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Leaders’ Questions

Tuesday, 7 February 2012

Dáil Éireann Debate
Vol. 754 No. 3

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Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin Last week I asked the Taoiseach if the Government had a national plan to protect front-line services following the well flagged and expected exodus of public servants on 29 February. He responded that the Government “has no intention of allowing a [269]situation where it is not possible for front-line services to be fulfilled.” He added that there was a central planning unit and sectoral planning units in place. However, he made no mention of the establishment of transitional teams, about which we had to wait until Sunday last to hear. A short while ago the Minister for Justice and Equality was unable to confirm the existence of a specific transitional team in his Department.

It appears that the transitional teams are stable door closing committees. This illustrates the mismatch between what is being said in the House and the reality on the ground. This is what we are picking up throughout the services. Various Ministers are saying the process of redeployment is being put to the test as a result. However, the trade unions are stating redeployment is not an issue, as there is total co-operation on the issue. It would appear that the real crux is when business plans are being sent up the line after redeployment has been agreed but are not being given the green light. That is particularly evident in the health sector. Maternity services are especially vulnerable to a situation such as this, and personnel are absolutely required to ensure safety and the avoidance of any difficulties. We gave the example of the maternity hospital in Limerick. Redeployment has been agreed locally and there is a need for additional staff after redeployment. One month after the business plan has been sent up the line, however, it has not been approved and it has not got the green light.

Yesterday the Minister for Health finally admitted that public patients will have their surgery cancelled as a result of what is happening.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt You are over time, Deputy.

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin These things would not be happening if there had been a planned approach to this particular issue. Why are we getting a constant drip feed of issues arising from the difficulties caused by this exit from the public service?

The public and the workers are awaiting certainty and guidance from the Government on this issue. If there is a plan, will the Taoiseach agree to publish it? Will he publish all documentation in every Department outlining the transitional work that is under way?

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny Deputy Martin is aware that there have been programmes over the years, involving every commentator in the land, about the bloated extent of the public service and the requirement to reduce overall numbers and, consequently, the cost of the public sector due to the impact down the line on pension payment requirements. Planning has been ongoing for quite a long time in this area. However, the situation in respect of the numbers leaving the public service at the end of February has not crystallised until recent days. While there has been quite a deal of intensive work across Departments, the figures did not become clear until very recently.

Given the age profile of public servants, it was assumed that up to 9,000 whole-time equivalent workers would retire by the end of February 2012. Provisional figures indicate that public service numbers fell to around 297,000 by the end of 2011 compared with the projected figure of 300,000. Latest figures indicate that 6,600 people plan to retire in January and February this year. The figures in the Department of Health go from September to the end of February. The expectation in the education sector is for 2,000 staff to retire while for the Civil Service it is 1,008 and in the health sector it is 2,263. There were 1,433 staff who went in 2011. Local authorities expect 859 staff to retire while 241 plan to retire from the Defence Forces and 297 from the Garda Síochána.

It is nothing new to have several thousand people leaving the public sector each year in the normal way. Given the figures we know by the end of February 2012, it is right and proper [270]that the transition be managed in a proper fashion so that services are not diminished for people who actually need them. That is why there should be transitional teams in the five areas of health, education, local government, justice and defence, headed by assistant secretaries in each Department, and that this line of communication right down to local planners would have a clear understanding of how they propose to continue to provide services following these retirements.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Thank you, Taoiseach.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny On top of that, there should be very active communication with the people about what is happening.

The Deputy has rightly identified health as being of particular importance. He spoke about redeployment. I listened to the nurses’ representative this morning working towards the objective of providing proper services for everyone. The Cabinet sub-committee on health had a meeting last week on this issue. There is another meeting about it tonight in my own Department. By next Tuesday, the transition teams and the way they are going to manage the business in each sector will be presented by the Minister for Public Expenditure and Reform in a memo to the Cabinet. There will be clarity, understanding and a communication to the people about how this will work.

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin I take it from that reply that no transition teams are in place today. Last Sunday the Taoiseach said on RTE that the Government had set up transition teams. We have to move away from saying one thing on Sunday and another thing on Tuesday.

Deputy Pat Rabbitte: Information on Pat Rabbitte Zoom on Pat Rabbitte Spoken like a true expert.

(Interruptions).

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin I agree with the Taoiseach that health is the most vulnerable sector. It is clear that there is an absence of any planning in this area. Surgery would not be cancelled to the extent that has occurred if there was any degree of planning in advance. There is now a nine month delay in processing medical card applications. There is not a Deputy in the House who has not been called by people about this issue, especially those who are applying to have their medical cards renewed. Does the Taoiseach realise that chronically ill patients who have been on medical cards for years have to pay between €120 and €150 to get life-saving medicine? It is very serious.

If people were planning and had some idea of what was happening on the ground, at least they would immediately tell pharmacists to allow the medication while the application for the medical card is being processed due to the inordinate delays at central level. The Government could take the practical step of making an executive order stating that those applying for a renewal of their medical card keep getting their medication under the old card until a decision has been made on their renewal application. Chronically ill patients are being put under enormous pressure when procuring life-saving drugs. I am not making that up. People across the House are regularly getting such calls. The Government could immediately act on this, as it could on community services, planned surgeries and so on.

Have any transition teams been established in any Department, or is it just something the Taoiseach invented on Sunday and is now going to follow through because it sounded good on “This Week”? Could he give Members the timeline for the establishment of these transition teams? They are urgently needed, especially in the health area.

[271]The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny The Deputy is very good himself at saying things that never happened. If he just listened to what I said, he would have heard that the figures for those leaving in the sectors I mentioned only became clear at the weekend. For that reason, it is right and proper that a plan be put in place in order that we can communicate to people about what is going to happen and how that will be managed. In the health area, for example, I expect that local hospital managers will be available to clarify the plans they have in place.

All of these discussions have taken place for quite some time, but in the absence of accurate figures. We now know those figures. The Cabinet sub-committee dealing with health confirmed this last week. There is also a meeting in my own Department this evening and all of these teams will be named and placed and approved by the Cabinet next Tuesday, so that people——

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin That is the stable door closing.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny ——will be well aware of the process by which the change will be managed in every area throughout the country in respect of——-

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin There are no teams in place. Sunday’s announcement was not quite correct then.

Deputy Pat Rabbitte: Information on Pat Rabbitte Zoom on Pat Rabbitte It is the team that we have had for the past 14 years——

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny The Deputy will recall the planning issue when he said he would give medical cards to those over 70.

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin In spite of the rugby match, people were keenly listening to what the Taoiseach was saying on Sunday.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny The Deputy will recall that he agreed to give medical cards to every person over 70 years and he assumed this would be about 10,000 people. He miscalculated by 60,000 at least.

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin We did it and it was a very good public health measure.

Deputy Timmy Dooley: Information on Tim Dooley Zoom on Tim Dooley These are just 15 committees.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny I think it is only right and proper that the Government should plan properly, based on the accuracy of figures which we now know and this is what is under intensive discussion here.

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin But do they exist?

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny It will come before Cabinet next Tuesday. Transition teams will deal with the areas, now that we know the accuracy of the figures.

Deputy Pat Rabbitte: Information on Pat Rabbitte Zoom on Pat Rabbitte For the information of Deputy Martin, we found the missing briefs.

Deputy Timmy Dooley: Information on Tim Dooley Zoom on Tim Dooley Who was on Deputy Rabbitte’s committee?

Deputy Billy Kelleher: Information on Billy Kelleher Zoom on Billy Kelleher The Taoiseach is having another Roscommon moment.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Could we have order, please.

[272]Deputy Gerry Adams: Information on Gerry Adams Zoom on Gerry Adams I agree with Deputy Martin regarding the plight of citizens who are waiting for new medical cards and who are caught in a bind because they have not received their medication. However, I want to talk to the Taoiseach about a different issue. Yesterday, the Minister for the Environment, Community and Local Government, Deputy Hogan, announced a temporary reduction in the registration cost for septic tanks from €50 to €5 and this is to be welcomed. However, hundreds of thousands of rural dwellers still face the prospect of punitive bills for the upgrading or replacement of septic tanks. Does the Taoiseach accept that this discriminates against rural dwellers, that it is an attack on them and on rural communities? Billions of euro have been spent on upgrading and providing a modern sewerage system in urban areas. Rural households helped to pay for this with their taxes yet they are being forced by the Taoiseach’s Government to bear the burden of the cost of improvements, upgrades or replacement. Is olc an scéal é go bhfuil pobal na tuaithe faoi ionsaí ag an Rialtas agus tá na mílte daoine ag cur in aghaidh an pholasaí seo trasna an Stáit. Sílim go bhfuil an ceart acu. The Taoiseach insists that rural householders will have to make improvements. We are in agreement about a clean environment and clean water and so on but on the other hand he is failing to provide standards or funding, he is threatening citizens with fines and prosecutions if they do not comply and he will criminalise rural households. Should not all people be treated equally? In another flip-flop, the Minister, Deputy Hogan, said this morning that some financial aid will be available but he did not give any details. I ask the Taoiseach to assure rural dwellers and communities that a full grant aid scheme will be available for those who are forced to upgrade their septic tanks.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny I understand Deputy Adams has a holiday cottage in Donegal but I am not sure if it is connected to the public sewerage scheme. I suggest the next time he is there he should have a look. I am quite sure this is the first time for a long time that I have heard him welcome anything in this House. I am pleased he welcomes Deputy Hogan’s common-sense approach to this matter. I am quite sure we are going to have people spluttering into their pints and saying, “Oh God, I should not have bought this, I should have registered the septic tank instead.” For less than the price of a pint in many establishments, a person can register the fact that he or she is the owner of a septic tank. As Deputy Adams will undoubtedly agree, what we need in this country is clean water and safe water. I refer to the situation in Galway city just a few years ago where the reputation of our country was diminished by the existence and the extent of cryptosporidium in the water and its impact on industry. I am quite sure that even Deputy Adams, from his party’s perspective, wishes to see as many people as possible employed and to have an environment and a water quality that is up to standard.

I have listened to hysterical comment about this and many other matters in the past few weeks. I have seen startling headlines and I have heard the Fianna Fáil Party say that rectification or improvement of a septic tank will cost €20,000. I have heard others say it will cost €17,000——

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin It is the Taoiseach’s own regulatory impact assessment, the Government’s own document.

Deputy Timmy Dooley: Information on Tim Dooley Zoom on Tim Dooley Deputy Michael Ring knows all about it. He is dealing with these things every day of the week.

Deputy Alan Shatter: Information on Alan Shatter Zoom on Alan Shatter That is the gold-plated version.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Order, please.

[273](Interruptions).

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny Any household can now register within the period at a cost of €5——

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath A Fiver Monday.

Deputy Alan Shatter: Information on Alan Shatter Zoom on Alan Shatter Deputy McGrath has been deep in it——

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny ——and next year, when the inspections commence — má tá tú ag dul ag caint faoi shéarachas, beidh mé ag caint leatsa Mattie, in a minute. It is not a universal inspection as was proposed in the Fianna Fáil proposal that every septic tank in the country would be inspected. In this case a sample number will be inspected based on quality of water. If a person is deemed to be the owner of a septic tank that is not in good condition, that is, living up to environmental standards, then the owner will be required to desludge the tank, which means, empty the tank and have the contents disposed of in the local authority system.

Deputy Alan Shatter: Information on Alan Shatter Zoom on Alan Shatter Deputy McGrath is the expert on desludging. He is a postgraduate and has a doctorate in desludging.

(Interruptions).

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Order, please.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny Deputy Adams will be aware, as the leader of his party, that his own members in Northern Ireland comply with and support charges that are very much in excess of what is being charged down here. This is part of a common-sense approach to have clean and safe water and having septic tanks that do what they are supposed to do — I acknowledge that the vast majority of them do so. Thousands of septic tanks were built under section 4 notices and where there was a lot of political input as much as input into the septic tanks——

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath Very few and none in Tipperary.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny In some cases these septic tanks were built on the borders and along the fringes of lakes and rivers where it is clear they could not function, given the status and structure implicit in those times.

Deputy Timmy Dooley: Information on Tim Dooley Zoom on Tim Dooley Of course, no Fine Gael councillors were bad.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny This is the issue and I remind Deputy Adams it will not be at a cost of €20,000, €17,000 or €10,000. It will cost €5 to register and if a random inspection decides there is a requirement then the consequence is that the septic tank must be desludged, emptied and the contents disposed of properly in the local authority sewerage system.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Deputy Adams has one minute for a supplementary question. Order, please.

Deputy Dinny McGinley: Information on Dinny McGinley Zoom on Dinny McGinley Give them back the fivers, Mattie. Pay back the fivers you took from the people.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Minister, please. I have called Deputy Adams.

Deputy Dinny McGinley: Information on Dinny McGinley Zoom on Dinny McGinley Give the fivers back. You are a fraud, Mattie.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath How dare you. I will not be accused of being a fraud by anyone.

[274]An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Deputy McGrath should resume his seat or he will leave the House.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath I will not accept that, as Gaeilge nó as Béarla.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Leave the House, Deputy McGrath.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath I will not.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt You will leave the House.

Deputy Dinny McGinley: Information on Dinny McGinley Zoom on Dinny McGinley He is a fraud. Ionsaí na hInse.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt I ask the Minister of State please to allow Deputy Adams.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath He has repeated that remark. It is an outrageous accusation and a slur. I will not accept that from anyone.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt You will resume your seat, Deputy McGrath.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath It is not fair. Why is he accusing me?

Deputy Dinny McGinley: Information on Dinny McGinley Zoom on Dinny McGinley A political fraud of the first degree.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Political charges are being made here. The Deputy will have an opportunity later. This is Leaders’ Questions.

(Interruptions).

Deputy Gerry Adams: Information on Gerry Adams Zoom on Gerry Adams There is a certain benign arrogance in the way the Taoiseach addresses some of these questions. One week he referred to citizens as being mad and this week he referred to them as spluttering into their pints. I am advised the Galway problem was caused by a public sewerage scheme and not by private septic tanks. It is the case that septic tanks in the North are desludged every year and the cost is borne by the state. In all of the Taoiseach’s ramblings——

Deputy Dinny McGinley: Information on Dinny McGinley Zoom on Dinny McGinley It is only 40%.

Deputy Gerry Adams: Information on Gerry Adams Zoom on Gerry Adams ——he avoided the question——

(Interruptions).

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Order, please.

Deputy Gerry Adams: Information on Gerry Adams Zoom on Gerry Adams Why cannot there be a full grant aid scheme? Just before Christmas, the Minister said this could cost citizens in excess of €8,000 but last night he said it would cost €100. I have attended public meetings, including in my constituency, and people just cannot afford to pay this. They see it as discrimination against them and I agree with them completely. Those directives dated back to 1975. Fianna Fáil, in its time, had plenty of time to bring this in. Labour and Fine Gael coalitions, in their time, had time to bring it in but they did not do it. Why should citizens in rural areas be expected to pay for what should be an essential right?

Deputy Pat Rabbitte: Information on Pat Rabbitte Zoom on Pat Rabbitte We will have to wait for Sinn Féin to desludge.

[275]Deputy Gerry Adams: Information on Gerry Adams Zoom on Gerry Adams In any society people should have safe sewerage and the State should uphold that. When one forces a system on people through a series of threats, fines and all the rest, why can the Minister not simply stand up and say that the State will bear the cost of upgrading any tanks that need to be upgraded?

Deputy Pat Rabbitte: Information on Pat Rabbitte Zoom on Pat Rabbitte Is there any bandwagon Deputy Adams would not get on?

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny On 29 October——

Deputy Dara Calleary: Information on Dara Calleary Zoom on Dara Calleary The Minister, Deputy Rabbitte, drove a few himself.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny ——2009 the European Court of Justice ruled against this country. This has been going on since then without any action being taken. The Minister set out clearly what it is that he intends to do. Someone who registers in the first three months does so for €5 and inspections do not start until 2013. The inspections are not universal in the way that applied under the Fianna Fáil proposal. It is not a requirement to bring all septic tanks up to the 2009 standard as set by the Environmental Protection Agency. That only applies in the case of new septic tanks. There are matters that householders living in the country, as I do, can take into account, namely, the prevention of run-off water from the roof and outside buildings running into the septic tank——

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath We all know that. Any clown would know that.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny ——the treatment of grey water, as it is called, whereby phosphates in washing detergent going into the system affect the working mechanism of a septic tank, and the issue of pipes leading to manholes.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath Do they wash the roofs and all with washing powder?

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny Deputy Mattie McGrath knows all about that.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath Did he wash the roofs and all?

Deputy Timmy Dooley: Information on Tim Dooley Zoom on Tim Dooley They go to the toilet on the roof.

An Leas-Cheann Comhairle: Information on Michael Kitt Zoom on Michael Kitt Please, Deputy McGrath.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny Even Deputy Mattie McGrath will understand that old-style septic tanks would overflow if they get filled.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath Tar ar ais.

A Deputy: You are full of it.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny There is also a requirement to keep down the level of unnecessary liquid and sediment going into the tank in the first place. The Minister set out the structure. There are no inspections until 2013. I would encourage everyone to avail of the common sense offer of a registration for €5 in the three month period.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath It is not common sense; it is a climb-down.

Deputy Michael Ring: Information on Michael Ring Zoom on Michael Ring Is Deputy Mattie McGrath not happy?

Deputy Pat Rabbitte: Information on Pat Rabbitte Zoom on Pat Rabbitte Take a laxative, Mattie.

[276]The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny Far from the evidence of the hysterical ranting of Deputy Mattie McGrath and Deputy Ó Cuív, this is a common sense approach——

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath The Government side would want a box of them.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny ——to a problem we have had for a long time in this country but have done nothing about.

Deputy Martin’s party put forward the view that we could get a derogation to allow us to cut turf all over the place for ten years, which was never the case.

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath What is the Taoiseach talking about? That is rubbish.

Deputy Michael Healy-Rae: Information on Michael Healy-Rae Zoom on Michael Healy-Rae There is nothing wrong with cutting turf.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny That is the kind of nonsense which prevailed for good Government and good governance in this country. In this case the Minister, Deputy Hogan, set it out clearly and reasonably. People in the countryside know that they want to contribute to having clean water——

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath We know that.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny ——and this will be done at a normal cost.

Deputy Timmy Dooley: Information on Tim Dooley Zoom on Tim Dooley People want to know the cost.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny I assure Deputy Dooley that if the system is not working——

Deputy Mattie McGrath: Information on Mattie McGrath Zoom on Mattie McGrath Fix it, so.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny ——the answer is that under this requirement the owner of the septic tank will have to desludge it. That means they will have to get it pumped out and treated properly in a local authority works.

Deputies: Hear, hear.

Deputy Timmy Dooley: Information on Tim Dooley Zoom on Tim Dooley What about the percolation area?

Deputy Finian McGrath: Information on Finian McGrath Zoom on Finian McGrath Very soon more than 3,000 people will leave the health service. Before the previous general election the Taoiseach made a big deal about the health service and reform, and also about the principle of a universal health service which many of us were prepared to support. Many people have genuine concerns about losing top quality people from front-line services, especially those in accident and emergency units, those involved in surgery, top class nurses and other quality health service staff. There are grave concerns about patient safety. Even the Minister for Health, Deputy Reilly, accepted publicly that operations would be cancelled or delayed.

Will patients suffer because of the retirements and what will the Taoiseach do about it? Will the waiting lists get even longer? Last week a senior citizen who is an amputee had his home help hours cut. What does the Taoiseach say to his family on this appalling situation? Is it true that acute hospitals will lose 330 staff, services for the elderly will lose 150 staff, the primary care area will lose 125 and mental health services will have 114 departures? How can they cope with this situation?

[277]Who are the transition teams? What do they do and what it their remit? How can the Government say it can run the health service in the next few weeks given the huge loss of quality people? Does he not accept that it will lead to chaos in the health service?

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny The Government has set out its plan for the development and introduction of a universal health insurance system which will apply at the end of the Government’s term of office. The Minister will publish a White Paper and there will be detailed consultations. The end result will be a better health system for everyone based on the need of the patient as distinct from his or her income.

That is precisely the reason for having competent transition teams to manage the exodus from the public sector in general. I have read out the figures. According to the latest figures, a total of 263 will leave the health service. That means approximately 1,433 left in 2011. What it means is that responsibility will be devolved to local planners in each hospital who will know how it is that they intend to deliver services depending on the numbers that leave in any particular hospital or in any particular sector in each hospital. Clearly, it is not equal across the board and it is not equal either in terms of the category of persons who leave. In that sense I noted the comment this morning from the representative of the INMO, Mr. Doran, on its view of focusing on the objective of giving best patient care and attention at all times. It is true that the end of the month will test the flexibility of the Croke Park agreement. In that sense, everything from redeployment to all of the other issues that apply in this regard, such as rosters and various categories of service provided, must be brought into play. It is clear that given the scale and challenge of providing continuing quality health care, it is necessary to have teams in place to deal with any situation that might arise, be it in health or any of the other sectors.

I cannot comment on the individual who is an amputee, to whom Deputy Finian McGrath referred, and whose home help service has been cut, but suffice it to say that care in the community such as home care packages is central to the delivery of health services by the Minister for Health. Community care, including home help, is critical. I have heard of reductions in home help hours in a number of cases in various parts of the country. A decision was obviously made by a manager in the HSE at whatever level. I would like such people being able to respond accurately and clarify why such decisions were made, but I do not have the details of the particular person to whom Deputy Finian McGrath mentioned.

Deputy Finian McGrath: Information on Finian McGrath Zoom on Finian McGrath The Taoiseach mentioned local planners. How can one realistically run an overcrowded accident and emergency department, for example, which is already under major pressure and stress, with fewer people? How can local planners deal with those issues on the ground? Can one carry out the same number of operations with fewer specialised nurses or doctors? That is a serious issue for many families and patients in the State.

Deputy Shane Ross: Information on Shane Peter Nathaniel Ross Zoom on Shane Peter Nathaniel Ross Hear, hear.

Deputy Finian McGrath: Information on Finian McGrath Zoom on Finian McGrath How, for example, can a disability service CEO provide the same emergency respite service with fewer hours and staff? For example, St. Michael’s House has seen its staffing reduce by 123 under the Croke Park agreement, yet it has to cope with the situation. Will these wonderful transition teams turn up at Beaumont Hospital’s accident and emergency department on a Saturday night and immediately whisk all of the patients on chairs and trolleys into beds? Does the Taoiseach now accept that within the next three weeks there could be a crisis in the health service? How will he sort it out with 3,000 fewer staff?

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny The Deputy is aware that 1,433 staff left the health service in 2011. Transition teams are not going to turn up in Beaumont Hospital or any other hospital in the middle of [278]the night and do what he suggests. There are local managers in each hospital who know who will leave the service by the end of the month and they will make arrangements with the HSE, working with staff and the unions, to see to it that cover is provided.

The Minister has stated it may be necessary to delay some elective surgery cases. That may well be the case. There has been a 10% increase in general admissions to hospitals. This may well be because of the change in the weather or respiratory problems in older people. As the Deputy is aware, the numbers fluctuate from time to time, depending on what the issue might be, but I want him to understand it is virtually impossible to know what situation might apply in an individual hospital at any one time. The important thing we need to do is to manage the system in the best interests of patients. That is why there is a need for very clear lines of command and responses from the Department of Health, the HSE, regional directors and hospital managers who have responsibility at the end of the line for their hospital. This takes into account the co-operation of staff and trade unions in order that patients who need attention will receive it. That is why there will be a continuous focus and intensity on the part of all of the teams between here and the end of the month in order that there will not be the crisis or catastrophe that some predict. We are all interested in matters of health, which are about patient care and patients receiving attention.

It is not possible to do what the Deputy says, given the extent of the reduction in numbers, but it is possible to see the benefits of having very strong primary care and community care systems. In Deputy Dara Calleary’s town I had the privilege of opening a modern primary care centre that takes many people away from the necessity of having to go to an accident and emergency department in the first place to have minor ailments treated. This eases the pressure on accident and emergency departments.

Deputy Dara Calleary: Information on Dara Calleary Zoom on Dara Calleary I did not see the Taoiseach there on Sunday.

Deputy Michael Ring: Information on Michael Ring Zoom on Michael Ring Was the Deputy there? He is a member of Fianna Fáil.

Deputy Dara Calleary: Information on Dara Calleary Zoom on Dara Calleary The Minister of State was not there either.

The Taoiseach: Information on Enda Kenny Zoom on Enda Kenny As a frequent visitor to observe what happens there, I am sure the Deputy is well aware that many of the patients do not need to go to an accident and emergency department with minor ailments in the first place and could be treated in a primary care centre, the provision of which we support strongly.


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