Thursday, 24 January 2019
Ceisteanna ar Reachtaíocht a Gealladh - Questions on Promised Legislation
I join all of my colleagues in congratulating the Minister for Health, Deputy Harris, and wish him well at this time.
With reference to the previous discussion, we need to provide reassurance - to use the Tánaiste's word - on two issues, the first of which is the backlog. Will the Government publish the medical advice the Minister for Health was given before he took the decision to proceed on the smear test issue? The second issue is that the Tánaiste keeps saying it is a matter for the laboratories. The Government took the decision to progress the expansion of the screening programme without providing resources for the laboratories. Does it intend to introduce a Supplementary Estimate to provide the necessary resources, once and for all, to address the backlog, as well as the second issue?
I have heard some doctors speak about this issue in the media today. It is important to say the problems related to secondary HPV testing are not solely connected to the increased volume of smear tests. We need to be accurate in considering what has contributed to what problem. There are two separate issues. One is capacity and one is secondary screening, when it has been necessary, in one of the three laboratories. It is important to separate the two issues. There is, of course, an obligation on the Government to be as accurate as it can when explaining what happened and why . The Minister, Deputy Harris, looks forward to doing so.
The Tánaiste speaks about confidence. We need it. Whoever is in charge of the HSE at this time, be it a Minister of State or a senior Minister, needs to answer serious questions. On numerous occasions today I have asked about when the Minister for Health received the advice. Was it in early or at the end of December? Why has it taken so long for the women who have been affected to be informed? While the Taoiseach is abroad, the Tánaiste is in charge. Surely someone is in charge of the HSE who can obtain the information as to when the Minister was informed, what he was informed and why the Government decided not to inform patients until now. As we still do not have a figure - it is about 6,000 - are we sure this is the number of people affected who have been identified? I impress on the Tánaiste and the Ceann Comhairle the need to make space available today to answer these questions and provide reassurance, if it can be provided, that someone has his or her finger on the pulse and is overseeing the matter from a Government perspective.
I ask the Deputies to listen as this is an important issue. The patients' representatives who are on the committee discussed this issue and agreed with that approach. I can get the date in December. I do not have it in front of me, but there is no hiding of information; we can get it. I understand the Minister then asked for a full report to provide the full details of the numbers involved and so on. As he had not actually received the report, he could not inform the House of its contents.
On behalf of my Labour Party colleagues, I wish the Minister for Health, Deputy Harris; his wife, Caoimhe, and their new child well. The idea of taking paternity leave is a very good one.
I have another health question for the Tánaiste. He will recall that the roll-out of free GP care was a Labour Party initiative that began in the term of office of the last Government. In bad financial times we were able to make great progress with it, but it has stalled since the change of Government. There is a commitment in the programme for Government to roll out free GP care to the under-18s. Given the lack of young adolescent mental health supports, this would be a very important contribution. When will the commitment be implemented to roll out free GP care to the under-18s?
Yes. We have started on a road on which we intend to continue and it has been very successful to date. However, lessons do need to be learned from past decisions. It cannot be rushed in trying to move too quickly, without ensuring the costs can be met and the capacity to deliver the service. The Deputy is aware that there have been ongoing discussions between GPs and the Department of Health on the services provided by GPs. Those consultations will continue.
I ask a simple question that I have been asking since last May about CervicalCheck. I asked Mr. Tony O'Brien, formerly of the HSE, who committed to giving me the answer to it. I asked the Minister for Health about the matter twice and he committed to giving me the answer to it. I also asked the Minister for Finance, Deputy Paschal Donohoe, when he replaced the Tánaiste today and he, too, committed to giving me the answer to it. It is a very simple question to indicate the political root of the problem with CervicalCheck. From which laboratories did the 221 misdiagnosed false negative results emanate? I believe the answer to this question will show very clearly that at the root of the this tragic problem - another woman lost her life recently - is the decision to outsource women's health. I ask the question again today and for an answer to it. I know - I have seen documentation - that the answer is simple. From which laboratories did the 221 misdiagnosed false negative results come? It is a simple question, to which there is a simple answer that the Government refuses to give to me. Having committed on several occasions to give me the answer, it still refuses and has done so since last May. Imagine how frustrated women are. The answer will show that at its heart was the decision to outsource women's health.
I have a question for the Minister for Justice and Equality, Deputy Charles Flanagan, as a result of the reply I received to a parliamentary question. There has been a dramatic reduction in the number of probationary gardaí assigned to County Tipperary. It is absolutely astonishing that, between 2015 and 2018, County Tipperary was allocated only 48 probationary gardaí out of a total of 2,146. Last year only eight gardaí were assigned to County Tipperary, a large rural county in which there are huge concerns about rural crime. I now hear talk about gardaí being picked to go to the Border. Are we to have the numbers of gardaí diminished again in rural areas? Such a measure would be totally unjustifiable. We need our fair share of Garda recruits and wish them well when they come.
The Deputy has raised a number of points, the most important of which is reported on in the media today, that the Garda Commissioner intends to deploy gardaí from rural areas to the Border. I refer the Deputy and all other Members to a statement by the Garda Commissioner in which he states quite clearly that reports of 600 gardaí being moved to the Border are entirely incorrect. He has not discussed this matter, nor considered the proposal. With regard to the position in County Tipperary, I assure the Deputy that operational issues are matters for the Garda Commissioner. However, I note his concern and intend to visit the county tomorrow where I will engage with stakeholders and interested parties on the matter of rural crime. I will be happy to furnish the Deputy with a report on the meeting.
In the programme for Government a commitment is given to build further capacity for the child and adolescent mental health service, CAMHS. Last year I was informed by the Government that an additional 114 assistant psychologists and 20 psychologists would be recruited, which I welcomed. In a response to a parliamentary question this month it was stated CAMHS was operating with only 39 out of 72 in-patient beds nationally. As of 26 November, there were 44 out of 74 beds in use.
Despite the commitment the Government made, does it accept that we are going backwards in this area?
We are certainly not going backwards. Yesterday I met the national management teams of the child and adolescent mental health service, CAMHS, including representatives from the nine community healthcare organisations, CHOs, the clinical leads and the management leads. We discussed this issue, along with many other issues, challenges and successes involved with CAMHS.
The issue of beds closing is very complex and can happen for a variety of reasons. It is often attributed to the behaviour of some patients who cannot be managed, meaning that beds have to be closed for safety reasons. A facility is currently closed because of the extensive damage that was done to it. Clinical cover is also an issue at times. It is an ongoing challenge and is one we are acutely aware of and are dealing with as best we can on all levels, including the HSE management and the clinical team.
Is the Tánaiste aware that smaller Irish fishing vessels have rights over only 13% of the national fish quota? Fishing quotas are very unequally distributed and traditional fishing families are being squeezed out. For example, in 2018 a tier 1 boat could fish 437 tonnes, but now, due to penalties imposed for exceeding the quota, the allowance for that boat has been reduced to 70 tonnes. A tier 2 boat, allowed to fish 149 tonnes in 2018, has now had its allowance reduced to 24 tonnes. Fishermen should not be penalised for landing fish over the quota, because under EU regulations excess fish cannot be discarded at sea. However, under Irish law, the only way to land the exact quota is to discard the excess fish at sea. Will the Tánaiste explain why there are conflicting regulations in the EU and Ireland on how fishing vessels can land exact quotas? The pilot quota balancing scheme will squeeze the lifeblood out of small fishing villages and towns. What does the Tánaiste intend to do to ensure a fair system for all in the fishing industry? Will the Minister, who is present, meet those people who have been severely fined under this new regime?
The Deputy will be aware, in the context of the small boats he alluded to, that we took a very significant decision in recent weeks to grant exclusive access to the inshore fishing sector, the area inside six nautical miles. That step will significantly enhance the financial viability of the small inshore fishing sector, of whom there are a far greater number than those operating in larger fishing boats. The Deputy is obviously aware that we operate within the confines of the Common Fisheries Policy. The fishing opportunities available to the industry are determined at the December council meeting each year. We attempt to secure the maximum possible opportunity for our fishermen while operating within the constraints of the objectives of the Common Fisheries Policy, which includes attaining a maximum sustainable yield, and within the constraints of the landing obligation. In the context of the outcome of this year's December council meeting, we have managed to achieve those objectives.
Before Christmas I raised the point that the Milford hospice was going to withdraw some of its palliative care services from north Tipperary. This has happened since 1 January, and I would like the Minister to tell us when the HSE plans to restore these essential services to the area. Are we going to be discriminated against once again?
I seek a definitive answer on the current status of the application process for the approval of nusinersen, or Spinraza. The parents of the 25 children involved and others who require this life-saving drug are at their wits' end and are desperately seeking information as to when a decision will be made. The parents group is meeting on Sunday. I appeal to the Minister of State not to further prolong the agony of those parents. We know that the HSE leadership group met last Tuesday. I appeal to the Minister of State to update this House and to give the parents of those children and the other people involved the definitive answer they so desperately need and deserve.
As Deputy Ó Caoláin said, the HSE group has met on this issue. Parents know what is going on. They are being held to ransom. This has been going on for far too long. Young lives are on hold. They are waiting week after week for an answer. We thought there would be a solution to this before Christmas, but unfortunately that did not materialise. I am hopeful that the Minister of State will have something positive to say today.
There was a meeting this week, and I await the final decision in that regard. I looked for an answer this morning because I was expecting that Deputy Curran would raise the matter. I may have an answer this afternoon. I do not want to build any expectations, but I will get an update this afternoon and will extend it to both Deputies. I appreciate where the Deputies are coming from, and I share their concern at a political level. I want a final decision to be made on this issue. We sometimes have to be careful what we wish for. If it is rushed, the wrong decision can be reached. We want the correct decision to be made, and a positive decision. I appreciate that time is of the essence for the people waiting at the other end of these responses. They are real people with real lives, and we have to keep that in mind.
On a point of order, this happens every Thursday. Last Thursday 11 speakers were added to Tuesday's list. Perhaps the reform committee might meet to make a half hour slot on Thursday, the same as the other days, to facilitate the asking of questions.