Léim ar aghaidh chuig an bpríomhábhar

Dáil Éireann díospóireacht -
Thursday, 13 Jul 2017

Vol. 958 No. 2

Topical Issue Debate

Hospital Investigations

I raise a matter of public importance, which is the need for the Minister for Health to establish an independent inquiry into the death of Malak Thawley in the National Maternity Hospital, Holles Street on the 8 May 2016. Representatives of the family have requested that I bring this emotional and personal matter to the floor of the Dáil.

Malak Thawley, who was living in Blackrock, was a 35 year old teacher who was expecting her first child with her husband Alan. An ectopic pregnancy was diagnosed at seven weeks and she required urgent surgery in the National Maternity Hospital. After surgery commenced, the abdominal aorta was torn by a bladed trocar. It took 55 minutes to identify this while an acute vascular haemorrhage was occurring on the theatre table.

A series of catastrophic and shocking errors then occurred. The consequence of these and the failure to follow basic protocol resulted in the death of Malak Thawley by medical misadventure as outlined by the verdict of the coroner. The significant cause of concern for the family, and for the public, is the contradictory evidence and information from the internal hospital inquiry and the facts as established by the coroner.

The hospital conducted an internal review of this tragic death by medical misadventure but following on from the considered and probative questions the family feels that crucial, vital and extremely revealing new facts, events and incidents have only now come to light. The family sees the internal hospital review as a shambolic attempt to hide crucial facts and salvage reputations. For public confidence, trust and transparency where serious adverse incidents occur we cannot allow hospitals to investigate themselves in this way.

There are a number of questions that illustrate the complete contradiction of evidence between the public coroner process and the internal review. Why did Mr. Thawley have to find out through a public forum that there was no blood in the lab, not enough blood in theatre and that his wife’s blood group was not cross matched? Why was there not enough staff to ensure basic functions such as having a laparotomy kit ready? Why were only junior staff available to treat Malak as she was dying? Why was there no supervision, no co-ordination and no accountability? Why was there a complete and total breakdown of communication at all levels? Why were staff not experienced in all forms of laparoscopy technique? Why did the hospital choose not to explain the difference between bladed and unbladed trocars in its internal investigation? Why was it never explained to Mr. Thawley that there was a recognised safer option of using the unbladed trocar? Why and how could it be that there was no consultant on site in the event of an emergency? Why did senior members of staff have their phones switched off or on silent? Why was it that ice for lifesaving cooling treatment had to be obtained from a nearby pub and why was this not explained clearly in the internal report? Why was there a lack of adrenaline available? Why did a Garda escort have to be arranged to procure other medical devices from another hospital? Why was there contradictory evidence provided by witnesses at the coroner’s inquest?

Some of the Minister's remarks in his correspondence to the family have disappointed them and while they acknowledge the Minister's expression of regret and sympathies, as the Minister for Health his correspondence referenced the future changes and the proposed move of the National Maternity Hospital to the St. Vincent's hospital site. In the family's view this is completely irrelevant to Malak's case. In his correspondence the Minister stated to the family “perhaps the inquest into the late Mrs. Thawleys tragic death and the investigation in the hospital have indeed established what went wrong”. The family interpret these remarks as completely insufficient and an implication that the inquest may be the end to the matter. This will not address the internal hospital systemic failures, accountability, full disclosure, transparency and what can be learned to prevent similar tragedies in the future.

The family has two specific and direct requests of the Minister. The first request is for the Minister to meet with them. What is the delay to that happening? The second request is that the family want to be able to tell the Minister why they believe that an independent inquiry is absolutely necessary. The family want to tell the Minister directly. Will the Minister agree to establish a public inquiry in the interests of a maternal hospital system and in the interests of this very tragic case?

I thank Deputy Chambers sincerely for raising this issue and giving me the opportunity to again convey my sympathies to the family of the late Malak Thawley. While, of course, the death of any young person in Ireland is terribly sad, this is a particularly tragic case, as outlined by Deputy Chambers.

I understand that an inquest into Mrs. Thawley’s death took place recently and a verdict of medical misadventure was returned. Separately, the National Maternity Hospital has undertaken its own review of the case and in accordance with its clinical governance procedures. I also understand that the National Maternity Hospital has apologised unreservedly for the very significant shortcomings in the care of Malak Thawley.

I am aware that Mr. Thawley has requested an independent investigation into the circumstances of his beloved wife’s death. I assure Deputy Chambers this evening, and more important assure the Thawley family, that I am considering that request with the seriousness it rightly deserves. I shall set out to the House a number of decisions I have now made on foot of that request in order to ensure that I am fully informed and actions that I have communicated to Mr. Thawley through his solicitors earlier today.

I have asked Dr. Peter McKenna, the former master of the Rotunda Hospital, a very experienced obstetrician and the clinical lead of the newly established national women and infants programme, and his team to examine both the coroner’s report and the National Maternity Hospital report, and to provide me with a view on the appropriateness of the clinical reviews which have been undertaken to date. I believe this is the appropriate thing to do, based on Deputy Chambers's outlining of the family's concerns around the internal hospital review. Dr. Peter McKenna, the clinical lead of the newly established national women and infants programme, and who has also had a very long and distinguished career as the master of a maternity hospital, will carry out the review and will report back to me on the appropriateness of the clinical reviews undertaken to date and any potential shortcomings in them.

I have also asked the national director of quality assurance and verification, Mr. Patrick Lynch, to examine how the National Maternity Hospital conducted the investigation into Mrs. Thawley’s death. I want to be assured that the review methodology was appropriate and that the review was undertaken in line with best practice. If that is not the case, I want to be advised as to what steps to next take. When these reports are to hand, I will be in a position to make a definitive decision. However, this evening I would like Mr. Thawley and this House to be assured that I have asked that these reports be completed without delay.

My Department takes very seriously the need to improve patient safety and, specifically, the need to improve the management of incidents. I have directed the newly established National Patient Safety Office to lead this work through new legislation, policy development and the development of a patient safety surveillance system. I should also mention that I have recently approved new HIQA standards on the conduct of reviews of patient safety incidents which will be launched shortly. These standards form part of a number of initiatives to improve the management of patient safety incidents. I am firmly of the view that we can make the system safer by listening and learning from incidents in tandem with ensuring that the patient and family are both informed and cared for by the system throughout. I can absolutely assure the House this evening that any lessons from Mrs. Thawley’s tragic death will be disseminated nationally by the national women and infants health programme.

In terms of the Deputy's first question, I have no difficulty meeting Mr. Thawley. However, as I outlined in my correspondence to his representative today, I still believe that there would be significant benefit in his meeting Dr. Peter McKenna, who is the clinical lead of the programme, a former master of another maternal hospital and the man that I have charged with reviewing this case and reporting to me. My aim is the same as the Deputy's aim and everyone else's aim, which is that Mr. Thawley would know the facts. I am happy to meet Mr. Thawley but suggest a meeting with Dr. McKenna first could be beneficial to him.

I welcome the Minister's final remarks but I think he should meet Mr. Thawley now. The family have asked it directly. They have gone through quite a traumatic experience with the hospital and in the Coroner's Court, where the evidence presented was completely contradictory to the internal hospital review. This raises serious questions. It was not any type of clinical review. We now know that a lot of the facts that the hospital claimed to have been established were inconsistent, incomplete, inaccurate, misleading and selective. Some of the recommendations from the report are meaningless because the facts as established in the Coroner's Court are different. For example, the internal review gave no recommendation about the issue with the ice that was aired in the Coroner's Court. This was one of the most descriptive and shocking developments in the Coroner's Court.

The Minister needs to listen to the family. They have been very direct about their request for a meeting with the Minister in order to outline why they believe an independent inquiry is absolutely necessary. They do not want any distraction or diversion by way of another meeting. The Minister should agree to meet them so that we can progress the matter. They have requested it repeatedly. They have serious concerns about this whole issue over the past number of months. That we have two seriously contradictory outlines of the elements and facts illustrates why the Minister needs to meet the family and why he needs to establish an independent inquiry. We cannot see that delayed by another process. While he might have a parallel process in train, the Minister should agree to meet Mr. Thawley and hear the serious concerns of the family.

These are concerns that might cause ripples through other aspects of our hospital system. This is one of the tertiary maternal hospitals. It had no ice. I do not have time to go through the detail of the internal report but it is absolutely shocking. This requires the full attention of the Oireachtas and this House. An independent inquiry is absolutely necessary, once the Minister has met the family. They are two simple requests. Will the Minister agree to the meeting?

I have given a very clear response to both of those requests. I have no difficulty meeting Mr. Thawley. I have said that clearly. However, I believe there is an advantage in Mr. Thawley also meeting the clinical lead of the national women and infants health programme. This is an eminent man with significant clinical experience in obstetrics. I have charged him, as the clinical lead of our national women and infants health programme, with carrying out a review of the processes that have taken place to date in order to advise me on additional steps. I consider that to be the appropriate approach for anyone holding the office that I hold, in addition to asking Mr. Lynch, who has a patient safety and quality role within the HSE, to look at how the National Maternity Hospital dealt with its own internal review of the situation. Within days of hearing Mr. Thawley publicly seeking further investigation into his wife's tragic death, I made requests of Dr. Peter McKenna and Mr. Patrick Lynch. I do not have a difficulty with meeting Mr. Thawley and do not wish to be interpreted in any way as having one. If he finds benefit in it, I have no difficulty with it. However, in an effort to help Mr. Thawley, I would hope that he and his family would engage with Dr. McKenna and his team.

As the Deputy mentioned it, and I am glad he did, I have heard from Mr. Thawley's representative on the issue of the co-location of a national maternity hospital. I do not wish in any way to conflate those issues. In fact, when I made my public comments in that regard, I said I was not commenting on an individual case. I was making the broader point that, in terms of our maternity services, it makes clinical sense to have them co-located with acute adult hospitals for times when medical care is needed. I do not make that point in any way in relation to this specific case. I very much take Mr. Thawley's request on board in that regard.

Again, I extend my sincere sympathy to Mr. Thawley and his family on the tragic loss of Malak Thawley. I am happy to meet Mr. Thawley. We just need to work out, in his interest, the optimum way for it to happen. All of our interests are in helping to establish all of the facts that Mr. Thawley wishes to obtain.

Hospital Procedures

As the Minister is well aware, the issue of 24-7 cardiac care and the provision of a second cath lab at University Hospital Waterford is one that has been raised on numerous occasions in this the Thirty-second Dáil by me and my colleagues, both cross-party and those of none. Notwithstanding the numerous representations on this issue, the current situation in University Hospital Waterford remains the same. Cardiac services in the hospital are time sensitive, opening Monday to Friday, 9 a.m. to 5 p.m., and being closed all day Saturday and Sunday. It is simply not acceptable that time restrictions play such a role in the day to day lives of the people of the south east. If a patient presents as requiring cardiac intervention services outside these times, the only option is an ambulance to Cork University Hospital or St. James's Hospital in Dublin. Recently, the death of Mr. Thomas Power brought into sharp focus the absolute single point of failure of the current service, the difficulty with the road network to Cork University Hospital and arriving there within the required 90 minutes and the capacity demand mismatch of the current opening hours.

On Tuesday of this week, after a frantic few days working with Deputy Cullinane to ensure the wording was correct, a motion was tabled in the Dáil. It was signed by all the Deputies of Fianna Fáil, Sinn Féin, the Labour Party, the Green Party and the Rural Alliance as well as Deputies Mick Wallace and Clare Daly. I thank each and every one of those who supported the motion. It has shown that we can work together. We may have different political ideologies, but this has to transcend politics because people's lives are at stake. As I said, the Power family recently lost a son, a brother, a husband and a soon-to-be dad.

The motion calls on the Government to immediately initiate a second independent review into the provision of cardiac care in the south east. The motion also calls on the Minister to commence its work within six weeks of the passing of the motion. Due to Dáil time restrictions and regulations this week, it was not possible to hear the motion. The motion was forwarded to the Minister and a meeting requested. As a result, we met the Minister, Deputy Harris, and officials from the Department of Health this evening at 6 p.m. All Waterford Oireachtas Members were invited to attend and those present were the Minister of State, Deputy Halligan, Deputy Cullinane, Senator Coffey and me. Senator Grace O'Sullivan was represented at the meeting.

This cross-party meeting was very constructive. This was not about politics. Rather, we were all working together, sitting around a table, trying to find a way forward, a clear pathway, a signpost as to how we could move on the issue.

This was a frank, open meeting and all those present outlined the pressing need for the review to commence as speedily as possible. We impressed on the Minister the need for urgent and speedy action. We pointed out what we consider to be the failings with the current system, the depth of feelings in Waterford and the south east and the absolute necessity for immediate movement. We all detected a step change with the Minister and his officials and a greater understanding of the issues being experienced in the south east. We all understand that this service can only be delivered based on clear medical and clinical need and, unfortunately, the Herity report did not show this to be the case.

I welcome the Minister's decision tonight to expedite a national review of all primary PCI services, encompassing the south-east region. I look forward to the statement he will make to the House.

I thank Deputy Butler for tabling this important Topical Issue. Her summation of our meeting this evening is accurate and I agree with it. First, I once more extend my sincere sympathy to the family of Mr. Power and to his community on his tragic loss. As I said previously, I expect that all appropriate procedures will be carried out to ensure the facts and information that are extraordinarily important in this case, including to the Power family, are made known to the family.

I welcome the opportunity to update the House on the provision of cardiac care in the south east. I thank Deputies Butler and Cullinane, Senator Coffey, the Minister of State at the Department of Education and Skills, Deputy Halligan, and Deputy Catherine Martin, on behalf of Senator Grace O'Sullivan, for attending our earlier meeting which I believe was very constructive. I note the apologies of Deputy Deasy, whom I have briefed on it. I also acknowledge the interest of Members of the Oireachtas from the south east in general, including the Minister of State at the Department of Housing, Planning, Community and Local Government, Deputy John Paul Phelan. I have significant respect and admiration for the way Members of the Oireachtas in Waterford and the south east are working on a cross-party basis and in a constructive manner to try to find a way forward.

On foot of the meeting and in light of the cross-party motion, I am pleased to confirm that I have agreed to expedite a national review of all primary PCI services, encompassing the south-east region. I issued a statement to that effect this evening. My Department will immediately commence the preparatory work on examining the scope of the review, including identifying an international expert. It is important to have an international expert. The guiding principles for this review will be to strive to provide a primary PCI service that can deliver clinical outcomes on a par with international standards, something to which we all subscribe. I wish to be clear this does not affect the additional resources I have already committed to provide to University Hospital Waterford, the commitment to review the impact of extended hours at the existing catheterisation laboratory, and the deployment of a mobile catheterisation laboratory, which will arrive in Waterford in the autumn.

As I have previously confirmed, the HSE national service plan for 2017 provided additional funding of €500,000 and, as part of that expenditure, the HSE is currently in the process of procuring a temporary mobile catheterisation laboratory at University Hospital Waterford which will contribute, on an interim basis, to the further reduction in elective cardiology waiting lists at that hospital. The organisation of primary PCI services is an issue for the entire country, as we discussed at our meeting. I accept it is an extraordinarily emotive and important issue in the south east, but there are also other parts of the country that have concerns and views about this. It must relate to how we provide services to the entire population taking account of the best independent clinical evidence available. The review will encompass all areas of the country, including the south east, and will seek to ensure that as many patients as possible have access on a 24-7 basis to safe and sustainable emergency interventions following a heart attack.

My Department will begin the preparatory work, which will include identifying an international expert and scoping the terms of reference. I intend to engage further with Members of the Oireachtas from Waterford and the south east in the coming weeks and certainly by early September to plan a way forward to ensure there is a robust process that will examine all parts of the country and the distribution of our primary PCI services. Ultimately, every Member of the Oireachtas and all parties wish to arrive at a point where the maximum number of citizens have access to 24-7 primary PCI services. Again, I thank the Deputies and Senators from Waterford and the south east for the constructive manner in which they have engaged this week. It has been useful and helpful and I hope we can progress along the lines I have outlined.

I welcome the Minister's statement. I also welcome the fact that following today's meeting we have moved much quicker to what we hoped to achieve by pressing the motion in September after the recess. The Minister stated that the review will seek to ensure that as many patients as possible have access on a 24-7 basis to safe and sustainable emergency interventions following a heart attack. The review will encompass all regions of the country, including the south east.

The Minister said his Department will immediately commence the preparatory work, including identifying an international expert and examining the scope of the review. Time is of the essence so it is essential that the preparatory work commences immediately and that no day is wasted. The terms of reference will be extremely important and I welcome that an international expert will undertake the review. The guiding principle for the review will be to strive to provide a primary PCI service that can deliver clinical outcomes on a par with international standards. This service can only be delivered on clinical and medical outcomes and the consultants in Waterford and the south east recognise that fact.

I also welcome that the review does not impact the additional resources provided to University Hospital Waterford, the extension of the eight hours opening time, for which staff are currently being recruited, and the commitment to the deployment of a mobile catheterisation laboratory which will deal with 460 people who are currently waiting for services. I also wish to refer to the Minister's previous commitment to a stand-alone regional review. We understand that this might be superseded in the event of a favourable recommendation following the national review.

This is a stepping stone. We have a long way to go. I respect what the Minister has achieved tonight and I look forward to engaging again with him and the other Members of the Oireachtas from the south east and Waterford. It is imperative that we work together. The outcome must deliver 24-7 cardiac care for the people of Waterford and the south east. Our voices will continue to be heard as we work together in a constructive manner.

I thank Deputy Butler for her fair and constructive remarks. I also thank her and all the Members of the Oireachtas from Waterford for not playing politics with an issue that we all agree is far more important than party politics. It is about showing that people can work together, regardless of party affiliation, to try to move forward in a constructive way. Deputy Butler spoke about the importance of clinical and medical evidence. That is important because we can only design a health service on that basis, not political decision making. For that reason, all parties in the House subscribing to the idea of a national review with an independent international expert and clear terms of reference is very important. It is important to have an international expert as that will add significantly to the national review.

To be absolutely clear, the additional resources which I have already announced for University Hospital Waterford will remain in place. There is a benefit to that in the immediate term through additional opening hours, extra staff, more procedures being carried out and the mobile catheterisation laboratory ensuring that elective procedure waiting times in the south east can be driven down further. We have made some progress on that in recent months and more will be made with the mobile catheterisation laboratory. I will continue to engage with my colleagues from the south east as we move towards the establishment of this national review, which hopefully will benefit all our citizens in all the regions as we try to plan the best possible primary PCI services to deliver standards that we can all be proud of and that are internationally benchmarked.

Postal Services

I wish to raise the future of the Portlaoise mail centre. It is a major hub for An Post in the midland region that deals with a large volume of mail every night. I hope this will be a useful and positive debate at this late hour. I also hope the Minister will be able to confirm that all is well and in order and that Portlaoise mail centre will be secure into the future. As we debate this tonight, the Portlaoise mail centre is processing up to 450,000 mail items in addition to approximately 28,000 parcels. It is one of the busiest mail centres in the country.

It is the largest post hub outside Dublin and the national hub for processing all international parcels arriving in the country. The mail centre has a customs service presence which means that high security measures are in place to detect illicit items that could arrive in the country by parcel post for onward distribution. The unit in Portlaoise is very active in conjunction with the customs service.

We must all recognise that the decline in mail volumes has placed postal services under pressure and that An Post must adapt to meet the future needs of its customers. The recent initiative whereby parcels will be delivered in the evening and on Saturdays is a great response to customer demands.

I understand An Post commissioned a report from McKinsey & Company which did not make any negative finding in respect of the Porlaoise mail centre and did not recommend scaling down or closing the centre. While there may be excess capacity in the country generally, its strategic geographical location makes Portlaoise mail centre a central hub in the network. The centre needs to be maintained for a variety of reasons. Few areas of the country cannot be reached by road within two hours from Portlaoise. I am sure I will meet one or two mail trucks on the road from Dublin to Portlaoise tonight. As a result, substantial sorting and onward distribution will take place at the Portlaoise hub during the course of the night. We all remember the mail trains which have been replaced by trucks because the improved road network makes it more efficient and faster to move mail from Dublin to Cork, Limerick, Galway or Sligo by road at night.

I ask the Minister to express his views on the future of the An Post mail centre in Portlaoise. I believe it has a great future as it is in an excellent strategic location. It should be developed and strengthened. I compliment An Post on taking a proactive approach to the future role of its distribution centres. The Portlaoise mail centre should be an example for all others to follow.

I recently met representatives of the Communications Workers Union whom I understand met other Deputies from the area. I hope and expect the Minister will confirm that he had a positive discussion about this matter with my constituency colleague, the Minister for Justice and Equality, Deputy Charlie Flanagan, whom I understand has been in direct contact with the Minister or An Post management. I look forward to hearing the Minister's response on the matter.

I thank the Deputy for raising this matter and welcome the opportunity to outline the position on it. The Deputy is correct that the Minister for Justice and Equality, Deputy Charlie Flanagan, has spoken to me about it.

As Minister for Communications, Climate Action and Environment, I have responsibility for the postal sector, including the governance of An Post to ensure the company is fully compliant with the code of practice for the governance of State bodies and the governance functions included in the statutory framework underpinning An Post. Day-to-day operational matters, including decisions on the restructuring of An Post and the operation of the post office and mail centre networks, are for the board and management of the company; they are not ones in which I have a statutory function. Nevertheless, as a Minister and public representative, I am acutely aware of the impact any issue relating to An Post operations has on communities, both rural and urban.

It is Government policy that An Post remain a strong, viable company in a position to provide a high quality, nationwide postal service and that it maintain a nationwide customer focused network of post offices in the community. However, the postal sector as a whole is undergoing systemic change as a result of the growth of the digital economy. The continuing decline in mail volumes, combined with the ongoing impact of e-substitution on retail businesses transacted through the post office network, is a significant challenge for the company and has an impact on its financial well-being.

An Post is operating in a challenging environment and facing an extremely difficult financial position. The company published its annual report and financial statements for 2016 and recorded an operating loss of €13.7 million for that year. Clearly, this is a very significant loss and losses of this scale cannot be sustained. An Post, assisted by McKinsey, is carrying out a fundamental review of the company, with a view to identifying the strategic changes and restructuring necessary to maintain it on a sound financial footing. As the process is nearing completion, speculation at this stage on the future of any part of the national mail network is premature until the full analysis is complete.

I have spoken to many of the staff at the Athlone mail centre, many of whom are my constituents. I am fully aware, therefore, of concerns about the future outlook for the mail centre network. Transforming the postal business will be difficult and will require tough decisions, but the new changes will be designed to make An Post fit for a future in which the organisation can be confident, robust and a winner in the digital world. Government policy is to offer Government services online. In time, it is likely that this will represent the default option in accessing services. For the foreseeable future, however, a segment of the population will not be comfortable or able to access services digitally. The post office network is the obvious choice for citizens as the offline gateway, with its nationwide network and existing strong relationship with offline citizens.

The post office network can play a role in simplifying back office functions to facilitate better and more efficient processes. In relation to the parcels market, this week An Post launched its new worldwide open advertising campaign aimed at its e-commerce parcels business. The company aims to grow its current 25% share of the parcel deliveries market by making it easier for consumers to trade goods. Owing to the growth of online shopping, the volume of parcel traffic through the mail centres is increasing.

I am closely monitoring the position and hope a pragmatic approach that will ensure the long-term sustainability of An Post and the post office and mail centre networks can be agreed. The Oireachtas will be briefed once a definitive strategy has been agreed for the company. Until that time, however, it would not be appropriate for me to comment further on the process.

I thank the Minister for his reply and acknowledge that he has come to the House to outline the position on An Post. We all understand the company is in a serious position, with a decline in activity, especially in the area to which the Minister referred. I am a little concerned by his comment that Government policy is to offer services online and that this is likely to be the default option. He stated that in the meantime An Post will have an important role to play as an offline gateway. He has sounded the death knell for the company by stating it will have a temporary role. He is effectively saying the moment broadband is rolled out, the need for An Post services will be substantially diminished. This is a negative view of the company's future. Essentially, according to the Minister, An Post will become redundant if everyone can do his or her business online. He must take a much more imaginative approach to the future development of the company. He has adopted a traditional way of looking at the company, which is not one that would allow a modern business to succeed. I hope An Post is not planning to fail because, if so, it most surely will. If that is the policy the company has in mind, the Minister's role is to shake that idea out of management heads and ensure they will think of the services the company will provide in the decades ahead, rather than bemoaning current changes.

While the Portlaoise mail centre is a national hub for onward distribution to all other major locations, it also deals with local mail deliveries. It covers counties Laois, Offaly, Kildare, Kilkenny, Carlow, Wexford and Tipperary and parts of counties Wicklow and Waterford. It is responsible for a large amount of local distributions, in addition to its onward distribution activities. As I stated, it is responsible for distributing approximately 18,000 parcels nationwide every night, including 5,000 in the catchment area I set out.

The Minister will appreciate, given his reference to the Athlone centre, that the Portlaoise mail centre is a great employer in the region. Some 200 people work in it, including approximately 50 who work in the parcels section which must be a growth area, given the current discussion about increased online shopping.

There are couriers delivering-----

The Deputy has exceeded his time. The Minister to conclude.

I will conclude. I thank the Leas-Cheann Comhairle for that.

The Minister must make a brief response.

This is a great service and it needs to be developed. An Post can have a bright future if we have a positive attitude.

The House was due to adjourn at 11.30 p.m., so the Minister should make a brief response.

There is no point in trying to hold the tide back. The digital economy is growing, and either An Post will be a part of that or it will not. More State and non-State services will go online. If we intend to use the old An Post model, then An Post will be in very serious difficulty.

The digital economy presents significant opportunities. This is not just a question of providing services, including digital ones, to older people. What can we do to bring young people into post offices? It should not be the case that the only time any of us goes to a post office is at Christmas or during the summer for foreign exchange or passport purposes. What will bring the next generation into post offices? The parcel service will be one aspect of that, as will banking and other financial services. There are significant opportunities for the company in that regard.

Thanks to the commitment agreement that I have penned with Eir, 97% of post offices will have direct access to high-speed broadband within the next 75 weeks. This is a significant opportunity to be exploited by the post office network. The digital economy is growing. Currently, Irish people are spending €14,000 every minute. The sad part about it is that €10,000 of that is being spent on goods and services from outside Ireland. This year, the digital market in Europe is worth €600 million. There are considerable opportunities for businesses at every crossroads in Ireland to exploit that situation. In order to do so, they must have access to an accessible postal service. That can be available. The front office is the local post office and the back office is the parcel service through the mail centres across the country.

The Dáil adjourned at 11.35 p.m. until 10 a.m. on Friday, 14 July 2017.