I welcome the Minister of State at the Department of Health, Deputy Kathleen Lynch.
Commencement Matters
Care of the Elderly Funding
I also welcome the Minister of State. I am delighted she could attend to discuss this matter regarding Ballinasloe Social Services. It is a wonderful organisation that provides an amazing service to the elderly in Ballinasloe and in the outlying areas of Kiltormer, Lawrencetown, Clontuskert, Kilconnell, Aughrim, Cappataggle, Taughmaconnell, Moore and Clonfad.
Ballinasloe Social Services has a minibus and it brings people to the centre four days a week. People who avail of the services are referred by general practitioners, GPs, public health nurses, social workers and family carers. Ballinasloe Social Services has a range of activities. It provides lunch for the elderly, music every Tuesday, exercise programmes, computer classes, arts and crafts and card playing. A Health Service Executive, HSE, community physiotherapist visits on a regular basis to maximise the independence and support or improve the quality of life of the older person. A chiropodist provides a clinic on a monthly basis.
There are two elements in the service. There is a day care service which is availed of by 62 elderly people. There is currently a waiting list of 13 for this service. The meals-on-wheels service is availed of by 65 elderly people, 27 of whom also avail of the day care service. Approximately 100 elderly people can remain in their own homes and communities as a result of the service provided by Ballinasloe Social Services.
The centre is staffed by a HSE nurse and a part-time social services nurse. However, since January 2013 the HSE post has not been filled on a permanent basis. Cover is provided from St. Brendan's community nursing unit in Loughrea on a daily basis from a pool of seven or eight nurses. The inconsistency gives rise to uncertainty as a different person could be there every day providing the service. That is not the best type of service to provide to elderly people.
With regard to its funding, the section 39 grant from the HSE has decreased over the years from €146,700 in 2008 to €131,000 in 2015. In 2014, it cost approximately €259,000 to provide the service to the elderly. This figure is similar to the figure for other years as the centre watches its costs very closely. A balance of €128,000 must be raised through fund-raising and service charges. This is unsustainable in the long term and puts enormous pressure on the staff and volunteers. Much time and effort is spent fund-raising each year which could be better spent in providing much needed services to the elderly citizens.
This is compounded by the fact that Ballinasloe is a RAPID programme town, in which there are high levels of deprivation and where the opportunities to fundraise are limited. We are looking for two things: for the nursing embargo to be lifted in this exceptional case to allow one person to be appointed to this post and for an immediate increase in the section 39 grant to enable Ballinasloe Social Services to continue providing the necessary services for the elderly people of Ballinasloe and surrounding areas.
Ballinasloe Social Services provides an amazing facility. The staff and volunteers are kind and caring and provide a warm and homely environment for the elderly persons in their care. I pay particular tribute to the staff but also to the large number of volunteers who give generously of their time to improve the lives of others. There is a wonderful atmosphere in the place which I have seen on the many occasions I have been there and I want it to continue to develop. Through this wonderful service, many elderly persons are enabled to remain in their homes, something the Minister of State and the Government are promoting very strongly and as a result of which, there are significant savings to the State.
To repeat my request, we want a nurse appointed on a full-time basis and an increase in the section 39 grant to enable the huge burden of fundraising that has to be borne by staff and volunteers to be reduced in the coming years. I thank the Minister of State for attending to deal with this matter.
I thank the Senator for raising the issue. The overarching policy of the Government is to support older people to live in dignity and independence in their own homes and communities for as long as possible and to support access to quality long-term residential care, where this is appropriate. The Health Service Executive is responsible for the delivery of health and personal social services, including home help and home care packages, meals on wheels, respite or day care and a range of other community-based services.
Day centres such as those provided by Ballinasloe Social Services provide invaluable support, advice and social interaction for older people who may, for any number of reasons, be experiencing isolation and loneliness. Ballinasloe Social Services has been operating as a social outlet in the area since 1972 and operates Monday to Thursday. Traditionally, the services provided have included services within the remit of what is now Tusla, Ballinasloe Social Services and the HSE. Personnel, including public health nurses and physiotherapists, have collaborated in the provision of services for older people.
The day care service is provided four days a week and staffed on a full-time basis by one nurse whole-time equivalent. This post is filled by a number of nurses from the pool at St. Brendan's CNU, Loughrea, as the Senator outlined. There is no embargo on the filling of this post. On the basis that the post of permanent, full-time nurse is a stand-alone position, the HSE has experienced difficulties in filling it. However, every effort is made to provide continuity of care through the pool of nurses.
Since 2011, the HSE has provided €131,000 annually for Ballinasloe Social Services through a section 39 grant. As we are all aware, the Health Service has been through a number of very difficult years, probably the most difficult in modern times. However, there is good news on the resources front and we have a little more money than previously. This year we secured the first increase in health spending in seven years and next year we will have nearly €900 million more compared to budget 2015. Notwithstanding the better economic news recently, resource availability remains tight across the health service. However, the Government remains fully committed to using the resources available in the most effective way possible and in a way that best matches the needs of service users. The HSE is continuously working to develop services on this basis. A priority for 2016 will be the development of an integrated model of care, with a strong emphasis on home and community care.
The level of services to be provided by the available funding will be set out in the HSE's 2016 national service plan which is currently being prepared by the Executive.
While I welcome the increase in funding for the health services in 2016, I do not underestimate the continuing challenge of delivering the services required against a backdrop of growing needs. It is essential that we continue to focus on cost containment, productivity and efficiencies, as these will continue to be a major cost pressure on the health service into the future. These pressures include an increased and aging population, an increase in chronic conditions and new and expensive medicines and treatments.
The HSE acknowledges the significant and valuable contribution made year after year by Ballinasloe Social Services and it looks forward to continuing its collaboration in the future with the mutual goal of providing the best possible care for older people in that area. The negotiations on funding are always carried out between the service and the HSE on a service level agreement. The service provided is appreciated.
I thank the Minister of State and I concur with her. The service is appreciated and I welcome the fact that there is no embargo on filling the post. I assume that efforts will continue to be made to fill the post on a permanent basis because it is not sustainable to have somebody coming every day from the service in Loughrea. I hope to see some progress there. I welcome the fact that there are additional resources available this year. I hope that the negotiations and discussions between the service providers, Ballinasloe Social Services, and the HSE management will result in a significant increase in the resources it receives in the coming year. I thank the Minister of State for coming in and I would like her to visit the service if she is in the area. It is a model service and is certainly something that can be replicated in other areas of the country.
The difficulty in recruitment is not only in areas such as Ballinasloe. It exists across the range, including in some of our very high tech hospitals, where one would imagine nurses would want to work. It is getting easier. That is all I will say. There are still vacancies but not as many as there were. If the right person becomes available the post will be filled.
General Practitioner Services Provision
I welcome the Minister of State to the House. I want to raise the plight of small rural GP practices. They seem to be in a state of crisis. I am not concerned with practices that have 1,600 or more patients. Many small rural GPs have fewer than 600 patients. There are 21 vacancies for full-time GPs in rural Ireland - 22% have been vacant for two years and 17% have been vacant for one year. Recruitment seems to be the problem. It appears that our investment in rural practice only amounts to 2.5% of the health budget whereas in the UK it is up to 9%. During the crash, rural GPs lost approximately 40% of their income. That included the rural practice allowance that was taken away and travel allowance to call-outs, which was put in place 35 years ago. A higher rate was paid if a longer distance was to be travelled. Now that things have improved, I ask the Minister of State to reverse the financial emergency measures that were introduced in 2008 and 2009 in order to entice GPs into rural practice. Their present situation is being reviewed but the outcome of that review will not be known until the end of 2016.
There is another problem. If rural GPs are forced out because their practice is unsustainable, patients cannot transfer to another local doctor. They are at the mercy of various locums who will be at their disposal and who are not familiar with them to the same degree as the full-time GP.
I am also aware that some GPs are earning less than their practice nurses. There is a crisis and investment is the only thing that can solve it. We are talking about the resuscitation of general practice in rural Ireland.
We need to be careful about the language we use. There are 18 vacancies in total and percentages can often give a false view when one is talking about a small cohort of people. All 18 vacancies are covered by locums. In some cases, as this has been on a prolonged basis, they will not be unfamiliar to the people they see on a daily basis. There is, however, an issue, with which we are not unfamiliar. We recently had two meetings on the subject.
I thank the Senator for raising this issue, as it provides me with an opportunity to update the House on it. I am very much aware of the issues facing general practice in rural areas. My colleague, the Minister for Health, Deputy Leo Varadkar, and I recently held separate meetings with the Irish Medical Organisation and the National Association of General Practitioners, at which we discussed general practice in rural areas, among other things. Under the general medical services capitation contract, GPs are eligible for a rural practice allowance when they live and practise in an area with a population of less than 500 where there is not a town with a population of 1,500 or more within a radius of 4.83 km of that centre and where the HSE considers it necessary to pay an allowance to retain a doctor in the area. The rural practice allowance under the capitation agreement is currently set at just over €16,000 per annum. GPs who satisfy the criteria for payment of the allowance are also entitled to claim practice support subsidies towards the employment of a practice nurse, secretary and manager at the maximum applicable rate which they would otherwise only be entitled to claim if they had a panel size of 1,200 and over. Qualifying GPs can also claim the maximum applicable contribution towards locum costs for periods of leave such as sick, annual, study, maternity and adoptive leave.
The HSE has recently reviewed its guidelines for dealing with applications for a rural practice allowance from GPs applying for a GMS contract in a rural area. The purpose of the new guidance is to ensure consistency, transparency and fairness in decision-making in respect of the relevant discretionary provisions of the GMS contract pertaining to the granting or otherwise of the allowance to new applicants. The new guidance does not, however, affect existing holders of the allowance. The HSE, the Department of Health and the IMO are engaged in a review of the GMS and other publicly funded health sector contracts involving GPs. The review is taking place within the context of the framework agreement which was signed by the parties in June 2014 and the memorandum of understanding signed in February 2015.
Among the topics comprehended by the review is the issue of supports for general practice in rural areas. With regard to the reversal of fee reductions introduced under the Financial Emergency Measures in the Public Interest Act 2009, FEMPI, I recognise that general practice has contributed its fair share under the Act, some €122 million, but others in society, including other health professionals, have also played a pivotal role in the country's recovery. A review will take place shortly of the fee adjustments introduced under the FEMPI legislation for contracted professionals in the health sector, including GPs. This follows on from engagement earlier this year between the Minister for Public Expenditure and Reform and public sector unions on an orderly unwinding of the legislation.
There is a lot of information included in my reply. This is not an issue about which we are unconcerned or with which we are unfamiliar. We hope that, through negotiation and regular contact, there will be some improvements.
It is positive that negotiations are ongoing, but I ask that they be fast-tracked lest more GPs are lost from rural Ireland.
The key to ensuring hospitals are not overrun lies in the community, while the key to the delivery of services in the community is GPs and nurses.
We cannot emphasise that enough, and it is on that basis that I hope we will go forward in terms of the negotiations.
Social Welfare Offices
I welcome the Minister of State, Deputy Phelan, to the House.
I submitted a similar Adjournment matter on 4 March 2014, the response to which I have before me. I will not go into the detail but there is a severe difficulty from a practical point of view in my home town of Bantry where approximately six different offices provide various social welfare services. We all want the one-stop-shop facility but when somebody goes into a particular office the file might be in another office, and people end up swapping files. In terms of security and an onus to be fair to the general public, the system in our town is 40 or 50 years out of date. Ten or 15 years ago it was mooted that a new premises should be acquired where the various branches of the relevant Department would be located under the one roof. I ask the Minister of State for an update on that and hope the response I receive will be more positive and enlightening than the one I got 20 months ago.
I thank the Senator for raising the issue and giving me this opportunity to update the House on the Department of Social Protection's plans to integrate its services in Bantry.
Since the transfer of responsibility for community welfare services and employment services from the Health Service Executive and FÁS, respectively, to the Minister for Social Protection, the Tánaiste and her officials have been looking at ways to better integrate services to provide a more streamlined and consistent service for their customers. The Office of Public Works has been working with the Department of Social Protection to support this process.
This vision has been given expression under the Intreo programme. Intreo is a very important step in transforming the way income and employment supports are provided. The role of the Office of Public Works in assisting the Department of Social Protection to deliver the Intreo programme is to provide appropriate, modern and efficient accommodation that meets the Department's business requirements and allows it to deliver its services to customers efficiently and effectively. This programme of works represents a very significant investment in terms of both funding by the Government and the allocation of administrative, architectural and technical resources by the OPW.
I am pleased to inform the House that by the end of 2015, the OPW will have modified or fitted out 73 buildings for Intreo in 61 cities and towns throughout Ireland. While priority has been given to delivering the Intreo programme, the Department of Social Protection has also commenced a programme of consolidating services in a number of towns, such as Bantry, where traditional signing services are provided under contract by a branch office, rather than a local office, and where other services such as community welfare and employment services operate from separate locations. This will likely result in a further programme of works for the OPW that will be delivered over the next two years.
It is a feature of the model of integrated services developed by the Department that the public facing side of operations such as waiting areas, serving hatches, interview rooms and group engagement rooms is significantly larger when compared with traditional local social welfare offices.
While this is a welcome development, it also creates its own challenges for the Office of Public Works. In some locations, particularly smaller regional towns, the size of existing office accommodation required to deliver the range of consolidated services may simply not be available, or may be in a less central and readily accessible location in retail parks on the edge of town. This can make access for those dependent on public transport more challenging. It may also be the case that there may be several years left to run on existing leased accommodation.
In such cases, the OPW and the Department are trying to balance the aim of consolidating services with the desire to avoid paying rent on premises that would be vacated prematurely if all services were consolidated in one location. This is particularly relevant where there is no alternative requirement for the accommodation that would be vacated. These types of considerations, together with the underlying demand for services in the various towns and the availability or lack of suitably-sized and located buildings, is feeding into the prioritisation of individual projects.
The Senator has outlined the particular circumstances that exist in Bantry where, in addition to the branch office on Bridge Street which is operated under contract by a third party, the Department's own staff deliver services from four other locations around the town. It is unfortunate, however, that none of the existing OPW-leased properties in Bantry is big enough to support an integrated operation.
A search for viable accommodation has been under way in Bantry for some time, but a lack of suitable buildings has hampered progress. Recently, however, the situation improved and my officials are now in preliminary negotiations with four potential landlords. Officials were in Bantry on 8 October to inspect these properties and meet their respective owners. This search process is ongoing, so if the Senator is aware of potentially suitable premises he should please feel free to forward the details to the Minister of State, Deputy Harris.
As the House will no doubt appreciate, I would prefer not to say anything more specific about the options identified to date, as doing so could inadvertently undermine discussions with potential landlords. Having said that, I am hopeful the OPW is moving to a position where it will be able to secure a suitable building in Bantry that will support the delivery of integrated social welfare services in the town and surrounding region. I trust this clarifies the situation for the Senator.
I thank the Minister of State. I needed an update and I have noted her advices and will pass on the information to the appropriate people. I hope a solution will be found because it is unfair to the general public and the staff. It is not the most ideal situation to have four different offices in a relatively small town with a population of 3,000 people.
I understand the Senator's concern and will pass the information on to him. I am not sure how this compares with the previous-----
There is a little more light at the end of the tunnel.
We will forward this to the Senator.
Motor Tax Rates
I thank the Cathaoirleach for placing this motion on the Commencement debate. I welcome the Minister of State. I hope events have moved on since I tabled this motion, which was to be taken last week. Due to pressure on the Cathaoirleach, it was deferred until today. I hope this extra time means the clarification required has already been given.
Since the ruling by the Court of Appeal on 21 October in the case of the DPP v. Perennial Freight Limited, Freight Transport Association Ireland, FTA Ireland, has been active in this regard. It has been in receipt of multiple queries by telephone and e-mail on whether articulated tractor units should now be weighed separately for the purpose of calculating motor tax. Despite the fact FTA Ireland has contacted the Department of Transport, Tourism and Sport, the Department of Finance, the Department of the Environment, Community and Local Government and the Revenue Commissioners it has received no clarification. I understand that at the beginning of this month there was some further clarification on the amount the owners of articulated tractors will have to pay, and the rate for articulated vehicles is now €333, which is the rate for non-agricultural tractors.
I have a number of questions on this, which are combined, and I hope the Minister of State will address them in her response.
Is the €333 an annual rate for articulated vehicles from now on? Will the Minister of State confirm this sum is the rate applicable for vehicles whose tax is to be renewed in November and December before the tax reductions announced in the budget kick in? This is important. Does it apply for November and December? Will the Minister of State confirm this to the local tax offices? I understand they are being forced to handle calls from confused hauliers nationwide. I have heard a few of these responses and there is most definitely confusion in the local authority offices. Different answers have been given to queries raised by hauliers. When will the Minister reflect the announcement in law? Will it be done in a statutory instrument or amending legislation? As a result of the successful case taken, will the Minister of State confirm that the several thousand prosecutions outstanding against hauliers for under-taxation of articulated units will now be dropped by the DPP? Will the Department refund the motor tax unlawfully overcharged on hauliers due to this misreading of the legislation by the local authorities and An Garda Síochána?
The conclusion of Mr. Justice Peart is summarised in paragraph 42 on page 28 of his judgment. He stated that the practice which had seen hauliers such as the appellant bring a trailer to be weighed in association with the tractor for the purpose of being licensed for the coming period had in his view no statutory basis. That was the reason the case was won by the freight company. That more or less sums up what I am attempting to find out and what Freight Transport Association Ireland members are attempting to find out. I will be grateful for the Minister of State's response.
I thank the Senator for raising this issue. Last month in budget 2016, the Minister for Finance announced that the rates of motor tax on larger goods vehicles are being reduced. The reductions apply to goods vehicles with an unladen weight exceeding 4,000 kg and will take effect for vehicle licences taken out with a commencement date of 1 January 2016 or after. As part of the changes announced, the rate structure of 20 bands is being simplified to five bands of motor tax, which will range from the current level of €92 per annum for electric goods vehicles up to €900 per annum for all goods vehicles in excess of 12,000 kg. The cost of the reductions is some €43 million annually. This change will benefit the owners of more than 28,000 goods vehicles.
A week later, on 21 October, the Court of Appeal made a judgment in a case between the Director of Public Prosecutions and Perennial Freight Limited. If I was to summarise briefly the import of the judgment, it is that only the mechanically propelled element of an articulated vehicle - in other words, the cab of the vehicle - falls to be taxed on the basis this is the only part of the vehicle that is independently capable of mechanical propulsion. Up to that point, articulated goods vehicles had been taxed based on the weight of the cab and the heaviest unladen trailer or combination of trailers that would have been drawn by the cab. The judgment further ruled that articulated vehicles are more appropriately taxed as a different class of vehicle than had been the case up until this judgment. This is the category under which non-agricultural tractors are taxed and it has a single annual rate of tax of €333. The judgment does not affect rigid trucks which continue to be taxed on unladen weight.
The necessary technical adjustments have now been made to the national vehicle and driver file to apply the €333 rate. This has been done pending fuller consideration of the implications of the judgment and the appropriate response to it. Legal advice on certain elements of the judgment has been sought by my Department through the Office of the Attorney General and once it is received and considered, a decision on how best to proceed will be taken.
On that basis, I hope the Senator understands that at this point in time, I am not in a position to comment further on the matter.
I thank the Minister of State. I appreciate that this matter is not within the her direct area of responsibility and that she is therefore relying on what her officials are telling her. I understand from the latter part of her reply that because legal advice has been sought, many of the questions I have raised in terms of refunds probably cannot be answered. My reading of the situation - perhaps the Minister of State can confirm this - is that the necessary technical adjustments have now been made to the national vehicle and driver file, NVDF. This would answer the question as to whether the local tax offices have now been informed of the change, which would eliminate any confusion in this area. The only question I can ask is if the Minister of State has any idea at all, or has any extra information apart from the response, as to how long it will take for the legal advice to work its way through the system so that there can be further clarification.
I do not have any further clarification, nor do I have a timeline. If the Senator sends me an e-mail stating the specific issues he has raised, I will undertake to try to get clarification on them from the Department.
Perhaps the Minister of State would address by letter the questions I asked, which were specific to the matter.
Sitting suspended at 3.12 p.m. and resumed at 3.30 p.m.