Seanad Éireann díospóireacht -
Wednesday, 31 May 2006

Vol. 183 No. 21

Adjournment Matters.

Hospital Services.

Mr. McHugh

I welcome the Minister of State, Deputy Tim O'Malley, to the House again tonight. He is a busy man as he was also here last night on the Adjournment. The Minister of State is probably aware of the high profile campaign on cancer services which has been ongoing for some time in the north west. The campaign covers retention of current cancer services and also considers the expansion of a range of ancillary cancer services for the people of the north west. I will not cover old ground I have previously covered with the Minister of State. As he is aware, proposals have been made for radiotherapy centres in Waterford and Limerick. We have existing services in Dublin, Cork and Galway. The north west is completely disenfranchised in terms of an equitable radiotherapy service. We are aware of arrangements with Belfast for patients from County Donegal, with the proviso that bed space must be available. However, Northern Ireland has a jurisdiction that caters for 1.5 million people. Belfast is not and will not be a centre to cater for the needs of the people of the north west. It is incumbent, therefore, on the Government to provide a satellite radiation centre in the north west because it is pivotal to the needs of the people there. It would cost €15 million to set up the centre. A key meeting will take place on 6 June between administrators of Altnagelvin, Galway and Letterkenny hospitals to discuss the potential of sharing services and the permanent appointment of a breast consultant surgeon in the north west.

At primary level, breast screening is not provided in the region. Donegal women do not have that luxury or option similar to women in the east. At secondary level, the appointment of a permanent breast consultant surgeon at Letterkenny General Hospital is urgently needed and this call is being echoed loudly and clearly by the people of Donegal. Recently, a demonstration took place in the town on a wet Sunday afternoon. More than 15,000 people turned up to highlight their frustration and anger and to demand equitable health services for their peers and families in the region. A radiation service must be provided at tertiary level. A satellite radiation unit is needed, which could operate on an east-west basis between Altnagelvin and Letterkenny hospitals and which could also incorporate Galway and Sligo hospitals.

Cancer patients are acutely aware that all specialist services cannot be sporadically provided throughout the State on a piecemeal basis. People appreciate such services must be located centrally where the expertise is available. All we are looking for in the north west is a level playing field and appropriate cancer services. Will the Minister of State intervene prior to the meeting on 6 June? The Minister for Health and Children visited Letterkenny last Monday and stated there would be an outcome after 23 June. However, between now and then, we need to know where we stand regarding the facilities that will be provided in the region.

A range of people are involved in this process. Ultimately the patient is the key part of the equation but the Government and the administrative and nursing staff and consultants are also involved. What is the consultants' favoured option regarding the relationship between Letterkenny, Altnagelvin, Galway and Sligo hospitals? We need to know where the consultants and the Government stand because nobody is standing at the moment. Everybody is sitting down and they are not delivering. A pathway needs to be found so we know where we are going in this regard.

Minister of State at the Department of Health and Children (Mr. T. O’Malley)

I welcome the opportunity to address the issues raised by the Senator and to set out the current position on the development of services in the north west and at Letterkenny General Hospital, LGH, in particular. Since 1997 cumulative funding of more than €47 million has been allocated to the north western area for the development of appropriate treatment and care services for people with cancer.

Cancer services at LGH are provided by a team of consultants and other professionals as follows: four consultant surgeons; one consultant medical oncologist; one consultant haematologist; one palliative care consultant; three consultant pathologists; six consultant radiologists; two senior pharmacists — specialists in oncology drugs preparation; a range of specialist nurse staff; and one consultant radiotherapist, three days per month. An 11-bed oncology ward was recently completed and officially opened by the Minister on Monday last. This development is supported by an oncology day case area, breast care suite and a clean air pharmaceutical preparation room.

The Senator raised the question of additional beds for LGH. The provision of a 30-bed modular short-stay ward at the hospital has been announced and this project will be funded from the accident and emergency department initiative moneys. Planning permission is being sought with contractor procurement being carried out over the next few months. These additional beds will alleviate the overcrowding experienced in the emergency department and day services unit. This will result in enhanced patient experience, and facilitate a return to full capacity of the day services unit. It is intended that these beds will be available to the hospital for the coming winter period.

A new purpose-built emergency department and 12-bay medical assessment unit is at design stage. This unit incorporates a dedicated X-ray room to improve diagnostic services within the department. It is intended that the planning application for this development will be submitted before year end. The capital plan of the HSE, recently agreed by the Minister, includes provision for additional ward space over the proposed new emergency department, which will be incorporated into the overall project.

When the Minister visited the Donegal area earlier this week she said:

Everyone in this country, regardless of where they live, should have access to the best possible health services. This is especially so for cancer services. The most important thing for patients is getting the best treatment. Outcomes for patients drives our policy and investment in cancer care. I am determined that everyone diagnosed with cancer will get top quality treatment, as near to their home as possible.

The Minister and I remain confident that the HSE can achieve these objectives.

The Senator raised the appointment of a permanent breast surgeon at LGH. A standalone breast service at the hospital is not an option as it does not, according to recognised cancer experts, have a large enough volume of new patients with breast cancer to achieve the high quality of services to which the women of the area are entitled. The HSE's preferred option is a partnership to be developed between Altnagelvin Hospital in Derry and LGH. There are strong links between these two hospitals and Altnagelvin Hospital is wholly committed to developing a workable solution with LGH. A process of discussion is in place.

The director of the National Hospitals Office and the network manager for the HSE western area are to meet with the respective management and clinical teams next week to seek to progress a partnership arrangement that can develop the best breast care in the region. It is understood that the model of care being sought will include combined multidisciplinary team meetings to discuss patients in both jurisdictions. Decisions on each patient will be examined collectively, involving the appropriate treatment and follow up. The HSE advises that it will also explore the option of a similar model with University College Hospital, Galway.

Consultant staff at Letterkenny General Hospital will refuse, as of tomorrow, to accept new referrals of breast cancer cases. Discussions at hospital level have taken place to seek a deferral of this action. Last Friday, the director of the National Hospitals Office wrote to the chairman of the medical board at the hospital advising that the HSE is pursuing a resolution of the issue of how best to provide breast cancer care to the population of Donegal. The director gave a commitment that the matter will be drawn to a definitive conclusion before the end of June, a little more than four weeks away. The Minister has urged HSE management to complete discussions on the future organisation of breast services by this date. The director also asked that any proposition to cease existing services from tomorrow should be withdrawn in the interests of assuring best patient care. However, medical consultants refused to rescind their decision.

The HSE, in the interests of women who will be diagnosed with breast cancer from tomorrow in Donegal, is making alternative arrangements. This is essential to ensure a service is maintained for women in Donegal with breast cancer.

I consider the action of a small number of medical consultants to be most regrettable, especially given that the HSE is making significant efforts to resolve the issue in the interest of women with breast cancer. I urge the consultants involved to reconsider their decision and to participate fully in the discussions next week. These discussions should take place in a positive environment and not against the backdrop of a refusal to provide services to vulnerable patients.

The Tánaiste met with representatives of BreastCheck and they are fully aware of her wish to roll out a quality assured programme to the country's remaining regions as quickly as possible. Additional Exchequer funding of €2.3 million has been made available to BreastCheck to meet the additional costs involved. The Tánaiste also approved an additional 69 posts and BreastCheck is in the process of recruiting essential staff. BreastCheck recently appointed clinical directors for the south and west, who will take up their positions later this year. Additional capital funding of €21 million has been made available to construct two new clinical units in the southern and western regions and to provide five additional mobile units and state-of-the-art digital equipment. BreastCheck is in the process of short-listing applicants to construct these units and is confident it will meet next year's target date for roll-out to the southern and western regions.

In coming years, nearly €50 million will be invested in health facilities in County Donegal, including nearly €28 million for additional beds and a new accident and emergency department at the hospital. Since 1997, this Government has quadrupled the budget of Letterkenny General Hospital and enabled the appointment of more than 550 additional staff. That is a clear expression of our confidence in the health services for County Donegal and we will spend more on further improving the services for Donegal people in coming years.

Flood Relief.

Mr. Moylan

I welcome the Minister of State, Deputy Tim O'Malley, to the House. I am calling on the Minister for Finance to take urgent action to alleviate the serious financial losses incurred by farmers in the Shannon callows area of County Offaly following the flooding of their farmland. In the past, when problems arose in other parts of the country, aid schemes were administered by the OPW.

Some of the television coverage of the flooding was not appropriate. Cattle were depicted as standing in water but farmers in my area would turn their livestock to the roads in preference to leaving them in water. I do not doubt that farmers would refute allegations that they left cattle to stand in water. The only option open to many of them when their lands flooded was to put their stock on uplands intended for hay or silage. These farmers will face real hardships later this year because of the loss of these crops. The Department of Finance should instruct Teagasc to determine who exactly has been affected because farmers who cut hay and silage later in the year will not suffer as much as farmers whose grazing lands were completely flooded and who had no option but to move sheep and cattle elsewhere.

I am aware that the Shannon will never be drained because, if a Minister made any suggestion to that effect, environmentalists would dig in along the side of the river to stop the project. Substantial amounts of money have been spent in the callows to preserve corncrakes but these birds were also affected by the flooding. Farmers and their livelihoods must come first.

While I refer this evening to County Offaly, counties Roscommon, Galway, Westmeath and other low-lying areas of the Shannon basin have also been affected. Nonetheless, the farmers I represent in west County Offaly face particular difficulties.

Mr. T. O’Malley

I am replying to this Adjournment debate on behalf of the Minister of State at the Department of Finance, Deputy Parlon, who is unable to attend the House due to another commitment. The Minister of State has asked me to apologise for his unavoidable absence.

The Shannon is the longest river in Ireland and one of the largest in western Europe. The river drains a catchment of 14,700 sq km to the Shannon Estuary, approximately one fifth the area of Ireland. It is characterised by relatively steep upper and lower sections and a flatter gradient through its middle reach from Lough Ree to Lough Derg. The low-lying lands surrounding the Shannon, the callows, have experienced regular flooding for centuries, particularly along theriver's middle sections.

The Minister of State and his officials in the OPW are aware of the current level of flooding in the Shannon callows. While winter and occasional summer flooding are features of the callows, severe flooding of the kind currently experienced is not. The recent exceptional flooding is due to May's unusually heavy rainfall. This month may prove to have the highest recorded rainfall for the month of May.

The question of possible compensation for financial losses incurred by farmers as a result of flooding is primarily a matter for the Department of Agriculture and Food. While it is true that the OPW was involved in recent years in overseeing a number of humanitarian aid schemes administered by the Irish Red Cross in the aftermath of severe flooding, these schemes were only introduced on foot of Government decisions in instances where the damage was particularly severe and widespread. The schemes were humanitarian in nature and designed to relieve hardship. They were not compensation for losses. While some of the earlier schemes provided assistance where hardship resulted from damage to businesses and farm buildings, provision of aid in more recent schemes was restricted to hardship resulting from damage to homes only.

The OPW no longer has any responsibility for such Government approved humanitarian aid schemes. This function has been transferred to the Department of Social and Family Affairs, following the recommendations of the interdepartmental flood policy review group. The Government approved the implementation of the group's recommendations in September 2004. The group recommended that the provision of emergency assistance in the aftermath of serious flooding should be limited to situations in which damage has occurred to homes and should be administered by the community welfare services of the regional health boards in conjunction with local community and voluntary groups and non-governmental organisations.

The Office of Public Works has no responsibility for the maintenance of the River Shannon. It would be open to the commissioners, under the provisions of the Arterial Drainage Act 1945 and the Arterial Drainage (Amendment) Act 1995, to prepare a scheme to prevent or substantially reduce flooding in an area. The possibility of undertaking an arterial drainage scheme for the Shannon has been considered on a number of occasions but has been ruled out on economic and environmental grounds.

In 2003, the Commissioners of Public Works undertook a further preliminary assessment of the Shannon flood problem by reviewing the conclusions of previous reports in light of the changes that had occurred to the catchment in the intervening 40 years. The review considered a variety of issues, including conditions and competing uses of the river; perceived changes in climate patterns; changes to agricultural regulations and practices; different economic circumstances for agriculture and other industries; the higher values being placed on environmental and heritage assets; and tourism opportunities, to establish whether a more detailed study might identify viable options to alleviate the flooding problem. It recommended that a pre-feasibility study of possible flood risk management opportunities should be undertaken. That study was completed in late 2004. Copies were given to the stakeholders.

Garda Deployment.

Mr. Browne

I welcome the Minister of State to the House. Local papers in Carlow last week carried front page headlines reading "Lack of gardaí led to closure of station". This was in Carlow town, which has a population of over 20,000 people. In yesterday's Carlow People the chief superintendent admitted there is a major drug problem in Carlow. There is grave concern in Carlow town and county about the manpower levels in the Garda division. There is a view that gardaí have been taken out of the station and diverted into the traffic corps and initiatives such as Operation Anvil. That comes at a cost because Garda numbers have decreased elsewhere.

The Minister's speech writers cite statistics on Garda levels in 1997. The population of Carlow has increased substantially in the past ten years but Garda numbers have not kept up. Unfortunately the increase in population has brought an increase in social problems. Carlow town is one of the fastest growing towns in the country and is almost as big as Kilkenny city. The Minister for Justice, Equality and Law Reform, Deputy McDowell, was in Carlow recently at a launch organised by the Irish Wheelchair Association and saw how big the town is.

It is vital that we have a proper dedicated Garda force with the facilities, resources and manpower to do its job. A serious incident recently occurred at 6.30 a.m. on a Monday which was attended by the only two gardaí on duty, leaving no garda in Carlow Garda station. While this was an isolated and exceptional case, it is worrying. I want the Minister to update us on the Garda manpower levels in the Carlow town area and commit to increasing them substantially in the coming months, especially to make up for any manpower losses as a result of diversions to the traffic corps, the drug squad or Operation Anvil.

Mr. T. O’Malley

The Garda Commissioner is responsible for the detailed allocation of Garda resources, including personnel. The Minister for Justice, Equality and Law Reform has been informed by the Garda authorities that the personnel strength, all ranks, of the Garda Síochána on 31 March 2006 was 12,439. This compares with a total strength of 10,702, all ranks, on 30 June 1997 and represents an increase of 1,737, or 16.2%, in the personnel strength of the force during that period.

The personnel strength, all ranks, of Carlow Garda station on 31 December 1997 and 30 April 2006 was 40 and 57, respectively. This represents an increase of 17, or 43%, in the number of Garda personnel assigned to Carlow Garda station during that period. Carlow Garda station, which is open on a 24-hour basis, is located in the Carlow-Kildare division in the eastern region. The numbers of gardaí, all ranks, stationed in the Carlow-Kildare division on 31 December 1997, 2000, and from 2002 to 2005, inclusive, and on 30 April 2006 were as follows: 1997, 281; 2000, 303; 2002, 323; 2003, 323; 2004, 323; 2005, 331; and 2006, 350. This represents an increase of 69, or 25%, in the number of Garda personnel allocated to the Carlow-Kildare division during that period. The divisional resources are further augmented by a number of Garda national units such as the Garda National Immigration Bureau, GNIB, the Criminal Assets Bureau, CAB, and other specialised units.

It is the responsibility of Garda management to allocate personnel to and within divisions on a priority basis in accordance with the requirements of different areas. These personnel allocations are determined by a number of factors including demographics, crime trends, administrative functions and other operational policing needs. Such allocations are continually monitored and reviewed along with overall policing arrangements and operational strategy. This ensures that optimum use is made of Garda resources and that the best possible service is provided to the public.

The current recruitment drive to increase the strength of the Garda Síochána to 14,000 members, in line with the commitment in An Agreed Programme for Government, is fully on target. This will lead to a combined strength of attested gardaí and recruits in training of 14,000 by the end of this year. As part of the accelerated recruitment campaign to facilitate this record expansion, 1,125 Garda recruits were inducted to the Garda College during 2005. The college will induct a further 1,100 recruits this year and again in 2007 by way of intakes of approximately 275 recruits every quarter. The first incremental increase of newly-attested gardaí under the current programme of accelerated recruitment took place on 16 March this year and a further 275 newly-attested gardaí will come on stream every 90 days thereafter.

The Garda Commissioner will draw up plans on how best to distribute and manage these additional resources, and in this context the needs of Carlow will be given the fullest consideration. An additional nine gardaí are due to be allocated to the Carlow-Kildare division in conjunction with the next incremental increase on 8 June. The Senator will already be aware from earlier this week that the Commissioner has decided to augment Operation Safeguard with the temporary allocation of 275 gardaí who have recently completed training, phase 3, at the Garda College. In addition to providing resources to the operation, it is expected that involvement at an early stage in their career will help focus these young gardaí towards road safety. In conjunction with this allocation, an extra 60 gardaí will be assigned to Garda divisional traffic corps throughout the country, bringing the total full-time dedicated traffic personnel to 685.

The primary focus of Operation Safeguard will be to improve a compliance culture among all road users. Where road users fail to comply with the law, the Garda Síochána is determined to take the appropriate action. Road safety is not solely the responsibility of the Garda Síochána, but each and every road user throughout the country. Many agencies also have statutory responsibility for road safety and the Garda Síochána meets regularly with ail such agencies.

There are plans to build an extension to Carlow Garda station and the Office of Public works is in the process of assembling a design team for the project. While it is not possible to say when the works will commence, there will be no avoidable delay in attending to the accommodation needs of gardaí in Carlow.

The PULSE system is currently available at 231 Garda locations nationwide, including Carlow town. This represents a significant increase over 2005 figures. An additional 50 stations were networked during 2005 and further extension is planned this year, including locations in County Carlow. As well as investing in the expansion of the system, over the past year significant resources have also been invested in upgrading the system to ensure it operates to maximum efficiency. In addition, a major new initiative involving the manner in which data is input to PULSE is currently under way with the establishment of the new Garda information services centre, GISC, at Castlebar, County Mayo. The centre, which is staffed by civilian personnel, allows gardaí at the scene of incidents to report such incidents by mobile phone to call takers at the call centre. This obviates the need for gardaí to return to their stations to report incidents. The system is currently in operation in the southern and south eastern regions and work is under way to extend the system nationwide. These new arrangements will benefit all gardaí, particularly those in non-networked stations. The Minister is confident that these measures, particularly the establishment of the call centre at Castlebar, will ensure gardaí will have access to the requisite information in the most efficient and effective manner possible.

Carlow is one of the 17 locations nationwide forming part of the Garda CCTV programme that remains to be completed. As the Minister for Justice, Equality and Law Reform has indicated previously, he is anxious to accelerate the implementation of this CCTV programme and reduce as far as possible the workload of the Garda Síochána in this regard. He believes that the answer is to outsource the installation of Garda CCTV systems to the greatest extent possible, making use not only of the technical but also of the project management expertise in the private sector.

The Department is currently in consultation with the Department of Finance with a view to proceeding as quickly as possible with the procurement process to contract the project managers and outsourced service providers for the development, installation and management of these CCTV systems. The Minister's ambition is to have a Garda CCTV system operating in Carlow and in the other locations at the earliest opportunity, subject to compliance with relevant procurement legislation and procedures.

The Seanad adjourned at 9.30 p.m. until2.30 p.m. on Friday, 2 June 2006.