Commencement Matters

Health Services

The Minister of State can take her seat. Usually Members have four minutes and the Minister has four minutes to reply. It is at my discretion to allow a supplementary question. I normally do but sometimes the times have been totally breached, which puts pressure on later speakers. Senator Paul Gavan has four minutes to outline his case.

The Minister of State is very welcome. I wish to raise the issue of health services in County Clare, with specific reference to the drastic curtailment of the Shannondoc service. As no doubt she is aware, Shannondoc is an urgent out-of-hours GP co-operative that was established in 2002. Its main purpose was to provide an urgent out-of-hours GP service to the people of the County Clare area. On November 14 of last year, despite protests from the local community, the service was massively scaled back in the county. Both Shannondoc centres at Kilrush and Ennistymon have relocated to Milltown Malbay on weekdays from 6 p.m. to 8 a.m. and on weekends the service is operational until 7 p.m. As Kilrush has such a large catchment, Shannondoc decided that it would introduce a nurse service on weekday evenings for an additional two hours to enable remote video consultations to soften the blow of taking the doctor away fully.

According to the HSE, which funds Shannondoc to the tune of nearly €5 million each year, the reason for the scaling back of the service is not related to funding. According to Shannondoc, the reduction in service is as a result of the inability to attract doctors to work in rural areas combined with a lack of available locums. Changes in immigration law in 2015 have also been cited as making it unattractive for locums. The long-standing failure to complete negotiations for a new GP contract has also been cited.

With the withdrawal of the Killaloe service, patients in east Clare now face the prospect of travelling to Nenagh, Limerick or Ennis to be seen by a GP after 6 p.m. We are informed that neither the Minister nor the HSE can determine or make changes to the decision of individual practitioners. The HSE promised to keep the situation under review every three months for the next 12 months. I ask the Minister of State to give me the details of that review in her reply. I would be interested to hear how the review got on and what were the results. A HSE spokesperson has been quoted as saying that the HSE might consider a rethink of the situation if there were "significant or adverse consequences to these changes". I wish to repeat that: If there are significant or adverse consequences to these changes, the HSE may consider a rethink of the situation.

What does that mean? Does it mean that it might reconsider the situation if a few people die? If so, how many deaths are required? This is a publicly funded service and families rely on it. What will the Minister do? Are the Minister and the Minister of State telling the people of County Clare that they do not deserve the same level of out-of-hours GP services as the rest of the country? Are people in rural parts of Ireland now expected to be treated as second-class citizens? I remind the House that, in the context of County Clare, the hospital in Ennis has been downgraded. Fianna Fáil took care of that. It only runs a 12-hour accident and emergency unit. There are no maternity services in County Clare. People living in remote parts of the county cannot get sick after 6 p.m. because the nearest doctor is stationed an hour's drive away. That is the same length of time it would take them to drive to the hospitals in Limerick or Galway, which happen to be the two hospitals worst hit by over-crowding.

I want answers with regard to the review, the action her Department is taking to address the situation, the GP contract negotiations and the visas issues that have been raised previously with the Minister.

On behalf of the Minister, Deputy Harris, I thank the Senator for raising this issue.

At the outset, I would like to assure the House that the Government is committed to enhancing primary health care services, including GP services, throughout the country. The development of primary care is central to the Government's objective to deliver a high quality, integrated and cost-effective health service.

GPs contracted under the General Medical Services scheme must make suitable arrangements to enable contact to be made with them, a locum or a deputy for emergencies outside normal practice hours. While there is no obligation on GPs to participate in GP out-of-hours co-operatives as a means of meeting the contractual requirement, such services have been developed and expanded over time and are now an essential part of the primary care services. This helps to ensure that, to the greatest extent possible, urgent care needs are met in the primary care setting.

As the Senator will be aware, in the mid-west region out-of-hours arrangements are discharged through Shannondoc, a not-for-profit GP co-operative owned and managed by a group of individual GPs across Limerick, Clare and north Tipperary, which is funded by the HSE. The HSE has signed a service arrangement with Shannondoc for 2017. Last year, Shannondoc announced that, due to a difficulty in attracting GPs, in particular, locum cover, it was no longer able to maintain its existing service across all its centres. Following discussions with Shannondoc, in order to ensure the sustainability of the service, the HSE accepted a proposal from the co-operative to changes in the provision of the service. The HSE's funding model to Shannondoc has not been altered and the changes to service provision decided on were not influenced by the availability of funding from the HSE. The most significant changes relate to part of east and west Clare, essentially affecting Ennistymon, Kilrush, and Killaloe, with minor changes in terms of operating hours in two locations in north Tipperary.

The changes made to the Shannondoc out-of-hours services are subject to a three-monthly review and their impact is being closely monitored and evaluated by the HSE. There have been no further changes in the provision of Shannondoc services to date. The Government is committed to ensuring that patients throughout the country continue to have access to GP services, especially in remote rural areas and also in disadvantaged urban areas, and that general practice is sustainable in all areas into the future. It is imperative that existing GP services in these areas are retained and that general practice remains an attractive career option.

As part of ongoing attempts to provide additional supports to GP services and to ensure the future provision of these services in all areas, A Programme for a Partnership Government commits to increasing the number of GP training places to 259 places annually. In July 2016, the GP training intake increased from 157 to 172 places and the HSE's 2017 National Service Plan envisages a further increase, to 187 places this year.

The Minister, Deputy Harris, is anxious to achieve further increases in future years in order to ensure that the future manpower needs of general practice can be met. Further efforts undertaken in recent years to increase the number of practising GPs include changes to the entry provisions to the GMS scheme to accommodate more flexible-shared GMS-GP contracts, and to the retirement provisions for GPs under the GMS scheme. An enhanced supports package for rural GPs was also introduced last year.

The Minister has also emphasised the need for a new GP services contract which will help modernise our health service and develop a strengthened primary care sector, and health service management have already progressed a number of significant measures through engagement with GP representatives. The GP contracts review process will, among other things, seek to introduce further measures aimed at making general practice a fulfilling and rewarding career option in the future.

I do not mean to be disrespectful but I must be frank with the Minister of State. I asked for detail of the three-month review that should have taken place by now and the Minister of State has given me no detail. I asked her to comment on any steps in relation to the visa restrictions issue for locums and she has not given me an answer in regard to that. I asked what steps the Department is taking to attract GPs to rural Ireland and the Minister of State has given me no answer on that. I asked what did the HSE mean by "significant or adverse consequences to these changes" and the Minister of State has ignored that as well.

I will put this in context for the people of County Clare. We hear a lot of guff from the Government in regard to protecting and enhancing rural areas. In reality, the Government is shutting down bus services. It is shutting down health care services. It is shutting down post offices. The Government is killing rural areas. The people of County Clare want to know why are they being treated as second-class citizens when it comes to their health service.

I again thank the Senator. Unfortunately, I do not have some of the information he is looking for but I will come back to him.

The Minister of State has given no answers.

I will come back to the Senator. There is a clear answer. The Minister has outlined and explained about the GP services. The Senator made it clear in his opening statement that there is a need for GPs in rural areas. Unfortunately, for whatever reason, GPs are not attracted to rural areas in some cases. The Government cannot force GPs to go into rural areas to become part of a practice.

The Government could take enhanced measures to attract them. They have done nothing.

There is a clear indication from the Minister's reply that the HSE and the Department are doing everything to enhance training for GPs and to bring more GPs into the service. That is something we all welcome. I will get the Minister's office to come back to the Senator on the review for the past three months and what the accomplishments have been.

It is not fair to say that the people do not deserve a proper health care system. Every citizen in this country does.

I never said that. I said the Government is treated them as second-class citizens, and it is.

I do not agree with Senator Gavan on that one-----

The people of County Clare would agree.

-----and neither does the Minister. I will come back to the Senator on the various points which I have made note of and I will relay them back to the Minister's office.

Wind Energy Guidelines

Do I take it that the Minister for Communications, Climate Action and Environment, Deputy Naughten, will not appear before this House to answer a specific notice of motion I placed for the Commencement debate on the erection of wind turbines in my constituency of Roscommon-Galway? Do I take it that the Minister is not here? He was in Leinster House last night. I was in the same vicinity as he was. He did not request me to postpone this motion. The Minister can run, but he cannot hide, from this issue.

The wind turbines in my area will destroy our locality and it is up to the Minister to bring in guidelines. It is three years since this matter was at issue. I ask that these turbines would be at a distance equal to ten times the height of the turbine. The height of one of these wind turbines is 130 m and it should be roughly 1,500 m from any house within that vicinity.

The Minister attended a public meeting. He knows the issue involved. In protest, I will be re-entering this matter. I will pursue this continuously until the Minister, Deputy Naughten, is prepared to stand up to his responsibilities, both as a Minister and as a Deputy for the constituency of Roscommon-Galway. I will not allow the Minister to destroy our area. He has in his power the right to bring forward the new guidelines and those guidelines are being held up by him. I hold the Minister personally responsible for this issue.

In this issue, I am walking out in protest of the slight and continuous insult on this House. I have received no explanation from the Minister, Deputy Naughten, who was in the House last night, and I was in the House last night.

To clarify, my understanding is the Senator asked for the Minister, Deputy Naughten, to attend. It was actually changed by agreement between the Minister, Deputy Naughten, and the Minister, Deputy Coveney's, Department. The Commencement matter states, "The need for the Minister for Housing, Planning, Community and Local Government" to attend. In fact, Senator Leyden wants Deputy Naughten rather than Deputy Coveney.

No explanations required.

I thank Senator Leyden. That concludes this matter. I suppose there is not much point in the Minister of State, Deputy Catherine Byrne, responding.

Prison Accommodation

I welcome the Minister of State, Deputy O'Donovan.

I welcome the Minister of State to the House. I thank him for coming in. I am sorry the Tánaiste and Minister for Justice and Equality is not able to be here to take this question.

He might pass on the fact that I wished to commend her on the penal reform programme generally and, in particular, the announcement this week that the Minister for Children and Youth Affairs, Deputy Zappone, will be introducing an order that finally ends the detention of young offenders in adult prisons, which is welcome.

This Commencement matter is a lengthy question that relates to a specific issue, that is, the imminent closure of the training unit prison on the North Circular Road prison estate beside Mountjoy Prison. It has been some years since I visited it, as I visit Mountjoy and Dóchas more regularly, but its imminent closure has given rise to serious concerns among current prisoners, staff, the Irish Penal Reform Trust, IPRT, and the Prison Officers Association. I have discussed this matter with Mr. Michael Donnellan, the IPRT and others, but I wish to raise directly with the Minister of State a number of concerns. Mr. Donnellan spoke at the justice committee on 8 March on this issue, but I wish to have more details about the consequences of the closure.

I will raise three specific issues. First, there is a concern among current prisoners that their regimes might be adversely affected by the closure. Those in the training unit are engaged in a wide range of rehabilitation measures. Many are on temporary or day release and are concerned about what the transfer will mean for them. For those transferring to open centres, such as Shelton Abbey and Loughan House, key issues will arise, for example, distance from families and services and continuity of their programmes. For those transferring to Mountjoy west, formerly St. Patrick's Institution, there is a concern around normalisation as being central to rehabilitation. Prisoners in the training unit have communal eating facilities. If they move to Mountjoy, will they be subject to in-cell eating and earlier lock-up times in their cells, will there be a deterioration in their family visiting conditions and will they be able to continue with their rehabilitation regimes? The concern is that the move could amount to a regressive step for those currently serving time in the training unit, in particular those with life or other lengthy sentences who are engaged in long-term rehabilitation regimes.

Second, why is it proposed to house older prisoners together in one place once the training unit is reopened? Mr. Donnellan stated that the unit needed to be upgraded and in-cell sanitation needed to be installed. Once that is done, it is proposed to reopen the unit. I understand that there are approximately 90 prisoners aged over 60 years across the prison estate. Why must they all be kept together?

Third, will the Minister of State confirm whether the closure is in line with the overall penal policy aim of rehabilitation as articulated by the penal policy review group? The IPRT is concerned about this matter. The strategic review group on penal policy recommended an increase in open prison provision, particularly in Dublin. The closure of the training unit will reduce the provision of semi-open accommodation by 96 places to under 7% of bed capacity. This reduction is contrary to the group's report. Mr. Donnellan stated that it would take 18 months to two years to refurbish the training unit. There is a concern that this will be a retrograde step, in that there will be a reduction in semi-open and open prison accommodation during that period.

There is also a concern that the plan to close the training unit in the absence of the provision of alternative open or semi-open facilities amounts to an efficiency measure rather than what it should be driven by, that being, the needs of prisoners and an emphasis on rehabilitation.

While I appreciate the need to refurbish the training unit, I wish to get the Minister of State's response about addressing these concerns on record.

At the outset, I apologise on behalf of the Tánaiste, who unfortunately cannot attend. I assure Senator Bacik that I have noted the individual concerns that she raised and I will relay them to the Tánaiste.

I thank the Senator for giving me the opportunity to discuss the planned repurposing of the training unit place of detention as an older prisoners unit. The training unit is a semi-open facility based within the Mountjoy Prison campus for males aged 18 years and over. As a semi-open prison, prisoners accommodated within the training unit are afforded more latitude in terms of out-of-cell time than prisoners with a higher security rating. A key action of the Irish Prison Service strategic plan, specifically action No. 2.5, is to ensure that older prisoners are identified as a specific group that has particular needs within the prison population. There are a number of such prisoners in the care of the Irish Prison Service who have significant and ongoing health care needs, many of whom are dispersed across the estate, in some cases significant distances away from the health care providers on which they rely.

The development of a bespoke facility to cater for the needs of this specific cohort will allow the Irish Prison Service to provide a physical infrastructure that takes cognisance of the needs of older adults in terms of mobility, access and appropriate age-related services, forge strong strategic links with statutory and community services critical to effective care provision for older persons in custody, ensure that age-related mental health and related social needs are met through appropriate assessment and intervention methods, including early detection, and ensure that older adults in prison are given opportunities for participation in meaningful and purposeful activity or occupation to meet their needs, preferences and capacities.

The House will be well aware that significant investment has been undertaken by the Government in Mountjoy Prison. As a result, overcrowding has been eliminated and all of the wings in Mountjoy Prison have been completely refurbished, thereby facilitating the elimination of the practice of slopping out and the significant enhancement of regime activities and facilities available to prisoners. To facilitate the refurbishment of the prison, one division of Mountjoy Prison, equating to 125 cells, has been continuously closed since 2010. With the recent completion of the refurbishment project, however, these cells are now available for occupation.

As a result of the developments I have outlined, an opportunity now presents itself to migrate prisoners to Mountjoy Prison from the training unit in order to repurpose the existing facility into a dedicated unit to accommodate older prisoners. The temporary closure of the unit will not result in any reduction in the regime or sentence management arrangements currently in place for prisoners accommodated there. Given the existing capacity within Mountjoy Prison, prisoners currently accommodated in the training unit will be transferred to an enhanced area of the prison, which will allow them to continue to avail of the level of openness of regime and provide improved, more structured activities than those currently available within the training unit. Moreover, there will be no interference with the sentence management plans in place for prisoners, many of which are based on recommendations of the Parole Board. Likewise, the temporary closure of the training unit will not result in the displacement from Mountjoy of staff currently serving in the unit. Staff will be reassigned across the Mountjoy campus and the resulting surplus of staff will be redistributed across the service by way of current voluntary transfer arrangements. The latter will have the significant added benefit of allowing the Irish Prison Service to consolidate its staffing resources and will greatly assist in addressing current staffing shortfalls, pending the training of recruit prison officers, which is scheduled to commence later this month.

In addition, a new lifers unit has recently opened in Wheatfield Place of Detention, offering prisoners a more open prison regime. It is the intention of Mountjoy Prison management to establish a second such unit for suitable life sentence prisoners, including those transferring from the training unit.

I thank the Minister of State for those words. I am grateful to Mr. Donnellan, the head of the Irish Prison Service, for also communicating with me much of the information that the Minister of State just provided. I appreciate the progress being made in refurbishing Mountjoy Prison, in particular the ending of the appalling practice of slopping out. I am glad to hear the Minister of State confirm that there will be no reduction in the regime or sentence management arrangements that are currently in place for prisoners accommodated in the training unit. I welcome that those being moved to Mountjoy will be transferred to an enhanced area of the prison and have the same level of openness of regime and so on. However, I will keep this issue under review. The IPRT is also following it.

I would be grateful if the Minister of State could ask the Tánaiste to follow up on the more specific questions that I have raised and to respond to me on same. I will follow them up with her as well. In particular, when will the new unit that was mentioned be established and open? I refer to the more open prison unit for those transferring from the training unit. Is this closure in line with the general policy of emphasising rehabilitation as a sentencing rationale?

On the Tánaiste's behalf, I assure the House that the Irish Prison Service and Mountjoy Prison management are working to ensure that prisoners relocating from the training unit are accommodated on regimes that mirror in so far as possible their current ones so that they can continue their rehabilitation and help their eventual reintegration on release from prison custody, which is a point that the Senator raised.

I counted seven specific queries. I will relay them to the Tánaiste and ask her to revert to the Senator.

I thank the Minister of State.

Skills Shortages

I welcome the Minister of State, Deputy John Halligan. I know he is aware of the skills shortage in the hospitality industry, especially chefs and front-of-house staff. The expert group claimed that we need approximately 5,000 chefs a year in terms of training, and I understand 1,800 currently go through the system.

My background is in the hospitality sector, and I know how important it is to have the right staff who are properly trained. The hospitality sector is very reliant on service delivery to their customers. Tourism numbers are up. No matter where people go, they will want to eat and drink.

I served on the old VEC and the LCETB for a number of years. I visited the training centre in Limerick, which is run by the LCETB, on many occasions. It has provided those who are long-term unemployed in the area with skills and training. Some have gone into front-of-house, management or trainee management and others have become chefs. I would like to see a similar system elsewhere. I would welcome any suggestions from the Minister of State regarding how he will address the situation.

Career decisions involve long-term choices. Culinary skills and front-of-house management in the tourism and hospitality sector offer long-term employment prospects. We need to examine how we can encourage people to apply for the relevant courses through the CAO system or return to education for reskilling or retraining as mature students. Education in skills is very important. Not everyone will go into third level education or the skills sector. I look forward to hearing the input of the Minister of State.

I thank Senator Byrne for her important question. When I became Minister of State I was made aware of the difficulty we are having in the area to which she referred.

In 2015, the expert group on future skills needs, EGSFN, carried out a study on the future skills needs of the hospitality sector. It assessed skills demand across the sector so as to ensure provision of the right supply of skills for the sector. The report was published in November 2015, and sets out a clear framework to provide for the skill needs of the sector in the years ahead.

A key recommendation of the study was the need to establish a national oversight and advisory group comprising all the key hospitality stakeholders to monitor progress on the implementation of the recommendations in the report. The hospitality skills oversight group was established last year, with membership including Government Departments and agencies, education providers, SOLAS, ETBs, HEA, the Restaurant Association of Ireland, Vintners Federation of Ireland, the Irish Hotel Federation, the Irish Hospitality Institute and the Licenced Vintners Association.

The group met on eight occasions. I have asked it to publish a report as quickly as possible. I have been told it will publish its first progress report shortly. To date, work has been undertaken on careers promotion via a range of fora such as, for example, the launch of the tourism insight online programme which is aimed at promoting careers in tourism and hospitality, the publication of a draft new specification for junior certificate home economics and the establishment by Skillnets limited of a dedicated training network for the hospitality industry.

Promoted by the Restaurants Association of Ireland, the network plans to design tailored programmes covering all aspects of the restaurant, food and beverage industry to SMEs nationally. Work is progressing on the development of a new commis chef apprenticeship, planned to commence later this year, led by the Irish Hotels Federation and the Restaurants Association of Ireland which are working with Kerry Education and Training Board.

We are working with the Department of Transport, Tourism and Sport on this issue. We realise that there is a difficulty, but we have taken the right approach in bringing on board all of the shareholders and asking them to report back. The report should be with me very shortly and I will be delighted to send a copy to Senator Byrne. If stakeholders such as the Senator believe they can add to the report, which has not been finalised, they can do so. We are asking stakeholders to come on board to assist us in the development of the apprenticeship model which we know is necessary.

Some months ago I was handing out certificates at an event and it was indicated that there is a shortage of perhaps 8,000 in the sector, which is a significant number. Once we receive the report all of the interested parties can push forward to determine how we can deal with the serious problem the Senator has addressed.

I thank the Minister of State for his response. I do not have the relevant information, but a number of people have contacted me who would be delighted to offer him some suggestions. I welcome that there will be an opportunity to provide input to the report.

I would like the Minister of State to see what is happening in the centre in Limerick to which I referred. It is something that should be rolled out across the country. It has taken people from areas of high unemployment and provided them with a skill set. The centre produced a very positive video. One woman spoke about not being in a good place because she was not working, but is now permanently employed. There have been a number of good news stories from the centre.

It is good that the Minister of State is addressing the issue and that the Department of Transport, Tourism and Sport is coming on board. That is important because both Departments have responsibility for this matter.

I would like to visit Limerick. I ask the Senator to arrange a visit with my Department over the next few weeks. If I am being told that we can create 8,000 jobs or 8,000 apprenticeships, which we are behind on, any information or advice I can possibly receive from any stakeholder or anybody who is involved would be helpful. If the Senator makes contact with my Department, I will be in Limerick within a few weeks.

Sitting suspended at 11.10 a.m. and resumed at 11.30 a.m.