Wednesday, 31 January 2018
Some months ago, I raised in Leaders' Questions the plight facing our hospices, employees in our hospices and indeed other section 39 organisations providing disability services and mental health services among others due to the Government's decision to exclude them from pay restoration agreements. There has been an unfair, cynical and downright dishonest approach to these organisations with regard to this issue. Funding has been deliberately withheld. Obfuscation has been the order of the day. The Minister for Health is now writing to the HSE to ask it to engage with these organisations to seek a greater and deeper understanding of the situation. I put it to the Taoiseach that that is insulting to those organisations and it is a joke. The HSE knows all about these organisations. It knows deeply about the plight that they are in, their financial situation and the issues surrounding pay restoration itself. I put it to the Taoiseach that those in organisations which provide up to 25% of disability services are being treated as second-class citizens while the Government loudly proclaims that it will ratify the UN Convention on the Rights of Persons with Disabilities and so on. That sort of hypocrisy drives people in this country mad. Employees who were used to a linkage with HSE pay scales are now treated as second-class citizens while, by the Government's own admission, they provide 25% of disability services. Employees in our hospices, the most cherished and universally lauded of our services, are treated like second-class citizens.
The issue has been to the Labour Court, which has adjudicated on this, saying that a pay linkage with the HSE exists and that where pay had either increased or decreased in the HSE, the pay rates of staff in Milford Care Centre had followed suit. This is a funding issue, not an industrial relations issue. I read in detail the Labour Court adjudication on this. I put it to the Taoiseach that the Government, for some reason, deliberately decided not to include the employees of these organisations within the pay envelope arising from the pay restoration agreements arrived at and, as a result, have put these organisations in deep trouble financially. More importantly, it has resulted in a huge drop in morale and huge recruitment challenges for the organisations themselves. When will the Government do the honest thing and accept that these employees are entitled to linkages with HSE employees and pay the organisations accordingly?
It is important to put on the record that there are more than 2,000 section 39 organisations throughout the State. They provide important disability services. They include many, but not all, of our hospices and provide vital services for our elderly people. A differential in pay has now opened up between staff working for HSE bodies and staff working for these section 39 bodies. That is causing an issue for recruitment in some places. Section 39 bodies are NGOs, charities and companies. They are not part of the public service and therefore the people who work for them are not Government employees or public servants, nor have they ever been. The Deputy will know from having read the Labour Court recommendation that the recommendation falls on the legal employers, which is not the HSE or the State. These bodies are part-funded by means of a block grant. They also raise money in other ways. They range from organisations that get as little as €10,000 from the Government to ones that get millions to provide important services. Some comply with public sector pay rules and some, as we know, have not in the past. That has been a real problem. Some reduced pay in line with pay in the public service and some did not. Almost all had their block grants reduced and almost all have had their block grants increased in recent years. In some cases, they have passed that on to staff in the form of pay restoration and in other cases they have not.
We are dealing with a diverse picture and it seems to me that staff working in these organisations have, in some ways, been caught in the middle, between their employers, the section 39 organisations themselves, the HSE and the Government. While we have been examining this for some weeks now, we still do not know how many people are affected and we do not know what the cost would be to resolve the situation. We have not been able to ascertain that. We want to establish a process whereby we can look at each of these organisations and their staff individually, find out how many people are affected, what it would cost to resolve it and whether, in some cases, block grants were increased but a decision was taken by those organisations not to pass on some of that to their staff in pay restoration in the way section 38 organisations had to.
That is a cop-out. It is unacceptable and dishonest. The HSE has been auditing these organisations year in, year out. There was correspondence from the Labour Court hearing from 14 December 2009 and January 2010 instructing these organisations, at the time of the pay cuts, to align their pay scales with the HSE pay scales. The net effect of that, said the Labour Court, was to apply pay cuts. Let us have honesty here. We know that St. Joseph's Foundation in Charleville and Marymount University Hospital and Hospice are in deep trouble financially because of this Government policy relating to these organisations. They include Abilitywest and others throughout the country. In saying that a process is now beginning, is the Taoiseach suggesting that, for the entirety of 2017, no one bothered to assess this? Did no one in the Department of Health say that, when the pay agreement was reached, section 39 organisations would be included? The opposite decision was taken. They were excluded and the Government hoped it would get away with it because it might upset the budgetary figures if they were included. That is what happened and it needs to be faced up to. I have seen the letter on behalf of the Minister to these organisations now suggesting that any resolution will have to be put into the service plan of 2019. It is obfuscation, delaying, fudge and basic dishonesty. The Taoiseach said months ago that he would look at this. He has not. He has gone along with this charade and this idea that we will begin a process on 31 January or whatever. That is wrong and it needs to be reversed. It is not fair to the workers in these organisations.
As I said earlier, the Government has proposed a process by which we can resolve this issue. I am pleased to confirm that just last night, one of the two unions concerned, Fórsa, has accepted the Government's offer and proposal. I welcome that Fórsa, as a trade union, has accepted our proposal and process to resolve this. I hope SIPTU will follow suit.
This morning, the ESRI published a major study into deprivation in 11 EU countries between 2004 and 2015. The study distinguishes between social groups who experience spells of deprivation and those who experience deprivation persistently. Across all countries, the highest material deprivation rates were found for the same two social groups: lone parents and working age adults with a disability. The study showed a significant gap in the rate of deprivation experienced by vulnerable adults in Ireland compared with other countries.
Out of 11 EU countries, Ireland's gap was the largest and it had increased the most between 2004 and 2015. The ERSI found that lone parents and adults with a disability were worse off than other people of the same age. In Ireland, the persistent deprivation rate is 26% higher among lone parents and 14% higher for adults with a disability and others. In Ireland and the UK, the persistent deprivation gap between vulnerable adults and other adults increased significantly over time. This did not happen in nine other countries. The lead researcher of the report, Professor Dorothy Watson of the ESRI, said that policies that successfully reduce poverty for the population as whole are not enough to support vulnerable groups and that proactive steps are required to address the deprivation experienced by lone parents and adults with disabilities and to tackle the higher rate of child poverty associated with these households. Such interventions are particularly urgent in Ireland because as the data shows the deprivation gap is most pronounced here.
The Indecon report published last year showed increases in deprivation rates for lone parent families. Among those surveyed, the majority of lone parents could not afford basic necessities such as a warm coat, a good pair of shoes or to turn on their heating. The Central Statistics Office, CSO, survey on income and living conditions, SILC, shows an increase in the at-risk poverty rate for lone parent families to 40.2% compared to a rate of 12% in households with two adults; a consistent poverty rate among lone parent families of 24.6% compared to 6.4% in households with two adults and a deprivation rate among lone parent families of 50% compared to 17.8% in a two adult household.
We now have another report in which Ireland stands out in terms of persistent deprivation among lone parent families when compared to ten other countries.
-----and poverty for years. It shows that our social welfare system is not successful in addressing this issue. What specific measures will the Government take to lift the most vulnerable people in our society out of deprivation and poverty?
It is important not to forget that we lost a decade in this country because of the economic and financial crisis. During that period, unemployment and poverty worsened and inequality widened. The people on this side of the House are not to blame for that financial and economic crisis but we worked very hard for a decade to put things right and get the country moving in the right direction again. During that decade, we were opposed on every occasion by Sinn Féin. Every time we sought to do something to get the economy back on track we were opposed by the Deputy's party.
The country has now turned the corner and we are back on the right track. According to the survey on income and living conditions, which the Deputy mentioned, in 2015 and 2016 poverty decreased, deprivation decreased and inequality narrowed. Using the gino coefficient Ireland is now in the middle zone in terms of income equality and it is one of the most equal in terms of income distribution among English speaking countries. We are very much moving in the right direction. While the figures for 2017 are not yet available I anticipate we will see them also moving in the right direction. The best anti-poverty policy is employment. It is our ambition to ensure we have full employment in this country and as well as that, a good job for everyone, one that pays the bills and has security and pension rights. According to the data published yesterday, unemployment has fallen from 15% to 6.1% and the percentage of long-term unemployed people - people out of work for more than nine months - is down to 3%, which is indicative of the enormous progress that has been made in a very short time. This has occurred because of Government policies. We are trying to get as many people into work as is possible because that is the best way to reduce poverty.
In terms of other things we are doing, we are increasing social welfare again. The Deputy will be aware that under a previous Government €16.50 per week was taken from the poor, the blind, the elderly and widows. We have restored €10 of that €16.50 per week and we intend to restore the full amount as soon as we possibly can. We have made changes to the family income supplement, raising the thresholds to support low income working families and to ensure that they are always better off working. The Deputy will know that anyone in receipt of family income supplement is given enough to bring them out of poverty. When it comes to lone parents, in particular, we have made changes to the lone parent payments. We have introduced subsidised child care because the cost of child care is a major barrier to lone parents getting into education and employment. The number of lone parents working is increasing every month and it is good to see that. We have restored educational supports, for example, the back to education grant for people who are lone parents with children and also couples with children. On disabilities, we are implementing the making work pay report which was launched by the Minister for Health, Deputy Harris, the Minister of State, Deputy Finian McGrath, and me not too long ago. This means that a person who is disabled and takes up a job retains his or her free travel pass for five years, which is a real positive, and that person can also now take up a trial of work. Many people with disabilities are afraid that if they try work and it does not work out for them they will not be able to get back on their benefits. We have changed the system such that people can automatically get back on their benefits. We have also abolished the provision that requires people to do some type of rehabilitative work. They can now do any work they like. We do not mind what type of work they do because all work is good.
The number of people with disabilities accessing higher education is increasing each year and the target in regard to the number of people with disabilities working for government has been increased from 3% to 6%. In response to the Deputy's question, that is a flavour of what Government is doing.
I wish I had more time.
The Taoiseach stated that everybody suffered during the austerity years but the ESRI report shows that the most vulnerable in our society, lone parents and people with disabilities, suffered more than anybody else. These figures are borne out in the latest SILC report which was published last year. It shows that there has been an increase in the at-risk poverty rate for lone parent families to 40.2%.
Fine Gael has been in government since 2011. These reports relate to the period between 2004 and 2015. Last week, Sinn Féin published a report that shows how lone parent families could be lifted out of the poverty and calling for the establishment of a child maintenance service. All the reports indicate that child maintenance is essential to help lift children out of consistent poverty levels. Sinn Féin outlined in its report how this model could be rolled out in this State. Has the Taoiseach read the report which I published last week. In March last year, the UN criticised Ireland for not having such a child maintenance service in place. Will the Taoiseach consider the establishment of such a service in Ireland?
I have not read the report but I will do so. When I can get around to it, I will take a look at all the Sinn Féin policy papers. What passes as a policy paper for Sinn Féin is called a press release in my party. All Sinn Féin does is take a press release, put a glossy cover on it and call it a policy paper but there is very little detailed costings or information in it but we will come back to that another time.
The people who suffered the most during the recession and the lost decade were people who lost their jobs. Lots of people faced pay cuts or tax increases and lots of people faced cuts in pensions and welfare but those who lost their jobs lost everything. That is why the focus for this Government has been on employment. We now have 2 million people working again in Ireland. We may even have record numbers of employment in the next year or so. Unemployment is falling rapidly and this should be acknowledged.
To give lone parents opportunities and lift them out of poverty we can do four things. First, we can provide them with employment and our initiatives in this regard are working, as indicated by the increasing number of lone parents taking up employment. Second, we need to address the child care issue. The Deputy will know that we have introduced two years of free preschool and subsidised child care and we propose to do more in this space. Third is access to education and in this regard we have restored education bursaries for people who are non-traditional backgrounds to allow them to access education. Fourth is increases in welfare, which has been happening for two years in a row and will continue so long as this Government is in power. Fine Gael and the Independents are working together to keep the economy on a solid footing and, therefore, able to fund those improvements.
I want to raise with the Taoiseach this afternoon the approach of the Government to the provision of home care packages. In particular, why are the two lowest levels of provision registered in community health care organisation, CHO, areas 3 and 5, which encompass north Tipperary and south Tipperary, respectively? All the other seven CHOs have a significantly higher number of persons in receipt of the packages. This cannot be explained simply by reference to population levels.
The information provided to me by the HSE shows that, at the end of December 2017, just 1,149 persons were in receipt of a package in CHO area 3, which covers Clare, Limerick, north Tipperary and east Limerick. The second lowest figure is in CHO area 5, where just 1,242 persons were in receipt of home care packages. This area covers Carlow, Kilkenny, south Tipperary, Waterford and Wexford.
It is deeply frustrating to me that the very low levels of home care package provision are evident in counties that consistently record the highest number of patients on trolleys. Everybody, including a second class student in national school, will know that there must be an impact on the trolley count. South Tipperary General Hospital and University Hospital Limerick consistently record the highest numbers of patients awaiting beds in accident and emergency departments. This is from Irish Nurses and Midwives Organisation, INMO, figures. This echoes what my colleague, Deputy Harty, raised with the Taoiseach yesterday, that is, the need to keep care for people as local as possible and away from our acute hospitals. This is the very purpose of the home care package model.
The circumstances reflect an absence of any co-ordination within the HSE. Surely it would make more sense to prioritise home care packages that keep people out of hospitals in those areas where the hospitals are mostly in difficulty. It is not rocket science but the HSE seems to be totally unable to grapple with this and adapt to any kind of change. It is just trundling along from day to day and from year to year, with endless money being pumped in and fewer outcomes. Since we do not have the approach I advocate, we are creating problems at both ends of the spectrum. That is obvious.
Our CHO now has the lowest level of community care and the highest number of patients in accident and emergency departments, clogging up the corridors. This is completely unsustainable. Added to this is the fact that South Tipperary General Hospital has been unable to de-escalate from the full capacity protocol, making the problem even greater. The hospital has been subject to the full capacity protocol for 18 months now. It is farcical. Why is it subject to the protocol day in, day out?
As requested in the Private Members' motion of the Rural Independent Group last December, will the Taoiseach commit to establishing the home care package scheme in law, thereby giving people an automatic right to participate in it? We called for a re-evaluation of the scheme so it would be targeted at those areas, such as Tipperary, that are simultaneously trying to cope with a chronic lack of capacity at hospital level.
I very much agree that home care resources and provision for home care need to be increased. We need to ensure patients in hospital can get home quicker, thus freeing up beds in hospitals. We also need to ensure that those in receipt of home care are less likely to deteriorate and become unwell. It makes sense on so many different levels to provide more home care.
The budget and the 2018 service plan of the HSE provide an additional €37 million across the State for home care. That will provide an extra 750,000 home care hours this year by comparison with last year. That is a very significant increase.
On the question as to whether there should be a statutory scheme, there is public consultation under way. Some 2,600 submissions have been received. We need to study them. We are actively considering the matter. The fair deal scheme was heavily criticised at the time it was introduced, but most people now accept it works reasonably well and assures people that if they need a nursing home space, they can get it within four or five weeks, although they have to make a contribution. What is being considered for home care is similar: a fair deal for home care, giving people the guarantee they will get the home care they need within weeks, even if it means having to pay a contribution if it can be afforded. If that were introduced on a statutory basis, as the Deputy mentioned, it would become a legal right and something that I believe can be delivered on. As I said, there is public consultation under way and we must study the 2,000 submissions and make a decision afterwards.
As the Deputy will know, plans and funding for a 40 bed modular unit in Clonmel have been approved. The project is now under way. We anticipate that the extra 40 beds for Clonmel will be in place this year and before next winter. As the Deputy knows, sometimes additional capacity works and sometimes it does not so it is important that the hospital prepares for the additional 40 beds and ensures it changes and aligns its practices and procedures to ensure the 40 beds improve conditions for patients.
The Taoiseach very much agrees with me, but agreeing with me and doing something about the matter are altogether different. The Taoiseach is aware that the entire system of care in the community is very closely linked to the issue of bed capacity. He said that himself. Another important strand concerns the carers. Statistics provided by the Central Statistics Office, CSO, for Tipperary show carers provide a staggering 250,000 hours of care per week. The findings also record that 7,041 people stated they provided regular unpaid personal help to a friend or family member with a long-term illness, health problem or disability. What is deeply alarming is that the Central Statistics Office found there were 138 carers under the age of 15 in County Tipperary. That is very worrying and I want to be reassured it will be investigated. The carers in question are being forced into these circumstances because of the lack of home care packages. This is directly linked to the first question.
The Taoiseach mentioned the 40-bed unit. We were promised that two winters ago. The Taoiseach said the project is under way. It is not, unless I am blind. The planning permission has not even been finalised for the project, never mind being under way. The spin machine is spinning in the wrong direction. It is jumping ahead of itself. The project is not under way. We are waiting for it, we are looking for it, and it is badly needed. Two winters ago, we were promised it. We will probably face another winter without it. We have promises and spin but no action. It is not fair to the staff or patients.
I am advised by the Minister for Health that it is very much under way. We expect to have it in place in the next couple of months, certainly before next winter. We really hope it works. If the modular build does work and the additional beds do make a difference in terms of overcrowding, efficiency and capacity in the hospital, it is a model we may be able to apply to other places. Just to show we are serious about this, 170 additional beds have already been added this Christmas across a number of hospitals.
Yesterday I listened to a segment on "The Pat Kenny Show" on Dublin traffic. Last night, "Prime Time" covered the same issue. Increasingly, the lack of capacity in public transport is raised in the context of what is becoming a very significant congestion problem. In the past week alone, a number of buses have been diverted to try to alleviate the traffic chaos that is fast becoming the hallmark of College Green. This was exacerbated by the introduction of the Luas cross city.
We are facing a significant problem in 2021 owing to fines for not adhering to our climate commitments. One of the best things we can do is invest in public transport to meet those climate commitments and avoid the fines. Not only will investment in public transport offset the fines but it will also deliver a public transport system fit for a modern Ireland. In the early 1990s, we received a significant investment from the European Union because we made a case that our traffic problems in Dublin were inhibiting our economic growth nationally. It is ironic that, a couple of decades later, the same case can be and is being made by the business community and others.
There is understandable anger over the disgraceful treatment of disabled people on public transport. I refer in particular to the rail network. That a disabled person would have to give notice of four hours just to take a DART into town, for example, is not acceptable. It is hardly reassuring to any rail users to note that a reply I received from Irish Rail last week states it has not received any funding for placing orders with manufacturers and, therefore, there will not be any deliveries of new trains in 2018, 2019 or 2020. The reply also informed me that the company has not purchased any new trains or carriages in the past five years. This means no additional capacity will have been added to the rail stock in eight years.
What of the game changer of DART underground? Not only would that significantly alleviate Dublin traffic but it would have far-reaching benefits for the surrounding counties and make our capital city function properly. Anybody who commutes on Irish Rail will tell the Taoiseach about commuter trains at peak times. One is doing well if one gets on and if one does, one will be squashed like a sardine. Is it any wonder people are opting for the comfort of their cars?
We know the lead-in time from order to delivery of new trains is three to four years so decisions will have an impact if they are made now. The Taoiseach spoke recently about the need to spend now to save later. Does that mean he will accelerate the funding to Irish Rail for the purchase of new trains? How can disabled people expect any improvement in how they are treated if Irish Rail is not in a position to purchase new accessible carriages for the foreseeable future? In terms of fleet strategy, will the Government take a very cautious approach or will it future-proof purchases to provide for the huge expansion that is expected in the commuter-belt areas in terms of housing? Will the Taoiseach commit to accelerating the DART underground project which has been proposed as far back as the mid-1990s?
It is the case that we have seen a return to a level of congestion and traffic gridlock in cities that we have not seen for quite some time. A lot of that is related to the fact that the economy has improved and people are working again. Passenger numbers on Irish Rail, Dublin Bus and Bus Éireann are increasing. On the Maynooth line, with which Deputy Catherine Murphy and I are familiar, it has not quite got back to where it was at peak but I have no doubt it will get there in the coming months and years.
The reality is that during the lost decade, those ten years I spoke about, we just did not have the money that we needed to invest in public transport. We lost ten years, which we could have used to improve the public transport system. We were able to do some important things in the greater Dublin area, for example, the Phoenix Park tunnel is open and passengers in Deputy Murphy's constituency use that service on many occasions. The Luas cross city is now a reality providing quality public transport to a lot of people and linking up Luas lines and commuter lines. We brought in real time passenger information, RTPI, so that people know when the bus is coming. Some Members may have watched "Prime Time" last night. I am delighted that it was accurate and that the signs on the Luas and Dublin Bus were within one or two minutes in terms of accuracy. Integrated ticketing was also introduced in the form of the Leap card. Even at a time when we had no money to invest in infrastructure we were able to do some very valuable things.
We are now in a different place as a country and I hope that in the next couple of weeks we will set out a very ambitious ten-year investment plan in infrastructure. Transport must be a big part of that. We will be guided in many ways by the National Transport Authority's greater Dublin area plan which runs up to 2035. Projects in the mix include BusConnects, additional carriages for Irish Rail, the metro project and new Luas lines. Deputy Catherine Murphy will know as well as I do that once one takes the decision to make the investments the lead-in time is very long before they become a reality. I remember the day I signed the order to connect the Luas lines and when my officials told me it would not be open until 2017 I was distraught because I could be anywhere in 2017. As it happens I am here, but public transport is something I really believe in and something in which we will invest very heavily into the future.
It is the case that Irish Rail has no new carriages on order but it is funded to refurbish 30 or 40 carriages and once they are refurbished they will be brought into use in the Limerick and mid-west area and that will have a knock-on effect in terms of allowing for greater capacity in Dublin and on some of our existing lines. While Irish Rail does not have the carriages to run additional peak services it will be able to run additional off-peak services.
I acknowledge much of what has been done, some of which was proposed in the early 1990s, including some of the projects the Taoiseach identified. The best way to inhibit a recovery is not to invest in it. There is no doubt that huge amounts of land are being zoned on the periphery of Dublin that is only going to add to the congestion unless the Government in parallel provides and plans for the growth, including public transport.
I was told at a Committee of Public Accounts meeting that climate fines are likely to be up to €600 million per year from 2021. Where is the spend now and save later approach if no order has been made for the purchase of new carriages and trains when it is perfectly obvious that there is a problem with capacity, in particular at peak times? If public transport is to function it must have capacity.
The Taoiseach did not reply to my question on the DART underground. Is that on or off the table at this stage? At what point will the Government invest in the carriages? When will the order be made? Is the Minister active on the issue? I did not hear him say very much about it.
The ten-year national infrastructure investment plan will be published as soon as it is agreed by the Government. I hope that will be in the next few weeks. The Deputy will then see what can be funded and what cannot be funded in the greater Dublin area and in the rest of the country in the decade ahead. All the projects she mentioned are in the mix.
Deputy Catherine Murphy is correct to say that we need to spend now to save later but to spend now one needs the money and let us not forget that until last year we were running a budget deficit. We were spending more than we were taking in in taxes and other revenues and we were increasing our borrowing every year. In order to spend and invest one has to have the money so the first thing we had to do was to get the economy back on track and on a sustainable footing and now we are in a position in the years ahead, provided we continue to steward the economy well, to invest in infrastructure in a way that we have not done for a very long time.
To pick up on another point the Deputy made on areas on the outskirts of cities that are zoned for development, she is correct that we need to ensure that transport is in place for those areas but perhaps what is more important is that we need to make sure that we put new housing in places that are already served by infrastructure and that means densification, going higher and having higher density, in particular in city cores not just in Dublin but in Limerick, Waterford, Cork, Galway and other places too. If people live near to where they work, in particular if they live within walking distance of where they work, that cuts out the need for all that expensive infrastructure and there are no emissions at all.