Thursday, 19 April 2018
Questions on Promised Legislation
Very tight lobbying legislation has been brought in in recent years. I think Deputy Howlin was involved in that. It is good legislation and it may well be tested in the context of some issues that have been raised in recent days. If lobbyists have acted in a way that is inconsistent with the law, then there are independent mechanisms to ensure that they are held to account. We will see how that transpires.
A Leas-Cheann Comhairle, ba mhaith liom an t-ábhar ar chlár an Rialtais a thógáil faoi do liosta feithimh. I ask about the reduction in waiting time for children suffering from scoliosis who are awaiting spinal fusion surgery and related appointments. The much-feted scoliosis action plan was abandoned early this year without even coming near to hitting its targets. The Scoliosis Advocacy Network has highlighted publicly that four-month surgery targets are not being met. It tells us that the theatre in Crumlin which is supposed to carry out these surgeries is only operating on a three-day week and outsourcing has stopped, although there are hundreds of children waiting for surgery for scoliosis in Ireland. We know that waits for first appointments for scoliosis are now running at two to three years. These waits are putting children at risk of deterioration, more complex procedures and poorer outcomes. When will we see a functional plan for scoliosis for 2018 with the necessary human and financial resources so that we can reduce these waiting lists and provide for these children and their families?
This is a serious issue. I have spoken to Deputy Harris about it on a number of occasions because we all deal with families and young people affected by scoliosis. I will hand over to the Minister of State in that Department to provide a more detailed answer.
I assure the Deputy, as he is aware since the numbers are on the record of the House, though I do not have them to hand, that there has been a significant decrease in the number of people waiting. That is not to take from the number that are waiting. Significant progress has been made in the past 12 months in the number of procedures that have been carried out. Efforts are continuing to reduce those waiting lists. It is important that we keep the balance and keep the focus on it to ensure that those numbers go down, while keeping the balance with all the other procedures.
Under the prudent maxim of "As we work for the best, we prepare for the worst" and given the public indication that contingency planning is under way across Departments in the event of a hard Brexit, we understand that upwards of 270 or 280 documents have been submitted. What interaction does the Tánaiste propose to have with Members of this House with regard to the preparations that will be required financially and legislatively - apparently emergency legislation will be required with regard to financial services and others - so that in the event of things going pear-shaped, which we work very hard to avoid, between now and next March, we are prepared for every eventuality? Will the Tánaiste brief us on that? Will he produce heads of Bills on that? How will he prepare for that issue?
I would like more time to respond to that but I will briefly say that an enormous amount of contingency planning is under way across Government. It is my Department's job to co-ordinate that. Before the summer, we will publish a framework document on what that looks like but it will not give all of the detail because it does not make sense to publish some reports that may undermine our negotiating strategy. As I have done to date, I will happily brief either leaders or party spokespeople and give them a lot of detail about the contingency planning, some of which might not be prudent to publish. I will happily do that as long as that confidentiality is respected, which it has been on many sensitive issues relating to Brexit so far.
Pages 75 to 77 of the programme for Government refer to services for children. I have a question specifically about children on the autistic spectrum. In north Dublin and Fingal, we have waiting lists of 20 months for a HSE assessment. When a child is two or two and half years old, 20 months for an early intervention is not an early intervention. We had a discussion yesterday at the Committee on Budgetary Oversight with the Minister, Deputy Donohoe, about additional funding that is probably available this year for health. Is it possible to bring forward a programme to eliminate those kinds of waiting lists and address early intervention, particularly for children on the autistic spectrum?
I agree that early intervention and early assessment are essential for children on the autistic spectrum. We put more resources into disability all the time. That will continue. This will develop as a conversation between the Minister for Health and the Minister for Public Expenditure and Reform.
This is a question for the Tánaiste or perhaps the Minister for Housing, Planning and Local Government. As they are aware, residents at the Leeside apartment complex in Cork are facing what is effectively a mass eviction at the hands of a vulture fund, a matter of concern to them but also to many others, given that homelessness in the country stands on the brink of 10,000 people. Is it sufficient that, for legal protection, residents of this kind have guidelines that have been handed down? Should there not be legislation which gives them firm rights in law, including the actual banning of economic evictions of this kind? Is that not more appropriate legislation?
We have discussed this before. Guidelines were issued in the course of last year. I said that if those guidelines need to be put into legislation, I will do that. Earlier this week, I brought heads of a Bill to protect tenants. Some new protections are coming in very quickly. If further legislation is needed, I have indicated that a second Bill is coming for the rental market later in the year. If the guidelines need to be put into law, we will do that at that time. We await the outcome of certain processes before the courts.
The programme for Government contains specific mention to sustainable rural housing. I ask the Tánaiste who was previously Minister for Housing, Planning, Community and Local Government and indeed environment about the European Court of Justice directive of February 2005. The Minister, Deputy Murphy, recently said in the Seanad that county development plans were not to be amended in any shape, make or form. They still had to apply the February 2005 EU guidelines. Will the Tánaiste clarify that they are still in place and that local authorities or councils cannot have any new guidelines until such a time as there is a comprehensive review and statement on the 2005 directive?
At the informal energy council in Sofia today, the Swedish, Austrian, Danish, Portuguese and other governments indicated that they want to increase the level of ambition for renewable energy in Europe as part of the 2030 package. Given our huge renewable resources, has the Government considered joining that pro-climate action club, considering our own energy ambition for renewables? Will it support those countries in that call for Europe? Will it amend our legislative plans accordingly?
We have a lot of ambition relating to renewable energy development in Ireland. We have one of the highest contributions from wind on our electricity grid and that is growing. We have a huge funding programme under way for ocean energy research, which we want to develop into reality. I would have to see the new proposed targets and speak to the Minister involved before making a commitment on that. We would certainly look at it.
The programme for Government states that to recruit and retain talent, it will "Implement the new procedures to ensure more efficient and timely recruitment of nurses".
I am sure the Tánaiste has read the open letter to the Government from a student nurse, Tara Nic Cormaic, which states the pay and conditions under which student nurses work are beyond shocking and that they and the job they do are worth so much more. It asks when the Government will recognise this. When will it make good on the commitment it has given in that regard? Tara is an example of the talent the Government has committed to recruiting and retaining. The health service and the Government are failing student nurses.
There is a big focus on trying to recruit more nurses into the system. They are being offered full-time contracts and other incentives to stay in Ireland and work in the health system. However, it is important to acknowledge that nurses work in many tough environments in the health system. The emergency departments in many hospitals are particularly pressurised. It is not easy for nurses or doctors. That is why we are trying to change things-----
The programme for Government contains specific recommendations to grow tourism nationwide, in particular along the Wild Atlantic Way. However, I highlight for the Tánaiste and the Minister of State at the Department of Transport, Tourism and Sport, Deputy Brendan Griffin, a situation in County Sligo where a flawed health and safety decision by the Marine Survey Office has led to the closure of Inishmurray to tourists seeking to visit the historical site on the island. Several skippers from Sligo have tours booked throughout the summer. It is vitally important, therefore, that access be reinstated. I ask the Minister of State to visit the site at his earliest convenience to see at first hand the problems being experienced. I also ask him to respond on the issue.
Like Deputy Tony McLoughlin, I have been contacted by people about this issue. A constituent of mine invested €200,000 in a boat to ferry people to the island. There has never been an accident in the course of tourists visiting the island, nor has anybody been hurt. The landing area on Inishmurray is safer than that on Skellig Michael. It is wrong that people are being prevented from earning a living and that tourists cannot visit the island. Many American tourists whose families used to live on the island visit it while on holidays.
I thank Deputies Tony McLoughlin and Eamon Scanlon for raising the issue. I am aware of it and although the specific matters raised are ones for agencies outside the control of my Department, the ramifications for the tourism industry in the area are pertinent. My Department is looking into the issue to see how it can help to resolve it. I appreciate the importance of the attraction to the tourism industry in County Sligo. I will visit the location as soon as possible to see for myself the situation on the ground and how the issue can be resolved.
The programme for Government contains a commitment to provide better healthcare. There is a need for increased investment in and expansion of the emergency department in Cavan General Hospital. It has ten examination cubicles, which is not adequate to deal with the 32,000 patients who attend it annually. There is one small triage room and no designated paediatrics area. There are no appropriate isolation or decontamination facilities. The reception area is very small. The Royal College of Surgeons in Ireland hospital group has made a case for upgrading the emergency department. I ask the Tánaiste to respond to that request.
I thank Deputy Niamh Smyth for her question. Project 2040 recognises the shortfall in capital infrastructure not just in Cavan but also country-wide. That is why €11 billion is to be committed in the next ten years to increase capacity and improve facilities. When compared with the €4 billion spent in the past ten years, the commitment shows the ambition of the Government to improve facilities, including those in Cavan.
I thank the Leas-Cheann Comhairle. The programme for Government contains a commitment to increase capacity in primary care services in a shift away from hospitals, as referred to by the Minister of State, Deputy Jim Daly. In recent months there has been a shift towards online consultations with GPs. A review of that practice has been carried out in the United Kingdom. People have been inappropriately prescribed drugs without an adequate history being taken and without a physical examination. Will the Department of Health mirror what is happening in the United Kingdom in that regard? It is a patient safety issue for those who have online consultations and are inappropriately prescribed drugs when they could have a severe medical problem.
The real No. 4 rises to speak. Page 66 of the programme for Government contains a commitment to conduct an evidence-based expert review of the current status of implementation of international best practice in mental health services in Ireland. The review will also advise on providing further capacity in child and adolescent mental health services, CAMHS. Yesterday I was informed at the Committee on the Future of Mental Health Care that 70 children of schoolgoing age had taken their own lives last year. That number does not include children between the ages of 16 and 18 years who were not in school. CAMHS teams all over Ireland are severely understaffed. It is almost two years since that commitment was given in the programme for Government, but the chronic shortage of staff has not improved and the plan is not working. I ask the Minister to lift the embargo on the recruitment of front-line staff and do whatever is necessary to fully staff CAMHS teams.
Staffing is a continuing challenge. As the Deputy is aware, it is not just about resources; it also about finding skilled and qualified staff. Since 2012 over 2,000 staffing positions have been approved, but to date we have only been able to fill 1,352 of them in mental health services. That is not down to finance but to the availability of staff such as consultant psychiatrists, of whom there is a scarcity worldwide, not just in Ireland. That is the recruitment challenge we face in dealing with the increasing demand for mental health services. As the Deputy is aware, €910 million has been allocated for mental health services, an increase of €200 million in the past five years. Funding has been increased significantly.
I refer to the commitment in the programme for Government to review the school curriculum at primary and second level and the promised legislation on a parents and students charter. There was an interesting debate in the House yesterday evening on relationships and sexuality education, RSE. The Minister for Education and Skills, Deputy Richard Bruton, gave a commitment that the National Council for Curriculum and Assessment, NCCA, would carry out a full review, in particular of RSE and social, personal and health education, SPHE. In view of the pressures on pupils, including mobile phone contact, the Internet, consent, obesity, health eating, mental health, relationships and sexuality, I ask the Tánaiste and the Government to give a commitment to the House regarding a date for the review of the primary and second level curriculum, in particular, with a view to placing on a statutory and mandatory basis a badly needed learning for life programme.
It is important to mention that, with other Members, I queued this morning to receive numbers. Deputy Pat Buckley was not in the queue.
The education (parent and student charter) Bill went through pre-legislative scrutiny in November 2017. It is on the priority list but it is proving to be more complicated than we had thought, but it is a priority and the Government intends to bring it forward soon.