Tuesday, 6 November 2018
Ceisteanna - Questions
I propose to take Questions Nos. 7 to 9, inclusive, together.
The role of the social policy and public service reform division is to assist me as Taoiseach, and the Government, in delivering on the programme for Government objective of public policies and services which drive a socially inclusive and fair society and to assist in renewing and transforming the public service. The division assists the work of Cabinet committees B, E and G and the associated senior officials' groups. Cabinet committee B covers social policy and public services including education, children, social inclusion, Irish language, arts and culture, and continued improvements and reform of public services. Cabinet committee E deals with issues relating to health, including delivery of health service reforms. Cabinet committee G provides political oversight of developments in relation to justice and equality issues, including implementation of the Government’s programme of reform in the areas of justice and policing.
The division also provides the secretariat for the Civil Service management board, which is chaired by the Secretary General of my Department. It incorporates the programme for Government office which publishes regular progress reports on implementation of the programme for Government. The division assists Dublin's north-east inner city initiative, including through the programme office, programme implementation board and the oversight group. It is responsible for liaison with the National Economic and Social Council, NESC, which falls under the remit of my Department.
The division also provides me with briefing and speech material on social policy and public service reform issues and participates in relevant interdepartmental committees and other groups.
I understand the Minister for Justice and Equality has finally brought outstanding legal advice to Cabinet this morning that will enable his Department to progress redress payments to survivors of the Magdalen laundries. A year has passed since the Ombudsman published his report of an investigation into the administration of the Magdalen redress scheme. That investigation found a serious inconsistency in the Department's application of the redress scheme's eligibility criteria. Women recorded as admitted to a different institution closely associated with another named laundry were wrongly refused admission to the scheme.
Even as the investigation was complete and the recommendations prepared, the first instinct of the Department was to push back and, at the Joint Committee on Justice and Equality earlier this year, Mr. Peter Tyndall told members that, in his ten years as Ombudsman, he had never reached a point where a Department had, prior to publication of a report, absolutely and categorically refused to engage in the process of accepting and implementing the recommendations made. While I welcome the belated decision to accept in full the recommendations made by the Ombudsman, I am utterly disappointed at the amount of time it has taken to do so and, more to the point, so are the women involved.
I am also alarmed to learn the Department has changed the redress scheme application process to require that elderly women include the weekly hours they worked in their respective laundries. Can the Taoiseach explain why this change was made and can he say if he believes it to be appropriate? Can he indicate that the women's applications will now be fast tracked with payments issued before Christmas?
I ask the Taoiseach to give information to the House about the specific public service reform measures being led by the social policy and public service reform division. Are there discrete units of reform that the Taoiseach has prioritised and the division is on top of? In particular, has it oversight of the reforms of An Garda Síochána? Previously all the work suggested by the Garda Inspectorate was to be driven centrally with a specific role for the Garda Commissioner.
Does the division have a role in Sláintecare reforms? Is it looking at implementation, timelines and funding requirements? What, in the reform agenda, specifically is under the remit of this division?
The Irish Nurses and Midwives Organisation is meeting, as we speak, to consider possible industrial action over the failure of the Taoiseach's Government to recognise the pay crisis at the heart of a complete inability to recruit nurses into the public health service and the consequent crisis in that health service. Pay and conditions are so terrible that, for every four nursing jobs advertised, one application is received. The Taoiseach refuses to take on board the need to increases nurses' pay significantly.
Teachers, having rejected the Government's plans not to restore pay equality for new entrant teachers, are engaging in and potentially escalating industrial action. I commend both groups because they have no choice but to fight for better pay if we are to recruit the nurses and teachers we need to provide staff in the public health service and education system. Is the problem - this is related to our earlier discussion - that much of the reason nurses and teachers have to demand and fight for extra pay and are not willing to work in these jobs at current pay rates is that their pay will not allow them to put a roof over their heads? When the Taoiseach says we just need to ramp up supply and that it is okay to sell public land to private developers to build houses at market prices, he fails to recognise that building houses nobody, including teachers and nurses, can afford when they cannot afford to pay rent either is pointless. It was that approach to housing that led to the last economic crash. It is not for ideological but practical reasons that we insist that the State needs to build public and affordable housing on public land because market prices are impossible to meet for ordinary working people.
What is striking about the Government's response to the interview given by Mr. Tony O'Brien to The Sunday Business Postlast weekend is how it has tried to focus on one personal comment about the Minister for Health, Deputy Harris, and ignored everything else said in the interview, particularly about health policy. We have all noticed how there has not been any credible attempt to deny the other substantive claims made in the interview about there being an obsession with media management and, in particular, lip service being paid to Sláintecare. We now have new figures for the unprecedented vacancies in key medical posts and all of the evidence is that they have impacted directly on services. I raised this issue with the Taoiseach the week before last in the Dáil. It is a very serious issue which goes to the heart of the quality of care provided and safety for patients in hospitals. Does the Taoiseach intend to bring forward proposals to address the critical shortages of qualified consultants in key positions? The decision by Fine Gael to abolish the board of the HSE has been identified by everybody, from the Irish Fiscal Advisory Council to the Department of Finance, as a key cause of the continuing excessive deficits. The excessive deficits in the health sector really started in 2015 and 2016. They began at approximately €100 million to €200 million under the then Minister, Senator James Reilly, in 2012 and 2013, but they catapulted from 2015 onwards to the extraordinary Supplementary Estimate of €700 million this year. The Government now wants to bring back the board of the HSE. Will the Taoiseach outline if he has accepted the error of his policy in abolishing the board which he is now going to restore? What other priorities does he have for structural change and when will they take effect?
Mandatory disclosure has been a priority for a while, particularly since the CervicalCheck issue. Is there a specific reason for the ongoing delay in delivering the legislation when there seems to be all-party agreement on this key issue? When will the expert group on the public-private mix in the health sector report? Does the Taoiseach accept that there are far too many vacancies in the mental health service and that it is a significant problem which has not been met to date? Will he indicate whether implementation of the social care provision recommendations of Sláintecare, particularly universal palliative care, has started? Sláintecare recommended that €50 million be allocated for palliative care services in the next five years. Does the Taoiseach intend to do anything to start that process?
There were many questions asked and I will do my best to answer as many as I can.
With regard to the Magdalen redress scheme, the Government accepted the Ombudsman's report last May. The Minister for Justice and Equality and I met the Ombudsman after he gave evidence at the joint committee. I was struck by his evidence. He is a mild mannered man, not given to condemnation, and when he criticises a Department in the way he does, while many criticise it daily, one wants to listen to his criticisms because he is very measured and a very competent public servant. On foot of his appearance at the joint committee, I asked to meet him with the Minister for Justice and Equality. We considered his report which we have accepted in full. It recommended that we extend the Magdalen scheme to women who were not resident in Magdalen laundries but who lived nearby, often in adjoining institutions, and who were required to work, unpaid, in the laundries. We are paying compensation to these women. It is for work for which they were not paid in the past. That is why there is a question about how many hours or days they worked. It is only to make sure we can maximise the amount of money paid to women making an application. It is not to try to restrict it in any way. We fully appreciate that, given the passage of time, in some cases it could be very difficult for someone to remember how many hours she worked 30 or 40 years ago. It is not to catch people out but to work out how many hours and days they worked in laundries in order that we can calculate how much they should be compensated for. I guarantee that nobody will be left short. We are trying to give people the payment they deserve. The Cabinet agreed today to pass primary legislation to extend the medical card and other health-related supports to the women concerned. We had hoped we would be able to do so without primary legislation, but it requires such legislation. It was approved by the Cabinet today and I ask for the co-operation of all Members of the House in getting it through quickly. Every time Members demand that time be set aside to deal with certain matters, they should bear in mind that it is having on a knock-on effect and delaying the passage of other important legislation. They cannot demand more time one minute and then the next complain that something is not happening. I ask them to be sensible in the use of Dáil time. Let us use it to get necessary legislation through and not make statements and speeches. That is all I ask for from them.
Deputy Howlin asked which reforms were being overseen by the division. Different divisions oversee different reforms. I cannot remember exactly where they all fall. This one comes under the assistant Secretary General Elizabeth Canavan. She is overseeing reforms at the Department of Justice and Equality, as well as the Garda and Sláintecare reforms. They are mainly led by the line Departments, but it is the role of my Department and Cabinet subcommittees to oversee them.
On recruitment in the public sector and nursing, it is important to acknowledge that recruitment and retention are a challenge across the economy. It is a challenge from fruit farms to the ICT sector and in the public sector, too. When full employment is approached, recruitment and retention inevitably become difficult because there are so many job opportunities. There is an international recruitment and retention challenge in the health sector that every country is facing. It is present in the NHS, Germany and America too. Notwithstanding this, we have been able to recruit an extra 700 nurses in the last year. An extra 1,500 nurses have joined the payroll in the last two years. If Deputies do not believe me, they should look at the Public Sector Pay Commission's report, page 57 of which details by how much the number of nurses in the country has increased every year for the past four years. They are nurses hired by the State. We also have 5,000 more teachers than two years ago and 600 more gardaí. Notwithstanding the recruitment and retention challenge, we have more nurses, gardaí and teachers this year than last year and many more than two years ago. This often does not come across, but it is a fact.
On public sector pay, we have a pay deal. We are in the first year of a three year deal with the public service. It involves pay increases this year, including an increase in October, as well as pay increases next year, with two increases for staff on less than €30,000 and a special increase in March for recent entrants. There is a limit to how much the Government can do and how much taxpayers can afford. There is an extra €1 billion for the health service next year, of which over €300 million is already earmarked for public sector pay increases. I hope the rest will go towards new drugs, equipment, new buildings, new medicines and new services. I do not want all of the money to be eaten up by pay increases and pay claims. We need to get the balance right. Significant resources are already going towards pay increases for public servants next year and I do not want us to be in a situation where we will have to start curtailing our plans for service improvements next year, in the process taking money away from patients, students and users of public services to increase public sector pay more than we have already agreed. That would not be right.