Seanad Éireann díospóireacht -
Thursday, 10 May 2018

Vol. 257 No. 15

Commencement Matters (Resumed)

Work Permits Eligibility

Minister of State at the Department of Employment Affairs and Social Protection (Deputy Pat Breen)

I thank Senator Victor Boyhan for raising the issue. I come from a rural background and agriculture is a very important part of our economy. It has played a very important part in our economic recovery. The good thing about agriculture on this island is that all the regions benefit from it. It is not just focused on one area.

Ireland's overarching labour market policy is to promote the sourcing of skills and labour needs from within the workforce of Ireland and the European Economic Area. In recent years, the employment permits system has been oriented towards highly-skilled occupations which are required for the development of the productive economy. As the economy improves and we approach full employment, labour as well as skills needs are becoming apparent in some sectors with the consequent potential to constrict growth due to labour shortages.

It is clear that difficulties are emerging in the agri-sector in particular for low-skilled, lower-waged workers in the horticulture, dairy and meat processing areas. In recognising the changing economy and labour market and the challenges faced by enterprises in attracting sufficient labour, my officials are undertaking a review of the economic migration policies underpinning the current employment permits system. The purpose of the review is to ensure our current policies are fully supportive of Ireland’s emerging labour market needs, be they skills or labour shortages.

In undertaking any adjustment in the orientation of the system, the interest of the 230,000 people on the live register in Ireland and the 17.5 million unemployed in the EU 28 must be remembered, and a balance must be maintained that does not disadvantage these jobseekers. The review is overseen by an interdepartmental group, chaired by my Department, and includes a public and stakeholder consultation as well as an EU and international benchmarking exercise. A report is expected before the end of June.

I am aware of the particular challenges facing parts of the agrifood sector which employs over 173,000 people across the regions which, as I said earlier, is nearly 8.7% of the workforce of the country. It contributes almost 8% to gross national income with exports worth almost €13.5 billion. It is extremely important to us and it is important that we in government ensure that any constraints that are there are recognised and that demands are met. It is also a very important indigenous sector and its reach in rural Ireland brings jobs and value to every region. For this reason, I asked that, in advance of completing the full review, the emerging labour shortages in the sector be prioritised in its deliberations. The review group has been examining this issue and I expect to be a position to make an announcement regarding the agrifood sector very shortly. We have been in consultation with the Minister for Agriculture, Food and the Marine.

Senator Victor Boyhan

I thank the Minister of State for the comprehensive report. It is interesting. I was talking to someone in the Irish Farmers' Journal. I told him this was happening today. I will be very happy to go downstairs and put it in the fax I will send to him. It is really important. It is important we communicate that message to the industry. Things are cranking up, certainly in soft fruit production and this is a very important time for the horticulture industry. We see it in the poultry and meat sector. It is important to grow this opportunity. The availability of seasonal workers for seasonal periods is an issue. They are not necessarily required for 12 months in certain sectors. We have an area that it is important to grow and manage in a sustainable way. I thank the Minister of State for his support and for the report.

Deputy Pat Breen

I am acutely aware, because I meet these processors and agricultural people on a lot of occasions, that in the horticultural sector, it is the height of the season for strawberries. There is a limited season for these things. It is important that we have the labour force to be able to supply strawberries.

The review covers all aspects of the current employment permit system with the principle objective of considering a policy rationale for employment permit systems when the economy is growing and the labour market is tightening, as evidenced in the agrifood sector. In the context of Brexit, the agrifood sector is extremely important given the fact that nearly 37% of our exports go to the UK. It is important we are competitive, that we have lean operations and that we have the necessary labour force in place to ensure we are at the top of the class in what has traditionally been a great source of trade for us particularly with our exports.

We produce enough of food for 35 million people when we have a population of 5 million so we have to export that food. It is important we produce it in the best possible way. I hope we will have more positive news on it for the Senator before the end of the month. It is important that when the review is completed we will let Members of the Oireachtas and the Senator know, given his particular interest in this area.

HSE Staff Recruitment

Senator Máire Devine

While I asked for the Minister for Health, Deputy Harris, to attend the House, I welcome the Minister of State, Deputy Catherine Byrne.

The office of the director general of the HSE is in disarray. Public confidence in high level management in the HSE is at an all-time low and we are all distressed at what is unfolding in the agency. Only last month we had the Garda Commissioner debacle and now the cervical smear story which is harrowing for the women of this island and their families. I see an opportunity to revolutionise the way that the Department of Health operates. However, it will take real tenacity.

I concur with the sentiment of the upcoming motion in the Dáil that Tony O'Brien, the director general of the HSE, should step down. Irreparable damage has been caused to public trust. The whole situation is drenched in secrecy. We must look to a positive future for not just women's health but everyone's, as well as for the health services. The Irish Times reported the recruitment process has already been stalled as the HSE is struggling to define the job description. If this is not indicative of the complete mismanagement and lack of governance in the HSE, then I do not know what is. It is bizarre and preposterous to imagine that for years the HSE could not describe the director general's role? How can there be proper checks and balances, as well as accountability for a role if there is no job description?

It is a year since the Sláintecare report was published. Will the Minister of State give the House an update on where we are with the board of the HSE? The accountability issue is glaring and it is inconceivable it has been left wide open for so long. According to the World Health Organization, good governance for health must include transparency, accountability, participation, integrity and policy capacity. It is obvious to everyone that the HSE administration fell far short of these. These values must be ensured for the next appointee.

How the Minister manages this process is vital, not only for the general public, but for the warriors on the ground in the health service. They want someone with a true capacity for leadership and who would be inspiring. Will he ensure a new fresh face for this post? Will he ensure the successful candidate will not come from the same toxic environment? According to media commentary, both deputy director generals and the chief strategy officer could be in the running for interim director general, as could the current HSE finance chief. In terms of culture, I have grave reservations about this. The process for finding a new director general should be open, accessible and revolutionary. The successful candidate must be a progressive agent for change. The chance is coming to change the captain of the ship. I hope this process is managed well. It is interesting to note that none of the current names floating around as possible candidates for Mr. O'Brien's replacement is a woman's. That raises a point in itself and should require some reflection.

Minister of State at the Department of Health (Deputy Catherine Byrne)

I apologise on behalf of the Minister for Health, Deputy Harris, who is unable to take this Commencement matter raised by Senator Devine.

The current director general of the HSE will be vacating the post towards the end of July. Preparations are at an advanced stage regarding the process for appointing his replacement. This will be done in accordance with the provisions of the governing legislation, section 16E of the Health Act 2004, as amended by the Health Service (Governance) Act 2013. This requires that the recruitment process will be undertaken in line with the Public Service Management (Recruitment and Appointments) Act 2004. The recruitment will be carried out by the Public Appointments Service and will include an international executive search. The post is expected to be advertised shortly.

The importance of attracting the highest possible calibre of candidates cannot be overemphasised. The director general's role is to lead the HSE and to manage and be accountable for the administration and business of the executive. The HSE has a budget of €14.5 billion in 2018 with over 115,000 staff in whole-time equivalent terms.

The Sláintecare report sets out an ambitious plan to transform and enhance health services over the next decade. The report advocates a reorientation of the health service towards a high-quality integrated system providing care on the basis of need. The Government has committed to a significant programme of health reform arising from the report and an implementation plan will be submitted to the Government shortly. The next director general will, therefore, need to deal with a changing governance environment.

Under the current system, the director general is the chairperson of the directorate. The directorate is the governing body of the executive with authority to perform the functions of the executive. Work is ongoing to bring forward a Bill this year to legislate for the establishment of a governing board for the HSE. The Minister for Health, Deputy Harris, will be bringing a memorandum to the Government next week with the general scheme for a Bill. He hopes to receive the co-operation of the Oireachtas in getting the legislation passed this year in recognition of its importance to the reform agenda.

All Members will agree we need to ensure more robust and transparent structures of accountability across our health service. The appointment of a strong board is essential to achieving this. Subject to this proposed legislation, it is intended the directorate will be replaced by a board and the post of director general will be replaced by a chief executive officer who will be accountable to the board. The next director general will be required to contribute fully to the successful transition in organisational governance structures; to support the new board in its duties; and to fully discharge their accountability as chief executive officer to the board when established.

It is the Minister's intention that the post of director general will be advertised as soon as possible. The Department of Health is engaging now with the Public Appointments Service to progress this as a priority.

Senator Máire Devine

I know section this and section that of the governance Act and so forth. The director general post will revert to chief executive officer again. Cathal Magee left this post because he did not really agree with the idea of a chief executive officer. We are going back for some reason.

We do not want somebody parachuted in as has happened. The interim director general cannot become permanent as happens de facto throughout our public services. We need somebody who not only has managerial experience but has proven clinical experience. They must also have hands-on experience to ensure they can stay in touch with the workers and patients on the ground.

Who is on the interview panel? Who chooses them? Will it be somebody parachuted in as has happened before? This is a massive opportunity to introduce change and an agent for change to the health system.

Deputy Catherine Byrne

I do not have the information on who is on the interview panel to hand. I am sure when the Minister brings the memorandum to Cabinet, matters about that will become clear.

I do not know who is running. I hope there will be women with the relevant qualifications from here and further afield who would be interested in the job. I do not agree with the Senator, however, about proven clinical experience. It is important that whoever gets the job understands the ins and outs of the medical profession, whether it is in hospitals, primary care centres and across the HSE. Such a connection will be important.

I do not have the exact date as to when the board will be in place. I know the Minister for Health is anxious to proceed to ensure when the incumbent, Tony O'Brien, leaves his post, his replacement will fit into the vacancy as soon as possible. I will ask departmental officials to come back to the Senator on some of the matters she raised.

Organ Donation Data

Senator Mark Daly

I thank the Minister for coming to the House. This matter on the Commencement is something I hope we can all work towards. I ask the Minister to sign a statutory instrument that would allow the sharing of information with the Health Service Executive, HSE, of people's intention to be organ donors. As the Minister is aware, code 115 on the driver licence indicates the person owning the licence has indicated the wish to become an organ donor. At this time, unfortunately, the information is not available to the medical profession. There are currently 2.6 million driving licences held by people in the country issued by the Department. Since the code was introduced through a European directive, over 400,000 licences were issued between 2013 and 2015, and 40% of those, including learner and full licences, indicated a wish to become organ donors.

I was nominated by the Irish Kidney Association and I am well aware of the trauma that families go through when asked in a hospital setting if they would consider donating the organs of loved ones. In most cases they never had the conversation because nobody believes the awful day might arrive when they would be asked that question. It is through huge generosity on the part of a family that so many lives are transformed and saved by those willing to donate their loved one's organs. Information is very important. If families could be informed by organ donor co-ordinators or a surgeon that their loved ones indicated they would like to be organ donors when they filled out the driver licence application, it would make a huge difference to the outcome. It would make the job of the organ donor co-ordinator easier if such information could be given.

It would be quite simple for the Minister to do this and it is a two-step process. I have asked the Oireachtas Library and Research Service to look into what is required and there is no requirement for further legislation. Under the Finance Act 1993, the Minister responsible for transport has the power to make regulations relating to licensing, and the Minister could make regulations stating that the donor information on driving licences relating to organ donations could be recorded on the national vehicle and driver file. That is the first step. The second step would come when the national vehicle and driver file would allow the HSE hospitals or doctors - whoever the Minister feels would be appropriate - to access the information. Currently, the National Transport Authority, the Road Safety Authority, the Courts Service, the Health and Safety Authority and, most recently, eFlow and Applus, which operates the national car testing service, have been given access to that information. Unfortunately, the HSE and its doctors would not have access to the information held by the national vehicle and driver file.

In 2015 the Department assigned a statutory instrument that allowed for those bodies, including those operating road tolls, to access the information. I ask the Minister to simply sign a statutory instrument to allow the health service to access the information currently held by the national vehicle and driver file so as to make it easier for families to come to a decision if asked to donate the organs of loved ones.

Minister for Transport, Tourism and Sport (Deputy Shane Ross)

I thank Senator Daly for raising the subject. It is a constructive suggestion and like all suggestions it has obstacles that sometimes may not be anticipated but it has merit. I will outline the difficulties but this has enough merit to justify me looking at those obstacles and seeing if they could and should be removed.

Driving licences in Ireland are in a format set at European Union level. They include information marked in the form of numerical codes. Some codes are standard across the EU, but some may be created by member states. Ireland has taken advantage of this facility to allow applicants for a driving licence to opt to have a code 115, which indicates they are willing to be considered as organ donors. I have not heard the suggestion before that the information in question might be shared with the HSE. That does not mean it is a bad suggestion and the definition of a conservative is someone who will not do something for the first time. It is not a reason this should not be done.

It would raise a number of important questions. First, and as the Senator mentioned, there is the matter of data sharing. The Senator is aware that new EU rules on data protection are due to come into effect from 25 May. Among other protections, we would need the permission of the data subjects to share their data. In this case, the difficulty is that people have been asked to indicate, as part of their driver licence application, if they wish to be organ donors. If they do, a code 115 is marked on their licence. However, they have not been asked if they are willing to have this data shared with a third party such as the HSE, and it would not be possible to share it without their consent. It may be possible to add a question to the application form as to whether people consent to the sharing of the information. As a licence is valid for ten years, it would take a decade to work through the system until everyone willing to share their data was covered.

There is also a risk to be considered, which is that people might be more reluctant to volunteer to have a code 115 if they had concerns about their data being shared. I do not know if it is true but it must be considered. What data would be shared? Are we talking about the names and home addresses of people who chosen to have a code 115? Would it include their licence details? We need to think this through. Given the general sensitivity to data security and data sharing, there must be a real concern that the number of people opting for a code 115 might drop. We also need to consider what the societal gain might be in this case. Consequently, there is a significant body of work to be done before this can be answered. Is it intended that the HSE could look up lists of potential organ donors, for example, where a patient died and the HSE wanted to know quickly if the patient had signed on to be a donor? If this is what is intended, there may well be benefits, but I certainly want to hear the HSE’s views on this, as well as those of the Road Safety Authority, RSA, before taking any action.

Taking all of this together, there may be a case for examining whether this should be done but before getting to the stage of asking the RSA to devote any resources to it I would need to be convinced that there was at least some chance of this proposal having advantages for the public. On that matter I would particularly require the initial views of the HSE. I will ask the HSE to give me those views and see if I can progress this proposal in a constructive way. It makes much initial sense and if we can get over the data protection issues, I am prepared to pursue it in response to the Senator's comments.

Senator Mark Daly

I thank the Minister for his reply and I welcome his positive response. Data protection is clearly a concern for everybody but I am not sure of the small print when one applies for a licence. There is an element of data sharing being signed off as the M50 toll company can now access data, as well as the Courts Service. It is clearly within the gift of the Minister to ensure others have access to data. If we can do it for the Courts Service, the Health and Safety Authority and others, I am sure it could be extended to the HSE.

There is the question of who would access the data. It would not be something general but it would happen when people at the coal face believe somebody is a potential donor. They should be able to find out whether the person had indicated a wish to be a donor.

That information could then be used with the consultant informing the family. These are the parameters of what we are seeking. The idea is to assist families in coming to a decision. It would be helpful to have that information available to assist them in ascertaining the intentions of their loves ones.

The Minister has made some valid points but the issues of data protection and sharing of data are already covered in the existing legislation. The issue at this stage relates to the HSE. Ultimately, the public good arising from this comes from lives being saved and transformed. Let us suppose the measure brings about even one extra organ donor per annum. That change alone can transform up to five lives and it would be because of the Minister's action. I recall a line from the Bible, although I have not read the Bible too often. The Book of Genesis says that if a man saves one life, he saves the world entire.

By introducing this statutory instrument, the Minister's influence will be felt for years after he has left office. Lives could be transformed as a result of this important information being shared and that could make a major difference for families and people in the country.

Deputy Shane Ross

I believe we are talking the same language. Earlier I made reference to whether this measure has advantages to the public. The Senator is right - that reference was undisguised code for the question of whether it saves lives.

I believe this is a potentially life-saving measure and I do not believe it would be right to stand in its way, at least not for any bureaucratic reasons. If there are practical reasons, although I do not see any at the moment, then so be it. However, I believe it would be absolutely wrong, in view of what the Senator has said, if I did not ask my official to open a conversation with the HSE to see if it would be in the interests of the HSE. Moreover, if the HSE agrees with it, then we could proceed, hopefully, to save some lives as a result of this measure.

Sitting suspended at 11.10 a.m. and resumed at 11.35 a.m.