Micheál Martin (Cork South Central, Fianna Fail)
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Last July, the Minister for Health and deputy leader of Fine Gael met with all the Laois Dáil Deputies regarding their concerns about the future role of Portlaoise General Hospital and particularly their concerns that there would be no reduction of accident and emergency services in that hospital. In subsequent radio interviews, many Deputies, including Fine Gael's Deputy Charles Flanagan, made it clear to the people of Laois that the Minister had given a commitment to retaining accident and emergency services at the hospital. However, the Health Service Executive has written to the Committee of Public Accounts outlining the actual plans for Portlaoise, which appear to be quite the opposite of the commitments made by the Taoiseach's deputy leader. Under this plan, the Portlaoise hospital will be downgraded to a level 2 hospital, which will mean the accident and emergency department will be a medical assessment unit dealing with low-risk patients only. There are also reports that, as a result, the intensive care unit will be removed.

We know that all sorts of commitments and promises were made over the last 12 months around the country. We know this because of the broken promises made about Roscommon hospital. It is clear, however, that Portlaoise is in a different category given the Census 2011 results which show that the area's population has grown by about 20% to unprecedented levels. Some 41,000 patients were seen in the hospital's accident and emergency unit last year alone.

In the last six months, the Minister for Health has taken personal charge of the HSE and his Department has underspent by about €40 million. Can the Taoiseach confirm what the plans are for Portlaoise hospital? Will he confirm what is contained in the HSE's communication to the Committee of Public Accounts as regards Portlaoise being downgraded to a level 2 hospital?

Enda Kenny (Mayo, Fine Gael)
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I have heard rumours and comment about Portlaoise and a number of other hospitals. The Minister for Health informs me that there are no plans to downgrade Portlaoise hospital from module 3 to module 2. I do not know what plan Deputy Martin is quoting from. This is an important, busy hospital in the midlands and the figures speak for themselves. The Committee on Health and Children will obviously consider all the reports concerning hospitals but, as I stand here this morning, there are no plans to downgrade Portlaoise hospital from module 3 to module 2.

Micheál Martin (Cork South Central, Fianna Fail)
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I am referring to a document which was sent to the Committee of Public Accounts by the HSE's national director for integrated services, performance and financial management, Laverne McGuinness.

James Reilly (Dublin North, Fine Gael)
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What is the date?

Micheál Martin (Cork South Central, Fianna Fail)
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It clearly states that a medical assessment unit in a module 2 local hospital was for GP-referred, differentiated medical patients with a low risk of requiring full resuscitation. It lists all the hospitals, including Ennis, Portlaoise, Nenagh, Navan, Roscommon, Loughlinstown, St. John's in Limerick, and Dún Laoghaire.

Deputies:

What is the date?

Micheál Martin (Cork South Central, Fianna Fail)
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That is the document I am referring to and I want confirmation from the Taoiseach-----

Peter Mathews (Dublin South, Fine Gael)
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What year?

Bernard Durkan (Kildare North, Fine Gael)
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That was when the Deputy was in government.

Micheál Martin (Cork South Central, Fianna Fail)
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It was in July of this year, when the Minister met with the Deputies concerned. The document is dated 26 July 2011. Therefore, at the same time the Minister was meeting those Deputies, the HSE wrote to the Committee of Public Accounts. It is coming up tomorrow at that committee.

Jerry Buttimer (Cork South Central, Fine Gael)
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Is it one of Deputy Martin's reports?

Micheál Martin (Cork South Central, Fianna Fail)
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There is a genuine issue there if Deputy Buttimer will allow me to articulate the point. All along we are getting different stories.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Will Deputies please allow Deputy Martin to continue?

Micheál Martin (Cork South Central, Fianna Fail)
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The issue is that different commitments are being made to different people, while different stories are being told on an ongoing basis. The HSE communication states that a medical assessment unit is in development in Portlaoise. The only reason it is in development is to replace the accident and emergency facility.

Dara Calleary (Mayo, Fianna Fail)
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A band-aid station is being established there.

Enda Kenny (Mayo, Fine Gael)
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I have just been speaking to the Minister for Health about this. I respect Deputy Martin bringing in the letter he mentioned from 26 July, but there is no capacity in the system to reduce a hospital like this to level 2, nor is there any intention of so doing. What the Deputy has there has no status in the context of the Government making decisions about this.

Tom Hayes (Tipperary South, Fine Gael)
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Deputy Martin should get his information right.

Enda Kenny (Mayo, Fine Gael)
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I can confirm, on behalf of the Minister for Health, that there is absolutely no intention of reducing Portlaoise from level 3 to level 2.

Dara Calleary (Mayo, Fianna Fail)
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That is what he told them in Roscommon.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Deputies can pursue the matter further by way of parliamentary questions.

Gerry Adams (Louth, Sinn Fein)
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I was astonished yesterday when, in response to a question from me, the Taoiseach announced that the Cabinet sub-committee on health has not met. That sub-committee was announced by the Taoiseach in June at the height of the controversy over his decision to close Roscommon hospital's accident and emergency unit in complete breach of commitments made both by the Labour Party and Fine Gael, and in advance of the crisis concerning junior doctors. Today we see more evidence of that with nurses on strike in Limerick since 8.30 a.m. because of gross overcrowding and the effect it is having on patient safety. The Taoiseach will also be aware that there were 394 patients on trolleys yesterday, with the worst case being in Our Lady of Lourdes Hospital in Drogheda.

These are choices which the Taoiseach's Government is making. Is é mo bharúil go bhfuil an Rialtas ag leanúint ar aghaidh le polasaithe Fhianna Fáil, agus ag cur fhulaingt ar shaol an phobail. Caithfidh an Rialtas stad a chur le polasaithe Fhianna Fáil. Cad faoin five-point plan? Point three of the five-point plan talked about reforming the health services. I ask the Taoiseach to stop implementing Fianna Fáil policy and to intervene directly to tackle this health crisis.

Enda Kenny (Mayo, Fine Gael)
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Tá ionadh ar an Teachta go bhfuil sé anseo mar Theachta Dála do Chontae Lú. Ná bíodh ionadh air faoi rud ar bith a tharlaíonn ó thaobh cúrsaí polaitíochta de. Níl an Rialtas ag comhlíonadh phleananna an Rialtais roimhe seo.

The situation in Limerick is a matter of concern to everybody. Every Deputy in this House, some of whom have been elected for the first time in the last general election, will experience crises arising of one sort or another in his or her local hospital which is always a cause of great strain and anxiety both for the staff working at the front line and for the patients and their families. The Minister for Health received this morning the report from the special delivery unit which is examining the admissions policy in every hospital. I am concerned about stoppages in any hospital, including in Limerick. This morning there are six patients on trolleys in Limerick and a further 41 in an overflow ward where they are not on trolleys but are awaiting admission. This is indeed indicative of a serious situation and it must be dealt with. Unless one knows the nature and scale of the problem, it is impossible to deal with it. This is the reason the special delivery unit, which was set up by the Minister, has reported to him this morning on the Limerick case.

I understand HSE officials put proposals to the trade unions at quite lengthy talks last night in the LRC but these were not acceptable to the unions and those talks will continue. This will not sort out the problem and neither will work stoppages by the nursing staff resulting from their concerns and anxieties. This situation must be discussed and a plan implemented to rectify it. This is the reason the special delivery unit has reported on the Limerick situation to the Minister for Health.

Deputy Adams referred to the hospital in his constituency and to which we referred yesterday and he also mentioned the situation in Galway. On Saturday morning at 8 a.m., 32 patients were awaiting admission in the accident and emergency department. This number was reduced to 14 in the late afternoon-----

Billy Kelleher (Cork North Central, Fianna Fail)
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From Roscommon.

Enda Kenny (Mayo, Fine Gael)
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-----and was reduced further on Saturday evening. On Sunday morning, 18 patients were waiting in the accident and emergency department for admission. In respect of Roscommon, last week, 17 people from Roscommon presented in the accident and emergency department in Galway and ten people presented the previous week.

Gerry Adams (Louth, Sinn Fein)
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The Taoiseach has just recited a litany of failure. This health sub-committee which he established has not even met. He expresses concern and I accept him at face value but he needs to go beyond the rhetoric in this regard. He says these issues need to be discussed but where will they be discussed? We have only this short time of one minute and a half in which to raise these issues.

All these issues result from the choices which the Taoiseach's Government is making. I repeat what I said yesterday. I suggest that people mark this date in their diaries; on 2 November, the Government will pay €700 million to bondholders in the toxic Anglo Irish Bank. Why, on earth, is he doing this?

Gerry Adams (Louth, Sinn Fein)
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Would this money not be better paid into the failing health services-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Please, Deputy.

Gerry Adams (Louth, Sinn Fein)
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These are deadly serious issues when a Government admits that almost 400 citizens are in corridors on trolleys and some of them, no doubt, on chairs or on floors. It beggars belief that there is heckling and hectoring over such a serious issue.

Jerry Buttimer (Cork South Central, Fine Gael)
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Deputy Adams should talk to his colleagues in the North and stop playing politics.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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The Deputy must ask a question.

Gerry Adams (Louth, Sinn Fein)
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This is all a result of choices being made by the Government. These decisions are being made by the Government over which the Taoiseach presides not by the people who came before him. Would it not be better to call a halt to these bad policies and to invest in our health services and in citizens, as opposed to bondholders and toxic banks?

Enda Kenny (Mayo, Fine Gael)
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Far from hectoring, I wish to inform the Deputy that we deal with reality. Neither the Deputy nor I can prevent people from falling ill. When people present in a hospital, they have been referred there or they travel to the accident and emergency department for analysis of their problem and admission to hospital. The situation in Limerick this morning is that six patients are on trolleys and 41 are in a waiting room for assessment for admission.

Billy Kelleher (Cork North Central, Fianna Fail)
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They are waiting for trolleys.

Enda Kenny (Mayo, Fine Gael)
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Far from being a litany of failure, it is dealing with the truth. The Minister for Health has the responsibility for dealing with this situation. As Deputy Adams well knows, the health structure in our country works exceptionally well on one hand and in other areas, significant blockages are created at the level of admission to the system for treatment by professional staff. This is the problem which the Minister has to deal with. Far from allowing failure to continue, he is looking at the reality of what can be done to deal with this problem. I reject Deputy Adams's attempt to portray this situation as a continuation of the status quo that applied before. When we get down to the business of examining the element of waste in the health service, the requirement for efficiency and competency in the management of our hospitals, and in providing facilities for trained professional staff at the front line to do their job in the interests of patients, that is not a litany a failure rather an examination of a political responsibility and an attempt to deal with the truth of what we face. If the Deputy wishes to take a different line, he may do so.

He may then go off to Europe with his comments in respect of the euro crisis. There will be a debate in the House next week and I expect the Deputy, as the leader of his party, to spell out credible alternatives and an economic policy that is not based on fantasy-----

Dessie Ellis (Dublin North West, Sinn Fein)
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We always do.

Enda Kenny (Mayo, Fine Gael)
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-----but on reality.

Enda Kenny (Mayo, Fine Gael)
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If the Anglo bondholders are paid, they will be paid from their own resources. This will not come from the taxpayer. The Minister for Finance has been dealing with this situation at the ECOFIN meetings. Deputy Adams has suggested it is very easy to have a write-down in respect of senior bondholders with the residual amount left in Anglo. The effect and consequence of this view, when it was mentioned in the case of Greece, was this contagion which immediately spreads into much bigger economies.

Deputy Adams says it is advisable to risk the reputation of the country and the advances we have made in the past number of months, both economically and every other way, just to do so. An alternative being pursued by the Minister for Finance is to examine what can be done with the promissory note signed off by the previous Government in respect of which the interest rate is more than 8% and which begins to be payable in 2013. If that can be dealt with by extending the maturity or whatever, the savings to the country will be substantially more and they will be in the public interest. Deputy Adams talks about a litany of failure. I encourage him to be very real in his contribution in the debate on the euro next week and we will see how credible and real are his proposals.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Do we always have to hear the same chorus every morning? I call Deputy Joe Higgins.

Joe Higgins (Dublin West, Socialist Party)
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The trauma continues for tens of thousands of homeowners who, with their families, comprise some hundreds of thousands of ordinary people whose homes are exploding in slow motion, but relentlessly so, because of pyrite-induced heaving emanating from contamination of underfloor infill. It is especially acute in west Dublin, north Dublin, Meath, Kildare and some other areas.

Since I raised this issue with the Taoiseach in May, there have been some important developments. Scandalously, Homebond, the builders' and developers' insurance scheme, cynically, coldly and heartlessly used a single court case to wash its hands of its responsibility to the homeowners, who thought they had comfort by way of this insurance scheme, and is walking away. Last week, the Minister for the Environment, Community and Local Government announced he was setting up a panel to look into the pyrite crisis. That is a start, but the his statement is deeply worrying. He said, "This is, of course, a civil matter to which the State is not a party or in any way liable". This is deeply worrying for affected homeowners who are in touch weekly with public representatives because the implication is that they will be left with their homes coming apart at the seams while a gaggle of developers, builders and insurance companies slug it out for years in the courts to try and evade their responsibilities.

I put it to the Taoiseach that the Minister's statement is based on a wrong premise. The State has a serious responsibility because it and its agencies were negligent in that the building regulator were negligent in not supervising the construction and the materials going into these homes when it had known about pyrites for decades. Also, the Homebond scheme was deeply flawed from the outset, from when it was set up in 1978. It is not all the fault of Fianna Fáil. Fine Gael and Labour were in Government twice in that time.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Has the Deputy a question?

Joe Higgins (Dublin West, Socialist Party)
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Who will make up the panel? Will the affected homeowners have direct representation on it? What is its timeframe - it must be very short - and will the Government compel Homebond to meets its responsibilities? Due to the huge worry that exists, will the Taoiseach set up an immediate State remediation scheme to provide testing and remediation to resolve the worries of homeowners and to pursue the corporate entities whose negligence, along with that of the State, caused this crisis?

Enda Kenny (Mayo, Fine Gael)
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A sense of pride in their home is very important to people and this is self-evident when one visits them. Unfortunately, for a substantial number of people, this cannot be the case. They have decided to buy or build and taken out a mortgage, but after a period they have found their home has begun to disintegrate. This is no joke. It is very distressing for people to experience gables splitting, floors rising, and cracks appearing in walls in front rooms, sitting rooms and bedrooms. I visited a number of these homes in County Meath with Deputy McEntee and also visited a number of apartment blocks in Santry and it is evident that pyrite explosions, particularly in the foundations when they have got wet, causes these fractures. Some contractors have taken measurements to assess the extent of the damage caused and a small number of contractors have rectified the damage themselves.

I cannot comment on the outcome of the long court case in respect of pyrite being in the material from the quarries or as to whether builders who used material from those quarries knew there was pyrite in that material. I met with Homebond last year and with a number of people in different communities who are affected by this distressing problem. I understand Homebond dealt with a number of people affected but that its resources are now used up. The Minister for the Environment, Community and Local Government has set up a working group. This is an opportunity for the working group to meet those affected by this problem and to ensure the issue is discussed by the Oireachtas committee dealing with the environment and housing.

I am sure the Minister and the Minister of State with responsibility for housing will be interested to hear proposals as to how the problem can be rectified. This is a civil matter. However, it is one in which the State has an interest for the well-being of families and people who purchased houses in which they intended to live. This is not a nice prospect when there is a 2 mm or 3 mm split across the wall or ceiling. I have seen this at first hand and am aware of the distress it has caused.

Joe Higgins (Dublin West, Socialist Party)
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The Taoiseach empathises with the homeowners and individuals concerned, which is good. However, when responding to questions, he spends much of his time describing the problem, which reminds me of one of his predecessors, one Bertie Ahern, who gave us the whole story and scientific background of everything, but did not answer the questions.

Enda Kenny (Mayo, Fine Gael)
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There is no comparison.

James Reilly (Dublin North, Fine Gael)
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The Deputy's clothes are safe here.

Joe Higgins (Dublin West, Socialist Party)
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I will pose the questions again. Will the Taoiseach ensure there is significant representation of homeowners on the panel? Will he set a timeframe by which it must come up with solutions? Considering that people's homes are cracking and they need to know whether this is due to pyrite and that the tests to check this cost from €2,000 to €3,000, will he set up a fund immediately to provide for this? Will he set up a remediation fund so that the problem can be solved? Will he go after whatever corporate entities are partially responsible for this? I put it to the Taoiseach that he has a moral responsibility in this regard because the State overlooked this problem and the proper supervision of it. Therefore, it cannot wash its hands as the Minister is trying to do.

Enda Kenny (Mayo, Fine Gael)
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I remind the Deputy that he is not playing handball against a haystack that kills the ball.

Billy Kelleher (Cork North Central, Fianna Fail)
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A haystack, as against a turf bank for the Taoiseach.

Enda Kenny (Mayo, Fine Gael)
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The Deputy was in that corner of the alley when he made that comment. The Deputy Higgins's figures are a bit out of line with regard to a cost of from €2,000 to €3,000. The figures I have seen for the rectification of some of these problems are of the order of €70,000 or €80,000. The foundations must be taken out completely and replaced with pyrite free material and the structure must be rectified afterwards.

The Minister is responsible for the working group and I am sure he will ensure homeowners are represented on it. I am also sure he will set a timeframe for coming back with an analysis of the scale of the problem and how it might be dealt with. I will not comment with regard to whether a remediation scheme can be put together but it is necessary to discover the true scale of the problem first. I have had some interaction with the Minister. I will pass on to him the points made by the Deputy on the working group and I am sure he will take them into account. It is a daily concern for those who have pride in their homes but have found something has happened over which they have no control.