Wednesday, 23 September 2015
I want to raise with the Taoiseach the sale of NAMA's Northern Ireland loan book, known as Project Eagle. This is the largest sale in which NAMA has engaged to date. We know from correspondence to the Minister, Deputy Noonan, at the time that even though misgivings were raised by one of the bidders - Pimco, which made NAMA aware of fee arrangements with third parties including NAMA's adviser on the Northern Ireland advisory committee - the Minister did not suggest to NAMA that the whole thing should be stopped in light of the stench that was emerging at that early stage. Of course, we know about the fee arrangements between the solicitors' firms - Brown Rudnick and Tughans - and third parties. Deputy Wallace has alluded to this in the Dáil. Again, no attempt was made stop the deal. People ticked the boxes and said they got assurances when Cerberus came in, despite the fact that they used the same solicitors' firms and the same fee arrangements to which NAMA had been alerted by Pimco. When I raised this issue with the Taoiseach in July of this year, I outlined all of my concerns. There are fundamental issues here because it involves the taxpayer. According to a report in this morning's The Irish News:
One of the bidders for Nama's northern debt portfolio expressed concern in a letter to the Taoiseach's office over the business practices of third parties leading up to the £1.2bn sale. Fortress Investment Group, [apparently] one of the final three potential buyers alongside US rivals Pimco and Cerberus Capital Management, is understood to have sent the letter to the Department of the Taoiseach in February 2014.
It seems that this letter "complained about business practices leading up to the sale of Nama's loan book, dubbed Project Eagle". Can the Taoiseach confirm that such a letter was sent to him and his Department? If so, can he confirm the contents of that letter and will he make arrangements to publish that letter? The Minister, Deputy Noonan, did not alert the Dáil at any stage about this entire saga until it was raised by a Deputy in the House. It is important for the Taoiseach to indicate whether he received such a letter. What happened in relation to any correspondence he received? What is his current position in relation to the ongoing investigations into Project Eagle?
This is a matter of very considerable concern. Obviously, questions about it have been raised and answered here previously. I think the Deputy said that a letter was sent to the office of the Taoiseach in February 2014. Is that his information?
Yes. I do not know, but I will have it checked immediately. If such a letter was received, I will see what happened in respect of it being replied to or where that was sent to, I will have the letter published and I will come back to Deputy Martin as soon as possible. As I stand here, I cannot recall receiving a letter in February 2014. If the Deputy says it was sent to the office of the Taoiseach, I am sure there is a record. I will have it checked and I will respond to the Deputy as soon as I can.
I would appreciate it if the Taoiseach would do that. It appears that his office was asked to do so yesterday, but it did not respond to the questions that were put to it regarding this correspondence. I would like to refer to the international investigation, particularly in the United States, where the matter is being taken extremely seriously. The national crime investigation unit or service in the United Kingdom is also involved in investigating this deal. Given that this involves Irish taxpayers, who would be the ultimate beneficiaries of the sale of these assets, does the Taoiseach not accept that there is an extraordinary contrast between how the Irish authorities are responding to this saga and how the UK authorities and the US criminal investigation authorities are responding to this serious issue? How does the Taoiseach account for the rather light response from the Irish authorities?
The Deputy has described the response of the Irish authorities in a very particular way. I am advised that the loan sale was executed in a proper manner. Despite all the confusion and the coverage in the media, the fact is that there are no claims of wrongdoing against NAMA. The loan portfolio sold for €1.5 billion because that is what the properties securing the loans were worth. The original amounts of €5.7 billion that were loaned by the banks prior to the establishment of NAMA have no relevance to the current value of the underlying property security. I am informed that NAMA paid no moneys to, or had any relationship with, any party to this loan sale against which allegations of wrongdoing are now being made. The loan portfolio was sold to the highest bidder for what it was worth following an open process. Attempts to conflate NAMA's open market loan sale process with an internal issue on the other side of the sale are wrong. As is now known, NAMA did not appear before the Committee for Finance and Personnel of the Northern Ireland Assembly. I understand it is not the intention of NAMA to be in any way unhelpful in the committee's work. It seems that its decision not to appear before the committee was a reflection of its sensitivity to the fact that it is accountable here to the Minister for Finance and the Oireachtas through committees like the Committee of Public Accounts-----
-----before which it recently appeared to discuss these important issues. Furthermore, as Deputy Martin will understand, NAMA undertook to respond to any written questions that the Northern Ireland Assembly committee may have regarding the sale which were not covered during the appearance of NAMA before the Committee of Public Accounts on 9 July. Last month, the committee submitted a list of questions to NAMA regarding the sales process. On 4 September, NAMA responded to the committee with detailed responses to its questions. The full response of over 300 pages is available on NAMA's website and has also been provided to the Committee of Public Accounts. Obviously, people with an interest would read that material. As I have said, I will check the report that a letter was received in the Department of the Taoiseach in February 2014 and I will advise Deputy Martin in that regard as soon as possible.
Just for the record, there are serious claims of wrongdoing by NAMA. I have written to the Taoiseach and the Minister for Finance about this matter. I have yet to receive a satisfactory reply.
I want to raise another issue here this morning. I have sent notice of this matter to the Taoiseach because it is very serious. On 26 August last, the two back wheels of an ambulance coming from Letterkenny fell off outside Sligo. The vehicle was carrying a chronically ill patient on a life-support unit, a nurse, two anaesthetists and two paramedics. The skill of the driver prevented this accident from becoming a much more serious incident with lives lost. The patient in question subsequently died, although it is not believed that the accident played any part in this. Go ndéanfaidh Dia trócaire orthu. Understandably, there was a delay of at least 30 minutes while a new ambulance was sent for. The ambulance which lost its wheels, which is a Mercedes Sprinter 515 model, is eight years old and has 411,000 km on the clock. That means it has been travelling 50,000 km a year.
The nub of my question and of the concern that is being expressed about this matter relates to an inspection report that has been carried out by an independent consulting engineer and assessor. According to the report, there is a serious design flaw with this model of ambulance. The engineer and assessor has suggested that the vehicle design has a major negative characteristic in the wheel stud nut design. His opinion is that this weakness in design could result in a wheel stud failure if a sudden stress were transmitted to the vehicle via the wheel. He has said, on the basis of his experience, that the wheel studs on the Mercedes Sprinter 515 are too small.
Do we know how much of our ambulance fleet is made up of this model? The implications of this for patients, paramedics and other road users are obvious. The independent report has been with the HSE for three weeks. Has this matter been brought to the Taoiseach's attention? What steps has the Government taken to ensure that this matter is urgently and thoroughly investigated?
I thank Deputy Adams for giving notice about a very specific matter here. In a general sense, obviously, the Government is very anxious to ensure that people get medical treatment as swiftly and as safely as possible from the health service. Since 2011 there has been a major change programme under way to reconfigure the way pre-hospital emergency care services are delivered throughout the country. Clearly, great progress has been made, but there is still a good deal of further work to be done. For instance, in 2015, €144 million was allocated to the National Ambulance Service, which serves 4.6 million people, responds to 300,000 ambulance calls per year and employs more than 1,600 staff across 100 locations. The service has a fleet of 500 different vehicles, including emergency ambulances, rapid response vehicles, intermediate care vehicles, motorbikes and the Dublin Fire Brigade ambulances. Clearly the programme is continuing to evolve and to change.
Deputy Adams raises a very specific case. I asked for a report on this, and I have a preliminary report here. The National Ambulance Service can confirm that an ambulance broke down near Ballindine, County Mayo, on the Mayo-Galway border, at ten minutes past two on 26 August 2015. Two of the vehicle's rear wheels were dislodged from the vehicle while a patient was being transferred from Letterkenny General Hospital to University College Hospital Galway. There was a patient on board the ambulance at the time, as Deputy Adams mentioned, as well as two paramedics, a doctor and a nurse. An ambulance was immediately dispatched to the incident, arriving at the scene at 2.15 p.m. - that is, five minutes after the incident happened - and the driver took the appropriate action. The patient, medical personnel and one of the paramedics travelled in the second ambulance to University College Hospital Galway and the patient arrived safely at 3.05 p.m., or five minutes past three. The ambulance from which the wheels had dislodged was recovered from the scene for further investigation and examination. I would point out that there was no deviation at all from the care and attention being given to the patient in question, and it is important to say that.
I can confirm for Deputy Adams that the ambulance service is carrying out a comprehensive investigation to determine what exactly happened and why this breakdown occurred. That investigation will include interviews with all of the staff members who operated the vehicle concerned during the transfer of the patient to Galway. Obviously the driver took appropriate and careful action which resulted in no adverse effects and no deviation from the care being provided to the patient. The investigation will also include a detailed examination of the vehicle by an independent engineer to determine the nature of the breakdown and an examination of the vehicle's service and maintenance history to see how that stacks up.
The vehicle, as Deputy Adams mentioned, has an 07 registration and had driven 411,786 kilometres in total. It was stationed at Letterkenny. The engine was replaced on 17 August 2010 at 165,000 km and again on 16 February 2015 at 390,000 km. The preliminary findings, for Deputy Adams's information, suggest that the wheel nuts loosened, which resulted in the wheels becoming dislodged. This is a cause of extreme concern to the NAS. An urgent examination of the vehicle is being undertaken and any necessary corrective action will be taken.
When I drove my own car, that happened to me once. The wheel became dislodged and the reason was that the change from wheel braces to air-tightening of nuts resulted in somebody not doing the job properly.
I thank Deputy Healy-Rae for that. I am quite sure that the ambulance service will determine the real cause of this, whether it was somebody inadvertently not tightening nuts properly or an incorrect configuration. In any event, it is lucky that the driver took appropriate action and was in charge of his vehicle, that another ambulance arrived within five minutes and that the patient was brought safely to UCHG with no change or lack of attention to the patient in question.
I have to say I am very disappointed with the Taoiseach's answer. It is of interest to the nation that the wheel came off his car one time, but that has nothing to do with the question I raised. The independent assessment - I have it - says very clearly that there is a weakness in the design. The independent assessor has pinpointed that in this particular model of ambulance there is a weakness in the design. My question was, what steps has the Government taken to ensure that this matter is urgently dealt with? I understand that some staff in the Sligo area are refusing to drive this particular model of ambulance. The Taoiseach may also be aware that there was a similar incident in March 2014 in County Louth. The week before, there was another such incident in the mid-west, and earlier that year a Dublin Fire Brigade ambulance lost a wheel. I do not know whether these ambulances were the same model as that which lost its wheels last month on the way from Donegal to Galway, but clearly this is a question that needs to be answered. We in Sinn Féin have continuously made the case that the Taoiseach's Government has presided over the erosion of our public services, and this incident is another example of a lack of proper investment.
This is most crucially felt in rural Ireland. Even the fact that a patient has to be transported from Donegal to Galway illustrates the deficiencies in the Government's health policy.
The questions are quite specific and I am not trying to score political points in terms of the particular report that has been made by the independent assessor.
He says clearly that there is a weakness in the design of this particular model. Ambulance users, hospital users and ambulance crews need to be assured that vehicles with this weakness in design are removed from service and replaced. That is number one. Two, we need to know how many ambulances have lost their wheels and whether it was as a result of this weakness in design. This report has been on the desk of the HSE for three weeks now. What has it done since then? It does not need to be a convoluted process. It has been identified as a weakness of design. What has it done to ensure that there is no recurrence of this dreadful incident?
All I am saying is that when one investigates something, there is a reason why a wheel comes off. Obviously if the nuts are the wrong configuration or they are not put on properly, then that happens. I am informed, and I do not know whether Deputy Adams has the independent engineer's report that he is quoting from-----
I understand that the Mercedes ambulances in the NAS fleet comply fully with maintenance and service records and I understand that the independent report from which the Deputy quoted has been acted upon. It is a matter of serious concern to the NAS if something like this happens, and I commend the driver involved. Deputy Adams mentioned in his initial question that there was a 40-minute delay, but I am informed by the NAS that it was a five minute-----
The ambulance was immediately dispatched to the incident and arrived at the scene at 2.15 p.m. The wheels dislodged at 2.10 p.m. Now, if the Deputy has different information, then we need to determine that as well.
I thank Deputy Mac Lochlainn for that information. This is a matter of serious concern. Let me confirm from my information here that the independent report has been acted upon and that all Mercedes ambulances in the fleet comply with the maintenance and service records fully.
As a nation, we look at our children and decide how much we cherish them and at our elderly and decide how well they are cared for. Old age comes to each and every one of us. The west has the highest population of elderly people per capitaof the regions, with counties Leitrim and Roscommon having the highest number of people per capitawith dementia in the country. In recent years, the Health Information and Quality Authority, HIQA, has visited and reported on many care homes and the Health Service Executive has given commitments to address the problems highlighted in HIQA's reports. The findings of some of HIQA reports are questionable, including, for example, the finding that not more than one person should be accommodated in a room. Some elderly people in nursing homes, which are their homes, do not have any relatives and wish to have somebody near them to talk to. That issue is one to be fought on another day and one for politicians to resolve through regulations or laws.
I welcome the recent announcement by the Minister of State at the Department of Health, Deputy Kathleen Lynch, that a funding package of €300 million will be provided for nursing homes and homes for persons with disabilities. I also welcome the announcement of a €150 million investment through public private partnerships, PPPs. I hope the new partnerships will not be similar to those used previously for medical centres as they gave builders a licence to print money. The State entered 25-year contracts that had to be renegotiated when they expired. The builders said the Government or State would pay €1 after 25 years to own the facilities.
In the west, we have care homes such as the community care home in Carrick-on-Shannon, Áras Mhuire in Tuam and, above all, the Sacred Heart Hospital in Roscommon which passed an inspection with flying colours in terms of the care provided by staff. Residents are happy in the home. People in Roscommon suffered a blow when the accident and emergency unit of the local hospital was closed. Politics should not be a game of leaving an elderly person of 80 or 90 years wondering whether money will be provided to allow him or her to stay in a nursing home.
I will ask a straight question. Will funding be provided to the Sacred Heart Hospital in Roscommon to ensure the 90 year old person to whom I spoke no longer lives in fear? The Government should not play politics by waiting for one, two or three weeks to decide when is the right time to make an announcement. Will funding be provided because the people in question do not deserve what they are going through?
Deputy Fitzmaurice raises a number of issues. He will be aware of the constraints placed on the Government in recent years in respect of the availability of money and the capacity to spend. That is the reason the public private partnership concept was brought into being and is, for example, delivering the extension of the motorway from Gort to Tuam at a cost of nearly €600 million. It is also delivering exceptionally high quality schools for children who need them at primary and secondary level as a matter of urgency. We did not have the capacity to deal with this issue because of the state of the public finances. Changes have been brought about in the operation of public private partnerships to make them more acceptable, effective and streamlined. However, these are difficult and complex contracts. In cases where projects have been delivered under public private partnerships, they have been built on time and on budget using contracts of 25 years. People in communities where schools and so on have been provided have seen very quick results.
As the Deputy is aware, the Health Information and Quality Authority was set up as an independent authority to make unannounced visits to facilities in any location and assess their quality. HIQA has brought to light some very unsavoury practices, inferior facilities and inferior attention to elderly people. The elderly person to whom the Deputy spoke in Roscommon must be treated with the same dignity and afforded the same quality of treatment as everybody else. However, the fact is that numbers of elderly people are living in homes in which facilities are inferior. In many cases, the buildings are very old and the quality of facilities is not up to standard.
I agree with Deputy Fitzmaurice that there are some people in these homes who would like to have another person accommodated in the room. However, HIQA has raised the standards laid out for single-occupancy rooms, including in respect of access, visibility for staff and so forth. People often tell me they would love to have somebody to talk to or someone else in the room. This depends on the individual's mentality, circumstances or, perhaps, his or her condition, for example, if dementia is advanced. The Government must deal with the reports of the Health Information and Quality Authority in respect of inadequate and poor quality facilities in some homes and institutions. That is the reason the Minister of State made the reference she did.
To be honest, I will not give a definitive answer about any of the ten or 11 homes that need to be-----
I am talking about not discriminating in respect of the quality of life of elderly people living in institutions and homes which have to be repaired.
The budget is on its way and the detail regarding Deputy Fitzmaurice's request about homes that will receive direct funding will be made known at that stage. That addresses the point the Deputy raises about public private partnerships and an individual home in Roscommon, one of quite a number that features in HIQA reports pointing out the need to deal with inadequate and antiquated facilities. The level of care and attention should be the same for the person to whom Deputy Fitzmaurice spoke and everyone else. I thank him for his question.
Everyone agrees that elderly people should receive the best possible care. Two weeks ago, senior HSE officials told me the Cabinet had to meet and the HSE would shortly know the outcome of that meeting. What does "shortly" mean to a 90 year old person who looks one in the eye and asks whether a nursing home will close forcing him or her to move out? I will not tell a lie to anybody and I looked the person in question in the eye and said I would do everything possible to help. The facts are, however, that the Government has the cheque book, the figures have been done and the announcement has been made. Why keep this person waiting and wondering? Are politicians in the game of trying to shorten people's lives by causing them to feel trepidation as a result of not knowing what will happen? Why does the Government not come clean and be straight when it makes announcements? Why not state whether funding is available for a home? There is an onus on the Taoiseach to be straight and tell people in Roscommon and other areas where nursing homes are needed that the funding required is available.
While there is certainly nothing wrong with the Deputy's comment, the annual budget is the outcome of the decisions made by the Cabinet in respect of providing services and running individual Departments for which Ministers have responsibility. As the Deputy is aware, the Health Service Executive submits its service plan to the Minister for Health who must sign off on it before it can be delivered. This can only happen when the Cabinet has signed off on the extent of moneys allocated to each individual Department and agency. It is not possible to give the Deputy a direct answer today because decisions have not yet been made about the budget. We have set out the parameters of it - out to €1.5 billion. Ministers are looking for far more than is available but we will not go down the same road we went down before.
This causes a complication if one has ten or 11 homes that are aged in building terms and where the facilities are not up to the standard determined by HIQA. Can they all be put together? Does one have the resources to do them all together and look after all the other things that apply also? In that sense, where many of these institutions or homes have come to light in this manner, one needs to have a strategy and plan to improve them and bring them up to standard or whatever else. If they do not meet the standard, they cannot remain open. The critical issue must be to give every person in all of those homes the best level of care, attention and dignity they can have in their circumstances. I would like to think that "shortly" means what the word is supposed to mean. The budget will determine the allocation of money to each Department and the priorities that apply afterwards, but if one has 11 or 12 of these homes to do now, one must have a method, strategy and plan to upgrade them and provide the facilities that are appropriate for elderly people in these circumstances. Many of them are in places they call home but the facilities they have are not up to standard by today's terms.