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Dáil Éireann díospóireacht -
Wednesday, 30 Sep 2015

Vol. 891 No. 1

Topical Issue Debate

Road Traffic Legislation

I thank the Ceann Comhairle for giving me the opportunity to raise this important issue. The issue of dirt bikes has plagued not just my community but communities across the country. People are now being seriously injured because of the reckless behaviour of some youths. During the summer I was contacted by residents of Rossmore Park in Ballyfermot, who expressed grave concerns in respect of the use of dirt bikes by youths in the area in terms of the noise that is generated and, most importantly, the risk to public safety.

I contacted the Garda locally to highlight the problem and Sergeant Gwen McKenna of the Ballyfermot Garda station provided a comprehensive response for which I am very grateful. I commend the report which was well laid out and emphasised the problems the Garda is experiencing. The report stated that the Garda is aware of the problems with dirt bikes locally but has real difficulty determining if a person is compliant with road traffic legislation. A licence is required where the motorcycle engine capacity exceeds 49 cc. However, a garda cannot determine the engine capacity without physically stopping the youths, which is nearly impossible in many cases. A number of months ago in Ballyfermot a member of An Garda Síochána was seriously assaulted when trying to seize dirt bikes. This has become a serious issue in the area and needs to be addressed as a matter of urgency. I understand the legal requirement to hold a licence only applies to public places as defined in the Road Traffic Act. However, dirt bikes are mainly used on waste ground, in fields, and, in recent months, on walkways near the canal, which are not defined as public places and, therefore, the legislation does not apply. The sad reality is that many youths on dirt bikes completely ignore the law and have no regard for local gardaí, regardless of whether they are in a public place or anywhere else.

Gardaí cannot access places because the vehicles are made to drive over rough terrain, which makes it difficult for officers to follow them. It makes their job twice as hard when they are pursuing three or four of them fleeing the scene at the same time. Gardaí have told me that some of the users are as young as eight and have no understanding of the rules of the road. When gardaí call to their parents, it can be quite difficult to get any response regarding their children's use of these dirt bikes.

Gardaí regularly visit local schools to explain the dangers of dirt bikes and to talk about road safety but, unfortunately, their advice often falls on deaf ears. Each year we provide money for youth projects, community development, youth clubs, GAA clubs and football clubs, and yet many of the youths who are involved in riding dirt bikes do not attend any of these projects or are not interested in confining themselves to being involved in these clubs.

The Garda is doing what it can but its hands are tied because of the limit of legislation governing dirt bikes. That is why I am asking the Minister to consider amending the road traffic legislation to see what might be done to address the problem before somebody is seriously hurt.

Last week I witnessed an incident near Blackhorse Bridge in Inchicore where two elderly people were walking home from getting their messages and were nearly knocked over by a youth on a dirt bike entering through the exit to their senior citizen complex. This is a very serious issue and it needs to be addressed. I look forward to the Minister's response.

I thank Deputy Catherine Byrne for raising what I know is an important matter in her constituency. My area of responsibility relates to the legislation concerning the use of motor vehicles in public places. This includes the use of dirt bikes or scrambler bikes in public areas. Enforcement of the relevant legislation, including addressing any illegal use of a mechanically propelled vehicle, is a matter for An Garda Síochána.

The use of vehicles is subject to the relevant requirements of road traffic legislation. The Road Traffic Act definition of a “public place” includes any street, road or other place to which the public has access with vehicles, whether as of right or by permission and whether subject to or free of charge. Based on the definition of a "public place" and a "mechanically propelled vehicle" in road traffic legislation, the Garda is satisfied that it has the necessary powers to deal with the misuse of such vehicles in public places. These powers allow the Garda to stop such vehicles in a public place and demand production of a licence or learner permit. In specific response to a point the Deputy made regarding whether the Garda has the legal ability to stop a vehicle, the view of my Department is that the current road traffic legislation gives it the power to stop such vehicles in a public place and request production of a permit or licence. I accept that having the legal ability to stop a vehicle does not get around the practical difficulty of trying to stop a person who is riding illegally and dangerously in a public place. The Deputy made the specific point on the law in the area and I wanted to confirm that to her.

The Deputy correctly pointed out that if the engine capacity of the motor bike is below 50 cc, the minimum age to hold a driving licence is 16 years. If it is above 50 cc, then the minimum age is 17 years. In addition, the Garda may inspect the vehicle for compliance with vehicle standards legislation. Road traffic law makes it an offence to drive without reasonable consideration, to drive carelessly or to drive dangerously. The Garda has informed me that any of these charges could be brought, where appropriate, in circumstances of misuse. In certain circumstances where the misuse of these vehicles involves criminal damage, a prosecution can also be brought under the Criminal Damage Act, if appropriate. The Garda also has powers of seizure, detention, storage and disposal of vehicles under section 41 of the Road Traffic Act 1994 and the regulations made under that section, SI 460 of 2011.

It appears to me, but I am happy to clarify the matter further for Deputy Byrne, that the powers do exist to deal with the matter that she has raised. I am not sure at this point if any further change to the law is required, although I would be happy to hear the Deputy's input in the matter. Based on my Department's consideration of the matter and the engagement we have had with the Garda Síochána, the law in regard to licensing, ability to stop and if need be, to remove a vehicle, does appear to be in place, but I do accept there are challenging matters in terms of the enforcement of the law given the behaviour to which the Deputy referred.

I understand that legislation exists, as was stated in the Garda report, but some of the areas in which dirt bikes are used do not come under the category of roads, streets or parks. They include laneways leading up to people's houses and in the vicinity of senior citizens. Another area where the bikes are used are rough walkways along canals used by people for fishing. They are not designated pathways and that is where the difficulty lies. Access to such areas can be difficult for Garda Síochána vehicles and therefore the gardaí cannot pursue those involved.

There has been a significant increase in my area in the number of young people who own such bikes and, unfortunately, the children who use them are getting younger. I am concerned that a young person using such dirt bikes will be killed. The bikes are now used by children as young as eight, ten and 12 years. When a garda from Ballyfermot tried to stop some youths recently he was seriously injured. That type of behaviour is part of the problem as well.

I accept what the Minister said about his brief and that the issue also comes under the remit of the Minister for Justice and Equality. I intend to raise the matter with the Minister for Justice and Equality also as serious incidents are occurring. I fear that the matter will only be further highlighted in the event of a young person on a dirt bike being seriously injured or an elderly person being knocked down and seriously injured. I respect what the Minister said in his reply, but we need to introduce further measures to curtail the use of dirt bikes, whether through his Department or the Department of Justice and Equality.

Much of the legislation to deal with this matter does come under the remit of the road traffic area, which is the responsibility of my Department. One matter which the Deputy has raised and on which I will check up and ask that a response would be provided to her relates to the definition of a public place. She gave the example of laneways. From my constituency work I am aware that frequently it can be difficult to define whether a laneway is private property or who owns it. It is my understanding that based on the definition of a public place in the context of road traffic law, the issue raised by the Deputy would be addressed, given that a public place is defined as an area to which the public has access, as opposed to a more traditional definition of an area owned by the public. The issue relates to access. I will ask for clarification on the matter and I will provide the information to the Deputy, which she might wish to share with the local Garda or others in the community.

I accept the point made by Deputy Byrne. I can see in the part of the city I represent that there are more such vehicles around and that they present a considerable threat to people when used in an illegal manner. While I am satisfied that the legislation governing the area is adequate, I am also aware that it is very difficult to enforce the law if someone is driving illegally on a vehicle in a public park in which children or families are present. I will revert to the Deputy on a definition of a public place as that falls within my area of responsibility and if I can be of any further help to the Deputy, I will be.

Tourism Promotion

When Waterford's 147 km coastline was excluded from the Wild Atlantic Way initiative I then sought assurances from the Department that my constituency was not being left behind in what we all know is a highly competitive tourism market. In reply to a Priority Question last April, the Minister of State at the Department of Transport, Tourism and Sport, Deputy Michael Ring, told me that the Ancient East tourism proposition, which is built on an abundance of culture and heritage assets in the south east and midlands, would have a positive impact on overseas tourism in Waterford. At the time the Minister of State highlighted places such as the historic round tower in Ardmore, Ghaeltacht na Rinne, and the unique mining story of the Copper Coast, which is a superb and wonderful geopark, as assets that could be promoted under the Ancient East initiative. The Minister of State said that the Ancient East project could be a game-changer for Waterford. They were his exact words to me in the Dáil at the time.

The question we are asking in Waterford now is why it is one of the only counties involved in the Ancient East initiative that has not received specific funding in the first phase of the initiative, which totals approximately €1.8 million. Many of us feel that this is a snub to the city and county, in particular to the many people who make their living in the Waterford city and county tourism sector. Many of those people have been most patient after we were short-changed in the Wild Atlantic Way initiative. We were told that we would be looked after under the Ancient East initiative. In the debate on the Wild Atlantic Way, the Minister of State resorted to shouting and screaming like a hyena. That was recorded on local radio in Waterford so the exclusion of Waterford from the Wild Atlantic Way initiative did not do the Government or the Minister of State any good.

I understand that only the first phase of the investment has been made. Could the Minister provide a commitment that submissions from Waterford will receive funding in the second phase? Could he also indicate when the funding will be made available? For instance, will the Metal Man project in Tramore be considered under the second phase?

At the time, the Minister of State told me that the Wild Atlantic Way was born out of a need to address the dramatic decline in international visitors to Ireland, in particular in the west. However, I pointed out that Bord Fáilte’s figures show a drop in visitor numbers to the south-east region from 1.1 million in 2000 to fewer than 685,000 in 2010. That was one of the most dramatic drops in any region in the State. Accordingly, the Minister can understand why very many businesses and people in the tourism industry in Waterford are aghast that we were completely excluded from the Wild Atlantic Way and that funding was not made available to Waterford for the Ancient East initiative. In addition, the funding might not even be made available until the second tranche, which might only be made available next year. We do not know what Government will be in power then.

I spent a day in Waterford just before the summer when I had an opportunity to meet many of the people involved in tourism in Deputy Halligan’s county. In fairness to the Deputy, although I was aware of it, I acknowledge that I heard from them about their dissatisfaction and annoyance at Waterford not being able to participate in the Wild Atlantic Way initiative. Deputy Halligan is correct to say that the Ancient East is a new plan that is designed to make the most of all of the assets a county such as Waterford has to offer. From tourism promotion work I have done with Tourism Ireland, I am certain there is a huge appetite for the development and launch of a heritage and arts-based tourism campaign that will attract a new kind of tourist to this country who is not currently coming in the numbers we need.

I am aware of the challenge to which Deputy Halligan referred in his region. From my recollection of the figures on the number of people who visit the Deputy's county, the share of the revenue of all the money that is generated in tourism in the country that goes to the county is considerably below what would be warranted by the number of visitors to the county.

One of the reasons for that is the low number of bed nights in the county and in adjoining counties as compared to other parts of the country. The Wild Atlantic Way has sought to address that in one part of the country, while Ireland's Ancient East is seeking to address it in another.

On the specific point the Deputy made on access to capital, the Viking triangle in Waterford City, which I had the opportunity to visit, received €10.5 million in capital funding alone from Fáilte Ireland. This appears to be very well invested in the centre of the city and I was extremely impressed by what I saw. In total, Waterford has now received just under €13 million in capital investment from Fáilte Ireland.

The Deputy's final point related to the consideration of applications from Waterford. I have discussed this matter with Fáilte Ireland and I learned that no application from the county was successful in gaining funding. As the Deputy will appreciate, I do not play a role in evaluating individual applications but I assure him that Fáilte Ireland is working with interests in the county to look at how applications can be strengthened so that they might be in a position to access funding in the near future.

Am I to take it that the Minister cannot give a commitment that we will obtain money for Ireland's Ancient East in the next tranche of funding? Some €10 million in State funding was given to the Viking triangle, which lies on the Ancient East trail. It is interesting that a couple of weeks later the Minister of State, Deputy Ring, suggested the capital would be invested in Youghal rather than in Waterford, which was an astounding statement for him to make. I think the Minister of State is out of touch with what is happening in Waterford at this stage.

The Minister, Deputy Donohoe, referred to tourism figures. The objective of the Wild Atlantic Way was to carry out an assessment of where tourism figures were dropping and where initiatives could be put in place, with the necessary finance, to attract tourism. Ultimately, it is about attracting tourism and one of the ways to do that is to boost tourism initiatives in the area, which means the provision of finance. The visitor numbers, as the Minister will see, have dropped substantially from 1.1 million to fewer that 700,000 in a few years. This is why it was of paramount importance for us to obtain funding for the Wild Atlantic Way. That has not happened and now we are not going to receive any of the €1.8 million, or at least we will not do so now, and the Minister cannot definitively indicate whether in the near future - namely, January, February or next week - we will receive it. This will further undermine job prospects in Waterford, which the Minister for Jobs, Enterprise and Innovation has acknowledged was one of the worst-hit areas in the past six years and where, a few weeks ago, he said there was a need to invest in tourism and to create jobs in the sector. One Minister is saying one thing and another tells us there is no money to invest in order that we can have substantive tourism and sustainable jobs in the area.

Deputy Halligan has a better appreciation of what work is under way in his county than I do but I visited Waterford and saw the work taking place in Tramore in the context of the development of surfing facilities to attract tourists who want outdoor holidays. I was hugely impressed by that. I saw the work the local authority is doing, with Government support, to develop the Deise greenway in Waterford and that was also hugely impressive. Regardless of whether the €10.5 million in funding came under the heading of Ireland's Ancient East - which it did not because it happened earlier in our term of office - €10.5 million is still €10.5 million. It is a very significant investment by Fáilte Ireland in the Deputy's city and it is money well spent because it will support the development of tourism.

In answer to the specific question on whether I could guarantee funding the answer is that I cannot. Fáilte Ireland made the decision. However, I am aware of the need for Waterford city and county to participate in Ireland's Ancient East and Fáilte Ireland is working to see how it can support businesses which put in applications which were unsuccessful on this occasion.

Health Strategies

I thank the Office of the Ceann Comhairle for selecting this matter. As the Minister of State will be aware, yesterday was World Heart Day and it was fitting that in Brussels the heart failure policy network launched a policy toolkit to tackle heart failure. The aim of the heart failure policy network is to create a lasting network of politicians working with other stakeholders to lead significant policy changes to improve the lives of people with heart failure in Europe. Ireland has two representatives on the network, myself and Niall Johnson, the chief executive of Croí, the west of Ireland cardiac foundation, an organisation which undertakes excellent work in the region.

The Minister of State will already know that heart failure is a chronic condition that often requires inpatient hospital treatment. It occurs when the heart is unable to pump enough blood to meet the body's need for oxygen and important nutrients. The condition affects at least 15 million adults across Europe and one in five people is at risk of developing the condition. In Ireland, over 90,000 individuals live with the condition, which is responsible for between 600 and 700 deaths annually. Most important is the increasing prevalence of the condition, with thousands of new diagnoses each year. In fact, heart failure is the leading cause of hospitalisation among those over 65 throughout Europe and accounts for 5% of all acute hospital admissions. Unsurprisingly, this is a condition which has a huge negative impact on people's lives and on quality of life.

For too long heart failure has been the forgotten condition in health policies, despite the economic impact on health care and the terrible burden caused by people with the condition. However, we can change this and the policy toolkit provides ten priority actions backed up by clinical evidence and the views and experiences of patients and it sets out the economic case for change. We need to make heart failure a national health priority. We can do this by establishing a national strategy, increasing public and clinician awareness of the condition and investing in reliable data to support policy decisions. We also need to ensure timely diagnosis, which can be achieved by providing specific training for medical staff. We need to introduce multidisciplinary person-centred care which would include treatment plans that were consistent and available nationally, dedicated follow-up care with specific points of contact for patients and outpatient care to help avoid further hospital admissions. All patients with heart failure should be offered a personalised long-term care plan to help them manage their condition and we need to expand primary care to include medical staff trained in heart failure in order to facilitate care for people in their communities.

I welcome the work that has already been undertaken with the heart failure programme. The objectives and aims of that programme readily complement the heart failure networks and the programme is certainly going in the right direction. However, the most recent update of the programme was in 2012 and while some hospitals were taking part, they are mainly located on the east coast. I firmly believe that, with a renewed effort, we can successfully meet the challenges posed by heart failure. I attended the launch of the policy toolkit in Brussels yesterday and a wide variety of politicians and clinicians from across Europe were present. This is not an issue that is peculiar to Ireland but is common throughout European and the condition impacts upon some 15 million people. Patients from Italy and France who had suffered heart attacks and heart failure and who were not given any follow-up or long-term personalised care plans spoke about their conditions. There is a great need to develop the toolkit strategy and we have a marvellous opportunity to do so.

I thank the Deputy for raising this issue. He is correct about everything he said. It is not just an Irish problem, but, indeed, an international problem. Europe does well when member states do things together. World Heart Day was founded in 2000 to inform people about heart disease and its prevention. This year the theme is creating heart healthy environments. The day is intended to spread awareness that premature deaths from cardiovascular disease can be avoided if the risk factors, including tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol, can be controlled. I am sure the Deputy heard all about this yesterday. Healthy Ireland provides a framework that supports heart healthy environments. It includes strategies on tobacco and alcohol. The Department is currently revising its healthy eating guidelines and is developing an obesity policy and action plan, which will be finalised this year. The Department's Changing Cardiovascular Health: Cardiovascular Health Policy 2010-2019 was launched in 2010. Subsequent to that, the HSE established three key clinical programmes for acute coronary syndrome, heart failure and stroke.

Significant improvements have been made with regard to access to acute treatments for coronary heart disease and heart failure as well as the development of stroke units across the country. Heart failure, HF, is one of the major chronic diseases in Ireland today and is one of the commonest reasons, as the Deputy pointed out, for hospital admission in the elderly, often requiring a prolonged stay. It is recognised that integrated management programmes for heart failure, encompassing primary care and hospital services, can produce significant reductions in the need for hospitalisation and achieve better quality of life and outcomes for patients.

The HSE's national clinical programme for heart failure aims to reorganise the way heart failure patients are managed. Recent developments include structured services of acute heart failure. Such services have been established in 11 hospitals as national heart failure units. These sites have introduced a structured specialist hospital service for patients presenting with acute heart failure, including post-discharge follow up. They deliver an integrated service through the model of care developed by the national clinical programme for heart failure, which follows international best practice.

A new diagnostic clinic in the Gorey-Wexford-St.Vincent’s University Hospital Group provides direct access for general practitioners to specialist blood tests and echocardiography in the community with remote specialist advice on echocardiography results and specialist review of patients in the community when required. This improves access for patients to diagnostics and specialist advice. A heart failure integrated care demonstration project in the Carlow-Kilkenny region is planned to commence shortly. It will demonstrate integration between primary care, secondary care and the hospital group. This uses existing e-health technology and will strengthen patient self-care with enhanced nursing supports and training.

Co-ordinated care between primary and secondary care will provide rapid access to specialist opinion and will support identification of heart failure patients in GP practice. It will also provide specialist day care advice to general practice for rapid but non-urgent cases. Appropriate use of specialist advice and avoiding need for hospital and outpatient attendance has been a key target of this programme. Recognising that giving GPs access to senior specialist advice in a structured and timely manner will avert the need for OPD and emergency department referral led to the development of a consultation service where GPs, practice nurses and specialist staff interact using web conference technology to discuss and manage cases collaboratively. This also allows simultaneous education for the health care professionals as they discuss relevant cases. I will deal with the Deputy's other questions in my supplementary reply.

I thank the Minister of State for her reply. I welcome the contents, particularly in the context of the national clinical programme for heart failure. The health failure policy toolkit can have a role in this. It has been rolled out across Europe and there should be liaison on this. I intend to follow up with the Department on this.

As the Minister of State has acknowledged many times, there is constant negativity around our health services and the negativity is so pervasive and persistent that it often overshadows and ignores the thousands of positive outcomes every day in every hospital and primary care unit. The negativity is bound to affect staff morale, etc. but it cannot be used to detract from the task before us. Ensuring the health service is efficient and provides timely, effective treatment is a mammoth task. I acknowledge the Department's role and the demands it faces regarding all illnesses and conditions. It is difficult to decide on how to allocate resources, particularly when there is constant strain on the national resources.

Under the national cancer strategy introduced by a previous Fine Gael-Labour Party Government in 1996 and its successor, which was published in 2006, cancer services have been transformed and, therefore, I hope a unified approach to heart failure can be adopted throughout the country and across Europe, which takes on board best practice and the best models. The health failure policy toolkit can work and there should be credit where credit is due. The strategy on cancer care under the former Minister, Mary Harney, has worked in many ways and has contributed to improved outcomes. Ultimately, the improvements in cancer outcomes have proven beyond doubt the positive benefits of the development and use of clear national strategies. I hope this can be done for heart failure. I urge the Minister of State to take on board the contents of the policy toolkit and development strategy for tackling this condition in conjunction with that has been planned and rolled out. As our population ages, this condition will become more prevalent and it will cause more serious issues, including financial problems, which will land on the desks of the Department.

I thank the Deputy for raising this significant issue. Three of the 11 hospitals involved are outside the greater Dublin region - Wexford, Cavan and Sligo. I agree with him there should be services in every significant area of population. I constantly say that the solution to overcrowded hospitals is within primary care and this is where this programme needs to go. This morning, we launched the diabetes in primary care programme, which will be delivered throughout the country in a primary care setting. It is about the management of a chronic disease and this is where the heart failure programme needs to go as well. That is where it is heading and we will increasingly provide for the management of chronic conditions in the primary care sector, of which HF will be one. I do not believe in the doomsday scenario, nor does the Deputy, but one must make one's case. If Healthy Ireland has an impact on how we live our lives and ensures we do not end up with heart failure because of alcohol abuse, tobacco use or inactivity, the future will be much brighter. However, a significant cohort will always end up with HF and we need to ensure they are managed in their communities where they feel most comfortable and where they are best known. The acute hospital should be a last resort.

Home Help Service Provision

What have the HSE and the Government against HSE-employed home helps? There is no doubt that there has been an assault on the hours available to home helps across the country over the past number of years. A total of 1.4 million fewer hours are available now compared to 2010. From a policy point of view, it does not make sense to curtail the number of home help hours available to families that are under huge pressure and stress trying to care for a loved one at home. Home helps are an integral part of the delivery of health care, as patients transfer from an acute hospital setting to a home care setting. However, people are scrounging on a daily basis to access additional hours. They contact local public representatives, including Deputies, to beg and plead for more hours. The number of hours available is not sufficient to cater for the demand.

There is a key problem regarding HSE-employed home helps who are being blackguarded to a certain extent. People who have a contract for X hours cannot secure additional hours. I cannot understand the preference for private companies that provide home help hours. When one does the sums, it does not make economic sense to be preferential towards private companies. It must be acknowledged that HSE-employed home helps have provided a critical, integral service in our communities for many years but the notion that they must work a set number of hours and cannot access additional hours is distasteful.

I would appreciate it if the Minister of State would revisit that policy, which seems to be ingrained on the part of HSE management, to reduce, on a continual basis, HSE employed home helps and preference private companies. If there was a logical or an economic reason for doing that, one could understand it but, by any stretch of the imagination or assessment, there is no benefit gained from operating in this way. I ask the Minister of State to revisit that issue in the broader context.

There are instances where people are being provided with a half and hour of home help care. What can a person do in half an hour? There is a need for the Minister of State to fundamentally review the number of hours of home help care available across the country. Taking account of the regions, there has been an appalling assault on the hours available. Some 1.4 million fewer home help hours are being provided than was the case in 2010. We have an ageing population; the demographic curve is in that direction. The stated policy is to transfer people from an acute hospital setting to a home-care setting, yet Government policy in this area leads to the opposite being the case. One of the main reasons we have overcrowded emergency departments - and bedlam and chaos in them on a continual basis - is that we cannot transfer people from an acute hospital setting back to a community-based or home-care setting. An integral element in ensuring that people can remain at home is their level of access to home help care.

In the context of the budget, I urge the Minister of State to not only review the number of home help hours available nationally but also to ensure that home helps employed by the HSE are treated fairly and with dignity and that they are not be continually blackguarded in terms of their hours being consistently reduced and priority and preference being given to private companies. It does not appear that the Minister of State can inform me as to why that is the practice, whether there is a rationale for it or whether a cost-benefit analysis has been carried out. I have been contacted by home helps whose hours have been significantly reduced from 40 to 15. Their basic original contract was for 15 hours, yet they had been working many hours in excess of that for the past number of years. However, when it came to the renewal of their home help hours or providing care for a new client, those hours have been given to private companies.

I am aware of the time constraints and the fact that the clock is ticking. The question the Deputy put down relates to the need for the Minister for Health to improve working conditions for home helps. The Deputy has moved into the broader region and I may be able to deal with that issue in a response to a supplementary question.

I thank the Deputy for raising this issue. While there will always be a need for long-term residential care for the older people in our society, it is important that those who wish to stay in their own homes and communities are supported and facilitated to do this and for as long as possible. It is also important that we support the return of those who have required acute hospital care to their homes.

In 2015, the HSE will spend €330 million on home care packages and home help services including €185 million to provide 10.3 million home help hours. These services are provided in two ways, either directly by the HSE or by private or voluntary organisations funded by the HSE. Home help services are provided mainly by staff directly employed by the HSE. However, in the greater Dublin area, Wicklow and Clare, home help services are provided by voluntary providers on behalf of the executive. The terms and conditions of home helps have been the subject of detailed consideration. A home help contract introduced for HSE employees in 2014 followed on from a lengthy consultative process on a range of issues that commenced in 2012. The discussions took place between the HSE and the unions under the auspices of both the Labour Relations Commission and the Labour Court. The annualised contract which emanated and was accepted is fundamental to both parties as it matches the actual workforce to the changing needs of the service. It also gives certainty to employees by way of guaranteed weekly minimum paid weekly minimum paid hours. Voluntary providers are funded under section 39 of the Health Act.

The HSE has in place service level agreements with these providers which set out the level of home help service to be provided for the grant to the individual organisation and which contain requirements in respect of standards of care. As the home helps employed by these section 39 organisations are not HSE employees, the HSE does not determine the salaries or other terms and conditions to apply to these staff, including pension arrangements. Accordingly, the arrangements offered by individual providers will vary. The pay and superannuation terms and conditions of the staff concerned are not subject to the control of the Department of Health and they are not classified as public servants. The granting of any pension entitlement in such circumstances is a complex matter. Access for home helps in voluntary organisations to a pension has been the subject of a number of Labour Court recommendations involving SIPTU, IMPACT and the HSE. Implementation of a Labour Court recommendation on payment of a gratuity to the home helps employed by the section 39 organisations has been hindered in recent years by the budgetary situation and is further complicated by the fact that the HSE is not the employer.

I am pleased to confirm that the issue was discussed during the recent Lansdowne Road talks and that the parties reached agreement on a process for giving formal consideration to the matter. The parties agreed to establish, in the short term, a working group to examine a number of issues, including gratuity payments for home helps. This process will now be progressed following the recent ratification of the Lansdowne Road agreement. As Minister of State with responsibility for primary care, I am committed to providing the necessary supports and assistance to allow our growing elderly population to remain in their homes and to provide good working conditions for those who can facilitate this.

I am aware that there were long, protracted discussions and negotiations in the Labour Court and the Labour Relations Commission in the context of trying to find an agreed basis for contracts for HSE-employed home helps. A home help who had X number of hours calculated on a base year - and I understand the number was roughly 80% of that - would have a set minimum contract but they would often have been given additional hours. The difficulty is that their hours in excess of the minimum contract are being pared back and given to private companies. As a result, there is a preference in the allocation of hours over and above those in the minimum contract which the HSE is obliged to honour. In case after case, home helps employed by the HSE are only being given the minimum contract hours. The contract refers to minimum weekly paid hours. There is no necessity for the HSE to deny them extra hours. Home helps across the country are still receiving the base minimum contract number of hours but they have been working extra hours in recent years. When the time comes to review their hours, those in excess of what is stated in the minimum contract are being given to private companies and the home helps hours are being reduced to the minimum. In this way, the HSE is meeting its basic obligations.

Why is there an obsession among HSE management, and as is evident in policy, to deny HSE-employed home helps extra hours when additional hours are being allocated to an individual? That seems to be the case. I have spoken to many home helps - I spoke to two of them before I came to the Chamber - and they have confirmed that is the case. They are now receiving the minimum number of hours when they would have been allocated many more hours up to now. There is a change in policy and the HSE is only meeting its obligations in terms of the minimum contract for these employees but it should not give preference to the voluntary organisations or private companies ahead of the HSE employees.

The Deputy will be aware that when the State is the significant supplier of any service, it is necessary, under European rules, to put an element of the contract out to tender. It was not this Government which negotiated that, it was negotiated by a previous Administration. That to which I refer is what needs to happen.

The home help service funding of approximately €185 million will provide for 10.3 million home help hours in 2015, the same level of service and funding that was provided for in 2012, 2013 and 2014, respectively. In addition, we also have the home care packages. We do not have an obsession - neither does the HSE - with private companies. I understand that when people wish to remain in their own homes, this is the best possible option for them. I understand that perfectly. It is an option that we would all choose for ourselves. I reiterate that there is not an obsession.

The difficulty is that, with the collapse of the economy, we had to ensure that not only did we get the best possible value - home helps are extraordinarily good value for the job they do - but we also had to ensure resources were spread as evenly as possible. It will certainly have to be kept under review because at the other end, we are putting people into long-stay residential care at a stage when, albeit in the minority of cases, they do not want to be in it and it is the more expensive option. I thank the Deputy for raising this matter which we will keep under review.

I thank the Minister of State for her response.

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