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Leaders' Questions (Continued)

Tuesday, 9 December 2014

Dáil Éireann Debate
Vol. 861 No. 1

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(Speaker Continuing)

[Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin] They had long passed those criteria and still had not been replaced and will not be until next year. We welcome that fact, but it is too late and shows a lack of proactivity. The report, which backs up the "Prime Time" programme, says that EMPs are not being adequately trained, there is a lack of strategic planning, and quality assurance of clinical care is limited.

An Ceann Comhairle: Information on Seán Barrett Zoom on Seán Barrett We are over time. The Deputy should put his question.

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin It also strongly criticises the issue of ambulance capacity being lost due to the delay in handing over to accident and emergency departments. It is not just a question of saying that it is far from perfect. There are serious issues which are crying out to be addressed-----

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny Yes, I know.

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin -----in terms of the reconfiguration and the move to centralisation. Would the Taoiseach accept that something has gone wrong concerning people's access to ambulances and the response times.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny Yes. I accept that it is not perfect and that there are serious issues, but they are being addressed by the Minister. I think the Deputy accepts that a €5.4 million increase in the ambulance budget next year is important. That is recognised by the Minister and it is now in place. Some 50 replacement ambulances will be provided. These are brand new ambulances. I had an opportunity quite recently to deal with a private company on the issue of a number of new ambulances and their facilities are absolutely first class.

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin But it is the public sector that should have them.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny Yes, I understand. The former Minister for Health, Deputy Reilly, brought in targets for the national ambulance service whereby, when a life-threatening condition occurs, a patient-carrying vehicle should be on the scene within 19 minutes for 80% of those calls. That does not actually deal with the problem, however.

Deputy Timmy Dooley: Information on Timmy Dooley Zoom on Timmy Dooley Like most of the things he brought in.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny I will tell the Deputy why. Target times are only one element of an ambulance service. At present, if an ambulance responds in under 19 minutes to a call in respect of a life-threatening situation and the patient unfortunately passes away, that is recorded as an ambulance meeting its target. On the other hand, if an ambulance responds in 20 minutes to a call in respect of a life-threatening situation and the patient makes a full recovery, it is recorded as an ambulance missing its target. The determination of times, therefore, does not give a comprehensive response, although it is one element of it.

Deputy Timmy Dooley: Information on Timmy Dooley Zoom on Timmy Dooley Whose fault is that?

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny The emergency aeromedical service support was a 12-month pilot project between the NAS and the Air Corps providing dedicated aeromedical support for the NAS in the west, specifically where roads were poor and land ambulance transit times were more severe. A review of that project found that a clinical need exists for the service.

An Ceann Comhairle: Information on Seán Barrett Zoom on Seán Barrett Thank you, Taoiseach. We are over time.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny It recommended that it be established on a permanent basis. The 2015 HSE plan includes a specific target for turnover at hospitals for the first time, so that is an improvement. We also have an air ambulance for the midlands and the west, which is important. It is not perfect but the air ambulance for the midlands and west is now in situ, which is a big improvement in terms of access and travel times for hospitals.

Deputy Caoimhghín Ó Caoláin: Information on Caoimhghín Ó Caoláin Zoom on Caoimhghín Ó Caoláin Must our voiceless in care depend on whistleblowers, unannounced HIQA inspections and RTE's "Prime Time" programme to expose the wholly unacceptable behaviour of some who work in our care homes and facilities? I know at first hand the great work that so many employed in these settings perform. I have a brother with an intellectual disability in a HSE care home. This drip, drip exposé of dreadful behaviour by some must also deeply hurt those who are true carers in these settings.

For all concerned, but especially for those who cannot speak for themselves, like my brother, this behaviour must be rooted out once and for all. In the case of Áras Attracta, HIQA had inspected, made recommendations, returned and felt that all had been addressed. These inspections are not enough and we cannot depend on them alone. A special RTE documentary to be broadcast tonight showing the RTE investigations unit's examination of the standards of care in an Irish residential care facility for adults with intellectual disabilities will once again raise this issue. The focus of tonight's programme is bungalow 3 at the Áras Attracta care home in Swinford, County Mayo. It is now the subject of investigations by the HSE, HIQA and An Garda Síochána following this exposé. A litany of 19 issues have been raised by the RTE investigations unit.

That home is geographically close to the Taoiseach, but the issues being raised are always close to me and my family, and to all families of loved ones with intellectual challenges in such placements. It is imperative that these matters are addressed. Accordingly, what real steps are the Taoiseach, his Government colleagues and the HSE going to take to ensure that this particular problem that presents time after time, in one incident after another is substantively addressed once and for all?

Let us ensure that we are not looking at people starting to believe that we have a culture of abuse of our most vulnerable in such care settings. As a sibling of one who is so placed, I do not accept that there is such a culture. We run the risk of people believing that, however, if we fail to take appropriate action. What action do the Taoiseach and his Government intend taking?

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny I thank Deputy Ó Caoláin for his question. I know that from his personal family circumstances he can empathise in a situation like this so much more deeply than others who may not have those particular family circumstances.

I was called about this last week by the Minister of State, Deputy Kathleen Lynch, and I took her call with a sense of dread and anger. I have since been briefed on it by the Minister for Health. I believe I speak for the whole country when I say that the idea that men and women with intellectual disabilities would be slapped or sat on - as I understand is shown in the footage of this programme - is utterly intolerable and unacceptable to us as a Government and as a people. Every person who uses our disability services is entitled to receive supports of the highest standards and to live in an atmosphere and environment of safety and care. There is no excuse - none whatever - for abuse or conduct in the circumstances that I understand have been outlined. I have not seen footage of the programme but I intend to watch it later on this evening or tomorrow morning.

The HSE alerted the Garda Síochána and HIQA immediately. In the interests of protecting residents and staff themselves, it put a number of staff off duty while the allegations are being investigated. I support the HSE's immediate initiation of an expert investigation into these serious allegations, which is chaired by Mr. Christy Lynch who is the CEO of KARE, whom the Deputy may know. He independently chaired the review of services provided at this facility, led by Dr. Kevin McCoy who is a former chief inspector of the Northern Ireland Social Services Inspectorate.

The director general of the HSE wrote to all the staff emphasising the serious responsibilities on them personally to ensure that individuals supported by the HSE in any setting are treated with respect and dignity. He also reminded them of their absolute duty to report incidents of maltreatment or poor practice concerning any person. As the Minister has said, the HSE is also planning to initiate its own undercover investigations into operations in HSE facilities to supplement the programme of inspections already in place. We had this before with Deputy O'Dowd a number of years ago in the Leas Cross situation.

The Minister has been fully briefed and has assured me that instructions have been given to the HSE to keep both himself and the Minister of State fully informed. I have also been assured that the HSE's priority is to protect the valued services that people residing in Áras Attracta receive as a critical support for them and their families.


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