Tuesday, 2 May 2017
Last November at Government Buildings, the Taoiseach and the Minister for Health announced with great fanfare that the National Maternity Hospital was to be co-located with St. Vincent's Hospital. It was greeted positively at the time but the Government gave no indication of the detail involved. The co-location is welcome. Holles Street is no longer fit for purpose. There is a moral and public interest obligation on all concerned to facilitate the co-location of the National Maternity Hospital with St. Vincent's in the interest of the safety of the women of this country and those who avail of the services. When the details emerged, people were very taken aback that the ownership of the hospital was to reside in the St. Vincent's Hospital group and the Sisters of Charity and that the State's investment of hundreds of millions of euro would not be reflected in the ownership of the new hospital. Notwithstanding the Minister had embraced this last November and must have been aware of the details, given that he appointed Kieran Mulvey as mediator, he rushed out saying he was going to write to the HSE to seek clarification on the deal. When in doubt the Minister wrote to the HSE now, as if he knew nothing about it - a rabbit caught in headlights. The furore that developed as a result of the revelations seemed to catch him by surprise. It is no surprise St. Vincent's Hospital group was taken aback by the Minister's position.
It is not just a church-State issue but a financial one and one of corporate interests.
It is about who protects the taxpayer and the taxpayers' investment in a facility such as this and who is negotiating on behalf of the taxpayer. Clinical independence is critical but so also is taxpayers getting full recognition and reflection for their investment in any new facility such as this. We need far more transparency in this particular deal. The public-private mix, for example, is an important issue that should not go without some degree of scrutiny. Will the Taoiseach confirm that there will be complete clinical independence in the new national maternity hospital to be located at St. Vincent's University Hospital? Will he also confirm that the hospital group and the Sisters of Charity will not have a majority on the board? Above all, will he ensure the State, through the taxpayer, will own the hospital and have its investment reflected in it as the bottom line, given the level of investment involved?
I can confirm that there will be complete clinical independence and that the Sisters of Charity will not have a majority on the board. Ownership is a matter that requires some consideration. As a former Minister for Health, Deputy Micheál Martin will appreciate that we cannot equivocate about having the very best facilities available to expectant mothers, including co-location with an appropriate hospital that can provide expert attention, if needed.
During the term of office of the last Government the decision was taken to move the National Maternity Hospital from Holles Street to the St. Vincent's Univeristy Hospital complex. I have listened to too many stories about the inadequate facilities available at Holles Street hospital in which 9,000 babies are born every year. While a planning application has not yet been lodged for the proposed new maternity hospital on the St. Vincent's University Hospital complex, the proposed structure guarantees that the very best facilities will be available for expectant mothers that one would expect to see in the early part of this century. Where these facilities are provided in Holles Street hospital they are completely unacceptable. I have listened very carefully to the words of the master of Holles Street hospital on many occasions about the difficulties there and the poor facilities available. Co-location with St. Vincent's University Hospital is obviously best practice, clinically, and will ensure that in the rare circumstances in which women need urgent care and attention, they will receive it immediately in St. Vincent's University Hospital, which is a very fine hospital. As the master of Holles Street hospital and the Minister for Health have stated, the new national maternity hospital will be completely independent, clinically and operationally. The move to St. Vincent's University Hospital was endorsed by the boards of the two hospitals last week.
It is clear that the focus now is on the issue of ownership. We can all agree on issues such as the importance of co-locating with a major hospital and the need for brand new facilities for expectant mothers and their babies. These are issues on which everybody can agree; the debate is about ownership. The Minister for Health has worked closely with both hospitals to get a deal on the new national maternity hospital. Members will recall that when the former Minister for Health, Senator James Reilly, made this decision and during the term of his successor, Deputy Leo Varadkar, there were two mediation efforts in an attempt to settle the question between the two boards. Subsequently, Mr. Kieran Mulvey negotiated a deal between the board of the St. Vincent's Trust and Holles Street hospital. The Minister for Health, Deputy Simon Harris, has asked for and been given one month by the Government to allow space for all parties to discuss further the question of ownership of the hospital. This is an issue that deserves real debate in the context of ownership of statutory and voluntary hospitals. The agreement reached between the two hospitals was that there would be a lien on the new facility in accordance with whatever funding arrangements would be put in place by the State. Different options have been used in the past in doing this and the Minister for Health believes there is potential to devise a solution that will provide absolute reassurance on the ownership of the facilities which will be paid for by the State. The Minister for Health has my support in that regard.
Across Ireland there are different hospital owners, including the HSE, voluntary charters, congregations and private companies.
The Minister for Health is examining how best to put in place a process to facilitate the broader conversation that needs to be held. I can confirm the first two points raised by the Deputy in his concluding questions. On the third point, we are in the process of devising a solution to the ownership concerns. Nothing is being held up. A planning application has not yet been lodged.
The Minister for Health must have known about the ownership issue last November. The Taoiseach must have known about it, but he chose not to tell anyone about it. He hoped people would not notice. It was only when it became public in the last two weeks that the Minister pretended that he never knew about it and suggested he would try to rectify it in the next month. I put it to the Taoiseach that there is a moral obligation on everybody, including the St. Vincent's hospital group, to provide and facilitate the provision of the hospital. It has been suggested there have been three mediations. On what are they mediating? It needs to be registered and said the St. Vincent's health care campus would not be in place without the current and capital expenditure input of the State. The women of Ireland need the new maternity hospital. The idea that some people are reluctant partners in facilitating its provision is out of order. There is an obligation to do so. People should have been far more transparent. Why do the Sisters of Charity want to own the hospital? Does anybody know the answer to that question? Do they want to own it for financial or corporate reasons? Is there something else we are not being told? Is the complicated financial set-up on the campus preventing the St. Vincent's hospital group from giving the property over to the State? I think we need answers to that question. Fundamentally, I put it to the Taoiseach that the State should own the hospital and that the State's investment should be reflected in the ownership model. He has not really given me an answer to these assertions. I do not think anybody could have any doubt about these basic principles or any reason to disagree with them, particularly in the modern era when religious orders are in decline. We have heard about lay trusts eventually coming on stream. That is not the right route into the future given the way things are going.
That is all part of the very argument, discussion and conversation in which the Minister for Health is engaging. Is it a fact that every time facilities are provided by the State the State has to own the building and the land? As the Deputy is aware, having allowed it to drift when he served as Minister for Health and Children-----
The master of the National Maternity Hospital and her predecessors have said it. The decision to move the hospital to the St. Vincent's University Hospital complex was taken by the previous Government. The land is owned by the trust mentioned. Deputy Micheál Martin has said the new hospital should be in public ownership. There are very strong opinions that that should be so, but the land is not owned by the State. Is the Deputy suggesting it should be acquired by means of a compulsory purchase order?
We can all agree that expectant mothers should have world-class facilities, that expert attention should be provided when there are complications with births and that the plans I have seen which I announced with the Minister and the HSE are absolutely world-class and first-class. The plans include private rooms and all the facilities expectant mothers should have in this day and age. I suggest we should focus on the issues. There will be complete and utter clinical independence. They will have no majority on the board. In the coming weeks we should discuss how best we can bring about a solution to the concerns about ownership that have been validly expressed. The Minister is focusing on this issue as a priority and he has the full backing of the Government in that regard.
Last week I received a letter from the Taoiseach dated 26 April 2017. It followed an RTE "Prime Time" investigation into the fatal shooting of Garda Tony Golden, the serious wounding of Siobhán Phillips and the death by suicide of Crevan Mackin. I have raised many of the allegations contained in the "Prime Time" investigation with the Taoiseach and the Tánaiste since October 2015, shortly after the tragic events in Omeath. I wrote to the Taoiseach four times and spoke to him directly on a number of occasions. I wrote to the Minister eight times and also spoke to her on a number of occasions. I gave information to the senior garda investigating the case and wrote to the Garda Síochána Ombudsman Commission, GSOC. It is unacceptable that the Taoiseach's letter of last week is the only substantive reply I have received in a year and a half.
Owing to the sensitivities involved, especially for the family of Garda Tony Golden, a brave Garda officer who was doing his duty and protecting a vulnerable woman, as well as the trauma inflicted on other families, I have not raised any of these matters in this Chamber until now.
Crevan Mackin had serious criminal convictions. He also had serious mental health issues. He was arrested in January 2015 for the possession of explosives. The search warrant revealed he had made inquiries with undercover FBI agents to import explosive devices. The FBI tipped off An Garda Síochána which believed Mr. Mackin had taken possession of six handguns and assorted ammunition. He had admitted to this in Garda custody. According to his family and solicitor, he told them that during interrogation he had been taken from Dundalk Garda station to a spot where two handguns were recovered. His family said he had told them that he had done a deal with the Garda interrogators.
I do not have time to go into all of the details. However, the Taoiseach has had these details since October 2015, as has the Minister for Justice and Equality and the Garda Commissioner. It is also clear that some in An Garda Síochána knew that Crevan Mackin continued to have access to at least four weapons when he was released on bail. Mr. Mackin subjected Siobhán Phillips to brutal violence. It was after such an assault that Siobhán, accompanied by her father and stepmother, sought to make a complaint at Dundalk Garda station. This was denied to them. Two days later they met Garda Golden who accompanied Siobhán to her home where the shooting happened.
There are many questions arising from this tragic series of events. In his letter the Taoiseach noted that GSOC had initiated a public interest investigation into these matters. While that is welcome, it only came after GSOC had received notice of the "Prime Time" programme. I made a complaint in September 2016 to GSOC which was not acted on. The GSOC investigation will not go far enough. Neither should it prevent a full criminal investigation from taking place. The response to my correspondence from both the Taoiseach and the Tánaiste and Minister for Justice and Equality over 18 months has not been satisfactory. Siobhán Phillips' family has called for a public inquiry. Will the Taoiseach act for the sake of all the families involved and authorise the holding of such an inquiry?
I thank the Deputy for raising this matter. Garda Tony Golden was shot dead on the evening of Sunday, 11 October 2015 in Omeath, County Louth. He was 36 years old and married with three young children. He was stationed in Omeath and lived in Blackrock outside Dundalk. He was the 88th member of the Garda force to die in the service of his country. As the Deputy said, he was responding to a domestic incident in Omeath at the home of Mr. Adrian Crevan Mackin and his partner Siobhán Phillips. Obviously, Ms Phillips had gone to the Garda in Omeath on the Sunday with her father and expressed her fear that Mr. Mackin was going to kill her and himself. Garda Golden escorted her and her father to the property to collect her personal items. When she and Garda Golden entered the house, Mr. Mackin shot her, Garda Golden and then himself with an illegally held handgun. Ms Phillips' father who had remained outside then telephoned the emergency services. Garda Golden and Mr. Mackin were dead at the scene, while Ms Phillips, as the Deputy is aware, suffered serious gunshot wounds to the head and was hospitalised. I am glad to say she is recovering.
The Garda is carrying out a full investigation. The Garda Commissioner has made it clear that it will take into account the full range of circumstances surrounding the shootings. Mr. Mackin who was from Newry was well known to the Garda. He had several previous convictions in Northern Ireland, including for firearms offences for which he had been sentenced and released on licence. In January 2015 he had been charged before the Special Criminal Court with membership of an illegal organisation, following his arrest in an intelligence led Garda operation. He had been released on bail pending trial.
The truth of the allegations made here has not been established. There are ongoing processes to do that which are set out clearly in law. I urge against the making of hasty judgments.
All of the concerns raised with me and the Tánaiste by Deputy Adams were quickly brought to the attention of and pursued by the Garda authorities in the context of their ongoing investigation and review process into the shootings and related matters. The Tánaiste expects to receive a final report from the Garda authorities addressing these matters when the investigation and review are completed.
The Tánaiste was also made aware in February last year by a firm of solicitors acting for Mr. Mackin's family that related matters had been brought to the attention of the Garda Síochána Ombudsman Commission, GSOC. It announced its decision recently to initiate a public interest investigation into certain matters and it indicates this public interest investigation will take place alongside the ongoing investigation of complaints made previously. I welcome this action by GSOC and its investigations must be allowed to take their course so the truth or otherwise of certain allegations made can be established quite independently. Without seeking to prejudge the issues involved, it would be of huge importance to learn anything that can be learned from the tragic events in Omeath. The GSOC investigation will be of considerable assistance in this regard.
I will make a final point. It is important to make the point that decisions in respect of the prosecution of offences are a matter for the Director of Public Prosecutions, DPP, who is fully independent in accordance with the law in discharging these functions. The office of the DPP is far better placed than anybody in the House to decide on the bringing of criminal charges in any given case and is uniquely well placed, with the relevant experience to make a determination as to what convictions are likely to be secured on the basis of the assessment before it.
The Taoiseach ignored what I asked, which is if he will authorise a public inquiry. I ask him that again. He welcomed the establishment of the GSOC investigation and I do so also as some level of progress. The Taoiseach knows the section 95 investigation allows only for disciplinary action to be taken against gardaí and not criminal action. I go back to what I said previously. The Government, including the Tánaiste and Minister for Justice and Equality, has had all this information for the past 18 months. I believe the Taoiseach when he said this was passed immediately to the Garda Commissioner. The Taoiseach went on to say these matters were pursued with the Garda Commissioner but will he explain what that means? How were these matters pursued with the Garda Commissioner? The weight of the allegations in this case surely warrants a criminal investigation. What is wrong in this State - this is prevalent - is that nobody is held to account. The family have asked for a public inquiry and I ask the Taoiseach to respond positively to that.
There are two ongoing investigations. There is the investigation by the Garda into all the circumstances surrounding the unfortunate and tragic death of Garda Tony Golden and the shooting of himself by Mr. Mackin. Separately, arising from information made available by a firm of solicitors in February last year, there is a GSOC investigation ongoing. It is only appropriate because this is a sensitive and tragic case for the Golden family that these investigations are now proceeding in parallel, and they should be allowed to proceed in parallel and be brought to a conclusion. The Tánaiste expects to get a report from the Garda Síochána in respect of that at the earliest possible opportunity.
I would appreciate having the opportunity to assess the information that will come from these investigations. They are formal investigations and, in the case of GSOC they are completely independent in the way the position is assessed. The DPP follows through with prosecutions. The Deputy says all the information has been in the hands of the authorities. As he is aware, there is information and allegations about issues, and that is what the investigation is about. Mr. Tony Golden has been taken from us, shot dead in the line of duty and in service to his country. Mr. Mackin then turned the gun on himself, having grievously wounded Ms Phillips. The Garda investigation is ongoing and parallel to that is the GSOC investigation.
The Minister for Justice and Equality will receive that report as soon as possible. Let us wait and see what comes from that and what we can learn from the determination of information that stands up, as against allegations which might not.
Last Friday, the Minister for Public Expenditure and Reform, Deputy Paschal Donohoe, when speaking on "Morning Ireland", indicated that he intends to seek to negotiate a further extension to the Lansdowne Road agreement. While noting that these negotiations would be challenging, he made it clear that he would not comment on possible negotiating positions until after the report of the Public Service Pay Commission. He said that doing so would make the existence of the commission pointless. The Taoiseach will recall that I argued that these discussions should have begun sooner. I believe some of the industrial unrest we have witnessed in recent months could have been prevented had that been the case. However, at least there appeared to be some logic to the position put forward last Friday by the Minister, Deputy Donohoe.
Today we see a mockery of that approach when we read in the Irish Independentabout the Government's plan to attack the so-called gold plated pensions in the public service. Clearly, that newspaper has been briefed on the Government's negotiating strategy, and that strategy has been established without waiting for the Public Service Pay Commission to report. We must now question whether that body is pointless, to use the Minister's word. We have legislated for career average pensions for all new entrants to the public sector. That measure will lead to a significant saving, estimated at 35%, in the future cost of pensions. It is also a reasonable measure, not least because those who are affected are aware of it and can plan for it from the moment they begin their careers. The strategy leaked today is a very different type of approach. The introduction of a career average pension for existing public servants would particularly hit those who are now approaching retirement. People approaching retirement will have considered what pension they will receive, will have planned for it for 40 years and will have planned their retirement on that basis. A dramatic cut to their pensions just before they retire would leave those plans in tatters.
I understand the desire in Fine Gael to be as tough as possible on the public sector - in many ways it is a dog whistle to the right wing voters they are seeking to court - but that is wrong with regard to public sector pensions. The average public sector pension is approximately €20,000. There is not much gold plating involved in that. The Taoiseach will also be aware of the clear legal advice of successive attorneys general that pensions are preserved property rights under the Constitution. What is the Government's exact position on the pension rights of public servants? Why was a position that cannot be constitutionally achieved briefed to the Irish Independent?
The Deputy asked about the Government's position on this matter. First, the Fine Gael Party has always valued the public service and the work that public servants do. I have highlighted that in the recent past in respect of negotiations with our European colleagues and previously during the EU Presidency, when we highlighted at all times the value, effort and unstinting commitment and dedication of public servants. The Government's position on this matter is that we should first wait to receive the report of the Public Service Pay Commission. The Minister has not received that and he has not made any comment, good, bad or indifferent, about it. Reports of what it contains are writings that I and no member of the Government have seen.
When the report is presented to the Minister he will bring it to the Cabinet, as is his responsibility. It will be published, discussed and debated. The only comment I wish to make in respect of the public service pensions issue the Deputy mentioned is that in December last year the Minister for Public Expenditure and Reform stated: "The value of public service pensions has clearly increased in recent years and this is why the work of the Public Service Pay Commission is going to be so important".
That is the position. We have not received the report. It is due to be received shortly. When it is received, the Minister will bring it to Cabinet, the Government will consider it, it will be published and it will be debated in the House.
Somebody briefed theIrish Independentwith specifics. Numbers were adduced in the article that the average public servant would lose €100,000 over the duration of his or her pension, and that was Government policy. Would the Taoiseach affirm or reject whether that is the case? Many public servants, in particular those who are approaching retirement in the coming years, are desperately anxious.
The Taoiseach will recall that when reductions to pay were made there was a fear that people would advance their retirement. We wondered what would happen with nurses, gardaí and others. In order to give confidence to people that the pensions into which they have paid for 25, 30, 35, 40 years or more will be preserved and paid as contracted by the State, will the Taoiseach confirm the accuracy of the newspaper article or disown it?
-----by the Minister, he will bring it to Cabinet, as the Deputy did with various other reports. It will be discussed by the Cabinet, decisions will be made and the report will be published and debated.
I repeat that the Deputy's allegation of a dog whistle in respect of public service and public servants is false. This party, as a political party, and the Government, as a Government, values the work of public servants and their commitment and dedication to serving our country in many areas.
The article is an article in a newspaper. The Government and Minister have neither seen nor received the report. The Minister will receive it in due course and bring it to Cabinet where it will be debated and a decision will be made. It will be published and debated in the House. I do not deal in conjecture, as the Deputy knows.
I wish to raise a matter of unfairness and the non-delivery of vital services in Kerry. I refer to cataracts. It is neither fair nor right that people of all ages have to wait for two or three years for a procedure. I will outline a couple of examples to the House. An 85-year old man, who is perfect in every way and is caring for his wife, needs a car to go to a shop and bring himself and his wife to mass but can no longer drive because he has been waiting over 18 months for an operation. He feels it would not be safe for him to drive and his car has been parked in a field. A 70-year old man who has had a disability for over 40 years had to sell the only thing he had in the world, his vintage car, for €4,500. He had been waiting for a year and a half for an operation and could not bear the fact that he could not see the television and watch the nine o'clock news and some other programmes. He is living alone and had to sell his vintage car to have an operation privately in order to restore his sight back to a reasonable level. A 62-year old man had to give up work because he was waiting for over two years to get one eye operated on. He now believes he has lost his sight in the second eye and is very depressed. That is what is happening with regard to cataracts in Kerry.
Teenagers have to wait four or five years for orthodontic treatment. Girls, in particular, are too embarrassed to socialise and are only barely able to go to school or college. In many cases they have lost their confidence. When treatment is carried out at the age of 17 or 18 years of age their gums are tough and the procedure is not as successful as it would be if carried out sooner.
We do not have nearly enough funding for home help. Few people, if any, get home help at weekends. This weekend was a long weekend due to the public holiday on Monday and, therefore, people went for three days without home help.
The people I am talking about do not get better at the weekend. They do not rise like Lazarus and go to a function or a ball because they are still in the same fix on Saturday and Sunday as they were on the other five days of the week. They need proper funding to be seen at weekends also. Many of these people are living alone and do not have any family. The Government has five ministerial office holders in the Department of Health and gave €950 million more to the HSE this year, or so it says, but things have not improved in these three areas. I ask the Government to do something about these situations which are not fair to vulnerable people.
Deputy Healy-Rae raises three valid questions on cataracts, orthodontics and home help hours. He knows some of the people involved and that is why he is raising them. This is not confined to County Kerry and these challenges face the health service generally throughout the country. In respect of cataracts and orthodontic treatment, decisions are made by people who are qualified to make decisions as to when operations should be carried out. It is not good to have people living on their own or otherwise who do not have the opportunity to look at television or read the local newspaper or whatever. However, there have been improvements in the cataract situation.
The Minister has pointed out on a number of occasions in the House in reply to questions from Deputies Danny Healy-Rae and Michael Healy-Rae the improvements that have been made and the areas where cataract operations are being carried out in other hospitals also. We will get the figures for County Kerry for the information of Deputy Healy-Rae to see what the improvement there has been.
The situation in respect of orthodontic treatment is nothing new. Issues of delay, in particular for young people who can be very sensitive about orthodontic requirements, arises every couple of years. All the orthodontic decisions are made by qualified orthodontists. The extensive waiting lists of the past have been reduced and there is a difference where it is a matter of carrying out a non-orthodontic but urgent dental procedure. The HSE has made inroads into the general orthodontic situation that applies nationally and we will get the figures for County Kerry for Deputy Healy-Rae.
Extra money has been allocated for home help and extra hours are being worked. It is a matter for the director of services in the Kerry area to define for the Deputy what extra help, if any, is being given in respect of home help. The overall allocation has increased and the number of hours has increased. Deputy Danny Healy-Rae is right to say that it is not good that somebody is left over a long weekend without attention but in general home help hours form part of a process of looking after people who are on their own and also need to be looked after by their broader families. In many cases, a roster is worked out of which home help is an essential part. Again, the information will be provided to Deputy Danny Healy-Rae as to the general situation for home help hours in County Kerry.
I do not want any more figures. I know what is happening on the ground. The people of Kerry are just as entitled to their sight as those from any other part of the country. We told the Taoiseach about the Sligo model where someone who presents with a need for regular treatment will be seen in six weeks. If it is more serious, they will be seen after that in 12 weeks and if it is more serious again, they will be seen after in six weeks. Why can we not have that model in Cork and Kerry? Deputy Michael Healy-Rae has raised this several times and it must be more of a problem in Kerry because I do not hear Deputies from any other part of the country bringing it up.
Home help hours are not being provided on Saturday and Sunday and I do not want any more figures from the Taoiseach on that. They did not get hours on the bank holiday Monday just gone and they have not got them on any other bank holiday Monday, which is not fair.
The Taoiseach states it is up to the local manager, but local managers tell us they do not have the funding. There is a Minister and four Ministers of State with responsibility for health. Get them to check it out and see what is happening. Money has been given to the HSE but we are not seeing results. The Government and Ministers with responsibility for health should ensure these services are given to the people fairly and that they are looked after properly.
The Deputy mentioned three people, namely, an 85 year old man, a 70 year old and a 62 year old. They are all people whom the Deputy knows, which is why he is raising the cases. The figures are very important. It is true to say the moneys given to the health Vote this year are higher than ever before, and responsibility for this has been transferred back into the Department for Health so transparency and accountability can follow. I do not know whether the Deputy has met with the director of services for home help in Kerry and asked whether the service is aware of the situation whereby people have been left at weekends without home help. I also do not know whether the Deputy has met with the medical personnel dealing with the waiting list for cataract operations in Kerry and pointed out the Sligo model. These are all qualified medical people who make decisions on these matters. Yes, there has been a waiting list, and there should not be, and it is not right that people cannot watch their favourite television programme or read their local paper, but the situation has improved and I will send the Deputy the figures. We will bring to the attention of the medically qualified people in Kerry who deal with orthodontics the success of the Sligo model, but they know this already.