Léim ar aghaidh chuig an bpríomhábhar

Dáil Éireann díospóireacht -
Thursday, 28 Sep 2017

Vol. 959 No. 5

Topical Issue Debate

Bord na Móna

It was with grave concern that we learned of Bord na Móna's plans to invest €60 million in the construction of a plant in Georgia in the United States. It seems that the woodchip which will be manufactured at this plant will be imported into Ireland for the purposes of biomass energy production. This concern is coupled with dismay in the light of the closure by Bord na Móna of its plant in Littleton, County Tipperary which led directly to the loss of 65 jobs and many other part-time jobs in the vicinity. It appears that there are no plans for the future utilisation of the plant and the 1,100 acres of land available with it.

There is major concern across Europe about the negative environmental impacts of misguided policy supports for wood biomass energy production. A recent investigation in the United Kingdom found that wood was being sourced from a timber company, Enviva, from mature hardwood saw logs in the south east of the United States to feed UK biomass energy production. Essentially, the UK taxpayer is subsidising the mass logging of mature hardwood forests in the United States for wood pellets to be shipped to the United Kingdom for inefficient power production. My concern is that Bord na Móna has embarked on this very strategy which is considered across Europe to be a failed one.

In 2016 Bord na Móna imported 35,647 tonnes of wood from Africa. The company, which is ultimately owned by the taxpayer, now seems to have decided that it makes more commercial sense to invest €60 million in a new biomass plant in the United States than to make a similar investment in Ireland. This should be of concern to the Government. We all accept that Bord na Móna must diversify from its core peat supplying activity. Biomass will be at the centre of this diversification. The company's recent media promotion of a new bioenergy division is proof of this development. While all of this is welcome, there is concern that Bord na Móna is taking its plans in the wrong direction. The investment of €60 million in the manufacture of woodchip in the United States for transport to Ireland across the Atlantic Ocean, while making Irish workers redundant, is neither efficient nor environmentally friendly.

As a semi-State company, Bord na Móna is responsible through its mandate for the development of rural Ireland and its resources. I believe there is an Irish solution to this problem. I suggest it should be considered by the company as an opportunity to fulfil its responsibility to its main shareholder - the State and the people. This alternative opportunity is in the agriculture and agrifood sectors which produce waste on a scale that could fuel the biomass energy sector indefinitely. Ireland is facing into penalties of €5.5 billion from the European Union by 2030 for non-compliance with emissions regulations. Urgent action needs to be taken now to avoid this potentially catastrophic result.

The solution should and can come from Ireland's agriculture and agrifood economy. Not only would this mitigate European penalties, it would create employment in rural areas where job creation has become a myth.

Previous schemes such as the bioenergy establishment scheme, which encouraged farmers to grow willow and miscanthus, have failed miserably, with just four farmers applying for aid in 2015. Anaerobic digestion plants located at separate locations nationwide will reduce renewable gas using key energy crops such as grass, grass silage, beet, maize and the byproducts of the agriculture and food service industries and domestic food waste.

This represents a significant opportunity for the Irish agrifood sector. There is a massive opportunity for the growing of crops such as beet, maize and grass to feed biomass production plants. If all organic waste from food production and households could be put through an anaerobic digestion process in a local area instead of being transported across the country in lorries, we could solve multiple problems at once.

A project such as the one I am advocating would require up to 70 plants nationwide at key locations throughout the country-----

Deputy, we will run out of time for the other Topical Issue matters.

-----similar to our dairy co-op structure.

The Deputy can come back in for his two minutes.

First, I would like to state that Bord na Móna is a commercial semi-State company operating under the Turf Development Acts 1946 to 1998. The matter raised by the Deputy is operational in nature and not one in which I, as Minister, have direct function. Nevertheless, as the Minister with responsibility for Bord na Móna, I am aware of the consideration by the company of plans to construct a biomass facility in the United States.

In line with the objectives set out in the national mitigation plan, Bord na Móna has committed to cease the harvesting of peat for energy purposes by 2030. This move necessitates the transition towards a more sustainable business model going forward. To this end, I recently announced the establishment of a new division of Bord na Móna, namely, Bord na Móna BioEnergy, which will focus on the development of the biomass sector in Ireland. The new division aims to be the largest supplier of sustainable biomass in Ireland and will contribute to the development of demand for biomass fuel in the country through the development of robust supply chains from both indigenous and international sources.

One of the founding principles I had ensured was written into the operation of Bord na Móna BioEnergy was stringent sustainability criteria. Bord na Móna has now confirmed to me that these sustainability systems are in excess of what is currently required at either EU level or within Irish legislation. A similar stringent criteria will be put in place regarding the renewable heat incentive scheme.

Bord na Móna BioEnergy will complement the forthcoming renewable heat incentive, which is a demand-side measure with the principal objective of contributing to meeting our national renewable energy targets. In addition, the scheme provides a key opportunity for the domestic biomass sector and commercial opportunities for farmers. This will apply not just to biomass but to biogas and biomethane as well so the issues Deputy Cahill has raised will be addressed in the renewable heat incentive.

The renewable heat incentive will be designed to incentivise commercial opportunities for renewable heat technologies, including biomass boiler installations, and it is expected that arising from that, new opportunities will open up for biomass feedstock producers and in regard to anaerobic digestion.

I wish to advise the Deputy that an investment of this nature by Bord na Móna is subject to ministerial approval from both myself and the Minister for Public Expenditure and Reform as the shareholding Ministers. Any request for ministerial consent would be subject to detailed financial analysis by NewERA and policy analysis by the shareholding Departments, including my Department. Such an assessment would consider all options to source biomass. At this juncture, there has been no formal request for ministerial consent in respect of this project.

In response to the Deputy’s statement that similar raw material could be available here in Ireland, I am advised that international supply chains would be required, in the short and possibly medium term, in order to meet the demand created by ramped up biomass co-firing for power and the new and expanded combined heat and power, CHP, plants across the country, particularly as a result of the forthcoming renewable heat incentive, RHI. The long-term strategy is to maximise the volume of biomass produced indigenously.

The Government is fully committed to transitioning to a low carbon energy future and the 2015 energy White Paper and the recently published National Mitigation Plan set out a clear policy framework for that.

While domestic biomass supply is currently limited, this is an area where Bord na Móna BioEnergy can play a role by encouraging growth and assisting producers in the mobilisation and optimisation of their energy crops. These measures will assist indigenous biomass producers in establishing a new source of income.

I am afraid the Minister will not have time to finish; the four minutes are up. I am sorry about that, unless Deputy Cahill wants to give his two minutes to the Minister.

The Minister's reply is welcome. That he still has not given ministerial approval to this planned investment is welcome also. We can have an Irish solution to this problem and that is what will benefit rural Ireland. That is the essence in terms of the reason these semi-State companies were founded. I accept the Minister's reply.

Currently, the average stocking rate is 80 kg/ha, which means that in terms of efficiency, we are using only 50% of our land. We have huge potential to grow energy crops in the agri-sector. We can develop this to benefit rural Ireland greatly. We have serious problems attracting investment into rural Ireland and this is an opportunity I do not want to see Bord na Móna let pass by.

The Minister's reply is along the lines of where I had hoped the Government's policy would be trying to take Bord na Móna and the biomass industry.

The sustainability of our food production is key to us. We see the problems the Dutch are experiencing with various environmental restrictions. We can take shortcuts to prevent this country going down that same cul-de-sac, and energy crops will have a huge part to play in that development in the future and in giving assurance to the consumer, and to the world, that we are producing food in a sustainable and environmentally friendly way.

This opportunity might not knock again. We have the ingredients to do this in rural Ireland. I welcome the Minister's reply and the initiatives coming from the Government. We can make this work for rural Ireland.

To finish what I was saying earlier, I reiterate that my focus is on fostering the sustainable production of biomass in Ireland. Any actions taken in terms of the sourcing of biomass from abroad should be evaluated in the context of the capacity of the Irish biomass market, and my long-term objective is to ensure that biomass used in Ireland is grown as close as possible to the end user.

I was involved in a debate at the ploughing championships last week with the chief executive of Bord na Móna, Mike Quinn. He made it crystal clear that the company will import one tonne less of biomass for every tonne of biomass that can be sourced here in Ireland.

We are all singing from the same hymn sheet on this issue. The two big users of biomass in the short term are Lanesborough and Shannonbridge power stations, which are on the edge of my constituency. There is a huge opportunity for local farmers to supply those, but the demand will happen before the yield comes on those crops. We need to work with the Department of Agriculture, Food and the Marine on establishment grants and get these crops up and running, but we need to source biomass in the short term to meet the immediate demand. If we do not put a clear supply chain in place, there will not be the demand for the product when the farmers have grown it. That is what happened previously. We do not want that system to arise again.

The Deputy raised the issue of the staff in Littleton. Two issues arise, the first of which is the staff redundancies. I have been actively engaged with both the company and the Minister for Public Expenditure and Reform on that issue. Second, I still believe there is a strong opportunity on that site to develop alternative industries, perhaps along the lines of what we have been speaking about here. I am happy to have a more detailed debate on all the strands we are now putting in place to develop the biomass renewable energy sector. I am happy to have that in the House or at a committee at any stage.

Drug Treatment Programmes Availability

It is nice to have the opportunity to speak about this issue again with the Minister of State, but I am disappointed there has been no movement regarding drug treatment services or the setting up of a proper drug treatment centre in Kildare. Given Kildare has a population of 220,000 - 120,000 in north Kildare and approximately 90,000 in south Kildare - it is not good enough or acceptable that these resources are not in place. This has been an ongoing issue that I have raised in the Chamber with the Minister of State for over a year. I do not like having to reintroduce it into the House but I must try to have it progressed. Even in correspondence from the Minister of State herself, the Department and HSE officials, they have identified the lack of resources regarding a drug treatment centre in Kildare as urgent and a priority. That is the way they have categorised it. They have also identified that they had hoped to put the service in place in the last quarter of 2017. That is what was stated in the correspondence I received from the Department. Now we are in that quarter and, to the best of my knowledge, the service has not been put in place and there is not the wherewithal to make it happen anytime soon. That is unfortunate, extremely disappointing and no longer acceptable or good enough. At present our nearest drug centre is in Dublin, and the HSE will tell us when we make representations on behalf of individuals who need this urgent drug treatment service that there is a nine-month waiting list. That is wrong. I have factual information to show that people are waiting up to 18 months. They are deemed urgent, important or critical but they are still waiting up to 18 months and have not got the service they require. I have advocated for some time for community groups such as the Abbey Community Project Celbridge to get some State funding. It is currently without any State funding. The only support it gets is bucket collections. I hope this can be moved on and we can support such groups to help in cases such as these where dual diagnosis is required.

This feeds into the area of mental health, which we know is another area of critical need and support. These community groups are the people providing the services to help these individuals who require these drug treatment services and support which is not being provided. Four different families have contacted me in the past week whose loved ones were deemed suicidal, and the only service offered to them is referral to an accident and emergency department. We all know that the accident and emergency departments are not adequately equipped, do not have the appropriate supports and probably do not have the proper staff to deal with these individual priority cases that are specialised. They must be retained and managed there until such time as the necessary support and resources become available. They are being treated in an environment that is not good for them and is adding further stress to them and their families, not to mention the fact they are taking up resources, such as hospital beds, that may be urgently required for patients who need that care and attention.

I hope I have painted the picture, which I regret to have to do again only a short few months since last raising this issue in this House. The fundamental issue is when this drug treatment service and support will be put in place for Kildare and where it will be located. The latter is important from an access perspective. It should not be located in either extreme of the county. For individuals and families who are really struggling and need to access this service, sitting around waiting 18 months for it is not good enough. Being told they must travel to Dublin, where they cannot access support very easily because of infrastructure and a lack of transport at times, is not easy either. I await the Minister of State's reply.

I thank Deputy O'Rourke for raising the issue of the provision of a drug treatment centre in Kildare. As the Deputy is aware, problem drug use continues to be one of the most significant challenges facing our country and is becoming more complex with a wider range of drugs being abused.

I wish to emphasise the Government’s commitment to tackling the drug problem. In July this year, together with the Taoiseach and the Minister for Health, I launched Reducing Harm, Supporting Recovery: A Health-led Response to Drug and Alcohol Use in Ireland 2017-2025. This document sets out the Government's strategy to address the harm caused by substance misuse in our society up to 2025. The vision of the strategy is to create a healthier and safer Ireland. Reducing Harm, Supporting Recovery emphasises a health-led response to drug and alcohol use in Ireland, which is based on providing safe, person-centred services that promote rehabilitation and recovery. It contains a series of actions which aim to reduce waiting times, provide greater equity of access to services around the country and remove potential barriers to accessing treatment by those with complex needs. Specifically, Reducing Harm, Supporting Recovery requires the HSE to identify and address gaps in provision in a range of settings across the country, including tier 3 treatment and rehabilitation services which provide specialist interventions, such as opioid substitution treatments. The intention is to increase the number of treatment episodes provided across the range of services available and strengthen the capacity of services for individuals with high support needs. As part its commitment under the strategy, the HSE will also examine potential mechanisms to increase access to opioid substitution treatments.

During 2017 in the region of €700,000 in funding has been allocated by the HSE to voluntary organisations in the South Western Regional Drug and Alcohol Task Force area, which includes Kildare, to help individuals with substance misuse problems and their families. In addition, the HSE provides counselling and outreach services in a number of locations in Kildare. A total of 112 people are currently accessing specialised services provided by level 1 and level 2 general practitioners, 145 people are accessing services through community pharmacies in Kildare and 74 people travel to Dublin for specialist treatment. At the end of July, 25 Kildare residents were on the national methadone waiting list.

The Department of Health is seeking resources in the Estimates process for 2018 to support the implementation of the new strategy. The outcome of this process will determine the funding available to address gaps in the provision of treatment and rehabilitation services. The question of a dedicated specialist treatment centre for Kildare will be considered in this context.

I thank the Minister of State for her reply. With the greatest of respect to the Minister of State, I am still without much detail and I would much prefer to discuss this with her without a stock reply because that would have much more meaning and substance. The reality is that the information she has given me I have received from her on numerous occasions during the past year. I am well aware of not only the number of people who have been treated through GPs and pharmacies, but also the increasing number that must be treated in Dublin. The problem is that a number of families have been waiting 18 months to get on a methadone programme. I have made numerous representations on behalf of these families and they are still no further on. Some of them this week have presented as suicidal. That is the crux of the matter.

I know the Minister of State is well-meaning and I understand she will try to do her best but I have been patient with the Government and her Department in this regard. I have correspondence dating back 12 months telling me this will happen, all things being equal, in the last quarter of 2017. Families have struggled, they have been patient and they have waited in the hope that this much-needed service will be provided. However, we still have no comfort this evening for the families sitting at home looking after loved ones who are waiting to get on one of these methadone programmes, who have been on a list for 18 months and who are at their wits' end, threatening suicide. That is the problem. While the Department waits to deliver the treatment service and treatment centre in Kildare, I respectfully ask the Minister of State to increase the resources in order that the people in need of this service in Kildare can access it as a matter of urgency. Perhaps she would do that for me as a matter of urgency. There are people who need this service, and it is not me identifying this need; clinical analysis has been done showing this need to access services. Will the Minister of State therefore increase the investment in this area to get these people the service they need next week while waiting to get the much-needed service into Kildare that we have been promised?

As I already said in my reply to the Deputy, one of the actions as part of the new strategy focuses directly on Kildare as well as a number of other areas as regards increasing the service on the ground. One of the problems that has arisen over the past couple of months is getting other tier 1 and tier 2 doctors to participate in methadone distribution and other services.

I can only guarantee that, through the new strategy, we will be looking at all of the different areas, particularly Kildare, which I guarantee the Deputy is on the list. If he has relevant information regarding people who are waiting 18 months, I would like to see that information because I need to follow it up. Nothing has come across my desk since I have been given this job to suggest people are waiting that long. I could understand a matter of weeks or maybe three months but I have seen nothing longer. If the Deputy provides the information, I will look into it in the next couple of days and come back to him personally through my office.

As I have explained, there are a number of people in the services in Kildare. I know we are facing challenges on the ground, given the growing number of people, particularly younger people, who are dabbling in very harmful drugs that not only alter their mind but can potentially cause death. I will talk to Deputy O'Rourke about that. I would like to know about those people he says are waiting 18 months for a service because that should not be the cause. I will do my best to try to intervene in the matter in the next couple of weeks.

The service the Deputy raises is very much needed, and I do not deny that. A large sum of money is going into task forces throughout the country to deal with people at a local level. The Deputy is correct that services on the ground need to be more focused, particularly around centres that people can access, and not just during the day. We need to look at services for young people during the evening, when the potential for them to take illegal drugs is greater. The Deputy can come back to me on this.

Hospital Charges

In recent weeks a letter has been sent out by the HSE to haemochromatosis patients throughout County Louth informing them of a new charge to attend appointments in the venesection clinic. As and from 1 September, an €80 charge per visit will apply, up to a maximum of €800 per year, for visits to the clinic. I believe the Minister of State will accept that the imposition of this charge will deter patients who do not have the financial means from attending the clinic. It puts an unfair financial burden on people. While medical card patients are covered, for those who may be just slightly over the medical card limit, €800 is both an exorbitant and disgraceful amount to ask patients to pay.

As the Minister of State knows, haemochromatosis is a lifelong illness. Iron overload is not curable. If patients have genetic haemochromatosis, they will need to be monitored and treated for the rest of their lives. It is very serious illness if it is not monitored regularly and treated accordingly. For example, if it goes untreated, it can affect major organs such as the heart, the liver and the pancreas, and it can eventually be fatal. Therefore, the importance of regular monitoring of patients with haemochromatosis is crucial. To impose a charge of €80 per visit to the clinic without taking into account the financial means of a patient is reckless. Will the Government include haemochromatosis on the long-term illness scheme?

I am taking this matter on behalf of the Minister, Deputy Simon Harris. I wish to thank Deputy Munster for raising this issue. I will address the charges for patients for venesections first. The Health Act 1970, as amended, provides that all people ordinarily resident in Ireland are entitled, subject to certain charges, to public inpatient hospital services, including consultant services, and to public outpatient hospital services. Under the Health (Amendment) Act 2013, a person who has been referred to a hospital for an inpatient service, including that provided on a day-case basis, is required to pay the statutory daily charge, currently €80 per day, up to a maximum of €800 per year. On this basis, where venesection for haemochromatosis is classed as a day-case procedure and is not carried out in an outpatient setting, the public inpatient charge applies. However, it is a matter for a treating clinician to decide how venesection for haemochromatosis is provided. It should be noted there are a number of exemptions to the public inpatient charge, including exemptions for medical card holders.

The Deputy may also be aware of the ongoing review of the GMS and other publicly-funded contracts involving GPs, and that the next phase of discussions to progress this work is under way. The aim is to develop a contract which has a population health focus, providing in particular for health promotion and disease prevention and for the structured ongoing care of chronic conditions. It is expected that the issue of venesection services for patients with haemochromatosis will be considered in the context of the overall GP contract review process.

In addition, the Irish Blood Transfusion Service, IBTS, has been running a haemochromatosis clinic in the Stillorgan blood donation clinic since 2007 and sees approximately 600 patients annually. In this clinic the IBTS only accepts hereditary haemochromatosis patients who are eligible to donate blood. In 2013 and 2014 the IBTS also commenced provision of a programme for hereditary haemochromatosis patients in its clinics at D’Olier Street in Dublin and St. Finbarr's Hospital in Cork, respectively. The clinics provide venesection at no cost to patients with a prescription from their treating clinician. The venesection would be performed, regardless of whether patients wanted to have their unit converted to a blood donation.

In regard to the inclusion of haemochromatosis on the long-term illness scheme, the scheme was established under section 59(3) of the Health Act 1970, as amended. There are 16 conditions covered by the long-term illness scheme but haemochromatosis is not included. Under the long-term illness scheme, patients receive drugs, medicines and medical and surgical appliances directly related to the treatment of their illness, free of charge. There are no plans to extend the list of conditions covered by the scheme.

It is very disappointing there are no plans to include patients with haemochromatosis on the long-term illness scheme, particularly given it is a lifelong illness, is not curable and needs regular monitoring and treatment, and given the fact it can lead to failure of vital organs and can be fatal if not regularly monitored. The response given is from the Minister and the Department. What the Government is saying is that it is fully happy to put a financial obstacle in the way of patients in regard to ongoing treatment for a serious illness and that it does not see the need to include this in the long-term illness scheme. It is happy with the fact patients may not have the financial means to attend a clinic with €80 stuffed in their pocket for the privilege. The Government is saying that is okay; it is acceptable.

The procedure itself takes a maximum of 30 minutes for the blood to be drawn down. The blood pressure is then checked and if it is okay, the patient is told to come back in a month. This means the patient is less than an hour in a bed but is being charged €80 for that privilege. It is grossly unfair. What the hell are we paying PRSI for if we have to pay every time we access a health service in hospital? Where is it going if it is not going towards patient care, preventive measures and medicines? What are we paying it for? Where has it gone?

I ask the Minister for Health to reconsider this given it is a lifelong condition.

Iron overload is not a curable condition and this new measure of imposing this charge will put a financial burden on people and will deter them. The objective of any health service should be about preventative measures and not deterring people because of their financial means.

As I have explained in the reply from the Minister's office, there is no intention at present to provide the service free of charge for those patients. The service is provided, however, under the medical card to many other people with different long-term illnesses. According to the Minister for Health and the Department, there is no intention at present to include it on the list in to the future. I will bring back the Deputy's reasons and concerns regarding this issue, on which she has spoken so well, to the Minister and I will explain in detail the Deputy's response. I will ask the Minister to revert to Deputy Munster.

Hospital Facilities

I will take this Topical Issue on behalf of the Minister for Health.

I have no difficulty with that, as long as I get an answer.

I wish to raise the issue of the closure of two operating theatres in Merlin Park University Hospital in Galway, which is the sister hospital to University Hospital Galway. The two orthopaedic theatres that have closed for a number of weeks happen to have the longest waiting lists and in recent years, a former consultant has referred to the fact that he was dealing with patients from the last century, bearing in mind that we now are in the second decade of the 21st century.

It is bad enough that the two theatres are closed as a result of a leak but none of us can figure out how the leak was not detected before this, as there was an inspection of the building in 2016. Patients have been left completely at a loss and to bring home the acuteness of this issue to the Minister of State, a mother has written to me about her 20 year old son. He has completed three years at college and took one year out to get a full hip replacement at the age of 20. She has no idea when this operation will happen. He is in receipt of disability allowance at present and this woman is at her wits' end. She and her son have discussed it with the consultant, who informed them that he has no idea as to what is happening, is totally frustrated with the system and that communication seems to be totally absent on this matter. We are reliant on bulletins from the local radio station. We know from this that 60 patients - at the very least - are having their procedures cancelled each week.

This is one specific issue that comes on top of a creaking system, as I highlighted earlier today to the Minister for Health. It would be bad enough were we simply dealing with an exceptional situation but I am afraid it is another symptom in a system that is simply not able to cope. This is why I asked earlier for a specific response with regard to the planning for a new hospital.

We seem to go from crisis to crisis in Galway in this regard. I take no pleasure from standing here today to highlight the bad state of the public health services in Galway. I am firm champion of the public health service. I believe in it passionately. I have seen the good and the bad of it. I have had personal experience of the bad side of it with my family, which is ongoing. These problems have been created by Government after Government who have failed utterly to fund the system and failed utterly to hold to account the Health Service Executive, HSE, in respect of what it is doing there.

To go back to specifics, will the Minister of State explain when the theatres closed? Why did they close? When will they re-open? What is happening in the meantime? What is the communication strategy for the patients who are waiting? What numbers of patients are waiting? At the very least this is basic information that should be at the Minister of State's fingertips and if it is not, my question will be to ask why the Health Service Executive has not come forward with all the facts and a plan of action.

I thank Deputy Connolly for raising this very serious issue. Saolta University Health Care Group has advised that on 4 September, a leak developed in the roof of a building in Merlin Park University Hospital that houses the hospital’s two orthopaedic theatres. Hospital management temporarily suspended operations for a week to allow the University Hospital Galway building and maintenance unit to make repairs. A second leak was noted on 13 September, however, and the Saolta group advises that a multidisciplinary team consisting of members of the hospital’s management and infection control teams, as well as the HSE, immediately decided in the interest of patient safety to suspend operations in the two theatres. This was done to allow a full assessment of the infrastructural damage and the development of a plan for repairs. As a result, elective orthopaedic surgeries are now being deferred at Merlin Park. Hospital management has contacted patients individually to apologise and provide assurances that their treatment will be rescheduled. It should he noted, however, that no emergency patients have been affected. I am very conscious of the upset and inconvenience that this closure is causing for both patients and their families while the theatres remain closed.

Saolta and the University Hospital Galway management team have engaged an external engineering firm to carry out a full assessment of the damage and to provide a timeframe for the completion of repairs. They are also exploring a range of potential interim solutions including the use of modular theatres, assessing the scope to utilise other theatre capacity in University Hospital Galway and potential outsourcing of some services to the private hospital sector. Saolta and the University Hospital Galway management team have both been in regular contact with the Department of Health to provide updates on the situation at Merlin Park hospital. The Department has requested that the Saolta group formulate and implement a contingency plan to address this incident and the Minister for Health is due to have a meeting with local management on this issue next week.

I assure Members that reducing waiting times for the longest-waiting patients is one of the Government’s key priorities. Consequently, budget 2017 allocated €20 million to the National Treatment Purchase Fund, NTPF, rising to €55 million in 2018. In order to reduce the numbers of long-waiting patients, the HSE, working closely with the NTPF, is currently implementing waiting list action plans for 2017. The inpatient and day-case waiting list action plan is being delivered through a combination of normal hospital activity and in-sourcing and outsourcing waiting list initiatives under the NTPF funding. The NTPF has advised that under its waiting list initiatives, to date approximately 6,000 patients have been authorised for treatment in private hospitals and nearly 3,000 have been authorised for treatment in public hospitals. Of these patients, more than 3,000 have accepted an offer of treatment and some 1,500 have already been treated. Under the NTPF in-sourcing initiative, there has been a particular focus on patients needing orthopaedic procedures and engagement is ongoing with the NTPF with regard to Merlin Park hospital. I will revert to the Deputy on some of the other issues after her response.

I thank the Minister of State for some of the clarification given. On 4 September there was a leak and on 13 September there was a further leak. This facility is a centre of excellence serving nearly 1 million people, if we take in the catchment under Saolta from Letterkenny down to Galway, as well as patients who come from County Clare, which is outside the area. This is a centre of excellence serving 1 million people but a roof is leaking in Merlin Park hospital, where the waiting list was extraordinarily high in the first place. The figures are absent from this response. How many procedures have been put off? How many patients have been affected? Surely this is the most basic thing that should be communicated, together with a full apology. The capacity of the university hospital is number one on the risk register. I shall repeat that; the capacity of the regional hospital, which apparently is in a better state than Merlin Park hospital, is number one on the risk register, as compiled by the hospital. This is why a new hospital in Galway is being sought. Then there is Merlin Park hospital, with extraordinary outpatient lists and people who are in pain. I have only read out one example. I want to work with the Government and I want to champion public health services but this does not help in any way. The HSE could have explained that 1,000 or 500 or 200 patients were waiting and it could have set out what it intended to do and that it would only be a matter of a few weeks. The executive could have clarified that when the hospital was assessed in 2016 the leak was not apparent or was apparent but was ignored. These are basic communication skills in order that we can reassure people and not insult them. I do not mean the Minister of State is insulting them; I realise she is doing her best with this answer. I welcome the fact that the Minister is going to Galway.

Certainly, I would like further details on the contingency plan, what it means, where patients will be treated, how many will be treated and how long they will have to wait. They should also receive a full apology from the Health Service Executive.

I acknowledge the concerns and frustration of the Deputy. Unfortunately, this situation was unforeseen. I acknowledge the matter has gone on for some time but the Minister explained he will be visiting this week. What plan will be put in place will become more apparent at that stage as will the position regarding cancelled procedures and which patients will be brought into the system. I have given the Deputy all the estimated numbers I have here. I cannot give her anything different. I note that on 19 September, the Saolta group said 80 patients had been impacted by this issue. They have been contacted and advised that their procedures will be deferred and rescheduled at a later date. The Saolta group also estimates that 60 patients per week are generally treated in the theatres concerned. As such, there has been a huge impact on an overburdened health service. People with orthopaedic illnesses who need surgery must be attended to as quickly as possible.

I will bring the Deputy's concerns to the attention of the Minister. I emphasise that after he meets the representatives of the hospital group, the Minister will come back to the Deputy with a proper outline of the plan for patient treatment over the coming months and weeks, however long it takes to repair the hospital roof. There may also be other necessary repairs which have to be done and that may add to the time it takes. I will go to the Minister and ask him to respond specifically to the Deputy on this matter when he returns from meeting people in Galway University Hospital.