additional nurses but what additional measures has she taken to recruit new nursing staff in settings such as Regina House and Raheen community nursing units and right across our health care provision network?

Deputy Kathleen Lynch

I will be brief. At certain times of the year staff shortages are more acute than at other times. That is obvious. Certain periods used to bedevil the last Government, especially the Christmas and new year period, if I remember correctly. Anyway, it was always that winter period. That is always an issue. People have a right to take their holidays. I am not suggesting people have a right to be sick but, when they are sick, they have a right to take time off to recuperate. It is important when nurses are dealing with older and vulnerable people and they become ill that they can take the necessary time off. We do not want them to work in circumstances that are less than ideal. Equally, we do not want people getting infections from one another, as can often happen in this type of setting.

Home help is allocated on an individual basis. It used to be allocated on a block grant basis, but not anymore. Each individual is assessed for the amount of home help he or she needs. Obviously, it is not as much as we would like but nevertheless that is what happens.

I will set out for Deputy Carey what we are doing in respect of recruitment. I have said this so often in the House in respect of different areas. We are now into our second phase of recruiting overseas, in England, in particular, where many of our nurses went. We are there desperately trying to encourage people back. We are offering them a good standard of pay. I suppose the only thing any country can really offer is its environment and living and working conditions, and that is what we are doing.

This year we are targeting new graduates. We have stands in the universities and we are desperately trying to recruit people from that cohort. However, young people who are newly qualified want to work abroad as well. They want the adventure of it and we cannot stop them from doing that. Anyway, we remain hopeful that some of them will stay at home and work within the system. In case some Deputies believe Clare is the only area affected, according to the last information I have there are 40 vacancies for nurses in Cork University Hospital. Yet in the case of anyone who walks in the door looking for a job, we are offering them a contract and a job. Despite this we are finding it remarkably difficult. We are not the only country with this difficulty. The UK has this difficulty and that is why those responsible recruit here. Canada is offering such rewards that we cannot possibly compete, but it is because the services there have shortages too. This is something we all have to deal with, despite having increased the amount of people graduating every year.

Residential Institutions Redress Scheme Eligibility

Deputy Clare Daly

I cannot believe we are in the Chamber discussing this again. This is another circumstance which, to my mind, represents an utter betrayal of the women who survived the Magdalen laundries. In their youth these women were violated and abandoned by the State. They had to fight for decades to receive redress for the damage done to them by the State. Now, we are about to implement this redress scheme, but what do they find?

Let us put first things first. The medical card they have been issued with is effectively branded. It is stamped in clear writing that the scheme relates to people eligible under the Redress for Women Resident in Certain Institutions Act, thus identifying them as Magdalen survivors. I cannot believe how anyone dreamt this up. I assume the justification is that this entitlement will give concessions that other medical cards do not give - I will deal with that point. If that is the justification, it could easily have been done by an initial or something like that. The idea that these women should have their privacy breached in circumstances involving their doctor, pharmacist, the person who finds their handbag on the bus, or a grandchild, who picks up the card and asks her granny what the words mean, is absolutely outrageous. These branded medical cards must be withdrawn. I would love to see an answer to the question of who dreamed it up. I simply do not know but I expect there should be a public apology for that aspect of it.

The second aspect is equally important. These women were led to believe by Mr. Justice Quirke and others that they were entitled to a medical card with benefits equal to the benefits of those under the Health (Amendment) Act scheme. Under the HAA scheme the supporting documentation ran to 58 pages setting out the benefits available to people on that scheme. The additional documentation for this scheme runs to five pages. As Justice for Magdalenes has said, it amounts to not much more than an ordinary medical card, which 90% of the women have anyway. The drugs, medicines and appliances are restricted to what is on the reimbursement list anyway. There are no complementary therapies, no counselling without a general practitioner referral, no counselling for family members, no appeals or complaints board and nothing for the women overseas.

This absolutely needs to be addressed. It represents a betrayal of these women. The scheme itself is completely inadequate. As organisations like Amnesty International, the Irish Council for Civil Liberties, the National Women's Council of Ireland and Justice for Magdalenes have pointed out, it is not actually human rights compliant at all. These women deserve more. My appeal to the Minister of State, and that of Justice for Magdalenes, is for emergency legislation to address this shortfall and ensure the scheme is in line with what Mr. Justice Quirke recommended. Those involved point out that 512 women have waived their right to legal action in anticipation that they would secure the full benefits. What they have got instead is a branded medical card and that is completely unacceptable.

Deputy Kathleen Lynch

I thank the Deputy for raising this issue. The Deputy will be aware that the Government accepted all the recommendations of the Quirke report and established an ex gratia restorative justice system. In that context, the Government set up a range of payments and supports for the women who worked in these institutions. Payments of up to €100,000 are made to these women, depending on their length of stay in the laundries. In addition, the Department of Social Protection is making pension-type payments to these women. I understand from the Department of Justice and Equality that over 500 applicants have received lump sum payments to a value of approximately €20 million to date. Mr. Justice Quirke also recommended that legislation be introduced regarding the provision of health services to Magdalen women. To that end, the Minister for Justice and Equality brought the Redress for Women Resident in Certain Institutions Act 2015 through the Oireachtas. The Act sets out the primary and community health services that are made available free of charge to these women. These services include GP services; prescribed drugs, medical aids and appliances; dental, ophthalmology and aural services; home nursing; home support; chiropody; physiotherapy; and counselling services. A woman qualifies for these services where the Minister for Justice and Equality has determined that she is eligible under the restorative justice scheme and the woman has accepted a formal offer made to her under the scheme.

The HSE has contacted the qualifying women directly to issue them with the redress for women resident in certain institutions, RWRCl, card on the basis of information provided by the Department of Justice and Equality about the acceptance of an offer. The HSE has also provided information to the women about the health service. In this way, participants in the ex gratia scheme receive their RWRCI card to enable them to access easily the primary and community health services free of charge.

I imagine the Deputy will appreciate that the Redress for Women Resident in Certain Institutions Act 2015 was debated and approved by the Oireachtas earlier this year. Under the legislation, a medical card is not being awarded to the women. Mr. Justice Quirke did not recommend that Magdalen women should be awarded medical cards. In fact, the judge pointed out that most of the women already hold a medical card, as the Deputy has already stated. Therefore, we did not issue them with medical cards. Instead, a specific card is provided to the women to ensure they can access the health services without any charge, as set out in the Act.

The separate RWRCI card is warranted because the women benefit from a greater range of entitlements than under the medical card. The cards provided to Magdalen women were intended to be similar in manner to the HAA cards. The shorthand name of the HAA card is based on the underlying legislation. The HAA cards are issued on the basis of the Health (Amendment) Act 1996. The 1996 Act provides certain health services to persons who contracted hepatitis C from a blood product or blood transfusion. In this case, the Redress for Women Resident in Certain Institutions Act 2015, which this House approved without a vote earlier this year, provides primary and community health services without charge to women who were admitted to and worked in certain institutions.

In the same way, these cards are called RWRCI cards as a shorthand description of the Act. It will be relevant to the Deputy to note that it was never intended to cause any offence or embarrassment by referring to the Act on the card. However, I accept that putting the full title of the Act on the card identifies the holders in a way that the Health (Amendment) Act card does not. I only saw the card this afternoon. I am completely open to changing the title as it appears on the card if this is what the women want. It will only require a small effort to correct it and I am happy to ensure it will happen. I hope this puts the issue to rest.

I will not conclude with what is contained in my script. I must state that had I seen the card in advance, it would not have been issued. I have given instructions in respect of it. I am not certain that we should withdraw the card, but Mr. John Hennessy, director of primary care in the HSE, will meet relevant stakeholders to determine what the design should be.

Like the Deputy, I do not understand why the full title should have been on the card since the card had to be used for identification or to hand to the secretary of the general practitioner. The initials would have been enough. We do have to indicate that the card is different. This is important, but it was equally important to settle on the form of identification.

I have been centrally involved in the Magdalen issue, as Deputy Clare Daly knows. Really and truly at this late stage, identification in the manner in question is not appropriate. We will ask the director of primary care to sit down with the relevant authorities to address the issue. However, this is not even needed as we all know instinctively how we would go about it. What is required is being done.

I am not certain that I want the women to return their cards, but I am saying to the Deputy that new, more appropriate cards will be issued.

Deputy Clare Daly

I actually believe it was important to give the Minister of State the extra time to contribute so forcefully and agree with the points I was making. I fully appreciate her bona fides on the issue of identification. The identification was outrageously insensitive, almost cruel, thoughtless and really clumsy. That somebody made this mistake was just ridiculous after all the women had been through. I fully acknowledge that the Minister of State has said she will address the issue and I am glad that it is happening. This will be best achieved through consultation with those involved.

The bigger issue for many of the people affected is obviously the shortcomings of the scheme. We discussed them at the time of the passage of the legislation. It is still the case that the women are very disappointed by the shortcomings. While I appreciate the nuanced statement of Mr. Justice Quirke that the card was not to be a medical card but a health services card, this led the women to believe they would have far greater entitlements than would be afforded with an actual medical card. In actual fact, it gives them little more and is not in any way on a par with the HAA card. Perhaps we have had this debate before, but when the women see the entitlements written down, the disparities are driven home. I would like to see this issue addressed through emergency legislation, although I know that is not very likely to happen. However, I am at least glad that one aspect of the issue is being addressed.

Deputy Kathleen Lynch

Since we were so anxious to do exactly what Mr. Justice Quirke had asked us to do, the legislation was very prescriptive. What was not prescribed, of course, was what happened in regard to the card, the health services card. I hope we will rectify the matter as quickly as possible. It would not be appropriate to ask the women themselves to return the cards. I am not certain how that would work, but I am saying the new card, when issued, will be anonymised as much as possible, although I am not certain it will be more discreet. It will have to be identifiable as being different from the other card. We all accept this.