Dáil debates

Wednesday, 25 February 2015

12:00 pm

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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I do not know if the Taoiseach saw last night's "Prime Time", which revealed a very serious analysis from Dr. Tony O'Connell, former national director of acute hospitals, in regard to the appalling situation within our emergency departments and in regard to delayed discharges. That analysis was written on 8 September, a month before the budget. He had some very telling things to say, including: “From a quality and safety perspective this situation is unacceptable... Frail, elderly patients risk nosocomial infections, falls, pressure ulcers, and medication errors." In terms of lengthening waiting lists and emergency department overcrowding, he said that both of these phenomena risk patient safety, delayed treatment for patients needing surgery and increased mortality for patients blocked in their transit through emergency departments. He also said that the solution is adequate funding of the social care sector and that the 2015 Estimates bid appropriately seeks additional funding for social care to address shortfalls in current funding levels.

The Minister was asked this morning about this matter. Of course, with his usual detached, commentator approach, and in a now common refrain from the Minister, he simply said, "It is not new to me" and that "It is going to get worse". His response to this was it is going to get worse. Therefore, there will be more people at risk of dying in our hospitals before the Government decides to get to grips with it.

The Taoiseach has been warned about this all along. From June 2014, the Government was warned about delayed discharges, the appalling cuts in the fair deal scheme and the fact that twice as many people are now waiting three times as long for fair deal scheme places. If we compare February 2014 to February 2015, the number of people waiting on trolleys has gone through the roof.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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A question, please.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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The fundamental point is that the Government had choices in the budget last October. It allocated €600 million to reduce taxation.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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A question, please.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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At the same time, it was asked to provide about €200 million to this specific area to deal with the risks to patient safety and of increased mortality, which is the risk of more people dying. The Government gave about 12% of what was asked by the HSE when it gave €25 million. Two months into this year, all that can be said now is that it is going to get worse.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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Sorry, Deputy. Will you put a question?

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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Does the Taoiseach accept the Government did not provide adequate funding in the budget to deal with this situation and to ensure that elderly people would not have to go through what they have gone through in the past number of months and are continuing to go through?

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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I will accept that this is a very challenging situation. I accept there have been difficulties for many years now with delayed discharges and the lack of beds, in some cases, to accommodate people who need this kind of attention. I would point out to the Deputy that, as the Minister said this morning, there is not anything new in the information provided in the letter by Dr. O'Connell, who is an eminent medical person. Clearly, he pointed out what is absolutely realistic in the context of older people and the difficulties that are created when we have a backlog situation.

The fact of the matter is that an extra €500 million was provided to fill the overrun in respect of health last year, with about €150 million for the budget for this year. A health service plan was presented and accepted. The Government supports the Minister fully in dealing with the many challenges in the area of health, not least of which is the fact that they are compounded by this particular problem in respect of delayed discharges.

The fair deal scheme, introduced quite a number of years ago, is being reassessed. That report's findings on the effectiveness or otherwise of the fair deal scheme will come before the Government when presented by the Minister. The estimate of the population of over 65s this year is 604,825 and this will rise by 100,000 in the next five years to over 700,000. This is a demographic challenge we face and, as I said, the Minister is reviewing the fair deal scheme. That will set out the options for the State, the costs and some data in respect of mapping for future needs. With over €13 billion in the health system this year, this is a very substantial amount of money but it is an area where the Minister has the support of Government in attempting to manage it in the interests of every patient.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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That is an appalling response. It is extraordinary that there seems to be no sense of urgency in government about the fact that people are at an increased risk of dying in our hospitals because of lack of funding. Dr. O'Connell outlined that the loss of 30 wards of capacity means that fewer beds are available to accept elective admissions and that this decreases the ability to cope with the surges in demand though our emergency departments. He referred to endoscopy lists going from 10,000 to 20,000 by year end, with greater risk of increased mortality.

Four years ago, the Taoiseach said he would review this scheme. In December 2006, when the fair deal scheme was brought in, Deputy Kenny led the attack and said this was "the introduction of a new death tax on the elderly". At that stage, it was at a 15% contribution whereas it is now at 22%, courtesy of his good self. However, in a letter to me two days ago, he now describes it in this way: "The scheme is a generous one in that it carefully matches the contribution made by residents with the ability to pay and it limits the portion of an applicant's assets." The Minister of State, Deputy Kathleen Lynch, has said it should be demand led, and the Minister nodded.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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Would you put a question, please?

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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Why was it not demand led last October?

Photo of Regina DohertyRegina Doherty (Meath East, Fine Gael)
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Because the Deputy's party bankrupted the country.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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Some €1 billion was spent between tax reductions and other things last October. The Government had warnings right across the system.

Photo of Finian McGrathFinian McGrath (Dublin North Central, Independent)
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Come on. They are four years in the job.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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The director general of the HSE said this is the "Achilles heel". He said 2015 is going to be a very difficult year.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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A question, please.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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We know how careful people in his position are with language. I would take that as code for something much worse, by the way. In other words, the Government should have provided far more funding in the budget for health than it did. Year after year, the Taoiseach is providing dishonest figures on health. He is saying the figures are adequate when we know that, by the end of the year, they are woefully inadequate.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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Will you recognise the Chair, Deputy? You are over time.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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It is not a smiling matter, Minister Varadkar. It is about time we had less of the Minister's detached commentary. People are dying in hospitals because he is putting other options and choices ahead of people in dire need now in our health service.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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The Deputy comes in here, week after week, purporting to have all the answers.

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
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He is elected to do that. It is his job.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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He stands up here, as the leader of his party, a party with no health policy at all-----

Photo of Mattie McGrathMattie McGrath (Tipperary South, Independent)
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The Taoiseach is pretty good at it himself.

Photo of Dara CallearyDara Calleary (Mayo, Fianna Fail)
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The Taoiseach promised to keep Roscommon Hospital open.

Photo of Mattie McGrathMattie McGrath (Tipperary South, Independent)
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On the back of a lorry.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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-----that was presented at some press conference in the past that did not even have the support of his own political party. It is the same old story from Deputy Martin every day: "I have all the answers but, actually, we have no policy in regard to health at all." The mythical-----

Photo of Dara CallearyDara Calleary (Mayo, Fianna Fail)
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He sounds like he is up on the back of a lorry again.

(Interruptions).

A Deputy:

They have no policy.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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The people of Roscommon know about the back of a lorry only too well.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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The mythical Fianna Fáil policy will deal with all of these answers some time in the future.

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
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The Taoiseach will not even drive through Roscommon any longer.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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When Deputy Martin says-----

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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It is not me. It is the former director, Dr. Tony O'Connell.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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The Deputy asks a question and then he cannot shut up and has to keep talking. The Deputy made the point there is no sense of urgency here.

Last December the Minister for Health convened an emergency task force to deal with unacceptable delays in people getting into the system and being discharged. An extra €25 million was made available for that. In addition, a range of other measures have been put in place. Some 900 additional transitional beds have been provided for this year on a temporary basis. In January 500 transitional care beds were funded in private nursing homes and a further 400 in February to assist in the discharge of patients from acute hospitals. Throughout the country 173 short-term public beds are being opened-----

12:10 pm

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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It is going to get worse.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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-----for a three-month period and arrangements are in place with the HSE to recruit front-line staff where it has been established that there is an urgent need for them. The day and night shift nursing complements have increased in Beaumont. There has been agreement on 70 nursing posts for the University of Limerick hospital group.

Photo of Mattie McGrathMattie McGrath (Tipperary South, Independent)
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The Government cannot get them to integrate.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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There have been 22 agency nursing conversions, 66 nursing posts and additional health care posts for Drogheda, and 39 posts for Naas. In addition, beds are due to open in Mount Carmel. There are plans for rehabilitation beds to open in Louth County Hospital later this month-----

Photo of Mattie McGrathMattie McGrath (Tipperary South, Independent)
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Another back of the lorry speech.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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-----and up to 300 overflow beds have been opened.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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Thank you. We are way over time.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Community intervention teams have been introduced in Naas and Drogheda. It is not true to say-----

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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Why is it worse this morning?

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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The Minister has a plan.

(Interruptions).

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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Things are getting worse.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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He is working this effectively. He has the full support of the Government, unlike the Fianna Fáil Party which goes back to its way of doing business, namely, a nod and a wink, no plan, no proposal and no case.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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It is getting worse.

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
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A nod and a wink. That is what the Roscommon people-----

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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Stay quiet, please, and let Deputy Adams make his point.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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This morning there were 479 citizens - I use the term "citizen" advisedly - languishing on trolleys in hospital corridors. The second highest number, 40 citizens, are in Our Lady of Lourdes Hospital in Drogheda in my constituency. I have raised this issue consistently on Leaders' Questions. It predates my election to this institution.

I have raised with the Taoiseach three times a letter from HIQA which points out that if recommendations it made in 2012 had been implemented, the current risk to patients would have been significantly reduced. The Taoiseach has yet to respond adequately to me on this issue. This deepening crisis is absolutely unacceptable and he should start his answer to me by acknowledging that.

What does the Minister for Health say when he is not talking to the Minister for Justice and Equality or smirking at Fianna Fáil? He says that this problem is a feature of our dysfunctional health system and that this is nothing new. He says that it only stands to reason that lives could be lost. He is the Minister for Health; he is not a neutral commentator. One could presume from his answers that lives have already been lost.

Is this not a national crisis? Is this not a totally unacceptable situation? The Taoiseach has refused to deal with it. There has been a Punch and Judy act between him and Fianna Fáil on these deadly serious issues. He allocated €25 million to the fair deal scheme.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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A question, please.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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That deals with only 300 citizens, or a quarter of those who have been clinically discharged. The Government gave more to the consultants in Irish Water. Will the Taoiseach acknowledge that this is a national crisis? Will he put in place emergency measures to tackle it?

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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I said in response to the leader of the party with no health policy that this is a matter of challenge for the Government. The Minister, Deputy Varadkar, has the full support of the Government in making arrangements to deal with this. That is why he set up the emergency task force to deal with delayed discharges.

Photo of Michael Healy-RaeMichael Healy-Rae (Kerry South, Independent)
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The Minister, Deputy Reilly, got the same support until you shafted him.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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That is why €25 million was made available which reduced the time people had been waiting for the fair deal and allowed for the beds I mentioned to be opened on both a transitional and an emergency basis. Of course it is realistic to say there are serious challenges facing the health system. The profession and system, while still challenged, is working better than it was when €16 billion was allocated to it.

Photo of Willie O'DeaWillie O'Dea (Limerick City, Fianna Fail)
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It is not.

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
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Who told the Taoiseach that?

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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On 17 February, there were 755 delayed discharges nationally, of which 370 were in the Dublin academic teaching hospitals.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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The Taoiseach made choices in the budget.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Some 555 of those delayed discharges were destined for long-term residential care. The point made by the eminent doctor is of course true. It is not an acceptable situation to have so many elderly people in these situations, and nobody wants to see that. That is why the review of the fair deal will allow for the Minister to present a report to Government on dealing with the challenges and how best to manage the situation effectively for the future. The report will also examine the consequences of the extra moneys allocated to deal with the opening of transitional and emergency beds. As I said, the budget for 2015 included an allocation of €600 million to cover the overrun of €500 million, and about €150 million which is modest in the context of the overall budget.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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It is paltry in the context of people dying.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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It is part of implementing the health service plan presented by the HSE which has been accepted by Government.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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There have been many warnings that patients' lives are at risk as a result of Government policy. Last night's "Prime Time" focused on this issue. This time the warning came from the former national director of acute hospitals, Dr. Tony O'Connell. That warning was issued last September, but the Oireachtas was not told about it by the Taoiseach or the Minister for Health. It came by dint of a freedom of information inquiry from an investigative journalist. So much for transparency or Paddy or Patricia needing to know.

Photo of Finian McGrathFinian McGrath (Dublin North Central, Independent)
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That is gone.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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In response to my first question, the Taoiseach said the system is working better.

Photo of Finian McGrathFinian McGrath (Dublin North Central, Independent)
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Paddy is cheesed off.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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When Dr. O'Connell wrote his analysis, there were 703 delayed discharge patients in the acute hospital system. Last week there were 755. How is the system working better when more patients and citizens are experiencing difficulties? He also said that some patients live permanently in our acute beds and have been waiting for more than three years for placements. Many of those affected are elderly.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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A question, please. Thank you.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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They are all sick and most, if not all, have been approved for private nursing care under the fair deal scheme, but they have not received the funding. There are currently 1,239 citizens waiting 11 weeks for fair deal funding. This situation is scandalous. Whatever Fianna Fáil did, this is happening on the Taoiseach's watch. He has been Taoiseach for four years. Dr. O'Connell concluded that-----

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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Sorry, Deputy. Put your question, please.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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-----the long-term solution to this problem is adequate funding of the social care sector. It is ABC stuff. If it is not safe to send citizens home, then we have to provide the social protections they deserve. That then frees up hospital beds and so on. Why has the Government ignored this building crisis? Why have the warnings from Dr. O'Connell and the HIQA recommendations been set to one side? I put it to the Taoiseach earlier that this is a national emergency.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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Thank you.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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The Government should take emergency measures to deal with it.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Deputy Martin has no policy and Deputy Adams has no faith. Deputy Adams decided to go elsewhere to get his health treatment, which is his choice.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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I beg your pardon. The policy the Taoiseach put before the House would take ten years.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Fianna Fáil has no health policy.

(Interruptions).

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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Settle down and let us hear the reply to Deputy Adams.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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He would not answer on "Morning Ireland".

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
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I apologise. I was taken by the Taoiseach.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Deputy Martin has no health policy.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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Deputy Dooley, allow Deputy Adams to get his reply.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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He wants it all funded by increases in income tax. Deputy Adams has no faith in the Irish health system which we are now trying to fix for everybody.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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Answer the question, Taoiseach.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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The Minister for Health has presented, from the HSE, the health service plan for 2015.

Photo of Mattie McGrathMattie McGrath (Tipperary South, Independent)
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The Government was going to disband it.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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The Government responded to that by not only dealing with the €500 million overrun of last year but also by putting more than €100 million into the budget for this year. Clearly, there are challenges. Nobody wants to see elderly people on trolleys and people who do not need to be in a hospital being kept there when they should be in transitional beds, nursing homes or other accommodation in order that they can have their medical needs properly supplied, but are prevented from accessing those services because of costs.

That is why it is important that there should be a review of the fair deal scheme-----

12:20 pm

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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Answer the question.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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-----which will be brought here.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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The review has taken four years.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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The extra beds that were allocated-----

Photo of Finian McGrathFinian McGrath (Dublin North Central, Independent)
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Four years and two Ministers.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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-----included some in the Deputy's locality. There were 400 home care packages approved for Dublin and 80 home care packages currently deployed throughout the country and the rate is increasing daily.

Photo of Finian McGrathFinian McGrath (Dublin North Central, Independent)
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Not on the northside.

Photo of Dara CallearyDara Calleary (Mayo, Fianna Fail)
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Does the Taoiseach believe that?

Photo of Mattie McGrathMattie McGrath (Tipperary South, Independent)
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Change the script.

Photo of Finian McGrathFinian McGrath (Dublin North Central, Independent)
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How many are on the northside?

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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In order to support the Dublin academic teaching hospitals and Our Lady of Lourdes Hospital and Naas General Hospital, a further 165 transitional beds were approved on 5 December to alleviate delayed discharges.

Photo of Martin FerrisMartin Ferris (Kerry North-West Limerick, Sinn Fein)
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Answer the question.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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Answer the question.

Photo of Martin FerrisMartin Ferris (Kerry North-West Limerick, Sinn Fein)
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Stop waffling.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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As of 26 January 2015, all of those beds have been accessed.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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Answer the question.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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The health service plan was accepted by the Government and the Minister has our full support in attempting to manage this.

Photo of Mattie McGrathMattie McGrath (Tipperary South, Independent)
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Give the man another page.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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The Minister today said it is going to get worse.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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We accept that this is a challenge and we want to see how best we can manage this in the interests of every patient.

Photo of Willie O'DeaWillie O'Dea (Limerick City, Fianna Fail)
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It is a bigger challenge for the patients.

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
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Four years later.

Photo of Tom FlemingTom Fleming (Kerry South, Independent)
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I welcome the recent Government awareness campaign for small business supports, although it is somewhat belated. Following the budget announcement last October, the Minister for Finance, Deputy Noonan, acknowledged that small businesses are the lifeblood of the economy. We must be mindful that 98% of Irish firms are small to medium enterprises, SMEs, and 69% of private sector employees work for an SME. Growth in employment will therefore depend on growth in smaller businesses. Job creation figures from last year indicate that small and medium-sized businesses created almost four times more jobs than the foreign direct investment sector, for example.

Dublin and some of the larger cities and urban areas are experiencing good growth but there is a two-speed recovery. Many of our rural towns and villages are being left far behind and the effects of any recovery are still to be felt. The inner parts of towns are becoming denuded of people because of the growth of large multiples on the outskirts of the towns which attract a large volume of business. Local government may see parking charges as a cash cow in such cases, so that issue must be addressed in the immediate future. The review of valuations has so far been confined to Dublin, Waterford and Limerick, with 48,000 businesses being checked in that process. All these valuations were carried out in a boom, for example, and businesses may have declined dramatically. There is a need to reduce valuations in such cases.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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Will the Deputy please put a question?

Photo of Tom FlemingTom Fleming (Kerry South, Independent)
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I ask that the process be rolled out across the country. There is no way the Valuation Office could have the resources or people to make this review with immediate effect, so I ask that an independent body be involved so as to accelerate the process. There is uncertainty in many businesses as to what direction they should take. I ask the Taoiseach to examine immediately these issues.

Photo of Finian McGrathFinian McGrath (Dublin North Central, Independent)
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Hear, hear.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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The Central Statistics Office published its latest statistics this morning. The report indicates that the Government and agencies of the Government have created 90,000 jobs since the beginning of 2012, when the Action Plan for Jobs was published. That is very important and great news for people who have been able to take up these new jobs. It means the Government is very much on track to beat the target of 100,000 new jobs by 2016. That means unemployment has fallen from 15.2% to 10.3%. As the Deputy knows, every decimal is worth approximately €90 million in savings for the people. We are moving very much in the right direction.

I am encouraged by and support the extent of growth in jobs created at home. The Deputy nevertheless makes an important point about the perception of a two-speed recovery. The cities of Dublin, Galway, Cork, Limerick and, to a lesser extent, Waterford seem to be attracting far more of the jobs than other locations. That is why local enterprise offices were set up in every local authority to provide information, access to assistance and an indication of what is available on a one-stop-shop basis.

Photo of Peadar TóibínPeadar Tóibín (Meath West, Sinn Fein)
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They are understaffed too.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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There are revamped Enterprise Ireland assistance schemes for small and medium enterprises and they are doing a fabulous job in helping people take the next step, recruit and export. IDA Ireland will launch its regional strategy for developing opportunities outside the main cities, and I am sure everybody welcomes the very substantial investment to be made by Apple in Athenry. That demonstrates the attractiveness of Ireland having economic and political stability for that kind of investment.

I take the Deputy's point. We need to improve broadband, communications, power and facilities for pristine water but they are all part of the strategy we must develop. Deputy Fleming's point is valid but the Government is working very hard on this with IDA Ireland, Enterprise Ireland and local enterprise officers. With regard to access to credit, the other day I launched with the Tánaiste and the Minister for Finance the Strategic Banking Corporation of Ireland, which will make available up to €800 million for new investment at lower interest rates and over a longer term. That is specifically for small businesses and elements are included for young farmers to avail of low-interest loans for purchasing agricultural machinery. The rural development programme will be approved shortly, with €4 billion in funding between now and 2020.

Photo of Mattie McGrathMattie McGrath (Tipperary South, Independent)
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The Government hijacked the Leader programme.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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It is in everybody's interest to increase jobs on the land.

Photo of Noel CoonanNoel Coonan (Tipperary North, Fine Gael)
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Deputy Mattie McGrath should get back in his box.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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There will also be value added with real growth.

Photo of Michael Healy-RaeMichael Healy-Rae (Kerry South, Independent)
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The Government is closing post offices like it closed Garda stations.

Photo of Seán BarrettSeán Barrett (Dún Laoghaire, Ceann Comhairle)
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Deputy Tom Fleming should be given a chance to ask a supplementary question.

Photo of Paul KehoePaul Kehoe (Wexford, Fine Gael)
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Deputy Mattie McGrath hates good news.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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He is wrong about the post offices too.

Photo of Tom FlemingTom Fleming (Kerry South, Independent)
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There is antipathy towards small businesses in the tax system. There is a glaring anomaly which sees us bend over backwards to accommodate the foreign direct investment sector, which attracts much industry to the country. Nevertheless, the domestic tax system penalises the self-employed sector. We had an opportunity to address this in the last budget but it was not addressed at the time. It is very obvious with a 55% marginal rate for self-employed rather than the 51% rate applied to general workers as there is no rational explanation for it. There is also discrimination against lower-income enterprises, with tax credits for all workers except the self-employed. That has the bizarre effect of penalising the lower-paid self-employed sector. I ask that such issues be taken on board in preparing the forthcoming budget for next October. It would be a welcome and positive step.

The Taoiseach is currently meeting representatives of the banks with regard to the mortgage crisis. In recent days there have been dramatic increases in bank charges for handling coins and smaller notes, which are used by small businesses. I ask the Taoiseach to take on board this matter in his discussions with the banks. My final point concerns energy costs. Oil prices have rarely been as low on the world markets but that does not appear to be having an effect on prices paid by the general or domestic consumer and our businesses. The energy costs are 6% to 8% higher than the European average. Will the Taoiseach examine that issue?

Photo of Finian McGrathFinian McGrath (Dublin North Central, Independent)
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Hear, hear. Answer that one.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Deputy Fleming raised a number of points. There has been a dramatic reduction in the cost of oil, which has reduced the cost of energy and brought a benefit to the consumer through lower fuel costs.

Clearly, what has happened in the United States, where energy costs have dropped substantially, has changed the balance for industry and industrial costs, and there are indications that companies wish to sign long-term arrangements regarding energy costs for their particular industries.

Regarding the move by banks to increase charges so people will move to electronic payments and electronic online systems rather than cash, it is not appropriate in many cases around the country at present. I have received an amount of contact from small businesses in the retail sector which are having difficulties arising from that.

As regards the self-employed, everybody got the same treatment where the reduction of the tax burden was concerned, although obviously the Government was very careful to ensure that those on higher levels of income paid higher levels of USC. The low pay commission is meeting this week and it will report to the Government before the summer. The Government will reflect on that report and obviously it will also have to take account of the impact of any change for employers, as it has always tried to do. It is a case of not putting a tax on work, but of making it easier for businesses to be set up and to employ new people. There is a raft of schemes for that. The more people who are working, the more that is fed into the economy and the more it can grow. It is about having more people having good jobs, so they can have careers and opportunities in their local and regional areas where that is possible. We strongly support that and it is a central part of the strategy in the Action Plan for Jobs. We expect to beat the 100,000 new jobs target by the end of this year.