Léim ar aghaidh chuig an bpríomhábhar

Seanad Éireann díospóireacht -
Wednesday, 11 Jul 2018

Vol. 259 No. 9

Commencement Matters

State Pensions Reform

I apologise for being slightly late. I have come directly from a meeting of the Joint Oireachtas Committee on Justice and Equality. I welcome the Minister of State, Deputy Jim Daly, to the House.

I raise this Commencement matter because there is an inequity in the system. Pay restoration is a fundamental principle across society, whether in the private or public sector. Many members of the public took a hit from 2008 or 2009 until 2014 or 2015 and their pay is now gradually being restored. There have been numerous examples of pay restoration, in particular across the public sector. It is likely that full pay restoration will be achieved in the next budget or the one thereafter.

However, in budget 2012 the pension guidelines, entitlements, structures and so on were changed for a group of pensioners who, prior to 2012, had a legitimate expectation to a specific level of pension entitlement when they retired. Under the new guidelines, many of those born in 1948 lost benefits to which they would have been entitled had they been born a couple of years later. A specific number of people have been affected by the changes.

The entire cost of reverting to the pre-budget 2012 guidelines would be approximately €270 million. An inequity has been created by the changes. The Minister for Employment Affairs and Social Protection, Deputy Regina Doherty, should consider reverting to the pre-budget 2012 guidelines. Doing so would not open a floodgate but, rather, help a specific number of people at a cost of €270 million. I do not ask for the entitlements to be backdated but, rather, that the former level of benefit now be restored. If that cannot be done immediately, I ask that a timeline for such be put in place.

The Department is fully aware of the circumstances of the issue because a constituent of mine has gone to the trouble of researching the matter, putting the figures together and making a case to the Department. Parliamentary questions on the matter have been tabled by Deputies. The case put forward by my constituent is fair and well articulated. This is a question of equity and fairness. I sincerely hope the Minister, Deputy Regina Doherty, will right the wrong done to these people, who have paid their taxes, served their country well and done their duty, or at least give a timeframe for that to be done.

I thank Senator Conway for giving me the opportunity to address this issue on behalf of the Minister, Deputy Regina Doherty. The current rate bands applying to the State pension were introduced from September 2012, replacing previous rates introduced in 2000, and more accurately reflect the social insurance contribution history of a person. A reversal of the rate bands for post-2012 pensioners to the 2000-2012 rate band percentages would carry an estimated cost of €73 million in 2018, including inflows from other payments such as the non-contributory State pension and increases for qualified adults, and rise at a rate of €10 million to €12 million per annum. That would mean an extra cost of approximately €85 million in 2019 and €97 million in 2020.

Better-off pensioners who do not qualify for means-tested pension payments and did not make sufficient contributions to the Social Insurance Fund to qualify for a full-rate contributory pension would be the main beneficiaries of a reversal of the changes. Prior to the introduction of the current rate bands, a person with an average of 20 pay-related social insurance, PRSI, contributions per year over his or her working life received a weekly State pension of only €4.50 less than a person with a yearly average of 48 to 52 contributions.

The Government does not propose the reversal of the rate band changes. Rather, it intends to introduce a total contributions approach to establish the level of entitlement for all new contributory State pension claims form 2020 onwards.

This is currently the subject of a public consultation which stays open until 3 September and is available on the Department's website. The total contribution approach, TCA, will ensure that the totality of a person's social insurance contributions, as opposed to the timing of them, will determine their final pension outcome. In particular, it will benefit people whose work history includes an extended period outside the paid workplace while raising families or in a full-time caring role.

The roadmap for pensions reform 2018-2023 sets out how it is intended to implement the TCA to calculating entitlement to the contributory State pension. In the interim, on 23 January, the Minister for Employment Affairs and Social Protection announced the agreement of the Government to a proposal that will allow pensioners affected by the 2012 changes in rate bands to have their pension entitlement calculated under a total contributions approach which will include up to 20 years of a new home caring credit. This approach will make it easier for many post-2012 pensioners affected by the 2012 rate band changes, who are currently assessed under the yearly average model, to qualify for a higher rate of the contributory State pension. A person who reached pension age after 1 September 2012 and has a 40 year record of paid and credited social insurance contributions, subject to a maximum of 20 years of the new home caring credits, will qualify for a maximum contributory pension where he or she satisfies the other qualifying conditions for the scheme. Up to ten years of other credits, for example awarded when on jobseeker's or illness benefit, may also be used, subject to the total credits not exceeding 20 years. People whose entitlements were assessed after the September 2012 rate changes will have the option to be reassessed under a TCA option and be paid whichever is the more beneficial amount.

Work is under way to draft legislation to enable implementation of these arrangements. In parallel with bringing in the legislative changes, IT system solutions are being developed to implement the changes. In the final quarter of this year, the Department of Employment Affairs and Social Protection will begin inviting relevant recipients of the contributory State pension to seek a review of their pension calculations with the first payments being made in the first quarter of 2019, backdated to 30 March 2018.

I suspected that this probably would be the answer. I will advise my client to feed into the review. It is an issue the House will address again in September because there is an inequity in this area. Perhaps we will need to do more research to be able to articulate the inequity a little more. I encourage everybody following proceedings who has an interest in this issue to feed into the review because it is important. The more people participate in the review and engage with the process, the better and more reflective of society the outcomes will be. I encourage people to participate. I thank the Minister of State for coming to the House to address this issue.

North-South Interconnector

I welcome the Minister for Communications, Climate Action and Environment, Deputy Naughten, to the House and thank him for taking time out of his busy schedule to be here. It is much appreciated.

I would like to discuss the North-South interconnector. It goes without saying that An Bord Pleanála's decision in 2016 regarding the North-South interconnector was met with a tsunami of disappointment, anger and frustration by the people affected. If EirGrid thought that was the end of the matter and people would take this decision lying down, it was very much mistaken. Two years on, the determination of the people affected is as strong as it has ever been. I have attended a number of meetings throughout the Cavan-Monaghan area and have witnessed at first hand that resolve.

Those affected received a shot in the arm by recent court decisions on both sides of the Border, one in Northern Ireland and a second in the Supreme Court. The High Court in Northern Ireland ruled that planning permission granted for a £240 million waste incinerator had been unlawfully authorised. Planning permission for the facility had been approved by a civil servant in the Department for Infrastructure in 2017. This landmark ruling would have a wide-ranging effect on the North-South Interconnector as it too was signed off on by a civil servant and not a Government Minister. At this point, I am sure the Minister will agree that all of us would like to the institutions in Northern Ireland back up and running for the benefit of all. I appeal to Sinn Féin and the Democratic Unionist Party to lead those who elected them to lead. The other shot in the arm was the Supreme Court's decision in favour of a Meath lady by the name of Maura Sheehy, a landowner affected by the proposed line. The court agreed to hear the case put forward by the North East Pylon Pressure Campaign. I understand the case is due to be heard at the end of this month.

In 2017, the Minister signed off on a procurement process for the installation of 409 pylons both North and South of the Border. At the time, we felt the Minister's decision was probably premature, to put it mildly, but I recall that he stated in his defence that it could be rescinded at any time. Given the decision by the courts, the fact that planning permission no longer exists for the facility in Northern Ireland and the Supreme Court case on the proposal in the South, the time is now ripe for the Minister to rescind his decision and ask EirGrid to withdraw from the tender process for these pylons. It would be a sensible thing to do and a good gesture on the Minister's part.

As the Minister is aware, the residents along the route, including in counties Monaghan and Cavan, remain resolutely opposed to the proposal. Both Houses of the Oireachtas have passed motions which seem to have fallen on deaf ears. Coupled with everything else that has happened over the years, this has only served to strengthen the will of the people that if this project is to go ahead, it must be undergrounded. Here we are ten years down the road and much has happened and many changes have occurred in that period. Technology moves on. I recall that when this project was introduced, we were told it would be 30 times more expensive to underground than to overground it. Most people on all sides now agree that undergrounding would not cost much more than overgrounding. At the time, EirGrid told us that from an engineering perspective, it was not possible to underground the interconnector. By its own admission, a few years on, the company now says it is possible to underground it. We have seen examples of projects similar to this in Belgium and Germany that have been undergrounded.

It is ten years on and things have changed but the one thing that has not changed and is as strong today as at any time in the past is the will of the people to ensure this project does not go ahead. From meetings I have attended and people I have spoken to, I assure the Minister that as far as the people and landowners along the route are concerned, not one single pylon will ever see the light of day. That is the message I am getting loud and clear and it is the message I would like to give to the Minister.

I congratulate the action groups in Monaghan, Meath and Cavan for their continued work. I hail the resolve of the people who are as determined today as they have ever been. I ask the Minister to instruct EirGrid to withdraw from the tender process to see where this is going because we are in a legal limbo at the moment and God knows how long it will be before we are out of it. Question marks hang over the independent report that was promised. We seek the report's publication.

I thank Senator Gallagher for raising this issue. The North-South interconnector is vital infrastructure in delivering the objectives of Ireland's energy policy, namely, ensuring competitiveness and security of supply. It will also ensure a safe and sustainable source of energy for the jurisdictions of the Republic of Ireland and Northern Ireland.

The interconnector, as proposed as an overhead line, was granted planning permission in Ireland in December 2016.

Following a planning process in Northern Ireland, the section of the project in that jurisdiction was also granted planning permission in January 2018. The construction of the project and all related procurement activities are operational matters for EirGrid and ESB Networks in respect of which I have no function. The 2012 Government policy statement on the strategic importance of transmission and other energy infrastructure states that "Government does not seek to direct EirGrid and ESB Networks or other energy infrastructure developers to particular sites or routes or technologies". However, I respect fully that this project gives rise to concerns for a number of people, particularly those living in close proximity to the proposed project. In fact, I was the first Minister in a decade to meet with the groups and listen directly to their concerns.

Following the planning decision in Ireland, two motions calling for an updated independent study into the North-South interconnector were passed by Dáil Éireann and this House in early 2017. I subsequently commissioned two studies designed to address the main points of the motions as well as key concerns expressed by those opposed to the development of an overhead line. Some impacts such as environmental and health concerns will not be assessed since the statutory planning process is the appropriate method by which such impacts are assessed and evaluated. The consultants undertaking the two studies have completed their respective reports and they were submitted to my Department earlier this year. They have now been fully considered by my Department and submitted to me. It is my intention that the reports will be brought to Government as soon as possible and made publicly available on my Department's website.

There are a number of ongoing legal issues in Northern Ireland which are ultimately matters for the authorities there. The judgment of the Court of Appeal in Northern Ireland on 6 July relates to a different project, although it has been acknowledged that it could have wider implications for decision-making in Northern Ireland, not just in relation to infrastructure but to the operation of government and decision-making generally. It is to be expected that the judgment will be studied over the coming weeks by authorities on both sides of the Border as to any implications for the North-South interconnector project.

To answer Senator Gallagher's question, I made it clear when I signed off on the procurement process that this could be paused or stopped at various stages in the process. I gave that commitment to the Dáil, definitely, and I may have given it here as well. I stand over that. It was the only basis on which I allowed the process to commence. I am monitoring the situation on an ongoing basis.

I thank the Minister for the response. There is a certain element of frustration in relation to the non-publication of the reports. I wonder if the Minister has an actual date for publication or whether he can provide a timeframe within which we can expect publication to occur. On the tendering process, the ordinary man or woman in the street will be of the view that if one is undertaking a major infrastructure project such as the one under discussion, one would not send out a tender document looking for people to price the construction of it until one was sure one had planning permission. That is how one would approach a shopping centre project, for example. This is because, with the passage of time, material prices may go up or down and one cannot be sure one is getting value for money. With respect, the Minister is a sensible individual and the sensible thing to do here is withdraw the tender process until we see what the road ahead looks like. At the moment, we cannot say how long that road will be or how long we will be in abeyance on both sides of the Border from a legal perspective.

This tender process is not just for the construction or potential construction of the route. As such, one cannot compare it to a shopping centre. To go ahead with the development of a shopping centre, one needs to know where the doors of each unit and the exits will be and what the overall design is. This process involves the design of transmission masts as well as the detailed design work. This is in order to meet the set timelines. As the Senator knows, there is a huge issue with electricity supply in Northern Ireland. In fairness, it is on both sides of the Border. All parties involved accept and acknowledge that there will be a severe shortage of electricity after the early 2020s in Northern Ireland which is an issue that must be addressed from an economic development point of view. There are many other aspects to it. The courts process in Ireland and Northern Ireland is not a matter in which I can get involved except to note that there are issues here and in the other jurisdiction which we are monitoring closely. I am constantly engaged through my officials in relation to various aspects of this.

Child and Adolescent Mental Health Services

I welcome the Minister of State, Deputy Jim Daly, to the House. I am delighted he is taking the matter. We have had issues every now and then with people not being in a position to give responses to supplementary contributions. I hope the Minister of State will respond to me today.

I have put in a question about the closure of the day programme at Linn Dara at 4 p.m. last Friday. My Dáil colleagues, Deputies Aengus Ó Snodaigh and Pat Buckley, raised the matter as a Topical Issue last night and I hope the Minister of State is not going to read out what was read out to them. We need to move on and work to get this vital service restored for our young children and adolescents. The Minister of State knows about Linn Dara. Last year, half of the beds in the inpatient unit were closed down and on Friday that happened to the day programme servicing the inpatient unit and outpatients to keep people at home to be treated in the community as per A Vision for Change. In 2006, it was announced that there would be 15 of these units opened across the country. We had three and are now down to two. We cannot stand over that. We cannot stand over the chipping away, brick by brick, at child and adolescent mental health services. The Minister of State has been frequently involved with the Committee on the Future of Mental Health Care and he knows about the absolute crisis in services for children. Many services are not being provided.

The Minister of State should not listen to the management of the HSE, he should listen to me and those people who are on the ground regarding their experience of how this service was shut down. On 11 June, the consultant was told by the director of services of concerns regarding staffing in CAMHS at the Linn Dara day programme. The possibility arose because the supporting CAMHS in Clondalkin was in dire straits. The consultant was willing to support the services in Clondalkin and formulated a solution with staff to provide 50% of capacity to Clondalkin with 50% remaining in the afternoon. It was half and half. Staff would go to Clondalkin in the morning and return to Linn Dara to carry out the assessments, appointments and therapies in the diary to provide long-awaited services to adolescents and children. As such, two members of staff went to Clondalkin and nothing else happened between 11 June and 27 June. On 27 June, an email was circulated by senior management instructing and advising of the closure of the day hospital programme on 6 July, which was last Friday. The senior manager went on to say the service should not inform any of the families directly about the closure and should continue to make appointments at 3.55 p.m. on Friday for children who have been on those waiting lists for a long time. This order not to inform families was the entire concern of management. They refused to communicate directly with the families or the staff. They said they would not issue letters to cancel appointments because they did not want them to end up on the Joe Duffy show.

The closure was kept quiet. Last Monday the team members were instructed to commence working in their new posts, but, again, they were not consulted. The closure has caused massive distress and led to significant consequences for the adults involved and their families. All of the adults were discharged prematurely from the day programme last Friday, 6 July. In the space of just one week the families were informed of the closure and that their loved ones would be discharged from the programme. The unit has ceased operations. We have been told that it will be reopened in September or October, but that is absolute balderdash, as I know that staff have been told that the issue will be reviewed in November. That does not mean, however, that the unit will be reopened. Consultants have been offered the opportunity to return, but the same courtesy has not been shown to any of the team.

I urge the Minister of State to show leadership. I want him to tell the HSE that enough is enough, that the people affected have had enough, that everything has changed and that it is the people of the nation and their children who are in dire straits. I plead with him to show leadership and provide assistance for the people concerned.

I thank the Senator. It is the policy of the HSE, as reflected in its annual service plans, to provide an age-appropriate mental health service for those under the age of 18 years. I reiterate the Government's commitment, in view of the significant additional funding allocated in recent years for the development of all aspects of the mental health service, including services for young people. I will continue to make the case for the allocation of further resources annually in line with evolving demands and in accordance with the commitments given in A Programme for a Partnership Government.

The HSE service plan 2018 commits to further developing the child and adolescent mental health services, CAMHS. This is against a background where the demand for access to CAMHS increased by 26% between 2012 and 2017 and where various youth mental health initiatives, other than the specialist CAMHS service, are also being progressed.

We have 69 CAMHS teams and three paediatric liaison teams that are supported by around 75 CAMHS beds nationally. Further beds are planned to come onstream as quickly as possible. In addition, the Government has agreed to fund an extra 140 psychiatric nurse undergraduate places each year to help to improve the planning and delivery of services in the next few years.

A key difficulty being addressed on a steady basis by the HSE is staff recruitment and retention, particularly in the sphere of CAMHS. The recent appointment by the executive of 114 assistant psychologists and 20 psychologists will help to develop counselling services in primary care. It is anticipated that these posts will deal with the less complex child and adolescent cases and thereby reduce the demand on CAMHS. In addition, I recently approved ten new posts of advanced nurse practitioners, ANPs, that will be specifically directed at the CAMHS service nationally. The new ANPs will play a key role in delivering better service co-ordination where local service pressures are greatest.

The HSE Linn Dara CAMHS service covers a region comprising County Kildare, west Wicklow and south-west Dublin and reflects a total population of around 420,000. There are seven multi-disciplinary community CAMHS teams for these areas. The HSE has indicated that a decision was taken by the Linn Dara management team to temporarily suspend its day programme from Friday, 6 July. This was to maintain essential community and inpatient services. It is expected that the day programme will reopen in September or October. The decision was taken owing to psychiatry and allied health professional temporary staffing shortages within the community sectors. To maintain essential provision of services, psychiatry and multi-disciplinary staff have been reassigned from the adolescent day programme to maintain other key community-based Linn Dara services and manage their overall capacity at this time. The small number of young people who were scheduled to attend the adolescent day programme will continue to attend their existing community CAMHS teams and receive appropriate individual and therapeutic programmes.

The HSE has a statutory responsibility to ensure safe, adequate and sufficient service provision in all areas of the CAMHS service. The Linn Dara inpatient unit will remain fully operational as normal, with 22 beds available, as well as functioning community teams. The Senator may rest assured that I will keep this matter under close review and that all efforts will continue to be made by the HSE to address ongoing service difficulties at Linn Dara.

The Minister of State has given the same reply as that given by his colleague, the Minister of State at the Department of Health, Deputy Finian McGrath, the last evening. I implore the Minister of State to please change his script and find a way to resolve the matter. He has mentioned that a "small number" of young people are involved. The CAMHS service covers a region with a population of 420,000, yet only 45 young people are treated annually, while waiting times, as we know, are off the Richter scale.

I welcome the recent announcement of ten new posts of advanced nurse practitioners. I plead with the Minister of State to listen to me. The unit's team provided a solution. Superficially, it was accepted by the senior management team, but, sadly, a week later it reneged on the offer and the unit's team was told not to ask questions, to close the doors within a week and not tell the parents. Management did not consult the staff. We need to change the script in that regard. A solution was provided this year, just as it was last year, but it was not taken on board. As legislators, we cannot stand by when children's health is at risk. Therefore, we need to show leadership by saying to the HSE senior management team that the closure will not happen and asking why it did not talk to us beforehand.

The Joint Committee on Future of Mental Health Care will continue to pursue this matter. The HSE turned down an invitation to appear before the committee today after initially accepting it to give its version of events which is the same as that of the Minister of State. I urge him to find out more about the matter and not accept the HSE's bland excuses about staff shortages because they fly in the face of the evidence that I have in my possession.

I note with interest that most of the Senator's references in this debate are staff-oriented, staff-related and staff-connected. They originated from staff.

No. The Senator only mentioned families once in her initial contribution.

No, I mentioned them three times. I mentioned parents and children.

I urge the Senator to be honest on the matter.

If need be, we can check the transcript.

I cannot allow a debate on the matter at this time. The Minister of State to continue, without interruption.

I did not interrupt the Senator when she commented and I am allowed to say my piece.

This is a two-way process but not if the Senator chooses to make dramatic statements and label things as balderdash. She loves to use the word "chaos" and the phrase "dismantling things brick by brick." She wants to have her moment in the sun.

The Minister of State does not need to get personal.

I have not personalised the matter.

I referred to the Joint Committee on Future of Mental Health Care. I urge the Minister of State not to get personal, as it just shows that he has a defeatist attitude. I implore the Leas-Chathaoirleach to ask the Minister of State to desist from making personal attacks.

The Senator and the Minister of State have had their say. I cannot allow the Senator to comment again. Under the rules, unfortunately, a Senator is only allocated four minutes in which to contribute. The Senator ran over time and, as normal, I showed latitude by giving her an extra minute.

For which I thank the Leas-Chathaoirleach.

The Minister of State is making his response, to which we must listen, without interruption.

I thank the Leas-Chathaoirleach. There is an issue that affects staffing and it is cross-sectoral. I am sure the Senator is well aware of the staffing issues, as she is very close to the staff. Therefore, she understands the issues and the challenges. However, I must view the issue at a policy level and identify the challenges at a national level.

The day programme has been suspended temporarily for the summer months in order to accommodate and ensure continuity of inpatient and community services. It is very important that best use be made of the available resources. I support the HSE in its efforts to widen the scope of the service and ensure it will continue. I understand the number of children impacted by the change to the day programme is fewer than three. When I say impacted, I use the term carefully because the children concerned continue to avail of services in their communities. The community CAMHS teams are delivering the services as opposed to the day programme run by Linn Dara.

CAMHS has grown exponentially in the past few years. The amount of money the State and the Government have put into developing it is astounding. We have moved from a situation where 20,000 people were in institutional residential care during the 1960s to one where the number is just 1,000 people. We have done so by building community teams and developing and growing CAMHS. I, therefore, ask the Senator to withdraw her remark that attempts are being made to dismantle the service brick by brick because nothing could be further from the truth.

No, I will not withdraw my comment. I thank the Minister of State for his reply.

I thank the Senator and the Minister of State.

I thank the Leas-Chathaoirleach.

Residential Care

I do not agree with what has occurred in the past few minutes.

In my Commencement matter I call on the Minister for Health to establish a forum on long-term residential care. I recall that I made such a proposal about two years ago owing to increasing pressure on the State to provide long-term residential and respite care. One of the proposals made called for the setting up of a biannual meeting of all of the key players. They included the Department of Health, the HSE, the Irish Nurses and Midwives Organisation, the Irish Medical Organisation and Nursing Homes Ireland. Such a meeting would allow them to meet and deal with challenges arising in the area. Over 23,500 people live in private residential care settings under the fair deal scheme.

We have another 6,000 to 7,000 in community care services. There is going to be a huge change in the demographics, with the number reaching 85 years of age increasing all of the time. The number reaching 65 years of age is also increasing. Therefore, there will be huge challenges. Likewise, there will be huge challenges in hospitals because of the growth in population. The figure used is that 51% of all hospital beds are occupied by people over 65 years of age. If there is an increase in that demographic, there will be an increase in the demand for beds in hospitals. Therefore, there will have to be a faster response from hospitals in trying to provide step-down care facilities. It is in that context that I propose a forum be set up to deal with the issue of long-term care that would meet either once every three months or once every six months to tease out issues arising and that there be a fast response from both the HSE and the Department in order that they would act before issues arose that would have to be acted on urgently. It is in that context that I raise the issue.

I thank the Senator for giving me the opportunity to address this issue. It is very real and there is no argument about it from my end, as the Senator is aware. I support his endeavours to have it addressed in a broader context and have a facility for all stakeholders and all those with an interest in and a working knowledge of what is going on in the sector. I have no difficulty in that regard. As the Senator outlined, people are living longer than ever before and success in improving health outcomes and extending life expectancy has been achieved. The projected numbers of older people are stark, to say the least.

The report of the Committee on the Future of Healthcare, Sláintecare, supports a significant shift in the model of care to one that is focused on prevention and early intervention and which will provide most care in the community. It is crucial that the appropriate supports be in place to match each person’s needs at whatever point he or she is at in the interaction with the healthcare system. The Senator is a particular proponent of the policy of prevention, rather than cure, and that we work with people in the community to try to prevent difficulties, but we also know that it is a fact of life that a large population will invariably require long-term nursing care in a residential setting, no matter what efforts we make to avoid this.

The Senator will be aware that the Department is developing a statutory home supports scheme. An important step in the development of the new scheme was a consultation process which was carried out in 2017, the purpose of which was to allow everyone with views on this topic to have his or her say. There was a very high response rate, with approximately 2,600 submissions received. A report on the findings of the consultation process was published last month.

Planning for future services will continue and it will be informed fully by the views and concerns of all stakeholders. However, this is not an issue that can be readily progressed by the kind of forum proposed by the Senator. The decisions that remain to be taken are less about what we need to do but about how to do it. It relates in large part to resourcing and the balancing of priorities within the health sector and government overall. I am pleased to inform the Senator that I will host a conference later this year on housing for older people which will bring together key stakeholders to share best practice and discuss how best to meet the needs of older people.

As the Senator knows, I have a particular interest in addressing the long-term care needs of older people in communities and supported living environments. Notwithstanding this, the Senator's point is valid. I support the validity of his request to have it considered further, that we have a specific forum, but what we do not want is a duplication of fora. We want to ensure we build it in, but I do know where the Senator is coming from. I have heard the case being made before and I am supportive and welcoming of it to ensure we can accommodate more voices at the table. The Senator mentioned some of the stakeholders, including Nursing Homes Ireland and the IMO. The conference we will organise in September, October or November will look at the long-term residential care needs of older people, not specifically in institutionalised settings but more in the community in supported housing. All of the people whom the Senator mentioned will have a role to play and a contribution to make. That will be part of the conversation. As opposed to isolating it to residential care settings, we hope to broaden it out.

The reason I am raising this issue is that Nursing Homes Ireland and some of the other organisations constantly contact me about situations where they go to the Department of Health and the standard response is that it must go and talk to the HSE. Likewise, when they go to the HSE, the response is that it must go and talk to the Department. Their view is that even if such a forum was to meet only once every six months, all of the stakeholders would sit down to talk about the issues and how they could be addressed before they became a real problem. It is in that context that they have raised the issue. They are being told that one party has to consult the other. As a result, they are finding that they have to go back and forth. They state a meeting on a biannual basis would help in dealing with a lot of the issues that arise.

The basic premise is that nobody has a monopoly of wisdom on what is the right thing to do. They are people who just want to be heard in a forum that is more complete in order that they are not potentially operating in a vacuum where one partner states it needs to discuss an issue with another. I have discussed the matter with Nursing Home Ireland and understand from where it is coming. Therefore, in the interests of completeness, I will certainly have the conversation on the Senator's behalf and progress the matter within the Department and the HSE to see if we can work out the detail of how it would work, be it a forum, a round table discussion or a biannual meeting. We must ensure people's voices will be heard on a more regular basis in a more complete setting where every voice will be represented at the table at a given time in order that answers will be more readily available to them.

Sitting suspended at 11.20 a.m. and resumed at 11.30 a.m.