Seanad Éireann díospóireacht -
Thursday, 6 Jul 2006

Vol. 184 No. 13

Adjournment Matters.

Hospital Services.

Mr. Ross

I am raising the issue of the run-down of the capital investment and the Government's commitment to the Adelaide and Meath Hospital in Tallaght. Concerns have been expressed by the hospital as the result of recent decisions. It is not just the recent decision on the location of the proposed national children's hospital. While the Adelaide may be losing its children's hospital, for some time there has been a certain amount of disillusionment in the Adelaide at the Government's commitment to the agreements made in 1996.

The main issue is that of tertiary paediatric care in the hospital and its removal. There is a deep feeling in Tallaght that this will dismember the hospital. The Minister of State will not need any introduction to the fact that Tallaght has the largest growing child population in the country. It also has the highest number of women of child-bearing age. The threats to the child and maternity care in Tallaght are not just serious for the hospital and its prevalent ethos but also to the area. The dangers of emasculating the hospital are serious and difficult to understand.

Two issues must be addressed in the threat to Tallaght Hospital. First, there is the real threat to medical treatment for people in the area and the dangers of a fall in standards in quality and quantity of medical attention, particularly in child and maternity care. There is also the danger to the ethics practised at the Adelaide hospital for so long. It is unique in that it protects for minorities the privacy of the doctor-patient relationship which is not practised in other hospitals. The possibility that some of the facilities will be removed from the Adelaide threatens that particular relationship. This is a sensitive area. It is a matter of parents from minority beliefs having to make decisions on requiring medical treatment that may not be acceptable to other denominations. In the Adelaide's case, it is important the pluralist ethos is not removed from the child and maternity care area.

In 1996, the then Government committed to the hospital's charter and its guarantee of minority rights. The danger now is that it no longer seems to consider the commitment to the guarantee is binding. In the light of the children's issue, will the Government consider the proposal made by officials from the hospital? The proposal stated that if the Government insists on having the main children's hospital in the Mater, there should at least be a ancillary one on Dublin's southside. It is not just because it has the fastest growing population in the country. It is also because there are real dangers to children's health if there is only one hospital in Dublin that can treat certain conditions. Yesterday a doctor informed me that there are dangers of children dying because they will not get across Dublin city in time. That is not an exaggeration. It is essential that the Mater is made a hub hospital and that the spokes are in Bray, west Dublin and north Dublin. I urge the Minister of State to consider that. He might also consider the real issue of Tallaght Hospital having been run down from a promised bed capacity of 800 beds to 513 beds and the crisis of under-feeding that existed in 1989.

I wish to make three brief points. We need paediatric hospitals on both the north side and the south side of Dublin. We also need a maternity hospital to be built on the site of the Adelaide Hospital. In addition, we need 200 new public beds in the Adelaide Hospital, as originally promised. Above all, we need academic development so that, as promised, Tallaght Hospital can have new chairs in radiology, anaesthetics and clinical genetics.

Minister of State at the Department of the Environment, Heritage and Local Government (Mr. N. Ahern)

I will be taking the Adjournment matter on behalf of my colleague, the Tánaiste and Minister for Health and Children, Deputy Harney.

The Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital, AMNCH, was opened in June 1998. The hospital was built at a cost of approximately €180 million and has 588 beds available. It replaced outmoded and inadequate facilities in the base hospital with a modern, state-of-the-art hospital, of which we should all feel proud.

The hospital was funded by the Eastern Regional Health Authority until 2004 and since then it has been funded by the Health Service Executive. The revenue allocation to AMNCH has increased from €63 million in 1997, before the hospital moved to Tallaght, to €192 million in 2006. That is a considerable increase in nine years. This increase compares favourably with the increased revenue allocations to the other Dublin academic teaching hospitals over the same period.

Even in the relatively short period since the hospital opened, a number of capital projects have been completed at the hospital. These include, a new magnetic resonance imaging system, MRI, a picture archiving computer system, PACS, and ICT upgrades. A new symptomatic breast unit has been set up and a specialised breast surgeon is in place since 2002. A total of 28 additional consultant posts have been approved at the hospital since it opened in 1998. These posts include consultancy services in geriatric medicine, palliative care, neurology, and medical oncology.

Additional funding has been allocated to develop cancer services at the hospital. The Tánaiste officially launched the oncology day unit and a new pancreatic unit at the hospital on Friday, 23 June 2006. Given that new units have opened as recently as that, it would give the lie to the assertion that the hospital is being run down. A sum of €1.5 million in capital and €2.2 million in revenue was included in the Tánaiste's ten-point accident and emergency plan to support the development of an acute medical unit at the hospital. Almost €1 million was allocated in 2004 to 2005 for the development of renal services at the hospital.

The service developments I have outlined for the House represent tangible evidence of the Government's commitment to the continued provision of high quality, inclusive, multi-denominational hospital services at the Adelaide and Meath Hospitals, including the children's hospital, in keeping with the ethos of the hospital as outlined in the Adelaide charter.

I apologise as many of the Senator's comments related to the children's unit and this does not appear to have been covered in the reply. It is my understanding that all of the medical experts felt that what was required was one state-of-the-art children's hospital in Dublin. I am not an authority in this area but I presume accident and emergency services or short-term facilities for children would be provided on the south side, given that the north side has been chosen as the site of the proposed national children's hospital. I doubt that the provision of a full children's hospital on the south side would be envisaged.

All the medical experts appear to be of the view that what we require is one state-of-the-art hospital and that the very best facilities would be located there. I accept that the losing side is unhappy with the decision but I hope the medical experts will be of a united view. That was the approach they took prior to the decision being taken. They appeared to believe that only one hospital was required and I hope they will not begin to fight over patches at this stage. I accept what the Senator said and I will report it back to the Tánaiste. I apologise that the reply did not take on board more specific aspects of the question. The Tánaiste was recently in the hospital announcing new facilities and while services for children may not be as good in the future when the new hospital is up and running — which will take a few years — it would appear that the development of the hospital is considered a major part of the health service in the future and will be fully resourced.

Mr. Ross

I wish to ask a supplementary question as I believe I am entitled to do. I thank the Minister of State for departing from that particularly irrelevant brief, for which I do not blame him. I appreciate that he took the trouble to answer some of the questions and undertook to report my inquiry on the children's hospital and the dangers attached to taking that to the Mater Hospital alone, to the Tánaiste. Will the Minister of State also confirm that the assurances given in the 1996 charter regarding the ethos of the Adelaide Hospital will be transferred in all cases in respect of the facilities going to the Mater Hospital?

Mr. N. Ahern

If the Senator's questions were on housing or drugs I might be better equipped to answer them. The reply included a guarantee to that effect in respect of the existing hospital. I believe a meeting was held last week——

Mr. Ross

With the Minister of State's brother?

Mr. N. Ahern

Yes. I think I saw some reference to that effect in the media. I am under the impression that assurances were given to that effect, and that any concerns people may have had about the ethos of the Mater Hospital being fully enforced were allayed. I believe the Government intends that the new children's hospital will be multidenominational or secular, whichever term the Senator may prefer. I do not speak as an authority on the matter but I did read that members of the board of the AMNCH sought assurances to that effect in regard to the new children's hospital and, as far as I am aware, they were given. However, I do not wish to be too categoric in that regard. If a meeting was held with the Taoiseach, the matter was obviously brought to a high level and it is my understanding that assurances were given in regard to these concerns.

Communications Masts.

Mr. Bradford

I welcome the Minister of State, Deputy Noel Ahern. I urge him to give consideration to amending the appropriate Planning and Development Act to ensure that we would have in place clear and understandable guidelines to govern the erection of mobile telephone masts.

As a user of a mobile telephone, I would be the first to concede that with all other mobile telephone users I require a good mobile phone service and I demand good quality reception. As part of that equation it is necessary that mobile telephone masts be erected. We have now reached the stage where there are approximately 4,000 masts of various types around the country. I am concerned about the location of some masts. For example, I am concerned about masts being placed close to or adjoining schools, large housing estates and other community facilities. My concerns stems from the fact that notwithstanding all the international studies that are under way, we still have no clear proof regarding the health implications of mobile telephone masts. While those concerns are being examined and the jury is still out, we must be careful to ensure masts are only erected in areas where we can be confidently assured that they pose no threat to the health of citizens.

One of the issues that concerns me is that the various local authorities seem to have their own rules for the erection of mobile telephone masts. What is considered appropriate in one area, therefore, might be considered inappropriate in another. In a country as small as this, we need a national standard for adjudications on the proposed installations of masts. Our colleagues on the Oireachtas Joint Committee on Communications, Marine and Natural Resources have made certain recommendations in this regard. In particular, they demand that rules and regulations be established in regard to the erection of masts and the monitoring of emissions.

Arising from the joint committee's report, the Government set up an interdepartmental advisory committee to examine this issue. I understand this committee has been in place since September 2005. We need results from the committee and, subsequently, action from the Government. In the meantime, while the advisory committee is making further investigations and arriving at some conclusion, no further permissions should be granted for the erection of masts in any location.

In many communities, applications have already been lodged for the erection of telephone masts. Many parents have expressed serious concerns about the health implications of such installations. We do not yet have all the answers and we must proceed with care and caution. The Minister of State is aware of the precautionary principle that operates at European level. This provides that where there is any doubt, one should proceed with great caution. While the Government awaits the report of its interdepartmental advisory committee, we should put a halt to any further planning decisions.

I recognise the need for telecommunications standards and infrastructure of the highest quality. We must, however, be cautious in regard to where these telephone masts are placed. In the case of applications for the erection of masts close to or adjoining schools, community centres, sports fields and large housing estates, the amber light at least must start flashing. I ask the Minister of State to take this issue on board. Given that the interdepartmental committee has been examining this issue since last September, he must ensure it produces a report and that action is taken. We must be able to provide satisfactory answers to the many communities throughout the country who are concerned about this situation.

Mr. N. Ahern

I am pleased to address the House on this important issue. I begin by emphasising that planning permission is generally required for communications masts. There is great confusion in this area, with many people mistakenly believing masts are exempt from the need to obtain planning permission. Like most security related developments, masts used for the purposes of or in connection with the operations of the Garda Síochána are not required to obtain planning permission. However, an alternative public consultation procedure is provided for in such cases under section 181 of the Planning and Development Act 2000.

My Department published guidelines for planning authorities on telecommunications antennae and support structures in 1996. These guidelines set out a locational hierarchy in regard to the siting of radio masts and advise the planning authorities that planning permission for free-standing masts within or in the immediate surrounds of smaller towns or villages should only be given as a last resort. In the vicinity of larger towns and in city suburbs, the guidelines state that operators should endeavour to locate them in industrial estates or in industrially zoned land. The guidelines further advise that only as a last resort and if all the alternatives are unavailable or unsuitable should free-standing masts be located in a residential area or beside schools.

There are also certain exemptions from the requirement to obtain planning permission for antennae. These exemptions are all clearly set out in the planning and development regulations 2001. These exemptions were the subject of extensive discussion in the House when those regulations were debated. The exemptions were endorsed by the Oireachtas in the context of the demand for additional antennae, which arises from the expectation of the public that it be possible to use mobile telephones at any time and anywhere.

One of these exemptions is the attachment of additional antennae to an existing antenna support structure or mast. This exemption is subject to several limitations. An important condition is that the attachment of the antennae must not result in the field strength of the non-ionising radiation emissions from the site exceeding limits specified by the Commission for Communications Regulation, ComReg. The commission will monitor emissions, particularly where requested to do so by any concerned member of the public.

Another exemption is the attachment of antennae to certain existing structures, including public or commercial buildings, telegraph poles and electricity pylons. Again, this exemption is subject to certain limitations. Educational facilities, child care facilities and hospitals are excluded. The limitation as to the field strength of the emissions again applies.

As regards health concerns, it is the policy of my Department and the Government, as stated in the guidelines, to keep abreast of the best available information and to follow best practice in ensuring that Irish telecommunications companies operate within internationally recognised safe limits in regard to exposure to non-ionising radiation. The Oireachtas Joint Committee on Communications, Marine and Natural Resources, in its report on non-ionising radiation from mobile telephone handsets and masts of June 2005, recommended, among other points, that planning guidelines and exemptions be examined with a view to ensuring that no equipment for emitting electromagnetic emissions or radio frequency emissions be permitted to be sited near health centres, schools or other sensitive sites such as playgrounds, sports pitches and so on.

My Department is represented on an interdepartmental advisory committee which is working on the appropriate response to the findings of the joint committee. I understand the advisory committee expects to report to the Government before the end of 2006. When we have its report and recommendations, we will consider appropriate further action. I understand the concerns of which Senator Bradford has spoken. There seem to be different views from various experts and medical people on the risks that may exist. There are several contentious installations in my constituency, where the Fine Gael candidate is a doctor. There seem to be many doctors in Fine Gael these days for some reason.

Mr. J. Phelan

Fine Gael is a popular party of which to be a member.

Mr. N. Ahern

We will not consider why so many doctors seem to be lining up to join the party. Perhaps they believe there is better protection for them in the party in terms of their contracts.

I have heard some medical experts express the view that we are at greater risk from a television than a mobile telephone mast, while others claim the latter are extremely dangerous. I accept there is concern in this regard and that it is desirable to be able to allay that concern. We must await the outcome of the investigations of the interdepartmental advisory committee.

Mr. Bradford

I thank the Minister of State for his reply. He said that the interdepartmental committee hopes to report by the end of this year. We should insist that it does so because it will have been investigating this issue for almost 15 months at that stage. Would the Minister of State not agree that until that report is in and the Government's interdepartmental committee has reported on the joint Oireachtas report we should instruct local authorities not to make further decisions on planning applications?

Mr. N. Ahern

The planning process is a formal legal process containing a great deal of legislation. I do not think Government could, even if it so wished, direct that should be set aside. The Senator alluded to inconsistencies in how different local authorities reach decisions. This may be due to different development plans but the Government does not tend to issue instructions in this regard. Interfering with the planning process would require primary legislation, though I understand the Senator's point and will relay it to the Minister for the Environment, Heritage and Local Government, Deputy Roche, who is responsible for planning issues.

Pension Provisions.

Mr. J. Phelan

I wish to raise the issue of pensions or, at least, enhanced gratuity payments for retired members of local authorities. I think the Minister of State may have been a member of a local authority. I was as were Senator Bradford and the Acting Chairman, Senator Moylan. I do not think I am eligible for a gratuity or a pension, however.

We are all familiar with people who have given years of service to local authorities around the country yet at the end of their time in politics leave without acknowledgement of the years of effort they have put in. I am reminded of a former colleague of mine on Kilkenny County Council who lost his seat in the last local election. He had been a councillor for 25 years. His wife told me that her husband had worked as a member of a local authority for 22 years without payment. He received payment for the last three years under the allowance system that was introduced. However, that man is in his 60s and will receive no financial acknowledgement in future for the effort he put in. There are many like him around the country and this is unfair.

Under the current system of payment, local authority members receive around €15,000 or €16,000 per year. This does not allow for the payment of the correct category of stamp that would entitle them to full pension rights upon retirement and this is the difficulty. Having spoken to a number of local authority members recently there seems to a general opinion that the Government is to make an announcement on this issue in the next couple of weeks, which is, primarily, why I put down this motion.

I would like to know how the Government sees this issue. There are many who believe there should be an enhanced gratuity payment for local authority members when they retire or lose their seats. That might be a better mechanism. I am not sure which method is best but I believe it is firmly wrong that one can give so much of a life to such an all-consuming job and not be entitled to some sort of pension. Being a local councillor is a full-time job nowadays. I hope the Government will look favourably on extending pension rights to retired local authority members.

Mr. N. Ahern

I appreciate that this is a topic of interest and concern across the House. The Local Government (Superannuation) Act 1980 enables the Minister for the Environment, Heritage and Local Government, with the consent of the Minister for Finance, to make superannuation schemes for employees of local authorities. However, councillors are not local authority employees and could not, therefore, be covered by any such scheme.

Under public service pension arrangements, it is only periods when employees are in receipt of salary or paid leave that count as pensionable service. Even if coverage under the local government superannuation scheme, LGSS, were possible for elected members, periods in receipt of the representational payment, which was introduced for councillors in 2002, would not count towards pension benefit since it is not a salary. It was made clear, right from its introduction, that the representational payment is meant to be a recognition of the work that councillors volunteer to undertake when they stand for election and subsequently serve their community. It is not meant to be a salary.

Membership of the local government superannuation scheme entails certain restrictions which do not apply to a councillor's retirement gratuity. Benefits under the scheme may not be paid until age 60, or age 65 in the case of new entrants since 1 April 2004. However, a councillor's retirement gratuity may be paid from age 50. In addition, the councillor has flexibility in terms of how to use the gratuity, for example, he or she may decide to invest it in a personal pension or a personal retirement savings account or supplement any additional pension entitlement by means of additional voluntary contributions.

In pure benefit terms, the councillors' retirement gratuity compares very favourably with retirement pension and lump sum payments. Using standard public service pension capitalisation rates, the gratuity payable to a councillor after 20 years' service, that is three times the representational payment, is equivalent to the retirement pension and lump sum payable to an employee under the local government superannuation scheme after 20 years' service.

In addition, councillors do not have to make any contribution towards the gratuity, whereas there is a contribution of 6.5% under the local government superannuation scheme and, where an employee is fully insured, the pension benefit is further reduced to take account of social welfare pension entitlement.

The tax exemption rules applicable to severance payments mean that very few, if any, councillors will be liable to pay income tax on the gratuity. While the retirement lump sum under the superannuation scheme is tax free, the pension is subject to tax, which may be deductible, depending on individual circumstances.

I wish to draw to the attention of the House that, at the current rate of representational payment, which is €15,949 per annum for a city or county councillor, the councillor is in effect clocking up a tax-free gratuity lump sum of €2,392 for every complete year of service since May 2000, with pro rata amounts for borough and town councillors.

It is important to note also that there is universal coverage for the gratuity. All councillors are covered, subject to minimum service requirements. This contrasts with the position in other European countries, where only a minority of councillors have pension coverage.

I consider that the gratuity stands up to scrutiny. It is free, in that councillors do not have to contribute. It is fair, in that it applies to all councillors and compares well with standard pension terms. It is flexible, in that it can be drawn down at an earlier age than pensions and can be used in the manner most suited to the circumstances of individual councillors.

That said, however, I can advise the House that my Department is looking at certain aspects of the councillors' retirement gratuity arrangements with a view to seeing if some improvements can be made. There are a number of legal issues which must first be examined and clarified, and my Department is currently seeking legal advice on the matter. I believe, in the circumstances, that this is the best way forward and my Department will be in touch with the associations representing councillors as soon as all the issues involved have been fully examined and clarified.

This is not under my area of responsibility in the Department. I was a councillor for 17 years. I might be entitled to feel that councillors nowadays are well looked after with their representational allowance and expenses. I lived quite close to the council chamber when I was a member and was not getting £20 per meeting. I accept that the world has changed and that councillors would like changes but I have no real information in that regard, other than the matter is being examined.

Mr. J. Phelan

The final part of the Minister of State's speech seems to indicate there will be some movement on this issue in the near future and I welcome that.

It is important to note that the gratuity payment is only back-dated to May 2000. Perhaps it can be back-dated further.

Mr. N. Ahern

I would second that.

Mr. J. Phelan

There are many former and current local authority members who would have served for many years before May 2000, who would not be covered by such a gratuity. Having said that, I am happy with the last part of the Minister of State's response. I am not hung up on the issue of whether it would be a pension or gratuity and most councillors would not be either. It would allow councillors to have a fair degree of flexibility and I am glad the Minister of State has made such a positive announcement.

The Seanad adjourned at 8.05 p.m. until2.30 p.m. on Wednesday, 27 September 2006.