Dáil Éireann díospóireacht -
Wednesday, 8 Jun 2016

Vol. 912 No. 1

Adjournment Debate

Drug and Alcohol Task Forces

Deputy Caoimhghín Ó Caoláin

This is the first opportunity I have had to address the Minister of State, Deputy Catherine Byrne, in the Chamber since her appointment. I congratulate Deputy Byrne on her appointment as Minister of State and hope that her addressing during the term of this Dáil the twin scourges of drug and alcohol abuse will be a success.

There is an urgent need to properly resource the Cavan and Monaghan drug and alcohol awareness service through increased and realistic resourcing and the provision of essential personnel to sustain this most important service, including the appointment of two full-time senior staff members to deal with case management and rehabilitation co-ordination, and a dedicated young person's counsellor who would double as a prevention education officer and an administrative staff member, all of which are essential positions to the current needs of the service. As well as the above, there is a clearly identified need for another counsellor for the adult service on a part-time basis and for a part-time family support worker.

All of the above and more are part of the basic services that already apply in comparable settings in Dublin and elsewhere. Why is it, given the significant heroin addiction problem and other harrowing substance abuse statistics for Cavan and Monaghan, that people there have to beg and to do so facing the real prospect of losing what they have?

The Cavan and Monaghan drug and alcohol service currently has four full-time employees covering two counties in what was the largest geographical constituency in the country. This is the only dedicated substance addiction service across these two Border counties. It deals with approximately 100 people each week. Great praise is due to the two general practitioners who operate the methadone clinic within the service. While the official capacity for a two-GP service is set at around 60, these great doctors, Dr. Maguire and Dr. Halligan, see approximately 75 heroin addicts each week. There are a further 12 known heroin addicts on a waiting list to be seen, many of them waiting for much longer than the three months that applies to the shortest waiting time across their number. There is no needle exchange or harm reduction service in Cavan and Monaghan. The Cavan and Monaghan drug and alcohol service is willing to take on this role if given the go ahead by the HSE. It has been waiting three years for that response.

There is a service level agreement with the HSE to deliver services on its behalf. Additional funding was applied for again last year but no response has issued. Funding has remained static at €213,000 per annum for each of the last three years. The current level of service provision is only possible because of the support of volunteers, community employment participants, Tús workers and student placements. Training is provided but none of these staff is able to stay and are lost to the service when they are arguably able to make a worthwhile contribution. We cannot build on such a human resources dependency. The experience and dedication of the lead players is what keeps this service together. Theirs is an heroic effort. I take this opportunity to acknowledge each of those people.

What price do we pay for our head-in-the-sand approach to such critical services? Untreated drug problems are contributing to the national hospital trolley crisis, over-crowding in our prison system, increases in crime statistics and overloading of our criminal prosecution system, not to mention the agony and misery of the victims of crime. Our problems are not confined to heroin addiction. The Minister of State, Deputy Byrne, and I were members of the previous Oireachtas Joint Committee on Health and Children and as such she will be aware of the two tragic deaths of young people within my community because of herbal high misuse. I appeal to her to look at the needs of the Cavan-Monaghan constituency.

Minister of State at the Department of Health (Deputy Catherine Byrne)

I thank Deputy Ó Caoláin for his kind words. The Deputy will be aware that I have recently been given responsibility for the national drugs strategy, which aims to tackle the harm caused to individuals and society through the misuse of drugs. I am keenly aware from my own work at community level that the drugs problem is a complex and challenging issue that has far-reaching consequences for problem drug users, their families and the wider community and society.

The Oversight Forum on Drugs, which I chair, is responsible for the high level monitoring of the implementation of the strategy across key Departments and agencies. I intend to convene a meeting of the forum in July to receive an update from all the stakeholders on their progress in delivering on the objectives of the current strategy.

In regard to the Deputy's question, the HSE currently provides a range of addiction services in the Cavan and Monaghan region to support people experiencing problems with drugs and alcohol, including a full-time primary counsellor. I am informed that Cavan and Monaghan Drug Awareness Trust, a key project supported by the north-east regional drug and alcohol task force, receives €213,000 in annual funding from the HSE to provide a range of addiction services in the region. These services include the provision of prevention and education initiatives and treatment and rehabilitation programmes. The trust is also responsible for the co-ordination of the methadone maintenance programme in the region. The north east regional drug and alcohol task force also plays an important role in the delivery of measures under the national drugs strategy, including in the Cavan and Monaghan region, such that there is a targeted response to the drug problem.

In addition, the HSE provides over €93,000 on an annual basis to Cuan Mhuire Teoranta, Ballybay, to deliver a transition residential programme and community counselling to people suffering with addictions, their families and others affected by addiction. This service also facilitates weekly meetings of mutual aid and aftercare support groups.

I am advised that HSE community health care organisation area 1 is undertaking a review of existing drug and alcohol services in Cavan and Monaghan. The outcome of the review will inform the future addiction service needed in the Cavan-Monaghan region including the need for any additional staff.

One of my main priorities this year is the development of a new national drug strategy, which will take effect from January 2017 when the current strategy expires. This process is being overseen by a steering committee, chaired by John Carr, the former general secretary of the Irish National Teachers Organisation, INTO. The development of the new strategy will provide an opportunity to have a constructive and wide-ranging public dialogue on the approach to drug use. The outcomes will also have a bearing on the kind of services and initiatives that we need to put in place to tackle the drug problem effectively, including in counties Cavan and Monaghan.

I acknowledge the work Deputy Ó Caoláin has done. As I complete the first two weeks of my time as Minister of State I pledge that I will consider all the things he has said and bring them to the relevant agencies. During the whole process we may be able to consider this again because drug addiction services should not be based in Dublin alone. They should be throughout the country. There is a need in Monaghan and other counties to be more effective in supporting and dealing with those who have drug addiction problems.

Hospital Waiting Lists

Deputy Paul Murphy

It is a pity the Minister for Health is not here. We heard today that more than 500,000 people are on hospital waiting lists. That is a really shocking figure. Sometimes figures like that are so big that they almost may not be real for people. To help make it real for the Minister of State I will read a letter sent today to my colleague, Deputy Coppinger.

On Thursday the 2nd of June 2016 my mam had a fall at home out in her back garden ... My mam is currently waiting on getting a hip replacement and has no power in her right leg due to this. We waited [from 4.50 p.m.] until 6:35 for an ambulance to get to my mam. [...]

My mam who was face down in the garden was like this for over three hours, she had tried to pull herself up the garden on her stomach as she needed to get to the back door to get some help but she was unable to do this. We were informed when we rang 999 not to move my mam in case she had injuries that we could not see or any internal injuries ... at 5.30 we were assured that an ambulance was on the way to us, we even gave them a second phone number [...]

My mam is 68 years old and because of waiting for a hip replacement she has had knock on affects [sic] to her health and daily life. In November last year, my mam had another bad fall in which she ended up in hospital for over two weeks in which they found that she had fluid on the brain. My mam I feel is a prisoner in her own home as she cannot leave to carry out daily tasks due to her hip it restricts her in every way and it makes simple tasks very difficult for her to carry out. [...]

My mam is on a state pension and has a medical card and I feel that she is being treated like she is in a third world country in respect to her appropriate health care. She is a second class citizen in the Irish health care system as, private patents are seen for hip replacements in a matter of weeks. [...]

We feel the situation she found herself in on the aforementioned date is a result of a failing healthcare system.

The writer of the letter asks several very pertinent questions of the Minister:

How can this be the norm in our health care system? How can people with money or the means to fund an operation get it done in a matter of weeks and vulnerable people have to wait years? Why do we have a two-tier healthcare system? How can a pensioner in Dublin be left for one hour and 45 minutes to be responded to by an ambulance?

That woman and 500,000 other people throughout the country need to hear answers because these waiting lists are not just numbers. They can prove deadly. The so-called cancer gap exposes the reality of what faces ordinary people who are not wealthy enough to get private health care. If people do not have it they can be left waiting on lists for tests and examinations; as the case of Susie Long tragically showed this can result in death while those who have health insurance can be seen more quickly and have a far lower mortality rate. Today we understand the Government agreed a €480 million top-up of funding for the HSE. This is to fill a funding gap for current services but the current services are completely insufficient if each month thousands of people join waiting lists.

Since the beginning of the capitalist economic crisis, more than 5,000 nurses have been lost to the health service. Pay levels have been slashed resulting in newly qualified doctors and nurses leaving the country. Late last year an independent study backed up the position of the Irish Nurses and Midwives Organisation, INMO, that accident and emergency departments have only 60% of the staffing level needed. Despite all of that, the HSE last month directed hospitals not to hire new staff to fill positions which had not already been agreed. The approach of the Government is to base itself on the bottom line. For it, the bottom line is money and for most people, certainly for the Anti-Austerity Alliance, the bottom line is patients. The 500,000 on waiting lists is the bottom line in a health service that shows that funding and staff are required.

We warn the Government not to use this crisis as an excuse to increase the levels of privatisation already in our health service, as planned in the programme for Government. The model of hospital trusts and a management unit is taken straight out of the playbook of the British Tories, a model that has resulted in nearly 40% of contracting services in the National Health Service, NHS, going to the private sector in 2015. The programme for Government will also force hospitals to use their funding to pay private companies to provide services if they do not meet their targets. Private companies and for-profit organisations have no place in our health service. They will not end or assist in any way in dealing with this health crisis. We need to work right now to create an Irish national health service, which is free at all points of access and paid for through progressive taxation.

Deputy Catherine Byrne

I thank Deputy Murphy for his question.

Every year there are 3.2 million outpatient attendances at our hospitals. A total of 100,000 patients have an elective inpatient procedure and 800,000 have a planned day case procedure. For those waiting to see a consultant or to have tests or surgery, the biggest worry is not the size of the list but how long they are likely to be on it.

Adding the total number of all patients waiting for treatment, regardless of whether they are waiting for surgical or diagnostic procedures or for a consultant-led outpatient appointment, and regardless of whether they were placed on the list two days, months or years ago, produces, as the Deputy says, a headline figure of more than 500,000.

Those headline figures, however, do not tell the story of the approximately 300,00 people on those lists whose wait will generally be less than six months. Nor do they illustrate the point that approximately 75% of people waiting for an outpatient appointment will not require any further treatment arising from that initial referral.

I fully acknowledge that there has been a considerable increase in demand for care in our health service in recent years. However, I want to acknowledge two examples of what has been achieved - the numbers waiting for outpatient appointments have gone down by almost 23,000 compared with May 2015, and the number of people waiting in excess of 18 months for a routine gastrointestinal endoscopy reduced from 87 to 28 within the past month.

The National Treatment Purchase Fund, NTPF, figures for May illustrate the absolute need for a sustained commitment to improving waiting times for patients from across the health service. Clinical need will determine that some patients require care more urgently than others and it is appropriate that patients are prioritised on this basis. After those who require critical or urgent care and in order to provide a fair and equitable service those patients waiting longest must be prioritised and the programme for partnership Government commits to continued investment of €50 million per year specifically for this purpose.

A scheduled care governance group has been established in the HSE to co-ordinate key initiatives to reduce waiting time and the number of patients awaiting treatment. Actions overseen by this group include driving greater adherence to chronological scheduling, relocation of low complexity surgical procedures to smaller hospitals and administrative and clinical validation procedures to ensure that patients are available for treatment. In addition, each hospital group has been mandated to designate a key person to lead and support waiting list management improvements to advance towards compliance with maximum waiting times.

I wish to reassure the House that the officials in my Department are working with the NTPF and the HSE in planning a designated waiting list to initiate focused endoscopy implementation this year and, on further investigation, to address urgently the waiting list for those waiting longer. There will be funding of an annual commitment of €50 million, including ring-fenced funding of more than €15 million in 2017 for the NTPF. This will allow us to balance demand and capacity in our acute hospital service and utilise primary, social and community care services to support the health of our citizens.

I refer to the Deputy's comments regarding someone having to wait for an ambulance for an hour and a half. I can assure him that I do not consider that to be appropriate. The issue needs to be examined.

Forestry Management

Deputy Marc MacSharry

I congratulate the Minister of State, Deputy Andrew Doyle, on his appointment and wish him very well. I am sure it is a great honour.

My Adjournment matter refers to afforestation in County Leitrim, of which I know the Minister of State is aware based on other representations that have been made to him. Traditional farming in the area is under threat. The reality is that while the forest service has aggressive targets to increase planting throughout the country, which is an honourable ambition, we cannot approach the country as if it was a blank canvas, because it is not. The official afforestation level of county Leitrim is listed as 17%, but anecdotally I have found that from speaking to people locally it is very unbalanced and the figure may be significantly higher than that.

The fact there are no planning regulations in regard to forestry and one merely needs the approval of the forest service, is wrong. Last week planning enforcement in Sligo informed me that I needed to take down a modest sign outside my office which I was not allowed to erect without planning permission. That is reasonable and I will take the appropriate steps. However, somebody can plant 17 ha with mere approval, and it appears that once he or she has begun to plant 17 ha, he or she is entitled to plant a further 17 ha.

I can provide the Minister of State with examples in Cloone, County Leitrim, where five plantations have begun in as many months. This is closing down communities. People want their right to light and views. There is no right to a view, but we must be cognisant of these issues and not approach the country with the attitude that it is a blank canvas. County Leitrim, west County Cavan and parts of Sligo are being targeted by wealthy speculators who can buy land at a cheaper price and, in some cases, pay a premium for land. The net result is that young local farmers who want to achieve some scale in their farming activities cannot compete. They cannot enter the industry because, as I said, wealthy speculators who have the benefit of premia and larger farms throughout the country with larger scale, shorter winters and better land are able to pay more.

The premia that attaches to this afforestation covers larger operations to the extent that they will make a profit, which pushes local people and communities out of business. The Minister of State should remember that the north west is a substantial part of the engine room of the suckler herd of this country which, as he knows, is from where some 40% of the weanlings come.

Local people are entitled to begin a career in farming in that part of the country, but if we are going to push them out of the sector by allowing this to take place, that is fundamentally wrong. Planning applications must be required for substantial afforestation and we must approach the country in an even manner. We cannot push everything into the north west of Leitrim, west Cavan and Sligo.

I would like the Minister of State to visit Cloone and Drumkeeran in County Leitrim and Blacklion in Cavan. I can show him three examples of communities being swallowed by afforestation. We need to plant more trees to improve the national carbon footprint, which is admirable, but that should not happen solely in our part of the country. We are well covered. In fact, we are over-covered and it is impeding upon communities. They cannot maintain the tradition of rural Ireland and produce quality beef through the suckler herd.

Will the Minister of State contact my office and arrange to come to that part of the country on a date on which he is available? I have no doubt that Deputies Eamon Scanlon, Tony McLoughlin and Martin Kenny, who also serve the constituency, share my views and would also be happy to visit the area with the Minister of State if he were prepared to make time. I know he has family members who are involved in forestry. They perhaps know infinitely more about it than I ever will. All I know is the reality of what is happening in my area, the distress it is causing to communities and the imbalance it is causing to our part of the country.

Statistically, the figures probably look good within the Department of Agriculture, Food and the Marine in terms of more trees being planted. As I said, the unintended negative impacts of this approach must be addressed by the Minister of State. It may well be the case that the premia that attaches to these plantings should be preserved for local people who will farm in the area rather than speculators from other parts of the country who have more capacity and can make profits by pricing local people out of the market. They are looking after their carbon footprint in their own parts of the country.

The programme for a partnership Government states that next year there will be a review of this issue. It is alleged that Deputy Michael Fitzmaurice may not have supported the Government because he pushed very strongly on this issue, as I know other rural Deputies have. I appeal to the Minister of State to take appropriate action in this regard and have his office make contact about what dates suit him to visit.

Minister of State at the Department of Agriculture, Food and the Marine (Deputy Andrew Doyle)

I thank the Deputy. This is my first opportunity to speak on this issue and in an Adjournment debate. The Deputy and I have known each other for quite a while and I am conscious of this issue. I was made well aware of the issue of afforestation in County Leitrim. Perhaps it is one of the consequences of having a policy. No matter how good it is, it always has the potential to upset people.

The Deputy acknowledged the important contribution that forestry makes it to the economy, environment and society. The Government has invested significantly, as have previous Governments, in the development of forestry over recent decades. A vibrant export-orientated forest product sector is one outcome from that investment, as is the contribution forestry makes to climate change mitigation.

The role of the Department of Agriculture, Food and the Marine is to assist the development of the forestry sector. The afforestation grant and premium scheme administered by my Department aims to increase the area under forest in Ireland from its current low base of just under 11%. In this context, it should be noted that the EU average is 38%. It is not intended or proposed that any increase in forest cover be undertaken without due regard to other elements within the environment.

The increase in the area under forest will be undertaken in a sustainable manner, contributing to the EU's priority of restoring, preserving and enhancing ecosystems related to agriculture and forestry. For this reason, all applications for approval to afforest land are advertised on the Department's website and are subject to detailed consideration and consultation with a number of notice bodies, including the Environmental Protection Agency, EPA, An Taisce and Inland Fisheries Ireland.

It is useful to consider the context of forest cover and the level of afforestation in Leitrim compared with national figures. Forests account for 10.8% of the land area of the country, with the forest cover in counties varying widely. In terms of forest cover as a proportion of the total county land area, the second national forestry inventory found that County Wicklow, the garden county, had the highest level of forest cover at 17.7%. Leitrim closely followed it at about 16.7%, a figure the Deputy mentioned.

As regards the ownership of lands under forestry in County Leitrim, I checked the figures and understand the bulk of the new forest plantation over the past couple of years has been undertaken by farmers. For example, of the 513 ha of new forest planting for which grants were paid in 2015, 81% was undertaken by farmers. Likewise in 2014, of the 272 ha of new forest in respect of which payments were made, just under 96% was undertaken by farmers.

It is also worth noting - perhaps we should engage in an awareness exercise - that farmers who hold valid herd numbers continue to have an advantage over non-farmers in that they can qualify for basic payment and forestry premium on the same land. They also qualify for areas of natural constraint and green, low-carbon, agri-environment scheme, GLAS, payments, whereas non-farmers cannot do so.

Forestry is a viable land use alternative and farmers have availed of the afforestation scheme in significant numbers in recent years. However, notwithstanding the continued availability of a State-funded afforestation programme, national planting figures have declined in recent years with payments made in 2014 for the new planting of 6,156 ha, compared to a peak of more than 23,000 ha in 1995. The general consensus is that it is necessary to achieve a higher rate of new forest planting to ensure a continuous, secure supply of quality timber from the forest industry. It is, therefore, vital to address the decline in the planting level now for the long-term future of the industry.

The afforestation grant and premium scheme, currently available under the forestry programme 2014 to 2020, offers a single premium rate. The scheme under former programmes offered different rates and for different periods of time depending on whether the applicant was a farmer or non-farmer. That was a change encouraged by the EU in terms of an equitable approach and also a recommendation of the Council for Forest Research and Development, COFORD.

In addition to an increased supply of timber in the long term, the other benefits of increased forest planting - for example, employment creation opportunities at the establishment phase and also those associated with the ongoing management of forests, including thinning and eventual clear-fell - should not be overlooked. It is worth noting that Masonite Ireland, located just outside Carrick-on-Shannon, is one of the largest ratepayers in County Leitrim. It employs a significant number of people, makes a very important contribution to the local economy and its activities are totally based on forestry. While an increase in planting levels is welcome, I am conscious of the concerns of the people of County Leitrim, including farmers. I am prepared to visit at a time that suits and I will consult with all colleagues to organise such a visit. I believe we can devise an approach and work out a solution.

Employment Rights

Deputy Jan O'Sullivan

I thank the Ceann Comhairle's office for selecting this matter for discussion on the Adjournment. I also thank the Minister, Deputy Mitchell O'Connor, for being present to respond.

At the end of last week, before the bank holiday weekend, the staff, parents and children of three crèches in the Limerick area were told the facilities were closing. There was no warning whatsoever. I refer to the Tic Toc crèches, one in Newcastle West, one in the city centre and one at the edge of the city in Westbury, Corbally. Since then, there has been some reprieve for two out of the three crèches but the one in Westbury continues to be occupied by the staff with the full support of parents because they were told, with no warning whatsoever, that the facilities were closing. A total of 17 staff members are affected and a large number of children. The crèches have gone into liquidation with no warning.

When I checked this afternoon, the staff had still not had a promised visit from the owner of the crèches, in particular the one in Westbury, which is the one where the jobs have been lost and the premises has closed. I understand the owner was due to meet the workers to address the issues around money owed to them in redundancy pay, holiday pay and salaries. The staff remain in occupation of the crèche. The workers have been assisted very well by Frank McDonald of SIPTU. They are seeking their rights and have approached the Department of Social Protection in regard to statutory redundancy. It is simply not acceptable that somebody would so callously close down a crèche, let down parents who have to go to work and who have no alternative and also let down dedicated workers who in many cases have been working in the crèche for a long time. There is a very warm relationship between the families and the workers. What happened is a complete shock to everybody.

A total of 55 children are booked in for the early childhood care and education scheme for next September and their parents must now try to find alternatives. Everybody hopes the crèche will be taken over and that it can continue to operate. It is a very good premises and it is very well stocked. One option under consideration is whether the crèche could become a community crèche. I and other local Oireachtas Members have been making inquiries in that regard on behalf of those involved. That is the preferred option but we are also exploring the possibility of the crèche being taken over by somebody else. Those affected have been left completely high and dry. People who had important meetings were not able to go to work because they did not have alternative child care. Understandably, the children were very unsettled by the whole experience when the place where they were being cared for was closed without any warning. It was particularly difficult for the children with special needs in particular who find it very difficult to adapt to change. The sudden closure of the crèche was traumatic for all of the children, their families and the dedicated workers.

I wanted to raise the issue tonight in the hope there will be a response from the Government. Last week when we had a debate on a Labour Party motion for workers' rights it was indicated that the Company Law Review Group is examining liquidations and protecting people in such situations. From a Labour Party perspective, while significant work was done when we were in government, we raised a number of other areas in the debate last week. My real concern is that the immediate needs of the workers, children and their parents are addressed and that they have an alternative, which is provided as quickly as possible and that in the meantime all of their rights are protected. I know the Department of Social Protection pays statutory redundancy where it is not paid by the owner or liquidator but that is a significant cost to the State and there must be some responsibility taken in such situations and some humanity shown as well.

Minister for Jobs, Enterprise and Innovation (Deputy Mary Mitchell O'Connor)

I thank Deputy Jan O'Sullivan for raising this serious matter and I share her concerns about the position of the employees in question. I know the Deputy has a significant interest in children's welfare and education, which was so evident when she was Minister for Education and Skills. I also share her concern about the position of families who may be affected by the sudden closure of the child care services in question. The uncertainty caused in this situation must be stressful for parents, children and workers alike.

At the outset, I confirm that there has been no engagement or communication from this company with my Department. However, I wish to reassure the workers concerned that we have a robust suite of employment rights legislation which provides strong protections to employees. Those protections include, for example: the Protection of Employment Acts 1977 to 2007, which provide for a process of information and consultation between the employer and the employee representatives in circumstances where a collective redundancy is proposed; the Minimum Notice and Terms of Employment Acts 1973 to 2005, which give employees entitlements to specified notice periods or payment in lieu of notice; and the European Communities (Protection of Employees on Transfer of Undertakings) Regulations 2003 which may apply in certain circumstances.

These regulations aim to protect the basic terms and conditions of employment for employees in situations where a transfer of a business takes place. Fourth, there are the Redundancy Payments Acts and the insolvency payments scheme, both of which are administered by the Minister for Social Protection.

The Workplace Relations Commission, WRC, is mandated to secure compliance with employment rights legislation. The WRC's customer service section provides information on employment, equality and industrial relations rights and obligations, as well as on how to obtain redress where appropriate. The WRC's customer service section can be contacted at the lo-call number, 1890 80 80 90, and the website also provides extensive information on employment rights.

I understand the concerns of the Deputy about the impact on families and children affected by this situation. I understand from the Department of Children and Youth Affairs that in response to the closure of Tic Toc, Limerick Childcare Committee is working with parents to assist them in making alternative child care arrangements. I understand further that all children registered in the early childhood care and education free preschool year at the three Tic Toc services have received their full entitlement for the 2015-2016 year. This represents the vast majority of children registered in the affected services. The Department of Children and Youth Affairs is keen to ensure that the areas served by the Tic Toc facilities continue to have access to child care and where it is possible for replacement services to be established at, or close to, the sites in question, that Department and other relevant bodies, which act as agents of the Department, will provide all possible assistance to potential new management. The Department of Children and Youth Affairs understands that some preliminary discussions have already taken place in this regard. The Deputy will appreciate that the provision of child care services is a matter for my colleague, the Minister for Children and Youth Affairs. The Deputy may wish to raise these matters separately with my colleague.

The Dáil adjourned at 9.15 p.m. until 10.30 a.m. on Thursday, 9 June 2016.