I welcome the Minister of State, Deputy Paudie Coffey.
Commencement Matters
Cancer Screening Programmes
Notwithstanding the fact that the Minister of State has taken the time to come to the House, I am disappointed that the Minister, Deputy Varadkar, is not here for the debate on this very important issue. Some weeks ago, I raised with the Minister the issue of ladies being referred to the symptomatic breast clinic at University Hospital Galway and who, effectively, were being sent home to undertake a form-filling exercise and to self-monitor for three months. At that time, I expressed concern to the effect that this is critical time that could be lost for those people, particularly if they are among the 7% of individuals who go from suffering with mastalgia, or breast pain, to developing the more serious problem of breast cancer. I was particularly worried by the fact that the Minister described the person on whose behalf I raised the matter as being the subject of an inappropriate referral. That proved not to be the case. The woman in question was lucky enough to have the funds available to allow her to have a private assessment carried out.
Thankfully, it happens that all is well and she is not one of the 7%, but the question that I rightly posed at the time was about those who were.
Today has seen a worse situation. Following the press coverage of my raising the matter with the Minister, Deputy Varadkar, a lady contacted me. I will quote most of her e-mail, as it speaks for itself. She wrote:
On reading the article I felt a pang of personal concern as I am currently on the public waiting list to see a doctor in Galway Breast Clinic. Initially I was told by the clinic I would only be 4-6 weeks due to the fact I was referred with a lump and discomfort in each breast and I am in a high risk group. The clinic confirmed on the day of my appointment to see the doctor if required any tests, mammograms would be completed.
After the 6 weeks passed, I re-contacted the hospital to learn that it may be up to next Feb before I see a doctor and any tests I may require will not be completed on the day. The lady was very kind and mentioned to contact my GP, [but that] realistically it is highly unlikely I would be seen before Christmas. Earliest may be Jan, latest end of Feb.
I am now quietly scared and worried, I had an encounter with cancer over ten years ago and it was early detection through the public system that prevented me having to go through a lot of treatment. Surgery and careful monitoring was [sufficient].
I am doing my best to stay positive, I do understand and take on board that over 70% of women with lumps and discomfort are usually okay and it can be hormonal or contraception issues. At the back of my troubled mind is the little nagging doubt... when I get to Galway will I have lost vital time?
These words are compelling and speak for themselves. While I appreciate that the Minister of State's area of responsibility is the environment and not health, this is an issue that requires the highest action by the Government. Recent years have seen debacles in the shutting down of various breast clinics, the setting up of other breast clinics and the so-called centres of excellence. In a matter of a couple of weeks, we have encountered two further incidents, one involving someone who had cancer previously and is in a high-risk age group being put on the never-never and another involving someone who was sent a booklet and told to self-monitor and fill out forms. The first person, who had more serious symptoms in terms of lumps and pain, was told that the clinic might get to her by the end of February and that not all of her tests would be done on that day.
There are also reports that the symptomatic breast clinic in Letterkenny is only seeing 16% of high-priority patients within the required timeframe. It is important to portray the health system as going well and, when one is lucky enough to access the service, the health professionals are probably doing very good work for people, but it is not acceptable for us to massage waiting lists and put patients like these two ladies at risk. I am sure that is not the Minister of State's intention. I worked with him in this House when he was a Senator.
It is unacceptable that the Minister, Deputy Varadkar's approach to this issue when it was first raised a few weeks ago concerning a different patient was to speak of inappropriate referrals. The Minister of State has heard this lady's words. She had a brush with cancer previously and is in the high-risk age group, yet she, too, is being put on the never-never. When the Minister of State leaves the Chamber, will he immediately contact the Minister, if not the Taoiseach as well, and ask that the appropriate interventions be made in the first instance for this patient, on whose behalf I have written to the Minister, and to outline how many people are only in this space because we seemingly do not have the resources in the Galway-Letterkenny-Sligo area to deal with them?
We will seek to amend the Order of Business to bring the Minister to the House on other health matters. I might have an opportunity to raise this issue with him then, but this is not the appropriate time and I do not want to take from the importance of this issue.
I thank Senator MacSharry for raising this issue and giving me the opportunity to update the House. I am taking this debate on behalf of the Minister, Deputy Varadkar, who apologises for unfortunately not being able to attend.
The symptomatic breast clinic in Galway forms part of a range of services that is in place for women with breast symptoms. Referrals are dealt with in accordance with the guidelines that have been developed by the national cancer control programme, NCCP. Most women experience breast pain at some stage. While this can cause worry, it is found that, in the absence of other symptoms, breast pain is rarely indicative of breast cancer. The NCCP, in collaboration with the Irish College of General Practitioners, ICGP, developed a booklet to support women with breast pain. It explains the types of breast pain, their possible causes and how pain might be easily remedied. It contains a three-month diary to help determine whether the pain is cyclical, as this information can help with prevention and care. This approach is evidence-based and regarded as good practice. The booklet highlights the importance of making a specialist referral if other symptoms are present.
General practitioners, GPs, have also been provided with a guideline for managing breast pain in primary care centres. This guideline contains the same advice as that in the patient booklet. Where the patient's clinical examination is normal, she is asked to follow the advice in the booklet for three months. If, after that time, the pain has not been resolved, a referral is warranted. All referrals to the symptomatic breast clinics in Dublin, Cork, Waterford, Limerick, Galway and Letterkenny are triaged on receipt and appointments are then offered.
Breast cancer survival rates have increased significantly in recent years due to a combined approach of screening, symptomatic detection and improved treatment. Breast cancer five-year survival is estimated at 81% for women diagnosed between 2006 and 2011, representing an increase from 72% for those diagnosed between 1994 and 1999.
Last November, the Minister announced the extension of BreastCheck to the 65-69 year age group in keeping with EU guidelines. I am pleased to confirm that the first invitations have issued and the screening of 500 women in that cohort will take place this year. Earlier this year, the Minister launched the national clinical guidelines on the diagnosis, staging and treatment of patients with breast cancer. Clinical effectiveness is fundamental to our health service. Implementing good quality clinical guidelines and audits can improve health outcomes for patients, reduce variations in practice and improve the quality of clinical decisions.
The Minister has asked me to assure the Senator that all women with breast symptoms are welcome at specialist breast services, including those with persistent and troublesome breast pain as outlined in the guidelines.
What about lumps? We heard nothing about those. This is not the Minister of State's core area but, to quote the lady in question, "when I get to Galway will I have lost vital time?" These patients are not being referred by lay people, traffic wardens or people in the street. They are being referred by medical professionals with seven years of training. I am bound to say that these delays and the speeches today and by the Minister about best medical practice do not stack up. There was no mention of the individual patient, but the Minister's office is aware of this case. Will the Minister of State raise her case with the Minister? She is on the never-never. She has breast lumps and pain, so it is not just mastalgia. The form filling, book reading exercise is not one that gives confidence to the ladies of the north west.
I welcome the Senator's raising of an important matter. Any elected representative would identify cancer as a major challenge for any family touched by it. The Senator is right to state that concerns arise where ladies find lumps in their breasts. It is important that there be early intervention and diagnosis to deal with problems.
I will reiterate the Minister's comments. He assures the House that all women with breast symptoms are welcome at specialist breast services, including women with persistent and troublesome breast pain as outlined in the guidelines. As to the specific case raised by the Senator, I undertake to relay his concerns to the Minister directly.
Technological Universities
I welcome the Minister, Deputy Bruton, to the House.
I also welcome the Minister and thank him for taking this important motion, even though it does not fall into his portfolio.
I am glad the Minister has taken this Commencement matter because he has taken a hands-on approach to what has been happening in the south east in recent years with the jobs action plan and the south-east action plan as well. The Minister will be aware of the importance of the need for a technological university for the south east. I am sure that in all the consultations he has had in the area and the region generally, the need for that university to be put in place comes up every time. It is seen by all the policymakers and stakeholders, including captains of industry, the business community generally, trade unions and those within the institutes of technology, that this clearly needs to happen for the region. By having a university the south east would then be on a level playing field. It is a vital cog in the region in terms of economic development and it needs to be delivered.
The problem is that the Government strategy up to now has been dogged with problems, delays and disagreements - some of them internal in the region while others are external. At times there has been chaos. The whole project came to a halt last year and then we had the appointment of Mr. Michael Kelly and subsequently the publication of the Kelly report. We were led to believe that the report would offer a roadmap and some sort of direction on how we could get to the end product, which is a technological university for the south east.
I am very supportive of a technological university and have backed that strategy from day 1. As the Minister knows, in 2012, I published a report on the issue. I was involved in consultations across the region and heard at first-hand the desire, need and support for such a university. I hate to say this but at this point we do not seem to have a clear plan, model, the necessary engagement, or the required buy-in. I do not see that buy-in coming either from the Department or the Higher Education Authority. There is a clear problem in that it is all very abstract. We all know that we want a technological university but there is no vision or model that people can buy into. Without such a model it is more difficult to convince people in the Carlow and Waterford institutes of technology who might be hostile or negative towards the creation of a technological university. It gives them the excuse when we do not have a tangible model that people can see. What we need is a new university, but such a model is simply not there.
I am seeking an update from the Minister as to where exactly the strategy currently is. Do we have any indication as to a roadmap, timeframes or when we will arrive at the final destination? Many people are sceptical about all this and it is not even seen in the context of a broken Government promise; it is a question of whether or not the region and the other stakeholders from the Department and the HEA are really committed to making this happen. Are they committed to bringing it to life and ensuring that the region will have a university?
I do not want to place all the problems on the Minister's shoulders or the Government generally because there are many different issues at play here. We need to name them and to be clear about where the problems lie. We also need to have a clear roadmap, plan and model. Unfortunately, however, I do not see them at this point. Perhaps the Minister can give us a positive update today on where things are. I look forward to his response.
I thank Senator Cullinane for raising this issue. From my own work in the region I know it is regarded as being pivotal for the long-term development of the south east. To be fair, when the National Strategy for Higher Education to 2030 was published back in January 2011, there was a clear roadmap as to what needed to be done. The journey was clearly mapped out and it recommended the consolidation of the institutes of technology sector and the creation of a small number of multi-campus technological universities. That is the roadmap that people now need to fulfil.
The process for designation as a technological university, TU, consists of four stages and requires the merger of two or more institutes of technology prior to application for designation as a TU. The technological university for the south-east project was initiated in 2011 and consists of a consortium of Carlow and Waterford institutes of technology. The consortium made good progress initially and submitted a stage 1 expression of interest in 2012. However, following this initial promising start, the consortium encountered a series of challenges and difficulties, and did not succeed in finalising a stage 2 plan prior to the decision by WIT to suspend merger activities in October 2014.
Following meetings with both institutes in early November 2014, the Minister for Education and Skills, Deputy Jan O'Sullivan, announced the establishment of a new process of engagement and consultation with the governing bodies, staff and students of both institutes, together with the wider community in the south east. The Minister appointed Mr. Michael Kelly to lead the process of consultation. While a ten-week timeframe was initially set for the process to be completed, the timeframe to completion was extended due to a number of factors, including the change in governing authorities of both institutions at the end of the first quarter of 2015.
The Minister for Education and Skills recently met with Mr. Kelly and received his report on the outcome of the engagement and consultation process. Mr. Kelly has undertaken a thorough and extensive consultation process with regional stakeholders on this important issue. Mr. Kelly met with stakeholders in all counties of the region in the last few months, including local authorities, chambers of commerce, employers, the enterprise development agencies and social and community groups, as well as public representatives. I understand that some 40 meetings took place and the Minister wants to place on record her gratitude to Mr. Kelly for undertaking such a comprehensive and wide-ranging consultation process and for producing a comprehensive report.
Mr. Kelly presented his report to the Minister on 2 July last. Following receipt of that report, the Minister discussed it with Cabinet colleagues. She subsequently met with the presidents and chairpersons of both institutions on 21 July to discuss the findings and recommendations in the report. The report was published on 27 July.
As outlined at the time of publication, it was agreed that a plan for a process of preliminary facilitation would be developed by mid-August for consideration at the Institute of Technology, Carlow, ITC, and WIT governing body meetings planned for the end of August. The facilitation process is the first step recommended by Mr. Kelly in order to assist with building mutual trust and respect between the two institutions. The governing bodies of both institutions held meetings at the end of August and agreed to engage in the proposed facilitation process, which is now under way. The Minister is pleased to report that there has been very good engagement in the facilitation process by the presidents and chairpersons of both institutions to date. This is an important building block for future collaboration. The Minister expects this facilitation process to be completed before year end.
The Minister believes there is a compelling rationale for a new type of higher education institution to support the economic and social development of the entire south-east region and this is clearly the wish of stakeholders in the region. The Government is committed to supporting the development of such an institution. The Senator can see from this reply that the Minister for Education and Skills has been very active in seeking to get this issue across the line. The work in this respect is ongoing.
It is obviously good and useful that both institutes are at least talking and that some progress is being made, if I am to take the Minister's word at face value. I am sure that some progress has been made. I have spoken to people in both institutes on numerous occasions, as well as other stakeholders mainly in Waterford but also in the wider region. The problem is that while they may be talking and there might be some progress, in the absence of a visible plan and model it is difficult to see how we can get to the end product.
The Minister is correct in saying that there is a legislative process in place which enables institutes to merge. That is fair enough and they are the nuts and bolts of how a merger can be created. We should ask what this technological university will mean for the south east, what model it will be, what type of courses it will deliver and where the main campus will be. All these issues are not there, however, so people do not see the big picture. Maybe that is one of the reasons we have these stumbling blocks because there will obviously be tensions within both institutes. In the absence of a clearly worked out model on the table, I would fear for the future of this project, although I am hugely supportive of it. I want to see it getting over the line, the same as everybody else. We all do, but we are nearly five years into this Government's term of office and unfortunately we cannot say that we are close to the end by any stretch of the imagination. I am not saying that all, or even any of it, is the Government's fault, but I am saying that there are clear problems. In my view, the biggest problem is that there is an absence of an actual model. Until we get that model, which may have to come from both institutes, I do not think people will have confidence that it will in fact be delivered.
First of all, the two institutions have been very important in this regard. I have worked to try to drive employment creation in the region. It is gratifying to see that in the last three years 24,000 extra people are at work in the south east.
I have also worked with both colleges in supporting new enterprises - one in China with Carlow Institute of Technology, and several from Waterford Institute of Technology.
They offer great technology and great support to enterprise.
Ultimately, a marriage is about the meeting of two sides and about people having a degree of consensus and understanding that their relationship is a working one. I have just been going through Mr. Michael Kelly's report and he has set out that this can be delivered within three years. As a result, there is an ambition or a roadmap, as the Senator described it, in place. Mr. Kelly is highly committed and he made a huge effort to bring this together but this process must go through a systematic route and it has to be something that endures and adds value in the region. To be fair, in the context of the work that has been done by all players, a route has emerged but moving forward will require everyone working together. One thing I have discovered from working in respect of the south east is that bringing people together is an important part of lifting a region. This is one of the areas in which - just as we did elsewhere - we seek to work to build new collaborations. I am optimistic for the south east and this is an important element but it must be done right and on a sustainable basis, which the Senator recognises. I will convey his concern to the Minister but people are putting in a significant effort to make this work.
Industrial Development
I welcome the Minister to the House and I thank him for taking the time to deal with this important issue. In light of yesterday's encouraging unemployment figures, the lowest since 2008, it is more important than ever that we should not take our eyes off the ball. The Minister agrees that we must do everything we can to continue to drive the recovery and the best way to do that is to create high-value, secure jobs while also ensuring that existing employment is maintained and developed. It is in this light that I wish to raise the issue of Parkmore industrial estate in Galway city. The Minister will be aware that IDA Ireland has been excellent in marketing this hub. It is home to companies from various industries, including medical devices, IT and research and development. More than 7,000 employees commute to the area daily and the value of that number of jobs is significant not just for Galway but for the western region as a whole.
Business leaders in the area have informed the public that severe traffic issues are having a direct effect on expansion, business productivity and the quality of life of their employees. Such is the problem that businesses have engaged in car pooling and flexitime for employees to ease the stress involved in getting to and from work. It is a simple fact that a relatively short commute in the area can take a multiple of the time it should. This problem did not appear overnight; it has become increasingly worse over the past two to three years and has reached the stage where business leaders in Parkmore have formed a group comprising chief executive officers and senior executives of the companies in the area to voice their concerns. The group has agreed to work with Galway City Council, Galway County Council and IDA Ireland in a constructive and proactive manner in order to try to find solutions. There are options on short-term, medium-term and long-term solutions, including changes to traffic light signalling, road markings, the addition of more exits, new bus routes and additional lanes at junctions. All these will help but they involve multiple agencies, including CIE, IDA Ireland, two local authorities, the National Roads Authority, NRA, and various other State agencies involved in planning. Funding is also an issue in the context of the works required.
The overarching consideration is jobs. While there has been movement in that the local authorities and IDA Ireland have met business representatives from the area to formulate a plan, I am concerned that, following several years of traffic chaos, we might experience more years of administrative delays until this matter is resolved. It is simply not good enough that we, as a nation, cannot sort out our infrastructure in a timely manner to ensure that jobs in Parkmore are retained and further investment is encouraged. I do not seek to blame anyone. Like the Minister, I am in the business of solution politics but I ask him, as a matter of urgency, to contact the State bodies concerned to emphasise the importance the Government places on the retention of jobs in Parkmore and future expansion there and to offer whatever assistance is required. I have details of the business community group in Parkmore. Will the Minister agree to meet a delegation from Parkmore to hear for himself the frustrations and issues of the employers and their employees?
I am aware of the issue and I have met some of the people involved. IDA Ireland is working hard with the local authority to find a solution to this. It is correct that this is a frustrating experience for a number of companies at Parkmore business park. It has been a successful park with companies such as Medtronic, Merit Medical, Celestica and Creganna Medical. The pressure has built against a background where over the past four years IDA Ireland has expanded its employment base in Galway by 33%, with 3,500 additional people working in its companies. The other backdrop to this is I have recognised clearly that we need to develop a much more integrated regional enterprise strategy where local authorities, State agencies and educational institutions work together as they seek to develop sectoral opportunities. It is very much part of my thinking to embrace the local authority as an equal partner in seeking to drive this matter forward.
IDA Ireland has been examining this matter for some time. It has developed proposals and is in discussions with the local authority in respect of them. Meetings were held as recently as last week and, arising out of them, both parties and their engineering teams are considering how this can be resolved. The Senator is correct that there is an immediate problem for the industrial estate. However, the local authorities are developing a longer term solution, which involves a considerable number of additional measures such as adding traffic signals, a widening of the road and changes at the N17 Parkmore Road junction. A comprehensive plan is under development and the urgency has arisen, particularly since schools reopened in September, because the companies experiencing significant congestion.
Mr. Pat Dunne, the managing director of Creganna Medical has set up a group, which is active in this regard, and the IDA is working closely with them. I assure the Senator that this issue is not being overlooked. IDA Ireland, which is under my remit, is working closely with the engineers and I hope that a solution can be developed. I spoke to IDA Ireland officials earlier and will continue my contacts with them. I will also speak to local authority officials should that be helpful. A sincere effort is being made by all sides to find a solution to a problem that has resulted from the success of the park and the region.
I thank the Minister for his detailed reply and I welcome his engagement with the relevant agencies. I appreciate that work is going on in the background but, given the number of agencies involved, there are many different moving parts involved. Leadership is needed whereby one person can pull all those moving parts together to make sure there are targets, delivery times and a timeframe. That would give greater confidence to the employers and employees working on the industrial estate. Many practical solutions can be put in place and I welcome the Minister's intervention in the context of speaking with IDA Ireland officials. I would welcome it if he contacted the local authorities as well because we cannot afford to allow this matter drift any longer. There are solutions and people are willing to put in the time and effort, including the business community. Business people have been proactive and they have approached this in a positive and constructive manner. However, there is a leadership issue with regard to setting timeframes and pushing the matter forward to ensure jobs are protected and industries in the west can develop.
I agree with the Senator that timeliness is essential. I fully recognise there are different bodies involved with different demands, standards and expectations to meet and they have to make sure that an agreed proposal is robust within the context of the demands which are rightly placed on them.
We have to work within that. There has been good engagement on both sides. There is a willingness to find a solution. The Senator is correct. We need to be able to find timelines for interim and longer-term measures and to see those integrated in a sensible way.
As I understand it, the two sides have had useful engagements. The engineering teams on both sides are assessing their respective needs and potential to resolve this issue. There is a willingness to do this. We have recognised at national level that a big part of continuing our recovery is to have a closer integration at regional level. The Department of Public Enterprise and Reform has agreed funding for significant property investment by the IDA to resolve issues over time and create the capacity to develop. There is a commitment on all sides to find a solution. Having raised the issue, I hope the Senator will underline her anxiety and that of many business people to see that the issues which are important are handled in a speedy and effective way.
Sitting suspended at 11.12 a.m. and resumed at 11.30 a.m.