Wednesday, 25 September 2019
Ceisteanna ó Cheannairí - Leaders' Questions
The savage assault last week on Quinn Industrial Holdings executive, Mr. Kevin Lunney, has both shocked and angered people across the country. The savagery and inhumanity involved reveals the continued existence of a minority criminal underground across the Border region that acts with impunity beyond the law, undermining the rights of the vast majority of decent and law-abiding citizens in the region. This assault on Mr. Lunney is the latest in a long series of attacks, including arson, intimidation, murder threats, destruction of property and endangerment to workers since 2011. It is worth reminding the House that in this region in recent years, two gardaí, Detective Garda Adrian Donohoe and Garda Tony Golden, were murdered in 2013 and 2015, respectively. These criminals have no respect for State authorities or the law and they operate in a twilight zone of their own with savagery and murderous intent.
When I heard of this savage assault on Mr. Kevin Lunney and the circumstances surrounding it, my mind went back to the savage murder of Mr. Paul Quinn in October 2007. He was a young lad who was lured into a barn. I subsequently met his parents, Stephen and Breege, and their campaign for justice has continued. They were in no doubt at that time who was responsible for the murder their son. They blamed the IRA at that stage. I am not connecting that to who is responsible for the attack on Mr. Kevin Lunney but the nature and similarity of the attack is the point of comparison. In Mr. Quinn's case, a team of approximately 15 people was involved in the murder, and he too was lured to an isolated barn. Six or seven individuals clad in overalls and surgical glove beat him to death; they were trying to avoid leaving forensic clues. His mother said to me. "They broke every bone in my son's body. If we fast forward some years later, groups of people are again trying to avoid leaving forensic clues, getting a person into an isolated location and beating him almost to death.
There is a terrible legacy in the Border region and we must face up to it. These acts did not stop after the Good Friday Agreement and certain paramilitary elements have carried on regardless in enforcing for and protecting a criminal financial empire. Operation Loft, which was undertaken by the Criminal Assets Bureau, CAB, in 2015 revealed a paramilitary financial empire of up to €70 million per annum with approximately €500 million in assets. The 2018 cross-Border threat assessment prepared jointly by the Garda and Police Service of Northern Ireland, PSNI, estimated that 43% of organised crime gangs in Northern Ireland have a cross-Border dimension.
The time has come for both the British and Irish Governments, as well as the Northern Ireland authorities when they return, to establish a statutory cross-Border multidisciplinary agency with a specific budget and personnel to once and for all root this evil out the Border region.
It needs teeth and resources. Task forces will not cut it any more. People have had enough and they want to go about their daily lives in business and their jobs without this threat, ongoing fear and intimidation. It has gone on for far too long. Will the Government give consideration to the establishment of such an agency?
I thank the Deputy for raising this matter. I was horrified to hear about the attack on Mr. Kevin Lunney, a decent, hard-working man whom I have known for many years. As a director of the Quinn group of companies, he supports the employment of more than 800 people in the Ballyconnell area. It is important that people should be able to go to and return from work without this type of horrific intimidation. What happened to him was absolutely outrageous. My thoughts remain with his family and friends and I wish him a full and speedy recovery. Of course, I urge anybody with information to come forward to An Garda Síochána. I am assured a full criminal investigation is under way.
I worked in Ballyconnell for many years and I am familiar with that part of the country. As a local Deputy and member of the Government, I stand behind the workers and with the directors of the company. They are Mr. John McCartin, Mr. Dara O'Reilly, Mr. Liam McCaffrey, Mr. Kevin Lunney and the plant manager, who is Kevin's brother, Mr. Tony Lunney. We will ensure the necessary resources are in place to bring to justice the perpetrators of this absolutely horrific attack. On a personal level, when I first heard about this, I was terribly upset to think a human could do this to another human. It was absolutely awful.
It is abundantly clear that these criminals are not supported by the communities in the region. Deputies will appreciate I am limited in what I can say about the incident, given that it is the subject of a significant investigation by both the PSNI and the Garda Síochána. In Cavan last week, Deputy Garda Commissioner John Twomey stated that every resource and the full weight of the Garda Síochána and its specialist units have been placed at the disposal of gardaí in Cavan. Both the Garda Síochána and the PSNI are conducting a major inquiry into this incident and they are determined to find those responsible. Deputies will have heard the Garda Commissioner during his appearance before the justice committee here last week speaking of the ongoing close co-operation between the Garda and the PSNI in response to this horrific attack. He confirmed the determination to bring these perpetrators to justice. The Minister for Justice and Equality, Deputy Charles Flanagan, and the Garda Commissioner are in Cavan today attending a cross-Border conference. The Minister plans to visit Quinn Industrial Holdings headquarters just outside Ballyconnell.
The Deputy spoke about setting up a task force.
Apologies. It was a special statutory body. It is something to which the Government will give consideration. There is currently a task force in place to tackle cross-Border crime. The joint agency task force was established by the Fresh Start agreement and it is led by senior officials from An Garda Síochána, the PSNI, the Revenue Commissioners and people from revenue and customs services in Northern Ireland. CAB and the National Crime Agency have also been involved. The Minister will address the task force today.
In 2015, Deputy Brendan Smith produced legislation with others in this House to set up a statutory agency drawing from the Revenue Commissioners, the police and environmental organisations to deal with the corrosive impact of fuel laundering and cigarette smuggling, which has been felt in the Border region for so long.
The Government at the time opposed the legislation but took elements of it by way of the Fresh Start agreement and a task force. However, it will no longer cut it. The point made in my presentation was this has gone on for decades at this stage. The existing operation is not working. The PSNI and An Garda Síochána co-operate well in tackling paramilitary violence and foiling bomb attacks and so on but, fundamentally, there is an alternative world in the Border region. There is considerable fear and a culture of omerta across the region which has its roots in the corrosive legacy of violence which has been ongoing for 30 or 40 years. It did not stop after the Good Friday Agreement. People have empires there. The murder of Veronica Guerin sparked the establishment of the Criminal Assets Bureau. I was in this House at the time when Fianna Fáil produced the relevant legislation while in opposition because the murder demanded such a response. The assault on Kevin Lunney is the last straw. We must provide protection and quality of life for people in the region and its economy. We must safeguard their livelihoods and provide pathways to attract investment. Above all, we must protect human life and property. That is why a statutory agency is needed. We are going to reintroduce the legislation. I want the Minister to go back to the Taoiseach and the Government for them to have an open mind, with a view to working to establish such a statutory cross-Border agency to, once and for all, take on the thugs and criminals and send the message that the only authority is that of democratic law and order and that no other will rule or reign on any part of the island.
Like Deputy Brendan Smith, I am well aware of the issues at the Border. This type of behaviour is totally unacceptable and puts fear into the heart of everybody. The Deputy mentioned Mr. Paul Quinn. I drove past an area not far from where he was tortured not too long ago and somebody pointed out to me the spot at which Mr. Quinn had been killed. It puts the hair standing on the back of one's neck thinking what happens to people and what happened to Mr. Kevin Lunney. So bad was it, it is hard to describe, or even to think about, what they did to him. It was horrific. Every effort is being made to ensure the criminals are brought to justice.
The issue of a statutory body was raised again by Deputy Micheál Martin. I will raise the matter with the Minister for Justice and Equality, but there is a very good cross-Border task force in place. I must say the PSNI and An Garda Síochána are working together and that all necessary resources are being put into investigating the case to bring the criminals to justice, ensure it will not happen again and stamp out this type of behaviour on the Border.
I join others in extending heartfelt thoughts to Mr. Lunney and his family. He is the father of six children. I met him in recent months to discuss Brexit. As others set out, the attack on him was utterly vile and criminal and every effort must be made to bring those responsible to justice. It is also worth saying the attack does not represent the standards or spirit of people who live in the Border region. Those who acted in this way did so of their own accord.
Yesterday we watched as the latest chapter of the Boris Johnson Brexit circus unfolded in London. The Supreme Court in Britain ruled that Mr. Johnson's suspension of Parliament was unlawful. The British Prime Minister was caught out in his latest bluff by the courts. Let us be in no doubt that he is wedded to his Hallowe'en Brexit strategy, come what may. He refuses to accept the democratic decision of the people in the North who voted to remain in the European Union. It is clear that he lacks the maturity or skill necessary to deal with the complexities of his country's departure from the European Union. His international credibility is in absolute tatters after the latest debacle.
The real challenge for us in Ireland is to ensure we do not become bedazzled, or distracted, by the latest instalment of the great Westminster soap opera. If the British Prime Minister wants to disrespect his office and duties, that is his problem, but we cannot allow it to become Ireland's problem. His stupid and dangerous Brexit fantasy cannot become Ireland's nightmare. Despite the chaos that is enveloping the British political system, he has said he will push ahead with Brexit on 31 October. He has also said he has an operable alternative to the agreed backstop. He has stated he has an operable plan to avoid the reimposition of a hard border on this island. We have all waited a long time for the British Government to produce workable solutions that are grounded in sense and reality. If Mr. Johnson does, in fact, have such a plan, this is the time for him to produce it, but I do not believe he has a plan. His behaviour in the past two months, since he entered 10 Downing Street, suggests such pragmatism is beyond him. I believe he has deluded himself into believing he can hoodwink Ireland and the European Union. It is the Taoiseach's responsibility to call his bluff because far too much is at stake for the sense of entitlement of the British Prime Minister to be entertained. The peace agreements, the economy and the rights of Irish people are on the line. In his arrogance Mr. Johnson perhaps believes Ireland will be the collateral damage in the Tory Brexit. He needs to be put straight that that will not happen. He needs a dose of reality. The Taoiseach met Mr. Johnson yesterday - Athena and Hercules in conclave - in New York. I want the Minister to confirm for the Dáil that the Taoiseach has reiterated to the Prime Minister that the backstop remains the bottom line, that the guarantees contained within it cannot be bartered away and that there will be no circumstances in which we can countenance the return of a hard border. The people of Ireland, North and South, need that reassurance today.
I thank the Deputy for raising this matter. Given the current political uncertainty in London, there is a significant risk of a no-deal Brexit. We do not want such an outcome, but Ireland cannot move away from an agreed and negotiated position to an unknown and untested solution. The responsibility to avoid a no-deal outcome lies with the United Kingdom because it will never be the choice of the European Union. Ireland and its EU partners stand by the withdrawal agreement. We are committed to finding a way forward and, as we have said repeatedly, open to hearing any credible, fully worked out proposal from the United Kingdom.
We have, of course, noted the findings of the Supreme Court in the United Kingdom and continue to monitor developments closely, but it would not be appropriate or helpful for me to comment on the internal workings of the British Parliament or courts. I will say, however, that any proposal from the United Kingdom must achieve the same outcome as the backstop. This test is crystal clear. A solution must avoid a hard border, fully protect the Good Friday Agreement and North-South co-operation and preserve the all-island economy, as well as the integrity of the EU Single Market and Ireland's place in it. To date, there is nothing on the table that would achieve the same outcome as the backstop. As the Taoiseach said when he met Prime Minister Johnson in New York on Tuesday, the gaps between the European Union and the United Kingdom are still very wide. Unless and until it is shown that any alternative arrangement could pass the test, the EU position remains that the withdrawal agreement, including the backstop, is the only way forward. Proposals which would not achieve these aims, or which would only partially achieve them, are unacceptable. Media speculation suggesting otherwise is simply incorrect.
We welcome the intensification of discussions between the European Commission and the United Kingdom. However, meetings are not enough, with only a handful of weeks remaining until the European Council meeting in October. The United Kingdom must match its stated aspirations with actions and present fully worked out solutions. Prime Minister Johnson has floated the idea of an all-island sanitary and phytosanitary, SPS, area, but, while SPS alignment will form an essential part of any solution, it is not enough in itself. Agreeing to this limited approach would have considerable negative impacts on life on both sides of the Border and such a proposal does not meet the test of having the same outcome as the backstop.
I welcome the clarification. It is very important, as the clock ticks down and people become very anxious about what might happen at Halloween, that the Government, as well as political leaders across the Dáil Chamber generally, remain firm in their resolve to secure and deliver the bottom line, the least worst option, which is the backstop. No one here is pretending that it is the all-encompassing answer to Brexit which was always bad news for us. We should not be led into a cul-de-sac in having to choose between the Single Market and the Good Friday Agreement, the all-island economy and citizens' rights. The task for all of us is to secure all of them. When does the Taoiseach intend to brief Opposition leaders again about his conversations with the Prime Minister, Boris Johnson, and the political plan for what might happen if Britain crashes out of the European Union? All of the things the Minister listed - the avoidance of a hard border, protection of the Good Friday Agreement, North-South co-operation, the all-island economy, to which I would add citizen's rights, and our position in the Single Market - are still imperatives if and when Britain crashes out of the European Union. We need a plan to secure them come what may.
Cross-Border travel for citizens is protected by the common travel area. It is important that people know that there is an agreement in place, that they can travel over and back every day to their place of work or to see their friends along the Border. We are an absolutely committed member of the European Union, membership of which has served the country extremely well. We will remain a committed member. As a member of the European Union, we must protect the Single Market and the customs union. Therein lies the difficulty in making sure we will not have a hard border between the Republic and Northern Ireland. I am very familiar with the area and the last thing I want to see is a border between us and Northern Ireland such that we could not continue to do what we do every single day in going over and back across the border. We do not notice it any more as it is seamless. We want that to continue, which is why the backstop is in place and we believe the withdrawal agreement is the best option on the table. We remain committed to it, as do our European partners.
My colleague, Deputy Jan O'Sullivan, and I come from the mid-west. Those us across the House, both in government and opposition, who come from counties Limerick, Clare and Tipperary, as well as from north Cork, depend on the University of Limerick Hospital Group. On Monday, 23 September, 81 patients were on trolleys in University Hospital Limerick. Can the Minister imagine what it will be like on 23 January? This is the highest the figure has ever been and we are only in September. That is despite the best efforts of management and staff. I plead with the Government to make a direct intervention. I was on the telephone to Mr. Paul Reid this morning. He knows that it cannot continue, but he needs the Government's support to do what needs to be done.
The constant high number of trolleys, the lack of bed capacity and the outrageous spending on agency staff all contribute to a situation which is the worst I have seen in my political career. Since I stood here last week, the INMO has highlighted that there are over 100 nursing posts unfilled. Behind the bluster and spin on the capital plan which was buried by the Minister for Health during the summer, there has been no real progress in building the necessary 96 bed block. Amazingly, University Hospital Limerick, unlike other model four hospitals, has only one MRI scanner. It is 14 years old and was donated by a local philanthropist. It constantly breaks down. The hospital cannot afford to buy a new one - it would cost €6.5 million - because of the overrun on the national children's hospital. It would cost €1.2 million to rent one, something it cannot afford to do.
Slaintecare funding was announced with further fanfare last week. The mid-west got nothing. Patients' well-being is suffering greatly. Staff are going on sick leave at record levels because they cannot cope. Compared to other groups across Ireland, University Hospital Limerick needs 130 more doctors, 200 more health and social care professionals, 150 more nurses, 160 more beds, about an extra 50 transitional care packages, in addition to a new MRI scanner. Its spending is €40 million below that of other groups. The people of the mid-west who are represented by me and others in this House are being discriminated against at a level not seen before. They are suffering. People in their 90s are on trolleys in University Hospital Limerick. Their families are crying on the telephone to me. I am not talking about one or two calls, but calls made every single day of the week. The issue takes up more time than any other on my political calendar.
I have three questions for the Government. When will it remove the recruitment ban which is stopping over 100 nurses from being recruited in the UHL group? Will it, please, bring forward work on the 96 bed block and include it in the capital plan? Will the Minister commit to bringing a new MRI scanner into the hospital? Of the 81 patients on trolleys, at least 30 would not be there if the hospital had a scanner that worked.
Nobody wants to see anyone on a trolley. It is acknowledged that the numbers on trolleys in University Hospital Limerick are unacceptably high. The HSE is working actively with the UHL group to ease congestion in the hospital, with the focus on facilitating transfers to level 2 hospitals, providing assistance at rehabilitation units and primary care services and the prioritisation of diagnostics to aid patient discharges. In addition to the new emergency department at University Hospital Limerick, a further 25 beds have been opened since 2017, including eight as part of the winter plan in 2018-19. A capital budget of €19.5 million has been approved for the provision of a modular 60-bed inpatient ward block at University Hospital Limerick, with funding of €10 million allocated in 2019. The new modular block will include three wards, comprising 20 single rooms with en suite facilities, two of which will have full isolation facilities and provide care and treatment for patients, from admission to discharge. The HSE has advised that the enabling works are complete and that the main contractor is commencing work.
The HSE has advised that while there is no recruitment embargo or moratorium, there is a priority requirement for all HSE services to get to and maintain an affordable staffing level that will be sustainable through 2019 and 2020, while also prioritising the delivery of safe services. In the light of this, the HSE advises that it has introduced control measures related to staffing and recruitment to ensure it will live within the resources provided. This means that in some hospital groups and community health organisations the filling of non-critical replacement posts will be paused. The preference is for the controls to remain in place for as short a period as is necessary, with an ongoing review, until there is satisfactory evidence of traction and delivery of balanced financial plans from hospital groups and CHOs.
The UHL group reports that it has recruited 68 staff in the past five weeks, 48 of whom are graduate nurses and midwives.
I thank the Minister for her generic response. I remember the Hanley report and the Teamwork report. They were the reports that were put in place to justify creating the model 4 hospital in Limerick. The issue was the resources and the capital required were never put into it. The amount of funding for staff such as doctors, nurses and health professionals was never in tandem with what was required. It has now come to a crisis.
Will the Government publish the report on the inequity in the funding of acute hospital groups in Ireland by Dr. Anne Dee, which has been buried by the HSE? It shows the discrimination that is happening to all of us in the mid-west. Will the Government publish it? It is a couple of years old but it still stands. It was buried. If the Government does not publish it, I will publish it and put it out there. Will the Government please publish it? It statistically shows how we are being discriminated against.
The situation in the mid-west needs direct intervention now. Can the Minister imagine what we are facing into over the winter? We need more staff. The recruitment embargo exists; it is real. I could name tonnes of people who have been offered jobs but cannot take them up. Will the Government please make a direct intervention to ensure those staff can take up their jobs? Will the Government please ensure we can get the capital resources needed, such as the scanner I outlined? Will the Government please ensure that in the budgetary process that is coming forward, the mid-west hospital group will not be discriminated against as it has been?
It is also important to put trolley figures in context. The hospital system is operating at close to full capacity. The number of patients attending emergency departments continues to increase year on year. Attendances in 2018 were up 3.5% on 2017 and this reflects increasing demand for unscheduled care, especially by patients in the 75 and over age group. Planning for winter 2019 to 2020 is under way. Although trolley numbers were lower over the 2018 and 2019 winter periods than the previous winter, attendances and admissions were higher than expected. Consequently, the HSE has commissioned an independent expert review group to identify the factors that contributed to performance over the winter period.
This group will carry out a comparative analysis of unscheduled care performance across the nine hospital sites and the relevant community healthcare organisations that were the subject of specific, focused support through winter 2018 and 2019. I will bring the concerns the Deputy has to the attention of the Minister for Health.
It has been reported today in the media that there is a wide gap on Brexit between the EU and the UK and the Minister has referred to same. There is certainly a wide gap between Boris Johnson's understanding of the UK Supreme Court judgment and what the judges said. I will borrow from that language in a different area and, while we are talking about gaps, talk about the even wider gap between the Government's commitment to deliver a public health system and the reality on the ground. As the Minister knows, I have raised the matter of University Hospital Galway on many occasions in a constructive manner and I have repeatedly highlighted that the hospital is not fit for purpose. The previous Fine Gael leader and Taoiseach, Deputy Enda Kenny, said in 2015 that the accident and emergency department was not fit for purpose. The current leader of Fianna Fáil has repeatedly endorsed this same stance. It is a hospital with 43,000 people on waiting lists. Two theatres were closed in September 2017, of which one is still closed and consultants are writing to us about the catastrophic regional waiting lists. There are 64 nursing vacancies. Today alone, 47 people are on trolleys. I invite any member of the Government to go onto a trolley, even for a day. They should remember the words of Dr. Fergal Hickey in Sligo University Hospital when he said there are 300 premature deaths every year that are directly related to the time patients spend on trolleys. On this day last week, there were 49 people on trolleys in University Hospital Galway and in August, 655 people in total were on trolleys. There is an options appraisal for the future, which is positive, but it has gone into abeyance.
I mention all of that by way of background to the question I will ask. The Minister can relax because it is a simple question. That is a hospital and a public health system creaking at the seams. I will look at primary care now, and according to the Minister for Health, he will focus on developing a strong and efficient primary care system. These words have been used over and over. We look at Galway in relation to primary care, which is essential of itself, but it is also essential to take the pressure off the hospital. Let me give the Minister a specific question and I might get a specific reply. We have 11 posts open in Galway. My colleague, Deputy Pringle, has a letter which details over 100 posts open in Donegal. The list starts with the post of a senior occupational therapist, an audiologist, a physiotherapist, a dental surgeon and so on. The point is they have gone through the process and the Garda vetting and they have got their jobs. Can the Minister imagine that? They have celebrated the fact they have got their jobs but what happens? They are told they cannot take up that position because sanction is needed from Dublin. That is from the letter me and my colleagues have been shown.
Please do not give me rhetoric or something I do not understand. Can the Minister tell me why those people cannot take up their posts if we are seriously interested in providing primary care? As I speak, i gConamara, i gcroílár na Gaeltachta, níl post ann don fhisiteiripe. Tá orthu dul isteach go dtí an chathair. There is nobody covering Connemara and all of the patients seeking physiotherapy have to go into the city. Specifically, is there an embargo or not?
As I understand it, there is no embargo but the Deputy spoke about issues with the hospital and trolleys. Since 2017, however, an additional 267 acute beds have been opened. The capacity programme for 2019 provides for a number of increases, namely, the provision of 75 acute beds and 70 community beds under the winter plan. Some 47 additional beds will include four high-dependency unit beds in Cork University Hospital, three in the Mater Hospital and a 40-bed modular build in South Tipperary General Hospital, which is due to be operational in the first week of January. Some 202 additional beds, of which 16 are critical care beds, will be provided during 2019, with a view to bringing this extra capacity into operation in quarter 1 of 2020.
On home care, which the Deputy mentioned, over €1.8 billion is available for 2019 for older persons' services. Of this, €985.8 million is available specifically for nursing home support schemes and €862 million is available for older persons' services. Despite the significant level of funding and service provision, demand for services continues to grow. The HSE is required to manage its budget and service provision throughout the year to ensure a balanced budget for 2019. As outlined in the HSE's national service plan for 2019, the HSE maximises the utilisation of current resources, prioritising those requiring discharge from acute hospitals and significant resources and services have been targeted in 2019 to facilitate timely access. In the winter of 2018 to 2019, the immediate focus was on reducing delayed patient discharges through mobilising the additional resources made available and ensuring that social care measures were effectively deployed to enable older people to move to a more appropriate care setting, including to step-down care or to transitional care in their own home with the supports they need. The Department of Health is engaging extensively with the HSE in the context of planning for winter, including consideration of the response to dealing with the current challenges, such as the high level of delayed transfers of care. While this engagement continues, the HSE has been authorised to undertake immediate action to mitigate the challenges. Engagement will continue over the coming weeks, having regard to the process for the 2020 Estimates.
Democracy is a fragile process. We know that from recent events in Oughterard. Part of the democratic process is for the Opposition to hold the Government to account in language the ordinary person understands. I have asked the Minister a simple question. I refer to 11 specific posts in Galway - there is list of over 100 unfilled posts in Donegal - where people have received their positions for vital posts in a vital pillar of the Government's health policy, namely primary care, which I agree with. Did the Government direct the director of the HSE not to fill these posts? Has it had a role in that? Has it been drawn to the Government's attention prior to me drawing it to the Minister's attention?
The Minister refers to balanced budgets. Is the Government telling us that the budget will be balanced at all costs and that these posts will not be filled in the interest of balancing the budget and having a surplus? Is that what I am to tell the people of Galway, the patients on trolleys and the 43,000 on waiting lists? I have made it easy for the Minister because I am asking her about this issue specifically. They have gone through the process. I do not like to repeat myself, but I wish the Minister would answer my question. How can she stand over having 11 empty posts which are only the tip of the iceberg? She should state whether she is in favour of filling these vacancies, or that she does not know anything about them and will look into the matter, but I ask her to, please, just give me an answer I can understand.
I can give the Deputy an update on the position in Galway. The design for the new emergency department at University Hospital Galway is at an advanced stage. There is a seven-storey building which will include paediatrics and maternity services.
I will get to the Deputy's question in a second. The hospital is awaiting planning permission. It is most likely that an application will be lodged with An Bord Pleanála. The Deputy asked me a specific question about posts.