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 Header Item Forbairt na nOileán (Continued)
 Header Item Adjournment Debate Matters
 Header Item Health Care Committee Establishment: Motion (Resumed)

Wednesday, 1 June 2016

Dáil Éireann Debate
Vol. 911 No. 2

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(Speaker Continuing)

[Deputy Seán Kyne: Information on Seán Kyne Zoom on Seán Kyne] Tá sé i gceist agam leanúint leis na seirbhísí rochtana seo atá riachtanach chun caighdeán maireachtála na n-oileánach a chothabháil agus a fheabhsú.

  Chomh maith leis sin, tá mo Roinn ag maoiniú na struchtúir bhainistíochta ar na hoileáin neamh-Ghaeltachta agus tá sé i gceist agam go leanfar leis an obair thábhachtach seo.

  Beidh sé i gceist freisin ag mo Roinn éascaíocht a dhéanamh, feadh a cumais, do sholáthar seirbhísí níos éifeachtaí agus níos comhtháite do na hoileáin, go háirithe trí údaráis áitiúla agus trí ghníomhaireachtaí eile Stáit.

Deputy Éamon Ó Cuív: Information on Éamon Ó Cuív Zoom on Éamon Ó Cuív An bhféadfadh an tAire Stáit a rá liom an mbeidh na cistí bunstruchtúir ag aistriú ar ais go dtí an Roinn? Mar is eol dó, sa deich mbliana sular tháinig an Rialtas deiridh isteach caitheadh €100 milliún ar bhunstruchtúir ar na hoileáin – rudaí ar nós céanna, ionaid sláinte, áiseanna spóirt agus caitheamh aimsire agus mar sin de. An mbeidh ciste bunstruchtúir aige agus an mbeidh freagracht aigesean as cistiú a leithéid de chéanna ar oileáin agus ar uile? Má tá i gceist go mbeidh, an bhféadfadh sé a rá liom cé mhéad airgid a chuirfear ar fáil dó le haghaidh na hoibreacha sin?

An mbeidh ionchur ag an Aire Stáit i gcúrsaí cosúil le hoideachas? An mbeidh ionchur aige i gceist na scoileanna beaga oileánda agus na bunscoileanna a chailleann múinteoirí agus nach bhfaigheann an dara múinteoir arís go dtí go mbeidh 15 duine sa scoil má thiteann siad faoi bhun ochtar dalta? An mbeidh ionchur aige sna rudaí sin, maidir le fadhbanna atá ag na meánscoileanna agus maidir le cúrsaí sláinte ar na hoileáin? Céard é an t-ionchur a bheas aige sna rudaí sin?

Deputy Seán Kyne: Information on Seán Kyne Zoom on Seán Kyne Ó thaobh an bhunstruchtúir de, beidh mé ag iarraidh níos mó airgid chaipitil chun infreastruchtúr níos fearr a chur ar fáil ar na hoileáin agus deisiú a dhéanamh ar an infreastruchtúr atá ann faoi láthair. Pléifidh mé é seo leis na hoifigigh i mo Roinn agus tá sé tábhachtach go mbeidh mé in ann airgead caipitil a fháil do na hoileáin, cé go bhfuil eacnamaíocht na tíre tar éis feabhsú.

Beidh ról agam maidir leis na céanna de. Mar shampla, bhí €8 milliún ceadaithe ag an Roinn Comhshaoil, Pobail agus Rialtais Áitiúil don ché nua in Inis Oírr. Gheobhaidh siad an t-airgead sin sa Roinn Ealaíon, Oidhreachta agus Gaeltachta agus pléifidh mé an cheist sin leis an Ard-Rúnaí freisin.

Ó thaobh oideachais de, tá sé ráite agam roimhe seo go raibh mé ag iarraidh cruinnithe a eagrú leis an Aire Oideachais agus Scileanna, an Teachta Bruton, agus bhí mé ag caint leis an tseachtain seo caite. Tá sé chun an cruinniú sin a eagrú chun na ceisteanna seo maidir leis na hoileáin, maidir leis an pupil-teacher ratio agus maidir leis an bpolasaí atá foilsithe idir an Roinn Oideachais agus Scileanna agus an Roinn Ealaíon, Oidhreachta agus Gaeltachta a phlé. Ní bheidh ról ag mo Roinnse maidir le sláinte ach arís beidh mé sásta na rudaí difriúla a theastaíonn sna hoileáin ó thaobh sláinte de a phlé leis an Aire Sláinte.

Deputy Éamon Ó Cuív: Information on Éamon Ó Cuív Zoom on Éamon Ó Cuív Gabhaim buíochas leis an Aire Stáit maidir leis an méid a dúirt sé faoi chúrsaí oideachais. Go n-éirí an bóthar leis ansin. Ar thuig mé go mbeidh na cistí atá ag an Roinn Comhshaoil, Pobail agus Rialtais Áitiúil do ché Inis Oírr ag aistriú go dtí a Roinn agus go mbeidh siad faoina chúram? Is dea-scéal é sin agus molaim é as é sin a bhaint amach. Ceapaim féin go mba cheart go mbeadh bunstruchtúr na n-oileán faoin rannóg oileánda. Bhí mé den dearcadh sin ariamh. Is dul chun cinn maith é sin.

Ó thaobh cúrsaí sláinte de, bhí córas comh-mhaoinithe ó na cistí bunstruchtúir i bhfeidhm nuair a bhí mise sa Roinn. Mar shampla, dhéanfadh muid comh-mhaoiniú ar ionaid sláinte ar na hoileáin. Is é an buntáiste a bhain leis sin ná go raibh an HSE sásta tosaíocht a thabhairt do ghnóthaí oileánda. An mbeidh a leithéid den chomh-mhaoiniú sin i gceist i rith a thréimhse mar Aire Stáit?

Deputy Seán Kyne: Information on Seán Kyne Zoom on Seán Kyne Phléigh mé an cheist seo leis An Taoiseach arís an tseachtain seo caite. Tá sé sásta go mbeadh ciste don Ghaeltacht agus do na hoileáin ann a bheadh seisean i gceannas ar agus a bheidh idir na Ranna Sláinte; Iompair, Turasóireachta agus Spóirt; Oideachais agus Scileanna agus aon Roinn eile atá aon bhaint aici leis na hoileáin. Nuair a bhí mé sa chruinniú cinn bhliana de Chomhdháil na nOileán, bhí daoine ag iarraidh go mbeadh rud mar seo ann. Tá An Taoiseach sásta é sin a dhéanamh agus beidh sé ina cheannaire ar an gciste sin. Tá sé sin tábhachtach.

Beidh muid in ann na ceisteanna maidir le cúrsaí sláinte a phlé. Tá a fhios agam go raibh deacrachtaí ann anuraidh maidir le cén Roinn a bhí freagrach as an ionad sláinte nua a thógáil ar Inis Bó Finne - an Roinn Ealaíon, Oidhreachta agus Gaeltachta nó an Roinn Sláinte. Ceadaíodh airgead don ionad ach níl cead pleanála acu fós. Tá a fhios agam go raibh an cheist sin ann. Is ceist thábhachtach í agus beidh ról ag an gciste idir-rannach sin maidir léi.

Written Answers are published on the Oireachtas website.

Adjournment Debate Matters

Acting Chairman (Deputy Alan Farrell): Information on Alan Farrell Zoom on Alan Farrell I wish to advise the House of the following matters in respect of which notice has been given under Standing Order 23(3) and the name of the Member in each case: (1) Deputy Caoimhghín Ó Caoláin - resourcing the Cavan-Monaghan drug and alcohol awareness services in terms of funding and personnel; (2) Deputy Éamon Ó Cuív - the National Parks and Wildlife Service and the delay in upgrading the Galway to Clifden N59 road and resolving the issues with the Oughterard to Maam Cross and Maam Cross to Clifden sections of the road; (3) Deputy David Cullinane - an urgent and targeted response to the Central Statistics Office's quarterly household survey for quarter one of 2016 which shows unemployment in the south east stands at 12.5%; (4) Deputies Hildegarde Naughton and Catherine Connolly - the continued operation of the dual energy X-ray absorptiometry scanning unit at Galway University Hospital in Merlin Park and a plan to ensure persons in the west benefit from this service; (5) Deputy Alan Farrell - the need for the Competition and Consumer Protection Commission to investigate the insurance industry; (6) Deputy Bríd Smith - the docking of workers' payments by Transdev during the ongoing Luas dispute; (7) Deputy James Browne - issues recently raised by the Mental Health Commission in inspection reports; (8) Deputy John Brassil - Japanese knotweed and its effect on the County Kerry landscape, for example, in the area between Laune Bridge and the Metal Bridge in Killorglin; (9) Deputies Dessie Ellis and Donnchadh Ó Laoghaire - funding for the youngballymun project and its importance to the local community; (10) Deputy Brian Stanley - the future of services at Portlaoise hospital in County Laois, in particular, services in the emergency department; (11) Deputy Joan Collins - the future of the Brú Aimsir hostel in County Dublin, given the urgent need for emergency bed accommodation; (12) Deputy Michael Harty - concerns about the curtailment of the provision of home health hours and home care packages which will lead to increased costs, hospital admissions and nursing home placements under the fair deal scheme; (13) Deputy Anne Rabbitte - staff safety and industrial relations at Oberstown Youth Detention Centre in County Dublin; (14) Deputy Mattie McGrath - the curtailment and withdrawal of home help care packages and hours and the subsequent impact on families; (15) Deputy Clare Daly - the crisis in the maternity services given recent maternal and baby deaths; (16) Deputy Thomas Pringle - the implications for fishermen of SI 125 of 2016, the European Union (Common Fisheries Policy) (Point System) Regulations 2016; (17) Deputy Mick Wallace - the construction of a 36 m building beside and its impact on St. Mary's Church on City Quay in Dublin 2; (18) Deputy Robert Troy - consumer concerns about excessive increases in motor insurance premiums in 2016; (19) Deputy Thomas Byrne - the policy of downsizing buses transporting children to school in 2016-17 and concerns that this will result in a significant reduction in the number of children availing of school transport on a concessionary basis; (20) Deputy Ruth Coppinger - investigation of the deaths of children in Cavan General Hospital since 2012 and other deaths in maternity hospitals; (21) Deputy Mick Barry - the proposed increase in the minimum qualifying age under the disability allowance scheme; (22) Deputy Richard Boyd Barrett - the arrest of two officials in Northern Ireland in connection with Project Eagle; (23) Deputy Martin Ferris - the Irish Heart Foundation's recently published national stroke audit and the Health Service Executive's national stroke programme at Kerry University Hospital; and (24) Deputy Timmy Dooley - the proposed increase in the public service obligation levy on electricity bills.

The matters raised by Deputies Alan Farrell, Brian Stanley, Anne Rabbitte and Thomas Pringle have been selected for discussion.

Health Care Committee Establishment: Motion (Resumed)

  The following motion was moved by the Minister for Health, Deputy Simon Harris, today, 1 June 2016:

That, notwithstanding anything in Standing Orders, Dáil Éireann:

recognising:

— the severe pressures on the Irish health service, the unacceptable waiting times that arise for public patients, and the poor outcomes relative to cost;

— the need for consensus at political level on the health service funding model based on population health needs;

— the need to establish a universal single tier service where patients are treated on the basis of health need rather than on ability to pay;

— that to maintain health and well-being and build a better health service, we need to examine some of the operating assumptions on which health policy and health services are based;

— that the best health outcomes and value for money can be achieved by reorientating the model of care towards primary and community care where the majority of people’s health needs

can be met locally; and

— the Oireachtas intention to develop and adopt a 10 year plan for our health services, based on political consensus, that can deliver these changes,

orders that:

(a) a special all-party Committee, which shall be called the Committee on the Future of Healthcare, shall be established, to devise cross-party agreement on a single long-term vision for health care and direction of health policy in Ireland;

(b) the Committee shall be made up of fourteen members of the Dáil, of which four members shall be appointed by the Government, three members by Fianna Fáil, two members by Sinn Féin, one member by the Labour Party, one member by Independents4Change, one member by the Anti-Austerity Alliance-People Before Profit, one member by the Rural Alliance and one member by the Social Democrats-Green Party group, and four shall constitute a quorum; members may be substituted as provided under Standing Order 95(2);

(c) notwithstanding the provisions of Standing Order 93, the Committee shall elect one of its members to be Chairman, who shall have one vote;

(d) the Ceann Comhairle shall announce the names of the members appointed under paragraph (b) for the information of the Dáil on the first sitting day following their appointment;

(e) the Committee shall have the powers defined in Standing Order 85 (other than paragraphs (3), (4) and (6) thereof);

(f) the Committee shall examine existing and forecast demand on health services, including the changing demographics in the Irish population;

(g) the Committee shall examine and recommend how to progress a changed model of healthcare that advocates the principles of prevention and early intervention, self-management and primary care services as well as integrated care;

(h) the Committee shall examine different funding models for the health service and make recommendations on the funding models that are best suited to Ireland and have these models fully costed;

 (i) the Committee shall examine and make recommendations on how best to reorientate the health service on a phased basis towards integrated, primary and community care, consistent with highest quality of patient safety, in as short a time-frame as possible;

(j) the Committee shall be mandated to hold hearings in public with expert witnesses; invite and accept written submissions; draw up a report(s); make findings; and-or suggest recommendations if the membership so agrees in unison or in majority/minority format;

(k) the Committee shall produce an interim report, containing also its proposed work schedule, to be debated at a meeting of the Dáil no less than one week, and no more than two months, after its establishment;

 (l) the Committee shall, within six months of the initial meeting, present a final report to the Ceann Comhairle for earliest possible discussion in the House;

and

(m) the Committee shall meet as frequently as appropriate to fulfil its remit.

Deputy Michael Harty: Information on Michael Harty Zoom on Michael Harty As I was saying before the debate adjourned, general practice is under severe pressure as a result of the cuts introduced under the Financial Emergency Measures in the Public Interest, FEMPI, Act, as well as the undermining of general practice and the failure to support it properly. If general practice is to be part of the solution to problems in the health service, and I believe it will be central to that solution, it needs to be supported. Many areas have lost their general practitioner and many general practitioners who will retire in the near future may not be replaced. Some 33% of general practitioners are aged over 55 years and 20% are aged over 60 years. New graduates are not taking up general practice because the current GP contract is not fit for purpose. A new contract must be urgently negotiated as part of any new framework for future health care and the cuts made under the FEMPI legislation must be reversed.

Patients spend 99% of their lives living in their communities where they are cared for by their general practitioner, public health nurse, community intervention teams and community therapists such as physiotherapists and occupational therapists, and supported by community pharmacy colleagues who supply essential services. If these services were to be fully developed, many patients could be looked after in the community and unnecessary hospital admissions avoided, thus taking pressure off overstretched accident and emergency departments. This could be achieved by managing chronic illnesses and old age in the community.

Ireland's demographic trends are frightening, with 20,000 people reaching the age of 65 years each year. Furthermore, patients aged over 85 years account for 14% of bed occupancy in hospitals but only 1.4% of the population. It is clear, therefore, that demographics are causing severe problems in hospital capacity.

It is essential that bed capacity in hospitals is increased. Hospital bed numbers are currently approximately 500 lower than what is required. Hospitals work most efficiently when operating at 85% capacity and yet many of our hospitals are operating at 100% capacity, which causes inefficiency.

We must also develop home care services and packages. Despite being highly cost effective, these services are the first item cut when the Health Service Executive seeks savings. This approach creates a false economy. Cutting home care hours and packages has a negative impact because people end up as patients on trolleys or occupying expensive hospital beds.

Services must be integrated.


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