Tuesday, 7 February 2017
Order of Business
Like many others, last night I watched "RTE Investigates: Living on the List" and was shocked and horrified by the programme's content. It is unbelievable that, in this day and age, people are left to suffer on hospital waiting lists to the extent that they contemplate suicide. Last night's programme unveiled that waiting lists may be significantly longer than those published by the National Treatment Purchase Fund, NTPF, with a pre-admit list comprising 23,000 patients and a pre-planned list of approximately 60,000 patients not included in the NTPF's monthly reports.
Last year, Deputy Kelleher of my party raised his concerns about waiting times for children suffering from scoliosis. I share his concern and believe that this situation highlights the need to get the new national children's hospital constructed without further delay. Obviously, there are concerns about costings, but these must be ironed out so that our children have an efficient and state-of-the-art facility to attend. They deserve nothing less. I have voiced my support numerous times for the national children's hospital, as it is a necessity in easing the waiting lists facing children with scoliosis and those suffering from other ailments.
The new orthopaedic unit has opened at Crumlin children's hospital. One would imagine that it would be fully operational and ready to help ease the suffering of children with scoliosis on waiting lists. However, the theatre is not open because of a scarcity of theatre nurses due to the Government's bad planning. This situation must be remedied immediately. Issues around staff shortages, the costs of implants and other bottlenecks in the health system must be addressed and the recruitment of new nurses must be a priority. Bad planning must be rectified immediately and those suffering on waiting lists, including children, must be given an opportunity to attend consultants and have their surgeries scheduled.
Yesterday was the international day of zero tolerance for female genital mutilation, FGM. More than 2,500 women and girls living in Ireland are estimated to have undergone FGM according to 2008 research done by the national network of African women living in Ireland. It is a major issue that I must raise in the Chamber today.It involves the mutilation of female genitalia for non-medical reasons and is a serious violation of the human rights of females. FGM has been inflicted on approximately 200 million females and the horrific procedure is generally performed on young girls between infancy and the age of 15 years. I reiterate the calls made by numerous non-governmental organisations for its elimination. Awareness of the practice is key. As such, it is necessary to raise the issue today.
On the issue I highlighted last week about children and their mental health, it is important that the House take a moment to reflect on last night's RTE programme, "RTE Investigates: Living on the List". It illustrated the physical and emotional burden on sufferers waiting for long periods for life-altering operations and the impact of the waiting periods on their families and friends as they watched them suffer. It also documented how, as time passed, the condition of patients worsened. The long-term impact can be far-reaching. One of the most disturbing findings of the investigation was that there were two unpublished waiting lists for health treatment in Ireland. I second the words of the Minister for Health, Deputy Simon Harris, when he stated this was wrong and something over which the Government could not stand. He also added that he was ashamed. What shames me as a Senator is that there are very sick children on waiting lists for mental health treatment, inlcuding for early onset psychosis, anorexia, bulimia, self-harm and addiction. They are equally vulnerable, but not once was the waiting list of these children mentioned last night. What shames me even more is that not only did they not get a look in last night, or this morning when the Government spoke about the need for extra beds and staff in the health service, but there was no mention that last year in Ireland 17,794 children had been referred to the CAMHS and that 5,379 children had not been dealt with at all. The waiting lists for mental health treatment are extremely serious and equally as critical as the devastating interviews we saw last night. Each month, approximately 2,500 children await assessments. Almost half of these children will not be seen during the first year, while some of them will not be seen after a year. What strikes me as bizarre is that the national service plan published in December 2016 warned us that the number of children on the waiting list would increase in the coming 12 months. Why are mental health sufferers second-class citizens? Why is the same urgency not given to dealing with their situation? It appears that this and previous Governments have operated a two-tier system of health care which ignores and neglects children and adolescents suffering from a mental health illness. In the 1990s the then Government got rid of the asylum. We opened up the doors of our Victorian hospitals and integrated those with mental health issues into society. I am beginning to wonder whether this institutional deconstruction had any effect on our attitudes and ideas about mental health services. Is anyone becoming a little exhausted with the talk about reform and the absence of a discussion on delivery? Is it not a source of outrage that the administration is not giving the public a full and frank image of waiting lists? Is it not a source of disappointment that once again mental health service waiting lists are completely ignored?
I refer to last night's programme on RTE. I commend RTE for the service it has done in highlighting the problem of waiting lists. It is not a new phenomenon to us as we deal with it every day, as we have for the past few years. It is deplorable that Minister for Health after Minister for Health, including Deputy Micheál Martin, Mary Harney, Senator James Reilly and the current incumbent, has presided over a situation where thousands and thousands of people throughout the country wait in pain without being able to obtain treatment.The crux of it is if I need an MRI scan tomorrow morning and I produce €250 or €300, I will get the same MRI on the same equipment with the same consultant within ten days, but if I do not have the money I have to wait in pain. The people who have been responsible for delivering that type of health service should hang their heads in shame.
I want to raise an industrial dispute issue in my own area. Hastings Garage in Westport recently imposed compulsory redundancies on three members of staff. Ex gratiapayments were recommended by the Labour Court for all three, with one employee to be given the option of returning to employment at the garage. The company has made it clear that it will not abide by this second ruling concerning payments. No explanation was given as to how the redundancies were chosen.
The Government’s industrial relations strategy is contradictory and utterly useless. These industrial disputes can often be viewed as legal proceedings going on in the background. In reality these disputes have led to great hardship for families, many of whom are already struggling. The Government has been at pains to instruct Bus Éireann workers and others to go to the Labour Court and abide by its recommendations. Here we have a case where a ruling has been made but one party refuses to abide by the decision. The Government cannot, on the one hand, hide behind the excuse of urging engagement with the Labour Court, yet in other circumstances remain completely silent. I would like to have the Minister for Jobs, Enterprise and Innovation explain to us here in the House exactly what the Government's strategy is to deal with industrial unrest.
It does not have to be that Minister. I know the Taoiseach is acutely aware of this dispute within his constituency. There is a basic need to stand up for fairness and to be seen to do so. We have enough problems with creating and keeping jobs in the west. It is vital that fair play is seen to prevail in this situation. I urge the Government to intervene to ensure that the right thing is done for these workers and that the company is made to adhere to the Labour Court ruling.
The Sunday Independentstated that a leaked report from the Department of Public Expenditure and Reform emphasised a number of pressures on the State's income and expenditure. However, it made no mention of 600,000 people with disabilities and mental health needs, even though it is acknowledged that these people are in the throes of a long-term crisis. We have public service pay pressures and a deep housing crisis, which also affects people with disabilities. We have the health issues that have again been exposed here today and we have the Brexit challenges. The glaring fact is that we have an ongoing crisis for those 600,000 people and their families, a crisis long acknowledged by successive Governments.
The troika left town at the end of 2013 and the recession ended that year. People with disabilities are now in the fourth year following the recession, still feeling its worst effects with little or no hope that the situation will change. Last week the CSO confirmed that the modest recovery has not extended to people with disabilities for whom poverty rates are increasing while they are thankfully decreasing for the general population. Four years after the troika left Ireland, more than half of people living with disabilities are not able to afford four essential items: adequate heating; two pairs of strong shoes; a warm coat; and meat a few times a week. These are the facts of Ireland today.
The SILC figures released last week show that people with disabilities are at twice the risk of living in poverty at just under 35% as opposed to 19% for the general population. These are stark facts. Consistent poverty for people with disabilities has increased by 8%; the deprivation rate has increased by just under 2%; and the risk of poverty has increased by almost 10%. While the rate is thankfully falling for the general population, it is going the wrong way for too many people.This crisis is absolutely out of control. It is going the wrong way and it needs to be acknowledged and tackled.
I pressed the Taoiseach in September last year, just before the budget, to prioritise the welcome but modest funding that was then available in the budget for people with disabilities. That did not happen. There are real pressures in other areas, but this too is a real issue and if the Government is honest and honourable about its commitments to people with disabilities, the upcoming budget in October has to have a real, meaningful, cross-Government package for people with disabilities. Will the Leader ask the Taoiseach to come into this House and set out what he and his Government intend to do to make that a reality for the coming year?
I welcome the announcement that the Government is establishing a commission of inquiry into the allegations of a campaign within the Garda to discredit whistleblowers within the force. I know that announcement has been made following a Cabinet meeting today. It is in keeping with the recommendation made by Mr. Justice Iarfhlaith O'Neill in his inquiry earlier last year.
I call on the Leader to arrange a debate on US immigration policy in light of the restrictions that were announced by US President Trump last week. I was among many people who protested outside the US Embassy on Thursday evening. The numbers there in the lashing rain showed the immense concern among Irish people at the nature of the new restrictions that President Trump announced, notably the restrictions on citizens of seven predominantly Muslim countries.
This is not just about that particular restriction. We saw the chairman of Ornua, formerly the Irish Dairy Board, talking about difficulties that he has had since President Trump took office with getting Irish graduates into the US for the first time. The new immigration policy in the US is a much bigger issue than just that restriction. I welcome that over the weekend, the US courts have effectively brought about the suspension of the ban. I am conscious that the ninth US Circuit Court of Appeals is hearing the appeal being brought by the US Department of Justice this afternoon. I hope the US justice system will be robust enough to withstand the dreadful critiques that we have seen from President Trump and the attacks that he has made on members of the judiciary. I hope we will see the most recent immigration restrictions lifted or indefinitely suspended.
If the restrictions remain in place, I would join with the Labour Party leader, Deputy Brendan Howlin, in calling on the Taoiseach to stay away from the White House on St. Patrick's Day. There is immense concern among Irish people at the nature of these restrictions and the Taoiseach would do well to note people's concerns.
-----as I am sure everyone does, upholding the decisions of the lower courts, and seeing therefore the joyful scenes in which people were reunited at the weekend and people were able to travel. We would love to see those being replicated, and not the absolute chaos, confusion, distress and trauma for so many people as a result of the restrictions.
There is huge human trauma caused by this sort of chaotic announcement of the restrictions, apart from the content of them.
I renew a call to the Leader for a debate on Syria. Perhaps in all the international news about President Trump, the international news focus has gone off Syria. This week, Amnesty International accused the Syrian regime of hanging 13,000 people at an infamous prison, Saydnaya, near Damascus. This appalling report was utterly dismissed yesterday by Syria's President, Bashar al-Assad, in a comment to Belgian media. The English translation of that refers to Mr. al-Assad being utterly dismissive of the United Nations, international tribunals, and any attempt to make his regime accountable for war crimes committed. I again call on the Leader for a debate on Syria.
I concur with Senator Bacik and others in commending the Government for finally implementing the recommendations of Mr. Justice Iarfhlaith O'Neill's committee, and actually going ahead with a commission of investigation into suggested ill-treatment of whistleblowers. Whistleblowers are the primary source of a lot of the reforms that we see today, and this situation needs to be dealt with once and for all.Like others and, indeed, the Minister, we were all horrified by what was unveiled last night on "Prime Time Investigates". It is outrageous that successive Ministers have been given information that is not accurate and that figures, waiting lists and reports are not accurate or reflective. This is not good enough. It is not good that a Minister would receive the wrong information. Effectively, this is a case of somebody lying. We need a serious investigation in the HSE as to why the Minister and previous Ministers were given the wrong information. Heads should roll. How can a Minister make a case to Government for extra funding if he or she does not have the full facts? In terms of the money that is required to get the health service up to a standard over which people can stand, it requires a significant increase in funding. We need a debate in this country about having no tax cuts for the next number of years. The extra resources that become available as a result of not having tax cuts should be ring-fenced and put into capital expenditure in the health services. Most decent human beings and taxpayers in this country would be quite happy to see their taxes increase by a percentage or two in order to solve this problem once and for all. Every year since I have been elected, people have stood up here pre-budget and looked for tax and universal social charge reductions and tax breaks. That day must go. We need to see a significant increase in health spending to deal with what we saw last night on television.
I agree with Senator Conway about the information being provided to Ministers. Mark Twain said that "facts are stubborn, but statistics are more pliable" but when one does not have the facts, there is nothing one can do about it. While heads should roll, in a modern democracy, the fact that the lists are not accurate means that the HSE has a lot to answer for. That does not mean that the Minister is not the person in charge. The former Minister, Deputy Varadkar, appeared here many times and one would swear that he was a commentator on the health service instead of being the Minister for Health. Nobody can point to any reforms he made when he was Minister for Health.
The leader of the DUP is also a person who seems to be unable to grasp facts as they apply to the real world. She is not a woman of detail, as we know, because even though she was in charge of the department that promoted and signed off on the renewable energy scheme, she said she did not realise that the devil was in the detail and that, in reality, she was giving away hundreds of billions of pounds to people to literally burn money. She was not very good on facts when she said yesterday that more people in Northern Ireland-----
In respect of the DUP leader's ability to grasp facts, she does not seem to understand that her department was in charge of signing off on the renewable energy scheme and that she has burned £500 million on this scheme to the point where I am informed by people in Northern Ireland that they are not even burning the pellets they are getting paid to burn. They are actually taking the pellets south and reselling them. That is enterprising and I am sure the DUP would love that type of enterprise. The leader of the DUP also said something yesterday that is not a fact either. She said more people in Northern Ireland speak Polish than speak Irish. That is not true. There are 30,000 Polish speakers and 105,000 people who speak Irish. She did not seem to understand the most important fact of all when she announced the DUP's policies and said that she did not support an Irish language Act and would not see one implemented. This is part of an international agreement.That is a fact. It is the St. Andrew's Agreement and it should be implemented. However, the DUP seems to want to roll back on an agreement to which it signed up itself. Ms Foster does not seem to have much of a grasp of the facts. It is deplorable that the DUP is now rolling back on its commitment to the Good Friday Agreement and the St. Andrew's Agreement. Finally-----
I also raise "Prime Time Investigates" and thank RTE as previous speakers have. It has done a great service to the State. We need to deal with the facts. I ask that the Minister for Health come to the House to explain the relationships among the HSE, the National Treatment Purchase Fund, the Department of Health and the Minister himself. It is a complex web. We cannot lay blame here today without all of the facts. We need to see what the role of the National Treatment Purchase Fund is. While I note and welcome the Government's commitment to provide additional funds and resources to the fund this year and next year as set out clearly in the budget and programme for Government, it is important to have a statement on the issue. Who actually validates lists and how does the whole system work?
We need more information than we heard last night. It was an appalling story and an appalling vista. Not one of us would like to be on one of those waiting lists or to have any family member on one. I ask the Leader to have the Minister attend at some point to make a statement on the interrelationships between the HSE, the National Treatment Purchase Fund and the Department.
Last month, I highlighted a report that was released by CyberSafeIreland on childhood safety in cyber issues. The report set out that 84% of teachers surveyed said they did not cover online safety on the curriculum while 64% said they did not have sufficient resources. We need to have a debate in the House on this very serious issue which is only getting worse given the extent to which technology and online matters are so far ahead of those who make policy in this area. A new survey released yesterday and conducted by the national anti-bullying centre at DCU emphasises the need for additional measures to combat this scourge as a matter of priority.
Only one in three parents feels confident that he or she can protect children online. Parental concerns revolve around risks of cyberbullying, access to pornographic content, online grooming and generally spending too much time on the Internet. When it comes to lifestyle issues, the last is the biggest of them all. Children are going online at increasingly younger ages. Combined with the exponential growth in mobile phones, this presents an immense challenge for parents.
The latest study highlighted how new apps and social media platforms are coming onto the market all the time and being targeted at children as young as nine. A second report out today also confirmed that one in ten children in Ireland says he or she has been cyberbullied. Both reports are being released to highlight Safer Internet Day which is tomorrow. They call for parental education around digital technologies and their use.
Meanwhile, the survey of parental attitudes conducted last month among parents of children aged zero to 18 found that they employ a range of strategies to try to protect their children, the most common being limiting screen time. As most children are accessing the Internet on tablets and mobile phones now, it is very difficult for parents to have any control. Certainly, they cannot watch their children on a 24-7 basis. Of parents, 53% are happy with how they monitor their children's use of the Internet but 40% admit it is easy for their children to use the Internet without their knowledge. I ask the Leader for a debate in the House on this issue and to suggest to the Minister that we create a one-stop-shop for this issue nationally. There should be strategic campaigns for parents and a back-up service to help them with the issue of cyberbullying.
We were all so affected by RTE's "Prime Time Investigates" programme last night. The Minister needs to direct the National Treatment Purchase Fund to obtain accurate and real figures on waiting lists. There are two waiting lists, one of which involves massaging the figures. Waiting lists are already shockingly high, with the number of scheduled procedures having risen from 50,000 in 2013 to 80,000 in 2016. The saddest point is that the public patients are suffering most.
Since Christmas, the number of people on trolleys in corridors of the hospitals has been the highest. The number of people waiting for appointments and procedures has rocketed. There is no accountability in the health system. There is no leadership. I heard the Minister say last night that this is unacceptable. It is unacceptable and it is not good enough.
Another urgent case that the Minister is not addressing - I have asked that the Minister appear in the House next week - concerns the unacceptably large number of cancer patients fighting for medical cards. A large number of people are waiting for months while further information is sought. These cancer patients need-----
The nation was shocked by the harrowing stories exposed on "Prime Time Investigates" last night. It is a shocking shame that it takes a television programme for notice to be taken rather than our calling out these issues long in advance of such programmes. Patricia Connolly told her story of waiting over a year for a gynaecology appointment in Cork. She is condemned to a life of pain on painkillers. She is one of at least 4,265 women, if not more, in Cork who are waiting for a gynaecology assessment. This is nothing new. I raised this matter with the Minister in September but nothing has happened since. There are just more women living in pain on the list.
We need to know what needs to be done to solve the issues in Cork. We just need the Minister to ensure that the doctors' four-point plan is put in place. The four recommendations the doctors made to the Minister some weeks ago are to employ additional gynaecology theatre staff to increase the theatre capacity from 30% to 100%; to develop a gynaecology day unit; to build and staff the gynaecology one-stop shop, which was part of the cancer plan in 2014; and to employ a minimum of four additional consultant gynaecologists.
To end the misery for women in Cork and the region, we need concrete action beyond the Minister's genuine emotion and warm words. I want to know what specific actions he will take. What is the timeframe for these actions? On 25 January, the last time the Minister addressed this matter in the Seanad, he told us he had requested a report from the HSE on both the inpatient and outpatient waiting lists. Is this report ready? Will it address the practical issues in CUMH, which issues are the outliers? Can we see the report? The Minister said on the occasion in question that the situation is not acceptable. What does this actually mean for women waiting to get the treatment they need? What action will the Minister take to provide a sustainable solution to build real capacity and not fund something that just relies on the National Treatment Purchase Fund? In January, the Minister promised to meet the consultants and management in February to agree the actions and promises. Has a date been set? The consultants have sent their proposals to the Minister. It would take him just under 30 minutes to consider their practical proposals. I would like the Leader to bring the Minister for Health here to answer these questions for all the people on the list.
I join those who have rightly raised the issue of the "Prime Time Investigates" programme last night. It is quite shocking that we have figures such as those aired and that there are two sets of figures. The CEO of the HSE, Mr. Tony O'Brien, has many questions to answer in this regard. People want to hear more than statements of shock from us. The HSE is charged with delivering a health care service to the people. There are children with scoliosis who need timely intervention and surgery but it does not seem to matter.The list goes on and I know that the Minister has been deeply affected. However, we have seen this with Minister after Minister and need to get to the bottom of it. What is shocking and shameful needs to be pointed out. I support the suggestion that the Minister come back into the House. I raised a very important concern about how the health care groups were operating. I am reliably informed that, since they have been set up, there have been 122 new general manager grade A posts at St. Stephens Hospital central administration but that there are 120 consultant vacancies nationwide. We need front-line staff, but these new managers cost in excess of €100 million per year. What is going on? I raised this issue during statements on the health service and have not received any answer. I would like an answer because it is very peculiar that, with vacancies a problem in the health service, there is no problem in filling managerial posts centrally.
There is a crisis in an industry which is estimated to employ 10,000 people in this country, namely, the greyhound industry. Last Saturday there was to be a picket placed at Shelbourne Park to highlight the difficulties within the industry. On Friday evening the interim CEO of the Irish Greyhound Board called off the race meeting due to be held in Shelbourne Park on Saturday night. Among other things, he claimed he was concerned that racegoers might be intimidated. The hard facts are that the people who attend race meetings on a weekly basis are the same people who were supporting the placing of the picket. The claim made by the interim CEO was unfounded and extremely unfair. The actions taken by owners and trainers have not been taken lightly but out of years of frustration at the lack of action in dealing with problems within the industry. I ask the Leader to invite the Minister for Agriculture, Food and the Marine to the Seanad for a debate on this issue and to find out why the legislation which has been promised since last year and which I am informed is ready is not being brought forward. I also want to know the circumstances around the departure of the former CEO before Christmas and its implications for the Irish Greyhound Board in terms of contractual obligations, given that the person in question only served two years of a three-year contract. I also want to ask about the procedures used in appointing the interim CEO to the Irish Greyhound Board, how long the appointment is for and when the position will be advertised. The Leader referred to a meeting held last Wednesday in Naas between the Dublin Greyhound Owners and Breeders Association and the interim CEO. The meeting was a non-event and completely unsuccessful. One of the issues raised by the group was the closing of the race track at Harold's Cross, one of the most profitable tracks in the country. The interim CEO said he did not want to discuss it. The track was being closed - end of. Another picket will be placed at Shelbourne Park next Saturday at 3 p.m. The national awards ceremony is taking place there at 4 p.m., but this is not the action of people who want to disrupt the industry. They are frustrated at the lack of action on the part of the Government to clean up an industry they all love and to which many of them have given their lives.
I say, "Well done," to RTE for its programme last night. I did not see it, but I do not need to see such a programme to find out what is going on. I call on the Minister for Health to come before the House to report on the overall situation in medicine and the health service.There is a crisis in the accident and emergency departments. We know that. Trolleys are being counted. We know that. I had reason to go to University College Hospital Galway, UCHG, over four days, from 26 to 31 January, as visitor, friend and relation. I must commend the excellent work on the ground. It was like a scene from Martha Mitchell's "Gone With The Wind" in Atlanta, Georgia, with the chaos. Organised chaos, perhaps. Once one gets into that situation the medical team moves very quickly. There were only two emergency recovery cubicles in that particular section. There needs to be a reconfiguration of the hospital system so that accident and emergency departments become mini hospitals within hospitals, and that there are beds allocated there to ensure that people are not on trolleys. The fact is that once one gets into the system one can be cured.
I would like to send best wishes to the Minister for Communications, Climate Action and Environment, Deputy Naughten, for a speedy recovery. He had an accident on 2 January six minutes from the closed accident and emergency department in Roscommon, and he was brought to Portiuncula and then on to UCHG. It is a disgraceful situation.
The former Minister, Senator Reilly, is here. He proposed the closure and Denis Naughten voted against it. Denis Naughten was carted from the car crash and-----
-----through the Chair. I will now call on the Minister, Deputy Naughten, to put the gun to this Government's head and demand that the accident and emergency department be opened, and if it brings down this Government so be it. I would welcome this Government collapsing on the basis of his commitment to this hospital. He voted to retain the accident and emergency department. Now he has the opportunity of saying to the Taoiseach-----
-----"My vote is not there anymore unless I get the restoration of the accident and emergency department in Roscommon, or I am resigning from this discredited Government. I do not care how long this Government lasts. If I get the accident and emergency department back so be it." Denis Naughton has to call for this now.
It is very disappointing to hear an experienced Senator like Senator Leyden using the health service as a political pawn. If he wants to talk about the history of politics and the way this country was left after his Government was in place, he should mention that his Minister for Health left not only our health services but our economy in a terrible state. Whatever we say about the last Government, it stood up to the mark over the last five years to repair the economy and put funding back into health services.
If we look at the facts, Ireland has the second highest expenditure on health services among OECD countries. It is not just about funding. It is about accountability. I would ask the Leader to bring the Minister to the House, because we need political accountability.
We also need administrative accountability for the manner in which these funds are being spent in our health services. I point the finger of blame at the HSE which is not managing the funding provided by the taxpayer to the best of its ability to provide essential health services to our communities.
My colleague, Senator Reilly, the former Minister for Health, was mentioned. He reconfigured the acute hospital networks in 2013, but the problem has been that the governing boards of those hospitals have not been appointed. We are now four years down the road. Without accountability the HSE is not going to be held to account for the harrowing scenes we saw on "Prime Time" last night, which we are all concerned about and are expressing our outrage on.
I ask the Leader to bring the Minister for Health to the House to explain why the hospital boards have still not been appointed to govern the hospital networks that were reconfigured in 2013. Without that accountability, without that governance, we are not going to see the improvements and efficiencies planned at that time. We all need to work together, across parties if necessary, to ensure that we get to the fundamental problems in our health services, because arguing on parochial issues as our colleague, Senator Leyden, has just done will not solve the problem. We need to stand up and be counted on a more national level.
I would also like to echo the sentiments around the House regarding the "Prime Time" report last night.It is shocking to think that 81,000 people are on a waiting list and 34,000 people are awaiting endoscopy procedures which are vital in the diagnosis of gastrointestinal cancers.
I call for an urgent debate on a separate issue, namely, to ascertain the plans the Minister has in place to safeguard the 50,000 or more employees who work in the pharmaceutical industry in Ireland. These people need safeguarding because of the policies of the President of the United States, Donald Trump. During his first press conference, the then President-elect decided to target the pharmaceutical and medical technology sectors. In doing so, the stock prices for major US pharmaceuticals dropped more than $25 billion in 20 minutes. It is the longer-term impact which can be more profound and about which we must be concerned.
My party colleague, Deputy Niall Collins, expressed his unease at President Trump's comments at the time and also questioned the failure of the Government to spell out any plan to respond to the emerging threats to jobs in US owned companies in Ireland. One month on, the Minister for Jobs, Enterprise and Innovation, Deputy Mary Mitchell O'Connor, has yet to adequately respond to these threats or illustrate any kind of plan to deal with them. President Trump wants the US pharmaceutical companies to which Ireland is home to close up shop and return to the US. He has spoken forcefully about getting US pharmaceutical companies to make a return and imposing sanctions on those which do not.
It is worth remembering that Pfizer employs 3,200 people at six different sites across the country. AbbVie's Irish operation employs more than 500 people in five locations across the country and Boston Scientific, which was founded in Galway in 1994, employs more than 4,000 people across Ireland. These are just a few of the companies that are providing jobs and benefitting the Irish economy.
If we have learned anything from the first 18 days of the reign of President Trump, it is that he was not simply paying lip-service throughout his campaign, and his plans for the pharmaceutical industry are no exception. He is a populist President and pharmaceutical companies are a popular villain. We cannot allow his comments, which are very likely to become actions, to rock a recovering country and one of our most fruitful industries.
I would also like to comment on the waiting lists covered by the television programme. It has been an ongoing problem for many years. We want waiting times diminished for patients but it is not and never has been just an issue of resources.
I wish to correct the record for the leader of Sinn Féin. During my tenure as Minister for Health, inpatient waiting lists came down to eight months, despite €2.5 billion less being available. The number of people who had to endure long waits on trolleys, the most acutely ill and seriously sick, reduced by a third. There are still far too many waiting on trolleys and more work has to be done.
The bottom line is that no part of the health service exists in isolation. If we want to cure what is happening in accident and emergency departments and fix our waiting lists, we must fix what is happening in primary care. Unless there is a new GP contract and more emphasis on prevention and early detection, people will continue to wait. As the programme pointed out last night, if people are left on waiting lists they go from being elective cases, that is, having their surgery in a planned way, to emergency cases. All the statistics show that the outcome is not as good for patients and the expense on the State is greater.
I commend the Minister for starting negotiations on a new GP contract but we also have to look at who is doing what within our health service. I have mentioned treating the patient at the lowest level of complexity that is safe, efficient, timely and as near to home as possible. Consultants are doing work that GPs could be doing and GPs are doing work that nurses could be doing. We are all doing work that other paramedics could be doing. All that must change.
I also want to comment on management. It takes six years for a student to become a doctor and approximately four years to become a GP or 12 years to become a specialist. What do we spend on our managers? Many of them are excellent administrators who were promoted into management positions, and who do not get study leave or extra training and are left in place.During our time with the special delivery unit, SDU, we set up a programme to train 30 a year and provide postgraduate training. That programme needs to continue and be amplified. The point has been made that the funds go into the system and that we have the best doctors and nurses in the world. It is management that we need to address. There is no point in Senators giving out about management unless they are prepared to train and support managers during the course of their careers in order that they can do the job we all want to see done.
There is still a need for capital investment. Members have mentioned the emergency department in Galway. The same can be said of the emergency department in Beaumont Hospital. There is a need for more primary care units and day hospitals. All of these things will help to treat patients long before they get to the position where they will need to be in an acute hospital. That is what needs to be done.
As clearly outlined by my colleague, Senator Mark Daly, it is clear from Arlene Foster's disgraceful comments yesterday on the Irish language that it is coming under attack north of the Border. From speaking to European colleagues, it has come to my attention that the Irish language may also come under attack in the European Union as a result of Brexit. As the Government has decided that the Taoiseach is the Minister for Brexit, I request his presence in the Chamber in the coming days to discuss this worrying prospect. Currently, there are 24 official languages of the European Union, Irish being the official language of Ireland. The EU institutions currently use three languages, namely, English, French and German, in conducting its everyday business. English is by far the dominant language, with 80% of documents written in it. The next most popular language is French, at 7%. When the United Kingdom exits the European Union, no country will have English as its official language. The talk is that France and Germany will push to have their languages become more prominent in EU institutions and lessen the use of English. As a result of this push, pressure may come on Ireland from other member states eager to maintain the status of English to drop Irish as our official language. Danuta Hübner, the head of the European Parliament's committee on constitutional affairs, has recently warned us of this prospect. The Wall Street Journalhas reported that French and German are being used increasingly since the referendum in June. Therefore, the prospect of Ireland coming under pressure to change our official language is worrying. The Government must guarantee that it will fight to maintain the status of the Irish language in order that it will not be diminished, notwithstanding the pressure that might be exerted on us to change it to facilitate other member countries. As an Irish speaker, I find this prospect worrying. We must protect the status of the Irish language in the European Union. If we do not, it will have a knock-on effect at home.
In view of the "Prime Time" programme broadcast last night, it is important to recognise that a great number of staff in the HSE - the vast majority - are working extremely hard and committed and dedicated to their jobs. My colleague referred to the average spend per head of population on health. We have the second highest spend in the OECD, but the question is whether we are spending the money wisely and, if not, how that situation has arisen. When one considers the HSE's 2015 annual report, it is worrying that the number of managers went from 4,700 to 5,000, an increase of 300. The number of clerical assistants increased by 700, whereas the number of public health nurses increased by 60. This is in an area in which we should be increasing the numbers of those on the ground to ensure people receive advice and care in their homes and localities rather than having to be admitted to hospital.
Some of the figures for the health service are being lost in the process. For instance, there are 3.2 million outpatient attendances every year, or 63,000 per week. There are 23,000 attendances in emergency department per week, which gives a total of 86,000 attendances in these two areas alone per week. This is outside the numbers in hospitals.The figure of 86,000 per week shows the volume of work that is being done. We do not give credit to those who are doing this work.
Three weeks ago, I wrote an article for the Evening Echoin Cork about the increase in population. In the past 30 years, the population of County Cork has increased from 410,000 to 542,000, an increase of 132,000 or approximately 30%. In the same period, the number of hospital beds in the county has not increased. We had plenty of money in the period between 1998 and 2008, yet not one new major hospital facility was opened in the county during that time and no real long-term planning took place. One of the major problems in health care is that planning seems to be done on an annual basis rather than for the long term. Time and again, I have raised the need to provide more hospital beds in response to demographic change. We can open all the primary care centres we like but they will not sort out the problems of accident and emergency departments and waiting lists. The number of beds in major hospitals must be increased. While doctors have increased the number of day procedures, which reduces the number of overnight admissions, this does not solve the problem. Planning is needed in this area.
The current national development plan runs to 2020 and its successor will be in place until 2040, by which point it is predicted the population will have increased by 1 million. As Senators will be aware, the bias shown towards Dublin has created serious logistical problems. In the past 20 years, an excellent road network has been constructed, which means there is nothing to prevent major urban development outside Dublin. The Minister speaks about such development but if he is serious about it, he should row back on the decision taken by the previous Government to put a stop to decentralisation. In Mullingar, where I live, more than €2 million was paid for a centrally located site that was fenced and shovel ready. It was to be used for a new Department of Education and Skills office in the town. Approximately 300 people took job offers and were ready to move to Mullingar before the plug was pulled on the project by the previous Government. I do not wish to make a party political issue of this decision but it is now up to the Minister to press ahead with this project to advance the national development plan.
The decentralisation programme was shelved for financial reasons and should be reintroduced under the national development plan. The site to which I referred in Mullingar is ready to roll and provides an ideal opportunity for a decentralisation project. I impress on the Leader the need to speak to the Minister for Education and Skills to find out whether he will roll out the 300 jobs promised to the town in a new departmental facility.
I should respond to Senator Leyden's timely intervention. Yesterday, while attending a conference a Boyle, a young man from Elphin thanked me for introducing an air ambulance service in County Roscommon, which saved his life. Six months ago, the air ambulance service transferred him from the scene of a car accident to an accident and emergency unit in Galway within 35 minutes. There are dozens of men and women, young and old, in County Roscommon who have had similar experiences.
I called into Roscommon hospital this morning on my way to Dublin, as I do every week. The hospital is so busy I could not find a parking space. This is a major issue and a national disgrace. The hospital has become much busier and needs more parking spaces.
The reason for my late arrival today is that I was attending the 13th national health summit in Croke Park, at which I was one of the speakers. More than 300 stakeholders in the health system, including managers, consultants and doctors, attended. After I spoke, Audrey Carville, who organised the summit, asked whether anyone present believed the downgrading of the accident and emergency department in Roscommon hospital had been a mistake or had cost lives. Not one of the 300 health professionals present raised a hand.
I would say to Senator Leyden to look at what is happening on the ground because I have seen a huge change in the last six months. The people in Roscommon are not fools. They will not tolerate people like the Senator going up to the top of the hill, moaning and shouting, and saying people's lives are at risk. They know that it is much safer, that they have a better hospital and that the work that the last Government did secured the future and safety of the people of Roscommon.
Both Senators have had their say. Never the twain shall meet as far as the two of you are concerned.
I rarely comment here but on the health issue, it is a problem people face at some time in their lives. Some commentators talk about mental health and disabilities in a very balanced way. We should have a full, balanced debate with the Minister some time. I have been in politics for more than 30 years and it has been an issue for all that time. With the way things are going, we should not have been surprised with the RTE programme last night. All it did was shine a spotlight. I held clinics for many years and many of those issues were raised. We tried to the best we could and we probably failed. We should have a full debate here, not an hour debate. Perhaps the Leader can invite the Minister to the House for four hours. Let us see who will contribute in a balanced way and get the Minister to respond. That is only a suggestion, which I rarely make from the Chair.
I thank the 22 Senators, including the Cathaoirleach, for their contributions to the Order of Business. Some 16 Members raised the issue of health in regard to the programme last night, entitled Living on the List. Those of us who are involved in our families, in our homes, in our lives and in our communities and as politicians recognise that the figures and what was portrayed in last night's programme were unacceptable. Nobody, whether young or old, man or woman or young boy or young girl, should have to wait in any type of pain. The stories and what was portrayed in that programme last night should not, as the Cathaoirleach said, be new to people. This has been going on for far too long, despite the best efforts of many and the abdication of responsibility by some. The "Prime Time Investigates" programme, if it does anything, will perhaps help to focus minds. Senator Boyhan was correct when he spoke of the need to have a synergy and a relationship between the Department of Health, the HSE and the National Treatment Purchase Fund. That is something that has been badly missing.
As Leader of the House and a former Chairman of the Joint Committee on Health, there should be one list. There should be no duplicity. There should be no changing or alteration. There should be one list that should be reflective of the situation. The figure is far too high. It is about time we looked at the reality here. It is time for accountability. Those who are tasked with the running and delivery of our health system must be held to account. There is political accountability but there is no accountability among those who are asked to administer the running of our health system. It is time this happened.
As somebody who has spent five years chairing the Joint Committee on Health and who had a working relationship with many in the health system, my confidence in those who are tasked with running our health system is at an all time low. I would question their ability to lead the health system out of this debacle. We have seen an increase in the budget allocated to the Department of Health and the HSE in the last budget. When the party opposite was in government, when Deputy Micheál Martin ran out of the Department of Health, the budget was at an all-time high and there were waiting lists. It is not about apportioning blame to Ministers. It is about apportioning blame to those who run the health system and who manage-----
The number of people on waiting lists is unacceptable. These are human beings, fellow citizens of ours, and they deserve better from our health system. It is time for holistic change regarding the use of theatre spaces. Senator Kelleher referred to Cork University Maternity Hospital and I very much welcome the appointment of Professor John Higgins to his new role. I support him, wish him well and hope to see a change in the use of theatres. We also need to see changes in the use of beds and we need to see more beds open if possible. Equally, consultants must look at their work practices, how they operate and do business too. As Senator Coffey rightly pointed out, we are allocating money but it is not just about the resources. How do we allocate that money and where is it spent? We have the second highest level of spending on health in the OECD. That is something we need to look at and change. The role of the HSE must be altered.
The National Treatment Purchase Fund, NTPF, allocation for this year will allow it to utilise capacity in the private acute hospital sector to provide treatment for those waiting longest. The HSE has been asked to submit an action plan to improve waiting lists in the public acute hospitals for inpatient, day case and outpatient services. The HSE and the NTPF must work strategically and collaboratively on this issue. The Minister has taken steps and while the action to date has been far too little, it is important that we work to end the blight of long waiting times for those who need to be seen. To go back to my fundamental point, they are people who deserve better. They are not numbers or statistics; they are people.
Senator Ardagh raised the issue of female genital mutilation in the context of the Criminal Justice (Female Genital Mutilation) Act 2012. I share her views and agree that we must work collaboratively to end this awful scourge. I would be happy to work with her on that and I thank her for highlighting the issue.
Senator Freeman raised the issue of child mental health and specifically mental health waiting lists. I do not see people being treated as second class citizens by anyone involved in the health system but mental health is an issue that we must continue to push to the fore. I would be happy to invite the Minister of State at the Department of Health, Deputy Helen McEntee, who was here last week, to the House to discuss the issue. She has secured more posts and increased funding for the mental health area.
Senator Conway-Walsh raised the issue of an industrial dispute in County Mayo. That is a matter for the mechanisms of the State, specifically the Workplace Relations Commission, WRC. The Senator could raise the matter as a Topical Issue but it is important that the mechanisms of the State are used to reach a resolution.
Senator Dolan referred to an article in the Sunday Independentbut I would not believe everything I read in that newspaper because it does not always get everything right.
I certainly would not believe everything in that regard. In his budget speech, the Minster for Public Expenditure and Reform made it quite clear that there would be a review of public expenditure. I hope that budget 2017 will be seen as a budget for the disabled because Senator Dolan is correct when he says that expenditure has been-----
The budget in the autumn of 2017. I would certainly be happy to organise a debate not with the Taoiseach, but with the Minister for Health, because he is the line Minister with responsibility. I would be happy to work with Senator Dolan in that regard.
I would make the point to Senator Dolan that we have set up quite a few cross-party subgroups in this House and perhaps we should consider setting one up for disability too. In that way we can work across party lines as we are doing on mental health and obesity and as we did on symphysiotomy in the previous Oireachtas. I would be happy to talk to the Senator further on that. I would also be happy to raise it the group meeting of leaders tomorrow because it is an important issue.
Senators Bacik and Conway raised the issue of the Government's decision on foot of the recommendations in Mr. Justice Iarflhaith O'Neill's report on whistleblowers. I welcome the announcement made earlier today. I would be happy to organise debates on Syria and on US immigration policy. Senator Martin Conway posed a question about the use of taxes and tax increases which, perhaps, is an issue for debate prior to the budget. I will be happy to ask the Minister for Finance to come to the House to debate it.
Senator Mark Daly spoke about the DUP leader and a multiplicity of other issues. I do not propose to get into the nuances of the election campaign in the North. However, I share the views of the Senator and those of Senator Lorraine Clifford-Lee on a different point about the Irish language, that it is important that people in the North who use Irish as their first language be supported in that regard. I have previously expressed the view which I reiterate today that the decision to withdraw funding for Irish language summer schools only to reinstate it was wrong. It should never have been withdrawn. The Government, as co-guarantor of the St. Andrew's Agreement, will continue to promote the use of the Irish language, including north of the Border.
In reference to Israel and Palestine, I will be happy to have the Minister for Foreign Affairs and Trade come to the House for a debate on the matter raised.
Senator Catherine Noone raised the issue of cyber safety. This is safer Internet usage week. All of us involved with children or who have children of our own or who are in a position to influence should raise the issue of cyber awareness and safety in the context of Internet usage. There is a very good advertisement promoting cyber security which poses the question: "Would you let your child walk around Dublin, meeting several thousand people...?" That is potentially what can happen on the Internet. It is important, therefore, that we raise the point.
Senator Denis Landy referred to the greyhound industry. I will be happy to have the Minister for Agriculture, Food and the Marine, Deputy Michael Creed, come to the House to discuss the issue. I am not aware of the details of appointments or reappointments. The Senator may be aware that the matter was discussed by the Joint Committee on Agriculture, Food and the Marine. I will be happy to arrange such a debate in the House.
Senator Keith Swanick referred to President Trump's policy on the pharmaceutical and medtech industries. The points made by the Senator are ones of which we should be much be more cognisant, given the changes in policy flagged by President Trump. US investment in Ireland last year amounted to €343 billion, an increase of 28% on the figure for 2014. Ireland constitutes 1% of the European economy but attracted 20% of all US foreign direct investment in Europe in 2015. More than 140,000 people are directly employed in over 700 US firms in Ireland, accounting for over 74% of IDA-supported employment. It would be worrying if the changes flagged were to come about. I will be happy to have the Minister for Jobs, Enterprise and Innovation, Deputy Mary Mitchell O'Connor, come to the House to debate the issue.
Senator Lorraine Clifford-Lee referred to Irish being the official language of Ireland in the European Union. I hope there will be no change in that regard. I certainly would not support any such change. I will be happy to have the relevant Minister come to the House to discuss the issue. The Senator might also consider raising it by way of a Commencement matter. The point she raises is worthy of support and I am happy to support her in that regard.
Senator Aidan Davitt referred to the national development plan and the proposals of the Minister for Housing, Planning, Community and Local Government, Deputy Simon Coveney, in the context of Ireland 2040. I will be happy to arrange a debate on the issue of decentralisation and how the programme collapsed under a previous Government led by Fianna Fáil. The issue raised by the Senator with reference to Mullingar is one-----
The issue raised by the Senator is one that both he and Senator Gabrielle McFadden have raised previously in the House. I will be happy to have it discussed again. Ireland 2040 is of importance. I will be happy to have the Minister, Deputy Simon Coveney, come to the House to debate it.
I have issued a request for the Minister for Health, Deputy Simon Harris, to come to the House for a debate on the issues arising from programme aired last night.