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Dáil Éireann díospóireacht -
Wednesday, 25 Sep 2019

Vol. 986 No. 5

Ceisteanna ar Reachtaíocht a Gealladh - Questions on Promised Legislation

I raise the issue of junior cycle history with the Minister, in particular, retaining it as a core compulsory subject. I speak with a degree of knowledge. In 1997 or 1998, prior to my becoming Minister for Education, an attempt was made to remove history as a compulsory subject. I vetoed it on that occasion and stopped it. I am not normally one for interfering and understand the National Council for Curriculum and Assessment, NCCA, must go through its processes. However, history is inextricably bound up with our sense of society, our sense of the past, and has application in a parliamentary democracy. It is imperative that we cultivate and nurture the study of history in schools. If it becomes non-compulsory or is not a core part of the junior certificate cycle, the level of follow-through to the leaving certificate will be even lower. As the humanities are losing out within the education system, I ask the Minister to speak to the Minister for Education and Skills to tell him that there is precedent for him not to take on board the advice of the NCCA in that regard.

As the Deputy noted, the National Council for Curriculum and Assessment undertook a review of this issue because the Minister for Education and Skills had asked it to do so. The Department received the NCCA's report in July and the Minister is giving it full consideration within his Department. It includes consideration of some very useful proposals made by the NCCA for how we can promote the study of history. I take the Deputy's concerns on board and will pass them on to the Minister.

There are reports in the media today of Irish hospitals hiring debt collection agencies to recoup the cost of unpaid bills from patients. It is reported that last year alone, over €500,000 was spent in hiring debt collection agencies. Patients are telling some very upsetting stories about harassment, threats, and strong-arm tactics being employed. They talk about being frightened. They are mainly vulnerable people who are recovering from illness or surgery and the reported behaviour of these agencies is completely and utterly unacceptable. No hospital should be engaging debt collection agencies to pursue in this manner vulnerable patients, many of whom might be in some financial distress. Will the Minister for Health come before the Dáil to make a statement on this issue? I believe it would be merited as this is a serious matter. Will the Minister join me in demanding that hospitals desist from the practice of using debt collection agencies to harass patients?

There is a reasonable expectation that people who can pay for services should pay. Having said that, I do not agree with the type of behaviour about which the Deputy has spoken. There is a need for compassion. People's personal circumstances need to be accounted for. This type of heavy-handed approach is not acceptable. There are those, however, who can pay but will not pay. Some patients also opt for private inpatient services in public hospitals and are liable for a range of private accommodation charges, from which there are no exemptions. We have increased medical card limits in order that many more people can avail of medical cards. We have also introduced free GP care for the under-sixes and over-70s to assist families with medical costs. However, I will bring this matter to the attention of the Minister for Health.

There has been a noticeable deterioration in the quality of the air as one walks around the streets of Dublin, to which sufferers of asthma can attest. Ten times as many people die by air pollution than in road accidents in the European Union. The United Nations has stated the failure of governments across the world, including Ireland, to ensure their citizens can breathe clean air is a violation of the rights to life, health and well-being. The Clean Air Alliance claims that four people die in Ireland each day from the effects of air pollution and that approximately 1,150 premature deaths in Ireland are attributable to air pollution. The Minister previously told me that up to 6 June, 98 breaches of the daily air quality limit had been recorded in the State, of which 65 had occurred in Dublin, including two in the Phoenix Park. The Government is all talk and no action about air pollution, its impact on the ecosystem and climate change. When will we see some action, as opposed to mountains of verbiage?

I am conscious that there have been exceedances of air quality limits. My Department is sitting down with the Department of Transport, Tourism and Sport and the local authorities to identify measures we could take in the short term to tackle the issue. As the Deputy knows, the climate action plan has at its heart the dramatic reduction of our dependence on fossil fuels, which causes much of the air pollution.

Where is the action?

In that context, we are pursuing a strategy to switch to electric vehicles in substantial numbers, to switch to cycling and public transport and to reduce our dependence on fossil fuels across the system. We are conscious that this is an issue of huge public importance and we are putting strategies in place to deliver on it. That is at the heart of what we will be working on in the coming months and years.

I never knew until this week that one could take a flight from Dublin to New York via Damascus. However, that is clearly what the Taoiseach did when he arrived at the UN summit to announce that he favoured banning the exploration of fossil fuels, or one fossil fuel, namely, oil. That is not possible. The Taoiseach received flawed scientific advice from the Climate Change Advisory Council and thinks he can do something he cannot. The only way to leave fossil fuels in the ground, which is what the movement is asking us to do and about which I am sure he heard them screaming right around the planet, is to allow the climate emergencies Bill I put before the Dáil to be passed. As the majority in this House has twice voted democratically in its favour, I ask the Government to issue a money message and allow the Bill to be passed. Otherwise, the Taoiseach's statement is hypocrisy, based on a Damascene conversion, which is no good to anybody. The Government must allow the Bill to be passed if it is serious about banning the exploration of fossil fuels.

There have been strong calls in recent days to listen to the science and take climate action on the basis of scientific solutions put forward as ways of resolving these issues.

Not flawed science.

That is precisely what the Taoiseach has done. He and I wrote to the Climate Change Advisory Council to receive the best scientific advice. It has advised clearly that there is a case for ceasing the exploration for oil but continuing the exploration for gas. The reason is that as we transition from a figure of 30% to 70% for renewable energy and eliminate major polluting fossil fuels such as peat and coal, we will become dependent on gas when the wind does not blow and the sun does not shine.

The Climate Change Advisory Council has clearly cited the supporting evidence and we are going to act on it.

It is flawed and not scientific.

We will be ending the exploration for oil, but we will continue to allow exploration for gas. It would be relevant for Ireland if we could supplement the Corrib gas field from which there is a significant supply to meet our gas needs.

When did we last discover oil?

The Minister could allow the Bill to be passed.

I raise the very serious issue of the mental health crisis in County Tipperary. A Fine Gael Government forced through A Vision for Change and left those of us in County Tipperary bereft of a single long-stay bed for persons with mental health issues. St. Luke's hospital in Kilkenny cannot take them. A Vision for Change promised a lot but delivered nothing. The people of County Tipperary will be taking to the streets in Clonmel next Saturday to demand that the Minister for Health reinstates beds. We have met the Minister of State, Deputy Jim Daly, who I believe is doing his best, but we have got nothing. The crisis house that was promised is not yet complete and we do not have a single nurse. People are being left on the street or sent home to die. In many cases, they take their own life. What is happening to people with mental health issues is a scandal out of all proportion. They are forced into overcrowded emergency departments, not treated or rejected and sent home. Many of them have spoken to me. Fr. Michael Toomey has spoken out on the issue, as have Maurice Cagney, Caroline Tobin and countless others. There are countless stories. We need action now because we cannot wait any longer. We are losing people on a daily basis, including young people.

I thank the Deputy for raising this matter. The HSE's mental health budget has been increased by more than €276 million since 2012. An additional €84 million for mental health services was announced in budget 2019, bringing the total available close to €1 billion, of which some €55 million was provided to progress new developments. I will bring to the Minister's attention the issues raised by the Deputy in his constituency.

In the past few days the prospect of a crash-out Brexit has somewhat receded. In the budget to be announced on 8 October can we expect to see the same level of support for Irish businesses and jobs, which was around €300 million, to be continued in 2020? Despite some recent more hopeful signs, has the Minister's Department costed the worst-case scenario of a crash-out Brexit?

For the past two years I have been working with the Minister for Finance, Deputy Paschal Donohoe, to ensure Ireland will have the necessary supports in place to help businesses to prepare for a hard Brexit. I continue to work with the Minister in preparation of budget 2020. Significant funding has been put in place to support Irish businesses as they prepare for Brexit. In 2018 Enterprise Ireland provided €74 million in grant aid for firms that would be impacted by Brexit. Two funds are available - the Brexit loan scheme fund of €300 million and the future growth loan scheme fund of €300 million. The Deputy knows that I am acutely aware of the importance of protecting jobs. I have established an early warning co-ordination process for firms experiencing difficulty. Working with the Minister for Employment Affairs and Social Protection, Deputy Regina Doherty, and the Minister for Education and Skills, Deputy McHugh, the Intreo offices stand ready to work with employers who are experiencing short-term difficulties. I welcome the announcement made by the European Commission that it proposes to use emergency funds to help countries badly hit by a no-deal Brexit. It follows the engagement between Ireland and the European Union on the matter.

There is a public transport crisis in County Meath. It can often take up to two hours to travel the 30 miles from Navan to Dublin, which means a four-hour commute every day for families. This is on the occasions the bus actually arrives because there are many occasions it will not arrive. When it does arrive, it is full, leaving dozens of people wating at bus stops unable to get to work. This morning the majority of workers left County Meath to work elsewhere. This happens in no other county. Navan is the largest town in the State which is not served by a rail line. We have a serious situation where families are being stuffed in commuting in County Meath. Before the Minister steps into any further photo opportunity on the issue of climate change, will she ensure bus services to my county actually work?

A lot of people commute from County Meath to Dublin. That is why as part of the future jobs initiative, a whole-of-government initiative, I have been looking more at the issue of remote working and developing hubs to where people can come to work in co-working spaces. I accept the Deputy's comments about the difficulties, which I will raise with the Minister for Transport, Tourism and Sport, Deputy Ross. It is about how we can reduce commuting times and improve quality of life. That is why we will put a strong focus on remote working in hubs with co-working spaces.

It is unfortunate that there is no Minister here to represent the Department of Health because many of the questions this morning are directed to that Department. A Programme for a Partnership Government included a commitment to reduce waiting lists and trolley queues. Yesterday there were 600 patients on hospital trolleys, most of whom were elderly people with complex needs. There were 80 patients waiting on hospital trolleys in University Hospital Limerick. Emergency measures are needed to address the specific and unique issues in Limerick. Deputy Kelly referred to the unique structural difficulties. There has been disproportionate underinvestment at Limerick University Hospital - by a figure of 20% - compared to other model four hospitals. As the Minister said, we cannot wait for the winter initiative to address these issues because it will not kick in for three months. I ask the Minister to pass on four requests to the Minister for Health. There is a need for a lifting of the embargo on nurse recruitment at University Hospital Limerick. There is a need for immediate provision of a second MRI scanner in Limerick, which is absolutely essential to allow patients to flow freely through the hospital. There is a need for an immediate release of funds for short and long-term step-down facilities. The Minister also needs to address the consultant manpower deficiency that is slowing down the health service.

I again raise an issue which I will probably raise for the remainder of my time in the Dáil related to University Hospital Limerick. It is a national disgrace and the Minister for Health should intervene personally. He attended the emergency department on 21 August. He told nobody that he was coming; he snuck in and snuck out. Nothing has got better since. In fact, everything has got worse. On Monday there were 81 patients waiting on trolleys, on Tuesday there were 80 and today there are 66. University Hospital Limerick has had 1,200 patients waiting on trolleys in September, 33% up on the figue last year, and the month is not yet over. We want to know what actions the Minister will take. He has said there is no recruitment embargo at the hospital, but obviously there is. We need 100 nurses and want to know when the embargo will be lifted. We want to know when MRI scans will be available as delays are being caused. We want to know when proper home care facilities will be available in order that patients can leave hospital when they are ready to leave. We want a proper answer to that question. The Minister has not come into the Chamber to answer any of these questions, but for the past few weeks he knew that they were coming up. He knew that they would also arise during the Topical Issues debate, but he did not turn up.

The Deputy's time is up.

I expect the Minister to come into the Dáil to make a statement on University Hospital Limerick and to stop hiding from all of us.

As I said, it is acknowledged that trolley numbers in University Hospital Limerick are unacceptably high. The HSE is working actively with the University of Limerick hospital group to ease congestion at the hospital, with the focus on facilitating transfers to level two hospitals, assistance from rehabilitation units and primary care services and the prioritisation of diagnostics to aid inpatient discharges. I will ask the Minister for Health to respond to both Deputies directly.

The primary medical certificate provides relief from vehicle registration tax, VAT, and motor tax to assist people with disabilities in the provision of transport so as to improve their mobility, something we all agree is very important. The qualifying criteria for a primary medical certificate are very strict. Essentially, a person has to be severely and permanently disabled, must be without limbs or without the use of both arms to qualify. In my constituency of Cork South-West I have come across dozens of constituents with severe disabilities, many of whom have been unsuccessful in qualifying for a primary medical certificate. One of the people in question is a lady in her late 80s who is suffering from dementia and is doubly incontinent. While she is not completely wheelchair-bound, she suffers from advanced osteoarthritis and is restricted by stiffness. She cannot get into an ordinary car and has to travel by wheelchair taxi to hospital and dental appointments and so on.

Her family were devastated when she was refused a primary medical certificate. They were told they could appeal the decision but this would require the elderly lady to hire a wheelchair taxi, at great expense, to travel the long and arduous journey from west Cork to Dublin and, having done so, the appeal would most likely be unsuccessful. I am calling for a review of this scheme on the basis that the criteria are too strict and exclude genuine cases of serious disabilities.

We all come across the type of cases mentioned by the Deputy. They are independently medically assessed. As the Deputy is aware, it is an independent process. On the appeal, I understand that occasional appeal sittings are held in Cork, which might be more convenient.

I understand the beef exceptional aid measure, BEAM, scheme is undersubscribed. This scheme needs to be reopened and redefined in terms of eligibility. Many suckler farmers cannot participate in this scheme because one of the criteria is that they must reduce the size of their herd. The average suckler herd farmer in Ireland has approximately 18 cows, with most of those living in and around where I live having only ten or 12 cows. To be eligible for the scheme, these farmers would have to reduce their herd which, in turn, would reduce their income. This disadvantages the smaller farmer. There are also issues arising in regard to the agri-environment options scheme, AEOS. There are many farmers who, when their contracts under this scheme ended, could not access the green low-carbon agri-environment scheme, GLAS. These farmers are now outside of both schemes and they are precluded from entering into the BEAM scheme. The Minister needs to reopen the scheme, change the criteria, reduce the onerous conditions attached to it and ensure that farmers, particularly suckler farmers, have equal access to it.

To add to what Deputy Martin Kenny said, many farmers did not apply for the BEAM scheme because they were not in an environmental scheme. The Minister needs to reopen GLAS to allow these farmers access to it because many of them are losing out on income as a result of not being in it. As stated by Deputy Kenny, they were also precluded from entering the BEAM scheme if they did not meet some of the other criteria as well. There have been problems with this scheme. Following the local elections, it became clear that there was going to be a 5% stock reduction requirement and that take-up has not been what it should be. I would appreciate it were the Minister, Deputy Creed, to update the House on how much of the €100 million has been used in respect of applications to date. Will he give an assurance that the Government will now seek a fund from Europe to cover the period from May until now, when losses were heavier than the reference covered under the BEAM scheme, which was September to May?

I thank the Deputies for raising this matter. The beef exceptional aid measure, BEAM, was approved by the European Commission. Like all measures under the Common Market organisation, CMO, regulation, it comes with specific terms and conditions. We were faced with a requirement at EU level to have a supply reduction element attached to the terms of the scheme. We felt it was best to approach this by way of a reduction in organic nitrates rather than, as portrayed by the Deputies, a simple head count reduction. This allowed for on-farm individualised management of organic nitrates rather than a head count reduction, which, I think, is the most efficient way for farms to benefit under the scheme without being obliged to reduce their herd size. For example, they can manage this by way of selling stock earlier or buying in stock later in order that their organic nitrates load matches the required reduction of 5% over the referred period.

With regard to the requirement that applicants be in an environmental scheme, the criterion is participation in an environmental scheme or a quality assurance scheme. Bord Bia has confirmed that it will accept participation in any quality assurance scheme to enable people to be eligible under the terms of the scheme.

On page 27 of the programme for Government there is a commitment to the establishment of a national register of derelict sites and to using vacant and underutilised sites for housing and urban regeneration. I wish to bring to the attention of the Minister for Housing, Planning and Local Government, Deputy Eoghan Murphy, an anomaly in regard to particular sites. There are hundreds, perhaps thousands, of sites around the country where there has been a developer-led sewage treatment system that Irish Water currently will not take in charge. Therefore, the local authority cannot take them in charge and they remain in limbo. This will have detrimental effects in the future because any estate that is not properly maintained or taken in charge by a local authority will ultimately deteriorate. I ask the Minister to address this anomaly.

I thank the Deputy for the question. On the broader point regarding vacant sites, since the vacant site levy came into force at least 40 sites have moved from vacancy to construction. Only two years ago, we more than doubled the size of that levy.

In regard to water treatment and developed sites, I am meeting officials today in regard to a couple of investment projects that are under way with Irish Water and some priorities that need to be reset to ensure there are no delays in development because of Irish Water connections or responsibilities not being met, either by that body or by the local authorities, following which I will update the House on the matter.

I want to raise the issue of maternity services at Mayo University Hospital and the staffing levels therein, which I have raised previously. Currently, there are 15 whole-time equivalent vacancies in the maternity unit. I appreciate that given the nature of this unit, it is difficult to predict how busy it will be on any given day. According to reports, last week there were insufficient birthing suites to meet need, including a number of emergency cases. The midwives and nurses in this unit are beyond amazing. They dealt with the situation and the care they provided was top class. Demand for this service is ever increasing, with people from all over the region seeking to access it. At the very least, the vacant posts need to be filled without further delay.

I thank the Deputy for raising the matter. Delays in maternity services are unacceptable. I will raise the issue with the Minister, Deputy Harris, and ask him to respond to the Deputy directly.

Carer's allowance and carer's benefit applications are taking up to four months to process. I appreciate that a carer's allowance application takes longer to process owing to the level of documentation to be assessed but carer's benefit applications are based on PRSI contributions and medical evidence and, therefore, should be processed quicker. I have been contacted by a constituent who was granted carer's benefit and was hoping to return to work this month but, sadly, her husband is sicker than they had wished for and she must remain at home longer to care for him. In early July last, she submitted new medical evidence in support of her application and to date she is still awaiting clarification on it and her payment has ceased. The Minister's response will be to submit the constituent's details but that is not good enough. Every Deputy has a list of constituents who have been waiting up to four months for decisions on carer's allowance and carer's benefit applications. This is too long given the people who have given up their jobs to care for their loved ones are in receipt of no payment while they wait.

I agree with the Deputy's comments in regard to the work of carers in terms of caring for family members who are ill. The Deputy also highlighted delays of four months, which I will bring to the attention of the Minister for Health, Deputy Harris. People who take time out from work need to have an income.

I wish to raise the Stardust fire of 38 years ago, in which 48 people were killed. Yesterday, families gathered outside the Attorney General's office expecting an announcement, which they had also expected over the summer months. These families have been seeking answers and an independent inquiry for a long time. They are getting older and they want answers now. I hope that the response of from the Minister, Deputy Humphreys, will be positive news.

I thank the Deputy for raising the matter. This awful disaster occurred in 1981, which is hard to believe. I remember it. The Attorney General is corresponding with the Stardust families this week. I regret I do not have any further information. Obviously, we all understand the difficulties still facing the families.

All Deputies have received representations from constituents who have family members in hospital awaiting discharge, in respect of whom they are seeking home help provision or access to residential care under the fair deal scheme. I will give some figures in this regard. According to the HSE, on Tuesday of last week the number of delayed discharges was 745, which is more than the number of people on trolleys. At that point, approximately 360 of that 745 had been waiting more than a month for discharge and 79 people had been waiting for more than six months.

Let us picture it. Last Tuesday, 79 people who had been ready for discharge before St. Patrick's Day were still in hospital. The problem is significant. In previous replies, the Minister mentioned increased capacity. These people want to move on. They do not want to be in hospital. They want to either move home with the support they need or move to nursing homes or step-down facilities. There are people on delayed discharge for extended periods, not a day or two, which I could understand. Half of that number - 360 people - had been waiting for discharge for more than a month while 79 people had been waiting for discharge since before St. Patrick's Day.

Figures released to our spokesperson on older people, Deputy Butler, show that 325 people in Cavan-Monaghan are waiting on the very service referred to by Deputy Curran, namely, home care supports. Home care supports provide the wraparound service that means people are not in acute hospitals and long-term nursing homes. I have raised this issue on numerous occasions not just with the Minister but with the Taoiseach. People in Cavan-Monaghan are waiting months and somebody has to die before home care supports are put in place. What will this Government do to take those 325 people off the waiting list for these supports?

To follow on from those figures, in March 2019, 105 people in Sligo-Leitrim were waiting for home help. By July, that figure had increased to 227, which is an increase of 122 or 120%. I am sure the numbers have not fallen since then. Yet I speak to people employed full time by the HSE to provide home care whose hours are being reduced. I cannot understand it. It is time for the Government to say whether it will provide home help because that seems to be the way it is. No hours are being provided in Sligo-Leitrim for anybody. As Deputy Curran noted, people have been in hospital for months and cannot get out of there because they have nobody to mind them.

I concur with the Deputies who spoke previously. I know of several people who are waiting for home help. One lady tried to come home but could not manage on her own and went back into hospital, which added to the hospital's waiting list. I ask the Minister to do something about it or to ask the Minister for Health to do something about it. He is doing things he was not asked to do such as giving people a third chance before they are arrested if they have drugs in their possession.

I thank the Deputies who raised this matter. It is something of which I am very conscious, particularly in Cavan-Monaghan. I have raised the matter with the Minister for Health, who is very conscious of it. While the HSE is doing everything it can, we need to do more in this area. I will again raise this issue with the Minister.

In July, the Minister for Housing, Planning and Local Government announced that work was commencing on an electoral commission. Despite the fact that an electoral commission has been promised since 2006 and was recommended by a joint Oireachtas committee in 2016, it is not part of the Government's priority legislation for publication. The Taoiseach has indicated that four by-elections will take place at the end of November, the Government has also published a Bill for a referendum for extending voting rights in presidential elections and there will be a general election as soon as Deputy Micheál Martin stops supporting the Government so the establishment of an electoral commission would be an important step in modernising an outdated system and maximising citizens' participation. Will the Minister for Housing, Planning and Local Government tell us when the general scheme of an electoral commission Bill will be published?

Eight Deputies have not been reached and will be given priority tomorrow.

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