Dáil debates

Wednesday, 3 October 2012

Private Notice Questions

Primary Care Centres Provision

2:30 pm

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

We now come to deal with private notice questions to the Minister for Health. Three Deputies have submitted private notice questions and I will call them in the order in which my office received them.

Deputy Joe Higgins asked the Minister for Health to make a full statement on the selection of sites for primary health care centres and deal with related issues which are the subject of public controversy.

Deputy Caoimhghín Ó Caoláin asked the Minister for Health in view of further revelations in this morning's press, the controversy surrounding the resignation of the former Minister of State, Deputy Róisín Shortall, and the importance of the development of primary health care to set out in detail the criteria for the selection of locations for primary care centres; how they relate to each of the 35 locations he has selected; the way in which the criteria have changed since the initial listing; and if he will make a substantive statement on the matter.

Deputy Billy Kelleher asked the Minister for Health as the roll-out of primary care centres is of national concern to explain to the House the recent criteria he used to add 15 centres to the primary care list; to clarify what criteria will be used for future primary care centres; and if he will make a statement on the matter.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I propose to take all questions together.

The key objective of the primary care strategy is to develop services in the community which will give people direct access to integrated multidisciplinary teams of general practitioners, nurses, physiotherapists, occupational therapists and other health care disciplines. This is central to the Government's objective of delivering a high quality integrated and cost-effective health system. A modern well-equipped primary care infrastructure is central to the effective functioning of primary care teams. These teams enable multidisciplinary services to be delivered on a single site, provide a single point of access for users and encourage closer co-operation between health care providers.

The infrastructure development through a combination of public and private investment aims to facilitate the delivery of multidisciplinary primary health care and represents a tangible refocusing of the health service to deliver care in the most appropriate and lowest cost settings. The intention to date has been that where appropriate infrastructure for primary care centres would be provided by the private sector through negotiated lease agreements, the Exchequer would also fund the delivery of some primary care centres, particularly in deprived urban areas, small rural towns and isolated areas. In addition, a list of 35 potential locations for development by way of public private partnership as part of the Government's infrastructure stimulus package was developed.

Earlier this year, the HSE put together a list of high priority locations for the development of primary care centres throughout Ireland. Three criteria were deployed for selecting primary care centres: an assessment of deprivation - the deprivation index for the catchment population of the centre; the service priority identified by each integrated service area and local health office; and an accommodation assessment which assessed accommodation available for the primary care team within the catchment area, the quality of the accommodation and whether the accommodation was spread over more than one building. Other factors were considered when selecting centres for the inclusion on the PPP list. New criteria were added. It was evident, for example, that consideration needed to be given to existing health facilities or the lack thereof; GP to population ratio; pressures on services, particularly acute services; funding options, including Exchequer-funded HSE build or lease; and the implementability of a public private partnership relating to its size, site and scale. By deciding to create a list of 35 rather than 20 locations, I provided positive encouragement for engagement and financial participation by GPs in this significant and important stimulus package. When dealing with public private partnerships, PPPs, it makes sense to maximise the options available.


As I mentioned earlier, PPP is one of the three methods of delivery being considered by the HSE for the purpose of developing primary care centres. Lease and Exchequer-funded HSE builds are also under consideration. The list of 35 potential locations referred to those that may be progressed by way of the public private partnership. It is envisaged that 20 of these locations will be progressed by these means. With regard to the criteria for progressing centres, I am satisfied that the criteria I have outlined are appropriate for the selection of primary care centre locations in the future.


The HSE is engaging with the National Development Finance Agency, NDFA, as required, to progress the primary care centre element of the Government's public private partnership programme. The HSE is analysing the available sites in each location and engaging with GPs in each location to determine their interest in participating in the primary care centre development.


I wish to clarify the record of the House. In the Irish Independenttoday, it is suggested that the site owned by Mr. Murphy was effectively selected by the HSE in 2010 as the site for a primary care centre. The newspaper suggested this information was available by way of a reply to a parliamentary question tabled by me in February 2010 when I was in opposition. The relevant journalist also made that statement on "Morning Ireland". My assistants retrieved the reply to the relevant parliamentary question and the follow-up letter I received from the HSE. That letter from 1 February 2010 states: "The HSE has selected a preferred provider for expressions of interest." It goes on to say: "The proposed site will be accessible by pedestrians off Dublin Street and should be well served by Dublin Bus." The letter appears, therefore, to support the report in the Irish Independent and on "Morning Ireland". The Minister for Education and Skills, Deputy Ruairí Quinn, referred to it during Leader's Questions in the House today and I referred to it on RTE radio today as well.


I have had this double-checked with the HSE and am advised that, in fact, the reports are incorrect. In fact, the letter from the HSE in 2010 refers to another site in an area called Stephenstown, some distance from the site owned by Mr. Murphy. It appears that option ran into a number of difficulties and in November 2010, the letter of intent was withdrawn. The HSE returned to the other interested parties and ultimately selected Mr. A.J. Noonan. In September of last year, the HSE signed an agreement for lease with Mr. Noonan to develop a primary care centre. This information has been provided to us by the HSE and if Deputies want further information, it can be furnished by the HSE.


I wish to make a few general points and then allow for the questions. We cannot deliver the quality of care required at a price the country can afford through the hospital-centric model of care and we need a new integrated model of care which treats patients at the lowest level of complexity and that is safe, timely, efficient and as near to home as possible. I want to work with GPs and I want their active and direct involvement in chronic disease management. I want them to work as part of a more responsive hospital service. GPs in primary care are central to our health and well-being and we need the active support of other sectors in our economy to improve health and well-being, which are essential to the sustainable development and the economic and social interests of the country.


The PPPs will deliver jobs and the first tranche of the €115 million of investment which is vital to our construction industry. The reforms I am delivering will keep people healthy, provide the health care people need, deliver high quality services and get best value from health system resources. The new health care system and primary care system will have a number of tangible changes that patients will experience: improved health and well-being, faster and equitable access to hospital care, free access to GP care, better management of chronic illness, more people treated in their homes, and improved quality and safety.


I want primary care centres to be the campus for best care and first choice for patients. Primary care is the best solution to support an ageing and more dependent population of patients. The population growth projections estimate the population of Ireland will reach 5.7 million by 2021, and significant increases are expected across all age groups. The modern primary care unit will support children, adolescents, adults and seniors. I want every community throughout the country to have a modern and dynamic primary care centre. I want to foster a culture that promotes health and well-being across the community. Above all else, I want the best outcomes for the patients we serve.

2:40 pm

Photo of Joe HigginsJoe Higgins (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

I do not know if the Minister is a fan of the late actor Humphrey Bogart but when it comes to the selection of primary health care centres in Balbriggan, Rick's joint in Casablanca definitely comes to my mind. Of all the streets, of all the areas in all of Balbriggan, the primary care centre would land in the lap of a Fine Gael businessman, a contributor to Fine Gael and a supporter of the Minister. Not only that but according to the Irish Independent, ACC Bank and Treasury Holdings have judgments on two tranches of that site. Therefore, a lease with the Health Service Executive would increase the value of this site enormously, thus alleviating the financial difficulties of the Fine Gael supporter in question. The gentleman who was given the lease is also a contributor to Fine Gael.


When the Minister assumed office, the Taoiseach told us with great conviction that this kind of political cronyism, stroke pulling and the like was with Fianna Fáil in its political grave and that we were in an era of transparency and honesty. The Labour Party, before it developed this most acute strain of Stockholm syndrome after being taken hostage by Fine Gael, also promised similarly. In respect of any ordinary person outside the political establishment looking at this fiasco over the selection of primary health care centres, what conclusion does the Minister think would be reasonable for him or her to draw? Would it not be that this was, unfortunately, a return to old practices, political stroke pulling and cronyism in north Dublin, an area in which certain individuals and a particular party excelled in those practices which have now been revived by the Government?


What is the Minister's relationship with the owner of this site? What is his political relationship? Has he any business connections with this person? What was the process of this site being selected? Has the Minister had any discussions with this person?

Have any representatives of the Minister had discussions with this person? Was the Minister kept informed of circumstances as they developed? What role did he play in the selection of the site in question?

2:50 pm

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

The Chair has ruled on many occasions that allegations of a serious nature against any Member of this House can be made only by way of a substantive motion. To suggest that people are acting corruptly or improperly is not in order. I remind Deputies that this has been the tradition in this House for as long as the records show.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Deputy Joe Higgins should note that the site is under the control of NAMA and that, as a consequence, Mr. Murphy does not gain. NAMA gains if there is any gain. NAMA represents the people in trying to get back the moneys that were lost. The people of Balbriggan, whom I support, also gain. Balbriggan is a town that has seen its population double in ten years and has the second highest unemployment density in the greater Dublin area. The town was chosen by the HSE in 2007 and 2008, and proposals on both it and Swords were brought to the board of the HSE in 2008 and were approved. Therefore, the need is long established, as is the priority. I consider it an insult to the people of Swords and Balbriggan to say to them that the only way they can get what they deserve and need, according to proven, independent individuals, is through political stroke pulling.

I want to answer the Deputy's other questions directly. I have no business connection with Mr. Murphy. I had no discussions with him about the primary care centre and I have absolutely no role in the selection of a site. As I stated on the radio today, the only site over which I have control and which I did not want included because I was becoming Minister for Health is the site I own in Swords. I hope that clarifies the matter.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

Has the Minister established why Mr. Murphy sought at first to distance himself from him and said he had only seen the Minister on television? A photograph, of course, speaks a thousand words, and that is what we saw this morning.


Can the Minister confirm that he added the 15 locations, including Balbriggan and Swords, to the list of 20 drawn up by former Minister of State, Deputy Róisín Shortall, for the development of primary care centres? Can he confirm that it was he who added those locations to the list, and not his predecessor, Ms Mary Harney, as was claimed this morning by the Minister for Education and Skills, Deputy Ruairí Quinn?


The Minister was on the Pat Kenny radio show this morning. What a performance. He tried to excuse his lack of communication with the former Minister of State responsible for primary care by saying to Mr. Pat Kenny that he "spoke to senior Labour Ministers" about his proposed primary care centre locations. That is a matter of considerable interest. To which senior Labour Ministers did the Minister speak about this matter, and when did he do so? Why did he not deem it appropriate to speak to the responsible, designated Minister of State at his Department, a party colleague of the Labour Ministers? I am sure the Ministers from the Labour Party, and all Members in this House, including the Independents, are very interested in hearing the reply of the Minister for Health because the Minister for Social Protection, Deputy Joan Burton, denied only last Thursday in this House, when questioned by my party colleague, Deputy Mary Lou McDonald, that there was any consultation on the part of the Minister for Health with her or any senior Labour Party Minister.


Let me refer to the criteria used. In his written replies to me and other Deputies last week, the Minister referred repeatedly to the criteria for selection as relating to public private partnerships. What are the criteria for selection by the other methods, including lease and Exchequer funding? Do separate criteria exist for these and will the Minister tell us what they are?


It appears the Balbriggan site is to be developed by lease arrangement, yet it was put on the list of those sites on which progress may be made by public private partnership. On what basis are locations switched between the lists? What is the position on the eight locations chosen for development with Exchequer funding? Is eight the correct number? We are not talking about a total of 35 at all. There are at least another eight, perhaps. Has the Minister signed off on this number and the locations? Is he aware that the former Minister of State, Deputy Shortall, denies that she switched locations on the lists, as the Minister's spokesperson claimed to The Irish Times. There is a clear and absolute denial of the practice on the part of the former Minister of State. Why, therefore, were some of the locations redacted from documents obtained under the freedom of information legislation? Why was this practice employed in this instance?


The Minister spoke this morning about a swamp. It is one entirely of his own creation.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I also mentioned alligators; I will not go beyond that. It was reported this morning that Mr. Murphy said he sees me on television. I made the point this morning on the radio programme, which the Deputy clearly listened to or had someone listen to and transcribe-----

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

I listened to it.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Good. Then the Deputy knows my answer very clearly. I am sure he finds the same response himself-----

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

Interestingly, we do not know the Minister's answer.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I did not interrupt Deputy Ó Caoláin and would like him to show me the same courtesy. Many people say to me that, because they do not see that much of me in my constituency since my job is of such considerable importance to the future well-being of the people, the only time they see me is on television. I am sure this is what Mr. Murphy was alluding to. However, I do not know how Mr. Murphy's mind works and will leave him to explain the matter himself if he chooses to do so. If Deputy Ó Caoláin had listened to the radio programme this morning, as he says he did, he will know I was in contact with the Minister for Public Expenditure and Reform because the stimulus package had to go to him for final sign-off and Government approval.


There are three separate methods: public private partnership, direct Exchequer funding and leasing. This is where it gets considerably arbitrary because while one can define when a lease is signed, which is straightforward, one must determine the point at which one decides on the term "might be done by lease". When does "might be done by lease" become "might not be done by lease"? Therefore, one can see that, no matter how much of a desktop exercise one does on the selection process, there are always practical or pragmatic considerations on the ground that preclude things being done in the way that might look sensible in an office setting. I mentioned this morning on the radio that if one accounted for all the parameters I put in place, etc. but left out the other facilities in the area, one would end up building a primary care centre in the shadow of a large hospital and yet have nothing in an area of considerable population density ten or 15 miles away.


I would like to cover one last issue raised by the Deputy, namely, the inference in The Irish Times that somehow things had been moved around by me at an earlier date. I have confirmed with HSE that it was it that moved those things around the list, not I. If Deputy Ó Caoláin wishes to ask the HSE directly, it will confirm that.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

What about the redacted locations identified through a freedom of information request?

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The Minister seems to be confused because we are not casting aspersions on his integrity in respect of whether there was a cosy deal done with Mr. Murphy. The point of the exercise is to get to the bottom of why names of towns, including Ballaghaderreen and Kilkenny and two locations in the Minister's constituency, appeared on a list although they were not on that list before that.

We are discussing primary care centres that are to deliver health care in a community setting. There was a list. That the Minister is clutching to the former Minister for Health and Children's approval as a safety net is a bit rich because that list included a further 198 towns throughout the country and was not prioritised. The Minister has claimed that he picked from a 2007 list, but he could have picked a further 198 as well.

The then Minister of State, Deputy Shortall, used a deprivation index to decide on the priority listing of health centres throughout the country. Some 20 were selected. The logical conclusion would be to take the next 15 if one wanted to increase the number, but the Minister decided to use his own criteria. A couple of questions must be asked. The Minister stated that he consulted widely. The Taoiseach told the House that the Minister consulted all Cabinet colleagues. It now transpires that the Minister only consulted a number of Cabinet colleagues. Equally, he was to have discussed the issue with senior officials in the HSE and the Department of Health, yet the Department's Secretary General stated that he could not confirm whether he had seen the final list.

There are differences between what the Minister is telling the House and what actually happened. As to the consultation with many Cabinet colleagues, we have found out that he only consulted one or two. This underlines the fact that he made these decisions off his own bat without any regard to criteria other than those that would suit the development of the centres in Swords and Balbriggan in his constituency.

To clarify regarding the site that Mr. Murphy owns, it was selected during the Minister's tenure and not before, which was previously stated. I am not saying that there was anything untoward or corrupt in terms of transactions, but some communities have materially benefited over others because the Minister was able to decide to locate the centres in his constituency. The people of Dundalk fell off the list, yet they had been No. 21. Are they less deserving than the people of Swords or Balbriggan based on the deprivation index and the criteria used to prioritise sites?

I cannot understand how the Minister can so glibly pass this matter by. A Minister of State resigned because of it. It is unheard of for a Minister of State to resign because of issues with a senior Minister-----

(Interruptions).

3:00 pm

Photo of Ciara ConwayCiara Conway (Waterford, Labour)
Link to this: Individually | In context | Oireachtas source

It was one Minister per week in the last Government.

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

Government Deputies should listen.

Photo of Ciara ConwayCiara Conway (Waterford, Labour)
Link to this: Individually | In context | Oireachtas source

We are.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

Through the Chair, please.

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

Those issues had to do with a senior Minister undermining an open and transparent process to confer-----

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

The Deputy has a short memory.

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

-----potential financial and commercial gain on individuals and entities. This is clearly a matter of concern. Does the Minister not agree that it should be of major concern to everyone in the House?

Photo of Niall CollinsNiall Collins (Limerick, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

Hear, hear.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

The Deputy across would like to believe that there was but one list. There were several lists. There was a list in 2007 and 2008. Such was the priority given to Balbriggan and Swords that they were approved by the board of the HSE in 2008.

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

Along with 198 others.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

Through the Chair, please.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Incorrect. For the Deputy's precise information, if I can recall correctly what I was told today, the board passed two lots of six and four. After these first ten, a tranche of 38, including Swords and Balbriggan, was passed by the board. These facts can be checked with the HSE.

Photo of Richard Boyd BarrettRichard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
Link to this: Individually | In context | Oireachtas source

Were they in addition to the 20?

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

If they were priorities in 2007 and 2008, surely Balbriggan's situation has become more needy rather than less, given its population explosion and unemployment level. Similarly for Swords.

Deputy Kelleher mentioned consultation. There certainly was consultation with others. While I might have had more consultation with some Cabinet colleagues than others, all Cabinet colleagues were able to sign off on this list. It was a Government decision. People have conveniently lost sight of that fact.

The lease might have been signed during my tenure, but the deal on the site that was first favoured fell out in November 2010 and new negotiations started elsewhere. This was before there was an election and I became the Minister for Health.

I wish to raise another issue. I have become a bit disturbed by a recent trend.

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

One the Minister started.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Deputy Sean Fleming, who is not present, stated on "News at One" last Sunday that I did this so that my site in Swords might be used. That is patently untrue and I will invite him to withdraw the statement. In fairness to the show's presenter, she corrected him. Similarly, Deputy Kelleher told the House this morning that I had "conferred financial and commercial gain on individuals" with whom I had political ties. I have already explained that I had no hand, act or part in this. Furthermore, if there was any gain, which I somehow doubt, it would be to NAMA and the people of Balbriggan, which is only right.

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

Does the owner have personal guarantees?

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I invite Deputy Kelleher to withdraw his comments. If he chooses not to, I suppose I shall have to come to him directly with my complaint.

Photo of Willie O'DeaWillie O'Dea (Limerick City, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

Pistols at dawn.

Photo of Joe HigginsJoe Higgins (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

On the question of ownership, Mr. Murphy stated that he was engaging with NAMA, but that the sites were in his ownership. Will the Minister clarify this issue? Is it not obvious that, just like the unjustified rezonings of the past, a lease between the HSE and the owner of a building or a site will confer significant financial advantage in the price secured? In any dealing with, for example, ACC Bank and a Treasury company, it would rebound to the benefit of the person in question that such a lease existed. This is very clear.

The people of Balbriggan, Swords, Boyle, Ballaghaderreen and Kilkenny deserve their primary health care centres, but so do the people in many other areas of great health needs around the country. Do not try to put those of us who are seeking clarity and transparency on the back foot as if we were not sympathetic and mindful of the needs. The objection is that locations that are in areas where Fine Gael as a political entity wields considerable influence are favoured without explanation over other areas. This is one of the issues.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

I am sorry, but I must correct the Deputy. An allegation has been made that decisions were taken for reasons other than genuine business reasons. Deputy Higgins is insinuating that what was effectively corruption was involved.

Photo of Willie O'DeaWillie O'Dea (Limerick City, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

He is asking a question.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

I have already told Deputy Higgins that, if he wishes to make such statements, it can only be done by way of a substantive motion, not by throwing allegations onto the floor of the House. This is the long-standing ruling of various Cinn Comhairlí, not just me.

Photo of Joe HigginsJoe Higgins (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

We are inviting clarification from the Minister regarding these issues.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

No, the Deputy is making a claim.

Photo of Joe HigginsJoe Higgins (Dublin West, Socialist Party)
Link to this: Individually | In context | Oireachtas source

The Minister must clarify. He stated that it was an insult to the people of Balbriggan and Swords to suggest that they could only get their primary care centres by favouritism, but what is an insult to them is that the centres have been chosen in a manner that is open to questions of political favouritism. No one is insulting the people of those areas. The Minister is constantly trying to divert.

Regarding the site in Swords, the Minister was in a partnership with general practitioners, GPs, in a deal on a site that he stated fell through.

Is that partnership, or any people in it, involved with or receive benefit from the new site that has been chosen?

Will the Minister specify with whom in the Cabinet he had discussions before this final list was agreed? Was the matter discussed with the Tánaiste and the Minister for Social Protection, Deputy Burton, and did the Minister get the agreement of these Cabinet members? Why did the Minister not reach agreement with the then Minister of State, Deputy Shortall, before signing off on the issue?

3:10 pm

Photo of Michael Healy-RaeMichael Healy-Rae (Kerry South, Independent)
Link to this: Individually | In context | Oireachtas source

With Mr. Reilly and Mr. Murphy it is like an episode of "Fawlty Towers".

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Deputy Higgins may be correct from a technical point of view in that the legal ownership may not have passed but I do not profess to be an expert on NAMA and I am not even sure if that is the way NAMA operates.

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The Minister should get used to it.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

NAMA takes control of the loan and the site but it does not necessarily incur all the legal costs in transferring ownership only to sell it on again. It controlled this de facto and any moneys arising from it, as far as I understand it. Perhaps the Deputy could ask NAMA about it. Once something is in NAMA, unless there is a major profit made, which is highly improbable in this case from what I heard, there will be no gain for the individual.

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

There may be less of a loss.

Photo of Richard Boyd BarrettRichard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
Link to this: Individually | In context | Oireachtas source

The individual would be kept in business.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

The Deputy mentioned the needs of the rest of the country, of which I am acutely aware. On the list of 338 places and the other list of 220-----

Photo of Mattie McGrathMattie McGrath (Tipperary South, Independent)
Link to this: Individually | In context | Oireachtas source

There is one in Carrick on Suir.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

Exactly.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

Do not mind the interruptions.

Photo of Finian McGrathFinian McGrath (Dublin North Central, Independent)
Link to this: Individually | In context | Oireachtas source

What of Coolock and Darndale?

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

The bottom line is there are three methods of developing primary care. If we had all the money we needed we could have tried to build all the facilities ourselves but we do not have it. As a result we have to look for investment from others to do it. What is key is that the people get the service they need as quickly as possible, and if we can do that through public private partnerships, PPPs, lease or other arrangements that may come to pass, I am very happy to engage in such a process. There must be a key involvement from general practitioners, and that is why I extended the list from 20 to 35. One can build a beautiful palace but if a GP does not go into it, there is no value to us. We do not want a position where we are held over a barrel.

The other sites will be built in different ways. As I tried to point out this morning and will do again now, this issue is in flux. Some of the elements in the PPPs will be built in other ways and come out of that process, and other elements will go into the PPP process. The PPP is a valuable fund but it is a lottery. Some 20 of the 35 facilities will be built by PPP, although we will build the others with other methodologies as money becomes available.

I have already told the House that the site in Swords has nothing to do with me. The two doctors who were co-owners with me have nothing to do with the new site either. I hope that clarifies matters for the House.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

The Minister claims no involvement in these decisions. Whatever the truth about individual sites, there is clearly no issue of his role in relation to town locations selection - you were most certainly the person directly involved in determining the additional 15 and the criteria employed to facilitate their selection. Has the Minister had any previous contractual or other arrangement with Mr. Murphy, either for electoral or any other purpose? What is the history of the Minister's association with Mr. Murphy?

There is the issue of communication with the former junior Minister at the Department. Why were there no further communications with the then Minister of State, Deputy Shortall, after the submission of her original list of 20 selected locations? The Minister should answer these questions in the House. Why did the Minister not engage with the Minister of State who had been given the responsibility to deal with primary care?

Photo of Michael Healy-RaeMichael Healy-Rae (Kerry South, Independent)
Link to this: Individually | In context | Oireachtas source

They were not talking.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

Let us know exactly the truth of all of that. The Minister made the point on Pat Kenny's radio show this morning that he spoke to senior Labour Ministers. That is very clearly what he said. In response to an earlier question, the Minister named the Minister for Public Expenditure and Reform, Deputy Howlin, but to whom else did he speak among the senior Labour Ministers? What did he advise them and what detail did he share with them? Did he advise the Minister, Deputy Howlin, or any of his Labour Party colleagues that he had not and would not go to further deliberate on these selections with the then Minister of State with responsibility for primary care, Deputy Shortall?


It is hard to be able to follow how the switching can be so easily accommodated. There is a mighty difference between a lease arrangement and some of the other possible methods, including PPP. There are a number of real difficulties in being able to square all that the Minister has indicated. The whole thing suggests it was a cobbled together exercise in order to accommodate a predisposed agenda on the Minister's part.


I asked the Minister about further locations for development by Exchequer funding, and some of these are referred to in this morning's The Irish Times. Would the Minister like to give us further detail in relation to those and whether the suggested number of eight would be a further eight already determined by the Minister, and that these would be in addition to the 35 we have been addressing over a number of days? It is time the Minister took the opportunity to put on the record of the House the real position that existed at the helm of the health Department while the former Minister of State, Deputy Shortall, had responsibility for primary care.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I have no wish to be in any way disrespectful but there has been much repetition in the questions and all of these were answered in my original statement last week and again here today. For the record, Mr. Murphy has been a member of Fine Gael for 40 years and I am deputy leader of the party: of course I know him.

Photo of Michael Healy-RaeMichael Healy-Rae (Kerry South, Independent)
Link to this: Individually | In context | Oireachtas source

He does know him.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

All sides would know that this man and his family have been held in very high regard in Balbriggan for decades and have done a lot of good work. To suggest there is any impropriety is incorrect, wrong, baseless and without foundation. To further suggest in any way that I would get any personal gain from either this decision or the one pertaining to Swords is equally baseless. Becoming involved in politics and going into an election with a prospect of becoming Minister for Health has clearly cost me money.

The Deputy spoke about criteria again. I have tried to say it in as many ways as I can, and I am sorry but I cannot explain it any further, that there were complex criteria used: there were not just three but several. This is a situation that is in flux. Things that are in the PPP if they get done by lease will go out of it, and other elements may be brought into the PPP. Agreed leases may fall through, as the Balbriggan example nearly did because of a lack of agreement between NAMA and the developer, A.J. Noonan, who tried to buy it.

Proposals in respect of which leases might have been agreed might fall through, as Balbriggan nearly did, because of a lack of agreement between NAMA and the developer, AJ Noonan, trying to buy it. Other ones we think might go ahead may have to cease if we do not have GP agreement. There is a whole range of different circumstances that pertain to this issue and there is no simple one-fix solution. I put it on record that if I had it to do again-----

3:20 pm

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The Minister would do it his way.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

-----I would not turn my back on the people of Swords and Balbriggan whose needs had been identified back in 2008.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

Answer the question in regard to the Labour Party Ministers with whom the Minister engaged.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

Deputy, will you please resume your seat?

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

A Cheann Comhairle, the Minister did not answer the question.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

No. Resume your seat.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

Will the Ceann Comhairle ask the Minister to answer the question?

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

Deputy, will you resume your seat? I am on my feet.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

A Cheann Comhairle, with respect-----

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

I call Deputy Kelleher.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

-----the Minister has ignored the question.

Photo of Finian McGrathFinian McGrath (Dublin North Central, Independent)
Link to this: Individually | In context | Oireachtas source

He has not answered the question.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

No, with respect, the Deputy abides by the ruling of the Chair.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

In terms of the ruling of the Chair, the Minister must reply.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

The Deputy has had his say.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

There are no senior Ministers in the Chamber at this time.

Photo of Mattie McGrathMattie McGrath (Tipperary South, Independent)
Link to this: Individually | In context | Oireachtas source

And no Labour Party Deputies.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

I call Deputy Kelleher. We are have spent nearly three quarters of an hour on this question.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

To whom else among them did the Minister speak?

Deputies:

Hear, hear.

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I have a number of questions and then we can move on from this.

A Deputy:

Jim will fix it.

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

When did the Minister become aware that the Murphy site was being identified by the HSE? Roughly when was it? Was it prior to or after he became Minister or after he sacked the board of the HSE? When did he become aware of the HSE's new interest in the Murphy site because of the difficulties and contractual problems it had in the previous site it had identified?

I did not cast any personal aspersions on the Minister but I said that decisions he made could confer financial gain on individuals. It is quite right to say that if a town is designated and a site has been identified, potentially it could increase the value of the site and, by extension, it could diminish the previous owner's liability and absolve him or her from personal guarantees. That is the clear situation. That is the point I was making. It was not that the Minister was going to gain financially or in any other way, it was that he was conferring potential financial gain on an individual whose site has been identified by the HSE-----

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

Deputy, this is Question Time.

(Interruptions).

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

-----and then the Minister subsequently added it to a list without any clear criteria being laid down.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

Will the Deputy put his question?

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

Will the Minister agree that in itself could inflate the value of a site not necessarily in Balbriggan, but in other towns as well, and absolve potential owners from liability or personal guarantees?

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

I call the Minister for a final reply.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

First, I have to point out to the Deputy that, according to Fionnan Sheahan's report this morning - I do not the "blacks" here but I have no reason to doubt him - the Deputy said this morning in this House "that Minister Reilly has conferred financial ...", and I have asked the Deputy to withdraw that remark. If his idea of a withdrawal is to say "I meant to say could have", fair enough, but I want to say the following-----

Photo of Finian McGrathFinian McGrath (Dublin North Central, Independent)
Link to this: Individually | In context | Oireachtas source

Do not forget the part about the former Minister of State, Deputy Shortall.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

-----there is an old saying that "there are none so blind as those who will not see and none so deaf as those who will not hear".

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

The Minister could apply that to himself.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I have laid out the criteria for the Deputy three or four times. The criteria are quite extensive and because all of them act in different ways it is a bit like a multiplier. One and one makes two and two and two makes four but four by four makes 16 and not four and four which makes eight, and so it is with this. It is a logistical logarithmic progression. There is nothing simple about it.

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

Can we get that in writing?

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

A logistical logarithmic progression-----

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

Do not be getting giddy, we are nearly finished.

Photo of Mattie McGrathMattie McGrath (Tipperary South, Independent)
Link to this: Individually | In context | Oireachtas source

The Minister is making us giddy.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

Will the Deputies allow the Minister to reply to Deputy Kelleher? Will the Deputy have control over some of his Members?

A Deputy:

The Minister is not answering the question.

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

That includes some of the former members as well.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

I call the Minister to proceed.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I would like to finish by saying that primary care is an essential part of universal health insurance. The programme for Government is something to which I am 100% committed. I was one of its major architects in regard to the health section of it. I adhere to it, I am committed to it, I am determined it will succeed and I am convinced it will succeed. As I said on radio this morning, when I see the new leadership-----

Photo of Mattie McGrathMattie McGrath (Tipperary South, Independent)
Link to this: Individually | In context | Oireachtas source

Answer the question.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

-----in the HSE, the new leadership in the VHI and the new leadership in the Department of Health, and the excellent men and women working on our front lines and what they have done already-----

Deputies:

Hear, hear.

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

When did the Minister become aware of the site?

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

-----I am fully 100% convinced we will succeed.

Photo of Billy KelleherBilly Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

When did the Minister become aware of the site?

A Deputy:

The Minister will have to come back in here again tomorrow.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context | Oireachtas source

That completes the private notice question.

(Interruptions).